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About Orthopedic Specialists

Orthopedic Specialists of Seattle provides new and advanced procedures including endoscopic carpel tunnel release surgery for carpal tunnel syrome, complex joint restoration procedures, anterior approach hip replacement surgery, and more.

Enjoy the Fruits of Your Labor with these Summer Gardening Tips

Have you ever noticed how a tomato plucked from a garden tastes so much better than store bought? It’s near impossible to purchase that amount of flavor. Anybody that has ever planted a vegetable garden is sure to agree. Enjoying a salad or sandwich made with fresh vegetables from your own backyard is one of summer’s many benefits.

Flower gardening is also enjoyable for many people, and often those who like to be outside in the warm weather will spend considerable time planting, weeding, and harvesting the fruits of their labor. For those with chronic hand pain due to arthritis, this once pleasurable activity could now become a chore due to the aggressive hand movements that are involved, and the anticipated discomfort that it may cause. Luckily, there are some ergonomically designed tools on the market that will help those with hand pain continue with their hobby, and also some self-treatment strategies to minimize pain. So take heart, you can still get out there and enjoy one of your favorite activities with a little planning and strategy.

Pace yourself

You may be used to planting an entire garden or pruning an entire yard full of bushes in a day, but working with arthritis means that you should often work slower to minimize the cumulative stress on your hands. Whether you have osteoarthritis or rheumatoid arthritis, this is a good idea. Plan your activity so that you spread the work out over a few days. This will help keep the arthritis from flaring and causing increased pain.

Use arthritis friendly gardening tools

Gripping is one of the major movements in gardening work. Repetitive clamping of pruning tools can put excessive pressure on the joints of the fingers and thumb. Some tool manufacturers such as Fiskars® have designed garden tools specifically for those with limited hand and arm strength. Many of these tools have been commended by the Arthritis Foundation due to their ease of use.  These tools include spring opened scissors and pruners which maximize leverage with the use of gears and longer handles.

Keep tools sharpened

Having a dull blade on your tools means that you will have to exert more pressure in order to cut branches and stems. Have your pruning tools sharpened annually to maximize their effectiveness. Many local hardware stores offer a sharpening service, and pricing is usually very reasonable compared with the cost of new tools.

Wrap tool handles in foam

Wrapping the handle of a trowel or hand rake in foam tubing increases the handle’s diameter and reduces the muscle pressure needed to keep the tool steady within your hand. Some tools made specifically for the arthritis sufferer already have a wider handle, but otherwise this is a great technique to alleviate hand stress. You can use water pipe insulation found at the same hardware store where you get your tools sharpened.

Wear gloves

Gardening gloves do more than just keep dirt from getting under your fingernails. They also absorb perspiration. This is important because as your hands get sweaty, they also get slippery. That means you must grip your tools harder to keep them from sliding in your hand. Wearing gloves mitigates this and results in less force needed to handle your tools.

Use a lightweight coiled hose

Managing a standard garden hose can be aggravating for anyone. The kinks that develop and cut off the water supply often lead the gardener to vigorously shaking the hose to untangle it. Of course, this adds to the cumulative strain on the arthritic hand and wrist. Today’s pre-coiled garden hoses are made of a lighter weight material than standard hoses, and they resist tangling. When you are finished, the hose automatically recoils, making clean up easier.

Stay ahead of the pain

Taking ibuprofen or naproxen based medications 30 minutes prior to gardening can reduce the inflammation associated with heavy use of the hands. If you know that working in the yard will produce some soreness, then you may wish to employ this strategy prior to starting.
So get out there and enjoy the nice weather. You don’t have to give up your gardening hobby because of arthritis. Try these tips, but if pain persists you should feel free to contact my office so we can discuss effective treatment options if further detail.

Shoulder Arthroscopy FAQ

What is arthroscopic surgery?

Arthroscopic surgery is a technique that orthopedic surgeons use to diagnose and repair structural damage within a joint.  The surgeon makes 3 or 4 small incisions around the joint, about ½ inch each. Here, a fiberoptic camera is used to see within the joint and miniature surgical tools are used to perform the repair.

Arthroscopic surgery of the shoulder is an outpatient surgery, which means that you will not have to be admitted to the hospital. You will return home shortly after the surgery is over.

Arthroscopy of the shoulder joint has been a major advancement in surgical technique. This procedure allows less cutting of intact tissue to perform repairs, allowing for faster recovery times than with open surgery.

What types of shoulder surgeries can be performed using arthroscopic technique?

Dr. Shapiro performs many types of shoulder arthroscopy. Among those are:

  • Rotator cuff repair
  • Subacromial decompression (removal of bone spurs)
  • Glenoid labrum repairs (SLAP tears)
  • Repair of shoulder instability (dislocation)
  • Biceps tendon repair
  • Bursitis
  • Debridement due to arthritis
  • Frozen shoulder release

How long will my surgery take?

Most surgeries will take 45 minutes to 1 hour. You will then be required to stay in the recovery room for about another hour. You will then be discharged home. Please be sure to make arrangements for a ride home, as you will not be able to drive the day of surgery.

How long is the rehabilitation process after shoulder arthroscopy?
This depends on the type of procedure you had performed. It is important to understand that physical therapy is an important piece of recovery. You must be committed to the post-operative rehab if you wish to achieve the best outcome.

General rehab guidelines for specific surgical procedures are as follows:

Rotator Cuff Repair, SLAP Repair, & Shoulder Dislocation Repair: Physical therapy is grouped into several phases, beginning with gentle mobility and progressing to strengthening through the full range of motion. The process generally takes 4-6 weeks. Dr. Shapiro will provide both you and your physical therapist with specific instructions following your surgery.

Bone Spur Removal: Because the shoulder is left structurally intact, the rehab process flows quicker, about 6-8 weeks.

How much pain will I have following my shoulder surgery?
This varies greatly from patient to patient. You will be prescribed pain medication following surgery, along with instructions for icing the shoulder, which will help control excessive swelling. During physical therapy sessions, you will be asked to move the shoulder joint in order to restore full arm motion.

This may cause an increase in your pain level, and for this reason it is recommended that you take your pain medication 45 minutes prior to the start of therapy sessions. In time, you will need to take less pain medication.

Will I have to wear a sling following surgery?
This depends on the type of surgery that you had performed. For rotator cuff repairs, SLAP repairs, and dislocation repairs, you will be required to wear the sling for 2 weeks after surgery. For subacromial decompression surgery, a sling may be worn for comfort measures following surgery, and discontinued as pain decreases.

Can I take a shower following surgery?
Showering is permitted 72 hours following surgery.

When do I follow up with Dr. Shapiro following my arthroscopic surgery?
Dr. Shapiro or his physician assistant will follow up with you 1 week following your surgery. The goal of this visit is to make sure that your pain is under control, and the incision is free of infection and healing well.

Physical therapy is also prescribed at this time. This visit is designed to give the patient an opportunity to ask any new questions that may have arisen following your surgery.

When can I return to work?
Of course, this is highly dependent upon your occupation. You will be unable to actively use your arm following rotator cuff repair, SLAP repair, or dislocation repair. This is important in order to allow for proper healing and to not disrupt the surgical area.

If you have a sedentary job or are able to secure restricted duty where use of the arm is not required, then you should anticipate being out of work for 5-7 days. If you are required to use your involved arm, then time away from work is greater. You should discuss your situation with Dr. Shapiro prior to surgery so that you can make appropriate arrangements with your employer.

Is it a Lump or Bump? Find out What You Should Do About Ganglion Cysts of the Wrist and Hand

Perhaps it starts as a very low grade aching in the wrist, barely enough to get your attention. Then the pain becomes more frequent and persistent. As you roll your wrist around in circles trying to figure out the cause, you notice a small bump on the back of the wrist. Of course, your next move is to do the same with the opposite wrist to see if it’s present on both sides. Nothing. No bump. Time to see the doctor.

Finding a lump on your body that you know was not there previously is generally concerning. Most bumps on the hand are not cancerous, but are important to have checked out promptly by a hand surgeon. In this case, a common cause is a ganglion cyst, a small mass that can develop around the joints of the wrist and hand. Ganglion cysts are benign, fluid filled sacs that may or may not cause pain in the affected area. They are the most common form of mass found in the hand and are generally found in younger individuals between the ages of 15-40.

The most common location is on the back of the wrist, but they may also be found on the palm side of the wrist or at the base of the fingers. The cause is not known, but often times there is a correlation between their development and chronic, mechanical stress in the wrist or hand. Athletes that have repetitive stress on the wrist and hand such as gymnasts have been found to have a higher incidence of these cysts developing.

These cysts may also develop at the most distal joint of the finger. This type of cyst, called a mucous cyst, is associated with wear and tear in the finger joints and is more common with age.

In my practice, ganglion cysts are a relatively common occurrence. The diagnosis is generally straightforward, usually requiring only a physical exam and occasionally an X-ray. The size and shape of the lump, along with its location, are generally sufficient to make an accurate diagnosis, but I sometimes will order an MRI if there is any uncertainty.

In most cases, these cysts are harmless and the treatment can be as simple as periodic observation for any changes that impact movement or function of the wrist or hand. Sometimes, the ganglion can disappear by itself. In cases where the cyst causes pain or becomes an impediment to movement and function, there are more aggressive treatments available. Often, the cysts are simply persistent and unsightly, requiring removal.

First of all, if you have been surfing the internet you may have read that ganglion cysts used to be called “Bible cysts” because in times past, a treatment was to slam a bible or other heavy book over the cyst, causing it to burst. DON’T DO IT. It is not effective and you could end up with a broken bone in your hand. It is just not worth trying.

Aspiration is usually the first treatment method used to reduce a ganglion. A small needle is inserted into the cyst and the fluid is drained. This produces an immediate reduction in the size of the lump. This is performed in the office setting, and there are no significant restrictions following the procedure. The downside is that the ganglion cyst may return in at least 50% of patients. This is because the root and capsule of the cyst is left intact. An analogy would be to think of deflating a balloon. With fluid production, the balloon can simply re-inflate. Even though the permanent success of aspiration is relatively low, given the ease and simplicity of the aspiration procedure, it is still often worth a try.

Should the cyst return following needle aspiration, surgery may be required that removes the capsule and root completely. This is an outpatient surgical procedure performed under a light anesthesia – usually a combination of a local anesthetic and a sedating medicine administered by the anesthesiologist. The ganglion plus a small amount of the joint capsule or tendon sheath from which the cyst stems is removed. Following surgery, the hand will be splinted for a short duration, and the patient will be able to return to normal activities within 2-4 weeks. Physical or occupational therapy is usually not needed, but a referral may be made in instances where a patient has significant stiffness in the hand or wrist joints. Although there is a small risk of the cyst returning, my patients enjoy a high success rate, with over 90% of all excisions being permanent.

It is important to have any persistent mass checked out by a physician. He or she can perform the appropriate physical exam and testing to confirm the diagnosis and refer you to the appropriate specialist if necessary. If you should have any questions regarding this or any other conditions of the hand, wrist or elbow, please feel free to contact our office at (206) 633-8100, ext. 18133 to schedule a consultation.

OSS Sponsoring Ballard Seafood Festival – July 13-14

OSS Sponsoring Ballard Seafood FestOSS is a proud Halibut level sponsor of this year’s 39th annual Ballard Seafood Festival. The event will be held Saturday, July 13th and Sunday, July 14th in downtown Ballard.

The Seafood Fest highlights local seafood and vendors, music, community booths, and the BeerFest. OSS will have a booth at this event featuring our foot and ankle specialist, Dr. Mark Reed. Dr. Reed will also be hosting a seminar for Landmark residents on his specialties. We will have away take-aways for both children and adults, so be sure to
find OSS’s booth during the festival.

The Seafood Festival features three stages for musical entertainment, including the MainStage, FamilyStage, and CommunityStage. Vendors will include arts and crafts, food, community, and non-profit booths. One of the seafood highlights includes the Salmon Barbeque. You can be sure that there will be family fun for all ages at this great local event!

Seafood Festival Details:

Downtown Ballard – Venue map below
Saturday July 13: 11am to 9pm
Sunday July 14: 11am to 7pm

For more info, visit SeafoodFest.org.

Seafood Fest Map - OSS Sponsored

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Come Out and Meet OSS at the July 6th Wallingford Family Parade and Festival

OSS at Wallingford Family Parade and FestivalWe are excited to be part of the 64th annual Wallingford Family Parade and Festival on Saturday, July 6th. The parade starts at 11am and the festival follows starting at 12 pm.

Come visit our booth during the festival and meet our newest doctor, Mark Reed, MD. He will be highlighting his foot and ankle treatment expertise as well as have take-aways for both children and adults.

This year, the parade has expanded and has been renamed the “Wallingford Family” Parade and Festival, formerly known as the “Kiddie Parade”. The parade will still be focused on children, but will also include families, local businesses, drill teams, marching bands, and family oriented organizations.

The festival portion following the parade will include local organizations including OSS, handicrafts, demonstrative booths, and multiple food vendors. There will be a multitude of events for kids including bounce houses and games. Music for the event will involve kid’s bands and local musicians groups.

Wallingford Family Parade and Festival Event

Meridian Park Adjacent to the Good Shepherd Center
Saturday July 6, 2013
Parade starts at 11am
Festival from 12pm to 5pm

Parade Event Map Below
Find more event details here.

Wallingford Family Festival Parade Map

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