Skip to content

GP Spotlight – How to spot a Rotator Cuff Injury

June 18, 2017

 

A typical history would be pain felt over the deltoid muscles where it inserts on the humerus, the upper arm bone.  The pain is fairly non-specific and generalised but focusses on this area.

This pain is usually worse at night and is aggravated by use of the arm at or around shoulder height such as reaching overhead for objects, putting on shirts and jackets etc.

The clinical findings under examination are normally some muscle bulk in deltoid and also usually of the supraspinatus muscle belly when looking at the patient from behind the muscle bulk above the blade of the shoulder will be smaller on the side with the cuff problems.

For further information about clinical signs click on the Shoulder Arthroscopy site.

Advertisements

Case study – Ms Yasmeen Khair – a member of the Jordanian women’s football team

June 18, 2017

Not only is Yasmeen Khair, a member of the Jordanian women’s football team, she also managed the dual task of promoting the U-17 Women’s World Cup in 2016 as the team’s ambassador– a significant role for Jordan.

She said at the time, “It was a great honour for me and I’m really proud to be one of the ambassadors of this tournament”.

This star caught the attention of her compatriots when she was a child, representing Jordan as one of the country’s most famous gymnast for many years. From an early age, she was nicknamed “The Butterfly’ because of her amazing all-round ability.   She showed accuracy in the floor exercises, strength on the uneven bars, speed on the vault, and fitness on the balance beam, taking part in many competitions against opponents who were years older than her. Her hard work and flair resulted in winning medals of different classes, though her goal was always gold.

Ms Khair later went on to represent her country in a very different sport, becoming a member of the Jordanian women’s football team. Yasmeen took part in three Asian competitions and, alongside her team-mates, helped drive Jordan to the group stage of the Asian Women’s Cup 2014.

Yasmeen travelled to London to see Simon as a result of a nasty ankle injury caused by a tackle causing a massive re-rupture of her lateral ligaments which she originally had stabilised many years ago.  Simon and his team were able to re-repair these for her successfully and augment this repair using the new system from Arthrex namely their internal brace.   As seen in this video link demonstrating an anatomic repair of the ligaments, there is an artificial brace over the top of this repair which provides added protection when the ankle is maximally stressed.  Yasmeen has now come out of her Aircast boot and is in the process of rehabilitating.  Simon and the team anticipate Yasmeen being fit to return to play at full contact level at approximately twelve weeks post this surgery.

 

 

 

 

Finding Sanctuary at Home

February 17, 2017

In today’s modern world, finding a sanctuary at home isn’t always easy, but as Simon Moyes recently discovered, sometimes a few tweaks are all that’s needed…

 

Studio Duggan are a West London based interior design firm who specialise in creating distinctive and well considered interiors for both high end residential and boutique commercial projects.  They recently added some finishing touches to Simon Moyes’s Notting Hill home – and the Director, Tiffany Duggan, has agreed to share her top 5 tips on how to create a warm, comfortable and inspiring retreat.

  • A good night’s sleep. It doesn’t get more fundamental than this.  Always buy a pocket sprung mattress and the best quality bed linen you can afford.  Blackout blinds or even better – full length interlined curtains are a must.
  • As the balance between work and home life become ever more blurred, a clearly defined and well designed office can make all the difference when it comes to quality of life. Excellent fitted storage, mood lighting and tactile surfaces are all key to creating a home office that is conducive to working both during and outside the hours of 9-5.
  • As we become ever more acquainted with the luxuries of hotel bathrooms, we have begun to expect this level of indulgence at home. Freestanding baths and marble clad vanity units, with the now ubiquitous twin sinks are firm requirements on almost every project we undertake.  We also like to dress en-suite bathrooms with side tables, beautiful artwork and an occasional armchair where space permits.
  • The trend for entertainment spaces within our homes shows no sign of abating. Whilst the ultimate luxury is a home cinema, indoor pool or games room, if space and budget restrictions render this impossible, a well stocked bar can lift an empty corner to new heights – as demonstrated by the cover image or one of our recent projects.
  • Last but not least, the most vital (but also the simplest) way to create a warm and inviting home is with layered lighting.  The trick is not to use too many of the same type of lights, particularly when it comes to spot lights – which can be grossly overused.  Wall lights, floor lamps, table lamps and well placed task lighting work wonders to bring a space to life and allow the mood to be changed depending on the task at hand.  Candlelight too can never be underestimated…

You can view more of Studio Duggan’s projects on www.studioduggan.com

African Elite

February 10, 2017

As a former lecturer of Orthopaedics at the Royal National Orthopaedic Hospital, working at University College Hospital and an international member of the Arthroscopy Association of North America, it comes as no surprise that Simon has attracted a clientele of elites from Africa.

Flamingo Magazine describes how Simon’s work has resonated amongst parts of Africa, even to the extent that some international patients would much rather prefer their treatments to be carried out in London where Simon’s clinic is based, than in their native countries.

Simon says, “Most international patients find me through word of mouth after I have treated friends, colleagues or relatives abroad…we have an International Relations service to make the whole journey as smooth as possible.

“There are interpreters available, plus any special dietary requirement can be catered for. All of our facilities and options ensure the patient experience is as comfortable and efficient as possible.”

For more information click on the link: Flamingo Magazine

Recovery Window

February 10, 2017

With Sports Medicine as a medical specialism, Simon is often the point of reference for athletes with intense shoulder and knee injuries. The Hippocratic Post and Athletics Weekly magazine recently published Mr Moyes’ expert advice that stressed, after having visited a GP, the injured patient should be referred to a specialist within a two-week window to avoid further complications and ensure a smoother, efficient recovery.

“Not enough adults are aware of the ‘two week referral window’”, says Simon.

“Acute soft tissue injuries of the knee can frequently be underestimated in an A&E setting where they may only be investigated with X-rays, yet they do represent a serious injury, and urgent referral is required for an appropriate assessment.”

He continues, “Delayed referrals, unknown diagnoses and lack of appropriate guidance for patients can lead to long-term complications.”

For more information click on the link to Athletics Weekly

Partnership with Oxygene ski school

February 10, 2017

Simon skies regularly in Val d’Isere and has just returned from a long weekend there.  He first encountered the very impressive Oxygene Ski School approximately five years ago when he was introduced to Pierre, the founder through a friend of a friend.  Pierre was an amazing instructor and he says “I was fortunate enough to have some one on one lessons from him and on subsequent visits over the last five as there is always room for improvement!  Oxygene Ski School has grown enormously and in my opinion is the best in Val d’Isere.

We partnered with Oxygene for tips and advice from its top skiing instructors.

A brief point summary for amateur skiers below includes tips such as:

  • Clothing – invest in warm technical tops and trousers to allow for a much better skiing or snowboarding experience
  • Equipment – discover your style when you feel ready, and start looking into the different equipment options out there
  • Attitude–Prevent the tantrums and tears, aswell as injuries and get into neutral mode to avoid disappointment

Click here for more tips and advice for beginner skiers.

High heels and other hidden health risks in your wardrobe

July 12, 2016

High heels, flip flops, heavy handbags and statement necklaces are all staple items in a woman’s stylish wardrobe, but they are causing damaging health problems in the pursuit of being fashionable.

Here’s my advice for avoiding potential health risks caused by accessories:

High heels

Everyone likes high heels, but women who repeatedly wear them can suffer from Achilles tendonitis. The Achilles tendon is the long thin tendon that runs from the base of the calf muscles down to the heel bone. This can become extremely painful due to chronic shortening of the calf muscles by repeatedly wearing high heel shoes.

One of the consequences of heeled shoes that most women are aware off is, the increased risk of developing bunions and calluses in the high heel. This is normally associated with the narrow toes associated with these shoes, pushing the front of the foot into the shoe and crowding the toes.

The good news is that as long as it is only temporary use, you should not necessarily damage your foot. You are more likely to develop bunions if you have a family history and are genetically predisposed to the condition. And, wearing high heels may accelerate bunion development.

The solution is to avoid wearing high heels for extended periods of time and use sensible shoes in concert with your heels. If the problems are long standing, then there is always a relatively straightforward surgical solution.

Flip flops

Flip flops can lead to plantar fasciitis, a very painful condition, which produces pain in the sole of the foot and in the heel; mainly on the inside of the foot. The plantar fascia is a thick sheet of tissue that runs from the heel to the ball of the foot, supporting the deep layers of muscles and tendons in the foot.

The lack of arch support and cushioning combines with the way you walk in flip flops can predispose you to this condition.

The condition is normally diagnosed clinically by the position of the pain, local tenderness over the plantar fascia, medial bundle of the plantar fascia and is confirmed with an ultrasound or MRI scan.

Treatment of the condition is usually straightforward with a physiotherapy programme working on stretching up the plantar fascia and calf muscles and returning to more cushioned, supportive footwear and avoidance of impact activities.

If the symptoms fail to respond to these simple stretching measures, alteration of footwear and activities, then ultrasound guided steroid injections can be administered.

Heavy handbags

Women’s handbags, like men’s briefcases can carry an enormous amount of material that can be surprisingly heavy. The way they are carried over the shoulder can predispose to the development of chronic shoulder pain, namely inflammation and impingement of the rotator cuff.

Patients may end up with pain at night and it may cause sleep disturbance, using their arm at or around shoulder height. There may also be the development of crepitus or noises arising from the shoulder girdle as the arm is moved.

Referral to an appropriate specialist is recommended. Clinic diagnosis is made, the condition is confirmed with imaging, including ultrasound and MRI scan. Fortunately, around 80 per cent of cases, the condition responds well to a combination of physiotherapy, postural instruction and steroid injections into the subacromial space.

To help avoid developing the condition with a heavy bag, try to unload heavier objects from the bag and change shoulders.

Heavy necklaces

There is a growing tendency for increased popularity of heavier necklaces. This combined with the use of heavier handbags can produce further protraction of the shoulder, curvature in the upper dorsal or thoracic spine and hyperextension of the lower cervical spine tending to have the head thrust forwards.

This can place a lot of strain on the base of the neck causing lower cervical pain. These two issues combined, with classic poor posture in a desk-based work environment produces a range of conditions that will cause pain in the base of the neck, upper dorsal spine, pain and impingement in both shoulders. All these things produce impingement in the shoulders.

Physiotherapists, personal trainers and orthopaedic surgeons are seeing more and more patients with pain from these areas. It is also very important to try and improve one’s posture and biomechanics by straightening up the cervical and thoracic spine. Stretching out the chest muscles, work biomechanics with workstation assessments, postural instructions and regular stretching will all help to relieve pain and symptoms.