Monthly Archives: August 2013

What is a Tendon Injury?



Tendons are the tough fibers that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but usually it is the result of many tiny tears to the tendon that have happened over time.

Doctors may use different terms to describe a tendon injury. You may hear:

  • Tendinitis. This actually means “inflammation of the tendon,” but inflammation is rarely the cause of tendon pain.
  • Tendinosis. This refers to tiny tears in the tissue in and around the tendon caused by overuse.

Most experts now use the term tendinopathy to include both inflammation and microtears. But many doctors may still use the term tendinitis to describe a tendon injury.

What causes a tendon injury?

Most tendon injuries are the result of gradual wear and tear to the tendon from overuse or aging. Anyone can have a tendon injury. But people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon.

A tendon injury can happen suddenly or little by little. You are more likely to have a sudden injury if the tendon has been weakened over time.

What are the symptoms?

Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.

  • The pain may get worse when you use the tendon.
  • You may have more pain and stiffness during the night or when you get up in the morning.
  • The area may be tender, red, warm, or swollen if there is inflammation.
  • You may notice a crunchy sound or feeling when you use the tendon.

The symptoms of a tendon injury can be a lot like those caused by bursitis.

How is a tendon injury diagnosed?

To diagnose a tendon injury, a doctor will ask questions about your past health and your symptoms and will do a physical exam. If the injury is related to your use of a tool or sports equipment, the doctor may ask you to show how you use it.

If your symptoms are severe or do not improve with treatment, your doctor may want you to have a test, such as an X-ray, ultrasound, or MRI.

How is it treated?

In most cases, you can treat a tendon injury at home. To get the best results, start these steps right away:

  • Rest the painful area, and avoid any activity that makes the pain worse.
  • Apply ice or cold packs for 10 to 15 minutes at a time, as often as 2 times an hour, for the first 72 hours. Keep using ice as long as it helps.
  • Take over-the-counter pain relievers such as acetaminophen or NSAIDs (such as ibuprofen or naproxen) if you need them.
  • Do gentle range-of-motion exercises and stretching to prevent stiffness.

As soon as you are better, you can return to your activity, but take it easy for a while. Don’t start at the same level as before your injury. Build back to your previous level slowly, and stop if it hurts. Warm up before you exercise, and do some gentle stretching afterward. After the activity, apply ice to prevent pain and swelling.

If these steps don’t help, your doctor may suggest physical therapy. If the injury is severe or long-lasting, your doctor may have you use a splint, brace, or cast to hold the tendon still.

It may take weeks or months for a tendon injury to heal. Be patient, and stay with your treatment. If you start using the injured tendon too soon, it can lead to more damage.

To keep from hurting your tendon again, you may need to make some long-term changes to your activities.

  • Try changing your activities or how you do them. For example, if running caused the injury, try swimming some days. If the way you use a tool is the problem, try switching hands or changing your grip.
  • If exercise caused the problem, take lessons or ask a trainer or pro to check your technique.
  • If your job caused the tendon injury, ask your human resource department if there are other ways to do your job.
  • Always take time to warm up before and stretch after you exercise.

Whether injury or wear-and-tear, you require the best care available.  At Blue Ridge Orthopaedic and Spine Center our physical therapists, physicians, and surgeons have the specialized training, expertise and experience you need to treat your condition, both surgically and non-surgically.  If you would like to schedule an appointment please call 540.347.9220 or visit to learn more about our services.

What is Pain Management?


What is Pain Management?

Pain management is a branch of medicine that applies the latest in treatment methods to reduce or control pain.  Our doctors specialize in a variety of solutions including pharmacological, interventional and alternatives to reduce or control pain.

At Blue Ridge Orthopaedic and Spine Center, our pain management group offers a variety of options tailored to address all our patients’ pain management needs.  We offer inpatient, outpatient, surgical and non-surgical services, as well as cutting-edge, minimally invasive pain management treatment for patients with acute or chronic pain.

Our Physicians are fellowship trained and board certified by the American Board of Medical Specialties in pain medicine.  We have the most advanced training and certifications available for pain medicine interventions and treatments.

Our Services:

Diagnostic and Therapeutic Spinal Interventions

  • Cervical, Thoracic, and Lumbosacral Transforaminal, Interlaminar, and Caudal Epidural Steroid injections and Spinal Interventions
  • Chronic Pain Management
  • Diagnostic Provocation Discography
  • Selective Nerve Root Blocks
  • Diagnostic Facet and Sacroiliac Joint Blocks and Radiofrequency Ablation
  • Sympathetic and Stellate Ganglion Blocks
  • Occipital Nerve Blocks
  • Peripheral Nerve Blocks
  • Fluoroscopically guided Diagnostic and Therapeutic Peripheral Joint injections
  • Cervical, Thoracic and Lumbosacral facet joint blocks and injections
  • Neurolytic Blocks
  • Intercostal Nerve Blocks

Minimally Invasive Surgical and Non-Surgical Interventions

  • Spinal Cord Stimulation Trials and Surgical Implants
  • Radiofrequency Ablation
  • Intra-Discal Electrothermal Therapy
  • Percutaneous Discectomy

No matter what kind of pain you may be experiencing, our pain management group works closely with the therapists and surgeons at Blue Ridge Orthopaedic and Spine Center in a multidisciplinary approach to develop a unique treatment plan that best suits each of our patient’s needs.  Our goal is patient satisfaction.  To schedule an appointment with the pain medicine specialists at Blue Ridge Orthopaedic and Spine Center please call 540.347.9220 or visit to learn more about the comprehensive services we offer.



Stretch Your Legs At The Office!



Do you know stretching your lower legs can be extremely beneficial in keeping your legs limber and your joints feeling great?

The following leg stretches from,4128 involve the ankles and knee joints.

Before beginning any stretching/exercise regime please keep the following in mind –

  • Always check with your doctor before beginning an exercise program, and if you have had knee surgery this is a must!
  • Warm up your muscles prior to stretching.  This might include five to seven minutes of light aerobic exercise such as walking or riding a stationary bicycle.
  • Start slow – build up your repetitions at an easy pace.
  • If you experience any pain during exercise, stop.
  • Repeat each exercise two to four times.

Achilles tendon and calf muscles

Standing two feet from a wall, lean forward with both hands touching the wall and one foot forward and the other foot 12 to 18 inches behind.  Keep feet flat during the stretch.  Stand in position for 15 to 30 seconds.  Complete all repetitions on one side before switching sides.

Lower legs

While standing with your feet 12 to 18 inches apart, put one foot in front of the other while keeping your toes pointed forward.  Slowly turn your weight forward, bending the knee that’s in front while keeping the heel of the back foot flat on the floor.  Switch legs and repeat.

Stair-step calf-raise

Stand on a step with toes of booth feet close to the edge.  Position your heels below the level of the step, and then rise on your toes.  Hold the stretch and gently return to start position. (If you have small feet and a large body be cautious-overdoing calf raises can cause damage to the foot, gradually increase the number and height of the raises.)

At Blue Ridge Orthopaedic and Spine Center our staff consists of a team of physical therapists and expert physicians that understand knee and joint pain.  Treatment options range from physical rehabilitation, surgical, and non- surgical procedures.  For questions or to schedule an appointment, please contact our specialists @ 540.347.9220 or visit

Flexor Tendon Laceration


What Causes A Flexor Tendon Laceration?

A flexor tendon laceration can occur when the hand, wrist, fingers, or forearm experience trauma from a deep cut into the palm which can causes injury to the flexor tendons (tissues that help control movement in the hand.  If you experience a flexor tendon injury you will find great difficulty if not impossible to bend your fingers or thumb.



  • An open injury, such as a cut, on the palm side of your hand, often where the skin folds as the finger bends
  • An inability to bend one or more joints of your finger
  • Pain when your finger is bent
  • Tenderness along your finger on the palm side of your hand
  • Numbness in your fingertip


Treating Flexor Tendon Lacerations

Your doctor can tell if your flexor tendon is cut by examining your finger. If the wound is very deep, the finger may be x-rayed to make sure the bone isn’t damaged, too. If the flexor tendon is cut all the way through, your doctor will do surgery to rejoin the two ends of the tendon and repair any other damaged tissue. After surgery, you’ll need to follow a specific exercise program to regain movement in the finger.


Your Surgery

  •  Your surgeon first exposes the cut tendon with a zigzag-shaped incision.
  • Then he or she finds the two separated ends and stitches them back together. In some cases, your surgeon may need to graft a new tendon to replace the cut one.
  • Nerves and other soft tissue may also need to be repaired.
  • Surgery generally takes 2 to 3 hours. You may be given anesthesia to make you sleep, or only the hand and arm may be numbed. In either case, you feel no pain during surgery. Usually you can go home the same day.

Starting Your Recovery

 Your hand may be in a splint or cast for several weeks after surgery. This protects the tendon as it heals. You will probably start a gentle exercise program soon after surgery. Exercising your finger as directed by your doctor or therapist is very important. Surgery creates scar tissue inside the finger. Without regular exercise, this tissue will stick to the tendon and the bone. Then you won’t be able to bend your finger easily. As the tendon heals, you’ll slowly begin to strengthen the tendon and muscles, and move your finger more. Recovery usually takes 6 to 12 weeks.

The hand is involved in almost every activity we perform, yet we often take our healthy hands for granted.  It is when we cannot use our hands we realize how vital they are.  The physicians, therapists, and hand specialists at Blue Ridge Orthopaedic and Spine Center work together as a multidisciplinary team to improve outcomes for patients as well as results in better patient care and recovery.  To schedule an appointment with the hand specialists of Blue Ridge Orthopaedic and Spine Center please call 540.347.9220 or visit to learn more about the comprehensive services we offer.


Take Care of Your Knees!


As we get older, years of stooping, kneeling and everyday activities catch up with our knees.  Women believe it or not, are more susceptible to knee pain as they are the weaker-kneed sex.  Studies show women are 6 times more likely than men to suffer from knee injuries.

In this article from see these great tips to reduce your pain.

Stiff or creaky knees – Patellofemoral syndrome (runner’s knee) can cause creaks, grinding, popping, and achiness during climbing or even after sitting for a long period of time.

  • Try this – If you normally do high impact workouts like running, playing tennis, reduce activity (don’t stop altogether or the muscles that support your knees will lose strength) and add less strenuous exercises such as swimming and yoga.  Also, it’s important to wear the proper workout shoes and if the soles are worn be sure to get a new pair so that your arches and joints are adequately supported.

Aching knees – If you feel a sharp pain between your kneecap and shinbone, you may have tendonitis which happens when the tendons connecting your kneecap to the shinbone become swollen and inflamed due to repeated pressure and overuse.  Symptoms tend to occur when you increase frequency or intensify your activities.

  • Try this – Take a nonsteroidal anti-inflammatory drug such as ibuprofen to ease pain and decrease swelling.  It’s important to ice, rest and evaluate your knee, especially after a workout.  Ask your doctor about patellar tendon straps which relieve pain by taking pressure off the tendon.  If pain continues or worsens, see your doctor.

Swollen and inflamed knees/difficulty straightening or bending of the knee – When the cartilage that pads our joints is reduced to bone on bone, osteoarthritis occurs which in turn causes swollen, inflamed and extremely painful joints.

  • Try this – According to one study, losing just 11 lbs. can take pressure off your knees and reduce arthritis by 50%.  Add anti-inflammatory drugs, rest and ice can completely alleviate the pain.  If your knee becomes red or feels warm to the touch, see your doctor, who may opt to drain the excess joint fluid with a needle.  Fact – about 25% of people who suffer from osteoarthritis will require knee-replacement surgery.

Knee pops and then buckles, causing extreme pain – (This usually occurs while playing sports) The anterior cruciate ligament known as ACL, an elastic band of tissue that stabilizes the knee, tears.

  • Do this – See your doctor right away!  About 1/3 of those who injure their ACL recapture strength and motion after 6 to 8 weeks of rest and physical therapy.  If the kneecap remains unstable, arthroscopic surgery may be required.  Practice exercises that strengthen your hip and butt muscles to help stabilize knees and reduce your risk of ACL injuries.

To schedule an appointment with the joint replacement specialists of Blue Ridge Orthopaedic and Spine Center please call 540.347.9220 or learn more about our comprehensive services at