“It’s a growing problem,” Dr. Charles Metzger, an orthopedic surgeon specializing in the upper extremities in Houston, told the Palm Beach Post. “It’s very common for younger and younger players to come in with elbow and shoulder pain and miss playing games as a result.”

One reason why more young children are complaining of elbow and shoulder injuries is because children are specializing in one sport or one position at younger and younger ages, leaving them more susceptible to injuries from overuse. They also play longer seasons, about 6.3 months on average for children age 7 to 15 years. And these young athletes are throwing curve balls and sliders at younger ages, which strains the shoulder joint. In some cases, these injuries may require physical therapy or even surgery. The best medicine, Dr. Metzger said, is prevention.

Experts say resting the arm regularly, cross-training instead of specializing in one sport or activity, and stretching the throwing arm after play can help minimize injury.

“If we can make it required that kids stretch after pitching a game, we can significantly lower the number of kids who have to quit baseball because [of] their arms pain or injury,” Metzger said. “My take-home message here is to do your stretches. They help.”

SOURCE: Pain Pumps › More young children suffering shoulder injuries from baseball

A team of researchers and orthopaedic surgeons at Keller Army Hospital in West Point, New York, and the Uniformed Services University of the Health Sciences reviewed 8,940 shoulder dislocations in patients at 100 emergency rooms across the country between 2002 and 2006. Of all dislocations, 71.8 percent were in men; 46.8 percent were in patients between 15-29 years of age; and 48.3 percent occurred during sports or recreation activities. Of the injuries that occurred during sports-related injuries, 37 percent were specifically from football or basketball activities. Among women, those ages 80 to 90 were at greatest risk of shoulder dislocation, most often due to falls at home.

“We were not too surprised to find the high number of young males dislocating their shoulders during athletic activity,” wrote Brett Owens, MD, orthopaedic surgeon at Keller Army Hospital. “However, the rate of shoulder dislocations among elderly women was higher than we had previously assumed.”

Shoulder dislocation is a potentially painful and disabling condition, and treatment can vary depending on severity of symptoms. Most patients will improve with bracing and physical therapy, however some will require arthroscopic surgery.

SOURCE: Pain Pumps › Young men, elderly women at highest risk of shoulder dislocation

Shoulder injuries are serious and can be career-ending. McCoy’s injury roused speculation from fans and sports media about McCoy’s future with the NFL, which prompted Texas to release the statement to set the record straight and quiet any concerns that McCoy’s injury would sideline his football career.

According to the statement: “Colt sustained a nerve injury involving his right (throwing) shoulder that prevented him from returning to the game. The injury caused numbness and weakness in his arm that prevented him from throwing with the strength or accuracy he needed. He wanted to go back into the game but with the weakness he was having in the shoulder, we couldn’t clear him to do that.

“The weakness in his shoulder also put him at risk of greater injury. From the time of the injury, we were continually treating and re-evaluating him but he wasn’t able to regain the strength he needed to get back on the field.”

SOURCE: Pain Pumps › Texas releases statement updating McCoy shoulder injury

UCLA

Shoulder injuries among athletes is not uncommon and can bench a player for weeks or months. There was a time when such injuries that required surgery brought about career-ending fears, but technology over the years has made full recovery a more likely possibility. However, just a few years ago, surgery to repair the shoulder often was the cause of more serious injury.

A recent study published in The American Journal of Sports Medicine first brought to light the connection between chondrolysis, a condition in which the cartilage in the shoulder has been eroded away, and the use of pain pump devices during and following arthroscopic shoulder surgery. Pain pumps are balloon-like devices that hold local anesthetics. During surgery catheters that lead from the balloon area of the device are inserted into the surgical site. Pain medication is then administered for up to 72 hours following surgery. Once the medication has been used up, the patient simply pulls out the catheter.

Pain pumps are approved by the FDA with the catheter placed in the shoulder tissue. However, in the late 1990s, pain pump manufacturers began instructing surgeons to insert the catheter directly into the shoulder joint, allowing the medication to drip directly onto the cartilage, a use that was not FDA approved.

In the early 2000s, doctors became puzzled when more and more patients who had surgery to repair shoulder injuries – and who showed no signs of cartilage wear at the time of surgery – were suffering from pain and loss of motion, and were ultimately diagnosed with chondrolysis. It didn’t take long for doctors to make the connection between the debilitating chondrolysis and the use of pain pump devices.

Since the connection was made, the FDA and professional groups have instructed surgeons of the correct, FDA-approved use of shoulder pain pumps, making the surgery safer for patients. Meanwhile, the lawsuits against pain pump manufacturers are mounting.

SOURCE: Pain Pumps › UCLA’s Keefe benched due to shoulder injury, but recovery likely

Shoulder injuries are not uncommon among athletes. Hard and repetitive throwing motions like those needed for football and baseball leave many players with shoulder problems, many of which require surgery. While a full recovery is usually possible, some patients’ injuries were worsened by shoulder surgery.

The phenomenon even confused doctors who performed the shoulder repair surgeries. They were finding a growing number of patients months or years after surgery were back in their offices complaining of pain, stiffness and loss of motion. Upon further inspection, doctors found those patients had developed a condition known as chondrolysis, caused by the breakdown of cartilage. As the cartilage wears away, bone begins to rub against bone causing even more pain and damage.

What doctors finally deduced was that it wasn’t the surgery that was causing this specific type of chondrolysis known as postarthroscopic glenohumeral chondrolysis (PAGCL), but the pain pump used during and after surgery. The pain pumps are devices that have a balloon filled with pain-deadening medication. That medication is fed directly into the wound site through a catheter for up to 72 hours.

The pumps were approved by the Food and Drug Administration (FDA) with the catheter placed in the shoulder tissue. But pain pump manufacturers began telling doctors to place the catheters in the shoulder joint, which allowed the joint space to be bathed in medication. What doctors didn’t realize is that constant drip of medication into the shoulder joint was slowly eating away at the cartilage, resulting in chondrolysis.

Since this discovery, published in a recent issue of The American Journal of Sports Medicine, patients who have suffered serious disability from the wrongful use of pain pumps have sued the manufacturers of pain pumps. If you are experiencing the symptoms associated with chondrolysis or PAGCL, you too may have a claim against the manufacturer.

Source: St. Petersburg Times

SOURCE: Pain Pumps › FSU quarterback faces shoulder repair surgery

Bradford wowed Sooners fans with his talent and his humility. Following last season’s successes, Bradford turned down what many expected would be millions of dollars from the NFL and opted instead to stick with his college team for another year. However, during the first game of the season against Brigham Young University, Bradford suffered a shoulder sprain. He missed three more games before aggravating the shoulder injury more in a loss to Texas. His decision to have the season-ending shoulder surgery prompted questions from media about whether he regretted his decision not to go pro last year.

“No. Absolutely 100 percent no regrets,” he said at a press conference announcing his decision. He later elaborated about his decision to stay: “Considering this is where I grew up and this is where I dreamed about playing, to put this in the past is extremely tough. I’ve been blessed to be here. The past 3 1/2 years have been 3 1/2 of the best years of my life. I wouldn’t trade a day of it.”

Shoulder surgery will put Bradford in a difficult situation with the NFL, as he will have to convince recruiters that he can make a full recovery. As of now, Bradford has until mid-January to declare for the draft.

Source: Tulsa World

SOURCE: Pain Pumps › Bradford to undergo season-ending shoulder surgery

Some rotator cuff disorders – especially the early stages of rotator cuff damage –  may be treated without surgery through rest and rehabilitation, ice and heat applications, anti-inflammatory medications, and physical therapy. Situations that may require surgery include symptoms that persist for more than 6 months, injuries that occurred suddenly, or if the tear is causing weakness.

Such injuries that may require surgery are those from a major sports injury or auto accident. Very large rotator cuff tears – larger than 2 inches – and tears that affect more than one of the four rotator cuff tendons sometimes cannot be repaired. But surgery may be able to relieve pain by removing damaged tissue from the joint.

Surgery, however, cannot always completely resolve problems with regular wear-and-tear over the years. And whether you choose to have surgery or not, rehabilitation and physical therapy will be required to get your shoulder back to near-par.

Surgery risks include infection, persistent pain, slow healing followed by stiffness, and the potential need for more surgery. In some cases, surgery may cause irregular heat rhythms, changes in blood pressure and heart attack.

Patients who have had shoulder surgery in the past have also suffered from a condition in which the cartilage has worn away, called chondrolysis. This condition was found to have been caused by a pain pump device that was implanted in patients following surgery to help relieve pain for up to 72 hours following surgery. If you have had shoulder surgery and are still experiencing pain and limited mobility, or have been diagnosed with chondrolysis, you may have a claim against the manufacturer.

SOURCE: Pain Pumps › Weigh pros, cons of shoulder surgery

The pinching of the shoulder cuff muscle is one of the most common types of shoulder injury suffered by athletes who use repetitive overhead throwing motions, such as baseball and tennis players. This injury is generally caused by a muscle imbalance that can be righted with specialized training but worsened by the wrong training, according to Dr. Brughelli of SPARTA Performance Science in Menio Park, California.

The shoulder can internally rotate as fast as 7,000 degrees per second during a baseball pitch. With an injury, range of motion is reduced, compromising performance and causing pain. To avoid such injuries, Dr. Brughelli recommends that swimmers perform upper-body exercises that increase shoulder range of motion and increase strength of the scapula muscles, such as overhead pressing exercises, rowing exercises, pull-ups, chin-ups and Olympic lifts.

Most importantly, athletes should be properly trained and supervised to ensure that they are doing the exercises correctly. “With proper training and diagnosis, shoulder pain can be prevented, controlled or possibly eliminated,” Dr. Brughelli says.

Source: San Jose Mercury News

SOURCE: Pain Pumps › Swimmers can suffer shoulder injury from repetitive overhead movements

Stryker Corporation, a multinational, publicly traded corporation, sells McKinley Medical pain products in the U.S., Canada and Mexico. Pain pumps are devices that deliver pain medication directly into the surgery site for up to 72 hours. The pumps were approved by the Food and Drug Administration (FDA) for use with the catheters inserted into the shoulder tissue; however, pain pump manufacturers, like Stryker, began advising doctors to place the catheters directly into the shoulder joint, which was not approved by the FDA.

When the pain medication dripped directly into the shoulder joint – where it was not FDA-approved to do – the medication ate away at the shoulder cartilage, resulting in a painful and debilitating condition known as chondrolysis. Soon physicians began making the connection between this use of pain pumps and chondrolysis. As a result, Stryker and other pain pump manufacturers are now facing hundreds of lawsuits from individuals injured by the devices.

During the same time that pain pump manufacturers were telling doctors to place the catheters of the devices into the joint space, it also began paying orthopedic surgeons for using the Stryker hip and knee replacement products, which is illegal. Questions still remain about whether doctors were also paid by Stryker to encourage other doctors to use Stryker products.

SOURCE: Pain Pumps › Pain pump manufacturer no stranger to controversy

Zone maintains that the cover of I-Flow’s On-Q pain pump contains holes that allow latex to come in contact with patients and health care professionals. The company contends that individuals who come in contact with the pump and suffer a latex reaction may not be properly treated based on the assumption that the I-Flow product does not pose a latex risk. Zone is the worldwide distributor for the Solace pain pump, which has a latex-free design.

I-Flow may want to take a closer look at patient safety. The company is one of several pain pump manufacturers – a list that also includes Stryker Corporation, DJ Orthopedics Inc., and Breg Inc. – facing lawsuits from plaintiffs that allege the pumps have caused lifelong and painfully debilitating shoulder injury. Lawsuits contend that manufacturers of pain pumps instructed physicians to use the pumps in a manner that was not approved by the FDA for shoulder surgery.

Instead of implanting the catheter of the pain pumps into the shoulder tissue as was FDA approved, surgeons were instructed to place the catheters into the shoulder joint area. Doing so allowed medication to drip into the shoulder joint and essentially eat away the cartilage, causing bone to rub against bone and resulting in a serious, irreversible condition known as chondrolysis.

Source: PR Web

SOURCE: Pain Pumps › I-Flow pain pump manufacturers face more lawsuits

The company’s Regional Anesthesia sales, which includes the company’s flagship On-Q product lines, also increased 9 percent during the same quarter, according to the report.

There are approximately 140 lawsuits against manufacturers of pain pumps, including I-Flow Corporation, currently pending in state and federal courts throughout the country, says Frank Woodson, shareholder with Beasley Allen Law Firm. That number has jumped considerably since the summer of 2008, as more and more evidence began to link pain pumps to a serious and debilitating shoulder injury known as chondrolysis.

Pain pumps are commonly used by surgeons when performing shoulder surgeries. The pump, which sits outside the body but is attached to a catheter that is implanted into the surgical site, delivers medication for up to 72 hours. Once all the medication has been injected, the catheter is gently pulled out by the patient.

Pain pump manufacturers were given Food and Drug Administration (FDA) approval to market the devices with the catheter in the shoulder tissue. In early 2000, manufacturers sought to have FDA approval to put the catheters directly into the shoulder joint but the FDA rejected the request. However, pain pump manufacturers went ahead and instructed physicians to implant the catheter in the shoulder joint. The medicine that dripped into the shoulder joint area ate away the cartilage in the shoulder joint causing the painful and debilitating condition known as chondrolysis. There is no cure for the condition and in some cases, more surgery may be required.

SOURCE: Pain Pumps › Pain pump manufacturer enjoys gains despite mounting lawsuits

However, in the 1990s and early 2000s, pain pump manufacturers began to market the product differently, according to Beasley Allen shareholder Frank Woodson. “The catheter was intended and approved by the FDA to be placed into the shoulder tissue. (But) with advice from manufacturers, the pain pump catheters were being placed in the joint space or intra-articular area, which allowed the pain medication into the joint space.”

By advising surgeons to use the pump in such a manner – one that had never been approved by the FDA – tragedy ensued. “Doctors began to see patients suffer severe damage to their shoulder cartilage that we’ve rarely seen before,” Woodson said.

What resulted was the loss of cartilage, or joint space, commonly called chondrolysis. It leads to severe pain because the cartilage in the shoulder space is gone, causing bones to rub together. As the condition progresses, patients may require shoulder replacement and it makes normal daily activities painful and difficult.

There are approximately 140 lawsuits filed by people who have been injured by misuse of these pain pumps. All are pending in state and federal courts throughout the country. “There are many more cases under review across the country and there will likely be many more filed,” Woodson said. “As patients and physicians learn more about the link between pain pumps and chrondrolysis, I think you’ll see many more people come forward.”

SOURCE: Pain Pumps › Pain pump manufacturer’s bad advice leads to ‘tragedy’

Osteoarthritis is a common aliment that has earned the condition a top ranking in disability of Americans. Symptoms of stiffness, pain and limited movement are caused when the cartilage at the end of the bone breaks down, causing the bones to rub together at the joints. The most common remedy has been arthroscopic surgery, during which surgeons insert a scope with a camera through small incisions, where they smooth damaged cartilage surfaces and flush out bone chips. This allows for faster healing time than traditional surgery.

To alleviate pain following knee surgery, doctors at times will insert a pain pump to deliver medication directly to the surgical wound site. These post-operative pain pumps can help alleviate the pain associated with surgery, but they may come at a greater risk. Post-operative pain pumps, or intra-articular pain pumps, are routinely used in similar arthroscopic surgeries for shoulder injuries.

A recent study by The American Journal of Sports Medicine identified a link between the post-operative pain pumps and a painful, cartilage deteriorating condition known as Postarthoscopic Glenohumeral Chondrolysis, or PAGCL. PAGCL can cause irreversible damage and may require additional surgeries.

Patients who are considering knee surgery are advised to discuss alternative options with their physicians.

SOURCE: Pain Pumps › Studies show medication, physical therapy as effective as knee surgery

The study analyzed data from the 2005-2007 National High School Sports Injury Surveillance System and showed that shoulder injuries made up 18 percent of all injuries caused during both baseball and wrestling, and 12 percent of injuries caused during football. The report identified that shoulder injuries were three times more likely to occur during competition.

Overall, six percent of shoulder injuries required surgery. The sport that caused more surgeries to shoulders was wrestling. When shoulder surgeries are performed, they most often require the use of a pain pump to deliver medication directly to the surgical site for post operative pain management.

However, these post-operative pain pumps, also known as intra-articular pain pumps, can cause severe problems in some patients. Many patients who have used pain pumps have suffered from Postarthroscopic Glenohumeral Chondrolysis, (PAGCL) a painful condition that occurs in the shoulder when the cartilage between the ball and socket of the shoulder breaks down causing the bones to rub against each other.

Individuals who have used a pain pump to manage pain following shoulder surgery – or any other joint-related surgery – should consult their physician if they experience continued pain; weakness; clicking, popping or grinding; or decreased range of motion.

SOURCE: Pain Pumps › Study: Shoulder injuries happen more often to high school boys than girls

This sort of story is happening to more and more young athletes due to the pain pumps used after shoulder surgeries. Shoulder problems are occurring in young athletes, causing them to look to surgery to relieve the pain and get back into the game. Little did they know that after the surgery, the pain pump used to alleviate their pain would leave them with permanent damage and little hope of returning to sports.

Since nothing can be done about past cases, the only thing to do is try to prevent shoulder injuries for young athletes in the future. Some of the sports that put pressure on the shoulder include swimming, baseball, softball and motorcross. No matter which sport, the steps to shoulder injury prevention are all the same.

First, using the proper technique is very important when throwing or using shoulder motions. When fatigue sets in, more strain is put on the shoulder causing problems to increase. Know the correct technique!

Next, flexibility of the shoulder is crucial. The rotator cuff muscles are dependent on good positioning of the scapula, which create the ability for the muscles to produce power. However, flexibility does not automatically mean stretching. Recent studies have shown that static stretching for flexibility should not be done prior to training. Static stretching is used to stretch muscles when the body is at rest. It is recommended that instead of static stretching, dynamic stretching is best for the shoulder. Dynamic stretching uses speed of movement, momentum and active muscular effort to bring about a stretch, according to Sports Fitness Advisor.

The next step to preventing shoulder injuries is core strength and stability. The important areas for the shoulder include the lumbar spine (lower back), cervical spine (neck) and the scapulothoracic joint (shoulder). If these areas are strained, it is passed onto the shoulder joint. It is crucial to strengthen and stabilize these areas.

The last step is muscle strength. Once the core is stabilized, it is important for the shoulder and arms to be strengthened. This can be done through weights or Thera-Bands.

Practicing these steps can help prevent shoulder problems that would eventually lead to surgery. Practice them. It’s worth it.

SOURCE: Pain Pumps › Steps to prevent shoulder injuries

Shoulder arthroscopy is a rapidly expanding field because it offers a less invasive and less painful option for patients. In arthroscopy, two very small incisions are made, one for instruments and one for a miniature surgical camera to allow the surgeon’s viewing of the area without a large surgical site.

To manage post-surgical pain and extend the deployment of numbing agents, the use of temporary intra-articular shoulder pain pumps was introduced into these types of surgeries.

The procedure involves placing a flexible intra-articular shoulder pain pump catheter into the shoulder joint with the pump remaining in the joint for several days to deliver controlled doses of pain medication, often a combination of bupivacaine and epinephrine. This course of treatment became popular because it reduced recovery time without the need for narcotic pain relievers.

But a few days of relief can result in a debilitating and lifelong condition that causes severe-and often, permanent-pain and mobility loss and the need for constant medication. In some patients, complete loss of the use of the shoulder occurs.

PAGCL, one of the most common complications from shoulder surgeries is a condition where overwhelming damage to the shoulder occurs when cartilage deteriorates following these types of arthroscopic procedures. Without cartilage, there is no bone-to-bone cushion, causing bones to grind together and resulting in intense pain and, in some cases, chronic arthritis.

A study of 152 patients who underwent arthroscopic shoulder surgeries revealed that 12 of the patients developed PAGCL. All 12 PAGCL patients received pain pumps during their surgeries; the use of the pain pump was the only factor that the PAGCL patients had in common. In fact, studies suggest that up to 63% of arthroscopic shoulder surgery patients who received an intra-articular pain pump are at risk for developing PAGCL.

In addition to living with acute pain and daily medication, PAGCL may result in a need for follow-up surgery. Unfortunately, arthroscopic surgery is not an option. The damage that occurs with PAGCL requires the more painful and invasive shoulder joint replacement surgery (arthroplasty), a more intense surgery option over arthroscopy. Arthroplasty involves replacing the joint with plastic and metal components. Surgery lasts two and three hours and patients usually remain in the hospital for three nights. Physical therapy is almost always required following this type of procedure. Despite surgery, many patients never fully regain use of their joint and some patients report increased pain.

No consistently successful PAGCL treatment has emerged and the damage from PAGCL is believed to be irreversible. Unfortunately, pain medications seem to worsen the symptoms of PAGCL and offer no long-term value concerning treatment or cure.

PAGCL tends to develop two to twelve months following surgery. Symptoms include shoulder pain, whether in motion or at rest; increased shoulder stiffness; popping or grinding when the shoulder is in motion; decreased to full loss of range of motion; and loss of joint strength. Diagnosis of PAGCL is confirmed via an x-ray indicating narrowing of the shoulder joint space and indicating additional surgery is required to replace the destroyed joint.

November 15th, 2007

SOURCE: Pain Pumps › Shoulder pain pumps can result in lifetime disability