elbow pain

How do you treat elbow pain?

Elbow pain can result from repetition or overuse of your arm during your favorite activity or the result of a new fitness routine that has you challenging your body in new ways. Being active is important, so whether elbow pain is a result of chronic overuse or new use, it’s time to figure out the reason behind that persistent pain.

Identifying potential causes of elbow pain

The key to properly treating elbow pain is to understand the cause. Aside from an obvious fall or other trauma to the elbow, there are many more subtle causes of elbow pain and injury. Whenever you change your activity level or take on a repetitive task, you can expect to be sore. But it’s important to understand the difference between temporary muscle aches and something more serious. Here are three of the most common symptoms and how to treat elbow pain.

Severe swelling or redness at the back of the elbow may be bursitis. Healthy tissue lies flat against your bone, but an aggravated bursa sac presents as visible inflammation of the cushion between bones in the elbow. Initial treatment often
includes rest, ice, and anti-inflammatories to reduce swelling.

Rest and immobilizing the area are important because continued movement and pressure on the inflamed bursa will not allow it to calm down and heal. People who have recurring bursitis can also consider drainage of the bursa or in some rare cases, surgical removal of the bursa if persistent. 

Continuous pain on the inside or outside of the elbow along with forearm soreness could be (inside) golfer’s elbow or (outside) tennis elbow. This pain is often more severe when people rotate their arm or hold on to things. Among the most common elbow injuries, they’re not reserved for tennis players or golfers. Repetitive motion of many types such as typing or repetitive lifting can be the cause.

As with many injuries, the same initial conservative treatments are often recommended: rest, ice, and NSAIDs can help with pain and reduce swelling. Some patients also participate in physical therapy or receive steroid injections. The most severe cases may require surgery. If you have a muscle or tendon tear or other serious damage, continued activity could make it worse, so see your orthopedic specialist for a diagnosis soon.

Numbness or tingling in the elbow, arm or finger may be different than pain, but is disruptive nonetheless. Pinching of the median nerve at the wrist, known as carpal tunnel syndrome, is one common cause of numbness in the thumb, index and long fingers. Pinching of the ulnar nerve (cubital tunnel syndrome), which wraps around the elbow, can also causes numbness or tingling but typically on the remaining fingers.

Work activities or exercise that put pressure on the elbow, or those that require the elbow to remain bent for extended periods can aggravate or pinch the ulnar nerve. This nerve is the least protected of the nerves in the elbow, which makes it more vulnerable to compression.

Keeping your elbow straight and avoiding long periods of bending is the first course of action you can take if you’ve been diagnosed with cubital tunnel syndrome. Many people benefit from a brace or splint that keeps them from bending their elbows while sleeping. Physical therapy can reduce stiffness and there are several surgical options if your nerve compression is severe or muscle damage has occurred.

While symptoms can vary widely, any chronic elbow pain, numbness or swelling means it’s time to see a doctor. He or she can provide a proper diagnosis and help you treat elbow pain. Your orthopedic upper extremity specialist can also help you find ways to remain active while still allowing your elbow to rest and heal.

For more information on elbow pain and elbow treatments, visit with one of our specialists:

Best Elbow Surgeons

A. Todd Alijani, MD

Dr. A. Todd Alijani


Wayne Gersoff, MD

Dr. Wayne Gersoff


Davis Hurley, MD

Dr. Davis Hurley


Cary Motz, MD

Dr. Cary Motz


H. Andrew Motz, MD

Dr. H. Andrew Motz


John Papilion, MD

Dr. John Papilion


Dr. Micah Worrell

Dr. Micah Worrell


Hurt Knee Skiing

Hurt my knee skiing

Avid Colorado skiers know that it’s been a good year so far, with snow levels pacing well ahead of last year. This is great news for locals who want to get in as many days as possible, but bad news if you hurt your knee skiing all that great powder. When people overdo it or get into terrain that is beyond their ability, knee injuries are common. If you hurt your knee skiing, there are several things you should know to minimize further damage and recover more quickly.

I hurt my knee skiing. Do I need to go to urgent care?

Thankfully, most knee injuries are do not require an expensive trip to the ER or urgent care and treatment can start at home as long as you see an orthopedist relatively quickly following your injury. Read on to learn about three of the most common skiing knee injuries, and how to prevent and treat them.

A) Knee Sprains – Knee sprains account for about 30 percent of all skiing injuries and are becoming more common than ever. Strains occur when one or more ligaments is stretched or torn. Skiing can naturally create circumstances where your knee is twisted or forced out of its normal position. If you have pain or swelling but still have range of motion and stability, you may have a knee sprain.

Sprains require RICE: Rest, Ice, Compression and Elevation, and then a trip to your orthopedic specialist. Your doctor will evaluate your knee to confirm it is indeed a sprain and recommend the right treatment to maximize the healing process. But be careful not to ice too long and avoid putting ice directly on your skin. A good rule of thumb is twenty minutes on, forty minutes off. Too much ice can cause nerve damage and frost bite.

B) Torn MCL – More severe than a sprain, a medial collateral ligament (MCL) tear is actually the most common skiing knee injury. The reason for this is twofold: first, beginner and intermediate skiers far outnumber advanced skiers and MCL tears are most likely to occur in less-skilled skiers. Second, the MCL becomes strained or torn when the knees are turned in, which is common when you go into a snowplow (or “pizza”) position.

The symptoms of an MCL tear are often similar to that of a sprain, so it’s important to see an orthopedic expert to ensure you are correctly diagnosed. Some MCL patients also experience a catching or locking feeling or recognize marked instability as well.

If you do manage to tear your MCL, the good news is that most MCL tears can often be treated without surgery. Treatment typically includes the RICE formula, physical therapy to maintain range of motion and build strength, plus the use of a protective brace as you get back into physical activity.

C) A torn Anterior Cruciate Ligament (ACL) is also one of the most common skiing knee injuries. ACL tears are usually considered more severe because they frequently occur in conjunction with damage to another part of the knee. An ACL tear is often caused by a sudden stop or change in direction (think crowds on the slopes, moguls, catching an edge, or navigating an unexpected turn).

While treatment often involves surgery, today’s technology is much less invasive than it was years ago, so you don’t have to worry about a giant “zipper” scar up the front of your knee and most patients begin physical therapy days after surgery. A good orthopedic surgeon can help patients get back to being active quickly with minimally invasive techniques and a comprehensive rehabilitation plan.

A fresh powder day is certainly tempting, but you don’t want it to be your last of the season! You can minimize your chances of these common skiing knee injuries by remembering a few key points:

  • Always ski within your ability and ensure that you keep yourself balanced as you go downhill. Keeping your weight forward (but not too far forward) with your hips and knees bent will help you maintain a balanced position. Leaning back forces your feet forward in your boots (ouch) and ensures you’ll be on your rear end more often than you’d like.
  • Take a break when you need to. It’s easy to get overly excited when there’s such great snow but remember if this is your first time up for the season (or the decade), take it slow! Skiing is a workout, and if you haven’t been doing many (or any) leg exercises, even a few runs can take their toll quickly. Don’t overdo it.
  • Get in ski shape. If you have time to start conditioning before you go, do it! Even just a few weeks of leg and core exercises will make a difference and help minimize your chance of common skiing knee injuries.

Even with all these precautions, accidents do happen, and knee injuries are quite common. If you are reading this because you think you may have injured your knee – we can help!

You know your body best, so never avoid emergency treatment if you think you need it. The good news is that many people are able to apply ice, elevate the knee, and use crutches to get around until their appointment. We can usually see you within 24 hours. Schedule an appointment today with one of our orthopedic knee specialists to get back on your feet and back on the slopes!

Dr. Roger Greenberg Retirement

Inspiration from the Desert: How Dr. Roger Greenberg Lives a BeActive Lifestyle in retirement

Dr. Roger Greenberg retired from Advanced Ortho at the end of 2016, but that doesn’t mean that his schedule is any less active. After spending more than 38 years helping hundreds of patients be more active, he and wife Diane lead an incredibly active life splitting their time between Denver and California’s Coachella Valley desert.

The couple’s schedule routinely starts at 6 am with a walk for Corzo and Skosh, their two Portugese water dogs, the family’s fourth and fifth of this breed over the years.

Twice a week they head to Pilates and other days they go to the gym to work out. And then there’s the golf. As a longtime golfer, Dr. Greenberg is a committed student of the game who practices or plays 4-5 days a week. As if 18 holes on a regular basis weren’t enough, he and Diane ride their bikes – eight miles round trip – to the course at least a couple of day per week as well.

All this happens on top of the couple’s active role in their community and Dr. Greenberg’s part time work reviewing orthopedic diagnoses for the social security administration. (Did we mention they’re “retired”?)

In addition to its warm climate, the Coachella Valley is known for its lively music and arts community and a remarkable desert ecosystem – all of which the couple celebrate and advocate for.

The Greenbergs are “Friends of the Desert Mountains” a local organization whose mission is to preserve land, support education, conservation and research in the Coachella Valley. “We’ve really enjoyed gaining an understanding of plant and animal life in the desert,” said Dr. Greenberg.

The couple has also participated in several University of California Riverside lectures on wildlife, including a recent series about big horn sheep migration patterns, some of which they’ve personally witnessed as the sheep have appeared on the fairway during more than one golf outing. “We had to work a bit harder to see scorpions,” says Greenberg, referring to a recent moonlit hike they took at the base of the Santa Rosa Mountains. “Scorpions naturally have a blue-green glow when exposed to UV or black light, and we were able to observe them at night using black lights.”

The Greenbergs often attend and host guests for the areas’ three major art festivals and the Coachella Valley Music Festival, the latter of which they attend with one of their two daughters, who works in the music industry.

While Dr. Greenberg loves his active life in California, he also misses the camaraderie of the Advanced Orthopedic group and seeing long-time patients. “I love staying in touch with the team and the practice,” he says. “And they’ve been very inclusive, keeping me up-to-date with the growth of the practice and what’s going on in their lives.”

And the feeling is mutual. The team in Denver never ceases to be impressed by the Greenberg’s latest adventures and activities – a family that truly lives the BeActive life. We’re inspired and hope you are too! Whether you balance work and play to find time to be active, or are busy in retirement like the Greenbergs, make sure physical activity is key part of your schedule. Have a great story about how you stay active? Get in touch.

runner’s knee pain

Did summer running season wear you down? How to cope with runner’s knee pain.

What is Runner’s Knee Pain?

Runner’s knee pain can encompass a wide range of aching pain around the kneecap that impacts runners and non-runners alike. Runner’s knee, also known as patellofemoral pain syndrome, often presents as discomfort that is experienced when bending down, walking downhill or descending stairs.

The pain from runner’s knee may be an indication of bone misalignment or a muscular deficiency; however, it is frequently the result of repetitive movements, high-impact training or blows to the knee. Common symptoms of runner’s knee include swelling around the kneecap and a corresponding clicking, popping or grinding sensation that occurs during movement.

Recovering from Runner’s Knee

Given the connection between runner’s knee pain and overuse or repetitive motion, “RICE” (Rest, Ice, Compression, Elevation) is typically the first line treatment. Wrapping the knee for support coupled with the use of NSAIDs like Advil are effective to aid short-term relief of pain or inflammation. In all scenarios, activity should be limited until the condition subsides.

How long it takes for the pain to subside varies by body type and degree of injury. It’s important to not rush back into your running shoes before you are fully healed. Signs of recovery include the ability to fully extend and bend the knee without pain and being able to successfully walk, run or jump without a pain sensation. Your injured knee should be able to demonstrate that it feels and performs like your non-injured knee.

Whatever you do, don’t rush the run. If you try to get back to impact workouts before you’re healed, you could damage the joint for good. Instead, try mixing up your routine with swimming or yoga – just stick to movements that don’t put force or repeated range of motion on the knee.

And when you do ease back into your running routine, be mindful of power movements or actions that require significant range of motion such as lunges.

If you’ve tried the RICE regimen and your pain persists, seek an orthopedic evaluation to ensure things don’t get worse. Your orthopedic specialist will assess your condition to determine if you need medical care such as physical therapy as it can be a successful aid to recovery.

Preventing Runner’s Knee

No one likes being on the sidelines, and there are preventative measures that you can take to reduce your chances of experiencing runner’s knee. Effective prevention tools include the right equipment, the right preparation and the right routine.

Your feet power your stride and overall mobility. Treat them with the care they deserve. Proper fitting shoes with strong support provide a vital foundation for your body whether on the road, the trail or even in the grocery store. Too often, however, we choose fashion over function or ignore the signs of wear and tear.

After a season of running in the Colorado sun, watch for uneven shoe wear. Worn soles can place significant strain on your legs and joints that lead to conditions such as runner’s knee. Don’t wait until Christmas to replace those worn treads; the gift of proper support is a year-round treat all feet should enjoy.

Depending on your pain and level of activity, you may also want to consider orthotics which help address many conditions by providing support for those with high arches or redistributing the energy caused by your foot’s natural pronation.

Once you have the right equipment, the right preparation powers peak performance. Maintaining a healthy weight to help minimize the strain on your body can be a challenging cycle for many but excess body weight has a direct impact on joint performance.

All bodies benefit from a regimen of proper warm up and stretching. Help your joints perform better by fostering flexibility and an adequate warm up prior to putting yourself through the paces.

Strength training builds muscle stability and is also an effective course of preventative action. In addition to the benefits of cross-training, muscle development reduces the strain on your body’s joints and bones.

A well-rounded approach to preparation and full-body training offers maximum protection from overuse conditions. It doesn’t mean that you must be any less intense of a runner. Cross training options can actually help you become a stronger runner while leaving some signs of overuse – such as runner’s knee – behind.

Feeling pain today? Schedule an appointment with one of our orthopedic knee specialists to find the right solution for you.

Best Knee Surgeons


Dr. Mark Failinger


James Ferrari, MD

Dr. James Ferrari


Wayne Gersoff, MD

Dr. Wayne Gersoff


dr harold hunt denver co

Dr. Harold Hunt


Jared Michalson, MD

Dr. Jared Michalson


Cary Motz, MD

Dr. Cary Motz


H. Andrew Motz, MD

Dr. H. Andrew Motz



Dr. Justin Newman


John Papilion, MD

Dr. John Papilion


Scott Resig, MD

Dr. Scott Resig


R. Presley Swann, MD

Dr. R. Presley Swann


numbness in hands

What to do if you experience numbness in hands or numbness in fingers.

Numbness in hands or fingers is a symptom that can be serious and should not be ignored. As with all health emergencies, call 911 or get emergency medical help if hand or finger numbness starts suddenly – especially if it occurs with weakness or inability to move, dizziness, or a sudden, severe headache.

Aside from emergencies, while numbness in your fingers or hands could be caused by several factors – including conditions like diabetes and various auto-immune diseases – it is frequently caused by some kind of nerve compression in your arm or wrist. A visit to your orthopedic hand and upper extremity specialist can evaluate for nerve-related causes, such as carpal tunnel syndrome and/or cubital tunnel syndrome.

What is cubital tunnel syndrome and how does it cause numbness in hands?

The ulnar nerve is one of three major nerves in your arm, and runs from the outside edge of your hand all the way up to your neck. Compression of this nerve occurs most frequently on the inside of the elbow, causing tingling and numbness in hands and fingers – specifically the pinkie and ring fingers. Your orthopedic hand specialist will work with you to relieve the symptoms using conservative treatments such as using a brace or adjusting the frequency and nature of daily activities. If these changes do not help, or if you have significant nerve or muscle damage, you may need to look at surgery.

Numbness in hands and fingers: How is carpal tunnel syndrome different?

While carpal tunnel may also present with numbness in hands or tingling in fingers, carpal tunnel typically causes pain in the thumb, index and middle fingers. Carpal tunnel is caused by compression of the median nerve, which runs down the length of the arm but passes through the carpal tunnel at the wrist, before going into the hand.

Without treatment, carpal tunnel syndrome generally gets worse over time. Early diagnosis is often the difference between non-surgical treatment to alleviate the compression and surgical options to avoid permanent damage to the nerve.

Pain and numbness in hands, fingers and thumbs from carpal tunnel can be influenced by a variety of factors including gender, genetics, age, occupation and activity level. Older people and females are more susceptible to carpal tunnel, and a small or “tight” amount of space in the wrist anatomy may be a hereditary factor. Prolonged or repetitive motions can lead to carpal tunnel. Medical conditions that range from pregnancy to thyroid imbalances, diabetes, and rheumatoid arthritis can also increase the occurrence of the syndrome.

If wrist pain or numbness in hands occurs at night, inadvertently sleeping with bent wrists (which is common) may aggravate carpal tunnel.

Although some patients experience relief by shaking their hands in an attempt to improve the numbness, the relief is fleeting. What’s worse, given the frequency that these conditions present gradually or come and go, it’s easy to ignore their signs. That can be a mistake, however, because early diagnosis can allow for the use of non-invasive solutions such as splinting and bracing as well as NSAIDS, or forgoing certain activities that aggravate the symptoms. Delayed diagnosis and treatment, on the other hand, can lead to permanent or irreversible nerve damage.

See a specialist to get the right diagnosis

If you have numbness in hands or numbness in fingers, see your orthopedic hand specialist for a proper evaluation, diagnosis and treatment. Your orthopedic hand surgeon will carefully examine, bend, flex, and test your wrists and arms. Strength assessments identify muscle weakness or atrophy and tapping along the corresponding nerve reveals sensitivity and numbness correlation. In addition to physical tests, nerve conduction studies can provide clear indication of nerve impingement.

Don’t ignore your symptoms – numbness in hands or fingers requires attention. Early diagnosis of hand and finger numbness can offer many non-surgical treatment and positive outcomes. Knowing what to look for makes a world of difference.

Best Hand Surgeons

A. Todd Alijani, MD

Dr. A. Todd Alijani


Davis Hurley, MD

Dr. Davis Hurley


Dr. Micah Worrell

Dr. Micah Worrell


Dr. Ng Success Story

Success Story: How endurance athlete Ryan Law got back on the race course after surgery with Dr. Ng

Ryan Law loves to run. So much, that in the past seven years, he’s run 11 marathons and seven ultra-marathons/endurance events (3X50 milers, 4X55k+, and Half Ironman – this guy knows how to #BeActive – we are talking serious distance here people!). But for years, he had been fighting through a chronic injury that was painful and performance-depleting.

After extensive online research to better understand the risks and potential upside of having surgery, in October, 2017 Ryan chose Dr. Alan Ng to perform surgery on his inflamed peroneal tendon. Due to an osteochondroma – a growth that forms on the surface of a bone near the growth plate – the tendon was inflamed and causing chronic pain.

Dr. Ng removed the osteochondroma and some damaged tendon tissue, carved out the channel along the ankle bone, and reattached the peroneal tendon. Shortly after surgery, Ryan began the road to recovery, working toward running and then up to more mileage over time.

“I started running again in March – about five months post-surgery – and I was able to return to my previously established 35 to 50 mile-a-week average by late May,” Ryan recalls. “My performance was not hindered by the surgery and if anything, it improved.”

Just this summer, in July, Ryan competed in the Copper Mountain Under Armor Mountain Running Series, less than a year after his surgery. And he’s still improving. This coming October will be a full year since the surgery and all signs point toward significant overall improvement. Ryan has every reason to be optimistic: “I suspect full recovery has not happened yet,” he said. “As I have yet to hit a full year and all my symptoms have improved since the surgery which is very reassuring.”

Dr. Alan Ng specializes in foot and ankle reconstructive surgery and trauma, and loves to help his patients getting back to the activities they love. And when he’s not helping patients he loves being active too – playing golf, skiing and mastering the martial arts of karate and Muay Thai kickboxing. Learn more https://advancedortho.org/alan-ng-dpm/

Hip pain

What is causing my hip pain? A look at top causes and how to treat them.

As the largest, and one of the strongest joints in the body, your hips can put up with a lot of repetitive motion and wear. Cartilage cushions the ball-and-socket to allow for smooth rotation as you walk, run and move.To keep your hip moving smoothly, a complex network of bones, cartilage, muscles, ligaments, and tendons must all work in harmony.

But as with all joints, the hip cannot withstand endless overuse,and the muscles, tendons and cartilage can wear down over time, or sustain damage from injury or disease. If you have hip pain, the first step is to understand what is causing it. There are numerous possibilities, depending on your medical and activity history. Seeing an orthopedic specialist is the best way to diagnose a hip injury, but understanding the most common causes of hip pain can be helpful.

Tendinitis

Tendinitis is inflammation or irritation of a tendonand canaffect tendons connected tothe muscles that control hip motion. The hip flexor, as the name implies, allows your hip to flex and rotate. It’s made up of two muscles known as the iliopsoas, which attach by a tendon to the upper thigh. The iliopsoasis called upon to help you walk and run, andalso to help other weaker muscles that aren’t pulling their weight leaving it susceptible to overuse and tightness. Translation – if you have weak gluteal or core muscles, your iliopsoas are probably doing more than their share and can becomeswollen and tender when put under repeated stress. This can certainly cause lingering hip pain.

Another common cause of hip joint tendinitis, particularly in runners, involves the thick span of tissue that goes from the outer rim of the pelvis to the outside of the knee known as the iliotibial or “IT” band. Also susceptible to overuse injury, it causes pain that can radiate along the entire length of the IT band from the knee all the way up to the outer side of the thigh to the hip. In fact, many people with IT band overuse present only with complaints pain to the outside of the knee.

Bursitis

Bursitis has many causes and can be intensely painful. Bursae are the fluid-filled sacs that cushion skin or muscle against the bone, allowing muscles and tendons to move smoothly. The most common hip related bursitis is on the outside of the hip socket near the “point” of the hip. Often triggered by repetitive motion and – you guessed it – overuse, this type of bursitis can also be brought on by things as simple as lying on the affected side for too long.

Labrum Tear 

Hip labral tears are actually not painful for many patients. When symptoms do occur, they generally take the form of deep groin pain, gluteal pain, clicking, catching, locking, or giving out. Limited range of motion or stiffness can also be indicators of a hip labral tear, which is why physicians test range-of-motion as part of an examination. Physical activities like golf, ballet, tennis and softball that repetitive twisting, pivoting and hip rotation cause strain on the joint that can lead to deterioration and ultimately a hip labral tear. Tears can also be caused by a collision (typically in contact sports) or structural abnormality.

Sciatica

When a herniated disc in the spine presses on the sciatic nerve, or if a tight muscle in the pelvis pinches around the nerve, it tends to cause pain that runs along the nerve from the lower back, down the hip and into one or both legs and feet. The pain is typically sharp or burning, and is often triggered by movement – even by a cough or sneeze –that can last for weeks. With sciatica, it’s uncommon for people to have hip pain alone.  Lower back pain is sometimes present, and patients often report a tingling, burning or feeling of numbness running down their leg.

Treatment

For most types of hip pain, there are multiple treatment options,available that typically begin with conservative, non-invasive options like a short course of NSAIDs (e.g. Advil or naproxen), periods of rest, yoga and stretching, physical therapy to increase hip strength, stability and range of motion.

If conservative options do not resolve hip pain, injections, surgery or hip replacement may be considered. Options can include:

Injections can both help to diagnose and treat some hip injuries. Orthopedic specialists can use an injection to numb the hip joint to determine if the joint is the source of hip pain, and then make treatment recommendations accordingly. Cortisone injections are also used to reduce inflammation and provide pain relief which may be done using ultrasound or fluoroscopy.

Hip Arthroscopy is a minimally invasive procedure that allows doctors to see the hip joint without making a large incision. It can be used to diagnose and treat a wide range of hip problems.

Hip Joint Replacement or Total Hip Replacement also known as Total Hip Arthroplasty (THA)to replace all or part of the hip joint with an artificial device to restore joint movement (prosthesis) when the cause of pain is significant arthritis of the joint.

The anterior hip approach allows your surgeon to access the hip from the front of the body and avoid cutting any major tendons or muscle groups, significantly reducing pain and recovery time. Many people back to an active lifestyle as soon as six weeks after the procedure, with far fewer post-procedure restrictions.

Revision total hip replacement is performed when the original primary total hip replacement has worn out or loosened in the bone. Revisions are also carried out if the primary hip replacement fails due to recurrent dislocation, infection, fracture or very rarely, ongoing pain and significant leg length discrepancy.

The hip is one of the largest weight-bearing and most interconnected joints in the body so it’s understandable why hip pain is so challenging. Don’t let hip pain keep you from being active. Get a professional diagnosis and treatment plan so that you can maintain or improve your mobility and remain active. Schedule an appointment today with one of our orthopedic hip specialists to find the right solution for your hip pain.

Best Hip Surgeons

dr harold hunt denver co

Dr. Harold Hunt


Jared Michalson, MD

Dr. Jared Michalson



Dr. Justin Newman


Scott Resig, MD

Dr. Scott Resig


R. Presley Swann, MD

Dr. R. Presley Swann


The Anterior Approach to Hip Surgery

Seminar on August 23 at 6:30 pm at Sky Ridge Medical Center in the Auditorium on the Garden Level.

Shoulder Replacement

When is it time to consider shoulder replacement surgery?

And what type of surgery is right for you?

Shoulder replacement surgery requires careful thought and planning, but for those who’ve exhausted other treatment options, it can be the best way to restore range of motion, relieve pain and help you return to an active lifestyle.

Many different conditions can lead to the severe pain and joint degeneration that necessitates a shoulder replacement, including various types of arthritis (osteoarthritis, rheumatoid arthritis, post-traumatic arthritis), serious fractures, or a combination of muscle tears and arthritis (such as rotator cuff tear arthropathy).

Understanding the source and nature of your shoulder pain will allow your orthopedic specialist to recommend the right procedure. Depending on the severity and type of condition, there are three types of shoulder replacements that are often considered.

Partial shoulder replacement surgery is often recommended when there is major damage to the head or ball of the upper arm bone (humerus), but the rest of the shoulder is healthy and intact. In this procedure, the ball portion of the upper arm bone is removed and replaced with metal.

Total shoulder replacement surgery is typically used to address arthritis and replaces both the damaged ball (the head of the humerus bone) and socket with metal and/or plastic. While total shoulder replacement recovery can take several months, patients often experience significant improvements in pain and motion following successful surgery and rehabilitation.

Otherwise healthy adults whose rotator cuff and deltoid are intact tend to be good candidates for total shoulder surgery. While there are few age or weight limits obesity, nicotine use and advanced age always increase the risk for post-surgical complications. Patients with severe osteoporosis or susceptibility to infections also have higher risks. 

Reverse shoulder replacement surgery may be the best option when there is significant damage to the shoulder tendons, namely the rotator cuff. If the shoulder joint is arthritic and there is a rotator cuff tear that cannot be repaired, a reverse shoulder replacement may be the best option for surgical treatment.

In this procedure, a prosthetic “ball”, usually metal, is placed on the shoulder socket. A plastic “cup” is then placed where the arthritic ball of the shoulder used to be. In doing so, the anatomy of the shoulder is “reversed” and the deltoid muscle is used to move the shoulder rather than the torn rotator cuff tendons.

Advanced Orthopedic has 10 board certifiedsurgeons who specialize in treatment of shoulder issues. The American Academy of Orthopaedic Surgeons considers patients with the following situations potential candidates for reverse rotator cuff surgery:

• A completely torn rotator cuff that cannot be repaired
• Rotator cuff tear arthropathy
• A previous shoulder replacement that was unsuccessful
• Severe shoulder pain and difficulty lifting your arm away from your side or over your head
• A complex fracture of the shoulder joint
• A chronic shoulder dislocation
• A tumor of the shoulder joint
• Patients who have tried other treatments, such as rest, medications, cortisone injections, and physical therapy, that have not relieved shoulder pain

If shoulder pain is severely limiting your daily activities or range of motion,and any of these descriptions apply, it might be time to raise your hand for shoulder replacement surgery. Contact our office to set an appointment.

Best Shoulder Surgeons

A. Todd Alijani, MD

Dr. A. Todd Alijani



Dr. Mark Failinger


James Ferrari, MD

Dr. James Ferrari


Wayne Gersoff, MD

Dr. Wayne Gersoff


Davis Hurley, MD

Dr. Davis Hurley


Cary Motz, MD

Dr. Cary Motz


H. Andrew Motz, MD

Dr. H. Andrew Motz



Dr. Justin Newman


John Papilion, MD

Dr. John Papilion


Dr. Micah Worrell

Dr. Micah Worrell


Dr. Keith Jacobson - 2018-2019 President-Elect for ABFAS

Dr. Keith Jacobson Elected as 2018-2019 President-Elect by the American Board of Foot and Ankle Surgery

DENVER – July 26, 2018 –Advanced Orthopedic and Sports Medicine Specialists is pleased to announce that Keith Jacobson, DPM will serve as an executive officer of the 2018-2019 American Board of Foot and Ankle Surgery (ABFAS) President-Elect. His term begins September 1.

Dr. Jacobson is board certified in reconstructive rear foot/ankle surgery and foot surgery

By the American Board of Podiatric Surgery. He’s a national expert in foot surgery and reconstructive rear foot and ankle surgery and specializes in foot and ankle trauma and reconstruction in both adults and pediatrics. His areas of focus include:

  • Reconstructive Foot and Ankle Surgery
  • Foot and Ankle Trauma
  • Cartilage Replacement in the Ankle
  • Total Ankle Replacement
  • Arthroscopy of the Foot and Ankle

As a longtime ABFAS board member, Dr. Jacobson has also served asa chair for the American Board of Foot and Ankle Surgery Computer-based Patient Simulation Committee.

About Advanced Orthopedic & Sports Medicine Specialists

Advanced Orthopedic and Sports Medicine Specialists is widely recognized as the regional leader in comprehensive orthopedic services. The 19 physicians of Advanced Orthopedic and Sports Medicine Specialists have received specialized training in orthopedic surgery and in subspecialty areas within the field of orthopedic medicine. They diagnose and treat even the most complicated orthopedic conditions and are supported by a professional staff of physician assistants, medical assistants, x-ray technicians and administrative personnel at our two offices in Denver and Parker. Learn more at advancedortho.org. Follow us on Facebook, Twitter, Pinterest and Instagram