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Upper East Side Orthopedics

David Dines, MD, has built his practice based on decades of clinical experience and research focusing on the shoulder and related injuries. He is the Medical Director for the ATP World Tennis Tour and has operated on thousands of shoulders throughout his career while publishing many of the most important research articles and textbooks on shoulder surgery.
Joshua Dines, MD provides a full range of Sports Medicine services, including surgical and non-surgical treatments for injuries to the shoulder, knee, and elbow. He works with the NY Mets and NY Rangers as well as college athletes, high-school athletes, weekend warriors, and those patients just looking to get back to performing their everyday activities without pain. Together, Dines Orthopedics offers offices in two convenient locations in New York City at Hospital for Special Surgery and in Uniondale Long Island, offering their patients surgical and non-surgical options in both locations.
Dines Orthopedic provides a broad range of highly specialized Orthopedic Sports Medicine Services. Our team will properly evaluate and treat sports-related and chronic conditions affecting the elbow, knee, and shoulder. Sports injuries are often a result of overuse and wear and tear.
When surgery is required, you can trust that you are in the right hands at Dines Orthopedic. Our surgeons have performed thousands of procedures and improved the lives of countless patients through our comprehensive care.

ACL Injuries

ACL injuries are typically the result of sports-related activity, either from impact or quick lateral movements. The ACL is one of the four ligaments in the knee, and injuries to this ligament often require surgical reconstruction. Tears to the ACL can occur from either non-contact athletic activity or through sudden impact to the knee. If left untreated, this injury can lead to decreased stability and control in the knee and damage to the other ligaments. There are non-surgical approaches to mending an ACL injury, but ACL reconstruction is required in severe cases. Visit our Upper East Side Orthopedics for your ACL injury today!

Treatment for ACL injuries begins with weeks of rehabilitative therapy. During this time, you may also wear a brace to stabilize your knee and use crutches to avoid putting weight on your injury. In severe cases of ACL tears, the ligament needs to be rebuilt, not merely repaired. This procedure involves taking a tendon graft from elsewhere in the body (patella tendon, hamstring tendon) and fixing the graft in the usual ACL location. Arthroscopic surgery techniques allow for smaller incisions to be used. An athlete can usually return to their sport 6-9 months after their surgery. Our team at Dines Orthopedic has treated many patients for this injury, and we utilize a comprehensive approach to care to treat each individual’s specific needs.

Tendon Injuries

Tendons are tough fibrous tissues that connect bones to muscles. Tendon injuries are often the result of overuse. They can range in severity from tendonitis, which is the inflammation of the tendon, to tendinosis, which is tearing in the tendons, to frank tears, which can be partial or full tendon tears. The treatment for less severe injuries can be remembered using the acronym “RICE.” Rest, ice, compression, and elevation can help improve symptoms associated with tendon injuries. Patients should avoid activities that involve the affected extremity. Physical therapy and immobilization of the affected joint are also helpful conservative treatment options. PRP injections into the injured tendons can also aid in recovery. Surgery may be necessary in more severe cases. During this surgery, the torn tendon is reattached together or back to bone through sutures. Here are some of the tendon injuries that Dr. Dines our Upper East Side Orthopedics treats:
  • Distal Biceps Tendon
  • Achilles Tendon
  • Quadriceps Tendon
  • Patellar Tendon

The knee joint is the largest joint in your body. It connects your thigh bone to the bones in your lower leg and also includes the kneecap. The bones in your knees are joined together by ligaments that help provide stability as you walk and move.

Tendon Injuries

If you’re experiencing swelling,  tenderness or pain around a joint, chances are you have injured a tendon. Different kinds of tendon injuries can occur, so you should know about them so you can be aware of them. However, if you do injure a tendon and need an Upper East Side Orthopedics, Dines Orthopedics is here for you so that you can move freely without pain.

Tendonitis

Tendonitis is one of the most common kinds of tendon injuries that people sustain. In general, this condition is a type of inflammation and irritation in the tendon that can be caused by a sudden injury or, more commonly, repetitive movement or stress that results in micro-tears. 

Stress on tendons depends on many risk factors, such as sports performance, extreme physical effort, the number of repetitive or forceful movements in one’s job, pre-existing conditions like arthritis, and age.

This tendon injury, while most often occurring in the shoulders, elbows, wrists, knees, and ankles, can occur in many places of the body, and the following conditions are just some of the many forms of tendonitis:

Upper East Side Orthopedics
  • Golfer’s elbow
  • Tennis elbow
  • Swimmer’s shoulder
  • Pitcher’s shoulder
  • Jumper’s knee
  • Achilles tendonitis
  • Tibial tendonitis
  • Peroneal tendonitis
  • Flexor tendonitis
Symptoms

No matter the placement on the body, the general symptoms of tendonitis are as follows:

  • Pain when moving a joint
  • Mild swelling
  • Tenderness
Treatment

If you believe you have tendonitis, you should consult an orthopedic specialist to get a diagnosis. If you are diagnosed with tendonitis, you will be given a treatment plan designed by your specialist for the specific joint affected and your needs as a patient. You may be wondering, “What kind of treatment can I expect for tendonitis?” Here are some potential treatment options for tendonitis:

  • Medication: Different medications, such as pain relievers, corticosteroid injections around the tendon, and platelet-rich plasma (PRP) treatment within the affected area, can help reduce tendonitis pain and irritation. These treatments are often used for chronic tendon conditions but help tendonitis as well.
  • Physical Therapy: Different exercises and stretches, such as eccentric stretching to mobilize and lengthen muscles, can also help tendons heal as they strengthen your muscles. Many tendon conditions can be treated with physical therapy, and it is considered to be the first option for treatment.
  • Other procedures: Other kinds of treatments, such as ultrasound to remove scar tissue, dry needling to stimulate tendon healing, and surgery for more severe tendonitis cases, may be used if physical therapy has not resolved your tendonitis.

It is also important to rest your injured tendon, so you do not strain it further and cause more injury.

Tendinosis

Tendinosis is a more severe form of tendonitis that can result from untreated tendonitis and/or chronic use of a tendon. Instead of inflammation of the tendon from micro-tears, the tendon tissue itself is degrading. 

Because tendons need more time to heal than other parts of the body, chronic overuse slows down healing time and leads to tendinosis. The condition can occur for the following types of people:

  • Older or middle-aged people
  • Those who exercise vigorously/without enough rest in between workouts
  • Those who perform repetitive tasks
  • Those who left tendonitis untreated
  • Those with poor posture
  • Those who do not wear proper footwear
  • Those who have tight calf muscles
Symptoms

Symptoms of tendinosis that you should watch out for include:

  • Pain in tendons while moving or touching them
  • Restricted movement and stiffness in the area
  • A tender lump in the area (in some cases)
Treatment

Tendinosis treatment can be determined by an orthopedic specialist who can determine the main goals of treatment, which are usually to prevent further injury, reduce pain, and thicken the affected tendon. If you think you may have tendinosis, you may be wondering about the kinds of treatments that accomplish these goals. Some recommendations for tendinosis treatment include:

  • Resting the tendon
  • Taking breaks from repetitive tasks
  • Practicing ergonomics with different keyboards and chairs
  • Wearing a brace
  • Taking pain medications
  • Physical therapy
  • Performing light stretches
  • Eccentric stretches/exercises
  • Massage therapy
  • Taking vitamin supplements for collagen production in the tendon

Tendon Rupture

A tendon may tear when there is an extreme amount of pressure or force placed on the tendon. This kind of tendon injury most commonly occurs in the quadriceps, Achilles tendon, rotator cuff, and biceps. All of these areas have different causes for their injury, but generally, tendon ruptures are caused by:

  • Trauma to the tendon
  • Advancing age
  • Excessive pressure
  • Steroid injections
  • Antibiotics like fluoroquinolones
Symptoms

People with specific diseases, such as hyperthyroidism and gout, and type O blood are also more susceptible to tendon ruptures. General symptoms of a ruptured tendon to look out for include:

  • A snap or pop in the area upon injury
  • Severe pain
  • Immediate or quick bruising
  • Weakness in the area
  • Inability to move or bear weight in the area
  • A deformity in that area

There are also specific injuries that relate to different parts of the body, so knowing these symptoms is important so you can describe them to an orthopedic specialist.

Treatment

You should go to an orthopedic specialist for treatment due to different treatments being used for the severity of the injury and different ruptured tendon injuries. Your specialist will be able to determine the best course of action for you.

However, if you think that you have a ruptured tendon, you may be curious as to what kinds of treatment you can expect. Here are some typical treatment plans for ruptured tendons:

  • Pain medication: NSAIDs like ibuprofen can reduce pain and swell in the affected area. You should ask your doctor about these medications before taking them, especially if you are on a blood thinner. Acetaminophen can also help decrease pain. 
  • Immobilization: In cases where the function is not severely impaired or surgery is considered risky, your specialist may put you in a cast for at least four weeks. If you show signs of movement without pain or discomfort, you may be able to continue treatment without a cast.
  • Physical therapy: Your orthopedic specialist may recommend physical therapy techniques, such as stretches and exercises, to treat your ruptured tendon once the pain and swelling have subsided. Physical therapy helps restore function and strength in the tendon.
  • Surgery: In more severe cases, surgery may be the best option. This treatment method is usually necessary if the tendon has completely separated from the bone.

Upper East Side Orthopedics

Dealing with a tendon injury can be stressful, especially when different types of injuries can occur. At Dines Orthopedics, we can figure out what kind of tendon injury you may have and give you the care you need. If you or someone you know is looking for an Upper East Side Orthopedics, we are here for you. Please visit our website to learn more about us. Do not wait any longer; contact us today!

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