Orthopedic Treatment For Shoulder Separation

by Administrator 24. April 2017 11:01

Shoulder Separation is a condition in which the clavicle (collarbone) and acromion (end of shoulder blade) are torn apart. Depending upon its severity, the condition can be classified into type I, type II and type III injury.  In type I the acromioclavicular (AC) ligament is partially torn, but the coracoclavicular (CC) ligament is intact.  In type II injury the AC ligament is completely torn. Type III injury occurs when both AC and CC ligaments are completely withered.

Risk Factors

  • Males are more likely to have Shoulder Separation
  • The injury is common in teenagers
  • Weak shoulder muscles
  • Shallow joints and loose ligaments


  • A car accident or a sudden fall
  • An injury while playing contact sports such as rugby, football, wrestling, hockey, etc.


  • Pain on the top of the shoulder
  • Limited movement of the affected arm
  • Swelling, cuts or bruises at the affected area
  • An upward pointing lump on the top of the shoulder due to separated collar bone
  • Tenderness at the junction of the displaced joint
  • Numbness or weakness in the affected arm due to nerve damage
  • Popping sensation


In order to diagnose the condition the doctor may ask the patient to hold weight and get an x-ray.  Holding weight allows the shoulder to move and the separation is clearly visible in the scan. To evaluate further damage to the tissues or ligaments, the doctor may ask for an MRI or CT scan as well.

Non-Surgical Treatment

  • Medication - The doctor may prescribe certain pain relieving medicines to alleviate affliction.
  • Rest – The patient may be asked to wear a sling and immobilize the arm for a while. This may allow the scar tissue to heal the injured ligaments and ensure speedy recovery.
  • Ice – In order to reduce inflammation from the affected area the doctor may ask the patient to apply ice after every 15-20 minutes. Icing increases the rate of blood flow to the affected area.
  • Rehabilitation Exercises - Stretching and strengthening exercises may be recommended to the patients to regain the lost functionality of the joint.

Surgical Treatment –

In severe cases a surgery may be recommended by the orthopedic surgeon. He may trim the end of the clavicle so that it does not rub against the acromion.  In some cases, the ligaments present underside of the clavicle may be stitched back together to ensure faster healing.

  • Open- Weaver- Dunn is another surgical procedure that can be recommended by the orthopedic surgeon.  In this method –
  • The surgeon may make a longitudinal incision over the AC joint to find the ruptured clavicle.
  • He may then obliquely excise the clavicle.
  • CC ligament may then be mobilized with a small amount of bone from acromion.
  • Holes may be drilled into the clavicle
  • Polydioxane (PDS) cord may be passed through the holes to put back dislocated clavicle and acromion.

To schedule an appointment with Dr. Kulwicki, the shoulder and elbow injury specialist in Flower Mound, TX, call at (972) 899 – 4679.

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Whiplash Injury: Orthopedic Treatment In Flower Mound

by Administrator 24. March 2017 03:17

Whiplash is a common injury caused when the neck is forcefully pushed in a particular direction. This sudden force stretches and tears the soft tissues (muscles and tendons) in the neck leading to immense pain. Sportspersons involved in playing contact sports are usually affected by Whiplash.

Risk Factors –

  • Women are more prone to have this injury
  • People suffering from a congenital spinal problem
  • Not wearing while driving seatbelts
  • The car has badly fitted head restraints


  • A motor vehicle collision that gives a sudden jerk to the head
  • Contact sports that include tackling such as football, basketball, boxing etc.
  • Horse-riding
  • Blow to the head with a heavy object

Symptoms –

  • Affliction and tenderness
  • Decreased range of motion
  • Difficulty in rotating the neck
  • Headache at the base of skull that radiates towards forehead
  • Feeling fatigued and dizzy
  • Back and shoulder pain
  • Ringing sound in the ears
  • Blurred vision and nausea
  • Inability to sleep
  • Numbness or tingling

Diagnosis - 

In order to diagnose a Whiplash, the orthopedic doctor may examine patient’s neck to see its range of motion and evaluate the damage caused to the ligaments. He may also ask patients to get imaging tests of the cervical spine, like X-ray, CT scan or MRI scan.

Treatment -

  • In most of the cases, the doctor recommends use of conventional methods to treat the condition. This include –
  • To reduce pain and swelling, the patient may be advised to apply ice packs after every 3 to 4 hours at the injured area.
  • Certain painkillers and anti-inflammatory medicine may be prescribed by the doctor to reduce affliction.
  • The doctor may suggest the patient to use a firm pillow to support the neck while sleeping.
  • In severe cases, other treatment options such as ultrasound or massage therapy may be suggested.

Prevention Tips –

  • Avoid sitting or lying down for prolonged periods.
  • Do not try to overstretch the injured neck
  • Maintain a good posture while sitting
  • Do not make excessive use of neck collars or braces
  • Preform muscle strengthening exercises
  • Wear proper sports equipment

For comprehensive treatment of Whiplash, visit Dr. Kulwicki. To schedule an appointment with the orthopedic surgeon in Flower Mound, call at (972) 899 – 4679.

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Shoulder Instability: Causes, Symptoms And Treatment

by Administrator 26. October 2016 08:07

Shoulder is a ball and socket joint which helps in the movement and rotation of arms. Shoulder Instability is a condition that occurs when the arm bone or (humerus) moves out of the shoulder joint. Overuse or sudden impact can cause injury to the shoulder leading to pain and inflammation.

Types of Shoulder Instability

  • Anterior instability: When the upper arm bone moves out of the shoulder socket in forward direction.
  • Posterior instability: When the ball moves out of the shoulder joint in backward direction 
  • Multi-directional instability: Dislocation of shoulder in different directions in known as multi-directional instability.


  • Repetitive stress to the shoulder joint
  • Shoulder dislocation
  • Accidents
  • Previous injury to the shoulder


  • Pain and swelling in the shoulder 
  • Weakness
  • Numbness
  • Bruising 
  • Difficulty in shoulder movement


The doctor may conduct physical examination of the patient and ask about his medical history. He may move the shoulder and check for the mobility and strength. Imaging tests such as X-rays, MRI may be recommended by the doctor to identify the underlying cause and severity of the condition.


Non-surgical treatment

  • Medications: Anti-inflammatory non-steroidal medications prescribed by the doctor may help to relieve discomfort. Cortisone injections may be administered in case of severe pain.  
  • Ice and heat therapy: Application of ice packs at regular intervals can be beneficial to ease inflammation. Heat therapy may also help to reduce pain and discomfort.
  • Exercise: The orthopedic doctor may recommend strengthening exercises to improve shoulder stability. These exercises may also enhance flexibility and range of motion.
  • Immobilization: Wearing a shoulder strap may help to restrict the shoulder movement and promote healing. Shoulder brace and cast may  also be used for immobilizing the shoulder joint. 
  • Activity modification: Providing rest to the shoulder joint and avoiding activities that aggravate the condition. 

Surgical treatment:

  • Bankart repair: The surgeon makes small incisions in the shoulder joint and repair the damaged tissues. This helps to provide stability to the shoulder joint.
  • Capsular shift:  When shoulder instability is caused due to loose shoulder joint capsule, this surgery may be recommended. In this procedure, the surgeons tighten the shoulder capsule to provide stability.

For complete diagnosis and treatment of Shoulder Instability, visit Dr. Kulwicki. To schedule an appointment with the orthopedic surgeon you can call at (972) 899 – 4679 or visit 4951 Long Praire Road Suite 100, Flower Mound, Texas 75028.

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Rotator Cuff Injury And Treatment Options

by Administrator 25. April 2016 11:57

The rotator cuff comprises of four muscles - supraspinatus, infraspinatus, subscapularis and teres minor as well as various tendons that surround the shoulder joint. It helps in stabilizing the shoulder joint and aids in its movement. An injury to the rotator cuff can severely hamper the movement of the shoulder and arm.

A rotator cuff injury can be classified as:

  • Acute Rotator Cuff Tear: This type of injury may occur during heavy lifting or falling on the shoulder.
  • Chronic Tear: People involved in sports that require repeated overhead movements generally suffer this type of Rotator Cuff Injury. Other reasons may include chronic shoulder injuries or bone spurs etc.
  • Rotator Cuff Tendinitis: The muscles and tendons wear out with age causing the rotator cuff to function improperly. The degeneration generally occurs where the tendon attaches to the bone. Lack of blood supply and frequent tears cause more problems in the rotator cuff movement.


  • Dull pain in the shoulder that can aggravate with movement
  • A sudden tearing sensation
  • Decreased range of motion and gradual weakness
  • Muscle spasms
  • Loss of muscle strength


The shoulder doctor may conduct a thorough physical examination to check for deformities and alterations in the appearance of the shoulder. He may also assess the range of motion of the shoulder and recommend certain imaging tests such as X-Rays, MRI or Ultrasonography. The following treatment options may be utilized:

  • Ice packs: Application of ice packs may be beneficial in reducing pain and inflammation.
  • Sling: A sling can provide support to the shoulder and restrict its movement to prevent further damage to the rotator cuff.
  • Medication: Anti-inflammatory medications may also relieve the pain and swelling.
  • Injections: Steroid injections may be administered in the shoulder joint in case of severe pain.
  • Physical therapy: Physical therapy can prove to be useful in regaining the shoulder strength after a rotator cuff injury.
  • Surgery: Surgical intervention may be required if conservative treatment methods fail to provide any relief. The surgical procedures may include:
  1. Arthroscopic tendon repair: A tiny camera or arthroscope is inserted to repair the damaged tendon.
  2. Open tendon repair: A large incision is made to reattach the damaged tendon to the bone.
  3. Shoulder replacement: In instances of severe rotator cuff injuries, shoulder replacement may be recommended by the doctor.

For treatment of Rotator Cuff Injury and other shoulder conditions, visit Dr. Kulwicki. To schedule an appointment with the orthopedic doctor in Flower Mound, TX, call at (972) 899 – 4679.

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Sports-Related Shoulder Injuries

by Administrator 18. December 2015 11:30

The shoulder is a ball and socket joint consisting of three main bones:

  • Upper arm bone, also known as Humerus
  • Collar bone, known as Clavicle
  • Shoulder blade or the Scapula

These bones are held together by muscles, tendons as well as ligaments and provide an extended range of motion to the shoulder joint. This highly mobile nature of this joint makes it prone to get injured when used excessively, particularly in sportspersons. Sports that involve throwing, stretching, picking heavy weights etc. put pressure on the joint and make it more susceptible to injuries. Below is a list of some of the most common sports-related shoulder injuries:


Complete or partial (subluxation) dislocation may occur when the shoulder suffers a sudden jerk while playing sports. If the humerus pops out, fully or partially, it is advisable to seek immediate medical supervision. A popping sound accompanied with acute pain indicates that the upper arm portion may have dislocated from the joint.

Rotator Cuff Strain

Rotator cuff muscles provide a cushion to the bony area and help in rotation of the shoulder. The condition is common in sports which require rotation of the shoulder joint like bowling in cricket, swimming or kayaking. A sudden pain in the shoulder, accompanied by a feeling of tearing may be experienced after a Rotator Cuff Strain. Sleeping on the affected shoulder may also become difficult.

Glenoid Labrum Tear

Glenoid Labrum is a ring of tissue which is attached to the rim of the shoulder socket where the ball of the humerus sits. Repetitive overhead throwing or catching heavy objects with an overstretched arm are common causes of this tear. Pain in the joint, feeling of instability, decreased range of motion etc. are common symptoms of a Glenoid Labrum Tear.

AC (Acromioclavicular) Joint Injury

Also known as Shoulder Separation, the injury occurs due to a fall on an outstretched shoulder or through trauma in contact sports. If the injury is severe, one may feel a small lump on top of the shoulder joint. The pain may occur in the entire shoulder area specifically starting from where the collar bone meets the shoulder joint.

Dr. Kulwicki provides comprehensive treatment for sports injuries affecting the shoulder joint. To schedule an appointment with the orthopedic surgeon in Flower Mound, TX, you can call at  (972) 899-4679.

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Radial Tunnel Syndrome: Orthopedic Flower Mound, TX

by Administrator 23. November 2015 12:36

Radial Tunnel Syndrome is a condition caused by an increased pressure on the radial nerve which runs from neck to the back of the upper arm. It occurs due to repetitive motions such as pushing, pulling, twisting, gripping of the hand or bending the wrist.

Risk Factors

  • People involved in activities involving strenuous wrist and forearm movements.
  • Athletes involved in contact sports such as soccer, rugby etc.
  • Poor muscle strength and flexibility.


  • Direct trauma or injury
  • Sudden twisting of the arm
  • Diabetes Mellitus
  • Hypothyroidism


  • Severe pain at the top of the forearm or back of the hand
  • Muscle weakness in hands and arms
  • Lateral elbow tenderness
  • Pain that worsens when rotating the wrist


An orthopedic doctor may physically examine the patient to locate the damaged area of the nerve. He may ask about any medical history related to the condition. Tests such as Electromyography may be conducted to see if the forearm muscles are working properly. Nerve Conduction Velocity Test may also be performed to determine the severity of the condition.


  • Rest: The doctor may advise providing adequate rest to the affected area. He may also suggest the patient to discontinue the activities that can aggravate the symptoms.
  • Immobilization: Wearing splints provide support and limit the movement of the elbow joint. The doctor may also suggest wearing elbow pads to immobilize the joint.   
  • Medications: Anti-inflammatory medicines may be prescribed by the doctor to reduce inflammation and pain.
  • Exercises: Specific exercises recommended by a physical therapist can help in strengthening muscles and restoring their flexibility. 
  • Heat and ice therapy: Ice packs may be applied at regular intervals to provide relief from pain and swelling. Heat pads may also offer relaxation to muscles.

If the symptoms persist for a longer time and non-surgical treatment do not provide relief, surgery may have to be performed. The procedure aims at relieving excessive pressure on the radial nerve through incisions along the outside of the elbow, down the forearm.


  • Warm up exercises: These are necessary before performing any strenuous activity such as playing football, soccer etc. as it helps  in reducing strain to the elbow  joint.
  • Protective equipment: Wear properly fitted and padded protective equipment such as elbow pads, slash guards etc. in order to prevent this condition.

For effective treatment of Radial Tunnel Syndrome, visit Dr. Kulwicki. To schedule an appointment with the orthopedic doctor in Flower Mound, TX, you can call at (972) 899 – 4679.

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Olecranon Bursitis: Causes, Symptoms And Treatment

by Administrator 19. October 2015 13:10

Olecranon Bursitis is a common condition that occurs due to inflammation of the olecranon bursa that is located at the outside of the elbow. The bursa is a thin sac containing synovial fluid that acts as a cushion between the skin and the bony tip of the elbow. Bursitis occurs due to the irritation of the synovium, a thin outer membrane of the olecranon bursa. Also known as Student’s Elbow, Popeye’s Elbow and Miner’s Elbow, the condition causes a painful bump at the outer tip of the elbow.


  • Leaning on the elbow for a long time or on hard surface
  • Hard blow at the tip of the elbow
  • Falling on the elbow
  • Crawling in tight spaces
  • Rheumatoid Arthritis and Gout
  • Infection of bursa


  • Swelling
  • Restricted range of motion
  • Redness and warmth at the tip of the elbow
  • Pus in case of infection
  • Tenderness
  • Fever


The orthopedic doctor may physically examine the arm and elbow to check for swelling. He may recommend an X-ray to rule out the possibility of a bone spur or a foreign body. The doctor may also take the sample of the bursa fluid to know if the condition is caused due to an infection or Gout.


Depending upon the severity, Olecranon Bursitis can be treated surgically as well as non-surgically. If the condition is due to any infection, the orthopedic doctor may suggest removing the fluid from the bursa using a syringe. He may prescribe certain antibiotics to prevent the infection from spreading to other parts of the elbow. If the bursitis is not caused due to an infection, the doctor may recommend using elbow pads to cushion the elbow and refrain from strenuous activities to avoid putting pressure on the affected joint. He may also prescribe anti-inflammatory medicines to reduce swelling.

In severe cases, Olecranon Bursitis may need to be treated surgically. During the procedure, the orthopedic surgeon may remove the bursa or the damaged part of the elbow bone. Post-surgery, the patient may be suggested to use a splint or cast to immobilize the elbow for a few weeks or till complete recovery.

For effective treatment of Olecranon Bursitis, visit Dr. Kulwicki. To schedule an appointment with the orthopedic surgeon in Flower Mound, TX, you can call at (972) 899 – 4679 or visit 4951 Long Praire Road Suite 100, Flower Mound, Texas 75028.

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Shoulder Fracture: Orthopedic Treatment In Flower Mound

by Administrator 23. September 2015 10:51

The shoulder is a flexible joint that allows upward, downward, rotatory and twisting movement of the arm. It is made of three bones, including scapula, clavicle and humerus, which are joined together by soft tissues. Any injury or trauma to these bones can result in shoulder fracture. The injury is most commonly seen among children, sportspersons and people who suffer from degenerative orthopedic conditions.


  • Direct blow to the shoulder
  • High impact trauma
  • Tripping or falling on an outstretched hand
  • Fall from a considerable height
  • Motor vehicle accidents
  • Sports related injuries


  • Intense pain
  • Swelling
  • Tenderness around the shoulder
  • Bruising and discoloration
  • Snapping or cracking sound
  • Visible bump or deformity at the site of injury
  • Inability to move the arm


To diagnose a shoulder fracture, the orthopedic surgeon may inquire about the nature of the injury. He may examine the joint physically to look for pain, tenderness, range of motion etc. An X-ray or CT scan may also be recommended to determine the exact location and severity of the fracture.


Non-surgical treatment

Initially, the orthopedic doctor may suggest the patient to wear a splint or cast for a few weeks following the injury. This will provide support to the joint and restrict any jerky movements. He may also recommend anti-inflammatory medications to reduce pain and swelling. Applying ice packs at the site of pain can also help to ease the symptoms of shoulder fracture.  Once the pain and swelling has subsided, physical therapy may be required to restore the joint’s strength and range of motion.

Surgical Treatment

If the fractured bones have been displaced, the patient may need to undergo surgery. During the procedure, the surgeon holds the broken bone pieces together with the help of metal plates, pins, wires or screws. Shoulder replacement may be recommended if the ball portion of the upper arm is broken or crushed. After the surgery, the patient may have to wear a sling to rest the arm and promote recovery. The doctor may conduct frequent X-rays to monitor the healing process. Physical therapy may assist in restoring the original functionality of the shoulder joint.

For diagnosis and treatment of shoulder fracture, visit Dr. Kulwicki. To schedule an appointment with the orthopedic surgeon in Flower Mound, TX, you can call at (972) 899 – 4679.

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Neck Injury Prevention: Flower Mound, TX

by Administrator 24. August 2015 05:03

Neck injury can be a painful and unbearable experience. Some of its common causes are competitive sports, falls, accidents, heavy lifting and cervical spine. These can either be mild or severe and may take a few days or even weeks to heal completely. However, neck injury can be easily prevented if you take certain precautions.

Here are some tips that can help you avoid neck injuries:

  • Always wear a seat belt: Neck injuries often occur when the neck feels a jerk due to sudden braking, so it is essential that you always wear a seat belt while driving. 
  • Use proper lifting techniques: Lifting heavy objects improperly can strain your neck. Make sure you stand close to the heavy object while lifting or moving it, bend at the knees and keep the object near your body while getting up. Avoid twisting or moving sideways while lifting a heavy object.
  • Regular stretching: The neck can also be strained by sitting or sleeping in one position for long time. Thus, it is advisable to stretch your neck after regular intervals. This will improve the blood circulation and make the neck flexible. Stretching will also reduce any stiffness or soreness in the neck.
  • Sleep in the right posture: Poor sleeping posture often leads to neck pain. Therefore, you must use a pillow that provides proper support and avoid sleep related neck problems.
  • Keep monitor at eye level: If you use computer for long hours, make sure you keep the monitor at eye level to avoid straining your neck. You should also make sure that your chair provides proper back support. While sitting, keep your elbows at 90 degree angle.
  • Warm up before exercising: Make sure you do some warm up before playing sports or doing rigorous exercise. Aerobics, jogging, riding a stationary bike etc. can help you warm up your muscles and increase the strength as well flexibility of the neck.
  • Use protective gear: While playing sports or riding racing bikes, make sure you wear helmet to avoid head on collision and neck injuries.
  • Do Not Dive In Shallow Water: You should never dive headfirst in water with a depth less than 12 feet. Make sure you assess the level of water first before going in, specifically without a diving board.

If you feel any strain or pain in the neck, visit Dr. Kulwicki in Flower Mound, TX. To schedule an appointment with the orthopedic surgeon, you can call at (972) 899 – 4679.

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Common Shoulder Injuries

by Administrator 15. July 2015 14:32

The shoulder is a complex mobile joint responsible for a wide range of motion of the arm. The shoulder bears a lot of pressure during actions such as throwing a ball, lifting boxes; paddling a canoe etc. and is susceptible to injuries during sports.

Here are some of the most common shoulder injuries suffered by athletes and sports persons:

  • Shoulder Dislocations: Due to trauma or high impact, the shoulder joint dislocates and ‘pops out’ of the joint. This may happen due to falling on an outstretched arm, hand and shoulder or sudden twisting. The main symptoms of shoulder dislocation include pain, inflammation and visible deformity. The dislocated shoulder needs to be put back and in case of recurrent instability, surgery is required to repair the torn ligaments.
  • Rotator Cuff Injuries: Rotator Cuff is a group of tendons that are responsible for the movement and stability of the shoulder. A Rotator Cuff Injury causes intense pain and may lead to disability. It is mostly repaired by keyhole surgery or open surgery.
  • Acromioclavicular Joint (ACJ) Injuries: Acromioclavicular Joint (ACJ) is a crucial joint on the top of the shoulder, which helps in overhead movement. The athletes often get the joint sprained due to overhead and throwing activities or repeated falls on the shoulder. The dislocation of the joint leads to painful lump on the shoulder. The dislocation is treated with the effective physiotherapy; however, in cases of persistent pain, the joint is removed surgically
  • Impingement Syndrome: This occurs due to repeated use of the arm overhead and impingement of the bursa or tendons in the shoulder bones. The main symptoms are persistent pain, tendinitis, bursitis and inability to carry out routine activities. The condition is often treated with medication, stretching exercises and rest.
  • SLAP Lesions: Superior Labral Antero-Posterior (SLAP) tears results due to overhead throwing, tackling sports and heavy lifting. The patient experiences intense pain inside the shoulder and often complains of a clicking sensation.
  • Labral Tears: The socket of the shoulder joint is surrounded by the labrum, which cushions the joint and protects it from injuries. Often falls and direct blows lead to labral tears, which is a painful condition. It is treated surgically or with medication.
  • Thrower's Shoulder: Stretching of the front of the shoulder due to repeat overhead throwing is known as the Thrower’s Shoulder. The condition requires expertise for proper diagnosis and treatment.
  • Bicep Injuries: The bicep muscles can rupture at the elbow during sports activities or due to a trauma. The condition is also common among old aged people and it is associated with rotator cuff tears.

Besides these injuries, bursitis and fractures are also common shoulder injuries that need to be treated surgically.

Dr. Kulwicki provides comprehensive treatment for all kinds of shoulder injuries and conditions. To schedule an appointment, you can call at (972) 899 – 4679 or visit 4951 Long Praire Road Suite 100, Flower Mound, Texas 75028.

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