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Treatment Areas

Nerve & Muscle Pain

Back pain, it's the most common type of musculoskeletal pain out there. It's debilitating, it prevents people from working, and it prevents them from participating in exercise, as well as all the activities of daily living. I'm here to tell you that it's treatable. In many cases, it's very easily treatable, and this is not just PT and acupuncture, or chiropractic. It's in addition to all these things. 
 
Hi, my name is Dr Jennifer Stebbing and I would like to talk to you about other alternatives to treating back pain. This includes prolotherapy and sometimes PRP. If your back pain is related to disk disease, or facet arthritis, or issues with the nerves coming out from the spaces between the bones. These are all potentially treatable. 
 
Some people do better, and some people don't do well at all. But I'm here to tell you, that I can assess these type of things and give you a reasonable way to maneuver through the medical system, so that you could get treated as best you can. 
 
I'm Dr Jennifer Stebbing. I'm border certified in Family practice and Sports Medicine. If you'd like to look at my website, it's drstebbing.com and I can be reached at info@drstebbing.com. Please reach out to me, I'd like to help you. Hi, I'm here to talk to you a bit more about back pain. There are reasons for back pain and the reasons behind the back pain can be anything from, for example, that you're out of alignment, or that you have trigger points, or that you have early arthritis, or you have scoliosis, or a leg length discrepancy that's causing a scoliosis. It's really important to evaluate all these things with x-rays, possibly MRI's and an ultrasound that I can do in the office. This helps us determine a more complete idea of why you're having pain. Sometimes the x-ray findings, if you just rely on them, will lead you astray, because they may not be the cause of your pain. 
 
I'm Dr. Jennifer Stebbing. I'm an Osteopathic Family Physician with a Board Certification in Sports Medicine and I use all different types of modalities to evaluate and treat back pain. I'm here to tell you that you can get back to work, you can get back to exercise, as we evaluate you more thoroughly with some diagnostic imaging that's available. If you'd like some more information, you can look at my website, drstebbing.com, or email me info@drstebbing.com 
 Hi. I'm here to talk to you a little bit more about back pain. There are reasons for back pain. And the reasons behind the back pain can be anything from for example that you're out of alignment, or that you have trigger points, or that you have early arthritis, or you have the scoliosis, or a leg length discrepancy that's calling a scoliosis. 
 
It's really important to evaluate all these things with X-rays, possibly MRIs, and an ultrasound that I can do in the office. This helps us determine a more complete idea of why you're having pain. And sometimes the X-ray findings, if you just rely on them, will lead you astray, as they may not be the cause of your pain. 
 
I'm Dr. Jennifer Stebbing, I'm an osteopathic family physician with board certification in sports medicine. And I use all different types of modalities to evaluate and treat back pain. I'm here to tell you that you can get back to work, you can get back to exercise, as we evaluate you more thoroughly with some of the diagnostic imaging that's available. 
 
If you'd like some more information, you can look at my website, drstebbing.com, or email me at info@drstebbing.com, and I will send you two more videos, from which you can get more information to help you feel comfortable about coming in to see me. Hi. Do you have pain going down your legs that you think is coming from your back? Sometimes this is a sign of nerve damage, or nerve compression, or an issue where the nerves exit at the spinal column. But it can also be indicative of a ligamentous referral pattern. There's other referral patterns like sclero patterns and trigger points have referral patterns, as well. Referral patterns are simply where you receive pain, but the pain may be coming from something else. It's really nice to have a doctor that can evaluate you in terms of these different pain patterns because it can change your pain drastically if the reason behind it is evaluated and treated appropriately. 
 
I'm Dr. Jennifer Stebbing. I'm Board Certified in Family Practice and Sports Medicine. I'm here to tell you that, although, back pain is difficult to treat, it is treatable, in many cases. And I'd be happy to evaluate for those. I can be reached at info@drstebbing.com,  
where I'll send you two additional videos that give you more information on back pain. I hope this makes you feel a little bit more comfortable about coming in and seeing me. Thank you. Hi. This is Dr. Jennifer Stebbing. I'm so happy that you're looking at this video. This is a further informative video on back pain, and I'd like to talk to you about causes. There are many different causes for back pain. The most common cause is probably called mechanical back pain, and there is no x-ray changes with mechanical back pain. It's pain that's caused by movement, and for this reason we usually treat people with physical therapy, chiropractic, acupuncture, and other different types of modalities that are aimed at strengthening the core, which includes your abdominal muscles, part of your psoas, your multifidi in your back, and some of the other smaller muscles that help support it. 
 
Because the back has so many different bones in it, there's a lot of room for something to go wrong. On one hand it allows us to have the flexibility, so that we can bend over and bend backwards, side bend and rotate in a whole bunch of directions in the low back. This is an incredible advantage that we have. However, because each of those areas moves, there's a potential injury at each attachment from one vertebrae to the next. The attachments, our joints are called facets and the facets can develop arthritis. When arthritis occurs, it is actually indication that the ligamentous structures that hold the spine together are a little bit lax. So what happens is you have additional movement from one vertebrae to the next, and this can cause the facets to widen as your body tries to stabilize it. 
 
Your body's very smart, it says, how can I make this a more stable joint? What I'm going to do is lay down calcium, make the joint wider. And when this happens, what can occur next is that it can make the space between the bones where the nerves exit the spine smaller, and this is called a foraminal stenosis. And when this happens, you can get pain that goes down into your butt or into your leg that is a result of the nerve being compressed. 
 
Additionally, if the disc is affected, meaning that the  ligamentous structures or these capsular structures that hold it in place are injured. For example, a whiplash injury or if your bio mechanics are such that over time you get an overuse injury that creates the disc to slide forward or backwards or partially to the side, the disc can cause compression near or onto the spinal column. And when that happens, you get a condition called spinal stenosis. 
 
All the literature suggests that if we wait, your body does a good job of trying to fix itself over the course of a year. But sometimes people in their haste to get out of pain, and in some cases, this may not be unwarranted, they pursue surgical options. And when this happens, depending on the type of surgery, you can get further decompensation of the spine over time. So understanding that there are different causes of pain in the spine is important and can be evaluated by MRI. 
 
When we talk about the different causes, then we direct treatment accordingly. For example, we know if the spine is stiff or tender with rotation one way or the other, we may have to use a little bit of manipulation to get that the facets so they're moving better. On the other hand, there may be some soft tissue injury. For example, an injury to the muscle that may cause pain right there, because the muscle then can't do its job properly. Under ultrasound we can sometimes see these defects or these areas where there's tears in the muscle or tears in the fascia, and we're able to treat those simultaneously. 
 
What do we treat these things with? And that's a great question, because sometimes the trigger points can easily be treated with an acupuncture dry needling. On the other hand, if the trigger point comes back again, it really suggests that the spine is hyper mobile and the muscle tightness that is occurring and the trigger points that are occurring are in direct response to try to stabilize that spine. In that case, prolotherapy or PRP can be used to help repair or heal the ligamentous structures or the capsular structures that surround the spine. And there are quite a few of them. For example, the supraspinous ligament can be injured with whiplash. Interspinous ligaments can also be injured with whiplash or any flexion or extension injury. The facet has a capsule around it. The capsules have pain fibers. The muscle itself can be injured, and there's ligamentous structures that we can treat on the backside of the spine. 
 
In addition, there's a huge role for physical therapy which is geared towards getting the back strong. I like massage. I love acupuncture. I like chiropractic. I'm an osteopath. I do manipulations, and we know that there is also probably a psychological cause of pain that can be treated at the same time. 
 
The thing about mechanical back pain is that if we don't treat it, the injury gets worse. So many times people will come in and say, oh yeah, I've had days where I'd lie on the ground for 24 hours and after that it gets better. What happens over time is that there are more days involved, it takes longer to recover, and you get more days lost from work. This is an ideal time to treat with prolotherapy. Once the disease has progressed more, then you start to get arthritic changes in the joint, and you may end up having more larger muscle tears and other things, in which case the PRP becomes really important in terms of treatment. 
 
If there's disc disease or if there's bone marrow changes and things like that, that's when stem cells and other higher level of options exist. And although I don't treat these specifically, I have colleagues across the country that I know that do a great job with treating disc disease. And I can help refer you to that if that's what you need. 
 
In the meantime, a very nutritious diet with lots of fruits and vegetables is important. Supplements such as vitamin D, lots of minerals, fish oil, and probably there's a role for glucosamine in there as well. It can help improve your healing. Obviously avoiding smoking and drinking alcohol plays a benefit in terms of your overall health. And exercise every day is really, really important. You don't have to run. You can do non weight bearing exercises if that's all you can tolerate, which includes pool work or exercise bicycle or an elliptical machine. You don't have to do weights. There are other ways to get your abdomen strong. 
 
The side effects to prolotherapy and PRP have to do with the anaesthetic and also where you are injected. You have to make sure that your needle is in the right place. And for that reason ultrasound is very important in terms of guiding treatment along the way. The following video is going to be about prolotherapy. And if you want additional information about PRP, there's a video on my website that you can look and get general information about that. Thank you for listening to the video. My website:  https://drstebbing.com Please email me at info@drstebbing.com if you have any further questions. Thank you.

Upper Body
– Greater Occipital Nerve
– Cervical Plexus
– Brachial Plexus
– Axillary Nerve Pain/Injury
– Suprascapular Nerve Pain/Injury
– Ulnar Nerve Entrapment or Injury
– Radial Nerve Entrapment or Injury
– Median Nerve Entrapment or Injury

Lower Body
– Superior Cluneal Nerve
– Iliohypogastric Nerve
– Ilioinguinal Nerve
– Lateral Femoral Cutaneous Nerve
– Femoral Nerve
– Sciatica
– Genital Femoral Nerve
– Saphaneous Nerve Injury
– Obturator Nerve Injury
– Peroneal Nerve Entrapment or Injury
– Tibial Nerve Entrapment or Injury

Pelvic Pain or Dysfunction

– Superior Cluneal Nerve
– Iliohypogastric Nerve
– Ilioinguinal Nerve
– Lateral Femoral Cutaneous Nerve
– Femoral Nerve
– Genital Femoral Nerve

Spine

Back pain, it's the most common type of musculoskeletal pain out there. It's debilitating, it prevents people from working, and it prevents them from participating in exercise, as well as all the activities of daily living. I'm here to tell you that it's treatable. In many cases, it's very easily treatable, and this is not just PT and acupuncture, or chiropractic. It's in addition to all these things. 
 
Hi, my name is Dr Jennifer Stebbing and I would like to talk to you about other alternatives to treating back pain. This includes prolotherapy and sometimes PRP. If your back pain is related to disk disease, or facet arthritis, or issues with the nerves coming out from the spaces between the bones. These are all potentially treatable. 
 
Some people do better, and some people don't do well at all. But I'm here to tell you, that I can assess these type of things and give you a reasonable way to maneuver through the medical system, so that you could get treated as best you can. 
 
I'm Dr Jennifer Stebbing. I'm border certified in Family practice and Sports Medicine. If you'd like to look at my website, it's drstebbing.com and I can be reached at info@drstebbing.com. Please reach out to me, I'd like to help you. 
Hi, I'm here to talk to you a bit more about back pain. There are reasons for back pain and the reasons behind the back pain can be anything from, for example, that you're out of alignment, or that you have trigger points, or that you have early arthritis, or you have scoliosis, or a leg length discrepancy that's causing a scoliosis. It's really important to evaluate all these things with x-rays, possibly MRI's and an ultrasound that I can do in the office. This helps us determine a more complete idea of why you're having pain. Sometimes the x-ray findings, if you just rely on them, will lead you astray, because they may not be the cause of your pain. 
 
I'm Dr. Jennifer Stebbing. I'm an Osteopathic Family Physician with a Board Certification in Sports Medicine and I use all different types of modalities to evaluate and treat back pain. I'm here to tell you that you can get back to work, you can get back to exercise, as we evaluate you more thoroughly with some diagnostic imaging that's available. If you'd like some more information, you can look at my website, drstebbing.com, or email me info@drstebbing.com 
Hi. I'm here to talk to you a little bit more about back pain. There are reasons for back pain. And the reasons behind the back pain can be anything from for example that you're out of alignment, or that you have trigger points, or that you have early arthritis, or you have the scoliosis, or a leg length discrepancy that's calling a scoliosis. 
 
It's really important to evaluate all these things with X-rays, possibly MRIs, and an ultrasound that I can do in the office. This helps us determine a more complete idea of why you're having pain. And sometimes the X-ray findings, if you just rely on them, will lead you astray, as they may not be the cause of your pain. 
 
I'm Dr. Jennifer Stebbing, I'm an osteopathic family physician with board certification in sports medicine. And I use all different types of modalities to evaluate and treat back pain. I'm here to tell you that you can get back to work, you can get back to exercise, as we evaluate you more thoroughly with some of the diagnostic imaging that's available.
 Hi. I'm here to talk to you a little bit more about back pain. There are reasons for back pain. And the reasons behind the back pain can be anything from for example that you're out of alignment, or that you have trigger points, or that you have early arthritis, or you have the scoliosis, or a leg length discrepancy that's calling a scoliosis. 
 
It's really important to evaluate all these things with X-rays, possibly MRIs, and an ultrasound that I can do in the office. This helps us determine a more complete idea of why you're having pain. And sometimes the X-ray findings, if you just rely on them, will lead you astray, as they may not be the cause of your pain. 
 
I'm Dr. Jennifer Stebbing, I'm an osteopathic family physician with board certification in sports medicine. And I use all different types of modalities to evaluate and treat back pain. I'm here to tell you that you can get back to work, you can get back to exercise, as we evaluate you more thoroughly with some of the diagnostic imaging that's available. 
 
If you'd like some more information, you can look at my website, drstebbing.com, or email me at info@drstebbing.com, and I will send you two more videos, from which you can get more information to help you feel comfortable about coming in to see me. Hi. Do you have pain going down your legs that you think is coming from your back? Sometimes this is a sign of nerve damage, or nerve compression, or an issue where the nerves exit at the spinal column. But it can also be indicative of a ligamentous referral pattern. There's other referral patterns like sclero patterns and trigger points have referral patterns, as well. Referral patterns are simply where you receive pain, but the pain may be coming from something else. It's really nice to have a doctor that can evaluate you in terms of these different pain patterns because it can change your pain drastically if the reason behind it is evaluated and treated appropriately. 
 
I'm Dr. Jennifer Stebbing. I'm Board Certified in Family Practice and Sports Medicine. I'm here to tell you that, although, back pain is difficult to treat, it is treatable, in many cases. And I'd be happy to evaluate for those. I can be reached at info@drstebbing.com,  
where I'll send you two additional videos that give you more information on back pain. I hope this makes you feel a little bit more comfortable about coming in and seeing me. Thank you.

Neck Pain
– Whiplash
– TMJ Pain or Bite Issues
– Degeneration
– Facet Issues or Arthritis
– Headaches referred from Neck
– Cracking, Tightness
– Cervical Plexus Pain-from nerves in the neck that radiate into head, ear, face
– Brachial Plexus Pain- nerves in the neck that lead to pain, numbness, tingling into the arm
– Mid Back Pain
– Rib Pain
– Low Back Pain
– Facet Issues or Arthritis
– Spondylolithesis
– Tightness
– Recurrent Back Pain, especially with a relatively normal MRI
– Stenosis- treated closely with another like minded physician
– Sciatica
– Whiplash
– Scoliosis

Sacroiliac or Pelvic Pain
– Instability
– Leg  Length Discrepancy that doesn’t hold with repeatd adjustments
– Pain after pregnancy
– Night time pain
– Trouble standing up straight
– Nerve Pain
– Abdominal Wall Pain
– Scar Pain

Knee, Ankle, & Foot

Hi, today we're going to talk about ankles. The most common ankle injuries is the outside of the ankle, we call this the lateral ankle. The fibula makes up the outside part of the ankle, the widest portion of the bone, and it has three ligaments that attach to the ankle, one here, one here, and one back here. When you have an ankle sprain, what happens is everything opens up like this and sometimes it goes back into the proper alignment and sometimes it just always remains loose. When that happens, we call that a chronic ankle sprain. People who have chronic ankle sprains, will typically re-sprain that ankle over and over again or have a weakness or instability at the foot. 
 
We use prolotherapy to treat at the attachments, the attachments are usually where the ligamentous injury occurs, and then we treat into the joint as needed. Sometimes we treat this joint as well, they can all be injured in an ankle sprain. A high ankle sprain is when the injury occurs into this area right here, this is the interosseous ligament, and what happens with a high ankle sprain is that the entire complex right here, this and this, splits open. This is the most severe injury, it hurts a lot and usually the athlete can't go back into sport for a while. The treatment again, is prolotherapy or PRP right into the ligament as well as the ligaments down here. Hi, I'm Dr. Jennifer Stebbing, I'm a sports medicine physician and I treat ankle sprains very commonly. Thanks. 
Hi. Today we're going to talk about plantar fascia pain. 
 
The plantar fascia is tissue that is not muscle and it's not tendon, but it forms a bridge on the bottom of the foot. The plantar fascia can be injured in a number of ways. Usually it has to do with the way that people's feet are structured, and it can also have something to do with the way that the ankle hits the ground or an it can be either improved or worsened by shoe wear. There's a lot of reasons for it and there's lots of different ways to treat it. 
 
The typical algorithm that I was taught initially included using a brace, night splints, steroid injections to the area and sometimes a walking boot. There's a lot of different things that have worked for people. And when all these things fail, there's two things that I think about. One is, was the diagnosis really plantar fasciitis. And number two, is there a tear or something else going on in the plantar fascia and that's the reason why it's not healing? 
 
The way that we evaluate plantar fascia is by ultrasound. We put the ultrasound on here. There's two different fibers or trajectories of the fiber here. Sometimes the injury can be in one fiber, which the inside one is the most common. The other is the outside and that's less common, but there can be an injury there so it's worth evaluating by ultrasound. We look at the ultrasound both lengthwise this way and also widthwise. 
 
If there is an injury, what we term as plantar fasciosis or an enthesopathy, it's a chronic injury where there's a loss of blood supply to the area. When that occurs the whole thing looks thickened. There are occasions where there's a tear in there and you'll see some fluid or a change in the thickness of the tissue, meaning it gets thinner or you stop seeing the tissue at its attachment by ultrasound. 
 
The other thing that can be involved in what appears to be heel pain at the bottom of the foot is that there's a nerve that comes around the ankle ... it comes around down here and it comes into here ... and it can be injured. Sometimes a scar can do that. Sometimes shoe wear can do that, but it can present just like plantar fasciitis. 
 
I typically will say, the first thing that we need to do is look or examine the area. The second thing we need to do is evaluate by ultrasound to see if the plantar fascia is the normal size or not. And if it is the normal size, then we can't call it a plantar fasciitis or plantar fasciosis or an enthesopathy, we have to think about the nerve as being the injury or the culprit. 
 
The treatment, if it's a nerve, is nerve hydro-dissection. You can look at that in my website, neural prolotherapy to the area. 
 
The other misnomer that occurs here is that there's a spur. People will tell you that the spur is the injury. The spur is a consequence to tight plantar fascia. So if there's a spur ... so the spur is a growth of bone that comes out in that direction ... the bone grows along the line of stress. So calcium gets deposited along the line of stress. That's a cardinal rule that has happened over and over again and what we noticed in arthritis. So we have to think about that as being a line of stress. It just tells us that there's a long term injury there. 
 
The most important thing about the success of the treatment, whether you do any type of injection treatment, is the alignment of the calcaneus or the heel bone afterwards. There's a role for orthotics, there's a role for some of the other things that go into it, as well as retraining the foot with physical therapy. 
 
Thanks. My name is Dr. Jennifer Stebbing. I'm a sports medicine physician who specialize in regenerative orthopedic procedures. Please contact me if you have any other questions. Thank you. 
Hi, today we're gonna talk about Achilles injuries. The Achilles tendon, tendons attach muscles to bone, it's comprised of two muscles, the Gastroc and the Soleus muscle, which both attach or come together and attach to the Calcaneus.  
 
When you have an Achilles injury, it hurts to put on shoes, snow boots, ski boots and the like because there's a compression right at the area that hurts. The tendon itself can become swollen, it can become enlarged, and it's very tender to touch, and anything that stretches the tendon, disposition of the foot, irritates it.  
 
In most cases, what you do first, is go to physical therapy, and they do exercises called eccentric contraction, where they lengthen the muscle tendon complex. You can do this at home too, you start off with simply standing on a broomstick. So you put your toes on the broomstick and you kind of let your heels sink down to the floor, and that can be an easy way to start off the stretch into the Achilles. However, the caveat to this, is that your position of your foot has to be in neutral position. So if you supinate your foot or you pronate your foot, so pronators lose their arch, supinators have a really high arch, and if you do one or the other of those and your foot, your ankle position isn't in neutral, you can actually make the injury worse.  
 
So some of the other treatments for Achilles tendon, include night splints, orthotics, good shoe wear, stretching exercises, trigger point releases, occasionally I can also treat with a nerve, to the nerve to regularize.  
 
But if all those things fail, you can move on to the regenerative medicine treatment, and this includes prolotherapy and PRP, and the treatment can occur either right at the attached main large tendon, which is called enthesopathy. Or it can happen into the middle portion of the tendon.  
 
The reason why the middle portion is injured, so this is the tendon sits right over the backside of the joint, so here's the ankle joint, it's upside down just cause I have the skeleton backwards, is because the blood supply to the tendon is compromised. You can usually get the blood supply down the muscle to the tendon or you can get it from the heel bone up into the muscle and so there's an area that doesn't get good blood supply and this is called a water shed area and this is the reason why the Achilles is at a high risk for injury than other tendons.  
 
So you can use prolotherapy or PRP, and its usually just one injection of PRP, to help restore the blood supply to the tendon and then it heals from there. There are other issues that can come into play with tendonopathies, which I'm happy to review if they are involved in your case.  
 
My name is Dr. Jennifer Stebbing, I'm a sports medicine physician that specializes in regenerative orthopedics. Please get in touch with me if you have any other questions. Thank you.

Arthritis
– Knee Cap Pain or Patellar Femoral Tracking issues
– Meniscus Injuries
– Medial Collateral Ligament Injuries
– Lateral Collateral Ligament Injuries
– Pes anserine Pain- pain under the joint at the top of the tibia
– Joint Effusion (Fluid on the Knee)
– Tibia-Fibula Joint Pain or movement (outside of the knee)
– Saphaneous Nerve Injury
– Obturator Nerve Injury
– Knee hypermobility
– Dislocations after the joint has been re– placed in correct position
– Scar and Pain after Surgery 

Foot & Ankle
– Ankle & Toes Arthritis
– Bunions
– Chronic Ankle Sprains & Instability
– Peroneal Tendinitis or Tendinopathy
– Plantar Fasciitis
– Tibia Nerve Entrapment
– Peroneal Nerve Entrapment
– Plantar Fasciitis or other foot pain
– Scar pain
– Continued pain after surgery


Shoulder

 I'd like to talk to you about shoulder pain. In this case, we're going to be talking about the rotator cuff. What is the rotator cuff, people ask. The rotator cuff consists of four tendons and muscles that attach right to the humerus, which is the arm bone. There's two on the back side, there's one that comes and travels underneath this bone, and there's a fourth that comes along the front side.  
 
All of them attach to the top of the humerus and are responsible for the small movements in the arm, the little movements. If they get injured, the shoulder does not work quite right, and you end up using larger muscles like the trapezius to help move your arm. That's a coordination pattern that we don't really want and can further injure the rotator cuff. 
 
The rotator cuff, when it gets injured, the most common muscle that is injured in muscle tendon complex is the supraspinatus, and that's because it comes under this bone. So as you move your arm up into space, what happens is if your arm movement isn't correct, this happens. This is called impingement, and if you get impingement and motion, you get this grinding sensation that happens onto the muscle, and it tears. 
 
Now the question is, what do you do if it tears? Many of us have small tears, and do they heal? The answer is yes. They do heal. The question then becomes, well when do you pursue treatment, and is surgery necessary? The answer is says is depends. I suspect that when you have an injury, my thought is that you should be a little bit more aggressive about treating it. Go ahead and at least see a physical therapist who can help correct some of the movement problems that can occur when you have an injury and prevent further injury from happening. 
 
There's a role for massage. There's a role for acupuncture, and there's some chiropractors who can help with that muscle tension. I'm an osteopath. I use OMT, or osteopathic manipulation to treat these areas and try to get them to calm down. However, if the discomfort or the pain persists, and the pain usually happens right where the tendon attaches, and it can radiate down the arm. Sometimes it's found right here, and it occurs with small movements. You know, lifting that arm, or reaching, lifting your arm that way, and in which case, some regenerative treatments may be beneficial, and by that I mean prolotherapy or PRP.  
 
So if you have a rotator cuff injury, I suggest that you get it evaluated, at least by a physical therapist, and if not by a physician, on the earlier side so that you know what you're dealing with
I'd like to talk to you about labral tears today. 
Labral tears are cartilage. They occur on the most inside portion of the shoulder. This is the humerus, or the arm bone, and this is called the glenoid. 
 
The glenoid is the bone that's right inside, and it has a layer of cartilage that helps make the joint a little bit wider so that the humerus, which is a ball on a plate, which is called the glenoid, has a little bit of a curvature to help guide the motion inside it. 
 
The labrum, at least the upper portion, is where part of the capsule in the biceps tendon attaches to.The injury there can be kind of debilitating and can give you a sense of weakness in the arm with lifting things. 
 
What I can tell you is that this is not necessarily a surgical treatment. 
 
We can use  prolotherapy. Sometimes we can use PRP to help strengthen the capsule.And you can recover much quicker, and without a scar, or any surgical complications. 
 
Contact me at info@drstebbing.com, or at drstebbing.com and I'd be happy to give you more information about this.
You know those people that are double jointed. They can take their thumb and bring it down to their forearm or when they straighten their arm it goes past 180 degrees. Or they used to be able to do party tricks where they could bring their leg behind their neck. Those people are hyper mobile. They are great gymnast. It sets them up for being quite a good dancer, ice skater. But they are also more prone to ligamentous injuries. And one of the ligamentous injuries that can happen is at the shoulder. It can become loose. 
 
And what can occur after that is they can get rotator cuff injuries or they can get bicep injuries. They can get other injuries in the shoulder. But the underlying background behind the injury is a loose capsule. And the capsule is something that attaches around the whole shoulder. It's loose on the underside, back down here. So that allows you to bring that shoulder all the way above your head.  
 
There's a redundancy down below, and on occasion that area gets stretched out. This also happens in throwing athletes, for example, tennis players and volleyball players and anybody who uses their arm above their head. 
 
What I can tell you is that even if you have a rotator cuff injury, something right here, and it gets treated with surgery, you haven't treated the underlying cause. And this can be treated before surgery, after surgery and maybe depending on the other injury, instead of surgery. Prolotherapy or PRP can both be used to treat ligamentous laxity or capsular laxity in hyper mobile people. 
 
My name is Dr. Jennifer Stebbing, and I'd love to be able to have a conversation with you and talk to you more about your injury. I can be reached at info@drstebbing.com, you can contact me through my website at drstebbing.com. I'm here to help you. Thank you.

– Arthritis
– Rotator Cuff Tears
– Labral Tears
– Bicep Tendinitis or Tendinopathy
– SLAP Tears
– Acromial Clavicular Joint Arthritis (AC Joint)
– Glenohumeral Instability
– Frozen Shoulder
– Axillary Nerve Pain/Injury (pain or weakness in the upper arm)
– Suprascapular Nerve Pain/Injury (scapula or wing bone pain or weakness)
Hypermobile or Unstable Joints (shoulder clicks or pops)
– Sternal-clavicular instability or pain
– Tightness
– Scar pain
– Posture related injury (shoulder forward)
– Muscle imbalance (common with weight lifters who concentrate on pecs and forget about lats)
– Rib – Shoulder Blade pain or tightness
– Shoulder Dislocations after shoulder has been put back into place.
– Continued pain after surgery

Hip

- Hi, today we're gonna talk about hips. In hip arthritis the issue is, is that there's been some sort of problem that has been longstanding. Although you could have a hereditary cause for this as well, where the joint is unstable. And it just moves a little bit too much and it causes excess bone growth. Right here, or around the entire 360 degrees around it. And it leads to x-ray changes. The x-ray changes, along with cartilage that lines the inside of the joint, we call this articular cartilage, can cause restrictions of motion in the joint, as well as pain with walking or standing on the joint. And typically, what people are told to do is get a steroid shot, do some physical therapy, and perhaps have a joint replacement. However, if you get treated on the early side of your hip pain, and you decide, "Hey, is there something more proactive that I could do?" There are other things like prolotherapy, PRP is the second tier, or stem cell, which is third tier, that can be used to help preserve the joint. We can't say that we use to cure it, because the FDA does not allow us to say that. But we can help preserve the joint for a longer period of time. And perhaps even abate the need for a joint replacement. The key with treatment of any type of joint is that if you just put the medicine, whatever your injecting, inside the joint right here, with is a really small space. That may not be enough to treat it. The entire joint is covered with a capsule, and it extends down around 360 degrees around it. In addition to the capsule, or as part of the capsule, are these ligamentous structures, which come up and support the front and the back side of the joint. And sometimes the issue with the whole problem of the joint, when it's unstable and not able to rotate in the joint correctly, is that the ligaments have been injured in the past. So this is where the whole concept of prolotherapy came from. And the goals with treating prolotherapy are to treat the structures surrounding the joint, including the capsule, the ligaments, some of the tendons, that can cause injury. Or that have been injured and may have led to the development of arthritis. So for example here's an attachment, where a couple of your muscles attached to. Here's another one. This whole area is where your adductor muscles can attach to. On the back side, there's some other areas where the adductor muscles can attach to. The capsule comes around into here. There's a lot of ligamentous structures that attach to the back side of the hip here too. All of those areas need to be treated. And if they're not all fully treated, then you get incomplete treatment if you're getting PRP or prolotherapy. If your disease is more advanced and you need stem cells, there are a few things that we use to augment that. And we can talk about that if you're a candidate. Usually, stem cell's reserved for a more advanced disease. I'm Dr. Jennifer Stebbing. I'm a sports medicine, regenerative medicine doctor, physician. And I'm happy to help you with any other questions you have. Please see my website, drstebbing.com, and you can book a 15-minute free consultation, if you're interested, thanks.
- Hi, I'm going to talk about labral tears today. Labral tears are a frequent cause of discussion as a reason or the consequence of joint pain. I'm not always sure if the labral tear is the cause of pain, even if it does show up on MRI. But in some cases, it truly is an issue, and my concern with surgically removing it is we change the architecture of the joint. The labrum attaches right to the outside of the acetabulum. The acetabulum is the socket of the joint. This is the ball. So it attaches all the way around the outside of it. It's a fibrocartilage, and its goal is to help continue this rounded architecture of the joint to help that, the ball, sit well in the socket. There are certain circumstances where the labrum is more frequently injured, and there are a lot of people that have injured labrums that don't have pain. They've been in some studies done with that. The big point here to take home is that labral tears, although present, may not be the actual cause of your pain. And even if they are, they can be treated non-surgically. The two treatment options that I do frequently for hips with labral tears are PRP first to the ligament and structures and prolotherapy to the actual labrum and tears. You can sometimes use stem cells also if it's a large tear. But in general, the labral tears can be treated non-surgically with regenerative orthopedic injection therapy. I'm Dr. Jennifer Stebbing. I'm a sports medicine physician with a specialty in regenerative orthopedics. Please contact me if you have any other questions.
- Hi, today I'd like to talk to you about the back side of the hip. Many times, people have discomfort at the widest portion of their hip. This is called the greater trochanter. It is where there's a lot of attachments of muscles to bone, so their tendon attachments all attach right here and this is really important for the stability of the hip. The most common big muscle attachments there are the glute minimus and the glute medius, which both come in and attach to this portion of the greater trochanter. People can get, have pain right there, and it's related to an injury from these muscle/tendon complexes. Additionally, there are other tendons, that are really important for hip stabilization. There's the obturator internus complex, which includes the gemelli, obturator internus, so both the gemelli, superior gemelli and the inferior gemelli, as well as the obturator internus and they attach down below to the back side right here. And they help control hip motion and it's kind of like a rotator cuff that normally we talk about in the shoulder of the hip. These are one of the important muscles for that. The other one is piriformis. There's a lot of discussion about piriformis, it's the reason behind sciatic nerve injuries. This is the sciatic nerve and the piriformis runs right above it. Sometimes the sciatic nerve runs right through it. Sometimes there's other variations of it, like the sciatic nerve is in two different bundles and one comes through it and one comes under it. In any case, the piriformis can become inflamed with that or it can injured separately and it can create a disturbance to the sciatic nerve. All these tendons can be evaluated with ultrasound and then be treated with some of the regenerative medicine treatments, which include prolotherapy and PRP. Many times, in my initial career as a sports medicine doctor, we talked about a bursa being the injury pattern here. The bursa is a collection of fluid. It runs between a tendon and the bone or the tendon and another tendon and it kind of helps cushion it. And we were told that any type of pain right here was a bursitis. We now know with ultrasound, that's not always the case and although sometimes I do see a collection of fluid and you can call it a bursa or a bursitis, typically there isn't anything there and it's actually a tendon attachment problem. In those situations, a steroid would weaken the tendon so you don't want that, which is the typical treatment when you are diagnosed with a bursitis. So consider prolotherapy or PRP for treatment of your hip pain, that many people refer to as on the outside of their widest portion of their joint. I'm Dr. Jennifer Stebbing, I'm a Sports Medicine Physician. I have a specialty in regenerative orthopedics and I'm here to help answer your questions, please contact me, thanks.

– Arthritis
– Labral Tears
– Greater Trochanter Pain-pain on the widest part of the hip, noted with laying on it
– Leg Length Discrepancy
– Cam & Pincer Deformity (congenital, from birth)
– Piriformis
– Psoas Tendinopathy
– Quadriceps Tendinopathy
– Gluteus medius, Gluteus minimus – Tendinopathy- weakness with standing on one leg
– Adductor Tendinosis
– Quadricep Tears, Tendinosis
– Hamstring Tears, Tendinosis
– Lateral Femoral Nerve Entrapment/ Injury
– Femoral Nerve
– Groin Pain or Numbness
– Numbness & Tingling of the Thigh or Groin
– Joint Hypermobility (gymnasts, dancers, performance ice skaters)

Elbow, Wrist & Hand


Elbow & Wrist
– Arthritis of Elbow, Wrist, Hand, Thumb, & Fingers
– Medial Epicodylitis or Epicondylosis (Golfer’s Elbow)
– Lateral Epicondylitis or Epicondylosis (Tennis Elbow)
– Ulnar Collateral Ligament Injury (Little League Elbow)
– Triceps tendinitis or tendinopathy
– Ulnar Nerve Entrapment or Injury
– Radial Nerve Entrapment or Injury
– Median Nerve Entrapment or Injury
– Joint Hypermobility

Wrist & Hand
– DeQuervain’s Tenosynovitis
– Trigger Finger
– Finger Joint Pain
– Dupytren’s Contracture
– Carpal Tunnel Syndrome
– Radial Tunnel Syndrome
– Ulnar Collateral Ligament Injury (Game Keeper’s or Skier’s Thumb)
– Joint Hypermobility or Instability

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