Frequently Asked Questions

 

What are your business hours?


Our practice hours are from 8:00am to 5:00pm, Monday through Friday.




What is your contact phone number?


(02) 4229 9116




What is your practice location?


Practice Location 54 Princes Hwy West Wollongong NSW 2500 Current Appointments Wollongong Hospital
Loftus St (main entrance)
Wollongong 2521 02 4222 5000 Shellharbour Hospital 15-17 Madigan Boulevarde Mt Warrigal 2528 02 4295 2500




Who do I call for appointments?


For all appointments and enquiries, please contact us on (02) 4229 9116.

Our practice hours are from 8am to 5pm Monday to Friday (excepting public holidays). Or request an appointment here




Where do I park for appointments?


Free parking is available onsite via the practice driveway off London Drive.




What if I need to cancel an appointment?


Telephone the office during business hours and allow at least 1 days’ notice so that we can offer your appointment time to patients on our waiting list.




What should I bring with me when I come for an appointment?


When you come for your appointment remember to bring the following:

  • Driver’s License or a valid ID
  • Insurance information
  • Referral Letter (if required)
  • Reports, X-Rays, MRI’s, CT scans and any other relevant medical information
  • List of medications (if any)




Does Dr Bhimani usually run on time?


We recognise that your time is valuable, and we make every effort to run on time. Occasionally emergencies or patients require a little more time, and these cause scheduling delays beyond our control. We apologise if we keep you waiting.




Should I make an appointment?


  • Do you have pain in your knees, hip or groin?
  • Is the pain restricting your daily activities?
  • Is the pain not relieved on taking medications?
  • Do you have swollen knee?
  • Do you limp while walking?
  • Does pain makes you stop when you walk more than a few blocks?
  • Are you having pain when lying or sitting down?
  • Are you getting pain for about 3 to 4 days per week?
  • Do your knees hurt when climbing or descending stairs?
  • Do you feel pain when walking for long time?
  • Does pain disturbs your sleep?
  • Do you find difficult to put your socks and shoes?
  • Do you have a sensation of instability or the knee is going to give out when you are physically active?
  • Do you need crutches, cranes or walkers to help you while walking?
  • Do you have tightness or limited range of hip motion?
If your answer is yes to the any of these questions, you might be suffering from arthritis - a degenerative joint disease, and you should contact us to arrange a consultation.




What if I need imaging?


During your initial consultation Dr Bhimani may write you a referral letter for additional imaging. Please ask at the time of your image referral letter for an image centre which is located near you.




What can I do if am happy with the service I have received?


If you like the service we provide please spread the word! Like Us on Facebook or take a minute to provide an online review for Dr Bhimani via Google Reviews, Rate MD or Doctoralia.




Am I likely to require surgery?


Surgery is the right decision when patients have tried non-surgical options first but are still not coping. Dr Bhimani encourages patients to make the decision to have surgery based on how their condition is upsetting their quality of life, their level of pain and their loss of normal function.
As a dedicated orthopedic surgeon Dr Bhimani always make sure his patients fully understand their condition, the treatment options available to them, as well as any risks or potential complications of a particular treatment. However it is crucial that patients understand that the decision to have any kind of orthopedic surgery is always theirs to make.
Once Dr Bhimani understands your diagnosis, you can both plan and agree on a sensible and holistic approach to treatment and rehabilitation for your best long-term results. If you decide that surgery is necessary, then not only is our objective to reduce your pain and increase your mobility, but to also facilitate the earliest possible return to normal activity post-surgery.
To accomplish these objectives for patients Dr Bhimani is extremely dedicated to ensuring he is at the forefront of developments in hip and knee surgery to provide patients with the best possible orthopaedic care.




Will physical therapy be required after surgery?


Getting a full range of motion, strength and flexibility back after surgery usually takes time. That’s where pre-operative exercise and education and post-operative physical therapy programs help to ensure you're physically and emotionally prepared for surgery and to maximise your recovery after surgery.

Dr Bhimani will choose the least invasive surgical procedure suited to your condition to minimise your recovery period. Dr Bhimani will ensure you understand what procedure you are having, how to prepare for surgery and what recovery program you need to follow. Physiotherapy is an essential part of this education, preparation and recovery process and will help you obtain a better surgical outcome.




Does Dr Bhimani see public and private patients?


Yes, Dr Bhimani sees both private and public patients.




What are Dr Bhimani's fees?


The following is a guide to the fees charged by Dr Aziz Bhimani. Please do not hesitate to contact our staff on 02 4229 9116 if you require further information or assistance. Consultation Fees Each consultation attracts a fee which is reimbursed in part from Medicare. The consultation fee will be advised to you at the time of booking your appointment. Operation Fees If you require a surgical procedure a detailed itemised quote of Dr Bhimani & his surgical team’s fees will be provided up front as well as an estimate of out-of-pocket expenses. You will meet with your anaesthetist before your operation so that you can obtain an estimate of his/her fees also. Procedures vary in complexity, difficulty and duration and these are all factors that determine out-of- pocket expenses. Please check with your Private Health Insurer regarding whether an excess is payable to the hospital under your level of cover. Pensioners Dr Bhimani is a no-gap surgeon for pensioners. Worker Compensation​ If you have your claim number, your consultation and operation fees will be charged directly to your workers compensation insurer with no personal charge to you. Veteran's Affairs (DVA) If you have a valid DVA number, your consultation and operation fees will be charged directly to the Department of Veterans’ Affairs with no personal charge to you.





General

 

Acute Knee Clinic

What is Osteoarthritis?


Osteoarthritis, also known as "wear and tear" arthritis, occurs when the cartilage that cushions and protects the ends of your bones gradually wears away. This leads to pain and stiffness that worsens over time, making it difficult to do daily activities.
Osteoarthritis is the most common form of arthritis. It develops slowly and most often occurs during middle age.
Although there is no cure for osteoarthritis, there are many treatment options available to help manage pain and keep people staying active.




What causes Osteoarthritis?


With osteoarthritis, the articular cartilage that covers the ends of bones in the joints gradually wears away. Where there was once smooth articular cartilage that allowed the bones to glide easily against each other when the joint bent and straightened, there is now a frayed, rough surface. Joint motion along this exposed surface is painful.
Osteoarthritis usually develops after many years of use. It affects people who are middle-aged or older. Other risk factors for osteoarthritis include obesity, previous injury to the affected joint, and family history of osteoarthritis.




What are the symptoms of Osteoarthritis?


Osteoarthritis can affect any joint in the body including the joints of the spine. Symptoms may range from mild to disabling.
A joint affected by osteoarthritis may be painful and inflamed. Without cartilage, bones rub directly against each other as the joint moves. This causes the pain and inflammation. Pain or a dull ache develops gradually over time. Pain may be worse in the morning and feel better with activity. Vigorous activity may cause pain to flare up.
The joint may stiffen and look swollen, enlarged or "out of joint." A bump may develop over the joint. Joint movements such as bending, straightening and rotation may become more difficult and loss of motion may follow.
Loose fragments of cartilage can interfere with the smooth motion of a joint. The joint may lock or "stick." It may creak, click, snap, or make a grinding noise (crepitus). An arthritic joint may weaken and weight bearing joints such as a knee or ankle may buckle and give way.

Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.




How is Osteoarthritis diagnosed?


Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.
When you visit Dr Bhimani, a complete medical history, physical examination, x-rays, and possibly laboratory tests will be done.
Medical History
Dr Bhimani will want to know if the joint has ever been injured. Dr Bhimani will want to know when the joint pain began and the nature of the pain. Is the pain continuous, or does it come and go? Does it occur in other parts of the body? Is it worse at night? Does it occur only with activity or at rest as well?
Physical Examination
Dr Bhimani will then examine the affected joint in various positions to see if there is pain or
restricted motion. Dr Bhimani will look for creaking or grinding noises (crepitus) that indicate bone-on-bone friction. muscle loss (atrophy), and signs that other joints are involved. Dr Bhimani will look for signs of injury to muscles, tendons, and ligaments.

X-rays
X-rays can show the extent of joint deterioration, including narrowing of joint space, thinning or erosion of bone, excess fluid in the joint, and bone spurs or other abnormalities. They can help Dr Bhimani distinguish various forms of arthritis.
Laboratory Tests
Sometimes laboratory tests, such as blood tests, can help rule out other diseases that cause
symptoms similar to osteoarthritis.




What are non-surgical treatments?


Early, nonsurgical treatment can help maintain joint mobility, improve strength, and relieve pain. Most treatment programs combine lifestyle modifications, medication, and physical therapy.
Lifestyle Changes
Dr Bhimani may recommend rest or a change in activities to avoid provoking osteoarthritis pain. This may include modifications in work or sports activities. It may mean switching from high-impact activities (such as aerobics, running, jumping, or competitive sports) to low-impact exercises (such as stretching, walking, swimming, or cycling). A weight loss program may be recommended, if needed, particularly if osteoarthritis affects weight-bearing joints (such as the knee, hip, spine, or ankle)
Medications
Non-steroidal anti-inflammatory drugs can help reduce inflammation. Sometimes, Dr Bhimani may recommend strong anti-inflammatory agents called corticosteroids, which are injected directly into the joint. Corticosteroids provide short term relief of pain and swelling.
Dietary supplements called glucosamine and chondroitin sulfate may help relieve pain from
osteoarthritis.

Physical Therapy
A balanced fitness program, physical therapy, and/or occupational therapy may improve flexibility, increase range of motion, reduce pain, and strengthen the joint. Supportive or assistive devices (such as a brace, splint, elastic bandage, cane, crutches, or walker) may be needed. Ice or heat may need to be applied to the affected joint for short periods, several times a day.




What are surgical treatments?


If early treatments do not stop the pain or if they lose their effectiveness, surgery may be
considered. The decision to treat surgically depends upon the age and activity level of the patient, he condition of the affected joint, and the extent to which osteoarthritis has progressed. Surgical options for osteoarthritis include arthroscopy, osteotomy, joint fusion, and joint replacement.

Arthroscopy
Dr Bhimani uses a pencil-sized, flexible, fiberoptic instrument (arthroscope) to make two or three small incisions to remove bone spurs, cysts, damaged lining, or loose fragments in the joint.
Osteotomy
The long bones of the arm or leg are realigned to take pressure off of the joint.
Joint replacement
Dr Bhimani removes parts of the bones and creates an artificial joint with metal or plastic
components (total joint replacement or arthroplasty).





 

Non-surgical treatment

What are your business hours?


Our practice hours are from 8:00am to 5:00pm, Monday through Friday.




What is your contact phone number?


(02) 4229 9116




What is your practice location?


Practice Location 54 Princes Hwy West Wollongong NSW 2500 Current Appointments Wollongong Hospital
Loftus St (main entrance)
Wollongong 2521 02 4222 5000 Shellharbour Hospital 15-17 Madigan Boulevarde Mt Warrigal 2528 02 4295 2500




Who do I call for appointments?


For all appointments and enquiries, please contact us on (02) 4229 9116.

Our practice hours are from 8am to 5pm Monday to Friday (excepting public holidays). Or request an appointment here




Where do I park for appointments?


Free parking is available onsite via the practice driveway off London Drive.




What if I need to cancel an appointment?


Telephone the office during business hours and allow at least 1 days’ notice so that we can offer your appointment time to patients on our waiting list.




What should I bring with me when I come for an appointment?


When you come for your appointment remember to bring the following:

  • Driver’s License or a valid ID
  • Insurance information
  • Referral Letter (if required)
  • Reports, X-Rays, MRI’s, CT scans and any other relevant medical information
  • List of medications (if any)




Does Dr Bhimani usually run on time?


We recognise that your time is valuable, and we make every effort to run on time. Occasionally emergencies or patients require a little more time, and these cause scheduling delays beyond our control. We apologise if we keep you waiting.




Should I make an appointment?


  • Do you have pain in your knees, hip or groin?
  • Is the pain restricting your daily activities?
  • Is the pain not relieved on taking medications?
  • Do you have swollen knee?
  • Do you limp while walking?
  • Does pain makes you stop when you walk more than a few blocks?
  • Are you having pain when lying or sitting down?
  • Are you getting pain for about 3 to 4 days per week?
  • Do your knees hurt when climbing or descending stairs?
  • Do you feel pain when walking for long time?
  • Does pain disturbs your sleep?
  • Do you find difficult to put your socks and shoes?
  • Do you have a sensation of instability or the knee is going to give out when you are physically active?
  • Do you need crutches, cranes or walkers to help you while walking?
  • Do you have tightness or limited range of hip motion?
If your answer is yes to the any of these questions, you might be suffering from arthritis - a degenerative joint disease, and you should contact us to arrange a consultation.




What if I need imaging?


During your initial consultation Dr Bhimani may write you a referral letter for additional imaging. Please ask at the time of your image referral letter for an image centre which is located near you.




What can I do if am happy with the service I have received?


If you like the service we provide please spread the word! Like Us on Facebook or take a minute to provide an online review for Dr Bhimani via Google Reviews, Rate MD or Doctoralia.




Am I likely to require surgery?


Surgery is the right decision when patients have tried non-surgical options first but are still not coping. Dr Bhimani encourages patients to make the decision to have surgery based on how their condition is upsetting their quality of life, their level of pain and their loss of normal function.
As a dedicated orthopedic surgeon Dr Bhimani always make sure his patients fully understand their condition, the treatment options available to them, as well as any risks or potential complications of a particular treatment. However it is crucial that patients understand that the decision to have any kind of orthopedic surgery is always theirs to make.
Once Dr Bhimani understands your diagnosis, you can both plan and agree on a sensible and holistic approach to treatment and rehabilitation for your best long-term results. If you decide that surgery is necessary, then not only is our objective to reduce your pain and increase your mobility, but to also facilitate the earliest possible return to normal activity post-surgery.
To accomplish these objectives for patients Dr Bhimani is extremely dedicated to ensuring he is at the forefront of developments in hip and knee surgery to provide patients with the best possible orthopaedic care.




Will physical therapy be required after surgery?


Getting a full range of motion, strength and flexibility back after surgery usually takes time. That’s where pre-operative exercise and education and post-operative physical therapy programs help to ensure you're physically and emotionally prepared for surgery and to maximise your recovery after surgery.

Dr Bhimani will choose the least invasive surgical procedure suited to your condition to minimise your recovery period. Dr Bhimani will ensure you understand what procedure you are having, how to prepare for surgery and what recovery program you need to follow. Physiotherapy is an essential part of this education, preparation and recovery process and will help you obtain a better surgical outcome.




Does Dr Bhimani see public and private patients?


Yes, Dr Bhimani sees both private and public patients.




What are Dr Bhimani's fees?


The following is a guide to the fees charged by Dr Aziz Bhimani. Please do not hesitate to contact our staff on 02 4229 9116 if you require further information or assistance. Consultation Fees Each consultation attracts a fee which is reimbursed in part from Medicare. The consultation fee will be advised to you at the time of booking your appointment. Operation Fees If you require a surgical procedure a detailed itemised quote of Dr Bhimani & his surgical team’s fees will be provided up front as well as an estimate of out-of-pocket expenses. You will meet with your anaesthetist before your operation so that you can obtain an estimate of his/her fees also. Procedures vary in complexity, difficulty and duration and these are all factors that determine out-of- pocket expenses. Please check with your Private Health Insurer regarding whether an excess is payable to the hospital under your level of cover. Pensioners Dr Bhimani is a no-gap surgeon for pensioners. Worker Compensation​ If you have your claim number, your consultation and operation fees will be charged directly to your workers compensation insurer with no personal charge to you. Veteran's Affairs (DVA) If you have a valid DVA number, your consultation and operation fees will be charged directly to the Department of Veterans’ Affairs with no personal charge to you.





 

Preparing For Surgery

What is Osteoarthritis?


Osteoarthritis, also known as "wear and tear" arthritis, occurs when the cartilage that cushions and protects the ends of your bones gradually wears away. This leads to pain and stiffness that worsens over time, making it difficult to do daily activities.
Osteoarthritis is the most common form of arthritis. It develops slowly and most often occurs during middle age.
Although there is no cure for osteoarthritis, there are many treatment options available to help manage pain and keep people staying active.




What causes Osteoarthritis?


With osteoarthritis, the articular cartilage that covers the ends of bones in the joints gradually wears away. Where there was once smooth articular cartilage that allowed the bones to glide easily against each other when the joint bent and straightened, there is now a frayed, rough surface. Joint motion along this exposed surface is painful.
Osteoarthritis usually develops after many years of use. It affects people who are middle-aged or older. Other risk factors for osteoarthritis include obesity, previous injury to the affected joint, and family history of osteoarthritis.




What are the symptoms of Osteoarthritis?


Osteoarthritis can affect any joint in the body including the joints of the spine. Symptoms may range from mild to disabling.
A joint affected by osteoarthritis may be painful and inflamed. Without cartilage, bones rub directly against each other as the joint moves. This causes the pain and inflammation. Pain or a dull ache develops gradually over time. Pain may be worse in the morning and feel better with activity. Vigorous activity may cause pain to flare up.
The joint may stiffen and look swollen, enlarged or "out of joint." A bump may develop over the joint. Joint movements such as bending, straightening and rotation may become more difficult and loss of motion may follow.
Loose fragments of cartilage can interfere with the smooth motion of a joint. The joint may lock or "stick." It may creak, click, snap, or make a grinding noise (crepitus). An arthritic joint may weaken and weight bearing joints such as a knee or ankle may buckle and give way.

Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.




How is Osteoarthritis diagnosed?


Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.
When you visit Dr Bhimani, a complete medical history, physical examination, x-rays, and possibly laboratory tests will be done.
Medical History
Dr Bhimani will want to know if the joint has ever been injured. Dr Bhimani will want to know when the joint pain began and the nature of the pain. Is the pain continuous, or does it come and go? Does it occur in other parts of the body? Is it worse at night? Does it occur only with activity or at rest as well?
Physical Examination
Dr Bhimani will then examine the affected joint in various positions to see if there is pain or
restricted motion. Dr Bhimani will look for creaking or grinding noises (crepitus) that indicate bone-on-bone friction. muscle loss (atrophy), and signs that other joints are involved. Dr Bhimani will look for signs of injury to muscles, tendons, and ligaments.

X-rays
X-rays can show the extent of joint deterioration, including narrowing of joint space, thinning or erosion of bone, excess fluid in the joint, and bone spurs or other abnormalities. They can help Dr Bhimani distinguish various forms of arthritis.
Laboratory Tests
Sometimes laboratory tests, such as blood tests, can help rule out other diseases that cause
symptoms similar to osteoarthritis.




What are non-surgical treatments?


Early, nonsurgical treatment can help maintain joint mobility, improve strength, and relieve pain. Most treatment programs combine lifestyle modifications, medication, and physical therapy.
Lifestyle Changes
Dr Bhimani may recommend rest or a change in activities to avoid provoking osteoarthritis pain. This may include modifications in work or sports activities. It may mean switching from high-impact activities (such as aerobics, running, jumping, or competitive sports) to low-impact exercises (such as stretching, walking, swimming, or cycling). A weight loss program may be recommended, if needed, particularly if osteoarthritis affects weight-bearing joints (such as the knee, hip, spine, or ankle)
Medications
Non-steroidal anti-inflammatory drugs can help reduce inflammation. Sometimes, Dr Bhimani may recommend strong anti-inflammatory agents called corticosteroids, which are injected directly into the joint. Corticosteroids provide short term relief of pain and swelling.
Dietary supplements called glucosamine and chondroitin sulfate may help relieve pain from
osteoarthritis.

Physical Therapy
A balanced fitness program, physical therapy, and/or occupational therapy may improve flexibility, increase range of motion, reduce pain, and strengthen the joint. Supportive or assistive devices (such as a brace, splint, elastic bandage, cane, crutches, or walker) may be needed. Ice or heat may need to be applied to the affected joint for short periods, several times a day.




What are surgical treatments?


If early treatments do not stop the pain or if they lose their effectiveness, surgery may be
considered. The decision to treat surgically depends upon the age and activity level of the patient, he condition of the affected joint, and the extent to which osteoarthritis has progressed. Surgical options for osteoarthritis include arthroscopy, osteotomy, joint fusion, and joint replacement.

Arthroscopy
Dr Bhimani uses a pencil-sized, flexible, fiberoptic instrument (arthroscope) to make two or three small incisions to remove bone spurs, cysts, damaged lining, or loose fragments in the joint.
Osteotomy
The long bones of the arm or leg are realigned to take pressure off of the joint.
Joint replacement
Dr Bhimani removes parts of the bones and creates an artificial joint with metal or plastic
components (total joint replacement or arthroplasty).





 

Anaesthesia

What is Osteoarthritis?


Osteoarthritis, also known as "wear and tear" arthritis, occurs when the cartilage that cushions and protects the ends of your bones gradually wears away. This leads to pain and stiffness that worsens over time, making it difficult to do daily activities.
Osteoarthritis is the most common form of arthritis. It develops slowly and most often occurs during middle age.
Although there is no cure for osteoarthritis, there are many treatment options available to help manage pain and keep people staying active.




What causes Osteoarthritis?


With osteoarthritis, the articular cartilage that covers the ends of bones in the joints gradually wears away. Where there was once smooth articular cartilage that allowed the bones to glide easily against each other when the joint bent and straightened, there is now a frayed, rough surface. Joint motion along this exposed surface is painful.
Osteoarthritis usually develops after many years of use. It affects people who are middle-aged or older. Other risk factors for osteoarthritis include obesity, previous injury to the affected joint, and family history of osteoarthritis.




What are the symptoms of Osteoarthritis?


Osteoarthritis can affect any joint in the body including the joints of the spine. Symptoms may range from mild to disabling.
A joint affected by osteoarthritis may be painful and inflamed. Without cartilage, bones rub directly against each other as the joint moves. This causes the pain and inflammation. Pain or a dull ache develops gradually over time. Pain may be worse in the morning and feel better with activity. Vigorous activity may cause pain to flare up.
The joint may stiffen and look swollen, enlarged or "out of joint." A bump may develop over the joint. Joint movements such as bending, straightening and rotation may become more difficult and loss of motion may follow.
Loose fragments of cartilage can interfere with the smooth motion of a joint. The joint may lock or "stick." It may creak, click, snap, or make a grinding noise (crepitus). An arthritic joint may weaken and weight bearing joints such as a knee or ankle may buckle and give way.

Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.




How is Osteoarthritis diagnosed?


Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.
When you visit Dr Bhimani, a complete medical history, physical examination, x-rays, and possibly laboratory tests will be done.
Medical History
Dr Bhimani will want to know if the joint has ever been injured. Dr Bhimani will want to know when the joint pain began and the nature of the pain. Is the pain continuous, or does it come and go? Does it occur in other parts of the body? Is it worse at night? Does it occur only with activity or at rest as well?
Physical Examination
Dr Bhimani will then examine the affected joint in various positions to see if there is pain or
restricted motion. Dr Bhimani will look for creaking or grinding noises (crepitus) that indicate bone-on-bone friction. muscle loss (atrophy), and signs that other joints are involved. Dr Bhimani will look for signs of injury to muscles, tendons, and ligaments.

X-rays
X-rays can show the extent of joint deterioration, including narrowing of joint space, thinning or erosion of bone, excess fluid in the joint, and bone spurs or other abnormalities. They can help Dr Bhimani distinguish various forms of arthritis.
Laboratory Tests
Sometimes laboratory tests, such as blood tests, can help rule out other diseases that cause
symptoms similar to osteoarthritis.




What are non-surgical treatments?


Early, nonsurgical treatment can help maintain joint mobility, improve strength, and relieve pain. Most treatment programs combine lifestyle modifications, medication, and physical therapy.
Lifestyle Changes
Dr Bhimani may recommend rest or a change in activities to avoid provoking osteoarthritis pain. This may include modifications in work or sports activities. It may mean switching from high-impact activities (such as aerobics, running, jumping, or competitive sports) to low-impact exercises (such as stretching, walking, swimming, or cycling). A weight loss program may be recommended, if needed, particularly if osteoarthritis affects weight-bearing joints (such as the knee, hip, spine, or ankle)
Medications
Non-steroidal anti-inflammatory drugs can help reduce inflammation. Sometimes, Dr Bhimani may recommend strong anti-inflammatory agents called corticosteroids, which are injected directly into the joint. Corticosteroids provide short term relief of pain and swelling.
Dietary supplements called glucosamine and chondroitin sulfate may help relieve pain from
osteoarthritis.

Physical Therapy
A balanced fitness program, physical therapy, and/or occupational therapy may improve flexibility, increase range of motion, reduce pain, and strengthen the joint. Supportive or assistive devices (such as a brace, splint, elastic bandage, cane, crutches, or walker) may be needed. Ice or heat may need to be applied to the affected joint for short periods, several times a day.




What are surgical treatments?


If early treatments do not stop the pain or if they lose their effectiveness, surgery may be
considered. The decision to treat surgically depends upon the age and activity level of the patient, he condition of the affected joint, and the extent to which osteoarthritis has progressed. Surgical options for osteoarthritis include arthroscopy, osteotomy, joint fusion, and joint replacement.

Arthroscopy
Dr Bhimani uses a pencil-sized, flexible, fiberoptic instrument (arthroscope) to make two or three small incisions to remove bone spurs, cysts, damaged lining, or loose fragments in the joint.
Osteotomy
The long bones of the arm or leg are realigned to take pressure off of the joint.
Joint replacement
Dr Bhimani removes parts of the bones and creates an artificial joint with metal or plastic
components (total joint replacement or arthroplasty).





 

Post-operative CARE

What is Arthritis?


Arthritis is inflammation of one or more of your joints that causes pain and stiffness. While arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. Some of these include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, septic arthritis, and psoriatic arthritis.
While each of these conditions has different causes, the symptoms and treatment are often thesame. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee and hip.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep patients staying active.




What causes arthritis?


Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or may develop following an injury (post-traumatic arthritis).
Other types of arthritis, such as crystalline arthritis, may come from an inflammatory process.
Still others, such as rheumatoid arthritis or lupus arthritis, are the result of a systemic disease
throughout the body.

Regardless of whether the cause is from injury, normal wear and tear, or disease, the joint becomes inflamed, causing swelling, pain and stiffness. Inflammation is one of the body's normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability.




What is osteoarthritis?


The most common type of arthritis is osteoarthritis. Also known as "wear and tear" arthritis,
osteoarthritis occurs when the cartilage that cushions and protects the ends of your bones gradually wears away.

It results from overuse, trauma, or the natural degeneration of cartilage that occurs with aging.
Osteoarthritis is often more painful in joints that bear weight, such as the knee, hip, and spine. However, joints that are used extensively in work or sports, or joints that have been damaged by injury may show signs of osteoarthritis.
In many cases, bone growths called "spurs" develop at the edges of osteoarthritic joints. The bone can become hard and firm (sclerosis). The joint becomes inflamed, causing pain and swelling meaning continued use of the joint is painful.




What is rheumatoid arthritis?


Rheumatoid arthritis is a long-lasting disease. Rheumatoid arthritis affects many parts of the body, but mainly the joints. The body's immune system, which normally protects the body, begins to produce substances that attack the body. In rheumatoid arthritis, the joint lining swells, invade surrounding tissues. Chemical substances are produced that attack and destroy the joint surface.
Rheumatoid arthritis may affect both large and small joints in the body and also the spine. Swelling, pain, and stiffness usually develop, even when the joint is not used. In some circumstances, juvenile arthritis may cause similar symptoms in children.




What is post-traumatic arthritis?


Post-traumatic arthritis results from an injury to the joint. If a broken bone or fracture extends into a joint it will damage the smooth cartilage that covers the joint surfaces. The surface becomes uneven and causes friction as the joint moves. Over time, the joint breaks down and becomes arthritic.




What is septic arthritis?


Septic arthritis is an infection of the joint. Most often bacteria reach the joint through the
bloodstream from an infection in another part of the body, such as the urinary tract. Infected joints are typically warm, red, and acutely tender. They are often swollen due to pus in the joint. An infected joint often needs surgical drainage in addition to antibiotics.




What is psoriatic arthritis?


Psoriatic arthritis is associated with the skin disease psoriasis. While it may involve larger joints such as the knees it often presents with symptoms in smaller areas such as the distal joints at the tips of the fingers and toes.




What is gouty arthritis?


Gouty arthritis develops as the result of uric acid build up in the bloodstream. The uric acid forms crystals which cause acute inflammation in a joint. The big toe, ankle, knee, and elbow are the most common joints affected. A gout attack can be acutely painful. The inflamed joint becomes red and very sensitive to touch. Gout attacks are most often treated with medicine rather than surgery. Long term, many patients develop soft tissue masses (tophi) over the affected joints.




What is Lyme arthritis?


Lyme arthritis can be one of the side effects of Lyme disease, a systemic infection caused by a tick bite. Lyme arthritis can present acutely as pain and swelling in early stages of the disease. Lyme disease is treated with antibiotics. Left untreated, Lyme disease can lead to chronic arthritis.




What is Lupus arthritis?


Lupus is an autoimmune disease that affects multiple organs including the kidneys, skin, blood, and the heart. Lupus arthritis can be systemic and cause chronic pain in multiple joints.




What is Juvenile arthritis?


Juvenile arthritis is the most common type of arthritis in children. There are several types of the disease and most are different from rheumatoid arthritis in adults.




How is arthritis diagnosed?


Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. Some of the findings of arthritis include:

  • Weakness (atrophy) in the muscles
  • Tenderness to touch
  • Limited ability to move the joint passively (with assistance) and actively (without assistance)
  • Signs that multiple joints are painful or swollen (an indication of rheumatoid arthritis)
  • A grating feeling or sound (crepitus) with movement
  • Pain when pressure is placed on the joint or the joint is moved




How is arthritis treated?


There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause.




What are the non-surgical treatments of arthritis?


Medications Over-the- counter medications can be used to control pain and inflammation in the joints. These medications, called anti-inflammatory drugs, include aspirin, ibuprofen, and naproxen. Acetaminophen can be effective in controlling pain.
Prescription medications also are available. Dr Bhimani will choose a medication by taking into account the type of arthritis, its severity, and your general physical health. Patients with ulcers, asthma, kidney, or liver disease, for example, may not be able to safely take anti-inflammatory medications.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is
important to know that repeated, frequent injections into the same joint can cause damage and undesirable side effects.
Viscosupplementation or injection of hyaluronic acid preparations can also be helpful in lubricating the joint. This is typically performed in the knee. Exercise and therapy Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learningmethods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy may be used to decrease stiffness and to strengthen the weakened muscles around the joint.




What are the surgical treatments of arthritis?


In general, Dr Bhimani will perform surgery for arthritis when other methods of nonsurgical
treatment have failed to relieve pain and other symptoms. When deciding on the type of surgery, Dr Bhimani will take into account the type of arthritis, its severity, and your loss of normal function.

There are a number of surgical procedures. These include:

  • Removing the diseased or damaged joint lining
  • Realignment of the joints
  • Fusing the ends of the bones in the joint together, to prevent joint motion and relieve joint pain
  • Replacing the entire joint (total joint replacement)




How is arthritis managed long-term?


In most cases, persons with arthritis can continue to perform normal activities of daily living.
Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.

In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function.
Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.





 

Joint Replacement Surgery

What is ‘Joint Replacement Surgery’?


For more information visit: Knee or Hip
Hip joint and knee joint replacements are helping people of all ages live happier more active lives. Joints are formed by the ends of two or more bones connected by tissue called cartilage. Healthy cartilage serves as a protective cushion, allowing smooth, low-friction movement of the joint. If the cartilage becomes damaged by disease or injury, the tissues around the joint become inflamed, causing pain. With time, the cartilage wears away, allowing the rough edges of bone to rub against each other, causing more pain.
When only some of the joint is damaged, Dr Bhimani may be able to repair or replace just the damaged parts. When the entire joint is damaged, a total joint replacement is done. To replace a total hip or knee joint, Dr Bhimani removes the diseased or damaged parts and inserts artificial parts, called prostheses or implants.
Over the last several years hip and knee replacement has evolved to be a minimally invasive surgical technique for patients to undergo.
The advantages of always aiming for the most minimally invasive surgical technique are clear:

  • Less tissue trauma – muscles and tendons are avoided or separated when possible so as to
  • not be cut
  • Promotes faster and less painful recovery
  • Incisions are smaller and there is less scarring
  • Shorter time in hospital
  • Reduced blood loss and less need for pre-surgery blood donation
  • Faster return to work and normal activities




When Is A Joint Replacement Recommended?


Several conditions can cause joint pain and disability and lead patients to consider joint replacement surgery. In many cases, joint pain is caused by damage to the cartilage that lines the ends of the bones (articular cartilage)—either from arthritis, a fracture, or another condition.
If nonsurgical treatments like medications, physical therapy, and changes to your everyday activities do not relieve your pain and disability, your doctor may recommend total joint replacement.




How Do You Prepare For A Joint Replacement?


In the weeks before your surgery, your surgical team and primary care doctor will spend time
preparing you for your upcoming procedure. For example, your primary care doctor may check your general health, and Dr Bhimani may require several tests — such as blood tests and a cardiogram — to help plan your surgery.

There are also many things you can do to prepare. Talk to Dr Bhimani and ask questions. Prepare yourself physically by eating right and exercising. Take steps to manage your first weeks at home by arranging for help and obtaining assistive items, such as a shower bench, handrails, or a long- handled reacher. By planning ahead, you can help ensure a smooth surgery and speedy recovery. For a step-by- step guide to planning your joint replacement surgery:
Preparing for Joint Replacement Surgery





 

Arthroscopic Surgery

What are your business hours?


Our practice hours are from 8:00am to 5:00pm, Monday through Friday.




What is your contact phone number?


(02) 4229 9116




What is your practice location?


Practice Location 54 Princes Hwy West Wollongong NSW 2500 Current Appointments Wollongong Hospital
Loftus St (main entrance)
Wollongong 2521 02 4222 5000 Shellharbour Hospital 15-17 Madigan Boulevarde Mt Warrigal 2528 02 4295 2500




Who do I call for appointments?


For all appointments and enquiries, please contact us on (02) 4229 9116.

Our practice hours are from 8am to 5pm Monday to Friday (excepting public holidays). Or request an appointment here




Where do I park for appointments?


Free parking is available onsite via the practice driveway off London Drive.




What if I need to cancel an appointment?


Telephone the office during business hours and allow at least 1 days’ notice so that we can offer your appointment time to patients on our waiting list.




What should I bring with me when I come for an appointment?


When you come for your appointment remember to bring the following:

  • Driver’s License or a valid ID
  • Insurance information
  • Referral Letter (if required)
  • Reports, X-Rays, MRI’s, CT scans and any other relevant medical information
  • List of medications (if any)




Does Dr Bhimani usually run on time?


We recognise that your time is valuable, and we make every effort to run on time. Occasionally emergencies or patients require a little more time, and these cause scheduling delays beyond our control. We apologise if we keep you waiting.




Should I make an appointment?


  • Do you have pain in your knees, hip or groin?
  • Is the pain restricting your daily activities?
  • Is the pain not relieved on taking medications?
  • Do you have swollen knee?
  • Do you limp while walking?
  • Does pain makes you stop when you walk more than a few blocks?
  • Are you having pain when lying or sitting down?
  • Are you getting pain for about 3 to 4 days per week?
  • Do your knees hurt when climbing or descending stairs?
  • Do you feel pain when walking for long time?
  • Does pain disturbs your sleep?
  • Do you find difficult to put your socks and shoes?
  • Do you have a sensation of instability or the knee is going to give out when you are physically active?
  • Do you need crutches, cranes or walkers to help you while walking?
  • Do you have tightness or limited range of hip motion?
If your answer is yes to the any of these questions, you might be suffering from arthritis - a degenerative joint disease, and you should contact us to arrange a consultation.




What if I need imaging?


During your initial consultation Dr Bhimani may write you a referral letter for additional imaging. Please ask at the time of your image referral letter for an image centre which is located near you.




What can I do if am happy with the service I have received?


If you like the service we provide please spread the word! Like Us on Facebook or take a minute to provide an online review for Dr Bhimani via Google Reviews, Rate MD or Doctoralia.




Am I likely to require surgery?


Surgery is the right decision when patients have tried non-surgical options first but are still not coping. Dr Bhimani encourages patients to make the decision to have surgery based on how their condition is upsetting their quality of life, their level of pain and their loss of normal function.
As a dedicated orthopedic surgeon Dr Bhimani always make sure his patients fully understand their condition, the treatment options available to them, as well as any risks or potential complications of a particular treatment. However it is crucial that patients understand that the decision to have any kind of orthopedic surgery is always theirs to make.
Once Dr Bhimani understands your diagnosis, you can both plan and agree on a sensible and holistic approach to treatment and rehabilitation for your best long-term results. If you decide that surgery is necessary, then not only is our objective to reduce your pain and increase your mobility, but to also facilitate the earliest possible return to normal activity post-surgery.
To accomplish these objectives for patients Dr Bhimani is extremely dedicated to ensuring he is at the forefront of developments in hip and knee surgery to provide patients with the best possible orthopaedic care.




Will physical therapy be required after surgery?


Getting a full range of motion, strength and flexibility back after surgery usually takes time. That’s where pre-operative exercise and education and post-operative physical therapy programs help to ensure you're physically and emotionally prepared for surgery and to maximise your recovery after surgery.

Dr Bhimani will choose the least invasive surgical procedure suited to your condition to minimise your recovery period. Dr Bhimani will ensure you understand what procedure you are having, how to prepare for surgery and what recovery program you need to follow. Physiotherapy is an essential part of this education, preparation and recovery process and will help you obtain a better surgical outcome.




Does Dr Bhimani see public and private patients?


Yes, Dr Bhimani sees both private and public patients.




What are Dr Bhimani's fees?


The following is a guide to the fees charged by Dr Aziz Bhimani. Please do not hesitate to contact our staff on 02 4229 9116 if you require further information or assistance. Consultation Fees Each consultation attracts a fee which is reimbursed in part from Medicare. The consultation fee will be advised to you at the time of booking your appointment. Operation Fees If you require a surgical procedure a detailed itemised quote of Dr Bhimani & his surgical team’s fees will be provided up front as well as an estimate of out-of-pocket expenses. You will meet with your anaesthetist before your operation so that you can obtain an estimate of his/her fees also. Procedures vary in complexity, difficulty and duration and these are all factors that determine out-of- pocket expenses. Please check with your Private Health Insurer regarding whether an excess is payable to the hospital under your level of cover. Pensioners Dr Bhimani is a no-gap surgeon for pensioners. Worker Compensation​ If you have your claim number, your consultation and operation fees will be charged directly to your workers compensation insurer with no personal charge to you. Veteran's Affairs (DVA) If you have a valid DVA number, your consultation and operation fees will be charged directly to the Department of Veterans’ Affairs with no personal charge to you.





 

Anterior Cruciate Ligament (ACL) Injuries

What are anterior cruciate ligament injuries?


One of the most common knee injuries is an anterior cruciate ligament sprain or tear.

The anterior cruciate ligament is one of the major stabilizing ligaments in the knee. It is a strong rope like structure located in the centre of the knee running from the femur to the tibia.

When this ligament tears unfortunately it doesn’t heal and often leads to the feeling of instability in the knee.

About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.

Injured ligaments are considered "sprains" and are graded on a severity scale.




How is the injury severity scale graded?


Grade 1 Sprains: The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched, but is still able to help keep the knee joint stable.

Grade 2 Sprains: A Grade 2 Sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament.

Grade 3 Sprains: This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable.

Partial tears of the anterior cruciate ligament are rare; most ACL injuries are complete or near complete tears.




What are cruciate ligaments?


These are found inside your knee joint. They cross each other to form an "X" with the anterior cruciate ligament in front and the posterior cruciate ligament in back. The cruciate ligaments control the back and forth motion of your knee.

The anterior cruciate ligament runs diagonally in the middle of the knee. It prevents the tibia from sliding out in front of the femur, as well as provides rotational stability to the knee.




What causes cruciate ligament injuries?


The anterior cruciate ligament can be injured in several ways:

  • Changing direction rapidly
  • Stopping suddenly
  • Slowing down while running
  • Landing from a jump incorrectly
  • Direct contact or collision, such as a football tackle




What are the symptoms of anterior cruciate ligament injuries?


When you injure your anterior cruciate ligament, you might hear a "popping" noise and you may feel your knee give out from under you. Other typical symptoms include:

  • Pain with swelling: Within 24 hours, your knee will swell. If ignored, the swelling and pain may resolve on its own. However, if you attempt to return to sports, your knee will probably be unstable and you risk causing further damage to the cushioning cartilage (meniscus) of your knee.
  • Loss of full range of motion
  • Tenderness along the joint line
  • Discomfort while walking




How are ACL injuries diagnosed?


During your first visit, Dr Bhimani will talk to you about your symptoms and medical history.

During the physical examination, Dr Bhimani will check all the structures of your injured knee, and compare them to your non-injured knee. Most ligament injuries can be diagnosed with a thorough physical examination of the knee.

Imaging Tests

Other tests which may help Dr Bhimani confirm your diagnosis includes:

X-rays: Although they will not show any injury to your anterior cruciate ligament, x-rays can show whether the injury is associated with a broken bone.

Magnetic resonance imaging (MRI) scan: This study creates better images of soft tissues like the anterior cruciate ligament. However, an MRI is usually not required to make the diagnosis of a torn ACL.




How are ACL injuries treated?


Treatment for an ACL tear will vary depending upon the patient's individual needs. For example, the young athlete involved in agility sports will most likely require surgery to safely return to sports. The less active, usually older, individual may be able to return to a quieter lifestyle without surgery.




What are nonsurgical treatment options?


A torn ACL will not heal without surgery. But nonsurgical treatment may be effective for patients who are elderly or have a very low activity level. If the overall stability of the knee is intact, Dr Bhimani may recommend simple, nonsurgical options.

  • Bracing: Dr Bhimani may recommend a brace to protect your knee from instability. To further protect your knee, you may be given crutches to keep you from putting weight on your leg.
  • Physical therapy: As the swelling goes down, a careful rehabilitation program is started. Specific exercises will restore function to your knee and strengthen the leg muscles that support it.




What are surgical treatment options?


Rebuilding the ligament: Most ACL tears cannot be sutured (stitched) back together, so to surgically repair the ACL and restore knee stability the ligament must be reconstructed. Dr Bhimani will replace your torn ligament with a tissue graft. This graft acts as scaffolding for a new ligament to grow on.

Grafts can be obtained from several sources. Often they are taken from the patellar tendon, which runs between the kneecap and the shinbone. Hamstring tendons at the back of the thigh are a common source of grafts. Sometimes a quadriceps tendon, which runs from the kneecap into the thigh, is used. Finally, cadaver graft (allograft) can be used.

There are advantages and disadvantages to all graft sources. You should discuss graft choices with Dr Bhimani to help determine which is best for you.

Because the regrowth takes time, it may be six months or more before an athlete can return to sports after surgery.




How is the procedure done?


Surgery to rebuild an anterior cruciate ligament is done with an arthroscope using small incisions. Arthroscopic surgery is less invasive. The benefits of less invasive techniques include less pain from surgery, less time spent in the hospital, and quicker recovery times.




Is rehabilitation important with ACL injuries?


Whether your treatment involves surgery or not rehabilitation plays a vital role in getting you back to your daily activities. A physical therapy program will help you regain knee strength and motion.

If you have surgery, physical therapy first focuses on returning motion to the joint and surrounding muscles. This is followed by a strengthening program designed to protect the new ligament. This strengthening gradually increases the stress across the ligament. The final phase of rehabilitation is aimed at a functional return.

The remaining rehabilitation will be supervised by a physiotherapist and will involve activities such as exercise bike riding, swimming, proprioceptive exercises and muscle strengthening. Cycling can begin at 2 months, jogging can generally begin at around 3 months. The graft is strong enough to allow sport at around 6 months however other factors come into play such as confidence, fitness and adequate fitness and training.

Professional sportsmen often return at 6 months but recreational athletes may take 10 -12 months depending on motivation and time put into rehabilitation.

The rehabilitation and overall success of the procedure can be affected by associated injuries to the knee such as damage to meniscus, articular cartilage or other ligaments.

The following is a more detailed rehabilitation protocol useful for patients and physiotherapists. It is a guide only and must be adjusted on an individual basis taking into account pain, other pathology, work and other social factors.

Acute (0 – 2 Weeks)

Goals

  • Wound healing
  • Reduce swelling
  • Regain full extension
  • Full weight bearing
  • Wean off crutches
  • Promote muscle control

Treatment Guidelines

  • Pain and swelling reduction with ice, intermittent pressure pump, soft tissue massage and exercise
  • Patella mobilisation
  • Active range of motion knee exercises, calf and hamstring stretching, contraction (non-weight bearing progressing to standing), muscle control and full weight bearing. Aim for full extension by 2 weeks. Full flexion will take longer and generally will come with gradual stretching. Care needs to be taken with hamstring co contraction as this may result in hamstring strains if too vigorous. Light hamstring loading continues into the next stage with progression of general rehabilitation. Resisted hamstring loading should be avoided for approximately 6 weeks
  • Gait retraining encouraging extension at heel strike

Stage 2- Quadriceps Control (2-6 Weeks)

Goals

  • Full active range of motion
  • Normal gait with reasonable weight tolerance
  • Minimal pain and effusion
  • Develop muscular control for controlled pain free single leg lunge
  • Avoid hamstring strain
  • Develop early proprioceptive awareness

Treatment Guidelines

  • Use active, passive and hands on techniques to promote full range of motion
  • Progress closed chain exercises (quarter squats and single leg lunge) as pain allows. The emphasis is on pain free loading, VMO and gluteal activation
  • Introduce gym based exercise equipment including leg press and stationary cycle
  • Water based exercises can begin once the wound has healed, including treading water, gentle swimming avoiding breaststroke
  • Begin proprioceptive exercises including single standing leg balance on the ground and mini tramp. This can progress by introducing body movement whilst standing on one leg
  • Bilateral and single calf raises and stretching
  • Avoid isolated loading of the hamstrings due to ease of tear. Hamstrings will be progressively loaded through closed chain and gym based activity

Stage 3- Hamstring/Quadriceps Strengthening (6-12 Weeks)

Goals

  • Begin specific hamstring loading
  • Increase total leg strength
  • Promote good quadriceps control in lunge and hopping activity in preparation for running

Treatment Guidelines

  • Focal hamstring loading begins and is progressed steadily throughout the next stages of rehabilitation
  • Active prone knee flexion which can be quickly progressed to include a light weight and gradually increasing weights
  • Bilateral bridging off a chair. This can be progressed by moving onto a single leg bridge and then single leg bridge with weight held across the abdomen
  • Single straight leg dead lift initially active with increasing difficulty by adding dumbbells
  • With respect to hamstring loading, they should never be pushed into pain and should be carefully progressed. Any subtle strain or tightness following exercises should be managed with a reduction in hamstring based exercises
  • Gym based activity including leg presses, light squats and stationary bike which can be progressively increased in intensity as pain and control allow. It is important to monitor any effusions following exercise and if it is increasing then exercise should be toned down
  • Once single leg lunge control is comparable to the other side hopping can be introduced. Hops can be made more difficult by including variations such as forward/back, side to side off a step and in a quadrant
  • Running may begin towards the latter part of this stage
  • Prior to running certain criteria must be met
  • No anterior knee pain
  • A pain free lunge and hop that is comparable to the other side
  • The knee must have no effusion
  • Before jogging start having brisk walks, ideally on a treadmill to monitor landing
  • Action and any effusion. This should be done for several weeks before jogging properly
  • Increased proprioceptive manoeuvres with standing leg balance and progressive hopping based activity
  • Expand calf routine to include eccentric loading

Stage Four-Sport Specific (3-6 Months)

Goals

  • Improve leg strength
  • Develop running endurance speed, change of direction
  • Advanced proprioception
  • Prepare for return to sport and recreational lifestyle

Treatment Guidelines

  • Controlled sport specific activities should be included in the progression of running and gym loads. Increasing effusion post running that isn’t easily managed with ice should result in a reduction in running loads
  • Advanced proprioception to include controlled hopping and turning and balance correction
  • Monitor potential problems associated with increasing loads
  • No open chain resisted leg extension exercises unless authorised by your surgeon

Stage Five-Return to Sport (6 Months Plus)

Goals

  • A safe return to sporting activities

Treatment Guidelines

  • Full training for 1 month prior to active return to competitive sport
  • Preparation for body contact sports. Begin with low intensity one on one contests and progress by increasing intensity and complexity in preparation for drills that one might be expected to do at training
  • To improve running endurance leading up to a normal training session
Full range, no effusion, good quadriceps control for lunge, hopping and hop and turn type activity. Circumference measures of thigh and calf to within 1 cm of other side





 

What is Arthritis?


Arthritis is inflammation of one or more of your joints that causes pain and stiffness. While arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. Some of these include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, septic arthritis, and psoriatic arthritis.
While each of these conditions has different causes, the symptoms and treatment are often thesame. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee and hip.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep patients staying active.




What causes arthritis?


Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or may develop following an injury (post-traumatic arthritis).
Other types of arthritis, such as crystalline arthritis, may come from an inflammatory process.
Still others, such as rheumatoid arthritis or lupus arthritis, are the result of a systemic disease
throughout the body.

Regardless of whether the cause is from injury, normal wear and tear, or disease, the joint becomes inflamed, causing swelling, pain and stiffness. Inflammation is one of the body's normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability.




What is osteoarthritis?


The most common type of arthritis is osteoarthritis. Also known as "wear and tear" arthritis,
osteoarthritis occurs when the cartilage that cushions and protects the ends of your bones gradually wears away.

It results from overuse, trauma, or the natural degeneration of cartilage that occurs with aging.
Osteoarthritis is often more painful in joints that bear weight, such as the knee, hip, and spine. However, joints that are used extensively in work or sports, or joints that have been damaged by injury may show signs of osteoarthritis.
In many cases, bone growths called "spurs" develop at the edges of osteoarthritic joints. The bone can become hard and firm (sclerosis). The joint becomes inflamed, causing pain and swelling meaning continued use of the joint is painful.




What is rheumatoid arthritis?


Rheumatoid arthritis is a long-lasting disease. Rheumatoid arthritis affects many parts of the body, but mainly the joints. The body's immune system, which normally protects the body, begins to produce substances that attack the body. In rheumatoid arthritis, the joint lining swells, invade surrounding tissues. Chemical substances are produced that attack and destroy the joint surface.
Rheumatoid arthritis may affect both large and small joints in the body and also the spine. Swelling, pain, and stiffness usually develop, even when the joint is not used. In some circumstances, juvenile arthritis may cause similar symptoms in children.




What is post-traumatic arthritis?


Post-traumatic arthritis results from an injury to the joint. If a broken bone or fracture extends into a joint it will damage the smooth cartilage that covers the joint surfaces. The surface becomes uneven and causes friction as the joint moves. Over time, the joint breaks down and becomes arthritic.




What is septic arthritis?


Septic arthritis is an infection of the joint. Most often bacteria reach the joint through the
bloodstream from an infection in another part of the body, such as the urinary tract. Infected joints are typically warm, red, and acutely tender. They are often swollen due to pus in the joint. An infected joint often needs surgical drainage in addition to antibiotics.




What is psoriatic arthritis?


Psoriatic arthritis is associated with the skin disease psoriasis. While it may involve larger joints such as the knees it often presents with symptoms in smaller areas such as the distal joints at the tips of the fingers and toes.




What is gouty arthritis?


Gouty arthritis develops as the result of uric acid build up in the bloodstream. The uric acid forms crystals which cause acute inflammation in a joint. The big toe, ankle, knee, and elbow are the most common joints affected. A gout attack can be acutely painful. The inflamed joint becomes red and very sensitive to touch. Gout attacks are most often treated with medicine rather than surgery. Long term, many patients develop soft tissue masses (tophi) over the affected joints.




What is Lyme arthritis?


Lyme arthritis can be one of the side effects of Lyme disease, a systemic infection caused by a tick bite. Lyme arthritis can present acutely as pain and swelling in early stages of the disease. Lyme disease is treated with antibiotics. Left untreated, Lyme disease can lead to chronic arthritis.




What is Lupus arthritis?


Lupus is an autoimmune disease that affects multiple organs including the kidneys, skin, blood, and the heart. Lupus arthritis can be systemic and cause chronic pain in multiple joints.




What is Juvenile arthritis?


Juvenile arthritis is the most common type of arthritis in children. There are several types of the disease and most are different from rheumatoid arthritis in adults.




How is arthritis diagnosed?


Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. Some of the findings of arthritis include:

  • Weakness (atrophy) in the muscles
  • Tenderness to touch
  • Limited ability to move the joint passively (with assistance) and actively (without assistance)
  • Signs that multiple joints are painful or swollen (an indication of rheumatoid arthritis)
  • A grating feeling or sound (crepitus) with movement
  • Pain when pressure is placed on the joint or the joint is moved




How is arthritis treated?


There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause.




What are the non-surgical treatments of arthritis?


Medications Over-the- counter medications can be used to control pain and inflammation in the joints. These medications, called anti-inflammatory drugs, include aspirin, ibuprofen, and naproxen. Acetaminophen can be effective in controlling pain.
Prescription medications also are available. Dr Bhimani will choose a medication by taking into account the type of arthritis, its severity, and your general physical health. Patients with ulcers, asthma, kidney, or liver disease, for example, may not be able to safely take anti-inflammatory medications.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is
important to know that repeated, frequent injections into the same joint can cause damage and undesirable side effects.
Viscosupplementation or injection of hyaluronic acid preparations can also be helpful in lubricating the joint. This is typically performed in the knee. Exercise and therapy Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learningmethods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy may be used to decrease stiffness and to strengthen the weakened muscles around the joint.




What are the surgical treatments of arthritis?


In general, Dr Bhimani will perform surgery for arthritis when other methods of nonsurgical
treatment have failed to relieve pain and other symptoms. When deciding on the type of surgery, Dr Bhimani will take into account the type of arthritis, its severity, and your loss of normal function.

There are a number of surgical procedures. These include:

  • Removing the diseased or damaged joint lining
  • Realignment of the joints
  • Fusing the ends of the bones in the joint together, to prevent joint motion and relieve joint pain
  • Replacing the entire joint (total joint replacement)




How is arthritis managed long-term?


In most cases, persons with arthritis can continue to perform normal activities of daily living.
Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.

In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function.
Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.





Arthritis

 

Osteoarthritis

What is Osteoarthritis?


Osteoarthritis, also known as "wear and tear" arthritis, occurs when the cartilage that cushions and protects the ends of your bones gradually wears away. This leads to pain and stiffness that worsens over time, making it difficult to do daily activities.
Osteoarthritis is the most common form of arthritis. It develops slowly and most often occurs during middle age.
Although there is no cure for osteoarthritis, there are many treatment options available to help manage pain and keep people staying active.




What causes Osteoarthritis?


With osteoarthritis, the articular cartilage that covers the ends of bones in the joints gradually wears away. Where there was once smooth articular cartilage that allowed the bones to glide easily against each other when the joint bent and straightened, there is now a frayed, rough surface. Joint motion along this exposed surface is painful.
Osteoarthritis usually develops after many years of use. It affects people who are middle-aged or older. Other risk factors for osteoarthritis include obesity, previous injury to the affected joint, and family history of osteoarthritis.




What are the symptoms of Osteoarthritis?


Osteoarthritis can affect any joint in the body including the joints of the spine. Symptoms may range from mild to disabling.
A joint affected by osteoarthritis may be painful and inflamed. Without cartilage, bones rub directly against each other as the joint moves. This causes the pain and inflammation. Pain or a dull ache develops gradually over time. Pain may be worse in the morning and feel better with activity. Vigorous activity may cause pain to flare up.
The joint may stiffen and look swollen, enlarged or "out of joint." A bump may develop over the joint. Joint movements such as bending, straightening and rotation may become more difficult and loss of motion may follow.
Loose fragments of cartilage can interfere with the smooth motion of a joint. The joint may lock or "stick." It may creak, click, snap, or make a grinding noise (crepitus). An arthritic joint may weaken and weight bearing joints such as a knee or ankle may buckle and give way.

Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.




How is Osteoarthritis diagnosed?


Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.
When you visit Dr Bhimani, a complete medical history, physical examination, x-rays, and possibly laboratory tests will be done.
Medical History
Dr Bhimani will want to know if the joint has ever been injured. Dr Bhimani will want to know when the joint pain began and the nature of the pain. Is the pain continuous, or does it come and go? Does it occur in other parts of the body? Is it worse at night? Does it occur only with activity or at rest as well?
Physical Examination
Dr Bhimani will then examine the affected joint in various positions to see if there is pain or
restricted motion. Dr Bhimani will look for creaking or grinding noises (crepitus) that indicate bone-on-bone friction. muscle loss (atrophy), and signs that other joints are involved. Dr Bhimani will look for signs of injury to muscles, tendons, and ligaments.

X-rays
X-rays can show the extent of joint deterioration, including narrowing of joint space, thinning or erosion of bone, excess fluid in the joint, and bone spurs or other abnormalities. They can help Dr Bhimani distinguish various forms of arthritis.
Laboratory Tests
Sometimes laboratory tests, such as blood tests, can help rule out other diseases that cause
symptoms similar to osteoarthritis.




What are non-surgical treatments?


Early, nonsurgical treatment can help maintain joint mobility, improve strength, and relieve pain. Most treatment programs combine lifestyle modifications, medication, and physical therapy.
Lifestyle Changes
Dr Bhimani may recommend rest or a change in activities to avoid provoking osteoarthritis pain. This may include modifications in work or sports activities. It may mean switching from high-impact activities (such as aerobics, running, jumping, or competitive sports) to low-impact exercises (such as stretching, walking, swimming, or cycling). A weight loss program may be recommended, if needed, particularly if osteoarthritis affects weight-bearing joints (such as the knee, hip, spine, or ankle)
Medications
Non-steroidal anti-inflammatory drugs can help reduce inflammation. Sometimes, Dr Bhimani may recommend strong anti-inflammatory agents called corticosteroids, which are injected directly into the joint. Corticosteroids provide short term relief of pain and swelling.
Dietary supplements called glucosamine and chondroitin sulfate may help relieve pain from
osteoarthritis.

Physical Therapy
A balanced fitness program, physical therapy, and/or occupational therapy may improve flexibility, increase range of motion, reduce pain, and strengthen the joint. Supportive or assistive devices (such as a brace, splint, elastic bandage, cane, crutches, or walker) may be needed. Ice or heat may need to be applied to the affected joint for short periods, several times a day.




What are surgical treatments?


If early treatments do not stop the pain or if they lose their effectiveness, surgery may be
considered. The decision to treat surgically depends upon the age and activity level of the patient, he condition of the affected joint, and the extent to which osteoarthritis has progressed. Surgical options for osteoarthritis include arthroscopy, osteotomy, joint fusion, and joint replacement.

Arthroscopy
Dr Bhimani uses a pencil-sized, flexible, fiberoptic instrument (arthroscope) to make two or three small incisions to remove bone spurs, cysts, damaged lining, or loose fragments in the joint.
Osteotomy
The long bones of the arm or leg are realigned to take pressure off of the joint.
Joint replacement
Dr Bhimani removes parts of the bones and creates an artificial joint with metal or plastic
components (total joint replacement or arthroplasty).





 

Rheumatoid Arthritis

Is this product a one time use?


Yes, this product is a nano, silicon based adhesive that is meant to be used one time. However, and not recommended....if you are careful enough taking them off you could replace it back onto the packaging applicator,




Is this product breathable?


Yes, this is a nano product which means that it is very porous.




Is this product flexible?


Yes, this product does not inhibit movement at all.




Does this product stick to the bottom of your foot?


Yes, The Barefoot Doobie was created to stick onto the bottom of your foot. The adhesive is strong enough to stay on your foot all day with normal use, and will not leave any sticky residue on your feet when taken off.




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Is this product eco-friendly?


Yes, this product is 100 percent biodegradable and eco-friendly!