Rheumatoid Arthritis: Can Knowing Your Risk Prompt Better Health Habits?

Article featured on Brigham Health Hub

If someone in your family has rheumatoid arthritis (RA), you may already know that you are more susceptible to developing the disease. Could understanding personal risk factors encourage you to change health habits, to possibly decrease your chances of developing RA?

Doctors at Brigham and Women’s Hospital are finding that people who learn their risks – based on genetics, blood markers, personal behaviors, and environmental exposures – are more likely to change behaviors to make them potentially less vulnerable to the disease.

“There are modifiable environmental factors that might have an impact on disease,” says Jeffrey A. Sparks, MD, MMSc a rheumatologist and assistant professor of medicine in the Division of Rheumatology, Immunology and Allergy at the Brigham. “Once you know what the risk factors are and how you can do something about it, you can act on that.”

What Causes Rheumatoid Arthritis?

Rheumatoid arthritis, the most common type of chronic arthritis, is caused by a dysregulated immune system. Symptoms include pain and stiffness in the joints (typically worse in the morning), as well as decreased energy, slight fever, appetite loss, and development of hard bumps beneath the skin near joints.

Progression varies from one person to the next. But when advanced, RA eventually can destroy both cartilage and bone, causing increased pain, swelling, deformities, and loss of mobility. Rheumatoid arthritis is more common among women and often begins between ages 40 – 60 years.

Genes probably don’t cause rheumatoid arthritis by themselves. But genetics may make a person more vulnerable to disease triggers, such as smoking and infections. In RA, the disease occurs in the “synovium” (the lining layer of the joints) when the immune system stops protecting the joints and instead damages bone and cartilage. Researchers at the Brigham and elsewhere are helping to understand the genes, health habits, and environmental factors that may increase a person’s risk of RA. They also are studying how to decrease that risk – including by changing some health behaviors such as smoking, obesity, low fish consumption, and poor dental health. These health behaviors likely affect RA risk by either increasing or decreasing the amount of inflammation in the body.

With these risk factors in mind, Brigham researchers including Dr. Sparks and Elizabeth Karlson, MD, MS are seeking ways to encourage prevention strategies for people at risk.

New Studies Suggest Knowledge Motivates Changes

Knowledge of risks is the first step to changing behavior. But what is an effective way for people to learn about their risks?

As part of the recent PRE-RA Family Study, Brigham researchers found that first-degree relatives of RA patients were familiar with the disease and symptoms. But they were relatively less aware of how their own health habits (including dental hygiene, smoking, overweight/obesity, and diet) could contribute to their risk of developing RA. In the study, those who received an interactive, web-based RA education tool that visually depicted their own personal risks showed greater increases in their knowledge of RA risk factors than those who received education that was not personalized to their own risks.

More importantly, the PRE-RA Family Study also showed that people would act on this new knowledge. Relatives who learned about their own personal risk of RA — based on genetics, autoantibody results from the blood, and their own behaviors — showed increased motivation to improve RA risk-related behaviors. The education included an interactive, visual presentation of their own risks, personalized for each participant, along with specific behavior changes (such as “eat more fish”) that might reduce those risks. Six months later, people who received personalized risk assessment and education, compared to those who received non-personalized information and education, were more likely to have increased fish intake, quit smoking, and brush and floss their teeth more frequently.

What You Can Do Right Now

For relatives of people with RA, but who themselves do not have RA symptoms, knowing and tracking your own personal health history is a good first step. The next is to be aware of how behaviors can affect your risk. Then pick actionable, attainable goals to reduce that risk, such as improved dental hygiene, quitting smoking, and maintaining a healthy weight.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

When to Use Ice Versus Heat for Pain

Article featured on Practical Pain Management

Depending on the type of pain you have, one may be better than the other.

Every pain is different. Each type can be a symptom of an underlying issue, an unpleasant sidekick to a condition, or an overall nuisance on everyday life. Treating pain can vary as well. While going straight to the doctor or trying an over-the-counter medication are options, another can be applying hot or cold compresses to the area where the pain is happening.

Hot vs Cold for Pain: What’s the Difference?
While both temperatures can soothe pain, they do so in different ways. Heat increases blood flow, nutrients, and oxygen to the affected area and, therefore, works to relax tight muscles. Cold lessens pain by reducing inflammation, muscle spasms, and circulation. While reducing circulation sounds bad, it’s actually a good thing because less circulation means your blood vessels shrink, which then lessens swelling and bleeding.

Let’s explore the different kinds of pain and how each responds when heat or cold is introduced:

Joint Pain/Inflammatory Pain

Typically caused by conditions such as arthritis and some autoimmune diseases like rheumatoid arthritis, joint pain/inflammatory pain can feel like stiffness in the joints or an “on fire” feeling throughout the body or similar to how you feel when you have the flu (fatigue, exhaustion, chills, etc.). Triggers for this type of pain can include intense physical activity, stress, and even weather. When to use heat or cold to treat joint pain depends on the cause of the pain and what works best for you. For example, gout responds well to heat because it eases stiffness and relaxes the muscles in the surrounding area. Osteoarthritis, on the other hand, does well with cold because it numbs pain. Once you know the underlying cause of your joint pain, such as an arthritis condition, you can talk to your doctor about adding heat or ice to your treatment plan and/or to manage flare-ups.

Muscle Pain

Muscle pain can affect one or more sections of the body at a time and can be caused by injury or overuse. For instance, with back pain, you could be hurting because you overworked your back muscles at the gym or because you strained (or “pulled”) a muscle by tearing the fibers of skeletal muscle. For the most part, if muscle pain is temporary (or acute) it can be treated with cold compresses for no more than 15 minutes a few times a day and rest to allow tissues to heal. At the same time, if the pain is chronic (lasts longer than 6 months) heat is the best bet; it can even be alternated with cold if desired.

Nerve Pain

Nerve pain can be caused by many different types of conditions and varies in how it feels. For example, a patient with sciatica (a condition where pain is caused by spinal nerve compression in the lower back) can be described as a “radiating” pain; other times, nerve pain can feel like numbness or tingling. Pain caused by conditions such as sciatica respond well to ice or cold treatments because that temperature tends to calm inflammation and numb any soreness in the tissue. It’s best to use cold when the pain is still sharp and move on to heat once that sharpness has subsided. The heat will increase blood flow and help tissues heal faster.

Home remedies like heating pads, microwavable gel packs, a ziplock filled with ice, or a store-bought freezer pack and other compresses can be helpful in alleviating frequent chronic pain. Apply for no more than 15 minutes at a time, two to four times a day. At the same time, it’s important to know your body’s limits. Regardless of the type of pain you are experiencing, if you get to a point where the pain is intolerable or if it turns into numbness or weakness, see your doctor right away.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

6 Ways to Ruin Your Knees

Article featured on WebMD

Whether you’re a seasoned athlete, a weekend warrior, or totally laid-back when it comes to exercise, knowing how to protect your knees from damage can mean the difference between a fulfilling lifestyle and longterm, strained mobility.Cruising on the track in the heat of a roller derby match, 27-year-old Rachel Piplica was not at all prepared for the realization that her knee could sideline her from competitive skating for months, possibly years.”Suddenly, I heard a pop and it felt like my knee bent sideways. The pain was so bad I just fell and crawled away,” Piplica tells WebMD.The Los Angeles fashion designer who skates under the name Iron Maiven tried to keep going. “I took one more stride and my knee just let go again. The doctor immediately said, ‘I think you tore your ACL.'”

Piplica had experienced some warning signs during her previous season of skating as captain of her team, but she ignored them for the most part. “I had tremendous pain in my leg anytime I’d squat down so I just kept my right leg straight. But I never saw a doctor for it. I just assumed, ‘I’m in a contact sport and this is what happens,’” she tells WebMD.

Knee deep: A complex and vulnerable joint

Her torn ACL diagnosis confirmed, Piplica quickly learned how susceptible the knees can be to injury. According to the American Academy of Orthopaedic Surgeons, these joints are responsible for sending nearly 15 million Americans to the doctor every year.

And it’s not just athletes who suffer. Knee problems can happen to anyone.

“Because they’re the main hinge between the ground and the rest of your body, the knees serve as your ‘wheels’ that get you around and allow you to be active,” says University of Pennsylvania orthopedic surgeon and sports medicine specialist Nicholas DiNubile, MD. “Life can really go downhill when you damage your knees,” says DiNubile, who is a spokesman for the American Academy of Orthopaedic Surgeons and author of FrameWork – Your 7-Step Program for Healthy Muscles, Bones and Joints.

Bound by an intricate system of ligaments, tendons, cartilage, and muscle, the knee is highly prone to injury. It’s a complex hinge where the femur (thigh bone), tibia (shin bone), fibula (next to tibia) and kneecap all come together.

“It’s hard to find the right balance between mobility and stability; the knee needs to move back and forth, twist a little, and pivot too,” DiNubile says. The knee’s ligaments can tear, its tendons can swell up, osteoarthritis can take hold, and even everyday wear and tear can ruin a perfectly good set of knees.Here are six pitfalls you can avoid to save your knees.

1. Ignoring knee pain.

An occasional ache here and there is common. “But knowing when you can and can’t ignore pain is key,” says sports medicine specialist Jordan Metzl, MD, from the Hospital for Special Surgery in New York City.

Metzl’s rule of thumb: When the pain limits your ability to do what you normally do, you need to have it checked out.

“If your body is sending you signals, you need to listen to them. If they persist, you need to have it checked out,” he tells WebMD.

For Piplica, exploratory surgery revealed a torn meniscus she had endured in the past — unbeknownst to her — followed by the more recent ACL tear.

“In hindsight, maybe that first injury could have been repaired earlier, although I don’t know if I could have avoided this one altogether,” she says. “At least I would have been more careful.”

2. Being overweight.

Every pound of body weight yields five pounds of force on the knee, so even 10 extra pounds can put a considerable load on those joints.

Being overweight also increases your chances of osteoarthritis in the knee, a common and often disabling form of arthritis that wears away the knee’s cushiony cartilage. Excess pounds also cause existing arthritis to worsen more rapidly. According to the CDC, two out of three obese adults suffer from knee osteoarthritis at some time in their life.

Although diet and exercise are critical for weight loss, it’s a double-edged sword.

“If your knees hurt, it’s harder to lose weight through exercise,” says Metzl. So he recommends activities that go easy on the knee.

For example, opt for a stationary bike over running on the treadmill, and walk on a flat surface instead of hilly turf. If you’re a die-hard treadmill fan, then go for longer sessions of walking punched with brief intervals of brisk walking or running every three to five minutes, DiNubile says.

3. Not following through with rehab and rest.

The rest and rehabilitation period after a knee injury is critical to avoiding future pain or reinjury. Depending on the type of damage and treatment, recovery could last anywhere from a couple of weeks to several months.

“During the rehab period, you need someone to help you tell the difference between something that just hurts, and something that’s going to do you harm,” says DiNubile.He tells WebMD that many of his young athlete patients are too eager to return to regular play as soon as they stop limping. He advises patients to work with an orthopedic surgeon, a sports medicine physician, a physical therapist, an athletic trainer, or some combination of these pros, in order to ensure proper focus is placed on gradually strengthening the knees.

4. Neglecting your ACL.

One of the most commonly injured ligaments in the knee, the anterior cruciate ligament (ACL) is responsible for about 150,000 injuries in the U.S. every year.

As Piplica learned firsthand, sports like roller derby that involve quick cuts, twists, and jumping, put the ACL at higher risk for rupturing. More traditional high-risk sports include soccer, basketball, football, and volleyball.Women in particular have a two- to eight-times higher risk for ACL tears compared to men, mainly because the way women naturally jump, land, and turn puts greater strain on the ACL.However, male and female athletes alike can be trained to “rewire” themselves and thus lower risks of knee injury. That’s done through neuromuscular training, which involves supervised practice in improving agility, leg strength, and jump-landing techniques for better knee joint stability.These specialized techniques are effective in reducing risks of knee injury by almost one-half, according to a 2010 review of seven neuromuscular training studies.

“Given what we know in how useful it can be in reducing ACL tears, it’s irresponsible of coaches and parents to not require athletes to undergo neuromuscular training,” says DiNubile.

He recommends that athletes of any age who play ACL risk-prone sports should seek help from an athletic trainer or other trained professional to help avoid this debilitating injury.

5. Overdoing it.

“You make gains in fitness when you work hard and then allow your body to recover. You can’t do a hard workout every day,” Metzl says.

A sudden increase in intensity or duration of exercise can cause overuse injuries from repetitive strain. Tendonitis and kneecap pain are common symptoms in the knee.Pushing too hard is also related to overtraining syndrome, a physiological and psychological condition among athletes in which they exceed their ability to perform and recover from physical exertion, often leading to injury or lowered performance.Be sure to include stretching exercises before and after working out. And follow hard training days with easy ones so your body can recover.6. Overlooking other muscles around the knees.

Weak muscles and lack of flexibility are primary causes of knee injuries. When the muscles around the kneecap, hip, and pelvis are strong, it keeps the knee stable and balanced, providing support by absorbing some of the stress exerted on the joint.DiNubile stresses the importance of building the quadriceps and hamstring muscles, as well as proper strengthening of the body’s core muscles, including the obliques, lower back muscles, and upper thigh.
His favorite tool to help accomplish this strengthening is a Swiss medicine ball. Other exercises to try are knee extensions, hamstring curls, leg presses, and flexibility exercises.Piplica recalls realizing just how weak some of her leg muscles were.”Roller girls are striding out so much with their outer leg muscles, but we aren’t necessarily working our inner knees,” she says. “I remember when I would run for exercise, my calves and shins would hurt so bad. That surprised me, because I thought if anything was strong, it was my legs.”Piplica says she wishes she had been better educated about crosstraining activities for roller skaters, and what muscle groups they need to focus on to keep their knees healthy.

As she awaits surgery to repair her torn ACL, Piplica tells WebMD that her perspective on long-term care for her knees has definitely changed.

“Half of me is frustrated about not being able to skate sooner, but the other half knows how important it is to get better so I don’t do this again. I’m 27 years old with a serious knee injury preventing me from moving around. So I need to look beyond just skating, skating, skating. I don’t want to have knee problems when I’m 40 or 50 because I’m not giving my body the kind of attention it needs right now.”


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

10,000 Steps a Day May Halve Dementia Risk

Article featured on MedicalNewsToday

As the global population ages, cases of dementia are also on the rise worldwide. The World Health Organization (WHO) states that some 55 million people currently have dementia, and the number is set to rise to 139 million by 2050.

The Centers for Disease Control and Prevention (CDC) estimate that Alzheimer’s disease, the commonest form of dementia, affects around 5.8 million people in the United States alone.

The greatest risk factors for dementia, according to the Alzheimer’s Society, are aging and genetics. Dementia is most common in those aged over 75, and having a close relative with dementia may increase a person’s risk of developing the disorder.

Other risk factors that we cannot control include sex — females are more at risk than males — and ethnicity. However, lifestyle changes, such as increasing physical exercise, controlling blood pressure, and keeping the brain stimulated, can decrease a person’s risk of dementia, even for those who have one or more risk factors.

And physical exercise need not mean sweating it out at the gym or taking up a new sport.

According to a study recently published in JAMA Neurology, simply increasing the number of steps a person takes each day can decrease their dementia risk by as much as 50%.

How did the study proceed?

The study used data from the UK Biobank. The 78,430 participants, of whom 44.7% were male and 55.3% female, had a mean age of 61.1 years. All participants were free of cardiovascular disease and dementia when they enrolled in the study. Researchers followed up with participants after a median of 6.9 years (6.4–7.5 years).

For the study, participants had to wear an accelerometer on their dominant wrist 24 hours a day, 7 days a week, to measure physical activity. The researchers then used an algorithm to work out the step count from the data collected by the accelerometer.

The researchers controlled for variables such as age, sex, race, socioeconomic status, smoking, overall health, and diet when analyzing the data.

At follow-up, 866 participants, or 1.1%, had developed dementia.

“The Alzheimer’s Association is conducting a clinical trial combining exercise with other lifestyle factors, like diet and social/ cognitive engagement, to determine if these factors in combination reduce risk of cognitive decline,” she added.

Dr. Porsteinsson agreed: “There are definite limitations to observational cohort studies but advantages as well. They are hypothesis-generating, that is they point us toward what we may want to study further in a controlled, randomized study. The good news here is that there is a bulk of evidence that suggests that exercise is beneficial in staving off dementia.”

What the study found

“This is an important study that may help inform public health guidelines around the amount of physical activity necessary to reap health benefits,” said Dr. Sexton.

“These results are not surprising given the robust data we have linking physical activity and better cognition. A strength of this paper is it used an objective, widely-understood measure of step count rather than self-reported data,” she noted.

The researchers found that both the number of steps and stepping intensity were associated with reduced dementia risk. For the greatest benefit — a 50% reduction in dementia risk — participants had to walk around 9,800 steps per day. Above this number, no further benefit was seen.

However, the good news for those who cannot achieve this many steps was that just 3,826 steps a day reduced dementia risk by 25%.

Dr. Porsteinsson agreed that any exercise will help reduce risk. “[It’s] never too late to get started and even a relatively small effort is beneficial and can then be added to as endurance improves,” he told us.

Purposeful steps, defined as more than 40 steps per minute, such as when going for a walk, increased the association with reduced dementia risk.

Stay active for mental and physical health

This study adds to building evidence that staying active as you age can maintain physical and mental health and improve longevity.

Another large-scale study of almost 650,000 military veterans found that being physically fit reduced dementia risk by up to 33%. In this study, even a small amount of exercise was found to help reduce dementia risk.

An analysis from the Alzheimer’s Society of 11 studies found that, out of taking regular exercise, not smoking, moderating alcohol intake, maintaining a healthy body weight, and eating a healthy diet, it was regular exercise that had the greatest impact on dementia risk.

For Alzheimer’s disease, regular exercise reduced risk by up to 45%.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How Retraining Your Brain Could Help With Lower Back Pain

Article featured on WebMD

Are you among the hundreds of millions of people worldwide with low back pain? If so, you may be familiar with standard treatments like surgery, shots, medications, and spinal manipulations. But new research suggests the solution for the world’s leading cause of disability may lie in fixing how the brain and the body communicate.

Setting out to challenge traditional treatments for chronic back pain, scientists across Australia, Europe, and the U.S. came together to test the effectiveness of altering how neural networks recognize pain for new research.

The randomized clinical trial recruited two groups of 138 participants with chronic low back pain, testing one group with a novel method called graded sensorimotor retraining intervention (RESOLVE) and the other with things like mock laser therapy and noninvasive brain stimulation.

The researchers found the RESOLVE 12-week training course resulted in a statistically significant improvement in pain intensity at 18 weeks.

“What we observed in our trial was a clinically meaningful effect on pain intensity and a clinically meaningful effect on disability. People were happier, they reported their backs felt better, and their quality of life was better,” the study’s lead author, James McAuley, PhD, said in a statement. “This is the first new treatment of its kind for back pain.”

Brainy Talk

Communication between your brain and back changes over time when you have chronic lower back pain, leading the brain to interpret signals from the back differently and change how you move. It is thought that these neural changes make recovery from pain slower and more complicated , according to the Neuroscience Research Australia (NeuRA), a nonprofit research institute in Sydney, Australia.

“Over time, the back becomes less fit, and the way the back and brain communicate is disrupted in ways that seem to reinforce the notion that the back is vulnerable and needs protecting,” said McAuley, a professor at the University of New South Wales and a NeuRA senior research scientist. “The treatment we devised aims to break this self-sustaining cycle.”

RESOLVE treatment focuses on improving this transformed brain-back communication by slowly retraining the body and the brain without the use of opioids or surgery. People in the study have reported improved quality of life 1 year later, according to McAuley.The researchers said the pain improvement was “modest,” and the method will need to be tested on other patients and conditions. They hope to introduce this new treatment to doctors and physiotherapists within the next 6 to 9 months and have already enlisted partner organizations to start this process, according to NeuRA.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Possible Ways to Fall Into Back Pain

Article featured on Atlanta Spine Institute

A chill in the air, sweaters, football, pumpkin spice, and colorful leaves are all signs that fall is here. Cold weather is coming, which means this is your last chance before winter to get those outdoor maintenance tasks done that you’ve been avoiding in the summer heat. Injuries from cleaning are more common than you’d think, and millions of people visit the ER every year for anything from improper lifting to lawnmower accidents. We all want to get our outdoor chores done, but it’s best to avoid them making us sore! Back injuries, muscle strains, injuries from repetitive motion, accidents, and tendonitis all top the list for common fall cleaning injuries. Never underestimate the falls, slips, and trips that can happen in the blink of an eye!

Stay ahead of these injuries with the tips below to help prevent fall injuries happening to you!

Rake Smart

If you’ve ever raked a yard, you know it’s no joke. It can be a full-blown exercise routine, depending on the yard. Take these tips into consideration before you get started this fall!

  1. Warm Up: You don’t exercise without stretching first, so don’t rake either. Stretch for at least ten minutes first.
  2. Size Matters: Make sure you buy a rake that is comfortable for your strength and height. Some rakes come with padded handles to prevent blisters. If they don’t, get some gloves to protect your hands.
  3. See Clear: We know it’s chilly, but keep hats and scarves out of your line of vision. It’s easier to avoid tripping if you can see what’s in front of you on the ground!
  4. Alternate: If you hold the rake the same way the whole time, it will cause strain and soreness in certain muscles. Switch hand and foot position to avoid overusing the same muscles.
  5. Bend Your Knees: When picking up leaves or branches, make sure to bend at your knees. This will help prevent injuring your back.
  6. Resist the Slip: With fall comes rain, which can make for slippery leaves. Wear footwear that is slip-resistant to avoid slipping on wet leaves or grass.
  7. Keep It Light: Too many leaves can be too heavy, especially if they’re wet. Pack your bags light to avoid carrying too much weight to help prevent back strain.

Mow Safe

Maybe you mow the lawn regularly, or maybe it’s your first time. Either way, there are certain precautions anyone should take while operating a lawnmower.

  1. Turn It Off: Of course you need power to mow the lawn, but you need gas to get the power! Before you refuel your mower or perform any maintenance, make sure the engine is off and cool.
  2. Keep Your Extremities Away: Never clear debris from under the mower with your hands or feet; instead, use a broom or sturdy stick. Just keep your hands and feet away from the blades at all times. Even if the engine is off, don’t risk it.
  3. Keep Your Guard Up: Some lawnmowers come with guards, shields, and/or safety devices. Do not remove these! They are there for your protection.
  4. Turn It Off: Oh, was this already mentioned? Never leave your lawn mower unattended while running. Just don’t.
  5. Wear Shoes. Good Shoes.: Don’t mow the lawn barefoot, or in sandals. Tennis shoes are made for physical activity and you could be on your feet for a couple of hours with a push mower. Even on a riding mower, wear tennis shoes. They help protect your feet from debris.
  6. No Drinking: Well, you should drink water, but no alcoholic beverages. It seems like common sense to not be inebriated while operating a machine, but it needs to be said.
  7. Release: Buy a mower that has safety features like handle release. This stops the mower from moving forward if you let go of the handle.
  8. No Children: A young person should be at least 12 years old with supervision and training to operate a lawnmower. They should be 16 to operate a push mower.

Climb Carefully

When falling leaves clog up the gutters, it’s time to bring out the ladder. It’s very easy to get hurt using ladders, so take these tips into consideration the next time you climb one.

  1. Inspect: Any time you use a ladder, make sure you inspect it first. Check for loose screws and hinges, and clean off anything on the ladder like mud or liquids to avoid slipping.
  2. Level: Use a level and firm surface on which to place the ladder. Make sure all four legs are stationed evenly. Soft ground will cause it to move or tilt.
  3. Engage: Before you climb, make sure safety braces and hinges are engaged.
  4. Avoid the Top: Do not stand or sit on the pail shelf of a ladder (it’s the very top). This is not meant to support the weight of a person.
  5. Choose Wisely: If you don’t have the right ladder for the job, don’t do the job until you do. Use a step or utility ladder for low or medium heights and for high heights use an extension ladder.
  6. Get Off: If you get uncomfortable and need to stretch while you’re on a ladder, get off. It’s better to take the extra ten seconds to climb down and reposition. Tilting the ladder even a bit because you are stretching could cause it to tip over.

Remember

Not every tip can be categorized. Here you will find some other tips to remember this fall while working hard.

  1. Stretch Again: It’s best to stretch before any physical activity, but most people don’t remember to stretch again when they’re done. Just a quick ten minutes when you’re done will do your body wonders, and it’s a nice, relaxing cool-down.
  2. Water. Water. Water.: Remember to stay hydrated. Make sure you take breaks for water. If it’s hard for you to remember to take a break, then set an alarm on your phone.
  3. Dress Appropriately: When working outdoors in the fall, it’s good to dress in long sleeves and pants. The thicker the material the better, but it needs to be weather-appropriate also. Sleeves and jeans help protect your skin from bug bites, scratches, and sunburn.
  4. Goggles: If you’re using motorized equipment, remember to wear safety goggles. This protects your eyes from debris and dirt.
  5. Earmuffs: Same as with goggles, especially if the equipment is loud. Protect your hearing.
  6. Mask and Gloves: Chemicals are contained in things like fertilizer and insect poison. Gloves and a mask will help prevent inhalation of toxic chemicals. Also, keep anything with toxic chemicals away from pets and children.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Best Exercises for Lower Back Pain Flare-Ups

Article featured on ProTailored

Why Do I Have Low Back Pain?

Low back pain is pain that occurs below the ribs, in the lumbar region of the spine. There are many causes of low back pain. Muscle tightness, injury to the ligaments or discs in the back, or problems with the bones and joints may lead to low back pain. Common causes include improper lifting, poor posture, lack of regular exercise, fracture, ruptured disk, or arthritis. Almost everyone will experience some level of low back pain at some point. Most of the time, your back will start to feel better on its own. However, sometimes the pain will not go away on its own and will require some form of intervention. Physical therapy is a great option to help with low back pain. Our physical therapists can do a full evaluation to determine what may be causing the irritation/inflammation/pain. The treatments will be focused on addressing the cause of the inflammation and helping to decrease pain levels.

Risk Factors for Low Back Pain

Some risk factors of developing low back pain include repetitive movements such as lifting, pulling, or anything that twists the spine. However, sitting at a desk all day can also be hard on your back, especially if your low back is not well supported, or you sit with poor posture.

Prevention of Low Back Pain

Prevention of the low back includes maintaining proper posture while sitting, but also while lifting or pulling. You want to make sure that you bend at the knees and lift with the legs rather than with your back. Exercise and having strong abdominal and back muscles can also help in the prevention of low back pain. If you are prone to low back pain, you may also want to try sleeping on a firm surface, sitting in supportive chairs (that are the correct height), and avoiding high-heeled shoes.

How Can Physical Therapy Help?

Our physical therapists will do a thorough examination to help determine the source of your pain. They will then work towards decreasing the source of the irritation with the use of manual techniques, cupping, scraping, dry needling, and therapeutic exercises. They will also help you determine things to do at home to help you manage and decrease your pain, and work towards preventing future pain.

What Should I Do During Flare-Ups or When I Have a Lot of Pain in the Low Back?

One of the best things that you can do when you have a flare-up or high levels of pain in the low back is to keep the back moving. Your pain levels may be so high that all you want to do is find a comfortable position and not move for a while. However, motion is key in helping alleviate low back pain. But there is a balance here, as you do not want to overdo it and create more pain. Therefore, the best thing to do is work in PAIN-FREE RANGES OF MOTION. That means movements that you can tolerate and that do not increase your pain.

Best Exercises for Flare-Ups of Low Back Pain

Lower Trunk Rotations

  • Start by lying on your back with both knees bent
  • Slowly rock your knees together to one side; hold for a second or two and then rock to the other side
  • If you have sharp pain with this motion, do not go as far!
  • This should feel like a stretch and should not be a sharp pain!
  • Complete slow rotations back and forth 20x

Single Knee to Chest

  • Start by lying on your back with both knees bent
  • Bring one knee up to your chest and hold for 5-10 seconds
  • Repeat on the other side
  • Do this exercise 10x on each side
  • If you have sharp pain with this motion, do not go as far!
  • This should feel like a stretch and should not be a sharp pain!

Pelvic Tilts

  • Start by lying on your back with both knees bent
  • Slowly flatten your back into the table
  • Then slowly rock your pelvis forward so that only your low back lifts off the table
  • Do this exercise back and forth slowly 20x
  • If you have sharp pain with this motion, do not go as far!
  • This should feel like a stretch and should not be a sharp pain!

Piriformis stretch

  • Start by lying on your back with both knees bent
  • Bring one leg up and place your ankle on your opposite knee
  • Use your hand to put pressure on your knee until you feel a stretch
  • Hold this position for 30 seconds and repeat 3x on each side
  • If you have sharp pain with this motion, do not go as far!
  • This should feel like a stretch and should not be a sharp pain!

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How to Walk Towards Healthier Knees

Article featured on ScienceDaily

A new study published today in Arthritis & Rheumatology led by researchers at Baylor College of Medicine reveals that walking for exercise can reduce new frequent knee pain among people age 50 and older diagnosed with knee osteoarthritis, the most common form of arthritis. Additionally, findings from the study indicate that walking for exercise may be an effective treatment to slow the damage that occurs within the joint.

“Until this finding, there has been a lack of credible treatments that provide benefit for both limiting damage and pain in osteoarthritis,” said Dr. Grace Hsiao-Wei Lo, assistant professor of immunology, allergy and rheumatology at Baylor, chief of rheumatology at the Michael E. DeBakey VA Medical Center and first author of the paper.

The researchers examined the results of the Osteoarthritis Initiative, a multiyear observational study where participants self-reported the amount of time and frequency they walked for exercise. Participants who reported 10 or more instances of exercise from the age of 50 years or later were classified as “walkers” and those who reported less were classified as “non-walkers.”

Those who reported walking for exercise had 40% decreased odds of new frequent knee pain compared to non-walkers.

“These findings are particularly useful for people who have radiographic evidence of osteoarthritis but don’t have pain every day in their knees,” said Lo, who also is an investigator at the Center for Innovations in Quality, Effectiveness, and Safety at Baylor and the VA. “This study supports the possibility that walking for exercise can help to prevent the onset of daily knee pain. It might also slow down the worsening of damage inside the joint from osteoarthritis.”

Lo said that walking for exercise has added health benefits such as improved cardiovascular health and decreased risk of obesity, diabetes and some cancers, the driving reasons for the Center for Disease Control recommendations on physical activity, first published in 2008 and updated in 2018. Walking for exercise is a free activity with minimal side effects, unlike medications, which often come with a substantial price tag and possibility of side effects.

“People diagnosed with knee osteoarthritis should walk for exercise, particularly if they do not have daily knee pain,” advises Lo. “If you already have daily knee pain, there still might be a benefit, especially if you have the kind of arthritis where your knees are bow-legged.”


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What to Do When You Overdo It

Article featured on Summit Ortho

Summer is a glorious season when we can enjoy getting out into our state’s natural beauty after a cold winter. In the summer months, people flock outside to the garden and do yard work; play sports like golf, tennis, or tennis; do spring cleaning; or go hiking, cycling, or swimming. With all of these options at our fingertips, it’s easy to overdo it.

Getting active is good, but if you overdo it, you might find yourself having aches and pains in joints and tendons or even numbness or tingling of fingers.

What to do if you overdo it

  1. Ice is best in the first few hours or days after an overuse injury — 20 minutes two to four times a day is good.
  2. Gentle massage and stretching is also helpful. Ice can make the area feel stiff, so ease into massage and stretching after ice.
  3. If the pain persists, heat might be more helpful in the days to follow. “Heat can be especially helpful if you suspect any arthritis pain could be contributing to your situation,” Evenson said.

How to avoid overdoing it next time

Evenson is a big proponent of prevention. “A few simple steps can prevent overuse injuries from happening in the first place,” she said.

Here are some quick prevention tips:

  • Don’t skimp on the warmup — five to 10 minutes of dynamic warmups, that is, gently going through the motions you’ll be using during the activity itself, will help warm up the muscles and lubricate the joints, getting them ready for the full activity.
  • Take breaks periodically — doing a half hour each day is better than doing four hours in one day.
  • Use good ergonomic tools and good body mechanics during the activity.
  • Start slowly — tennis may be your new favorite sport, but you’ll want to cut your play sessions short at first to avoid injuries.
  • Stretch after the activity — static stretching for up to 30 seconds can help with flexibility.
  • Know — and heed! — your limits.
  • Stay hydrated — good hydration will help prevent injury.

If your discomfort and irritation have lingered for more than a week after overdoing it, even with at-home treatment, it’s time to make an appointment with your primary care provider or orthopedic specialist. “People say all the time, ‘I wish I hadn’t waited so long to come in.’ If you haven’t seen improvement after a week, it’s a good idea to get it checked out,” Evenson said.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Therapeutic Massage for Pain Relief

Article featured on Brigham Health Hub

A therapeutic massage involves the application of the hands or elbows with the intention of solving a physical problem, such as back pain. Alternatively, non-therapeutic or relaxation massage is more passive and is typically used to promote comfort.

“Therapeutic massage can be used to treat a range of conditions, the most common of which is low back pain, followed by neck and shoulder pain. I also use therapeutic massage to treat headaches, jaw pain and Temporomandibular Joint Dysfunction (TMJ),” says Arthur Madore, LMT, a licensed massage therapist at the Osher Center for Integrative Medicine at Brigham and Women’s Hospital.

What are the benefits of therapeutic massage?

Most massage techniques are designed to promote pain relief, stress reduction, and improved movement in daily living.

Therapeutic massage has been shown to improve joint flexibility, relieve lower-back pain, and stimulate the release of endorphins. It can also be used to treat and prevent the following conditions:

  • Arthritis
  • Sports injuries, work-related injuries, and repetitive strain injuries (carpal tunnel, plantar fasciitis, tendonitis, bursitis)
  • Anxiety, depression, tension, and stress
  • Walking or running-related pain
  • Poor posture and suboptimal use of the body in movement

“Therapeutic massage manipulates the body’s soft tissue, so it also stimulates the flow of fluid in the lymphatic system, which can improve natural immunity. In addition, when received soon after surgery, therapeutic massage can help reduce post-surgery swelling or adhesions,” says Madore.

What are the various massage techniques?

The first massage technique that most therapists learn is Swedish massage which involves the application of oil and is used to promote relaxation.

Other massage styles and techniques include:

  • Reiki: Involves light touch, and is designed to work with the body’s energy.
  • Craniosacral therapy: Involves only five grams of pressure, and influences the central nervous system.
  • Deep tissue massage: Uses intense pressure and targets the deepest layers of muscle tissue, tendons and fascia.
  • Rolfing and myofascial release: Involves more aggressive techniques that aim to manipulate the soft tissues.

Madore specializes in Neuromuscular Therapy (NMT), a technique that releases trigger points within tight muscles. NMT is used to create balance among muscle groups to correct postural strain patterns.

“The treatment is based on pain patterns, but also on an assessment of how a patient’s muscle tension is producing twists or other alignment problems,” says Madore.

How often should you visit a massage therapist?

For individuals without a particular problem, visiting a licensed massage therapist once a month is appropriate. For those with a condition such as back pain, it may be appropriate to work with a massage therapist three-to-six times within a short period of time.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm