Article featured on National Spine Health Foundation
Nutrition for healthy bones is important knowledge. Ours bones play many roles in the body, from providing structure and support and protecting our organs to acting as a mineral storage for calcium and phosphorous. However, bone health is often overlooked until the diagnosis of osteoporosis or the occurrence of a fragility fracture later in life. Good nutrition throughout life plays a vital role in building strong and healthy bones. Taking steps to ensure you are getting bone building nutrients during childhood and adolescence, as well as the adult years, will help to maintain bone density and reduce your risk of developing osteoporosis later in life.
Bone is a dynamic living tissue that is able to rebuild and replenish itself. It is continuously changing as new bone is made and old bone is broken down. It does this through the workings of two key bone cells: osteoclasts and osteoblasts. Osteoclasts help to break down and reabsorb old bone cells while osteoblasts generate new bone cells to replace them. When you are young, your body makes new bone faster than it breaks down old bone.
As an adult, although bone remodeling continues, you begin to break down bone cells faster than you generate new ones. Osteoporosis, defined as a chronic progressive disease characterized by a deterioration of bone tissue, occurs when the old bone cells are being broken down faster than they are being replaced. Osteoporosis results in bones that are weak and fragile, leaving them at an increased risk for fractures. Maximizing bone accumulation during the adolescent years, known as peak bone mass, is the first crucial step to ensuring strong bones later in life.
Bone Health in Childhood
During the adolescent years, bone grows rapidly until peak bone mass is achieved. Peak bone mass refers to the greatest mass, strength, and density your bones genetically can accumulate. You can think of bone building as if one is climbing a peak during adolescence, reaches the peak in early adulthood, and then starts to decline later in life. By age 18, 90% of peak bone mass has been achieved and most young women and men reach their maximum bone density by their late 20’s. Although genetics determine 60 – 80% of peak bone mass, lifestyle choices, including diet and physical activity, are also predictors of bone accumulation during growth.
Any condition that interferes with achieving optimal peak bone mass can, therefore, increase fracture risk later in life. The figure on page 39 illustrates the life cycle of bone and how diet and lifestyle choices during the adolescent years can influence peak bone mass.
Nutrition for Healthy Bones
Physical activity and nutrition are essential to achieving peak bone mass. Many studies addressing nutrition and bone health in children have concluded that inadequate nutrition, particularly insufficient intake of calcium and vitamin D, during growth may negatively affect peak bone mass. Moreover, malnutrition that occurs with eating disorders has also been shown to have a direct effect on bone mass development. In young individuals with anorexia nervosa, bone loss can be detected after only six months of illness and deficits can remain even after weight gain recovery. The severe deficiency of nutrients that occurs with anorexia results in a reduction of bone formation, as well as increased bone resorption.
Even nutrient deficits from short-term fasting, (four days or longer), results in a marked decrease of bone formation markers in normal healthy young people. Achieving peak bone mass cannot be emphasized enough. It has been shown that achieving peak bone mass during the adolescent years could significantly delay the onset of osteoporosis by 13 years, reducing the risk of osteoporotic fractures later in life.
By the age of 40, we all slowly begin to lose bone mass. However, as with adolescents aiming to achieve peak bone mass, quality nutrition and regular exercise also help adults avoid the severe bone loss that leads to osteoporosis. A recent study examining the effects of diet on bone health found that postmenopausal women who ate a Mediterranean diet were less likely to suffer from hip fractures. The Mediterranean diet is well known for its emphasis on eating foods like fish, vegetables, fruits, legumes, whole grains, nuts, seeds, and olive oil. Meat, cheese, and sweets are very limited. This study highlights how an overall healthy diet may be more important in supporting bone health than focusing on the intake of any single nutrient.
How Calcium Factors into Bone Health
The health and strength of our bones rely on a balanced diet that provides a steady stream of many key nutrients, most importantly, calcium and vitamin D. Calcium has always been known as one of the vital nutrients for building strong bones.
This is because the matrix of bone is mineralized with calcium and phosphate, which in turn gives strength to its structure. Calcium is also important for muscle contraction, heartbeat regulation, nerve impulse transmission, regulation of blood pressure, and immune system function. 99% of calcium is stored in our bones, and unfortunately, when you don’t get enough calcium in your diet, the body will pull calcium from the bones to support these other functions. Without adequate calcium, bones become weak and fragile.
Recently, there have been ongoing debates surrounding the intake of calcium supplements. While they do not question the importance of calcium in maximizing bone strength, they do question the healthiest or safest amount recommended for optimal bone health. Some studies found no evidence that calcium supplements prevent fractures in adults or increase bone mineral density in healthy children. Calcium supplementation has also recently been associated with an increased risk of heart attacks. Therefore, healthy adults and children should aim to get the recommended daily amount of calcium from food first and supplement only if needed. In fact, there is no added benefit to taking more calcium than you need in supplements and doing so may increase your risk of other health issues
Although dairy products are the most well-known sources of calcium, it’s not healthy to solely rely on milk, yogurt, and cheese to supply your calcium needs. Adding other foods like:
- Leafy green vegetables
- Fish
- Beans
- Nuts and seeds
Adding these things to your diet will also help you reach your recommended daily intake of calcium. Pairing calcium-rich foods with foods high in vitamin D, such as egg yolks, shiitake mushrooms, and fish (specifically salmon, mackerel, sardines, and canned tuna), will help the absorption of calcium from your food.
Sun Exposure and Vitamin D
Safe sun exposure and supplements are also ways to maintain adequate vitamin D levels.The National Osteoporosis Foundation recommends women and men over the age of 50 years to consume 800 – 1,000 IU of vitamin D daily. Magnesium is another mineral component of the bone matrix and plays an important role in bone metabolism. Magnesium stimulates the hormone calcitonin, which enhances the absorption of calcium from the blood into the bone. Magnesium also helps to convert vitamin D into its active form, which then aids in calcium absorption. Unfortunately, most people don’t get enough magnesium through diet alone.
Additionally, eating a diet high in processed foods and even supplementing with excessive calcium can result in magnesium deficiency. You can help to maintain healthy magnesium levels by including these foods that are high in magnesium in your diet: spinach, pumpkin, sesame and sunflower seeds, Mackerel, beans, quinoa, brown rice, cashews, and almonds. Aim for 400 – 800 mg of magnesium a day.
What About Vitamin K?
Low levels of vitamin K are also emerging as a dietary risk factor for osteoporosis. Vitamin K deficiency has been linked to an increased risk of osteoporotic fractures. Studies have shown that postmenopausal women with osteoporosis who supplemented with vitamin K2 achieved significant improvement in vertebral bone mineral density and reduction in the overall risk of fractures. In addition, improved vitamin K status in healthy young girls was associated with a decreased rate of bone turnover. Vitamin K, and more specifically vitamin K2, is necessary to ensure that calcium gets absorbed into the bones and prevents it from being deposited in other areas of the body, such as organs, joint spaces, and arteries. Vitamin K2 is also essential for the activation of osteocalcin, a protein needed to bind calcium to the bone matrix and for blocking the formation of too many osteoclasts. Dietary sources of K2 are primarily found in fermented foods such as Natto, cheeses such as Brie and Gouda, meat, poultry, and eggs. Two common supplemental forms of vitamin K2 are menaquinone-4 (mk-4) and menaquinone-7 (mk-7). Mk-7 is derived from a natural fermentation process and has a longer duration of action, making it a better choice for supplementation.
Studies have shown 45 – 150 micrograms of K2 in the form of mk-7 per day is important for increasing bone strength. Use caution when supplementing with vitamin K if you are taking anticoagulant medications because vitamin K is a fat soluble vitamin, meaning it needs to be taken with fat to maximize absorption.
For years, there has been ongoing debate about the effects of animal protein on bone health. Many in the field of nutrition suggest that eating foods such as meat can create a more acidic environment in the body, causing calcium to be leached from the bones. However, recent studies suggest that, although eating animal protein may increase calcium excretion, it also significantly increases calcium absorption resulting in no adverse effects on calcium balance. Animal proteins also provide many important bone growth factors that aid in bone mineralization.
Many plants provide proteins, too, and are also an excellent source of vitamins, minerals, fibers, and antioxidants that are essential to bones. For optimal bone health, add variety to your diet by intermixing nutritious plant-based proteins (beans, legumes, nuts, seeds, natural soy) with high-quality animal proteins (eggs, salmon, lean meats). This will ensure you get all the valuable nutrients needed to build a strong body. Not only nutrient deficiency, but also poor dietary choices, can have a negative impact on bone health.
The Sugar Effect on Bone Health
Diets high in refined sugar have been shown to impair bone growth and mechanical strength. Drinking carbonated soft drinks containing phosphates and coloring has been shown to interfere with calcium metabolism. It is also well known that salt, especially abundant in processed foods, increases the excretion of calcium through the urine. Excessive caffeine, such as four or more cups of coffee a day, can result in loss of calcium and magnesium, predisposing you to higher risk of fractures.
Alcohol also has a negative effect on bone health for several reasons. It alters bone formation and remodeling, interferes with calcium balance, causes disruption in hormones, which can lead to irregular menstrual cycles in women and decreased testosterone in men, and can elevate cortisol levels, leading to bone break down. To maintain healthy bones, limit your alcohol to one or two drinks a day. Your lifestyle choices also affect your bone health.
By far, one of the biggest risk factors for osteoporosis is smoking. Smoking a pack of cigarettes a day increases your risk of osteoporosis by 60%. It has been shown that adolescents that smoke fail to achieve peak bone mass.
Why Exercise Matters
Getting enough physical activity can also mean the difference between a frail and strong skeleton. There is no question that both children and adults who exercise regularly are at less risk of bone loss. Impact exercises, like power walking, jogging, and racket sports, as well as weight lifting, increase bone density.
Recent research indicates that just hopping for two minutes a day can increase bone mass in the hip! Because osteoporosis has no symptoms and is often not discovered until a broken bone occurs, importance lies in taking steps to prevent osteoporosis at an early age. A balanced and varied diet is an important key factor in ensuring proper bone development among young people.
As we age, proper nutrition continues to be necessary to maintain a strong skeleton. If you already have osteoporosis, the good news is that by improving your diet, adjusting your lifestyle habits, and beginning an exercise program, you can slow down bone loss and, in some cases, even reverse it!
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, foot and ankle conditions, 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 and podiatric 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
4 Common Myths About Total Joint Replacement
in Joint ReplacementArticle featured on Beufort Memorial
Nearly 800,000 knee replacements and 500,000 hip replacements are performed each year in the United States, many of which are total joint replacements. When knee or hip pain gets too severe for you to function normally, your orthopedic surgeon will go into the joint in question and replace it with a new joint made from artificial materials.
This extremely beneficial surgery can reduce your pain dramatically and improve your mobility. Too many people, however, have misconceptions about the process of total joint replacement surgery and can put off having it, prolonging their pain and stiffness. We’re here to dispel those myths and get you back to the life you once enjoyed.
Myth #1: I’m Too Young for Joint Replacement
Fact: Total joint replacement is for people of any age whose hip or knee pain limits their daily activities and negatively impacts their quality of life. In recent years, the age of people having total joint replacements has trended downward, with adults in their 30s, 40s and 50s having the procedure. Joint replacements can help many people experiencing pain or stiffness related to arthritis, a joint injury, or the wear and tear of active living.
Another common age-related misconception is that the new joint will wear out and require revision surgery, in which an orthopedic surgeon must replace the implant. However, most joint implants today have longer lifespans than they used to, thanks to improvements in materials and surgical techniques. In addition, orthopedic teams have a better understanding of presurgical physical therapy, weight loss, rehabilitation and other strategies that lead to more successful joint replacement surgeries than in the past. Today, estimates suggest that artificial knee and hip joints can last 15 to 20 years, with some lasting longer than 25 years.
Myth #2: My Joint Pain Isn’t Bad Enough Yet
Fact: “Too often, people will think they don’t need surgery because they’ve adapted to their pain and don’t think it’s ‘that bad,’” says Dana Aiken, RN, total joint and spine coordinator. “But joint pain threatens your lifestyle by keeping you from doing the things you enjoy — playing with your kids, participating in sports or doing something as simple as taking a walk.”
There is no marker for how bad your pain must be to have a total hip or knee replacement surgery. Everyone experiences pain differently, and we build tolerance to pain over time. You might be surprised what a reduction in your pain feels like, and regardless of your pain level, regaining mobility is an excellent reason for having the surgery. The less mobile you are, the less active you become — and sedentary living can lead to other serious conditions, such as heart disease and diabetes.
Myth #3: Recovery Takes Too Long and Is Too Painful
Fact: Another common refrain when someone decides not to get total joint replacement surgery is, “I don’t have time for a long recovery process.” Fortunately, surgical advancements mean you’re not out of commission for long periods after your procedure.
Your recovery timeline depends on factors such as:
Your surgical recovery begins the day of your procedure. Your team will have you up and moving around a few hours after it’s over. Your hospital stay will average no more than a few days. Some people can even go home the same day.
You’ll start physical therapy almost immediately to begin strengthening the muscles around your new joint and help you perform regular activities of daily living. Physical therapy typically lasts between two and 12 weeks, depending on your specific needs. Most patients are back to their daily routines in one to three months.
Myth #4: Joint Replacement Will Limit Me in the Future
Fact: Some people fear that total joint replacement permanently restricts what they can do post-surgery. You will need to avoid high-impact sports for the longevity of your joints. However, this shouldn’t hold you back from doing low-impact activities, such as swimming and golfing.
Engaging in your favorite activities is beneficial to your recovery. Even light movement strengthens the muscles around your new joint and improves your joint’s range of motion. You may need a walker or crutches for the first few weeks. Your rehab team will help you progress off those as quickly and safely as possible.
You can also work with your physical therapist on your individual goals post-surgery. After all, helping you regain mobility is the reason for replacing your hip or knee in the first place. Are you an avid hiker or cyclist? Tell your physical therapist so they can tailor your therapy sessions and exercises to the activities you enjoy most.
The only way to know whether total joint replacement is the right choice for you is to explore your options. An orthopedic surgeon can answer your questions and ease any concerns so you can make the most informed decision possible. It’s time to stop letting joint pain rule your life and get back to enjoying life’s adventures, big and small.
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, foot and ankle conditions, 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 and podiatric 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
Help Ease Arthritis Pain and Stiffness With Exercise
in Arthritis, Joint Pain, Nutrition & General HealthArticle featured on Mayo Clinic
Exercise helps ease arthritis pain and stiffness
When starting an arthritis exercise program, know what to do and how much to do for best results.
Everyone needs exercise, but it’s especially important for people with arthritis. Exercise increases strength and makes moving easier. Exercise reduces joint pain and helps fight tiredness.
Of course, when joints are stiff and painful, the thought of walking around the block or swimming a few laps might seem like too much. There’s no need to run a marathon or swim for miles. Even moderate exercise can ease pain and help you stay at a healthy weight. In short, when arthritis tries to slow you down, exercise can keep you moving.
The right kinds of exercise can improve health and fitness without hurting joints. Combined with a treatment program, exercise can add to quality of life. And it can:
Bones need strong muscles for support. Not exercising weakens those supporting muscles. Weak muscles put more stress on joints.
Check with your health care provider first
Talk to your care provider about making exercise a part of your treatment. The best exercises depend on the type of arthritis and which joints the arthritis is in. A member of your health care team, such as a physical therapist, can work with you to find the exercise plan that’s best for you.
Exercises for arthritis
Exercises for arthritis might include exercises that put joints through their full range of motion and strengthening exercises. Exercise that raises heart rate, known as aerobic exercise, is also important.
Range-of-motion exercises
These exercises lessen stiffness and put joints through their full range of motion. Examples of these exercises are stretching arms up high or rolling shoulders forward and backward. Most of these exercises can be done every day.
Strengthening exercises
These exercises help build strong muscles that can support and protect the joints. Weight training is an example of exercise that can help build and keep muscle strength. Using resistance bands, hand weights or machines can help build strength.
Weight training should be done every other day for at least two days a week. It should include all the major muscles in the body.
Aerobic exercise
Exercises that raise heart rate, known as aerobic exercises, help with overall fitness. They can improve heart and lung health, help control weight, and increase energy.
Examples of aerobic exercises that are easy on joints include walking, bicycling, swimming and water aerobics. Try to work up to 150 minutes of somewhat hard aerobic exercise every week. You can exercise 10 minutes at a time if that’s easier on your joints.
It’s best to do moderate aerobic activity most days of the week. But even a couple of days a week can help. Exercise at a rate at which breathing is harder than usual while still being able to talk.
Other activities
Any movement, no matter how small, can help. Daily activities such as mowing the lawn, raking leaves and walking the dog count.
Exercises that focus on how the body moves, such as gentle forms of yoga or tai chi, also can help. They can improve balance and posture, prevent falls, and ease tenseness.
If you’re in an exercise class, tell your teacher about your arthritis. Listen to your body. Don’t do anything that causes pain.
Tips to protect your joints
If you haven’t exercised in a while, start slowly. Don’t push yourself too hard — that can overwork muscles and make joint pain worse.
Consider these tips:
Listen to your body. Don’t push too hard. Build up slowly. Add more and harder exercise as you get stronger.
Don’t overdo
You might feel some pain and stiffness after exercise if you haven’t been active for a while. In general, if pain lasts more than two hours after exercise, you might be pushing too hard. You might need to exercise less often or for less time. Talk to your health care provider about how to know when pain is a sign of something more serious.
If you have rheumatoid arthritis, ask your provider if you should exercise during flares. You might work through your joint flares by doing only range-of-motion exercises. Or you might exercise in water. Even during a flare, it’s good to keep your body moving.
Exercise programs for people with arthritis
Check with your care provider about exercise programs in your area for people with arthritis. Some hospitals, clinics and health clubs offer special programs.
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, foot and ankle conditions, 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 and podiatric 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
The Affects Weather Has On Joint Pain
in Joint Pain, Nutrition & General HealthArticle featured on Med Travel
If you’ve ever felt an ache in your knees, hips, or hands when the weather changes, you’re not alone. Many people with arthritis, past orthopedic injuries, or joint replacements notice that cold, damp, or stormy weather seems to intensify their joint pain. But is there a real connection between the weather and your orthopedic health, or is it just an old wives’ tale?
Does Weather Really Affect Joint Pain?
Yes, and science backs it up. Many studies suggest that barometric pressure changes, temperature drops, and humidity fluctuations can all influence joint stiffness and inflammation.
How Different Weather Conditions Impact Joints
If you notice your arthritis symptoms or old orthopedic injuries flare up before a weather shift, you’re likely sensitive to these environmental changes.
Who is Most Affected by Weather-Related Joint Pain?
Not everyone experiences weather-induced joint pain, but some individuals are more prone than others. You might be at risk if you:
How to Protect Your Joints from Weather Changes
The good news? There are ways to manage weather-related joint pain so it doesn’t interfere with your mobility or quality of life.
1. Keep Your Joints Warm
Cold weather constricts blood vessels, which can lead to joint stiffness and pain. To counteract this:
2. Stay Active with Low-Impact Exercises
Regular movement lubricates the joints and prevents stiffness. Try:
If you’ve recently undergone orthopedic surgery, consult your physical therapist to adjust your rehabilitation plan accordingly.
3. Maintain a Joint-Friendly Diet
Inflammation is a major cause of weather-related joint pain, and what you eat can either soothe or worsen symptoms.
Eat more anti-inflammatory foods, such as:
Limit:
4. Hydrate to Keep Joints Lubricated
Cartilage—the cushioning tissue in your joints—relies on water to stay flexible and shock-absorbent. Dehydration can make joint pain worse, so aim for at least 8 glasses of water per day.
If you’re traveling for orthopedic surgery through medical tourism, staying hydrated is especially important to help your body adjust to new climates.
5. Try Temperature Therapy
Alternating heat and cold treatments can ease discomfort from weather fluctuations:
If your joint pain persists despite these strategies, it may be time to consult an orthopedic specialist.
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, foot and ankle conditions, 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 and podiatric 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
Minimally Invasive Orthopedic Surgery
in Nutrition & General Health, Surgery Recovery, TechnologyArticle featured on Dearborn & Associates
Minimally invasive orthopedic surgery has emerged as a transformative advancement in joint restoration and musculoskeletal care.
Unlike traditional orthopedic procedures that often require large incisions and extensive recovery, minimally invasive surgery focuses on smaller incisions, targeted treatment, and expedited healing timelines.
The shift toward these methods is not solely about comfort—though reduced pain and faster recovery are certainly major benefits. It also represents a broader trend in modern medicine toward preserving natural anatomy and minimizing collateral tissue damage. These techniques are especially beneficial in joint procedures, such as hip and knee replacements, where accuracy, precision, and postoperative mobility are critical for long-term function and quality of life.
Benefits That Extend Beyond the Operating Room
The advantages of minimally invasive orthopedic surgery extend far beyond the surgical suite. For patients, one of the most significant benefits is the decreased trauma to muscles, tendons, and soft tissue. This means that less energy is needed to repair the body after surgery, which can shorten the hospital stay and minimize the need for extensive rehabilitation. Patients can typically expect smaller scars, less postoperative discomfort, and a faster return to normal activities, compared to traditional orthopedic approaches.
In clinical terms, reduced bleeding, lower infection rates, and fewer complications are also frequently reported with minimally invasive procedures. These outcomes not only improve patient satisfaction but also align with broader healthcare goals—such as reducing readmissions and overall healthcare costs. For older adults or those with underlying health conditions, the lower physiological stress of a minimally invasive procedure makes it a safer and more appealing option.
Common Procedures Performed Minimally Invasively
While minimally invasive techniques are used across many orthopedic specialties, they are particularly effective in joint restoration procedures. Some of the most common minimally invasive surgeries include:
This involves smaller incisions and less soft tissue disruption around the knee joint. Specialized instruments and navigation systems help ensure that the prosthetic components are placed with precision, enhancing longevity and performance.
Often performed using an anterior approach, this method allows surgeons to work between muscles without detaching them, reducing pain and accelerating recovery time.
Used for conditions like meniscus tears, ligament repairs, or joint debridement, arthroscopy involves inserting a small camera and surgical tools through tiny incisions to visualize and treat the interior of joints with minimal trauma.
The Surgical Experience: What to Expect
Patients considering minimally invasive orthopedic surgery often wonder what the experience entails. After a thorough preoperative evaluation, which includes imaging, functional assessments, and medical history review, a surgical plan is created to meet each patient’s unique goals.
On the day of surgery, patients typically undergo general or regional anesthesia, depending on the procedure and health profile. The surgery itself is performed using specialized instruments that allow the surgeon to operate through small incisions. Advanced imaging systems, including computer-assisted navigation or robotic assistance, may be used to ensure alignment and precision.
Postoperatively, patients are monitored closely and often begin gentle movement within hours of surgery. Most can expect a shorter hospital stay—sometimes going home the same day—and will begin a tailored physical therapy program shortly after. Follow-up appointments ensure progress is being made and that the joint is healing as expected.
Is Everyone a Candidate for Minimally Invasive Surgery?
Not every patient is a candidate for minimally invasive orthopedic surgery, although the majority of joint restoration patients qualify. Factors that may affect eligibility include bone deformities, extensive joint damage, prior surgeries, and specific anatomical considerations. However, advancements in technology and surgical technique continue to broaden the eligibility pool.
Candidacy is determined through a careful consultation process. Evaluation includes that of not only the patient’s physical condition but also their goals, lifestyle, and overall health. This approach ensures that each individual receives the treatment that offers the best possible balance of safety, effectiveness, and recovery outcomes.
Enhancing Recovery Through Modern Rehabilitation
A key component of successful outcomes in minimally invasive orthopedic surgery is the rehabilitation process. Because these procedures preserve more of the body’s natural structure, patients can often begin movement and strengthening exercises sooner. At-home care plans typically involve physical therapy, low-impact activities like walking or aquatic exercise, and close communication with the surgical team.
Patients are taught how to move safely, manage swelling, and set realistic expectations for healing. The result is a smoother, more empowered recovery process—one where patients actively participate in regaining strength and mobility.
The Future of Joint Restoration
Minimally invasive techniques are no longer considered the “alternative”—they’re increasingly becoming the standard. The field of orthopedic surgery continues to evolve with better tools, improved materials for implants, and enhanced visualization technologies. All of these advancements contribute to outcomes that are safer, more predictable, and longer lasting.
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, foot and ankle conditions, 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 and podiatric 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
Avoiding Fatigue: 10 Office Ergonomics Tips
in Ergonomics, Wellness Tips, Working From Home- TipsArticle featured on ErgoPlus
Follow these quick and easy office ergonomics tips to decrease fatigue, discomfort and physical stress while also increasing comfort and productivity.
“Ergonomics” is the science of designing the workstation to fit within the capabilities and limitations of the worker.
The goal of office ergonomics is to design your office work station so that it fits you and allows for a comfortable working environment for maximum productivity and efficiency.
An ergonomically correct office work station will help you avoid fatigue and discomfort – who doesn’t want that? Whether you’re an OHS professional in charge of providing a safe work environment for the employees at your company or simply a computer user who wants to avoid fatigue, following a few simple guidelines can help you significantly improve your office work station.
Office Ergonomics Tips
Follow these 10 office ergonomics tips to help you avoid fatigue:
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, foot and ankle conditions, 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 and podiatric 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
Getting Your Knees Ready for Summer Hiking
in General Orthopedics, Health & Wellness, Knee Injuries, Knee Pain, Sports Medicine, Sports Related Injuries, Wellness TipsArticle featured on AZ Ortho
Are you an avid hiker ready to hit the trails and conquer new heights? We get the appeal—hiking is an amazing way to connect with nature while staying active at the same time. However, you have to keep an eye on your joints, especially your knees, to ensure a smooth and pain-free hiking experience.
Here are some handy orthopedic tips specifically tailored for hikers to prevent joint strain and keep your knees trail-ready.
Choose the Right Footwear
Investing in the right footwear can make a significant difference in protecting your knees while hiking. Opt for hiking boots or shoes that are specifically designed for rugged terrain. Look for features like ankle support, cushioned insoles, and durable outsoles with good traction. Properly fitting footwear also helps prevent blisters, hot spots, and discomfort that can indirectly affect your knee health.
Additional Tip: Consider Orthotic Inserts
If you have specific foot issues or pronation concerns, consider using orthotic inserts in your hiking shoes. Orthotics can provide additional support and alignment for your feet, which can help reduce stress on your knees.
Warm-Up and Stretch
Before starting your hike, spend at least 10–15 minutes warming up your muscles and performing dynamic stretches. No one should go into any type of exercise with cold muscles!
Good dynamic stretches should involve active movements that mimic the actions you’ll perform during the hike, such as leg swings, high knees, and lunges. These exercises increase blood flow to your muscles, improve flexibility, and prepare your body for the physical demands of hiking.
Additional Tip: Include Foam Rolling
Incorporate foam rolling into your pre-hike routine to release tension in your muscles and fascia. Focus on rolling out your quadriceps, hamstrings, calves, and IT band. Foam rolling can help improve your range of motion, reduce muscle tightness, and enhance overall mobility, which can contribute to better knee health during your hike.
Maintain Proper Posture
Proper posture lets you prevent knee strain and maintain good overall body alignment during hiking. Keep your head up, shoulders relaxed, and gaze forward to avoid rounding your shoulders or slouching. Engage your core muscles to support your spine and pelvis, which reduces strain on your lower back and knees. Periodically check your posture throughout your hike and make adjustments as needed.
Additional Tip: Use Backpack Ergonomics
If you’re carrying a backpack during your hike, make sure the straps are adjusted properly to distribute weight evenly. Use a backpack that has padded shoulder straps, a waist belt, and a chest strap to stabilize the load and prevent strain on your back and shoulders. Pack essential items strategically to minimize unnecessary weight and optimize balance while hiking.
Gradually Increase Intensity
Whether you’re a beginner or an experienced hiker, it’s best to progress gradually when increasing the intensity of your hikes. Start with shorter distances and easier trails, gradually building up to longer hikes with more elevation gain. Listen to your body’s cues and take breaks as needed to rest and refuel. Pushing yourself too hard too soon can lead to overuse injuries and trouble for your knees.
Additional Tip: Incorporate Cross-Training
Incorporate cross-training activities like cycling, swimming, or yoga into your fitness routine to gain better strength, flexibility, and endurance. Cross-training can help prevent muscle imbalances, improve joint stability, and reduce the risk of overuse injuries.
Watch Your Foot Placement
Pay attention to where you step while hiking to avoid uneven terrain and obstacles that could lead to slips or falls. Take deliberate steps and use caution when navigating rocky or slippery surfaces. Choose stable footing whenever possible and use trekking poles for added balance and support, especially during descents or challenging terrain.
Additional Tip: Use Proper Descending Techniques
When descending steep slopes or rocky terrain, use proper techniques to protect your knees. Descend slowly and maintain a slightly bent knee position to absorb shock and reduce the impact on your joints. Avoid locking your knees or landing with excessive force, as this can strain your knee ligaments and cartilage.
Strengthen Your Leg Muscles
Strong leg muscles provide the support and stability your knees need during hikes. Incorporate strength training exercises into your fitness routine to target your quadriceps, hamstrings, calves, and glutes. Squats, lunges, calf raises, and leg presses are excellent exercises to build strength and improve knee stability. Consistent strength training can help prevent joint strain and enhance your hiking performance.
Additional Tip: Focus on Functional Movements
In addition to traditional strength training exercises like squats, lunges, and leg presses, prioritize functional movements that mimic hiking actions. Include exercises such as step-ups, single-leg squats, and lateral lunges to improve balance, stability, and agility. Functional training prepares your muscles for the specific demands of hiking, reducing the risk of injuries.
Listen to Your Body
Lastly, listen to your body and pay attention to any signs of discomfort or pain in your knees while hiking. If you experience persistent pain, swelling, or instability, seek medical attention and avoid pushing through the pain. Rest, ice, compression, and elevation (RICE) can help alleviate minor knee injuries, but consulting with an orthopedic specialist is needed for proper diagnosis and treatment.
Additional Tip: Implement Recovery Strategies
After your hike, prioritize recovery strategies to promote muscle recovery and reduce inflammation in your knees. Perform gentle stretching exercises, use foam rollers or massage tools to alleviate muscle tension, and apply ice packs to reduce swelling. To get fully recovered and help your joints, get a good amount of rest, hydration, and nutrition as well.
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, foot and ankle conditions, 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 and podiatric 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
Strong Bones at Any Age: A Guide to Lifelong Nutrition
in Bone Health, Health & Wellness, Nutrition & General HealthArticle featured on National Spine Health Foundation
Nutrition for healthy bones is important knowledge. Ours bones play many roles in the body, from providing structure and support and protecting our organs to acting as a mineral storage for calcium and phosphorous. However, bone health is often overlooked until the diagnosis of osteoporosis or the occurrence of a fragility fracture later in life. Good nutrition throughout life plays a vital role in building strong and healthy bones. Taking steps to ensure you are getting bone building nutrients during childhood and adolescence, as well as the adult years, will help to maintain bone density and reduce your risk of developing osteoporosis later in life.
Bone is a dynamic living tissue that is able to rebuild and replenish itself. It is continuously changing as new bone is made and old bone is broken down. It does this through the workings of two key bone cells: osteoclasts and osteoblasts. Osteoclasts help to break down and reabsorb old bone cells while osteoblasts generate new bone cells to replace them. When you are young, your body makes new bone faster than it breaks down old bone.
As an adult, although bone remodeling continues, you begin to break down bone cells faster than you generate new ones. Osteoporosis, defined as a chronic progressive disease characterized by a deterioration of bone tissue, occurs when the old bone cells are being broken down faster than they are being replaced. Osteoporosis results in bones that are weak and fragile, leaving them at an increased risk for fractures. Maximizing bone accumulation during the adolescent years, known as peak bone mass, is the first crucial step to ensuring strong bones later in life.
Bone Health in Childhood
During the adolescent years, bone grows rapidly until peak bone mass is achieved. Peak bone mass refers to the greatest mass, strength, and density your bones genetically can accumulate. You can think of bone building as if one is climbing a peak during adolescence, reaches the peak in early adulthood, and then starts to decline later in life. By age 18, 90% of peak bone mass has been achieved and most young women and men reach their maximum bone density by their late 20’s. Although genetics determine 60 – 80% of peak bone mass, lifestyle choices, including diet and physical activity, are also predictors of bone accumulation during growth.
Any condition that interferes with achieving optimal peak bone mass can, therefore, increase fracture risk later in life. The figure on page 39 illustrates the life cycle of bone and how diet and lifestyle choices during the adolescent years can influence peak bone mass.
Nutrition for Healthy Bones
Physical activity and nutrition are essential to achieving peak bone mass. Many studies addressing nutrition and bone health in children have concluded that inadequate nutrition, particularly insufficient intake of calcium and vitamin D, during growth may negatively affect peak bone mass. Moreover, malnutrition that occurs with eating disorders has also been shown to have a direct effect on bone mass development. In young individuals with anorexia nervosa, bone loss can be detected after only six months of illness and deficits can remain even after weight gain recovery. The severe deficiency of nutrients that occurs with anorexia results in a reduction of bone formation, as well as increased bone resorption.
Even nutrient deficits from short-term fasting, (four days or longer), results in a marked decrease of bone formation markers in normal healthy young people. Achieving peak bone mass cannot be emphasized enough. It has been shown that achieving peak bone mass during the adolescent years could significantly delay the onset of osteoporosis by 13 years, reducing the risk of osteoporotic fractures later in life.
By the age of 40, we all slowly begin to lose bone mass. However, as with adolescents aiming to achieve peak bone mass, quality nutrition and regular exercise also help adults avoid the severe bone loss that leads to osteoporosis. A recent study examining the effects of diet on bone health found that postmenopausal women who ate a Mediterranean diet were less likely to suffer from hip fractures. The Mediterranean diet is well known for its emphasis on eating foods like fish, vegetables, fruits, legumes, whole grains, nuts, seeds, and olive oil. Meat, cheese, and sweets are very limited. This study highlights how an overall healthy diet may be more important in supporting bone health than focusing on the intake of any single nutrient.
How Calcium Factors into Bone Health
The health and strength of our bones rely on a balanced diet that provides a steady stream of many key nutrients, most importantly, calcium and vitamin D. Calcium has always been known as one of the vital nutrients for building strong bones.
This is because the matrix of bone is mineralized with calcium and phosphate, which in turn gives strength to its structure. Calcium is also important for muscle contraction, heartbeat regulation, nerve impulse transmission, regulation of blood pressure, and immune system function. 99% of calcium is stored in our bones, and unfortunately, when you don’t get enough calcium in your diet, the body will pull calcium from the bones to support these other functions. Without adequate calcium, bones become weak and fragile.
Recently, there have been ongoing debates surrounding the intake of calcium supplements. While they do not question the importance of calcium in maximizing bone strength, they do question the healthiest or safest amount recommended for optimal bone health. Some studies found no evidence that calcium supplements prevent fractures in adults or increase bone mineral density in healthy children. Calcium supplementation has also recently been associated with an increased risk of heart attacks. Therefore, healthy adults and children should aim to get the recommended daily amount of calcium from food first and supplement only if needed. In fact, there is no added benefit to taking more calcium than you need in supplements and doing so may increase your risk of other health issues
Although dairy products are the most well-known sources of calcium, it’s not healthy to solely rely on milk, yogurt, and cheese to supply your calcium needs. Adding other foods like:
Adding these things to your diet will also help you reach your recommended daily intake of calcium. Pairing calcium-rich foods with foods high in vitamin D, such as egg yolks, shiitake mushrooms, and fish (specifically salmon, mackerel, sardines, and canned tuna), will help the absorption of calcium from your food.
Sun Exposure and Vitamin D
Safe sun exposure and supplements are also ways to maintain adequate vitamin D levels.The National Osteoporosis Foundation recommends women and men over the age of 50 years to consume 800 – 1,000 IU of vitamin D daily. Magnesium is another mineral component of the bone matrix and plays an important role in bone metabolism. Magnesium stimulates the hormone calcitonin, which enhances the absorption of calcium from the blood into the bone. Magnesium also helps to convert vitamin D into its active form, which then aids in calcium absorption. Unfortunately, most people don’t get enough magnesium through diet alone.
Additionally, eating a diet high in processed foods and even supplementing with excessive calcium can result in magnesium deficiency. You can help to maintain healthy magnesium levels by including these foods that are high in magnesium in your diet: spinach, pumpkin, sesame and sunflower seeds, Mackerel, beans, quinoa, brown rice, cashews, and almonds. Aim for 400 – 800 mg of magnesium a day.
What About Vitamin K?
Low levels of vitamin K are also emerging as a dietary risk factor for osteoporosis. Vitamin K deficiency has been linked to an increased risk of osteoporotic fractures. Studies have shown that postmenopausal women with osteoporosis who supplemented with vitamin K2 achieved significant improvement in vertebral bone mineral density and reduction in the overall risk of fractures. In addition, improved vitamin K status in healthy young girls was associated with a decreased rate of bone turnover. Vitamin K, and more specifically vitamin K2, is necessary to ensure that calcium gets absorbed into the bones and prevents it from being deposited in other areas of the body, such as organs, joint spaces, and arteries. Vitamin K2 is also essential for the activation of osteocalcin, a protein needed to bind calcium to the bone matrix and for blocking the formation of too many osteoclasts. Dietary sources of K2 are primarily found in fermented foods such as Natto, cheeses such as Brie and Gouda, meat, poultry, and eggs. Two common supplemental forms of vitamin K2 are menaquinone-4 (mk-4) and menaquinone-7 (mk-7). Mk-7 is derived from a natural fermentation process and has a longer duration of action, making it a better choice for supplementation.
Studies have shown 45 – 150 micrograms of K2 in the form of mk-7 per day is important for increasing bone strength. Use caution when supplementing with vitamin K if you are taking anticoagulant medications because vitamin K is a fat soluble vitamin, meaning it needs to be taken with fat to maximize absorption.
For years, there has been ongoing debate about the effects of animal protein on bone health. Many in the field of nutrition suggest that eating foods such as meat can create a more acidic environment in the body, causing calcium to be leached from the bones. However, recent studies suggest that, although eating animal protein may increase calcium excretion, it also significantly increases calcium absorption resulting in no adverse effects on calcium balance. Animal proteins also provide many important bone growth factors that aid in bone mineralization.
Many plants provide proteins, too, and are also an excellent source of vitamins, minerals, fibers, and antioxidants that are essential to bones. For optimal bone health, add variety to your diet by intermixing nutritious plant-based proteins (beans, legumes, nuts, seeds, natural soy) with high-quality animal proteins (eggs, salmon, lean meats). This will ensure you get all the valuable nutrients needed to build a strong body. Not only nutrient deficiency, but also poor dietary choices, can have a negative impact on bone health.
The Sugar Effect on Bone Health
Diets high in refined sugar have been shown to impair bone growth and mechanical strength. Drinking carbonated soft drinks containing phosphates and coloring has been shown to interfere with calcium metabolism. It is also well known that salt, especially abundant in processed foods, increases the excretion of calcium through the urine. Excessive caffeine, such as four or more cups of coffee a day, can result in loss of calcium and magnesium, predisposing you to higher risk of fractures.
Alcohol also has a negative effect on bone health for several reasons. It alters bone formation and remodeling, interferes with calcium balance, causes disruption in hormones, which can lead to irregular menstrual cycles in women and decreased testosterone in men, and can elevate cortisol levels, leading to bone break down. To maintain healthy bones, limit your alcohol to one or two drinks a day. Your lifestyle choices also affect your bone health.
By far, one of the biggest risk factors for osteoporosis is smoking. Smoking a pack of cigarettes a day increases your risk of osteoporosis by 60%. It has been shown that adolescents that smoke fail to achieve peak bone mass.
Why Exercise Matters
Getting enough physical activity can also mean the difference between a frail and strong skeleton. There is no question that both children and adults who exercise regularly are at less risk of bone loss. Impact exercises, like power walking, jogging, and racket sports, as well as weight lifting, increase bone density.
Recent research indicates that just hopping for two minutes a day can increase bone mass in the hip! Because osteoporosis has no symptoms and is often not discovered until a broken bone occurs, importance lies in taking steps to prevent osteoporosis at an early age. A balanced and varied diet is an important key factor in ensuring proper bone development among young people.
As we age, proper nutrition continues to be necessary to maintain a strong skeleton. If you already have osteoporosis, the good news is that by improving your diet, adjusting your lifestyle habits, and beginning an exercise program, you can slow down bone loss and, in some cases, even reverse it!
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, foot and ankle conditions, 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 and podiatric 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
Common Reasons for Joint Replacement Surgery
in Joint Pain, Joint ReplacementArticle featured on Raleigh Orthopedic
What is Total Joint Replacement?
Total joint replacement is a commonly performed surgical procedure in which arthritic or damaged joints are replaced with prosthetic components to restore the function of the joint. The prosthetic device is made of metal, plastic, or ceramic. The goal of joint replacement is to relieve pain and make it possible to perform daily activities more easily.
Total joint replacement is only considered when you have tried and failed more conservative treatments, yet continue to have significant pain, stiffness, or problems with the function of your joint – often the hip or knee. If nonsurgical means, such as lifestyle changes, physical therapy, and mobility aids are no longer helpful, joint replacement surgery may be the next option to consider.
Common Causes Leading to Joint Replacement
The most common cause of joint replacement is arthritis. Osteoarthritis, rheumatoid arthritis, osteonecrosis, and post-traumatic arthritis are the most common forms of this disease.
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, foot and ankle conditions, 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 and podiatric 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
Common Swimming Overuse Injuries
in Back Pain, Knee Injuries, Neck Pain, Shoulder Injuries, Sports Medicine, Sports Related InjuriesArticle featured on Physiopedia
Swimming is a great sport enjoyed by all age groups at all levels of ability. It is a unique sport, in that it combines upper and lower extremity strength exercises with cardiovascular training in a non-weight bearing environment. Swimmers are unfortunately prone to injuries. Most swimming injuries are classed as overuse injuries and relate to faulty biomechanics. The most common swimming injury regions are the shoulder, neck, lower back and knee.
Swimming overuse injuries usually arise from one or a combination of the below:
Stretching is important for swimming because of the great range of muscles used when you’re in the water. Unprepared muscles don’t perform as well as muscles which have been warmed up ahead of exercising. A good stretching regime including at a minimum:
Note – The above list gives a guide to what to look for in each of the specific conditions listed below. This page does not give full physiotherapy procedures, instead providing great links to the sites that will have relevant information.
Swimmers Shoulder
Shoulder pain is the most frequent orthopaedic injury in swimmers, with a reported prevalence between 40% and 91% in elite swimmers. Swimmer’s shoulder is a condition with a gradual onset due to repetitive activity and can be classified as microtrauma. Swimmer’s shoulder usually presents as subacromial impingement involving the rotator cuff tendon, bicipital tendon, or subacromial bursa.
Primary subacromial impingement involves compression of these structures between the acromion and greater tuberosity (due to usually a tight posterior capsule causing the humeral head to migrate anteriorly) or abnormal acromial morphology. However, primary impingement syndrome is less common in competitive swimmers than secondary impingement.
Secondary impingement occurs through a series of impairments, usually in a swimmer with increased anterior glenohumeral laxity (shoulder ROM in swimmers often exhibit excessive external rotation and limited internal rotation). This shift in ROM towards increased external rotation is an adjustment to the demands on the glenohumeral joint allowing anterior laxity and greater demand on the rotator cuff and the long head of the biceps to reduce humeral head elevation and anterior translation.
Chronic swimmer’s shoulder can result in pathology of the rotator cuff, glenoid labrum, and long head of the biceps.
Swimmers Back
The spine is also a recognized site predisposed to injury in the elite swimmer, mainly associated with butterfly swimmers ( 33.3%-58%) and breaststroke swimmers (22.2%- 47%), figures varying from differing studies.
As swimming athletes are positioned horizontally in the water, gravity and buoyancy forces are traveling through the body with the potential to cause changes at the lumbar spine. Due to the undulating motion (lumbar extension) utilised in butterfly and breaststroke, there is potential for developing pain secondary to stress on the joints.
Causes include:
Swimmers Knee
Knee pain figures range from 34% to 86% for a single knee episode, being highest in breaststrokers.
A 2008 study found the 200 – 400 m breaststroke events increase the risk for knee overuse injuries more than other strokes or distances. Additionally training for more than four times a week increases the risk twofold for knee and fourfold for shoulder overuse injuries.
A 2004 study looking at competitive swimmers interestingly reports that breaststroke swimmers are at significant risk of: groin injury; groin injury is positively correlated with increased magnitude of breaststroke training; and groin injury may prevent participation in practices and competitions. So take the time to assess then groin and complete length of hip adductors, not just distally.
Swimmers Neck
Neck pain is mainly seen in the older athlete It may be due to facet joint arthritic change, and disc degeneration +/- nerve root irritation. Muscle innervation and sensation to the shoulder region is predominantly derived from the C5/C6 nerve roots. If these nerve roots are irritated due to degenerative change in the neck, shoulder complaints can arise. Arthritic change may limit neck rotation making correct breathing patterns difficult. Swimmers who unilaterally breath are more prone to neck pain. Looking forward rather than directly downward and extending the head too high when taking a breath increases the load on the neck and create pain.
Conclusion
Swimming can be a great sport for recreational swimmers up to elite swimmers. As a physiotherapist help swimmers overcome their injuries and liaise with trainers, coaches and physicians for the best results.
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, foot and ankle conditions, 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 and podiatric 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
Minimally Invasive Hand Surgery: What is it?
in Hand Fractures, Hand InjuriesArticle featured on Rothman Orthopedics
When it comes to hand and wrist conditions, many people typically think of traditional, open surgeries with long incisions that come with longer recovery times and significant downtime. However, thanks to advancements in minimally invasive techniques and surgical instruments, many hand surgeries today are performed with smaller incisions, faster healing, and fewer complications. These procedures allow us to treat a variety of hand and wrist issues effectively, often with less pain and quicker recovery. Let’s take a closer look at some of the minimally invasive options that are revolutionizing hand surgery.
Carpal Tunnel Syndrome (Endoscopic Carpal Tunnel Release)
Carpal tunnel syndrome is a common condition where the median nerve, which runs from your forearm into the palm of your hand, gets compressed as it passes through a narrow tunnel in your wrist. This can lead to numbness, tingling, and weakness in the hand. Traditionally, surgical treatment for carpal tunnel syndrome involved an incision from the wrist to the center of the palm to take pressure off the median nerve. The procedure was performed under general anesthesia and patients were often placed in a splint to rest the wrist for a few weeks.
Now, with endoscopic carpal tunnel release, we can perform the same procedure through one small incision at the wrist crease using a tiny camera (endoscope) to guide the surgery. This minimally invasive technique, which takes about 5 minutes to perform, reduces the risk of wound complications, minimizes scarring, and allows for a quicker recovery. Moreover, the procedure is typically performed with the patient awake, using only local anesthesia (like a dental procedure). The patient can drive themselves home with just a Band-Aid on the wrist. Studies have shown that patients return to their daily activities much sooner after endoscopic carpal tunnel release than with traditional carpal tunnel surgery.
Ganglion Cyst (Arthroscopic Wrist Ganglion Cyst Excision)
Ganglion cysts are fluid-filled lumps that typically form on the back of the wrist. While these cysts are almost always non-cancerous, they can cause discomfort and affect hand movement. Cysts can be drained with a needle, but the recurrence rate is greater than 50%. In the past, removing these cysts required a large incision on the back of the wrist with a deep dissection all the way down to the wrist bones to remove the cyst in total.
With arthroscopic wrist ganglion cyst excision, we can remove the cyst, simply by eliminating its connection to the wrist joint, using 2 “poke pole” incisions and a small camera (arthroscope) inserted into the wrist joint. This minimally invasive approach minimizes soft tissue damage, leaves the patient with barely noticeable scars, and significantly shortens recovery time. Patients experience less pain and faster healing after this procedure compared to traditional open surgery.
Hand and Finger Fractures (Intramedullary Nail Fixation)
Fractures of the hand and fingers can be particularly tricky to treat, especially when they involve small, intricate bones. Fractures that are significantly displaced may require surgical stabilization. Typically, this is accomplished using metal plates and screws that are just a few millimeters in dimension but require an incision the entire length of the bone to secure the hardware. Incisions like this may result in additional swelling and scarring which are the biggest detriment to recovering hand function after a fracture.
However, with intramedullary nail fixation, we can now treat many hand and finger fractures with a much smaller incision, which means less swelling and scarring, and a quicker recovery. This technique, inspired by the way lower extremity fractures are fixed, employs a long, thin metal rod inserted into the central canal of the bone though a small drill hole at the end of the bone. Surgeons can stabilize the fracture internally without the need for external metal hardware on the surface of the bone or large incisions. This method frequently allows patients to start using their hand for activities like driving, hygiene, or using a keyboard nearly immediately after surgery. With less swelling and scarring, some patients can even avoid the need for supervised hand therapy, an essential part of the recovery for fractures fixed with external plates and screws.
Thumb Arthritis (Thumb Carpometacarpal Arthroplasty Surgery)
Arthritis in the thumb carpometacarpal (CMC) joint, at the base of the thumb, is a common source of pain and dysfunction, particularly in older adults. Patients with CMC arthritis have pain and weakness with gripping the steering wheel, squeezing a tube of toothpaste, pinching a pair of socks to pull them up, and seemingly all use of the hand. In the past, treating severe CMC arthritis required “arthroplasty” surgery with incisions in the forearm and wrist to remove a small arthritic bone called the trapezium and harvest a rolled-up tendon to be used as a cushion at the base of the thumb. The patient’s tendons were also used to wrap around the thumb to stabilize it. Outcomes were very good, though recovery times were quite long.
Today, newer techniques of thumb CMC arthroplasty provide a minimally invasive approach with faster recovery times. Now, the only incision needed is a small incision at the wrist. With breakthroughs in surgical implant technology, surgeons can now use bone anchors and extra-strong sutures that very effectively stabilize the thumb after surgery, avoiding the need for the tendon cushion and tendon wrap performed in the past. This results in less post-operative pain and a faster recovery.
Hand and Wrist Arthritis (Neurectomy)
Arthritis in the hand and wrist can cause debilitating pain, stiffness, and loss of function. In cases where arthritis is severe, typical surgical strategies to relieve pain have included joint replacement surgery (metal and plastic implants similar to hip and knee replacements) or joint fusion. Both procedures, while effective, can leave the patient with limited function and limited to no joint motion as a tradeoff for pain relief.
A newer strategy to address severely arthritic joints in the hand and wrist is called a neurectomy procedure. A neurectomy (nerve removal) is a minimally invasive surgery intended to cut or remove only the nerves that transmit pain signals from the affected joint to the brain, and not the other more important nerves that provide sensation and muscle function to the hand. The neurectomy procedure otherwise leaves the arthritic joint intact, preserving the patient’s normal joint anatomy and function, and hastening the recovery. This technique is still evolving and currently does not provide complete pain relief in all patients, though it might be considered as an easy first step to address the problem and could be incredibly effective.
Dupuytren’s Disease (Needle Aponeurotomy and Collagenase)
Dupuytren’s disease is an excessive thickening of the normal connective tissue in the palm and fingers which causes the fingers to bend inward, making it impossible to fully straighten them. Traditionally, treating this condition involved extensive surgery to carefully and precisely remove this invasive tissue that intermingles with all of the important structures of the hand, in order to straighten the finger. Patients spend considerable time in therapy after surgery and full recovery usually occurs around 6 months post-op. However, two newer procedures focus on simply cutting or dissolving the thickened connective tissue, instead of fully removing it, to allow the finger to straighten.
With needle aponeurotomy, a needle is inserted through the skin multiple times and in multiple locations to break up the tight tissue, without making any incisions. This can be done in the office or in an operating room with light sedation anesthesia. Another option, collagenase injection, uses a special enzyme to dissolve the thickened tissue by means of an injection performed in the doctor’s office. A day or two later, the contracted finger is manipulated to release the thickened tissue and restore finger movement. Both of these minimally invasive treatments offer significant benefits over traditional surgery, including faster recovery, less pain, and a lower risk of complications. However, it should be noted that within 5 years of the procedure, 50% of the time, the thickened Dupuytren’s tissue reforms and the finger contracture recurs and might need to be treated again.
Why Minimally Invasive Procedures Matter
The benefits of minimally invasive surgeries extend beyond the immediate recovery period. These procedures typically involve less soft tissue disruption, which reduces the risk of infection, scarring, and complications. As a result, patients often experience less pain, shorter recoveries, and a quicker return to normal activities.
Furthermore, these advancements in hand surgery make it possible for people to maintain or regain function in their hands and wrists, which are essential for nearly every aspect of daily life. Whether you’re dealing with arthritis, nerve issues, or fractures, minimally invasive options provide effective, safer treatments that can improve your quality of life.
In Conclusion
Minimally invasive hand surgeries are a game-changer in the world of orthopedics. If you are struggling with hand or wrist pain, it’s worth discussing these advanced options with your orthopedic hand surgeon. With shorter recovery times, less pain, and fewer risks, these innovative procedures can help you get back to what matters most—whether that’s typing on a keyboard, playing sports, or simply enjoying time with loved ones.
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, foot and ankle conditions, 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 and podiatric 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