What is a Calcaneal Fracture?

Article featured on Cedars Cinai

Overview

The calcaneus is the large bone at the heel of the foot. It is usually fractured after a fall from a great height or in a motor vehicle accident.

Symptoms

Some calcaneal fractures are obvious, resulting in an inability to put weight on the heel, swelling of the heel and bruising of the heel and ankle. Pain is usually severe enough to require an emergency room visit. If the fracture is caused by a stress fracture, over time, then symptoms may be far more vague. There may be some pain, increasing throughout the day, often described as being dull and achy. Bruising may or may not be present.

Causes and Risk Factors

Calcaneal fractures are most commonly suffered by roofers and climbers after a fall, although automobile accidents can also cause such fractures to the heel bone. Males between 30 and 50 years old fracture their calcaneal most often of any age group or sex.

Diagnosis

A physical examination followed by X-rays and/or CT scans are generally used to diagnosis calcaeneal fractures. Such diagnostic studies also help determine the extent of the fractures. An MRI can be used to distinguish a calcaneal fracture from plantar fascitis.

Treatment

Calcaneal fractures can be difficult to treat. The heel bone is like an egg with a strong shell and a soft interior. Therefore, the heel bone often shatters when it is traumatized by a fall or accident. Therefore, treatment requires the repair of multiple fractures in the heel bone, as well as restoring the subtalar joint. The subtalar joint connects the calcaneus and the talus, which is the small bone connecting the heel and the leg. Given the joints location, it carries most of the load of the body.

If the fracture has not displaced the bone, rest and partial to complete immobilization can heal the bone. Usually a cast of some sort is used to immobilize the heel. The time required to heal depends on age, degree of fracture and general health of the patient. Some such fractures take more than 6 months to heal.

Some calcaneal fractures can be treated by manipulating the foot while a patient is under anesthesia, but not involving surgery. This procedure is called closed reduction. If such a procedure does not treat the fracture or if the fracture is more extensive, then surgery may be required (called an open reduction). Surgery may be recommended immediately after a fracture or a few weeks later to allow inflammation to decrease. After both closed or open reduction, a patient must avoid putting weight on the foot, usually through the use of a cast or splint.

In severe cases, further surgery may be required to fuse the subtalar joint. If the subtalar joint is severely damaged, fusion is the only option.


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

Achilles Tendon Rupture

Article featured on Cleveland Clinic

The Achilles tendon is a thick band of tissue that attaches your calf muscle to your heel bone. It is the largest and longest tendon in your body and is built to handle a lot of stress. But you can rupture your Achilles tendon under extreme stress — like during a sudden start or stop, or if you fall. Sometimes it heals with rest and bracing, but many people need surgery to repair it.

What is an Achilles tendon rupture?

The Achilles tendon attaches the calf muscle to the heel bone. This thick band of tissue is very strong. In fact the Achilles tendon is the largest and strongest tendon in the body. The Achilles tendon gives your leg strength to walk, run and jump.

An Achilles tendon rupture is a full or partial tear of the Achilles tendon. This acute (sudden) injury occurs when the tendon stretches to its breaking point. It happens most frequently while playing sports. Tripping, falling or twisting your ankle can also cause an Achilles tear.

How common are ruptured Achilles tendons?

Achilles tendon ruptures are very common sports injuries. They occur most frequently in people ages 30 to 40 and are more common in men than in women.

People who are “weekend warriors” (usually adults who don’t train regularly, then exercise at a high intensity) are more likely to tear an Achilles tendon than younger, well-trained athletes.

Symptoms and Causes

What causes an Achilles tendon rupture?

Sudden movement that puts stress on the Achilles tendon can lead to a rupture. Typically, people tear the Achilles tendon while playing sports. The biggest culprits are sports with sudden stops, starts and pivots — such as soccer, football, basketball, tennis or squash. Achilles tendon tears aren’t always a sports injury. You can tear your Achilles tendon by tripping, missing a step when going downstairs or accidentally stepping into a hole and twisting your ankle. Some medications — including certain antibiotics and steroid injections in the area — can weaken the Achilles tendon. This can put you at a higher risk for a tear.

What are the symptoms of a torn Achilles tendon?

The classic sign of a ruptured Achilles tendon is feeling (and sometimes hearing) a pop or snap at the back of your ankle. People often mistakenly think something has hit them, but they’re actually feeling the tendon snap.

Other common symptoms include:

  • Sharp, sudden pain in the back of the ankle near the heel.
  • Swelling and bruising in the back of the ankle.
  • Pain when walking, especially upstairs or uphill.
  • Tenderness in the spot where the tendon is torn.

What are the complications of an Achilles tendon rupture?

A torn Achilles tendon is a traumatic injury that requires medical attention. Without treatment, an Achilles tendon rupture may not heal properly. This can increase your risk of rupturing it again.

Diagnosis and Tests

Your healthcare provider will physically examine your foot and ankle. They’ll check your ability to move it in various directions and see how you react to pressure on the area. They will also feel for a gap in the tendon that suggests it’s torn.

Your provider may also use imaging tests — such as ultrasound or MRI — to determine the extent of the Achilles tear.

Management and Treatment

How is a ruptured Achilles tendon treated?

Even before you seek medical help, you can reduce pain and swelling to the injured tendon by following the RICE (Rest, Ice, Compression, Elevation) method:

  • Rest, by staying off the injured leg.
  • Apply ice to the injured area.
  • Wrap your ankle to compress the injured area and prevent more swelling.
  • Elevate your leg at or above the level of your heart to reduce swelling.

Full healing of a torn Achilles tendon typically takes about four to six months. Medical treatment for a ruptured Achilles tendon may include:

  • Brace or walking cast: Nonsurgical treatment for a torn Achilles tendon requires immobilizing the injured foot and ankle. Your provider will place your foot, ankle and calf in a brace or walking cast. Your foot and ankle flex downward so that the Achilles tendon can heal.
  • Surgery: Most providers recommend surgical repair of a torn Achilles tendon in people who are active and middle-aged or younger. During surgery, a surgeon stitches the two ends of the torn tendon back together. After surgery, you’ll need a cast on your lower leg to immobilize the tendon while it heals.
  • Physical therapy: You will need physical therapy to regain strength and mobility in your Achilles tendon, whether or not you had surgery.

Prevention

How can I prevent a torn Achilles tendon?

You can’t always prevent an accidental injury like tearing your Achilles tendon. But you can take steps to reduce the risk of an Achilles tendon rupture, including:

  • Doing warmup exercises before a workout or game.
  • Increasing the intensity of workouts gradually.
  • Regularly stretching your calf muscles and Achilles tendons.

Outlook/Prognosis

What is the prognosis (outlook) for people with an Achilles tendon rupture?

With proper treatment, most Achilles tendon ruptures fully heal within four to six months.

Having surgery to repair a torn Achilles tendon is usually the best option for younger, active people. After surgical repair, you can regain your Achilles tendon’s full strength and function.

When should I call the doctor?

You should call your healthcare provider if you experience:

  • A snap or pop at the back of your ankle during activity.
  • Sudden sharp pain at the back of your ankle.
  • Difficulty walking after an injury.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

  • Do I need surgery to repair my Achilles tendon?
  • How long will I need to wear a brace or cast?
  • When can I start exercising or playing sports again?
  • Am I at risk of tearing my Achilles again after it heals?

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

Hip Dislocations: What Are They?

Article featured on Mercy Health

What are hip dislocations?

A hip dislocation occurs when the femur (thighbone) is forced out of the hip socket in the pelvis. This is a serious medical emergency that needs to be treated ASAP.

Most hip dislocations occur when the thighbone is pushed out of the socket backward, called a posterior dislocation. An anterior dislocation occurs when the thighbone is forced out of the socket in the forward direction.

Causes of hip dislocations

A hip dislocation is typically caused by major trauma, such as a car collision or fall from a substantial height. In hip dislocations caused by car crashes, the knee hits the dashboard and pushes the thigh backwards, driving the femur out of the hip socket.

Risk factors for hip dislocations

  • Car collisions — patients who are in car collisions with direct impact are more likely to dislocate a hip.
  • Susceptibility to falls — patients who are susceptible to falls are at higher risk for a hip dislocation.

Symptoms of hip dislocations

Hip dislocations are very painful. Patients are unable to move the leg and could potentially lose feeling in the foot or ankle due to nerve damage.

Diagnosis of hip dislocations

A hip dislocation is a medical emergency and must be treated right away. Do not move someone with a hip dislocation. Call for medical help and keep the patient as comfortable as possible until they arrive.

Your doctor can typically diagnose a hip dislocation by looking at the position of the leg compared to the body and no other testing is necessary.

Your doctor may also order an x-ray, CT scan or a MRI to determine the full extent of the injury.

Treatments for hip dislocations

If you only have a hip dislocation without other injuries, the physician will manipulate the bones back into place while you are under sedation. The procedure is called a reduction.

Surgery is required in cases where there are loose tissues and fragmented bones in the affected area. In many cases, a hip dislocation will cause other complications such as nerve injury (crushed or stretched nerves that cause pain), osteonecrosis (bone death due to lack of blood supply to the bone) or arthritis (wearing down of cartilage in the hip).

Physical therapy and rehabilitation are often recommended to strength the muscles after this traumatic injury.

Recovery from hip dislocations

Patients can recover from a hip dislocation after two to three months of healing. If there are other fractures, the recovery period could be longer. Patients will use crutches and other walking aids initially and then progress to walking on their own.


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

Ways to Improve Chronic Back Pain

Article featured on Orthopaedic Associates

Back pain is a pain to deal with, affecting millions of Americans every day. Those who suffer from back pain daily may find it hard to focus on their daily activities, like going to work or cooking a meal. Unfortunately, back pain tends to be persistent and doesn’t just go away overnight.

If you find your back pain has lasted longer than three months, it’s considered chronic back pain. That being said, chronic back pain doesn’t have to be a life sentence.

Causes of Chronic Back Pain

Chronic back pain typically affects men and women as they age, but it isn’t always correlated with age. Other common reasons patients may experience back pain include:

  • Trauma
  • Arthritis (in the spine)
  • Bulging or herniated discs
  • Spinal stenosis (narrowing of the spinal cord)
  • Pinched nerves

If you’re unsure what is causing your back pain, it’s important to see a specialist who can properly diagnose you. Diagnostic testing to determine the cause of your back pain can help your physician better treat you and can help you focus on home remedies that best suit your needs. Your physician may recommend an MRI scan or x-ray to establish the source of your back pain.

Many believe the only way to treat their back pain is through surgery, but that is far from the truth. There are several ways you can treat your chronic back pain without using surgical techniques, including the following.

1. Physical Therapy and Exercise

Physical therapy and light exercise are some of the best things you can do to reduce your chronic back pain. Physical therapy sessions and regular exercise will help you strengthen the muscles in your back and around your spine, reducing both inflammation and the straining of the muscles in your affected areas. We encourage you to work with a physical therapist to find which exercises will work best for you and your condition.

2. Injections

Injection-based treatments are minimally invasive and can often be as effective as invasive surgical procedures. Injection-based treatments include nerve blocks, steroid injections, and forms of regenerative medicine like platelet-rich plasma (PRP) therapy. These treatments are effective because they directly introduce an anti-inflammatory or regenerative medicine to your affected areas.

3. Lifestyle Changes

When you have chronic back pain, you often have to accept it and adapt. This doesn’t mean giving up hope – rather, it means reducing instances that can worsen your inflammation by making small changes to your lifestyle. Some lifestyle modifications our physicians recommend include making several trips to carry in groceries rather than carrying them in all at once and taking short breaks between long periods of strenuous activities like cleaning the house or mowing the lawn.


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

Meniscus Tears and Surgical Treatments for Sports-Related Injury

Article featured on NY Orthopedics

A torn meniscus tear is one of the most common knee injuries found in athletes. These types of injuries commonly occur when the athlete twists their knee. Most meniscus tears are primarily found in athletes who perform in contact sports like football and rugby. However, active basketball players, skiers, and volleyball players are also at risk.

Below you’ll find some common symptoms of a torn meniscus, how to treat it, and the best and quickest ways to recover.

What Are the Common Symptoms of a Torn Meniscus

Your meniscus is a C-shaped piece of cartilage that sits between your shinbone and thighbone. It’s often referred to as the knee’s shock absorber, reducing the impact on your joint every time your foot makes contact with the surface.

Patients With a Torn Meniscus Report Experiencing:

  • A popping sensation in their knee
  • Swelling
  • Stiffness
  • Discomfort turning their knee
  • Knees locking into place
  • Difficulty straightening the knee
  • Instability

Meniscus Tears in Athletes

In many cases, a torn meniscus will heal over time. Rest, medication, and physical therapy can speed recovery times in those cases where surgery is not necessary. In more severe cases, arthroscopic surgery may be required to repair the meniscus. This is more common in cases where the knee has locked into place.

Can You Play Sports With a Torn Meniscus

You should not continue to play sports if you are experiencing any torn meniscus symptoms. In fact, you should avoid any activity that may cause the knee to twist. If you’re experiencing any of the symptoms we’ve listed above, contact one of our qualified knee specialists for an examination as soon as possible to determine if they are related to a meniscus tear.

What Natural Methods Can I Perform to Heal a Torn Meniscus?

If your doctor chooses a non-surgical approach to heal your meniscus tear, they will likely recommend a combination of rest, ice, compression, and elevation, otherwise known as R.I.C.E.

  1. Rest – Keep off your knee as much as possible for the next couple of days. Putting pressure on your knee could aggravate your symptoms and limit your recovery time.
  2. Ice – Place an ice pack on your knee for 10 to 15 minutes a few times a day to reduce any swelling.
  3. Compression – Your doctor may recommend a wrap or brace to stabilize your knee until it fully heals.
  4. Elevation – Try to sit or lay back and elevate your knee above your heart. This will promote blood flow toward your heart which will aid in recovery.

What is the Recovery Time for Non-Surgical Torn Meniscus Treatments?

With any treatments, recovery can last around six to eight weeks; however, even minor tears may take longer to heal.

Torn Meniscus Surgery

In more severe cases, a doctor may recommend surgery. There are three main procedures a specialist may perform.

  • Meniscus Repair – Your surgeon will perform an arthroscopy to determine the extent of the tear. From there, the surgeon will sew the torn pieces of the menisci back together.
  • Trimming the Meniscus – Through an arthroscopy, a surgeon will trim back and remove any damaged cartilage, leaving the healthy cartilage intact.
  • Meniscus Transplant – In some cases, a surgeon may choose to replace the meniscus with a healthy one from a donor. A patient must often meet several criteria to qualify for this type of treatment.

What is the Recovery Time For Torn Meniscus Surgery?

Recovery times can vary depending on the extent of the surgery. However, a healthy estimate is anywhere from six weeks to three months.

What are the Best Exercises After Meniscus Tear Surgery?

Your doctor will likely recommend light exercises to promote healing and improve your range of motion as you fully heal from your meniscus surgery. Here is just a sample of the types of torn meniscus exercises your doctor may recommend:

Hamstring Contractions:

Lie on your back with your knees bent and pull your heels in, tightening the muscles behind your thigh. Hold for five seconds and repeat ten times.

Straight Leg Raises:

Lying on your back, lift your outstretched leg about six inches off the ground. Hold for five seconds before lowering. Repeat ten times.

Standing Leg Raises:

Stand up using a railing or table for support. Slowly lift your leg forward, raising it about four to six inches off the ground. Gently lower your leg. Repeat ten times.

Can I Still Play Sports After Meniscus Surgery?

While each meniscus tear is different, the vast majority of patients who receive treatment will experience full mobility after treatment is complete. Athletes can continue playing the sports they love and stay competitive.


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

Total Shoulder Replacement: What is it?

Article featured on Orthopaedic Institute Brielle Orthopaedics

Total shoulder replacement is a surgical procedure that treats severe shoulder osteoarthritis that does not respond to nonsurgical treatment options.

At The Orthopaedic Institute Brielle Orthopaedics our Shoulder Specialists have extensive experience and utilize the latest technology in performing shoulder replacement procedures.

The procedure is effective because it removes osteoarthritic bone and cartilage and replaces it with functional metal and plastic components that serve as a “new shoulder”. After recovery and physical therapy, patients experience tremendous pain relief and live normal lives with minimal restrictions.

Important procedure steps are:

  1.  Anesthesia. A Board Certified Anesthesiologist administers general anesthesia so no pain or discomfort is felt during the procedure.
  2. Incision. A small incision is made on the front of the shoulder. Muscles and soft tissues are retracted so the joint can be visualized.
  3. Bone preparation. The head of the humerus (arm bone) and glenoid cavity are carefully cut in preparation of implants.
  4. Trial implants. Trial implants are placed in the shoulder until the perfect size is found. A physical examination confirms the implants fit and the shoulder moves properly.
  5. Permanent implants. Biological cement is placed over the bones and permanent metal and plastic implants are put in place. Once the cement hardens, an additional physical examination is performed.
  6. Incision closure. Sutures and skin staples close the incision and sterile dressings cover it. A shoulder sling is put on to keep the shoulder in a neutral position.

Total procedure time is usually 1 hour depending on osteoarthritis severity and shoulder anatomy.

A short hospital stay is necessary for pain management, infection prevention and physical therapy purposes. In some cases, a partial total replacement (one bone is replaced) or reverse total shoulder (implant positions are reversed) replacement are performed.

It is always best to receive a shoulder osteoarthritis diagnosis as soon as possible. Early treatment relieves symptoms and prevents the chronic condition from becoming worse.


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

What Different Types of Knee Pain Mean

Article featured on Healthgrades

If you’ve ever experienced pain in one or both of your knees, you’re not alone. About one-third of all Americans have felt pain in this major joint at some point in their lives. Women are slightly more likely than men to be affected by it (about 20% of women versus 15 to 20% of men).

Yet the millions of people with this pain don’t all feel the same thing. Knee pain can be sharp or dull, burning or excruciating, accompanied by strange noises or silent. What does your knee pain tell you about what’s wrong?

1. Knee pain with a ‘crunch’

Sometimes knees creak, crack or crunch when you bend them. These sounds—called ‘crepitus’—may be alarming, but don’t necessarily signify a problem, unless your knee hurts at the same time.

If that happens, you could have an injury, such as a torn meniscus (a type of cartilage in your knee) or a dislocated kneecap. The sounds together with pain also could indicate osteoarthritis. Your doctor should check for the source of both your painful sensations and strange sounds.

2. Knee pain when running

If you have a dull pain in and around your kneecap when you run or are doing other activities, you may have ‘runner’s knee,’ also called patellofemoral pain syndrome. Other symptoms include kneecap tenderness, pain when you sit for a long time with your knees bent, and rubbing, grinding or clicking sounds when you bend or straighten your knee.

This syndrome can be caused by running and overuse, as well as structural defects in the knee, shoes that aren’t supportive enough, walking or running with your feet positioned improperly (such as turning in), and injury.

3. Knee pain in the morning

If you wake up with a painful and stiff knee, but find that the aching eases over the course of the day, you may have rheumatoid arthritis. This is an inflammatory disorder in which the body’s immune system attacks joints, such as the knee. Other autoimmune disorders, such as lupus, also can cause similar symptoms.

If you have rheumatoid arthritis symptoms, contact your doctor, especially if you are experiencing pain and stiffness in other joints. Left untreated, rheumatoid arthritis can lead to joint disfigurement.

4. Knee pain when climbing stairs

One of the first signs of osteoarthritis is pain in the knee when going up or down stairs. This pain tends to get worse throughout the day. While osteoarthritis knee pain is usually achy, it can also sometimes be sharp or burning. Other symptoms include swelling, stiffness and feeling like your knee is grinding or may give way.

Osteoarthritis is a degenerative condition in which protective cartilage at the end of your leg bones wears down. This can ultimately result in bones rubbing against each other, causing pain, swelling, and loss of motion.

5. Knee pain with a pop

One common type of knee injury is a tear to the anterior cruciate ligament, or ACL, which connects your thigh bone to your shin and helps keep your knee stable. When the injury happens, you’ll likely hear a loud pop or else feel a popping inside, along with severe pain.

A damaged ACL is likely to leave you with rapid, significant swelling; difficulty fully straightening your leg or bending your knee; and pain when you try to put weight on it. You may feel like the knee is going to give way. In some cases, surgery to repair the ligament may be necessary.

6. Knee pain that’s sudden and severe

If you experience a sudden onset of severe knee pain along with redness, warmth and swelling, especially in the early morning, you might have gout, an arthritic condition that is most commonly seen in the big toe. However, gout also can strike other joints, especially in the leg. Gout can recur and should be treated to help prevent permanent joint damage.

Another reason for sudden severe pain and swelling in a knee is Lyme disease. Children are especially likely to have this symptom of Lyme disease, an infection caused by bacteria from an infected tick. If you suspect Lyme disease, promptly seek care to reduce the risk for complications associated with the disease.

7. Knee pain with bending and kneeling

People in professions that require repetitive kneeling, such as roofers, floor installers, plumbers, coal miners, gardeners and maids, are most at risk for bursitis of the knee. Bursitis refers to inflammation of the bursal sacs of fluid that are around joints.

Repeated bending and kneeling, especially on hard surfaces, can irritate the bursa in the knees, causing gradually worsening symptoms. These symptoms include pain, redness, warmth, swelling, joint stiffness, and sometimes fever, which is a sign of infection. Notify your doctor for a full evaluation and to rule out infection. Bursitis also can be caused by an injury, but this is less common.


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

Causes of Sciatica

Article featured on News-Medical

Sciatica is caused by pressure on the sciatic nerve or its roots. Any condition which causes compression of the spinal cord, or the nerve roots emerging from the spinal foramina, causes sensory and motor symptoms in the area supplied by the sciatic nerve in a dermatomal distribution. The most common cause of sciatica is disc herniation in the lumbar region.

The causes of sciatica include:

  • Lumbar disc prolapse, or herniation of the cartilaginous intervertebral discs, which then put pressure upon one or more nerve roots in the lumbar region, causing the symptoms of sciatica.
  • Lumbar spinal stenosis, or narrowing of the bony canal surrounding the spinal cord, which puts pressure on the lumbar cord and its nerve roots, producing the classic symptoms of compression of the sciatic nerve. Occurring mostly in older people, it is characterized by more or less constant back pain, with leg pain or numbness soon after the patient starts walking.
  • Spondylolisthesis, where one disc slips forward over the one beneath, leading to narrowing of the available spinal canal space at that point. This can compress the spinal cord and nerve roots, and in the lumbar region, it causes sciatica. The fourth and fifth lumbar vertebrae are most commonly affected in lumbar spondylolisthesis, which is usually a sequel of spinal arthritis.
  • Spinal infection leading to abscess formation in the paraspinal region, causing pressure on the nerve roots or the spinal cord, depending on the location.
  • Spinal trauma or injury, leading to deformity which puts pressure on the spinal nerve roots.
  • Tumors growing within the spine, which compress the nerve roots.
  • Bone spurs or osteophytes, which are outgrowths of bone that form on stressed or degenerating bone, especially following cartilage loss. These can narrow the spinal space, or the space between adjacent vertebra where the nerve roots emerge.
  • Piriformis syndrome: the piriformis muscle is a thick small muscle located deep to the large buttock muscles or glutei, and it passes over the sciatic nerve. Spasm, swelling or tightening of this muscle leads to the piriformis syndrome by compressing the nerve. In addition, the nerve passes through the muscle rather than below it in about 14% of people, which may carry a higher risk of sciatic nerve compression.
  • Space-occupying lesions in the lumbar region, such as abscesses, clots, tumors, put pressure on lumbar nerve roots or the sciatic nerve itself.
  • Poor sitting posture can lead to paraspinal muscle spasm, ligamentary laxity or spinal deformity, putting pressure on the lumbar spine and pinching the nerve roots.

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

Know the Warning Signs of Knee Osteoarthritis

Article featured on MedicalNewsToday

Osteoarthritis of the knee happens when the cartilage that cushions the bones in the knee starts to erode. The bones begin to rub against each other, resulting in damage, swelling, and pain.

Cartilage is a smooth but tough tissue that stops the bones from rubbing together and prevents damage. It allows the bones to move pass smoothly over each other. As people get older, the weight they carry can cause the cartilage to wear away.

As the cartilage breaks down and the bones rub together, osteoarthritis (OA) can result.

OA is the most common type of arthritis. The symptoms include swelling, pain, and stiffness. When it affects the knee, it can be difficult for a person to exercise, to climb stairs, or even to walk.

Early signs and symptoms

OA usually affects people who are over 50 years of age, but it can happen earlier, too.

Symptoms that can appear at the early stages of knee OA are:

  • pain, especially on bending and straightening the knee and with weight bearing
  • swelling, caused by a buildup of fluid in the joint, or by bony growths called osteophytes that form as the cartilage breaks down
  • warmth in the skin over the knee, especially at the end of the day
  • tenderness when pressing down on the knee
  • stiffness when moving the joint, especially first thing in the morning or after a period of inactivity or walking
  • creaking or cracking on bending, known as crepitus

Activity can make symptoms worse, leading to pain at the end of the day, especially after a long time of standing or walking.

If the knee is red, the person has a fever, or both symptoms occur, the problem is probably not OA.

Treatment

Treatment of OA depends on how severe the symptoms are.

Home treatment

Some remedies and over-the-counter treatments for OA of the knee can be used at home and are readily available from the pharmacy.

These include:

  • Applying heat or cold: Heat relieves stiffness, and cold can ease pain and swelling. The heating pad or ice pack should be covered with a towel so as not to burn the skin.
  • Using an assistive device: A cane or walker can help take some of the weight off of the knees. Holding the cane in the opposite hand to the painful knee is most effective.
  • Pain relief medications: These are available over the counter, but people should use them with caution as they can cause side effects.

Medical treatment

If home or over-the-counter remedies do not help, the person should see a doctor.

They may prescribe one of the following:

  • steroid injections in the knee joint to reduce inflammation
  • physical therapy, with exercises to improve flexibility and range of motion in the joint

If these solutions do not work and damage is severe, the physician may recommend surgery to replace the joint.

When to see a doctor

For some people, pain and other symptoms are severe enough to interfere with daily life, and over-the-counter medications do not help.

The next step is to consult a general physician, who may refer the person to a rheumatologist or orthopedic surgeon.

To find out whether a patient has OA, the doctor may ask:

  • When and how did the pain start?
  • Where does it hurt?
  • Is there any stiffness, creaking, warmth, or swelling?
  • What makes it better? What makes it worse?
  • How have you treated it? Did home treatments work?
  • How have the symptoms affected daily activities?

The doctor will examine the knees, moving them forward and back to note the range of motion and to find out which movements cause pain.

They will look for areas of tenderness, check the warmth and see if any swelling is present. The physician will also check the ligaments for stability.

Diagnosis

A number of tests can help to diagnose OA:

  • Joint aspiration: The doctor uses a needle to draw a sample of fluid from the joint. They send the fluid to a laboratory for tests to check for signs of other joint problems, such as gout or infection.
  • Magnetic resonance imaging (MRI): This can provide detailed images of the knees, which may show fluid buildup in the thigh or knee bones.
  • X-rays: These can reveal damage to the knee joints in the later stages but may not detect changes in the early stages.

Lifestyle changes

Some lifestyle changes can relieve the pain and stiffness that occurs with knee arthritis:

Losing weight can relieve pain and prevent further joint damage.

For people with OA of the knee and either overweight or obesity, current guidelinesTrusted Source strongly recommend weight loss. A doctor can advise on how much weight to lose.

Exercise, and especially low-impact activities such as walking, riding a recumbent bicycle, or swimming, can relieve arthritis pain.

Swimming is ideal because the buoyancy of the water takes pressure off the joints, while the warmth soothes them.

Exercise increases motion and flexibility and strengthens the muscles that support the joints. It also helps people to maintain a healthy weight.

Takeaway

OA is a common but painful condition that affects many people as they age. Pain, stiffness, swelling, warmth, or cracking in the joints may be early signs that it is time to seek medical help.


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

What is Mallet Toe or Hammer Toe?

Article featured on Mercy Health

What is hammer toe or mallet toe?

Hammer toe is a foot abnormality that occurs because of imbalanced muscles, tendons, or ligaments around the toe. It typically impacts the second, third, or fourth toes. The toe appears like a hammer because it is bent in the middle joint of the toe.

Hammer toe can be healed with relatively simple treatments, but if left untreated may require surgery. Many people with hammer toe develop corns or calluses on the top of the middle joint of the toe or on the tip of the toe.

mallet toe is like hammer toe but impacts the joint closest to the tip of the toe.

Causes of hammer toe or mallet toe

There are many causes of hammer or mallet toe including:

  • Shoes that do not fit properly such as high-heeled shoes that do not have a proper toe box.
  • An impact such as jamming and breaking the toe can cause hammer toe or mallet toe.
  • Imbalanced toe muscles can cause toes to contract.

Risk factors for hammer toe or mallet toe

  • Age — hammer toe or mallet toe affect older people more than younger people but all ages can develop the conditions.
  • Gender — women are more likely to develop hammer or mallet toe.
  • Heredity — hammer toe or mallet toe can be passed down from parents.
  • Second toe length — a person who has a long second toe (longer than the big toe) is more likely to develop hammer or mallet toe.

Symptoms of hammer toe or mallet toe

Symptoms of hammer toe or mallet toe include:

  • Bend in the joint of the toe that is not typical
  • Pain when bending the toe
  • Corns or calluses that form from rubbing in shoes
  • Pain in the ball of the foot under the bent toe
  • Swelling and redness in the toe joint

Diagnosis of hammer toe or mallet toe

A primary care physician or an orthopedic specialist will diagnose hammer toe or mallet toe in a physical exam.

In order to get a better view of what is happening in the bones, joints, and muscles the physician may also order an x-ray.

Treatments for hammer toe or mallet toe

Treatments for hammer toe or mallet toe can be as simple as changing your shoes to surgery for the most severe cases. More advanced treatment options include:

  • Orthotics
  • Splint or brace
  • Rehabilitation or physical therapy

Recovery from hammer toe or mallet toe

Recovery after surgery to correct hammer toe can take as few as 2 weeks to as many as 3 months depending on the severity of the injury.

It is important to follow your physician’s instructions on resting your foot and choice of footwear during the healing process.

Patients who have surgery on the right foot will need to avoid driving for a few weeks to allow the injured toe to heal.


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