Symptoms & Solutions: Rotator Cuff Tears

Article featured on Arkansas Surgical Hospital

Rotator cuff tears are intensely painful injuries to the rotator cuff area, which is a group of muscles in the shoulder that allows you to make a wide range of movements. While a minor rotator cuff tear can be treated in various ways, a severely torn rotator cuff often requires surgery for a full recovery.

Most rotator cuff tears result from a single incident, such as a sports accident, a fall, or lifting something that’s too heavy. Sometimes, a tear can result from a bone spur in the shoulder. Rotator cuff tears are also prevalent in individuals who use repetitive motions, such as lifting boxes or reaching above their heads. For example, construction workers and delivery people often develop rotator cuff tears after years of overusing their shoulder joints.

Symptoms of a Torn Rotator Cuff Pain

The first and most noticeable sign of a rotator cuff tear is pain that can be excruciating. The pain will cover a large area, including the outside of your shoulder and upper arm. The discomfort increases when you lift your arm over your head and is usually worse when you’re trying to sleep. Because nerves run down the arm from the rotator cuff, some patients experience pain as far down as their elbow. A constant, dull throbbing or ache in the shoulder is also common.

Movement Limitations

If the rotator cuff is torn, it will be difficult to move your arm and shoulder normally. Simple activities like brushing your hair, getting dressed, and preparing food will cause a great deal of pain. Carrying even small items may be difficult because you don’t have a full range of motion.

Stiffness

Your shoulder becomes stiff and tender when you have a torn rotator cuff. If you stop moving your arm, the area will become even more inflexible. This complicates the situation since movement is painful but not moving the joint can lead to a stiff or frozen shoulder.

Weakness

When your rotator cuff is torn, your shoulder can’t support as much weight as it normally does. Lifting something even as light as a book or a mug of coffee may be difficult. Your grip may be weak, making it difficult to keep hold of things.

Treatment Options for a Torn Rotator Cuff

Rest, Ice, & Physical Therapy

If the tear is minimal, resting the area and periodically icing it to reduce the inflammation may be helpful. Doctors usually combine this method with physical therapy to promote movement and keep the area from stiffening and impacting your range of motion. After several days, ice may be alternated with heat to improve blood flow. Patients may want to use a sling to support the shoulder and minimize discomfort when they’re not in physical therapy. In addition, over-the-counter pain medications can alleviate shoulder pain.

Steroid Injections

For intense pain, steroid injections into the joint near the tear can reduce swelling and help you rest comfortably. These injections provide temporary relief so you can continue with physical therapy and sleep better. However, using them for too long or at high doses should be avoided to minimize the risk of weakening the damaged tendon.

Rotator Cuff Surgery

There are several surgical options for rotator cuff tears. And if the injury is severe enough, surgery may be the only option.

Your physician can help you determine whether surgery is the best option for you. If you have to use your arms to lift or reach over your head for work or sports, surgery may be a good idea. Other indications that rotator cuff repair surgery may be the right choice for you include:

  • Pain that has lasted at least 6 months
  • A tear resulting from an acute injury
  • A tear larger than 3 centimeters in an otherwise healthy tendon
  • Weakness, loss of function, or a limited range of motion that lasts several months

Types of Surgery for Rotator Cuff Tears

Partial Rotator Cuff Repair

A partial rotator cuff repair is performed when the tendon is torn but hasn’t fully detached from the underlying bone. Part of the acromion bone—which is located on the scapula, or shoulder blade—is removed during the procedure. This gives the rotator cuff more room for movement.

Arthroscopic surgery is then performed to removed the inflamed bursa sac and smooth the frayed ends of the torn tendon. If needed, a damaged ligament may also be removed. This procedure is done through small incisions on the side and back of the shoulder.

Full Rotator Cuff Repair

A full rotator cuff repair surgery is needed if the tendon has torn through completely or is completely detached from the humerus, or upper arm bone. A full rotator cuff repair may be performed in a few different ways based on the extent of the damage.

  • Arthroscopic surgery: Small incisions are made in the back and side of the shoulder, debris is flushed out with a saline solution, and the surgeon removes any damage such as bone spurs. Then, the tendon is reattached the humerus with suture anchors.
  • Open surgery: This is done only in cases of severe joint degeneration or severe injury. Bone and tissue grafts from other areas of the body are used to replace damaged bone, cartilage, and tendons. The tendon is then reattached to the head of the humerus bone.
  • Mini-open surgery: This “in-between” option is sometimes done if the surgeon needs a larger incision than is used in arthroscopic surgery, but grafts or opening the entire shoulder joint aren’t required.

Get Help for Your Torn Rotator Cuff

If shoulder pain and limited movement impact your daily life, it’s essential to see a doctor who’s familiar with the treatment options for rotator cuff tears.

Physicians will use x-rays, MRIs, arthroscopy, and other tools, combined with a physical exam, to determine the extent of the damage and advise you on your treatment options.


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

How to Stay Strong and Coordinated as You Age

Article featured on Harvard Health

So many physical abilities decline with normal aging, including strength, swiftness, and stamina. In addition to these muscle-related declines, there are also changes that occur in coordinating the movements of the body. Together, these changes mean that as you age, you may not be able to perform activities such as running to catch a bus, walking around the garden, carrying groceries into the house, keeping your balance on a slippery surface, or playing catch with your grandchildren as well as you used to. But do these activities have to deteriorate? Let’s look at why these declines happen — and what you can do to actually improve your strength and coordination.

Changes in strength

Changes in strength, swiftness, and stamina with age are all associated with decreasing muscle mass. Although there is not much decline in your muscles between ages 20 and 40, after age 40 there can be a decline of 1% to 2% per year in lean body mass and 1.5% to 5% per year in strength.

The loss of muscle mass is related to both a reduced number of muscle fibers and a reduction in fiber size. If the fibers become too small, they die. Fast-twitch muscle fibers shrink and die more rapidly than others, leading to a loss of muscle speed. In addition, the capacity for muscles to undergo repair also diminishes with age. One cause of these changes is decline in muscle-building hormones and growth factors including testosterone, estrogen, dehydroepiandrosterone (better known as DHEA), growth hormone, and insulin-like growth factor.

Changes in coordination

Changes in coordination are less related to muscles and more related to the brain and nervous system. Multiple brain centers need to be, well, coordinated to allow you to do everything from hitting a golf ball to keeping a coffee cup steady as you walk across a room. This means that the wiring of the brain, the so-called white matter that connects the different brain regions, is crucial.

Unfortunately, most people in our society over age 60 who eat a western diet and don’t get enough exercise have some tiny “ministrokes” (also called microvascular or small vessel disease) in their white matter. Although the strokes are so small that they are not noticeable when they occur, they can disrupt the connections between important brain coordination centers such as the frontal lobe (which directs movements) and the cerebellum (which provides on-the-fly corrections to those movements as needed).

In addition, losing dopamine-producing cells is common as you get older, which can slow down your movements and reduce your coordination, so even if you don’t develop Parkinson’s disease, many people develop some of the abnormalities in movement seen in Parkinson’s.

Lastly, changes in vision — the “eye” side of hand-eye coordination — are also important. Eye diseases are much more common in older adults, including cataracts, glaucoma, and macular degeneration. In addition, mild difficulty seeing can be the first sign of cognitive disorders of aging, including Lewy body disease and Alzheimer’s.

How to improve your strength and coordination

It turns out that one of the most important causes of reduced strength and coordination with aging is simply reduced levels of physical activity. There is a myth in our society that it is fine to do progressively less exercise the older you get. The truth is just the opposite! As you age, it becomes more important to exercise regularly — perhaps even increasing the amount of time you spend exercising to compensate for bodily changes in hormones and other factors that you cannot control. The good news is that participating in exercises to improve strength and coordination can help people of any age. (Note, however, that you may need to be more careful with your exercise activities as you age to prevent injuries. If you’re not sure what the best types of exercises are for you, ask your doctor or a physical therapist.)

Here are some things you can do to improve your strength and coordination, whether you are 18 or 88 years old:

  • Participate in aerobic exercise such as brisk walking, jogging, biking, swimming, or aerobic classes at least 30 minutes per day, five days per week.
  • Participate in exercise that helps with strength, balance, and flexibility at least two hours per week, such as yoga, tai chi, Pilates, and isometric weightlifting.
  • Practice sports that you want to improve at, such as golf, tennis, and basketball.
  • Take advantage of lessons from teachers and advice from coaches and trainers to improve your exercise skills.
  • Work with your doctor to treat diseases that can interfere with your ability to exercise, including orthopedic injuries, cataracts and other eye problems, and Parkinson’s and other movement disorders.
  • Fuel your brain and muscles with a Mediterranean menu of foods including fish, olive oil, avocados, fruits, vegetables, nuts, beans, whole grains, and poultry. Eat other foods sparingly.
  • Sleep well — you can actually improve your skills overnight while you are sleeping.

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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

10 Stretches for Shoulder Tightness

Article featured on MedicalNewsToday

Shoulder stretches can help relieve muscle tension, pain, and tightness in the neck and shoulders.

Stiff or tight shoulders can cause discomfort and limit a person’s range of motion. If the tightness goes unchecked, it can lead to neck pain and cause tension headaches.

In this article, we describe 10 shoulder stretches and their benefits. We also discuss what causes shoulder tightness and how to prevent it.

1. Neck stretches

Neck stretches can help release tension at the top of the shoulders. To do a neck stretch:

  • Stand with the feet hip-width apart.
  • Let the arms hang down by the sides.
  • Look forward.
  • Tip the head to the right, trying to touch the right ear to the right shoulder.
  • Feel the stretch in the left side of the neck and shoulder.
  • Tip the head to the left, trying to touch the left ear to the left shoulder.
  • Feel the stretch in the right side of the neck and shoulder.Each time, hold the position for 10 seconds.
  • Repeat this three times on each side.

2. Shoulder rolls

Shoulder rolls are an easy way to stretch the shoulders. To do shoulder rolls:

  • Stand with the feet hip-width apart.
  • Let the arms hang down at the sides of the body.
  • Breathe in and lift the shoulders up toward the ears.
  • Move the shoulders back, squeezing the shoulder blades together.
  • Exhale and drop the shoulders back.
  • Move the elbows forward, feeling the stretch at the back of the shoulders.
  • Repeat this 10 times.

3. Pendulum stretch

The pendulum is a gentle way to increase movement in the shoulder using the force of gravity. To do this stretch:

  • Stand with the feet hip-width apart.
  • Lean forward and look at the ground.
  • Place the right hand on a table or chair for support.
  • Let the left arm hang down.
  • Swing the left arm gently in small circular motions, letting gravity do most of the work.
  • Continue for 30 seconds to 1 minute.
  • Change the direction of the motion.
  • Repeat this, using the other arm.

4. Cross-body arm swings

Arm swings help warm up the shoulder joint and increase movement. To do cross-body arm swings:

  • Stand with the feet hip-width apart.
  • Inhale and lift the arms out to the sides, squeezing the shoulder blades together.
  • Exhale and gently bring the arms in toward each other.
  • Cross the right arm under the left, keeping both arms straight.
  • Inhale and swing the arms back out to the sides, squeezing the shoulder blades together.
  • Exhale, and gently swing the arms in toward each other again.
  • This time, cross the left arm under the right, keeping both arms straight.
  • Repeat this 10 times.

5. Cross-body shoulder stretch

The cross-body shoulder stretch helps extend the back of the shoulder. To do this stretch:

  • Stand with the feet hip-width apart.
  • Stretch the right arm out straight.
  • Bring the right arm across the body, so that the hand points to the floor on the other side of the left leg.
  • Bend the left arm at the elbow.
  • Hook the left forearm under the right arm, supporting the right arm above the elbow.
  • Use the left forearm to pull the right arm further in and across the body, stretching the back of the right shoulder.
  • Hold this for 20 seconds, then repeat the stretch on the other side.

6. Child’s Pose

Child’s Pose is a gentle yoga pose that can help stretch the back of the shoulders. To do this pose:

  • Kneel on the ground or a mat.
  • Touch the big toes together.
  • Spread the knees apart.
  • Sit up straight.
  • Inhale and reach the arms above the head.
  • Exhale and bow forward, toward the floor, reaching the arms out in front.
  • Touch the ground with the palms.
  • Bring the elbows to the ground.
  • Sit back, bringing the bottom of the back toward the heels.
  • Feel the stretch in the back of the shoulders.
  • Breathe deeply, and hold the position for 1 minute or longer.

7. Ragdoll Pose

Ragdoll Pose is a forward-bend yoga pose that may help release tension in the shoulders. To do Ragdoll Pose:

  • Stand with the feet hip-width apart.
  • Bend the knees slightly.
  • Bend forward and try to touch the toes.
  • Keep the stomach against the bent knees to support the lower back.
  • Place each hand on the elbow of the opposite arm.
  • The crown of the head should point toward the floor.
  • Let the head hang heavily, releasing tension in the neck and shoulders.
  • Stay in the pose for 1 minute or longer.

8. Eagle arm stretch

The eagle arm stretch is inspired by the upper body position in the Eagle Pose in yoga. This stretch may increase flexibility in the shoulders. To do it:

  • Stand with feet hip-width apart.
  • Inhale and lift the arms to the sides.
  • Exhale and swing the arms in toward the body.
  • Allow the right arm to cross under the left.
  • Cradle the left elbow in the crook of the right elbow.
  • Bring the palms together if they reach.
  • If the palms are not touching, hold the backs of the hands together.
  • Take three or four deep breaths.
  • Release the stretch and repeat it on the other side, with the left arm crossed under the right.

9. Cow Face pose

The Cow Face pose is another yoga stretch for the shoulders. To do the Cow Face pose:

  • Stand with the feet hip-width apart.
  • Reach the right arm up straight toward the sky.
  • Bend the right arm at the elbow.
  • Keeping the elbow raised, reach the right hand over the head and down the back.
  • Stretch the left arm down toward the ground.
  • Reach the left hand behind and up the back.
  • Bring the left and right hands close together, clasping them if it feels comfortable.
  • Take three or four deep breaths.
  • Release the stretch and repeat it on the other side.

10. Side-lying thoracic rotation

The side-lying thoracic rotation may sound complicated, but it is easy to do. This shoulder stretch helps improve mobility in the thoracic spine, lumbar spine, and shoulders.

To do a side-lying thoracic rotation:

  • Lay on your right side on the ground or a mat.
  • Bend the knees slightly.
  • Stretch the right arm straight ahead.
  • Place the left hand on top of the right.
  • Keep your gaze fixed on the left hand.
  • Reach the left hand straight up.
  • Rotate the left arm toward the floor behind the back, as if drawing an arch in the air.
  • Keep the knees and hips pointing to the right throughout.
  • Bring the left arm back over to meet the right hand.
  • Repeat the drawing motion several times.
  • Then, practice it on the other side.

Benefits

When a muscle stretches, its fibers and the surrounding fascia, or bands of connective tissue, extend to full length. This improves the ability of the muscle and fascia to extend during activity.

Shoulder stretches have numerous potential health benefits. Stretching can:

  • reduce tension
  • relieve pain
  • increase mobility
  • reduce the risk of muscle and joint injury
  • improve posture

Research suggests that stretching alone is as effective as stretching alongside strength training for people looking to reduce chronic neck pain. Shoulder tension can cause this pain.

A small-scale 2015 study found that a 4-week regular stretching program could reduce neck and shoulder pain. The researchers noted that the stretching program improved neck function and the quality of life among office workers with chronic, moderate-to-severe neck pain.

What causes tight shoulders?

Tight shoulders can result from:

  • improper posture
  • sitting for long periods
  • working at a laptop or desktop that is not well-positioned
  • the overuse of a cell phone
  • stress
  • carrying heavy bags
  • injury
  • arthritis

Shoulder tension may worsen with age.

Preventing shoulder pain and tightness

Regular stretching can help prevent the shoulders from becoming tight in the first place. Getting plenty of exercise is also important. Yoga may help reduce stress and tension and increase flexibility.

When working at a computer, use a stand to place the screen at eye-level. This reduces the need to bend the neck and shoulders and lowers the risk of shoulder tension.

Maintaining good posture is also important. If a person notices that they are slouching, the shoulder roll exercise above can help with repositioning the shoulders.

Practicing good posture while sitting and standing, especially during long periods at a desk, can reduce shoulder and neck tension in the long term.

Outlook

Shoulder pain and tightness are common and treatable. Practicing the stretches above may reduce tightness and increase a person’s range of movement.

When ongoing shoulder pain does not improve with stretching, massage therapy may help.

If shoulder pain is severe, a person should see their doctor, who can diagnose and treat any underlying conditions.


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

Ankle Sprain Rehab Exercises to Get You Back on Your Feet

Article featured on verywellfit

One of the most common sports injuries, an ankle sprain occurs when the ligaments surrounding the ankle joint are stretched or torn as the ankle joint and foot is turned, twisted, or forced beyond its normal range of motion.

If you suspect an ankle sprain, there are things you can do immediately after being injured to protect your ankle. Once the initial injury begins to heal, use exercises to rehabilitate your ankle and get back to the activities you love.

Ankle Sprain Causes and Grades

The most common cause of an ankle sprain in athletes is a missed step or a missed landing from a jump or fall. Ankle sprains vary in severity and are classified by the degree of severity:

  • Grade I: Stretch and/or minor tear of the ligament without laxity (loosening)
  • Grade II: Tear of ligament plus some laxity
  • Grade III: Complete tear of the affected ligament (very loose)
Immediate Treatment

For immediate relief, you can use the R.I.C.E. treatment plan: rest, ice, compression, and elevation.1 While there is general agreement that the best approach to an ankle sprain is immediate rest, there is some conflicting advice about what comes next.

Until definitive answers are available, the following approach is still the most widely recommended:

  • Rest: Avoid weight bearing for 24 hours, or longer for a severe sprain. You may need to use crutches.
  • Ice: Apply ice (bagged, crushed ice wrapped in a thin towel) to the ankle joint. To avoid frostbite, ice should not be left in the area longer than 20 minutes at a time. Ice for 20 minutes every two hours for the first 24 hours to control swelling.
  • Compression: Wrap the ankle with an elastic bandage (start at the toes and wrap up to the calf) to help prevent swelling and edema.
  • Elevation: Raise the ankle above the hip or heart to reduce swelling.

If the swelling doesn’t subside in 48 to 72 hours, or if you are unable to bear weight on the injured ankle within 48 hours, seek medical treatment for a complete evaluation.

Ankle Sprain Rehab

After the initial 24 to 48 hours of rest and icing, slowly begin bearing weight over several days as tolerated. Avoid full weight bearing during this phase. Gradually progress to full weight bearing. Try to use a normal heel-toe gait.

Start doing rehabilitation exercises as soon as you can tolerate them without pain. Range of motion (ROM) exercises should be started early in the course of treatment. Gradual progression to other weight-bearing exercises should follow shortly after.

Assessment of the Ankle Joint

After an ankle injury, the joint should be assessed for misalignment or structural defects caused by the sprain. A physician will check the joint and test for weakness or deficits in soft tissues (tendons, ligaments, and cartilage).

Your injury may require taping or bracing. If a fracture or dislocation is suspected, an MRI or an X-ray will confirm the diagnosis and determine the most appropriate treatment.

Any ankle injury that does not respond to treatment in one to two weeks may be more serious. Consult a physician for a thorough evaluation and diagnosis.

Types of Rehab Exercises

Specific exercises are prescribed to help restore ankle stability and function. These exercises are progressive (they should be done in order) and are generally prescribed for range of motion, balance, strength, endurance, and agility.

  • Range of motion (flexibility) exercises
  • Progressive strength exercises
  • Balance (proprioception) exercises
  • Progressive endurance exercises
  • Agility (plyometric) exercises

The following exercises can be used to rehab a Grade I ankle sprain. If your sprain is more severe, you should follow the plan prescribed by your physician and physical therapist. Your physical therapist can design the best program for your specific injury and your limitations.

Flexibility and Range of Motion Exercises

As soon as you can tolerate movement in the ankle joint and swelling is controlled, you can begin gentle stretching and range of motion exercises of the ankle joint.

  • Towel stretch: The towel stretch is a simple and effective way to improve the flexibility of your calf muscles. While seated on the floor, simply wrap a towel around the ball of the foot and gently pull the towel so the toes and ankle flex up.
  • Standing calf stretch: Stretching your calf muscles is important to help loosen the muscles and prevent further injury. While facing a wall, place one leg behind. Lean toward the wall until you feel a slight stretch in the calf of your extended leg.
  • Achilles soleus stretch: Slowly stretching your Achilles tendon can help you prevent injury and keep the tendon flexible. To stretch your tendon, stand an arm’s length away from the wall and place one leg back. Keeping the leg slightly bent at the knee, slowly lean forward and press your heel to the floor.
  • Toe circles: Move your ankle through its entire range of motion—up and down, in and out, and in circles. Move only the ankle and not the leg.
  • Alphabet exercise: With your leg extended, try to write the alphabet in the air with your toes.

Strengthening and Endurance Exercises

Once you have a good range of motion, joint swelling is controlled, and pain is managed, you can begin strengthening exercises.

  • Step-ups: Begin on a short step and slowly step up in a controlled manner while focusing on contracting the muscles of the foot, ankle, and leg. Turn around and slowly step down in the same manner. Repeat 20 times, several times per day.
  • Towel curls: To perform a towel curl, you will need to be seated and barefoot. Place a small towel on a smooth surface in front of you. Grab the towel with your toes. Keep your heel on the ground and curl your toes to scrunch the towel as you bring it toward you. Let go and repeat until you’ve moved the towel to you. Then, do the action in reverse to push the towel away from you. Repeat 10 times, several times a day.
  • Isometric exercises: Gently push against an immovable object in four directions of ankle movement—up, down, inward, and outward. Hold for 5 seconds. Repeat 10 times, several times a day.
  • Tubing exercises: Use elastic tubing to create gentle resistance. Wrap the elastic band around the ball of the injured foot and resist the band as you move your ankle up, down, inward, and outward. These exercises incorporate the four movements of the foot: inversion, eversion, plantar flexion, and dorsiflexion. Perform three sets of 15 repetitions for each movement and repeat several times a day to build endurance.
  • Toe raises: Stand with your heel over the edge of a step. Raise up on the ball of your foot, hold for 3 seconds, and slowly lower your heel to the starting position. Perform 20 repetitions several times a day.
  • Heel and toe walking: Walk on your toes for 30 seconds. Switch and walk on your heels for 30 seconds. Build up to 1 minute on toes and heels alternating for 5 to 10 minutes. Perform several times per day.

Proprioception Exercises

After you are able to place your full weight on the injured ankle without pain, you may begin proprioceptive training to regain balance and control of the ankle joint.

  • One-leg balance: Try to stand on one leg for 10 to 30 seconds. Increase the intensity by doing this with your eyes closed.
  • One-leg squat: Stand on the affected leg with your foot pointing straight ahead and the knee of the other leg slightly bent. Extend your arms for balance if necessary. Lift the non-supporting foot slightly off the floor and lower to a squat position.
  • Balance board ball toss: While balancing on a wobble board, balance board, or BOSU, catch and toss a small (5-pound) medicine ball with a partner.
  • Balance board with half-squats: While balancing on a wobble board, perform 10 slow, controlled half-squats.
  • Step up onto balance board: Place a balance board (or soft pillow or foam pad) 6 to 8 inches higher than your starting point. Step up 10 times.
  • Step down onto balance board: Place a balance board (or soft pillow or foam pad) 6 to 8 inches lower than your starting point. Step down 10 times.
  • One-leg squat and reach: Stand on the affected leg and raise the other leg slightly. As you squat, reach toward the floor with the hand opposite your standing leg.

Agility Exercises

Once you have regained balance, strength, and control, you can begin working on agility.

  • Lateral step up and down: Step up sideways to a step bench and then step down sideways.
  • Plyometric exercises: These can include single-leg hops (hop forward and concentrate on “sticking” the landing), single-leg spot jumps (hop from spot to spot on the floor), or reactive spot jumps (place numbered pieces of tape on the floor and as a partner calls out a number, hop to that number).
  • Sport-specific skills and drills: Sport-specific drills can be added as long as return to sports guidelines are followed.

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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

5 Causes of Thumb Pain

Article featured on American Society for Surgery on the Hand

The thumb is involved in about 50% of all hand functions. When the thumb is painful or injured, it becomes very difficult to use the hand. During normal life, we take our thumbs for granted. When the thumb is not working properly, tasks are more difficult, and we then realize how important the thumb is. There are several causes of thumb pain including:

  1. Trigger thumb
  2. Arthritis
  3. Tendonitis
  4. Carpal tunnel syndrome
  5. Skier’s thumb.

Read below to learn more.

1. Trigger thumb

The tendon that bends or flexes the thumb is called the flexor pollicis longus (FPL). If there is swelling or inflammation around the thumb tendon, it will not glide smoothly. Sometimes the tendon gets stuck in the thumb pulley, causing the thumb joint to click, catch, or lock. This is called a trigger thumb. The thumb can also become swollen, stiff, and very painful. Treatment includes rest, anti-inflammatory medications, splinting, and steroid injections. Most patients improve without surgery. If symptoms persist with treatment, trigger thumb release surgery is very effective and has low risks.

2. Thumb arthritis

The human thumb is unique. We can touch the tip of the thumb to the small finger — a function called opposition. Most animals do not have an “opposable” thumb. This gives us the ability to write, use a needle and thread, and use hand tools. The joint at the base of the thumb which allows opposition is called the carpometacarpal (CMC) joint. Normal, every day activities can cause wear and tear in the thumb CMC joint. When the joint wears out, it can become inflamed and painful. This process is called osteoarthritis or degenerative joint disease.

Anyone can get osteoarthritis if they live long enough. So far, we have not found a way to prevent osteoarthritis. Wear and tear is part of the normal aging process. However, the symptoms of osteoarthritis can be treated by reducing inflammation in the joint. Ways to reduce inflammation and treat thumb CMC osteoarthritis include topical anti-inflammatory gels, oral over-the-counter medications, adjusting hand activities, using a thumb splint, and steroid injections. Most patients improve without surgery. If symptoms persist with treatment, thumb CMC surgery can greatly improve quality of life.

3. DeQuervain’s tendonitis

The tendons in the wrist that lift the thumb up are prone to tendonitis. These tendons travel through a tight compartment on the thumb side of the wrist. If there is friction on the tendons, they can become inflamed and very painful. This is classic in young mothers, and is sometimes called mommy’s thumb. Treatment consists of splinting, anti-inflammatory medications, therapy, and steroid injections. DeQuervain’s release surgery is occasionally necessary to resolve this condition.

4. Carpal tunnel syndrome

Carpal tunnel syndrome is a type of pinched nerve. When the nerve is pinched in the carpal tunnel, patients have numbness and tingling in the thumb, index, middle, and/or ring fingers. Initially symptoms come and go, and are often worse at night. Some patients feel electric shock sensations or burning pain in their thumbs. In severe cases, the thumb muscles can become weak and atrophied. Treatment for most patients includes wearing a wrist brace at night, stretching exercises, hand therapy, and steroid injections. Carpal tunnel surgery is very effective for most patients if non-operative treatment is not successful or if nerve compression is severe.

5. Skier’s thumb

Trauma to the thumb is common. During a fall, most people land on an outstretched hand to brace themselves. Unfortunately the ligaments in the thumb can become injured in this way. The ulnar collateral ligament (UCL) of the thumb is vulnerable to tearing as the thumb is bent backwards and away from the hand. If this ligament does not heal properly, patients can have pain and weakness with pinch tasks. For most minor sprains of the thumb, temporary immobilization in a splint or cast is successful to allow healing. If the ulnar collateral ligament is fully torn, however, surgery is usually recommended to fix the injury. Hand therapy is often helpful during the recovery process to regain range of motion and strength.

If you have an injury to your hand or thumb, or pain which does not go away with conservative treatment, make an appointment with a hand specialist to get an accurate diagnosis and good treatment plan.


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

10 Tips for Getting Around on Crutches

Article featured on Healthgrades

1. Verify Your Fit

Properly fitting crutches can make the difference between comfort and calluses. When you’re standing up straight with your arms at your side, the top of the crutches should be 1 to 2 inches below your armpit, and the handgrips should be at wrist-level. Your elbow should be slightly bent in this position. If your crutches don’t feel right after using them for a day or two, don’t hesitate to ask your care team for a different size.

2. Walk This Way

To walk, start standing up straight on your good leg with your crutches gripped in your hands. Lean onto your good leg, lift your crutches, and set them down 6 to 12 inches in front of your good foot. Lean your weight into your hands and step your good leg 6 to 12 inches in front of your crutches. Rest as necessary and repeat. Always look ahead—and not down—as you walk. Your body will follow your gaze.

3. Get a (Cushioned) Grip

Your hands—not your armpits—should bear your weight when you use crutches. If you push your crutches into your armpits, nerve damage could occur and send pain down your arms. If your hard-working hands become sore, cushion the handgrips with an adhesive pad. Or consider wearing fingerless gloves with padding if you need to walk a far distance.

4. Scan for Obstacles

You certainly don’t want to take a tumble while you’re on crutches and risk injuring another body part, like a wrist or your good leg’s ankle. While you’re walking, be on the lookout for ice patches, puddles, curled-up rug edges, gravel, and small steps. Think about how to safely and slowly get past your obstacle—or find another way to get where you’re going.

5. Use Care When Sitting

Sit down slowly every time. Transfer both crutches to the hand on the same side as your injured leg. Lean into your crutches, then reach back with your free hand to feel the chair, sofa, stool or bed. Sit down into the seat. Be sure to set your crutches down upside-down within reach. When standing up, slide to the edge of the your seat, and reverse these steps. Keep the back of your good leg touching the seat.

6. Sit Down on the Steps

If there’s an elevator to take you up and down floors, use it. But if you need to negotiate stairs on crutches, The American College of Foot and Ankle Surgeons recommends that you do so seated. That may feel odd, but it reduces your risk of a tumble and further injury. Be sure to push your crutches up or down in the direction you’re going before you start, so they’re available when you stand up again.

7. Contain Beverages and Foods

When you’re on crutches, carrying a cup of coffee or a sandwich to the couch can be a challenge without help. One way to do this on your own is to transport foods in closed travel containers, such as plastic containers or travel mugs. You can carry even more if you use a backpack or side-slung pack.

8. Equip Your Pad

You may spend more time at home than usual while your leg heals. So outfit your pad with props that save you time and effort. Use a wheeled office chair to roam the rooms of one level of your house. In the kitchen, set up a high, stable bar stool that you can lean on while you prepare food and drinks. And use (clean) trash grabbers or long barbeque tongs to pull small items down from tall shelves.

9. Care for Your Crutches

Once a week when you’re sitting down, check your crutches for anything that may weaken their support. Look for things like loose hardware, worn tips, and items like small rocks or stickers that have become lodged to the rubber ends. The more sturdy your crutches are, the more steady your pace will be.

10. Embrace Your Pace

You simply aren’t going to get around as quickly or as easily on crutches as you could before them. Give yourself plenty of time to get everywhere. And give yourself a pass on most of the items on your to-do list for a bit. The more slowly you go, and the more rest you give yourself and your injured leg, the more quickly you’ll regain strength and speed. And ultimately, you’ll recover quickly and safely.


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

What You Need to Know About Torn Bicep Tendon Injuries

Your bicep is the muscle in the front of your upper arm. It helps you bend your elbow and twist your forearm.

Three tendons attach your bicep to bone:

  • The long head tendon attaches your bicep to the top of your shoulder socket.
  • The short head tendon attaches your bicep to a bump on your shoulder blade called the coracoid process.
  • A third tendon attaches your bicep to your radius, which is one of the bones in your forearms.

When you have a torn bicep, one of these tendons is damaged or detaches from the bone. Any of these three bicep tendons can tear.

Types of bicep tendon tear injuries

There are three types of bicep tendon tear injuries, categorized by their location and severity. Tears can also be partial (in which a tendon is damaged) or complete (in which the tendon completely detaches from the bone).

The three types of bicep tendon tear injuries are:

Proximal biceps tendon tear at shoulder

This injury occurs when one of the tendons that attaches the bicep to the shoulder tears. The long head tendon is more likely to tear than the short head tendon. This type of tear often starts as normal tendon fraying, but can also tear if you get injured.

It’s likely that only one part of the tendon will tear in this injury. This means that you can usually continue to use your arm. However, a bicep tendon tear at the shoulder may damage other parts of the shoulder at the same time.

Distal biceps tendonitis and tear at the elbow

A bicep tendon tear at the elbow usually happens when the elbow is pushed straight against a heavy weight. This stress can tear the tendon from the bone, and usually causes a complete tear.

When you tear your bicep tendon at the elbow, your other arm muscles will compensate, so you’ll still have full range of motion. However, your arm will most likely lose strength if the tendon is not repaired. Bicep tendon tears at the elbow are not common. They happen to approximately 3 to 5 people per 100,000 per year. They’re also less common in women. Distal biceps tendonitis is inflammation in the biceps tendon near the elbow. It’s usually caused by normal wear and tear but repetitive motion can make it worse.

Tendonitis (microtears from use)

Tendonitis is the inflammation or irritation of the long head of the bicep tendon. This can cause microtears. As with distal biceps tendonitis, tendonitis of the long head of the biceps tendon is usually due to normal wear and tear, but can also be made worse by repetitive motion. It often happens with other shoulder problems, such as arthritisshoulder impingement, and chronic shoulder dislocation.

Torn bicep tendon symptoms

Symptoms of a torn bicep tendon include:

  • a “pop” or tearing sensation when the injury happens
  • warmth around the injury
  • swelling
  • bruising
  • pain or ache at the injury site, and throughout your arm (usually severe at first, and may get better over a few weeks)
  • arm weakness
  • difficulty turning your palm
  • fatigue or increased pain in your arm when you do repetitive activity
  • bulge in your upper arm, because the bicep is no longer being held in place (you might also see a gap or indentation in front of your elbow)

Causes of a torn bicep tendon

The two main causes of a torn bicep tendon are injury and overuse. Injuries might be caused by lifting something heavy or falling on your arm. Most tears of the elbow bicep tendon happen because of an injury.

Overuse can cause the tendons to wear down or fray over time. This happens naturally as you age. It may also be made worse by repetitive motion, and is common in people who participate in sports such as weightlifting, tennis, or swimming.

Diagnosing a torn bicep tendon

To diagnose a torn bicep tendon, a doctor will first take a medical history. They’ll ask about your symptoms, whether you had any recent injuries, and when the pain began.

Then they’ll do a physical exam to test your range of motion and strength. During these tests, they’ll see if you have pain or difficulty with certain movements, especially rotations. They’ll also look at your arm for swelling, bruising, or bulging.

A history and physical exam are often enough to diagnose a bicep tendon tear. However, your doctor might also do an X-ray to help rule out any bone injuries, or an MRI to see if the tear is partial or complete.

Torn bicep treatment

Treatment for a torn bicep will mostly depend on how severe the tear is, as well as your overall bicep function and whether you damaged any other body part, such as your rotator cuff. Potential treatments include:

Rest

Taking time off from exercising, lifting, or holding anything heavy — and using your arm as little as possible — can help you recover, especially from overuse injuries. Be sure to avoid any activity that causes pain, even if it doesn’t seem strenuous.

NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are over-the-counter medications that help reduce inflammation. They can help reduce the inflammation (the hallmark of tendonitis), as well as help reduce swelling from bicep tears. They can also help reduce the pain you might have from any bicep tendon injuries.

Physical therapy

Physical therapy can help you regain strength and range of motion after a bicep tendon injury. A physical therapist will take you through a series of motions designed to help heal your injury and relieve pain.

A physical therapist or your doctor might also give you exercises to do at home when you’re healed enough to do so. These might include exercises to flex and extend your arm, arm rotations, and strength-building exercises like bicep curls.

Torn bicep surgery

If none of the measures above help your bicep injury heal, or if more than half the tendon is torn, your doctor might recommend surgery to repair the bicep tendon.

Many doctors will recommend surgery as a first-line treatment for bicep tendon tears at the elbow, although surgery can also be done later if other treatments don’t restore range of motion and strength.

Surgery is used to reattach the tendon to the bone. Complications of surgery are rare, but may include arm numbness or weakness. In some people, the tendon can tear again.

Torn bicep tendon recovery time

Recovery time depends on the severity of the bicep tendon tear, as well as type of treatment. Even mild injuries can take at least two months to heal. It often takes four to five months before you can start returning to normal activities.

After surgery, you’ll probably need to wear a sling or otherwise immobilize your arm such as in a splint or cast for four to six weeks. You’ll then have to do physical therapy and exercises to help strengthen your arm and improve range of motion.

Complete recovery from surgery can take up to a year, although most people recover much of their range of motion and strength in four to six months.

Takeaway

Bicep tendon tears can be serious, but many respond to nonsurgical treatment, such as rest and physical therapy. If you think you might have injured your bicep tendon, see a doctor as soon as possible. Getting a diagnosis and treatment early can help you recover more fully.


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

Why You Shouldn’t Ignore Joint Pain

Article featured on

If you have sudden or ongoing pain in your knee, hip or shoulder, you may wonder when it’s time to seek medical care for your joint problem. You may be able to manage pain on your own for a while, but how do you know if joint pain is a sign of a serious problem that needs care?

When should you seek care for joint pain?

If you have joint pain or mobility issues, it’s important to contact an orthopedic expert who specializes in treating conditions that affect the muscles, bones, joints and connective tissues.

Joint symptoms can be addressed through a range of treatment options and making an appointment with an orthopedic surgeon is often the first step in finding relief. Some of the reasons to see an orthopedic surgeon include:

  • New joint pain that isn’t getting better on its own
  • Chronic joint pain that has lasted for months or years
  • Limited mobility, such as difficulty walking, climbing stairs or reaching above your head
  • Difficulty changing position, such as moving from a sitting position to a standing position
  • New use of a cane, walker or wheelchair due to your joint pain or mobility issues
  • Severe pain that may wake you at night
  • Regular use of over-the-counter medications to manage your joint pain
  • Changes to a joint’s appearance, like a straight leg that has begun to bow

“You shouldn’t have to live with joint pain,” says Jeffrey Lange, MD, a hip and knee surgeon at the Center for Joint Health and Mobility at Brigham and Women’s Hospital. “If something is wrong, call us to be evaluated. Every evaluation is different, because every patient is unique.”

Delaying joint care can lead to injury and other problems

For patients who have joint pain or mobility issues, it’s important to stay current with your joint health. In some cases, ignoring joint pain for too long may increase pain or mobility problems, or even result in a fall or injury.

“The more proactive you are in preserving your joints, the longer we anticipate they will last,” says Dr. Lange. “Taking care of your joint pain early could delay or prevent the need for surgery. If you do need surgery, having surgery earlier can lead to better outcomes in many cases. The details differ for every person, which is why we always suggest having an evaluation with a clinician to better understand your own unique situation.”

A check-in with your orthopedic specialist can help you understand all the available options for your unique situation. Together, you and your orthopedic specialist can:

  • Address your joint symptoms and concerns
  • Review or order imaging, such as an X-ray or an MRI
  • Discuss exercises or other lifestyle changes that can reduce pain and improve mobility
  • Discuss the role of pain medicine
  • Schedule a cortisone injection to help relieve pain and inflammation in a joint
  • Pursue a referral to physical therapy
  • Discuss joint replacement surgery or another procedure
  • Discuss the risks and benefits of continuing care versus waiting for a period of time

Benefits of virtual care for joint problems

A consultation with an orthopedic specialist can be done in-person or virtually. A virtual visit allows you to accomplish many of the same things you would review during an in-person visit. Many patients are realizing the benefits of virtual care for joint problems, including:

  • Convenience: Patients don’t have to drive to the clinic or hospital. This is particularly helpful for orthopedic patients who may be in pain or who have limited mobility.
  • Saving time: The average virtual visit lasts about 20-30 minutes and doesn’t involve the time needed to do things like travel to an appointment and find your doctor’s office.
  • Connection: Many patients have been able to maintain strong emotional connections with their providers during virtual visits.

“Going to the doctor’s office used to be a half- or even full-day affair for some patients,” says Dr. Lange. “With a virtual visit, patients can meet with me for a short period of time from the comfort of their homes. They feel like they are still connected with their provider without having to put themselves at risk by leaving their home during this difficult time.”

Safe care for joint pain during COVID-19

While many knee, hip and shoulder problems can be addressed remotely, your orthopedic specialist may want to see you in person for a follow-up evaluation. If you need to visit the clinic, your provider can give you an overview of what to expect during your in-person meeting.

Guided by our Safe Care Commitment, the Center for Joint Health and Mobility has put many safety measures in place to provide the safest possible environment for patients during COVID-19. If you need to visit the clinic for an in-person visit, you will encounter the following safety protocols designed to protect patients and staff:

  • A universal masking policy that requires all patients and staff to wear a face mask
  • Screening of all patients and staff to confirm they don’t have symptoms of COVID-19
  • Spacing of furniture in waiting rooms and other common spaces to maximize physical distancing
  • Signage that directs foot traffic and optimizes the flow of staff and patients
  • Fewer patients in waiting rooms and fewer providers in clinical spaces at any one time
  • Regular deep cleaning of clinical spaces, waiting rooms and frequently-touched surfaces
  • Cleaning and disinfecting of exam rooms after each visit

Patients who are admitted to the hospital for an orthopedic surgery are required to get a COVID-19 test prior to their scheduled procedure. Patients who test positive for the coronavirus must reschedule their operation.

“Many patients who have joint replacement surgery during the pandemic choose to go home on the same day of their procedure,” says Dr. Lange. “Patients can stay in the hospital after their procedure if they choose, but patients who qualify for a same-day surgery have the option to go home faster if they want.”

Patient-centered approach to caring for your joints

The Center for Joint Health and Mobility at the Brigham is home to expert orthopedic specialists who combine advanced treatments with a modern and personalized approach to manage your joint health.

“We’re not just a joint replacement center, we’re a joint health center,” says Dr. Lange. “We provide a single center where patients can get all of their joint health needs in one place, from rehabilitation specialists to joint replacement surgeons. We take a holistic approach to keeping your joints healthy and in optimal condition for as long as possible.”


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

Bone Fractures: 10 Things Doctors Want You to Know

Mending Your Bone Fracture: What Doctors Say

About 6 million people break bones in the United States every year. The most frequently broken bone is the clavicle, or collarbone. Other common bone fractures include those in the arms, wrists and ankles. If you’re over 65, you’re more likely to break your hip than any other bone. You can break bones due to injury or diseases like osteoporosis, which weakens bones. Orthopedic surgeons specialize in treating broken bones in all scenarios. Here’s what three board-certified orthopedists want you to know about bone fractures, risk factors associated with them, and tips for helping them heal properly.

1. “A fracture and a break are the same thing.”

Patients frequently think bone fractures and bone breaks are different. Sometimes people think “fracture” means a crack while “break” means a clearly separated bone, but this is not true. “Fracture” is simply the term doctors use to refer to any break or crack in a bone.

2. “If you smoke, your fracture might not heal as fast.”

If you ingest nicotine—whether through cigarettes, cigars, chew tobacco, or even the nicotine patch—you may find that your fracture takes longer to heal than for a non-smoker. This is due to the effect of nicotine on the healing process. If you quit smoking, it will take three months before your body responds to bone breaks like a non-smoker’s would.

3. “Try RICE for non-emergency injuries.”

If you have a broken bone cutting through your skin or your bones are looking crooked and weird (what doctors call a deformity), you need emergency medical care. But if you only have pain and swelling, and aren’t sure if it’s a break, he says, you could try treating your injury at home for a day or two with “RICE”: rest, ice, compression (wrapping with an ace-type bandage) and elevation. If that doesn’t work, then you can be seen by a doctor.

4. “Don’t wait too long to be seen.”

If you wait too long to bring your possible bone fracture to your doctor’s attention, your bone could start healing on its own—and possibly in a crooked way. That makes fixing the problem more difficult than if you’d come in earlier. Or you could have underlying damage to the surface of the joint or other problems that are harder to treat the longer you wait. Waiting can also make it more likely you’ll need surgery. For non-emergency fractures it is recommended patients be seen within a couple of days. If you require an operation, this gives you time to get it scheduled before bones start knitting back together (which usually happens within a few weeks).

5. “Even little fingers and toes need to be checked out.”

You crack your little toe against a table leg. Should you bother getting it checked for fracture? It depends how bad you feel, noting that in similar situations, he might wait a couple days and, if still in pain, see a doctor to have it X-rayed. But in general, it’s better to err on the side of caution and see your doctor. After all, broken toes that heal crookedly can cause your shoes not to fit right, resulting in pain. Similarly, ignoring finger fractures can cause “significant disability” and lead to longer surgeries once patients finally come in, he says.

6. “Moving it doesn’t mean it is not broken.”

Patients say they didn’t think their bone was broken because they could still move the affected body part. But, he says, this is a fallacy. There’s only one way to know if it’s broken and that’s with an X-ray. The idea that if I can move it, therefore it can’t be broken is ridiculous. You can almost always move it, even if it is broken. Signs that it could be a bone fracture include significant swelling, tenderness around the site, bruising, and an inability to bear weight on it even after a couple of days’ rest. 

7. “I don’t always operate.”

People think orthopedic surgeons do surgery 99% of the time. This can cause some patients to avoid seeing them, because they think they’ll wind up in the operating room. It’s perhaps an understandable misconception, given that “surgeon” is part of his title. But, most of what they do isn’t surgery. Instead, orthopedists do the least invasive procedures possible first to promote bone fracture healing, only moving up to surgery if more conservative measures don’t work.

8. “When we tell you to elevate it, take us seriously.”

Folks come in a couple of days after a broken ankle, for example, and they may have been laying around on the couch but not with the ankle truly elevated—which is above the level of your heart. If you’re lying down, you can put two or three pillows under your leg to achieve proper elevation, but if you’re sitting, you’re going to have to use more than that to get your leg high enough. Elevation is key to preventing swelling, which also could delay surgery, if that’s needed.

 9. “Splints are not second-class citizens.”

Casts are non-removable and go all around your broken bone, while splints go only halfway around and can be taken off and on. Both casts and splints are used to immobilize your broken bone and both can be written on and decorated. Yet some patients think casts are best and get disappointed if they get a splint instead. A lot of times patients don’t give the splint a lot of respect. Doctors use splints for several reasons, including when a cast is difficult to place due to the location of the break or when doctors want to leave room for swelling.

10. “Forget the ‘6-week rule’ of bone healing.”

Patients think they know fractures are cured in six weeks, which is an incredible piece of misinformation; no adult is going to heal in six weeks. Most bone fractures take anywhere from 2 to 6 months to heal, depending on many factors, he says. There’s not just one rule for every broken bone. It’s important to understand there is specificity and details matter, such as where a bone is broken, what bone it is, what the fracture pattern looks like, and so on. It’s difficult to generalize.


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

2 Simple Exercises to Keep Your Feet Healthy

Article featured on Cone Health

According to Marcus Duda, MD, a Greensboro orthopedist and member of the Cone Health Medical and Dental Staff, proper foot care is important to your health.

“During the pandemic, people became less active as gyms closed and activities stopped,” says Dr. Duda, a foot and ankle surgeon who has patented a graduated compression sock. “I started seeing a lot more foot and ankle issues.”

Many patients complained of a stone bruise or burning pain on the bottom of the foot and ankle stiffness. Achilles contracture or tendon stiffness was the culprit.

“After prolonged sitting, the Achilles tendon tightens and puts more pressure on the plantar fascia on the bottom of the foot,” shares Dr. Duda. “Stretching out this tendon takes pressure off and relieves the pain.”

Dr. Duda suggests simple exercises. While leaning against the kitchen counter with your hands, place one foot back with the heel flat on the floor and lean forward with knees straight. As you stretch the back of your calf, you should feel the stretch from your heel up through the back of the knee. Stretch for 60 seconds five times a day.

“As you age, connective tissue called fascia weakens,” he adds. “This can lead to pain and weakness in your joints and muscles along with balance problems.”

To build fascial strength, Dr. Duda recommends doing short 30-second exercises several times a day. Hold onto the counter, and face forward. With bare feet, raise up on your toes like you are trying to grab a marble while lifting your heels. Once you have enough strength, try hopping on the ball of your foot.

If your foot or ankle pain is severe or does not go away, consult with your doctor or orthopedist.


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm