Article featured on Complete Concussion Management
Historically, patients with concussion were told to rest, rest, rest. And when that didn’t work, they were told to rest some more.
The research on concussions is evolving at an exponential rate and we are realizing that not only does prolonged rest not work; it can actually make you worse.
Sadly, many healthcare practitioners are not keeping up with the explosion in concussion research and are still telling their patients that the only treatment for concussion is rest. If you have fallen victim to this, you don’t need more rest; you need a second opinion.
While it is true that during the early stages following injury, moderate rest is still important, that timeline seems to be getting shorter, with longer duration rest creating worse outcomes for patients. So, if you have been resting for more than a week, and are still having significant symptoms, it’s time to switch it up. More rest is likely contributing to your ongoing symptoms.
If not rest, then what?
The top 5 most effective evidence-based treatment options for concussion:
1. Exercise Therapy
Following concussion, animal (and many human) studies have demonstrated a reduction in blood flow to the brain in the early stages. Recent research has found that these blood flow changes may persist for some time following injury due to ongoing dysfunction in the Autonomic Nervous System (ANS). The ANS consists to two opposing sides that tend to work in opposition to one another. The Sympathetic Nervous System is also known as the “Fight, Flight, or Freeze” system – this side of the ANS is responsible for increasing our heart rate, dilating our blood vessels to pump blood to our muscles, release adrenaline, dilate our pupils, and get us ready for action. Our Parasympathetic Nervous System on the other hand is our “Rest & Digest” system – this side of the ANS is responsible for lowering our heart rate, increasing our digestion, activating our metabolism, and helping us to be relaxed and calm.
These two systems can be thought of like a teeter-totter. When one is up, the other is down. They fluctuate their dominance throughout our days but the system should maintain a harmony and balance.
Concussion creates an imbalance in the ANS with most suffering from high “Sympathetic Tone” – this means that we are stuck in a fight or flight state. Our heart rate tends to be elevated and doesn’t respond well to increased demands, blood flow to our brain is not as responsive, our digestion shuts down sometimes leading to stomach pains, food sensitivities, and increased inflammation, our anxiety levels increase, we may get lightheaded more easily, and we suffer symptoms with increased cognitive and physical activity.
The good news is that this problem can be tested for and rehabilitated very easily; provided you know what you’re doing!
The mainstay rehabilitation for this problem actually goes against conventional thought: exercise!
Researchers at the University of Buffalo have published numerous studies demonstrating complete symptom resolution and improved brain blood flow (as measured on fMRI) through a specific graded exercise program alone.
More recent evidence suggests that exercise might even help speed recovery in the early stages after concussion!
It is important to see someone who knows exactly what they are doing with this protocol. Testing with a trained professional must be done first to establish set points as well as your specific program. There is also more to balancing the Autonomic Nervous System that must be taken into consideration as well.
2. Manual Therapy & Neck Rehab
With every concussion, there is also a whiplash.
Studies have demonstrated that the acceleration required to cause a concussion is somewhere between 70 and 120 G’s (where G = force of gravity = 9.8m/s2). Whiplash, on the other hand has been shown to occur at only 4.5 G’s.
It is therefore conceivably impossible for a concussion to occur without also causing a sprain or strain injury to your neck! In fact, a Canadian study found that 100% of the time, these injuries are happening together.
What becomes even more confusing is that the signs and symptoms of whiplash and neck dysfunction are the exact same as concussion! Headaches, cognitive and emotional problems, balance problems and dizziness, eye movement control problems, and brain blood flow abnormalities43 have all been shown to occur in whiplash and neck pain patients.
There is actually no way to tell if the symptoms are coming from your neck or from your concussion except with testing (some specific tests that we won’t go into here). In fact, most of the patients healthcare practitioners see in this category don’t report any neck pain; which makes this all the more confusing for practitioners. In a recent unpublished study with the University of Buffalo, the researchers found that there was absolutely no difference in the symptoms that whiplash patients report and the symptoms that concussion patients report.
Concussion is an injury that typically resolves quite quickly in most people (symptoms generally disappear for 80-90% of patients within 7 to 10 days); however, whiplash symptoms can linger for up to a year or more.
So, if you are still having concussion symptoms, even if you don’t have neck pain, you may actually be suffering from symptoms that are coming from your neck; which are easily treated with manual therapy and rehabilitative exercises.
3. Diet/Nutritional Changes
With injury to any tissue, there is inflammation; concussions are no exception with several studies demonstrating increased inflammatory markers following injury.
Concussion results in a metabolic dysfunction (read: energy deficit) in the initial stages, which is why strict rest used to be prescribed early on; the thought was – anything that burns energy, such as thinking or physical activity, could increase symptoms. As mentioned above however, rest is no longer considered an effective treatment for concussion.
It is important to note however that the majority of studies examining this metabolic disruption show a recovery between 22 and 45 days after injury. In other words, beyond a 3-6 week period, there is little metabolic explanation for your symptoms; unless of course you did not rest in the initial stages and/or received a second concussion soon after the first.
Treatment options for both of these things can include simple dietary changes such as avoiding pro-inflammatory foods (red meats, refined sugars, white breads and pastas, artificial sweeteners) and replacing them with healthier options such as fruits and vegetables, fresh caught fish (salmon, mackerel, herring), and good fats (coconut oil, flax seed, almonds). These changes may help to offset an ongoing inflammatory response and reduce your symptoms.
Another option would be to speak to your doctor about a short course of anti-inflammatory medications. Note that we say “short course” as, over a prolonged period, these medications can begin to harm your stomach and gut leading to ulcers.
4. Vestibular and Visual Rehab
Dizziness is one of the most common ongoing complaints of patients with persistent symptoms. This may be due to a number of overlapping issues such as problems with the balance centres of your brain, your visual system, and/or problems with the muscle and joint sensors of your neck.
Visual system problems may also be one of the causes of ongoing cognitive complaints such as trouble with concentration and/or memory. If you find yourself reading a passage and then having to re-read it several times before you understand what it is saying, you might have a problem with how your eyes are moving or working together. Testing for each of these areas requires extensive knowledge of each of the systems and how they may interact. If you have not had extensive testing of these systems, then you are in the wrong place!
Following a thorough assessment of these areas a proper rehabilitation program can be set up. The research on rehabilitation for these areas is extensive with numerous studies showing resolution of dizziness, and visual abnormalities with a fairly short course of treatment.
5. Education and Reassurance (due to Psychological Comorbidities)
It has been well established that patients with a pre-existing history of depression and/or anxiety tend to have prolonged symptoms. Not only that, the symptoms of these and other mental health conditions can result in, or mimic, the same symptoms of concussion (dizziness, mental confusion, concentration problems, sadness, emotional outbursts).
Many of these issues can begin before or after the concussion, which may be due to the concussion itself, or a direct result of being mismanaged by someone giving you improper advice. In other words, being told to sit in a dark room, avoid all social contact, not go to work or school, and not do any physical activity for months on end may be causing to the very anxiety, depression, and symptoms that you are attempting to stop.
Studies examining the overlay of mental health and concussion are endless (so much so that I won’t even begin to start referencing them), and mental health will always be a big part of concussion management. In most cases, patients often feel much better following some education and reassurance. The Ontario Neurotrauma Foundation recently demonstrated to be one of the best evidence-based treatment options for preventing long-term symptoms was patient education and reassurance!
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 is Osteoarthritis and Everything You Need to Know
in OsteoarthritisArticle featured on Medical News Today
Osteoarthritis (OA) causes inflammation in the joints and the breakdown and gradual loss of joint cartilage. As the cartilage wears down, a person experiences pain and difficulty with movement.
OA is a common joint disorder. It develops in the hand, for example, in 1 in 12 people over the age of 60, according to the Arthritis Foundation.
OA is a progressive disease, which means that symptoms worsen over time.
There is no cure, but treatment can help manage pain and swelling and keep a person mobile and active.
Symptoms
OA leads to pain and stiffness in the joints.
In the early stages, a person may have no symptoms. Symptoms may occur in one or more joints, and they tend to appear gradually.
When symptoms develop, they can include:
The progression of OA involves:
Effects
Cartilage is a protective substance that cushions the ends of the bones in the joints and allows the joints to move smoothly and easily. In people with OA, the smooth surface of the cartilage becomes rough and starts to wear away. As a result, the unprotected bones start to rub together, causing damage and pain. Eventually, bony lumps form on the joint. The medical names for these are bone spurs or osteophytes, and they can lend a knobbly appearance to the joint. As the bones change shape, the joints become stiffer, less mobile, and painful. Fluid may also accumulate in the joint, resulting in swelling.
While OA can develop in any joint, it commonly affects the knees, hips, hands, lower back, and neck.
The knees
OA usually occurs in both knees, unless it results from an injury or another condition.
A person with the condition may notice that:
The hips
A person with OA in the hips may find that any movement of the hip joint, such as standing up or sitting down, can cause difficulty or discomfort.
Pain in the hips is a common feature of the condition. OA in the hips can also cause pain in the knee or in the thighs and buttocks.
A person may experience this pain while resting as well as while walking, for example.
The hands
In the hands, OA can develop in:
A person with the condition may notice:
For some people, the finger pain decreases and eventually goes away, though the swelling and bumps remain.
Anyone who experiences joint stiffness and swelling for more than 2 weeks should see a doctor.
Causes
Doctors do not know the exact cause of OA, but it seems to develop when the body is unable to repair joint tissue in the usual way.
It often affects older people, but it can occur at any age.
Genetic factors
Some genetic features increase the risk of developing OA. When these features are present, the condition can occur in people as young as 20 years old.
Trauma and overuse
A traumatic injury, surgery, or overuse of a joint can undermine the body’s ability to carry out routine repairs and may trigger OA, eventually leading to symptoms.
It can take several years for OA symptoms to appear after an injury.
Reasons for overuse or repeated injury include jobs and sports that involve repetitive movement.
Risk factors
A number of risk factors increase the chances of developing OA.
Other conditions
Some diseases and conditions make it more likely that a person will develop OA.
Diagnosis
A doctor will ask about symptoms and perform a physical examination.
No definitive test can diagnose OA, but tests can show whether damage has occurred and help rule out other causes.
Tests may include:
X-rays and MRI: These can reveal bone spurs around a joint or a narrowing within a joint, suggesting that cartilage is breaking down.
Joint fluid analysis: A doctor will use a sterile needle to withdraw fluid from an inflamed joint for analysis. This can rule out gout or an infection.
Blood tests: These can help rule out other conditions, such as rheumatoid arthritis.
Treatment
While no treatment can reverse the damage of OA, some can help relieve symptoms and maintain mobility in the affected joints.
Interventions include exercise, manual therapy, lifestyle modification, and medication.
Medication
Medication can help reduce pain.
Physical therapy
Various types of physical therapy may help, including:
Assistive devices
Various tools can provide physical support for a person with OA.
Do not use a splint all the time, however, as the muscles can weaken without use.
Surgery
Some people may need surgery if OA severely affects the hips, knees, joints, or the base of the thumbs.
A doctor will usually only recommend surgery if other therapies have not helped or if there is severe damage in a joint.
Some helpful procedures include:
Arthroplasty
This involves a surgeon removing the damaged areas and inserting an artificial joint, made of metal and plastic. Some refer to this procedure as a total joint replacement.
The joints that most often require replacing are the hip and knee joints, but implants can also replace the joints in the shoulder, finger, ankle, and elbow.
Most people can use their new joint actively and painlessly. However, there is a small risk of infection and bleeding. An artificial joint may also come loose or wear down and eventually need replacing.
Arthrodesis
This involves a surgeon realigning, stabilizing, or surgically fixing the joint to encourage the bones to fuse. Increased stability can reduce pain.
A person with a fused ankle joint will be able to put their weight on it painlessly, but they will not be able to flex it.
Osteotomy
This involves a surgeon removing a small section of bone, either above or below the knee joint. It can realign the leg so that the person’s weight no longer bears down as heavily on the damaged part of the joint.
This can help relieve symptoms, but the person may need knee replacement surgery later on.
Complications
Septic arthritis is joint inflammation caused by bacteria. Joint replacement surgery slightly increases the risk of this infection.
This is a medical emergency, and hospitalization is necessary. Treatment involves antibiotic medication and drainage of the infected fluid from the joint.
To discover more evidence-based information and resources for arthritis, visit our dedicated hub.
Lifestyle tips
A range of strategies can help ease the symptoms of OA. Ask the doctor for advice about suitable lifestyle adjustments. They may recommend:
Exercise and weight control:
Exercise is crucial for:
Current guidelines recommend that everyone should do at least 150 minutes of moderate-intensity exercise each week.
A doctor or physical therapist can help develop an exercise program, and it is important to follow their instructions carefully to prevent further damage.
Choose activities that will not put additional strain on the joints. Swimming and other types of water-based exercise are a good way to keep fit without putting additional pressure on the joints.
Learn more here about suitable exercises for arthritis of the knee.
Assistive devices and adjustments
A loss of mobility due to OA can lead to further problems, such as:
A physical or occupational therapist can help with these issues. They may recommend:
Supplements
Some research has suggested that people with low vitamin D levels have a higher risk of OA. Also, in people with a low vitamin C intake, the disease may progress more rapidly.
Low levels of vitamin K and selenium may also contribute, but confirming these findings will require further research.
Some people use supplements for OA, including:
The American College of Rheumatology note that there is not enough evidence to support the safety and effectiveness of these supplements for OA. They recommend asking a doctor before using them.
Outlook
OA is a common disease that causes joints to deteriorate, leading to pain and stiffness. It tends to appear during middle age or later.
There is currently no cure, but researchers are looking for ways to slow or reverse the damage. Lifestyle remedies and pain relief medications can help manage it.
The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, 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
Common Sports Injuries and How to Treat Them
in Sports Related InjuriesArticle featured on Arkansas Surgical Hospital
Most sports injuries result from either overuse of a joint or damaging a joint through tearing or spraining ligaments or muscles. Some of the most common sports injuries include torn ACLs, shoulder dislocation, torn rotator cuffs, and sprained ankles. During the late summer months, emergency departments and orthopedic specialists see a sharp uptick in these injuries. Sports such as baseball, basketball, volleyball, and tennis contribute to the increase in sports injuries.
Sprains
Sprains or strains are the most common sports injury, with ankle sprains affecting 25,000 people every day. Any sports activity that requires running, lunging, or shifting on your feet can lead to an ankle sprain, which is the stretching or tearing of ankle ligaments. A strain is damage to the tendons or muscles. Both cause swelling, pain, and the need to stop using the ankle for a while.
To minimize your risk of ankle sprains, make sure you stretch and warm up properly before any sports activities. Stretching helps warm up the ligaments and muscles and makes them more flexible. More flexibility means less chance of overextending the ligaments and causing damage.
Torn ACL
Knee injuries can be devastating to casual exercisers as well as athletes. The ACL (anterior cruciate ligament) in the knee is one of the major ligaments controlling joint movement and preventing overextension of the knee. The ACL connects the upper and lower leg bones. Most torn ACLs are the result of sudden stopping and starting movements or shifts in direction. They are common in basketball and other sports that may cause the individual to shift balance quickly. Jumping and landing, as in volleyball, can also cause a torn ACL. If you are exercising or participating in a sport and hear or feel a sudden “pop” in your knee, you may have torn your ACL. A torn ACL will cause severe pain, the inability to put weight on your leg, and swelling.
As with any potential sports injury, the first step in prevention is proper preparation. Stretching and warming up will help prepare the ligament for exercise. Stretching after workouts will also help keep the joint from tightening up and becoming injured.
Exercising correctly is also crucial. Practice landing and jumping properly. Your knees should be straight for jumping and bend when landing. Try not to twist your knees when you’re jumping or coming back down, which increases stress on the ACL. Changing directions should also be practiced so you can do it without twisting the knees.
Shoulder Dislocation
A dislocated shoulder has a wide range of symptoms, including deformity of the joints, severe pain, swelling and bruising, instability or locking of the joint. There may also be weakness, burning, or numbness in the neck or arm. Some people may experience shoulder spasms that increase the pain. Unfortunately, there is a 7 in 10 chance of a repeat shoulder dislocation after the first one. For this reason, it’s imperative to learn ways to prevent it in the first place and minimize the chance of recurrence.
For tennis players and others who rely on their shoulder joint, warm-up and stretching are a good idea, but they should also take the time to strengthen the shoulder joint, so it’s less likely to become dislocated. Exercises can be as simple as pushing out against a wall with your arm; elbow flexed as though shaking hands with someone. Repeat this up to 20 times, holding for 5 seconds each time. Then push the arm and shoulder inward, pressing the bent hand into the opposite palm, repeating 20 times for 5 seconds each time. Resistance band exercises can also strengthen the shoulder joint, as can working with lightweight dumbbells.
Many shoulder dislocations are the result of falling and catching yourself improperly. If you do fall, resist the urge to catch yourself with your hands, as this frequently leads to a shoulder dislocation or broken arm bone. Keep your arms bent close to your body, spinning so that you land on your buttocks or side. Wearing protective gear on your shoulders can also help prevent repeat injuries.
Torn Rotator Cuff
Fraying or the tearing of rotator tendons in the shoulder is known as a torn rotator cuff. While physically active people are most susceptible to a torn rotator cuff, you can also sustain a torn rotator cuff even if you are sedentary. The pain of a torn rotator cuff may be sudden and severe or begin as a nagging pain when using the shoulder for routine activities such as shaking hands, lifting things, putting on clothing, or reaching behind the body. Severe pain at night due to swelling may interfere with sleep.
Exercise focusing on strengthening the small cluster of muscles in the rotator cuff. Combine activities that strengthen the entire shoulder area with some exercises specifically for the rotator cuff. Lower resistance with multiple repetitions is best for strengthening the area. Keeping the movements small and controlled will also help.
The Takeaway
Increased activity and participation in sports are good for your health, and changes in the weather makes it more enjoyable. To make sure you can continue to enjoy your activities, the crucial elements are proper warm-up, exercises to strengthen your joints, and knowing how to move correctly to minimize the possibility of injury. Working on balance and stability is also helpful. Yoga, tai-chi, and other activities that focus on slow stretching and enhanced, safe movement can help reduce injuries. Knowing your limits is also essential. If you haven’t played basketball for a few years, a rigorous game the first time out isn’t a good idea. You need to relearn how to move safely and make sure your muscles and ligaments are properly toned and warmed up every time you play.
The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
8:00am – 4:30pm
When to Turn to Spine Surgery When Nothing Else Will Do
in Spinal Surgery, SpineArticle featured on Brigham Health Hub
For many years, Diane Daigneau of Woburn, MA, was able to successfully manage her back and neck pain. Through occasional chiropractic treatments and mild pain relief medications, she was able to continue to work and play.
A few years ago, however, she discovered that circumstances can change dramatically, to the point where even the best non-surgical care fails to provide adequate relief. Such was the case during the summer of 2013, when the pain radiating through Diane’s back, neck, and arms had become so debilitating and persistent that no physician was recommending anything other than cervical spine (neck) surgery.
From Manageable to Intolerable
Diane likes making things pretty. More than that, it’s her job.
She often spends several hours hovering over a single piece of furniture while meticulously applying delicate gold or silver leafing, or some other type of elegant exterior. It’s a mentally and physically demanding job, particularly for someone who has struggled with back and neck pain. But Diane’s pain was never so bad that she ever worried about not being able to do her job or any other enjoyable pursuits. That changed suddenly during a family vacation at the end of July 2013.
Diane woke up on the second morning of her vacation with a new kind of pain. “The pain was unbearable,” says Diane. “It was something like I had never experienced before. There was nothing I could do.”
Along with intense pain, she had limited range of motion in her neck and numbness throughout her neck, shoulder, arms, and chest.
She ultimately headed back home for an MRI, which revealed that two herniated (bulging) discs were crushing nerves in her cervical spine.
A Surgical Solution
Through a colleague, Diane was referred to a spine neurosurgeon for a consultation. Based on her condition, the doctor recommended a two-level anterior cervical discectomy (disc removal).
The doctor started the procedure by approaching Diane’s spine through the front of her neck instead of through her back. There are two distinct advantages to this method. The most important is a significantly reduced risk of damaging the spinal cord. The other is less cutting of muscle, which helps to reduce postoperative pain.
Once the affected area of the spine was reached, the doctor completely removed both bulging discs to take the pressure off of the nerves. Next, to maintain the integrity of the spine, he snugly inserted a graft into each area where a disc had been removed.
The carbon fiber cages used for Diane’s surgery are now the standard of care for discectomy and fusion in the doctor’s practice, and a significant advance from the combined use of grafts (natural or synthetic) and titanium plates. A multi-center study, in which the doctor participated, demonstrated that using a carbon fiber cage alone provides the same strength and functionality as provided by a graft and titanium plate. However, the comparative simplicity of the carbon fiber cage – less material, fewer parts – decreases operation time, reduces the impact on surrounding tissue, and minimizes manipulation of the esophagus.
No Surprises
Diane admits that her recovery hasn’t been easy, but neither has it been a surprise. “I knew all along, step by step, how things were going to be for me,” she explains. “It’s not fun, but at least you’re feeling confident that things are going in the right direction.”
The doctor is similarly confident about the progress of Diane’s recovery. He told Diane that the carbon cages and fused vertebrae eventually will make her neck so strong and stable, as strong as it was before, that she could participate in extreme sports within a year.
Although she finds that claim to be reassuring, Diane doesn’t plan on jumping out of any airplanes in the near future. She’s quite happy to simply be walking, jogging, working – or waking up – without the fear of back and neck pain.
The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
8:00am – 4:30pm
What is Secondary Osteoporosis?
in OsteoporosisArticle featured on MedicalNewsToday
Osteoporosis is a bone disease that involves a loss of bone density. It causes the bones to become more fragile and prone to fractures. Secondary osteoporosis develops either as a result of a medical condition or as a side effect of a medication.
Osteoporosis affects about 10 million people in the United States. The disease may be primary or secondary. Primary osteoporosis occurs as a result of the natural aging process, whereas secondary osteoporosis occurs due to other reasons.
This article describes the difference between primary and secondary osteoporosis. It also outlines the possible causes of secondary osteoporosis and provides information on the symptoms, diagnosis, and treatment options.
Primary vs. secondary osteoporosis
Doctors categorize osteoporosis into primary and secondary osteoporosis.
Primary osteoporosis is a consequence of the aging process. In females, hormones such as estrogen and progesterone decline after menopause. These hormones are essential for healthy bones, and when their levels are low, the body becomes less able to produce new, healthy bone tissue.
Secondary osteoporosis develops when an underlying medical condition or the use of a certain medication interferes with the body’s ability to produce new bone tissue.
Causes of secondary osteoporosis
Secondary osteoporosis may develop when certain medical conditions or medications interrupt the formation of new bone tissue. An imbalance between the loss of old bone and the production of new bone leads to a lower bone turnover rate. The result is a loss of bone density.
Medical conditions
Medical conditions that may lead to secondary osteoporosis include:
Medications
In most cases, secondary osteoporosis occurs as a result of taking certain medications, which include those below.
Hormones and medications that affect the endocrine system
The endocrine system is a network of glands that produce and secrete hormones for a wide range of bodily functions. Hormones and other medications that affect the endocrine system may cause secondary osteoporosis. Examples include:
Medications that affect the immune system
The immune system consists of various organs, cells, and proteins that work together to protect the body from pathogens and toxins. Medications that affect the immune system may cause secondary osteoporosis. Examples include antiretroviral therapy and calcineurin inhibitors.
Medications that act on the central nervous system
The central nervous system (CNS) consists of the brain and spinal cord. Medications that affect the CNS can increase the risk of secondary osteoporosis. These include anticonvulsants and antidepressants.
Medications that affect the gastrointestinal tract
The gastrointestinal tract consists of all the organs involved in the digestive process. Medications that affect the gastrointestinal tract can increase the risk of secondary osteoporosis. An example is proton pump inhibitors, which reduce the production of stomach acid.
Symptoms
People with osteoporosis are usually unaware that they have the condition, as they typically do not experience any symptoms. Often, people only receive a diagnosis of osteoporosis following a bone break from a fall or sudden impact.
The most common injuries associated with osteoporosis are:
As the bones become increasingly fragile, people may experience fractures in other parts of the body. Seemingly harmless activities, such as sneezing or coughing, can sometimes cause these fractures.
Some older people with the condition may develop a stooped posture due to bone fractures within the spine.
Diagnosis
A doctor will perform a thorough medical examination to look for conditions that may cause secondary osteoporosis. They will also take a full medical history to help identify any medications that may be associated with the condition.
Simple screening procedures can help identify possible causes of secondary osteoporosis. These procedures may include:
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
Options for Treating Arthritis in the Knee
in Arthritis, Knee Injuries, Knee Pain, Knee SurgeryArticle featured on The Noyes Knee Institute
Knee osteoarthritis can occur when the cartilage around the knee wears down. Without the protection of cartilage, bones in the joint grind together, causing inflammation and pain. In severe cases, a knee surgeon might recommend knee replacement or arthroscopic surgery. Fortunately, many non-invasive options help relieve the pain of arthritis in the knee.
Osteoarthritis and Rheumatoid Arthritis: What’s the Difference?
Knee osteoarthritis is a progressive condition in which the subchondral bone suffers damage as the cartilage slowly wears away. This type of arthritis is common in middle-aged and elderly patients and happens more frequently in females than males.
Rheumatoid arthritis (RA) is a disorder of the autoimmune system which leads to chronic inflammation. RA usually presents in both knees at the same time. Other joints, including fingers, toes, ankles, and wrists may also be affected.
Both types of arthritis respond to the conservative treatments listed below. However, as an auto-immune disorder, RA also requires specific medical care.
Treatments for Arthritis in the Knees
Weight Loss
For every pound of weight lost, you relieve four to six pounds of pressure from the knee. Carrying a significant amount of extra weight puts extra strain on knee joints which aggravates arthritis symptoms. However, even if you are not obese, losing just five to ten pounds could significantly relieve arthritis pain.
Avoid Aggravating Activities
While it’s important to continue exercising and moving your knees, overdoing it can make problems worse. Avoid the following activities if you notice pain or swelling up to 24 hours after participation:
It may not be practical to avoid all of these activities every day, but reducing them as much as possible should help alleviate arthritis knee pain.
Anti-Inflammatory Medications
NSAIDs can be extremely helpful in easing arthritis pain. However, it’s important to use prescription or over-the-counter anti-inflammatory medications only as recommended by your physician. Overuse can cause serious side effects.
Knee Injections
Steroid or synthetic lubricant injections such as Synvisc may be recommended when diet and other lifestyle changes are ineffective.
Physical Therapy
Physical therapy and “knee-friendly” exercises are often recommended to help regain strength and flexibility in the knee joint.
Knee Surgery
When conservative methods fail, it may be time to consider knee surgery. Many people automatically think of total knee replacement when they think of surgery for treating knee arthritis, but there are several other surgical options to consider:
You and your knee surgeon will determine the surgical option that’s best for your situation. If you have sustained additional knee injuries, other procedures may be performed simultaneously as surgery to correct arthritis.
Should I see a Knee Surgeon?
If you have tried conservative therapies, but your arthritis pain continues to get worse, it may be time to consider surgery.
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 Happens After ACL Surgery
in ACL Injuries, Knee SurgerySee our recommendations for helping your knee recover (and when to call the doctor) after surgery. Find out what to expect from your rehab program, when you’re likely to start walking, and when it’s safe to start swimming and running.
Recovery from ACL Surgery
After anterior cruciate ligament (ACL) surgery, move your ankles up and down an average of 10 times every 10 minutes. Continue this exercise for two to three days to help blood circulation and to prevent blood clots from forming in your legs. If you develop acute pain in the back of your calf, tell your doctor. This could be an early sign of clots.
Elevate leg
Keep your operated leg elevated at a minimum of a 45-degree angle. Prop your leg on cushions or pillows so your knee is at least 12 inches above your heart for the first three to five days after surgery. Keep your leg elevated if your knee swells or throbs when you are up and about on crutches. Don’t put pillows behind your knee because this limits motion of the knee. Place pillows under your heel and calf.
Take pain medication
Expected pain and discomfort for the first few days. Take pain medications as your doctor advises. These could be over-the-counter painkillers, such as ibuprofen or acetaminophen, or stronger narcotic drugs.
Bend knee
Slowly begin bending your knee. Straighten your leg and bend your knee. If necessary, place your hands behind your knee for assistance bending your knee. The goal is to achieve a range of motion of 0 to 90 degrees by the time you return for your first post-operative visit a week after surgery.
Monitor for fever
A low-grade fever – up to 101 degrees Fahrenheit or 38.3 Celsius – is common for four or five days after surgery. If your temperature is higher or lasts longer, tell your doctor. Your temperature should go down with acetaminophen.
Remove bandage
The dressing on your knee is usually removed the day after surgery. There may be some minor fluid drainage for two days. Sterile dressings or bandages may be used during this time. After surgery, keep the wound clean and dry. Take sponge baths until the sutures are removed.
Rehabilitation
Your rehabilitation program to restore range of motion to your knee begins the moment you wake up in the recovery room. During the first week after surgery, most patients are encouraged to lift their legs without assistance while lying on their backs. These are called straight leg raises. By the end of the second or third week, patients usually walk without crutches.
Sessions with a physical therapist usually begin seven to 14 days after surgery. During physical therapy, weight bearing is allowed if you did not have a meniscus repair.
A range of motion of 0 to 140 degrees is a good goal for the first two months.
Don’t work your quadriceps early on because this can stretch the ACL graft. Stationery bike riding or lightweight leg presses are recommended during the first three months after surgery. These exercises strengthen the quadriceps while using the hamstrings to protect the ACL graft.
Don’t swim or run for five months. You can swim with your arms, without paddling your feet, at about two to three months after surgery.
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
Top 5 Most Effective Evidence-based Treatment Options for Concussions
in Sports Medicine, Sports Related InjuriesArticle featured on Complete Concussion Management
Historically, patients with concussion were told to rest, rest, rest. And when that didn’t work, they were told to rest some more.
The research on concussions is evolving at an exponential rate and we are realizing that not only does prolonged rest not work; it can actually make you worse.
Sadly, many healthcare practitioners are not keeping up with the explosion in concussion research and are still telling their patients that the only treatment for concussion is rest. If you have fallen victim to this, you don’t need more rest; you need a second opinion.
While it is true that during the early stages following injury, moderate rest is still important, that timeline seems to be getting shorter, with longer duration rest creating worse outcomes for patients. So, if you have been resting for more than a week, and are still having significant symptoms, it’s time to switch it up. More rest is likely contributing to your ongoing symptoms.
If not rest, then what?
The top 5 most effective evidence-based treatment options for concussion:
1. Exercise Therapy
Following concussion, animal (and many human) studies have demonstrated a reduction in blood flow to the brain in the early stages. Recent research has found that these blood flow changes may persist for some time following injury due to ongoing dysfunction in the Autonomic Nervous System (ANS). The ANS consists to two opposing sides that tend to work in opposition to one another. The Sympathetic Nervous System is also known as the “Fight, Flight, or Freeze” system – this side of the ANS is responsible for increasing our heart rate, dilating our blood vessels to pump blood to our muscles, release adrenaline, dilate our pupils, and get us ready for action. Our Parasympathetic Nervous System on the other hand is our “Rest & Digest” system – this side of the ANS is responsible for lowering our heart rate, increasing our digestion, activating our metabolism, and helping us to be relaxed and calm.
These two systems can be thought of like a teeter-totter. When one is up, the other is down. They fluctuate their dominance throughout our days but the system should maintain a harmony and balance.
Concussion creates an imbalance in the ANS with most suffering from high “Sympathetic Tone” – this means that we are stuck in a fight or flight state. Our heart rate tends to be elevated and doesn’t respond well to increased demands, blood flow to our brain is not as responsive, our digestion shuts down sometimes leading to stomach pains, food sensitivities, and increased inflammation, our anxiety levels increase, we may get lightheaded more easily, and we suffer symptoms with increased cognitive and physical activity.
The good news is that this problem can be tested for and rehabilitated very easily; provided you know what you’re doing!
The mainstay rehabilitation for this problem actually goes against conventional thought: exercise!
Researchers at the University of Buffalo have published numerous studies demonstrating complete symptom resolution and improved brain blood flow (as measured on fMRI) through a specific graded exercise program alone.
More recent evidence suggests that exercise might even help speed recovery in the early stages after concussion!
It is important to see someone who knows exactly what they are doing with this protocol. Testing with a trained professional must be done first to establish set points as well as your specific program. There is also more to balancing the Autonomic Nervous System that must be taken into consideration as well.
2. Manual Therapy & Neck Rehab
With every concussion, there is also a whiplash.
Studies have demonstrated that the acceleration required to cause a concussion is somewhere between 70 and 120 G’s (where G = force of gravity = 9.8m/s2). Whiplash, on the other hand has been shown to occur at only 4.5 G’s.
It is therefore conceivably impossible for a concussion to occur without also causing a sprain or strain injury to your neck! In fact, a Canadian study found that 100% of the time, these injuries are happening together.
What becomes even more confusing is that the signs and symptoms of whiplash and neck dysfunction are the exact same as concussion! Headaches, cognitive and emotional problems, balance problems and dizziness, eye movement control problems, and brain blood flow abnormalities43 have all been shown to occur in whiplash and neck pain patients.
There is actually no way to tell if the symptoms are coming from your neck or from your concussion except with testing (some specific tests that we won’t go into here). In fact, most of the patients healthcare practitioners see in this category don’t report any neck pain; which makes this all the more confusing for practitioners. In a recent unpublished study with the University of Buffalo, the researchers found that there was absolutely no difference in the symptoms that whiplash patients report and the symptoms that concussion patients report.
Concussion is an injury that typically resolves quite quickly in most people (symptoms generally disappear for 80-90% of patients within 7 to 10 days); however, whiplash symptoms can linger for up to a year or more.
So, if you are still having concussion symptoms, even if you don’t have neck pain, you may actually be suffering from symptoms that are coming from your neck; which are easily treated with manual therapy and rehabilitative exercises.
3. Diet/Nutritional Changes
With injury to any tissue, there is inflammation; concussions are no exception with several studies demonstrating increased inflammatory markers following injury.
Concussion results in a metabolic dysfunction (read: energy deficit) in the initial stages, which is why strict rest used to be prescribed early on; the thought was – anything that burns energy, such as thinking or physical activity, could increase symptoms. As mentioned above however, rest is no longer considered an effective treatment for concussion.
It is important to note however that the majority of studies examining this metabolic disruption show a recovery between 22 and 45 days after injury. In other words, beyond a 3-6 week period, there is little metabolic explanation for your symptoms; unless of course you did not rest in the initial stages and/or received a second concussion soon after the first.
Treatment options for both of these things can include simple dietary changes such as avoiding pro-inflammatory foods (red meats, refined sugars, white breads and pastas, artificial sweeteners) and replacing them with healthier options such as fruits and vegetables, fresh caught fish (salmon, mackerel, herring), and good fats (coconut oil, flax seed, almonds). These changes may help to offset an ongoing inflammatory response and reduce your symptoms.
Another option would be to speak to your doctor about a short course of anti-inflammatory medications. Note that we say “short course” as, over a prolonged period, these medications can begin to harm your stomach and gut leading to ulcers.
4. Vestibular and Visual Rehab
Dizziness is one of the most common ongoing complaints of patients with persistent symptoms. This may be due to a number of overlapping issues such as problems with the balance centres of your brain, your visual system, and/or problems with the muscle and joint sensors of your neck.
Visual system problems may also be one of the causes of ongoing cognitive complaints such as trouble with concentration and/or memory. If you find yourself reading a passage and then having to re-read it several times before you understand what it is saying, you might have a problem with how your eyes are moving or working together. Testing for each of these areas requires extensive knowledge of each of the systems and how they may interact. If you have not had extensive testing of these systems, then you are in the wrong place!
Following a thorough assessment of these areas a proper rehabilitation program can be set up. The research on rehabilitation for these areas is extensive with numerous studies showing resolution of dizziness, and visual abnormalities with a fairly short course of treatment.
5. Education and Reassurance (due to Psychological Comorbidities)
It has been well established that patients with a pre-existing history of depression and/or anxiety tend to have prolonged symptoms. Not only that, the symptoms of these and other mental health conditions can result in, or mimic, the same symptoms of concussion (dizziness, mental confusion, concentration problems, sadness, emotional outbursts).
Many of these issues can begin before or after the concussion, which may be due to the concussion itself, or a direct result of being mismanaged by someone giving you improper advice. In other words, being told to sit in a dark room, avoid all social contact, not go to work or school, and not do any physical activity for months on end may be causing to the very anxiety, depression, and symptoms that you are attempting to stop.
Studies examining the overlay of mental health and concussion are endless (so much so that I won’t even begin to start referencing them), and mental health will always be a big part of concussion management. In most cases, patients often feel much better following some education and reassurance. The Ontario Neurotrauma Foundation recently demonstrated to be one of the best evidence-based treatment options for preventing long-term symptoms was patient education and reassurance!
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
COVID-19 Pandemic Highlights Need to Assess Your Risks to Prevent Falls
in COVID-19Article featured on CORA Physical Therapy
Know Your Risks Beforehand and Be Proactive to Effectively Manage Your Health Care Needs
Losing balance as we age is something that most of us accept as inevitable. Dizzy spells, reaching out to steady yourself on a countertop or second thoughts about going for a walk with the grandchildren all are understandable concerns.
We know that one in three people 65 or older fall every year is due to a lack of practice and misuse of the systems in the body that contribute to balance. What many people did not anticipate is how a global pandemic could throw our population into sedentary lifestyle, speeding up a loss of balance in the course of a year versus what may have normally happened over a period of several years.
The Impacts of Inactivity and Deconditioning
Numerous articles studying activity levels during lockdowns brought on by the COVID-19 pandemic repeatedly cite a significant reduction in activity levels, an increase in sedentary lifestyles, increased anxiety and increased depression across age groups and populations. With the general decrease in activity levels and deconditioning over the last two years, it is no surprise that a survey conducted by the National Poll on Healthy Aging showed that 25% of respondents aged 50-80 had a fall between March 2020 and January 2021, and 40% of those had fallen more than once during the same time period. The good news is you are much more in control of improving your balance than you might think.
A simple fall can be devastating, causing a fractured hip, pelvis or spine. These events can result in a lowered quality of life, a visit to the hospital, or worse. If a fall can literally be a matter of life or death, it’s imperative to routinely visit the doctor and take steps on your own to ensure that you can stay active safely in your later years.
According to Jordan Cuenin, PT, DPT, clinic manager at CORA PT in Easley, South Carolina, “A fear of falling is common among individuals who have experienced a similar event. This phobia can be debilitating as it can limit one’s motivation to participate in activities, including attendance at social events. Not only is the fear of falling real, but experiencing a fall also increases your chances of falling again twofold.”
Balancing As We Age
Our ability to balance relies on the combination of information from the eyes, inner ears, joints and muscles. When all these systems are working well together, you’re well-balanced. As we age, so do the small bones in our ears, and our vision can suffer as well. Loss of appetite, reduced food intake, and decreased activity can make the joints and muscles suffer. It takes two to three weeks of inactivity or decreased activity for strength losses to become apparent. For many of us, even those who were previously active, the pandemic forced us into a sedentary lifestyle for many months. This can result in losses of strength, power, and cardiovascular health.
For the most part, the solution to balance issues is straightforward. Increasing daily movement in a gradual but challenging way is the key. Moving away from a sedentary lifestyle has immense benefits for everyone, and it’s even more important as we age.
“Keep moving. All too often, I see regular activity become less frequent as people age and retire, leading to deconditioning in all areas of health,” Cuenin reiterated.
We do not have to accept having a fall as a part of life just because we’re aging and are living through a pandemic. If you notice issues with loss of balance or perhaps light-headedness in situations where you’d normally feel in control, or if you feel unstable as you return to your prior level of activity, it’s time to schedule a visit with your doctor or a physical therapist.
Virtual and In-Person Fall Risk Screens
CORA Physical Therapy offers virtual and in-person fall risk screens. A therapist can assess your risk of falling in a matter of minutes, while being able to provide you with options on how to proceed with your care and how to reduce your risk of falls if need be. Whether you’re getting back into an active lifestyle after a long, sedentary pandemic, or whether you’re just trying to stay healthy, a personalized program can be prescribed for home use or implemented in a clinic, to target patient-specific needs. Treatment options can range from exercises to increase function of the inner ear to exercises for rebuilding strength in your legs, or specific balance activities to improve confidence and stability. If you can’t make it into a clinic, our therapists can provide telehealth visits and/or a home exercise program and safety checklist for decreasing your risk of falls within your home environment.
But what does the process look like? Is it really possible to go from feeling unsteady to regaining that confident spring in your step? Yes! If you don’t want to go through the lengthy process of having a doctor diagnose you with an issue before seeing a physical therapist, in many states you can see a physical therapist for up to 30 days without a doctor’s intervention.
Want to Achieve a Steady, Healthy Life? We Can Help.
Knowing your risks beforehand, developing a regimented exercise program and making slight modifications to your home can help prevent falls and protect you and your loved ones. Being proactive with your health is a much more cost-effective way to manage your health care needs than recovery from a fall.
The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
8:00am – 4:30pm
6 Tips for Parents With Kids Who Have Osgood-Schlatters Disease
in Knee Injuries, Knee PainArticle featured on Orthogate
Anterior knee pain is a common complaint of young athletes participating in sports. As a teenager, most of the aches and pains disappear as fast as they show up. However, when the pain doesn’t go away it can be frustrating and scary to deal with as a parent. Osgood-Schlatters Disease (OSD) is one of the common ailments that cause pain in the front of knee particularly in teenage athletes ranging from 12-15 years old. Injuries at this age can be a challenge, as kids of that age have difficulty communicating their pain, understand their diagnoses, and can get frustrated with the missed time on the playing field.
Osgood-Schlatters also tends to linger and stay longer than any teenager would like. That’s when you decide to see a doctor. However, OSD is just common enough and not serious enough that some doctors might brush it off as unimportant. What’s a parent to do? Here’s a guide to help you and your growing teenager get through it and maintain the sanity of your household through the process.
What is Osgood-Schlatters Disease?
First, the word disease can be a little misleading. Osgood-Schlatters Disease is less of a disease and more of an overuse injury involving the patella tendon. OSD is most common during the adolescent growth spurt as the bones are maturing. The pull from repetitive movement such as jumping causes tension through the patella tendon on Tibial Tuberosity. This traction injury can cause inflammation, tenderness to the touch, and formation of a painful bony bump to form on the front of the shin.
Risk Factors for Osgood-Schlatters Disease?
The primary risk factors for Osgood-Schlatter disease are repetitive movements during a certain age range. Other risk factors include:
Top Tips for Patients To Help Recover from Osgood-Schlatter Disease
Create a Schedule
This might be the most important tip to consider. Recovering from OSD requires consistency and a schedule can help. Create a daily schedule to ice the tendon, to stretch the quadriceps, and to even perform self-massage can speed up recovery. Also, schedule some downtime to allow the knee adequate rest. Kids tend to have a really hard time understanding the importance of treating their injuries seriously. For good time management skills try writing out daily, weekly, and monthly recovery goals.
Take Active Time Off
OSD is an overuse injury from repetitive patellar tendon tension. If the young athlete continues to play and practice without adequate tendon rest it could re-injure the tendon. This can prolong the recovery timeline and cause more frustration. The tendon needs proper time to heal and this can be difficult during the middle of the season, especially for a teenager. Try to help them understand that active movement and activities such as walking and biking are good but they need to take a break from jumping, running, and sports. Figure out other ways they can be involved with the team while they heal as OSD can take up to 6-8 weeks to heal in severe cases.
Brace it
For mild cases and athletes returning to their sport, a brace may help with pain and prevent a recurrence. A brace for Osgood-Schlatters changes the location of tension from the Tibial Tubercle to the brace. The tendon is allowed to heal with less tension but yet your athlete is still able to participate. This may also stop the progression of new cases of OSD before they become severe and help them get back to sports sooner.
Emphasize Proximal Hip Strengthening
The knee is a slave to the hip and ankle. The knee joint bends forwards and backward but the rotation of the knee is controlled from the joints above and below it. One of the best ways to stabilize the knee focuses on the lateral hip muscles through exercises such as the side-lying clamshell and the single-leg deadlift. The stronger the hip gets, the more stable the knee will become and it will be able to handle more stress. These exercises also won’t aggravate OSD, so they are safe to start at any time.
Talk about Expectations
Taking 4-6 weeks off during the middle of the season may seem like an eternity for a 13-year-old but it’s important to talk about expectations and timelines. The younger teens may not understand the importance of healing now to prevent future complications. They shouldn’t be running or jumping while at school. Take time to talk to them about how they feel about missing playing time. The young athlete may be seen apprehensive about losing their starting spot in the lineup or worry that they will be forgotten by their teammates. Feeling depressed about their injury is fairly common.
Prevent it with Cross-Training
One of the best ways to prevent OSD from returning or starting in the first place is through cross-training. Specializing in one sport has been shown to increase the injury rate in young athletes. The demands of participating in different sports change the repetitive trauma to the muscle, tendons, and ligaments. By playing multiple sports over the year it promotes well-rounded muscle development, better movement quality, and needed rest between seasons. Kids need to be well-rounded athletes before they can specialize.
Conclusion:
Osgood-Schlatters can be a frustrating and scary injury to deal with as a parent. However, with a solid game plan, proper communication, and maintaining active rest, your young athlete will be back on the field in no time.
The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
8:00am – 4:30pm
7 Rare Causes of Knee Pain
in Knee PainArticle featured on Healthgrades
Knee Pain Without Injury
Injury, ongoing stress, and aging are the most common causes of knee pain. But what if none apply? One of several rare causes of knee pain may be at work, including benign tumors, fluid buildup, infection, certain types of arthritis and even genetic mutations. Many of these causes have the exact same symptoms but require very different treatments. It’s important to work with your doctor to arrive at an accurate diagnosis so you can not only start easing symptoms, but also prevent long-term damage to your knee joint.
1. Tenosynovial Giant Cell Tumor (TGCT)
2. Synovial Chondromatosis
3. Chondrocalcinosis 2 (CCAL2)
4. Pigmented Villonodular Synovitis
It’s not yet known what causes pigmented villonodular synovitis (PVNS), and the symptoms are similar to other knee conditions. When you have PVNS, the lining of your knee joint swells and grows, and fluid builds up. Your doctor may test fluid from your knee to diagnose the condition. Symptoms can come and go, so the first step may be resting your knee and taking nonprescription pain relievers. If symptoms are severe and persist over time, your doctor may recommend surgery to remove your knee joint lining. A non-invasive procedure may be an option.
5. Adult Still’s Disease
Adult Still’s disease is a type of inflammatory arthritis that can come with distinct symptoms in addition to knee pain: rash, fever, and sore throat. Your knee joint may also feel achy, and nearby muscles may hurt. It’s not known what causes Adult Still’s disease, but some research points to infection. The condition is usually treated with one or more of these medicines: NSAIDs; steroids; methotrexate; and biologic drugs that target your body’s inflammatory response at the cellular level.
6. Septic Arthritis
Septic arthritis is a joint infection, and the most common type is Staphylococcus aureus (staph). The infection can be caused by an injury such as a cut or animal bite or it can be introduced during surgery–but it’s usually caused by an infection that has traveled from another part of your body like your urinary tract or skin. Septic arthritis is painful, and it may come with swelling, redness, warmth, or fever. Treatment usually includes draining the fluid around the knee joint and taking antibiotics.
7. Reactive Arthritis
Like septic arthritis, reactive arthritis in the knee can also be caused by an infection that has travelled from another part of your body. The most common types are sexually transmitted infections (STIs) and food poisoning. Antibiotics are usually prescribed to cure the infection. Symptoms include pain and swelling, as well as irritation of the genitals or eyes. If you have any symptoms of a rare knee condition, try to write them down and note how long they last. Bring this information to your doctor’s appointment to inform the diagnosis and help speed your time to treatment.
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