Treating Ankle Injuries

Article featured on UCSF Health

Ankle sprains are the most common ankle injury among regular athletes and weekend warriors. The top orthopedic complaint, sprains occur in an estimated 27,000 Americans a day.

Many athletes, however, who suffer from ankle sprains tend to play right through their injury, which can lead to lifelong problems with recurring sprains, unstable joints, arthritis-like pain or other complications like tendon or cartilage damage. And the earlier in life a sprain occurs, the higher the chance of recurrence. Therefore, it’s important to properly treat initial sprains, especially in young athletes.

If you sprain your ankle and it hurts to run, you should sit out the rest of the game. Once a sprain has occurred, follow these three steps to help you recover:

Step 1: RICE

Follow the instructions represented by the acronym RICE as often as possible for three days. RICE stands for rest, ice, compression (with an elastic ankle wrap) and elevation (toes above the nose). For significantly swollen ankles or if limping persists for more than three days, you should see a doctor.

Step 2: Rehabilitation

To prevent permanent damage to the ankle, take steps to achieve better range of motion (flexibility), balance and strength. Many of these exercises can be done at home.

Range of motion exercise

Place one foot on a stairway step. Allow the back heel to stretch downward over the edge of the step. Hold each foot in this position for 30 seconds.

Balance restoration exercise

Stand on one leg with your eyes closed. Gradually build up to standing 30 seconds on each leg. Repeat three times.

Strength exercise

Lie on your side on the sofa, with the upper leg hanging over the edge. Place the top of your foot through the handles of a plastic shopping bag filled with one to two pounds of weight (one or two cans of soup). Slowly lift your toes toward the ceiling and hold for three seconds. Repeat 10 times.

Step 3: Supportive devices

When back to playing sports, previously injured athletes should probably wear an ankle brace, no matter how much they have rehabilitated their ankle or how good their sneakers. An injured ankle will never have the same support again, so a brace should be considered.

Step 4: If pain continues

For ankle pain and significant instability that persists despite adequate rehabilitation or physical therapy, you should see a doctor for further evaluation. You may have injured the cartilage or tendons in your ankle, which may require special testing.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.


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

Shoulder Replacement Surgery: What to Know

Medically Reviewed by Tyler Wheeler, MD on December 08, 2019 from WebMD

If your shoulder joint gets seriously damaged, you might need surgery to replace it. Before you have your procedure, you should know some things.

About Your Shoulder

The joint where your upper arm connects to your body is a ball-and-socket joint. The bone in your upper arm, called the humerus, has a round end that fits into the curved structure on the outside of your shoulder blade.

Ligaments and tendons hold it together. Ligaments connect the bones, while tendons connect muscles to the bone. A layer of tissue called cartilage keeps the bones apart, so they don’t rub against each other.

The ball and socket lets you move your arm up and down, back and forward, or in a circle.

Why You’d Need It Replaced

You may have to have it done if you have a condition that makes it painful and hard to use your arm, such as:

  • A serious shoulder injury like a broken bone
  • Severe arthritis
  • A torn rotator cuff

Your doctor will probably try to treat you with drugs or physical therapy first. If those don’t work, they may recommend surgery.

Shoulder replacement surgery is less common than hip or knee replacements. But more than 50,000 shoulder replacements are done in the U.S. each year.

What to Expect

An orthopedic surgeon will replace the natural bone in the ball and socket of your shoulder joint with a material that could be metal or plastic. It’s a major surgery that’ll keep you in the hospital for several days. You’ll also need several weeks of physical therapy afterward.

There are three types of shoulder replacement surgeries:

Total shoulder replacement: This is the most common type. It replaces the ball at the top of your humerus with a metal ball, which gets attached to the remaining bone. The socket gets covered with a new plastic surface.

Partial shoulder replacement: Only the ball gets replaced.

Reverse shoulder replacement: Usually, you’d get this if you have a torn rotator cuff. It’s also done when another shoulder replacement surgery didn’t work. The metal ball gets attached to your shoulder bones, and a socket is implanted at the top of your arm.


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

Everything You Need to Know about Fibromyalgia

Everything You Need to Know about Fibromyalgia

From Medical News Today

Fibromyalgia is a common and chronic syndrome that causes bodily pain and mental distress.

Symptoms of fibromyalgia can be confused with those of arthritis, or joint inflammation. However, unlike arthritis, it has not been found to cause joint or muscle inflammation and damage. It is seen as a rheumatic condition, in other words, one that causes soft tissue pain or myofascial pain.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), around 5 million adults aged 18 years or over in the United States experience fibromyalgia, and 80 to 90 percent of fibromyalgia patients are women.

Fast facts on fibromyalgia:

Here are some key points about fibromyalgia. More detail is in the main article.

  • Fibromyalgia causes widespread pain, fatigue, and other types of discomfort.
  • Symptoms resemble those of arthritis, but fibromyalgia affects the soft tissue, not the joints.
  • The cause is unknown, but risk factors include traumatic injury, rheumatoid arthritis and other autoimmune disorders, such as lupus, and genetic factors.
  • There is no cure, but medications, exercise, acupuncture, and behavioral therapy can help relieve symptoms and improve sleep quality.

Symptoms

Common symptoms include:

  • widespread pain
  • jaw pain and stiffness
  • pain and tiredness in the face muscles and adjacent fibrous tissues
  • stiff joints and muscles in the morning
  • headaches
  • irregular sleep patterns
  • irritable bowel syndrome (IBS)
  • painful menstrual periods
  • tingling and numbness in the hands and feet
  • restless leg syndrome (RLS)
  • sensitivity to cold or heat
  • difficulties with memory and concentration, known as “fibro-fog”
  • fatigue

The following are also possible:

  • problems with vision
  • nausea
  • pelvic and urinary problems
  • weight gain
  • dizziness
  • cold or flu-like symptoms
  • skin problems
  • chest symptoms
  • depression and anxiety
  • breathing problems

Symptoms can appear at any time during a person’s life, but they are most commonly reported around the age of 45 years.

Treatment

Medical attention is needed because fibromyalgia can be difficult to manage. As it is a syndrome, each patient will experience a different set of symptoms, and an individual treatment plan will be necessary.

Treatment may include some or all of the following:

  • an active exercise program
  • acupuncture
  • psychotherapy
  • behavior modification therapy
  • chiropractic care
  • massage
  • physical therapy
  • low-dose anti-depressants, although these are not a first-line treatment

People with fibromyalgia need to work with their doctor to come up with a treatment plan that provides the best results.

Medications

Medications may be recommended to treat certain symptoms.

These may include over-the-counter (OTC) pain relievers. However, the European League Against Rheumatism (EULAR) issued a recommendation against using non-steroidal anti-inflammatory drugs (NSAIDs) to treat fibromyalgia in their updated 2016 guidelines.

Antidepressants may help reduce pain. Anti-seizure drugs, such as gabapentin also known as Neurontin, and pregabalin, or Lyrica, may be prescribed.

However, a review has suggested that patients often stop using these drugs because they are not effective in relieving pain or because of their adverse effects.

Patients should tell the doctor about any other medications they are taking to avoid side-effects and interactions with other drugs.

Exercise

A combination of aerobic exercise and resistance training, or strength training, has been linked to a reduction in pain, tenderness, stiffness, and sleep disturbance, in some patients.

If exercise is helping with symptoms, it is important to maintain consistency in order to see progress. Working out with a partner or personal trainer may help to keep the exercise program active.

Acupuncture

Some patients have experienced improvements in their quality of life after starting acupuncture therapy for fibromyalgia. The number of sessions required will depend on the symptoms and their severity.

One study found that 1 in 5 people with fibromyalgia use acupuncture within 2 years of diagnosis. The researchers concluded that it may improve pain and stiffness. However, they call for more studies.

Behavior modification therapy

Behavior modification therapy is a form of cognitive behavioral therapy (CBT) that aims to reduce negative, stress- or pain-increasing behaviors and improve positive, mindful behaviors. It includes learning new coping skills and relaxation exercises.


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 are My Legs and Feet Numb?

Why are My Legs and Feet Numb?

From Medical News Today; Medically reviewed by Seunggu Han, M.D. — Written by Jennifer Huizenon January 22, 2020

A person may feel numbness in their legs and feet due to sitting in a position that puts too much pressure on the nerves or reduces blood flow. However, long-lasting or unexplained numbness may be a sign of an underlying medical condition.

Long-term numbness or a tingling feeling in the legs and feet may be due to conditions such as multiple sclerosis(MS), diabetes, peripheral artery disease, or fibromyalgia. The sensation may be felt in the whole leg, below the knee, or in different areas of the foot.

In this article, we look at some of the reasons why a person might experience numbness in the legs and feet, along with symptoms and treatments.

Causes of numbness in legs and feet

Crossing the legs for a long time may cause numbness and tingling in the legs and feet.

Often, a person’s legs go numb temporarily because of their posture. However, chronic or long-lasting numbness in the feet and legs is almost always a sign of an underlying medical condition.

Conditions associated with feet and leg numbness include:

Posture

Postural habits that put pressure on nerves or reduce blood flow in the lower limbs are the most common cause of temporary numbness in the legs and feet. Many people say their leg has “fallen asleep,” and the medical term is transient (temporary) paresthesia.

Habits that can cause the feet and legs to fall asleep include:

  • crossing the legs for too long
  • sitting or kneeling for long periods
  • sitting on the feet
  • wearing pants, socks, or shoes that are too tight

Injury

Injuries to the torso, spine, hips, legs, ankles, and feet can put pressure on nerves and cause the feet and legs to go numb.

Diabetes

Some people with diabetes develop a type of nerve damage called diabetic neuropathy. Diabetic neuropathy can cause numbness, tingling, and pain in the feet, and if severe, the legs as well.

Lower back issues and sciatica

Problems in the lower back, such as a breakdown or herniation of spinal discs, can cause compression of the nerves going to the legs, leading to numbness or sensory disturbances.

Sciatica is the name for irritation of the sciatic nerve, which runs from the lower back to the legs. If this nerve becomes irritated or compressed, a person may experience numbness or tingling in their legs or feet.

Tarsal tunnel syndrome

Tarsal tunnel syndrome occurs when a nerve that runs down the back of the leg and along the inside of the ankle and into the foot is compressed, squeezed, or damaged.

The tarsal tunnel is a narrow space on the inside of the ankle. People with tarsal tunnel syndrome tend to feel numbness, burning, tingling, and shooting pain in their ankles, heels, and feet.

Peripheral artery disease

Peripheral artery disease (PAD) causes the peripheral blood arteries in the legs, arms, and stomach to narrow, reducing the amount of blood they can pump and reducing blood flow. The legs are one of the most common parts of the body impacted by PAD.

Most people with PAD experience pain and cramping in their legs and hips when they are walking or going upstairs. Some people with PAD also experience leg numbness and weakness.

Symptoms of PAD typically go away after a few minutes of rest.

Tumors or other abnormal growths

Tumors, cysts, abscesses, and benign (non-cancerous) growths can put pressure on the brain, spinal cord, or any part of the legs and feet. This pressure can restrict blood flow to the legs and feet, causing numbness.

Alcohol use

The toxins in alcohol can cause nerve damage that is associated with numbness, especially in the feet.

Chronic or excessive alcohol consumption can also lead to nerve damage that causes numbness. This type of nerve damage is linked to reduced levels of B vitamins, such as B-1 (thiamine), B-9 (folate), and B-12, which is caused by excessive alcohol intake.

Fibromyalgia

Fibromyalgia is a chronic or long-lasting condition that causes widespread body pain, aching, and tenderness. Some people with fibromyalgia also experience numbness and tingling in the hands and feet.

Most people with fibromyalgia experience a variety of symptoms including:

  • stiffness and soreness for no apparent reason, especially in the morning or after sleeping
  • chronic exhaustion
  • memory problems and difficulty thinking clearly, sometimes called fibro-fog
  • restless leg syndrome

Almost everyone with fibromyalgia experiences symptoms in more than one part of their body for at least 3 months at a time. If numbness in the legs and feet is not accompanied by any other symptoms or is not long-term, it is unlikely to be caused by fibromyalgia.

Multiple sclerosis

People with multiple sclerosis (MS) experience sensory nerve damage that can cause numbness in a small region of their body or whole limbs. Although numbness associated with MS often only lasts for a short period, it can last long enough to become disabling.

Stokes and mini-strokes

Strokes or mini-strokes can cause brain damage that may affect how the mind interprets and processes nerve signals. A stroke or mini-stroke can sometimes cause temporary or long-term numbness in parts of the body.

Symptoms

Numbness is just one of the many symptoms associated with temporary and chronic numbness.

Many people with numbness in their legs and feet experience additional symptoms at the same time or intermittingly, such as:

  • tingling
  • burning
  • tickling
  • itching
  • a crawling feeling under the skin
Treatment

The proper treatment for numb legs and feet depends entirely on the cause.

Medication

Medical options for long-term numbness in the legs and feet include:

  • Antidepressants. Some antidepressants, such as duloxetine and milnacipran, have been approved for the treatment of fibromyalgia.
  • Corticosteroids. Some corticosteroids can help reduce chronic inflammation and numbness associated with conditions such as MS.
  • Gabapentin and pregabalin. Medications that block or change nerve signaling may help reduce numbness associated with conditions such as fibromyalgia, MS, and diabetic neuropathy.

Home remedies

Home remedies that may help to relieve uncomfortable numbness in the legs and feet include:

  • Rest. Many of the conditions that cause leg and foot numbness, such as nerve pressure, improve with rest.
  • Ice. Ice can help reduce swelling that can put pressure on nerves. Apply cold compresses or wrapped icepacks to numb legs and feet for 15 minutes at a time several times daily.
  • Heat. Heat can sometimes help loosen stiff, sore, or tense muscles that can put pressure on nerves and cause numbness. However, avoid overheating numb legs and feet, as this may or worsen inflammation and cause pain and numbness.
  • Massage. Massaging numb legs and feet helps improve blood flow and may reduce symptoms.
  • Exercise. A lack of proper exercise can weaken the heart and blood vessels, reducing their ability to pump blood to the lower limbs. Activities such as yoga, Pilates, and tai chi can promote blood flow and reduce chronic inflammation or pain.
  • Supportive devices. Braces and specially designed footwear can help reduce nerve pressure caused by conditions such as injury, tarsal tunnel syndrome, or flat feet.
  • Epsom salt baths. Epsom salts contain magnesium, a compound known to increase blood flow and circulation. Epsom salts are available for purchase online.
  • Mental techniques and stress reduction. People with conditions that cause chronic numbness, such as MS and fibromyalgia, should try to focus on the fact that the periods of numbness are often short-lived and go away on their own. Stress also tends to make the symptoms of central nervous system disorders worse.
  • Sleep. Many of the chronic conditions associated with leg and feet numbness are known to worsen with a lack of proper sleep.
  • A healthful, balanced diet. Malnutrition, especially vitamin B deficiencies, can cause nerve damage leading to numbness. Getting enough vitamins and other nutrients can also reduce chronic inflammation and pain, which can cause numbness.
  • Alcohol reduction or avoidance. Alcohol contains toxins that can cause nerve damage and numbness. Alcohol also usually makes the symptoms of chronic pain and inflammatory conditions worse and can even cause flare-ups of symptoms.

When to see a doctor

Talk with a doctor about numbness in the legs and feet that:

  • is not related to postural habits or lifestyle factors, such as tight clothing and footwear
  • lasts for long periods
  • is accompanied by any other chronic symptoms
  • is accompanied by permanent or long-term changes in the color, shape, or temperature of the legs and feet

Numbness in the legs and feet is a common disorder, though when it becomes chronic, it may be a sign of an underlying medical condition.

Anyone who experiences numbness that is unexplained, persistent, frequent, painful, disabling, or accompanied by other chronic symptoms should see a doctor for a diagnosis and to discuss 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

Common Causes of Sciatica

Common Causes of Sciatica

From Medical News Today

Sciatica is a type of nerve pain that radiates down the back into the hip and leg. It often goes away in a few weeks, but for some people, the condition is chronic.

The pain can feel like an intense cramp or burning electrical sensations.

Sciatica that lasts more than 3 months or that goes away and comes back may be chronic sciatica.

Chronic sciatica is a long-term condition that can cause ongoing pain. It is more difficult to treat than acute (short-term) sciatica, but several remedies can offer relief.

This article reviews what sciatica is, what causes it, and how to treat it.

Why is my sciatica not going away?

Sciatica happens when something presses on or traps the sciatic nerve.

The most common cause is a herniated disk in the lower spine.

Another risk factor is spinal stenosis, a condition that causes the spinal column to narrow.

Herniated disk

Doctors do not know why some cases of sciatica become chronic.

Many acute and chronic cases happen because of a herniated disk. In most cases, herniated disks improve on their own within a few weeks. When they do not, this may cause chronic pain.

Injury

People with herniated disks often remember a specific injury that triggered the pain.

An injury does not mean that the pain will be chronic.

However, people who have a herniated disk from an injury may develop the same injury again, especially if they continue repeating the movements that led to it.

Inflammation

Inflammatory conditions can trap spinal nerves, causing sciatic pain.

People with chronic inflammatory conditions, such as rheumatoid arthritis, may notice that their sciatica flares when their condition gets worse.

Treating the underlying condition may help treat the sciatica.

Infection

An infection in or around the spine can cause an abscess, which is a swollen and infected mass. This abscess can trap spinal nerves, causing sciatica and, sometimes, other symptoms.

A person with an abscess may develop a fever, have pain in other areas of the body, or find that sciatica begins after they have another infection.

Spinal mass or cancer

Any type of mass in or near the spine may trap spinal nerves, causing sciatic pain.

Some masses are cancerous. In other cases, an epidural hematoma, which is a swollen blood spot near the spine, can cause the pain.

It is important that people with sciatica see a doctor to rule out potentially dangerous conditions such as cancer, especially when sciatica does not go away.

Wear and tear

As a person ages, the normal wear and tear on their spine can cause the spinal column to narrow, resulting in spinal stenosis.

For some people, spinal stenosis causes chronic or worsening pain.

Lifestyle issues

Several lifestyle factors may increase the risk of sciatic pain or extend the healing time.

People with these risk factors may find that sciatica becomes chronic or recurs. Risk factors for sciatica include:

  • little physical activity and prolonged sitting
  • having overweight or obesity
  • smoking

As sciatica often follows an injury, people may also find that the symptoms do not improve if they continue the activity that caused the original injury.

Spinal misalignment

When the spine is not properly aligned, such as when a person has scoliosis or another chronic condition, it can put pressure on the space between the vertebrae.

This pressure may cause herniated disks. It can also compress the sciatic nerve, causing nerve pain. Depending on the cause, a person may need surgery, physical therapy, or other treatments.

Will my sciatica come back?

Sciatica can and does come back, especially when a person has a chronic medical condition.

People who do not make lifestyle changes to prevent more sciatic pain may also redevelop symptoms. However, for most people, sciatica heals on its own within a month or two.

 


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

What to Know About Front Shoulder Pain

What to Know About Front Shoulder Pain

From Medical News Today; Medically reviewed by William Morrison, M.D. — Written by Sunali Wadehraon January 22, 2019

Damage to the shoulder may result from repetitive movements, manual labor, sports, or aging. A person may also injure this part of the body due to a bad fall or accident. Many people visit the doctor with front, or anterior, shoulder pain.


The shoulder is a mobile structure that allows the arm to move freely in all directions. Shoulder problems may limit arm movement, causing pain or discomfort.

The shoulder has three major bones:

  • the humerus, which is the long arm bone
  • the scapula, or shoulder blade
  • the clavicle, or collarbone

These bones interact at four joints. A joint called the glenohumeral or shoulder joint connects the upper arm bone and shoulder blade. Although surrounding structures provide support, this joint is susceptible to injury.

In this article, we discuss some common causes of front shoulder pain and explain how doctors diagnose and treat them.

What are the causes?

Shoulder pain can develop from problems in any part of the shoulder.

Damage to the joint may result from repetitive movements, manual labor, sports, or aging.

It may also occur when a person has a bad fall or accident.

Some injuries may cause a sudden onset of shoulder pain. Examples include dislocations, separations, and fractures.

Common causes of chronic front shoulder pain include the following:

Rotator cuff injury

The rotator cuff comprises muscles and tendons that act to stabilize the shoulder.

Bursae, which are fluid-filled sacs, reduce friction between the shoulder structures. The rotator cuff tendons, which connect the muscles to the bone, are vulnerable to compression from surrounding bony structures.

Rotator cuff tendinopathy, or injury to the rotator cuff tendons, may develop from repetitive activity, generally at or above shoulder height. People with rotator cuff tendinopathy may have pain around their shoulder, particularly when reaching overhead.

Impingement occurs when the acromion, a part of the shoulder blade, puts pressure on the rotator cuff tendons and bursae. It presents in an almost identical way to rotator cuff tendinopathy.

Rotator cuff tendon tears may result from sudden injury or slow, degenerative change. Symptoms include shoulder weakness and pain, as well as popping sensations during arm movement. Severe tears may impair the use of the shoulder, limiting day-to-day activities.

Biceps tendinopathy

Biceps tendinopathy is an injury to the tendon of the biceps muscle, which may result from repetitive lifting and reaching overhead. Symptoms include pain in the front of the shoulder that becomes worse when lifting, reaching overhead, and carrying objects. Continued performance of these activities may result in the sudden rupture of the tendon.

Adhesive capsulitis

Adhesive capsulitis, which people sometimes refer to as frozen shoulder, may develop from not using the shoulder. People with this condition may experience pain, a decrease in their range of motion, and stiff joints. Common causes of shoulder disuse include rotator cuff tendinopathy, diabetes mellitus, biceps tendinopathy, and trauma to the shoulder.

Osteoarthritis

Osteoarthritis, also known as “wear and tear” arthritis, commonly occurs in either the glenohumeral joint or the acromioclavicular joint. In this form of arthritis, the bones rub together as the cartilage between them wears away. Symptoms include pain, swelling, and stiffness in the shoulder joint.

Osteoarthritis generally worsens over time.

Fracture

Fractures, or breaks, occur most often in the collarbone or upper arm bone. Both types of fracture may result from a fall onto an outstretched hand or a blow to the shoulder. In most cases, they will cause severe pain, swelling, and bruising. The shoulder will be tender to touch around the injury, and the bones may appear out of position.

Dislocation

Shoulder dislocations occur when the ball of the upper arm bone pops out of its socket. The arm bone may dislocate forward, backward, or downward, either partially or completely.

Dislocations may recur if the surrounding structures of the shoulder become worn down. Symptoms include pain, swelling, numbness, and weakness. The arm may look out of place.

Separation

A shoulder separation occurs when the ligaments tear. The ligaments are tissues connecting the bones and cartilage. Separations in the acromioclavicular region between the collarbone and shoulder blade may occur from falls or direct blows. Symptoms include pain, swelling, and tenderness in the front shoulder, as well as a bump at the point of separation.

Treatment

People can manage many types of shoulder problem at home.

Treatment typically involves a period of rest and avoidance of activities that aggravate the pain.

A doctor may also recommend applying heat or ice to the injury for pain relief, as well as placing pressure on the area to reduce swelling. Physical therapy improves shoulder strength and flexibility.

Slings can be helpful in managing shoulder dislocations, separations, and fractures, as they keep the structures of the joint in position. Before applying a sling, a doctor will put the bones back into place.

Sometimes, doctors recommend medication to reduce pain and inflammation. Over-the-counter drugs, such as ibuprofen and aspirin, are available. Doctors can also prescribe medications and inject steroids or numbing medicine directly into the shoulder to relieve pain.

Some injuries require surgery for treatment. For example, rotator cuff tears and adhesive capsulitis do not always improve with rest and medicine. Severe rotator cuff tears or recurrent dislocations may warrant early surgical consultation rather than a trial of at-home management.

Diagnosis

Several conditions lead to shoulder pain.

A thorough clinical evaluation helps pinpoint the cause. A doctor will take a medical history and carry out a physical examination, during which they may ask the individual to perform several specific movements to assess the injury. They may also order lab and imaging tests if they need additional information.

If the pain is mild, it may not be necessary to visit a doctor right away. Some people prefer to rest and see if the pain will go away. If the pain does not improve, it is best to go to the doctor for further evaluation.

People should see a doctor right away if they experience any of the following signs or symptoms:

  • intense pain
  • sudden swelling
  • weakness or numbness in the arm or hand
  • inability to use the shoulder
  • deformity

Takeaway

Shoulder pain is a common complaint. The unique anatomy and range of motion of this joint make it susceptible to injury. Common triggers for injury include accidents, repetitive movements, manual labor, sports, and aging.

An injury that causes severe pain requires immediate care. A person should also see a doctor right away if they have any joint deformity, sudden swelling, an inability to use the joint, weakness or numbness in the arm or hands, or intolerable 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

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Cycling During COVID-19:How to Ride Safely

Cycling During COVID-19: How To Ride Safely

From Aventon

While the coronavirus pandemic continues to spread across the world, it has also caused the cycling world to make changes to their daily lives. Not only has the pandemic led to canceled bike races across the country, but it has also led many riders to ask what cycling during coronavirus looks like.

In this article, we’ll discuss some of the basics about COVID-19 to give you a better understanding of the virus so that you can take the necessary safety measures to cycleduring this time safely.

THE BASICS

Let’s start off by talking about the basics of the coronavirus.

COVID-19 is a new strain of the coronavirus for which there is no known treatment or vaccine at the moment. While it’s very likely that some of us may have experienced some kind of coronavirus at some point in our lives, recent public health studies suggest that this strain is more contagious than previous ones.

Like most viruses, COVID is spread through droplet transmission and generally presents itself as the common cold with minor respiratory ailments. However, complications may arise in varying severity; in some cases, even leading to death.

You can also contract the virus by touching an object or surface that where droplets from a cough or sneeze has landed. Once the droplets have contaminated your hands, you may inadvertently touch your nose or mouth, introducing the virus into your respiratory system.

Recent studies suggest that the virus itself may be able to survive for as long as three days on plastic, metal, or glass surfaces.

 

PRECAUTIONARY SAFETY MEASURES TO TAKE DURING THE PANDEMIC

There are a few simple steps that everyone can take to make sure they will not get the virus, or spread it. While this list is not complete with everything to help fight back against the spread of the coronavirus, it is a valuable starting point.

SOCIAL DISTANCING

As many of you have heard,social distancing is a great way to prevent further transmission of the coronavirus. This means not gathering in large groups, and always observing a distance of six feet between you and the person next to you.

Additionally, as a rule of thumb, unless you know where your companions have been and who they have been in contact over with the past 14 days, it is in the interest of your health to not risk visiting with other people at the moment. Even one gathering can mean the difference between breaking the chain of transmission.

WEAR A MASK

Droplet transmission means that an infected person can expel the virus through coughing, sneezing, or talking. If you happen to be in close proximity to them (that is, within approximately six feet), there is a chance you might inhale the virus and introduce it into your own body.

If you have to be around others in public for any reason, best practice suggests wearing a mask to protect yourself and others. Face coverings of any kind can reduce droplet transmission when we talk, cough, or sneeze.

WASH YOUR HANDS THOROUGHLY

Washing your hands thoroughly with warm soapy water after touching frequently-used items is another excellent way to prevent transmission. Time your hand washing routine so you spend at least 20 seconds covering the entire surface area of your hands with soap before rinsing.

Rubbing with hand sanitizer also works, but does not eliminate the virus as efficiently as washing with soap and water.

ADDITIONAL HEALTH AND SAFETY MEASURES

    • Do not touch your face.
    • Practice good hand hygiene at all times.
    • Cover coughs and sneezes with a tissue, your shoulder, or elbow.
    • If possible, work from home to prevent unnecessary interaction with other people.
    • Keep away from being around many people as much as possible.
    • Stay home if you feel you are sick or beginning to feel sick.
    • Avoid unnecessary travel.
    • Get at least 8 to 9 hours of sleep.
    • Take your vitamins.
    • Protect your immune system.
    • Exercise and eat healthy.

HOW TO SAFELY RIDE YOUR BIKE DURING THE CORONAVIRUS OUTBREAK

So, what does all of the above have to do with riding a bike?

 

Cycling is a great way to remain healthy, both physically and emotionally, while also living in a socially-distanced environment. But how can you ensure your safety, as well as the safety of others while you are cycing?

 

Well, the good news is that cycling not only carries minimal risk of transmission of COVID-19, it’s also extremely unlikely to contract COVID-19 while cycling, especially while riding on your own. However, just to be safe, let’s take a look at a few recommendations for the next time you feel like going for a ride.

 

First and foremost, if you think you have been exposed, self-quarantine. As unfortunate as this will sound, this is of utmost importance.

 

Unless you get tested, you cannot be certain that you are not carrying the virus, even if you are not exhibiting symptoms. Stay home to avoid the risk of infecting others. Restrictions include not riding outdoors until you have been self-quarantined for at least 14 days.

 

If you plan on cycling with a group of others, keep a minimum of six feet of space when riding with the group. Furthermore, it’s recommended not to ride with people who reside outside of your household or if you have not discussed how each one of you has been quarantining.

 

Additionally, when you find yourself need to pass someone on the road or on the bike lanes, try to give as wide a berth as possible to make sure both parties are adhering to social distancing best practices.

SHOULD YOU WEAR A MASK WHEN RIDING?

CDC guidelines have recently been updated to urge people to wear fabric face coverings in any public setting where social distancing measures cannot strictly be ensured (i.e., grocery stores, bike shops). So, what does this mean for athletes and people who exercise outdoors?

 

Read more: eBike Laws and How They Impact Riders

 

Well, it is not a situation to take lightly. While you may not need to wear a mask while you are cycling by yourself, you should bring one along in the event of an emergency or if you need to stop at a store to grab a drink. Face coverings do two great things:

  1. They prevent spread from the ill and protect against inhalation in healthy individuals.
  2. They are highly effective when used correctly.

 

The objective of the mask is not only to protect yourself from the virus, but also to protect others from it, as well. The asymptomatic spread of the virus remains a critical concern, which means someone might have the ability to spread the virus to other people without knowing they even contracted it.

You can never be sure if the person next to you is infected, or if you yourself are. Wearing a mask by default could greatly help in decreasing the transmission of this highly contagious virus.

 

 


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

Exercises and Stretches for Hip Pain

Exercises and Stretches for Hip Pain

From Versus Arthritis

Here are some exercises designed to stretch, strengthen and stabilize the structures that support your hip.

It’s important to keep active – you should try to do the exercises that are suitable for you every day. Repeat each exercise between 5–10 times and try to do the whole set of exercises 2-3 times a day.

Start by exercising gradually and build up over time. Remember to carry on even when your hip is better to prevent your symptoms returning.

If you have any questions about exercising, ask your doctor.

It’s also a good idea to try to increase your general fitness by going for a regular walk or swim, this will strengthen your whole body – which helps support your hip. It can also improve your general health, fitness and outlook.

Simple stretching, strengthening and stabilising exercises

The following exercises are designed to stretch, strengthen and stabilise the structures that support your hip. These exercises for hip pain (PDF, 983 KB) are also available to download and keep.

It’s important not to overstretch yourself if you’re in pain. It’s normal to feel some aching in the muscles after exercising, but you should stop and seek advice if you have joint pain that lasts more than a few days.

If you’ve had a hip replacement you will probably be advised to take it easy for the first six weeks and not to push yourself too much. Ask your physiotherapist what exercises they recommend you should start with and how to do them.

You may feel slightly uncomfortable during or after exercise, but this should settle within 24 hours. It shouldn’t be painful. If you feel any sudden pain stop exercising and seek medical advice.

An illustration of someone marching on the spot.

Hip flexion (strengthening)

Hold onto a work surface and march on the spot to bring your knees up towards your chest alternately. Don’t bring your thigh above 90 degrees.

An illustration of someone standing whilst holding onto a table, moving their leg backwards and keeping it straight.

Hip extension (strengthening)

Move your leg backwards, keeping your knee straight. Clench your buttock tightly and hold for five seconds. Don’t lean forwards. Hold onto a chair or work surface for support.

An illustration of someone standing and holding onto a chair, lifting their leg sideways.

Hip abduction (strengthening)

Lift your leg sideways, being careful not to rotate the leg outwards. Hold for five seconds and bring it back slowly, keeping your body straight throughout. Hold onto a chair or work surface for support.

An illustration of someone standing whilst holding onto a table, bending their knee towards their bottom.

Heel to buttock exercise (strengthening)

Bend your knee to pull your heel up towards your bottom. Keep your knees in line and your kneecap pointing towards the floor.

An illustration of someone squatting down, bringing their knees towards their toes.

Mini squat (strengthening)

Squat down until your knees are above your toes. Hold for a count of five if possible. Hold on to a work surface for support if you need to.

An illustration of someone laying on their back with one bent leg and one straight leg with a towel under it's knee. They're raising their foot off the floor.

Short arc quadriceps exercise (strengthening)

Roll up a towel and place it under your knee. Keep the back of your thigh on the towel and straighten your knee to raise your foot off the floor. Hold for five seconds and then lower slowly.

An illustration of someone laying down with their legs straight, pulling their toes and ankles towards them whilst pushing their knees to the floor.

Quadriceps exercise (strengthening)

Pull your toes and ankles towards you, while keeping your leg straight and pushing your knee firmly against the floor. You should feel the tightness in the front of your leg. Hold for five seconds and relax. This exercise can be done from a sitting position as well if you find this more comfortable.

An illustration of someone laying on their back with their knees bent and hands under the small of their back. They're pulling their belly towards the floor.

Stomach exercise (strengthening/ stabilising)

Lie on your back with your knees bent. Put your hands under the small of your back and pull your belly button down towards the floor. Hold for 20.

An illustration of someone laying on their back with their feet to standing, lifting their pelvis and lower back off the floor.

Bridging

Lie on your back with your knees bent and feet flat on the floor. Lift your pelvis and lower back off the floor. Hold the position for five seconds and then lower down slowly.

An illustration of someone laying on their back and pulling their knee toward their chest.

Knee lift (stretch)

Lie on your back. Pull each knee to your chest in turn, keeping the other leg straight. Take the movement up to the point you feel a stretch, hold for around 10 seconds and relax. Repeat 5-10 times. If this is difficult, try sliding your heel along the floor towards your bottom to begin with, and when this feels comfortable try lifting your knee.

An illustration of someone sitting with their knees bent and feet together, pressing their knees downwards.

External hip rotation (stretch)

Site you your knees bent and feet together. Press your knees down towards the floor using your hands as needed. Alternatively, lie on your back and part your knees, keeping your feet together. Take the movement up to the point you feel a stretch, hold for around 10 seconds and relax. Repeat 5-10 times.

 


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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

What to Know About Lower Back Pain When Sitting

What to Know About Lower Back Pain When Sitting

Medically reviewed by Emelia Arquilla, DO— Written by Hana Ames on October 14, 2020. | From Medical News Today

The cause of pain in the lower back while sitting may involve posture, an injury, or a health condition.

Back pain is one of the most common medical problems in the United States. About 1 in 4 adults in the country have at least 1 day of back pain in any 3-month period.

Here, we describe the causes, treatments, and prevention of lower back pain while sitting.

What does it feel like?

Back pain may be acute, in which case it comes on suddenly and usually lasts a few days or weeks. Or, the pain may be chronic, lasting longer than 12 weeks.

Pain in the lower back may be sudden and sharp or a dull, constant ache.

Causes

A variety of factors can cause pain in the lower back while sitting, and the best approach to treatment depends on the cause.

The treatment plan might include over-the-counter pain relief medication, physical therapy, a new exercise routine, surgery, or a combination.

Posture

Poor posture can cause or worsen lower back pain. Improving posture involves changing a person’s position as they sit or stand. It can often ease or relieve the pain.

Injury

A person might injure their lower back while lifting something incorrectly, leading to a strain or sprain in the area.

The injury might instead result from trauma, sustained during sports or from a car accident, for example.

Sciatica

Sciatica happens when something presses on the sciatic nerve, which travels through the buttocks and extends down the back of the leg, and the issue can cause pain throughout the area.

The pain may be intense and feel like an electric shock or be a dull ache.

Herniated disk

A herniated disk refers to a disk in the spine bulging outward and pressing on a spinal nerve. Any disk in the spine can be affected.

Treatment for this condition usually involves medication and physical therapy.

Lumbar disk disease

Lumbar disk disease, also known as degenerative disk disease, is not actually a disease. Usually, it results from aging.

It occurs when the disks between the vertebrae of the spinal column wear down.

Spondylolisthesis

Spondylolisthesis involves a vertebra of the lower spine slipping out of place and pinching nearby nerves.

Home care strategies

A person may not need professional treatment for lower back pain while sitting.

Often, a person can take steps at home to relieve the pain and keep it from returning. Some strategies include:

Staying active

It can be tempting to rest as much as possible, but the medical community recommend keeping active to ease lower back pain.

Try not to do too much at once, however. Instead, try coupling physical therapy or a recommended form of exercise below with other home treatments.

Using heat and cold

Alternating between heat and cold can often help ease lower back pain.

Taking a hot bath or using a hot water bottle may help alleviate the pain. Heat can also increase blood flow to the area and promote healing in the muscles and tissues of the back.

Applying ice packs or bags of frozen vegetables to the area can also ease pain, but ensure to wrap them in a cloth first.

Heating or cooling sprays are also available over the counter, and they can stimulate the nerves in the area.

Taking pain relief medication

Nonsteroidal anti-inflammatory drugs, or NSAIDs can help ease pain in the lower back. Many, such as ibuprofen, are available without a prescription.

People tend to take these medications orally, but they also come as creams, gels, patches, and sprays.

Stretching and exercising

Exercises and stretches can help strengthen the lower back and prevent the pain from occurring.

Routines that focus on working the core, or abdominal, muscles may also help speed recovery from chronic lower back pain.

Yoga, for example, can help relieve pain in the lower back and neck, and other forms of exercise that may help include:

  • swimming
  • walking
  • Pilates

Stretches that can help alleviate lower back pain include:

  • Deep lunge: Kneel on one knee, with the other foot in front. Facing forward, lift the back knee up. Hold the position for 5 seconds.
  • Back stretch: Lie on the stomach, using the arms to push the upper body off the floor. Hold the position for 30 seconds before allowing the back to relax.
  • Sagittal core strengthening: Standing 3 feet away from a wall with the feet should-width apart, tighten the abdominal muscles, then reach through the legs to touch the wall, keeping the hips and knees bent. Use the hips to push the body back to a standing position, then extend arms and reach over the head and slightly backward.

Prevention

Lower back pain is more common in people with obesity and people who smoke.

Also, people who are infrequently active are more likely to have lower back pain, as are people who tend to be inactive but occasionally engage in strenuous exercise.

The best sitting position

The Department of Health and Human Services warn against slouching and recommend sitting up straight, with the back against the back of the chair and the feet flat on the floor.

They also recommend keeping the knees slightly higher than the hips when sitting.

Diagnosis

To determine the cause of back pain, a healthcare provider will ask the person about their medical history and perform a physical examination.

If the pain is acute, further tests are usually not necessary, unless the pain results from an injury.

The treatment for chronic pain depends on the cause, and surgery may be an option.

When to see a doctor

Seek medical attention if lower back pain is severe, lasting, or does not improve with stretches, exercises, and other home care techniques.

Also, contact a doctor if the pain results from an injury.

 

 


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 COVID Has Impacted Bone Health and What You Can Do About It Right Now

How COVID Has Impacted Bone Health and What You Can Do About It Right Now

From YouAreUNLTD by Feel It In Your Bones

Osteoporosis is often described as “a silent disease.” During COVID, this has never been more true. Bone health took a back seat. Health assessments, bone density testing and sometimes treatment itself were upended by the pandemic. This disruption in care may have serious, long-term consequences for patients.“The impact is going to be seen both immediately and down the line, as we see people not getting diagnosed, not getting treated,” says Dr. Vivien Brown, a family physician, assistant professor with the department of family and community medicine, University of Toronto. “And ultimately, we may see an increase in fracture risk and fracture rate. And now, six months into COVID when we’re referring patients for bone density tests, there is a backlog.”

Screening for osteoporosis is critical, according to Dr. Brown, especially for women over the age of 50. More than breast cancer, more than heart attacks or stroke, women are most likely to experience a fracture due to weakened bones. Medical intervention to prevent or treat osteoporosis, as well as the adoption of healthy lifestyle behaviours, may be needed. Failing to diagnose the disease can lead to serious outcomes.

“Until they’ve had a fracture, until they’ve had an event, people don’t really have osteoporosis on their radar as a concern,” explains Dr. Brown, who just updated her book, A Woman’s Guide to Healthy Aging (to be published in January 2021). When COVID hit, the focus for healthcare was on providing essential services only. Bone density testing was not considered essential.”

Long-term consequences of the care gap

These interruptions have caused a care gap, making incidents like hip fractures an even greater concern. The research is alarming – 28 per cent of women and more than 37 percent of men over the age of 80 die in the first year after a hip fracture. “It can be a life-altering event, if not a life-ending event,” she says. “We really need to still maintain our level of vigilance around osteoporosis. And I don’t think that’s happening day to day in the medical community.”

Furthermore, she points out that hip fractures can become family tragedies, according to Dr. Brown. “Some patients can’t return home to live independently. They may not be able to walk without assistance. They may not ever be able to drive again. It really alters their quality of life, which impacts the entire family…. The way I think about osteoporosis is that it is not just a bone disease. Osteoporosis is your independence on the line.”

As the impact of COVID has rippled across the country, continuity of care for osteoporosis patients has suffered. For those who were prescribed injectable medications, missed shots were an issue. “The consequences are really significant because the benefits of an injectable medication are completely reversible,” points out Dr. Brown. “That means when you get past that six-month window where you’re supposed to get your next injection, if you go more than a month or so, you start to reverse the benefits you’ve had because the drug is out of your system. That reversal actually increases your risk of fracture. It’s really important to stay on schedule with this medication. It means being creative – either seeing your doctor for the injections, getting it from a pharmacist, or learning how to self-inject. Just delaying an injection is not acceptable.”

During COVID, the focus on osteoporosis decreased. Good lifestyle habits also waned as people stayed home. Sedentary behaviour and poor dietary habits increased, while the ability to exercise in a gym and access to healthy food was negatively impacted. “A number of my older patients who live at home alone and don’t want to go to the grocery store are not eating healthy diets,” she says. “And if they’re not checking in with their doctor and not being reminded of what they need to do – something gets forgotten or left by the wayside.”

“The Way I Think About Osteoporosis Is That It Is Not Just A Bone Disease. Osteoporosis Is Your Independence On The Line.”

Issues with fracture follow-up

The pandemic has had a profound impact on our social support systems, too, especially when someone goes into the hospital with a fracture. Due to safety protocols, they cannot have their partners or someone else with them to be present to listen to a doctor’s instructions post-discharge. It’s concerning to Dr. Brown who fears that something will be overlooked. “If you’re in the hospital by yourself, it may be scary and you may be in pain,” she says. “You may not hear what the doctor is saying clearly. You get your cast or have the fracture treated, then get sent home. I don’t know that people are getting good follow up care.”

That lack of follow-up has a direct impact on continuity of care – a key component in successful osteoporosis management. “In some ways, osteoporosis is like hypertension. Patients often don’t feel it,” she notes. “Maybe they take their drugs for a couple of months, but then stop taking them if the meds are not easily accessible, if they don’t understand them, or not feeling the impact of the disease… It’s important to adhere to whatever has been prescribed.”

Now, it’s time to get back on track and to make bone health a priority again. How do we do that? Here are a few pointers from Dr. Brown:

6 ways to get back on track with your bone health during COVID

  1. Contact your doctor for a health review, which should include a discussion of osteoporosis prevention and ensuring you’re up-to-date with any medications to treat the disease.
  2. Let your doctor know whether you’ve had a recent fracture. A fracture may need to be investigated further to rule out osteoporosis as an underlying cause.
  3. Take an easy online test to determine your risk of a fracture. The FRAX fracture assessment tool can be done in just a few minutes and will look at key factors to calculate how likely you are to experience a fracture in the next 10 years.
  4. Have your risk for osteoporosis assessed by a healthcare provider. Factors that heighten your risk include: low body weight, family history of osteoporosis or broken bones from a minor injury, lifestyle behaviours (smoking, having three or more alcoholic drinks a day, and being sedentary), certain medical conditions (like rheumatoid arthritis), being a woman over the age of 50, and certain medications.
  5. Ask your doctor or pharmacist whether it’s time to schedule a bone density test. It is recommended that all women and men over age 65 have routine bone density tests. Men and women from the age of 50 to 64 with risk factors for fractures should also be tested.
  6. Resume good habits, like eating a diet with adequate vitamin D and calcium, exercising and sitting less.

 

 


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