3 Types of Exercises to Fight Arthritis

Article featured on Penn Medicine

Exercise is crucial for everyone, especially those suffering from arthritis.

“Sometimes, my patients think that the only way to relieve pain is to stop all physical activity,” said Craig Israelite, MD, orthopaedic surgeon and Co-director of the Knee Service at Penn Medicine. “Keeping active is actually very good for individuals suffering from joint pain or arthritis. Exercises that work the muscles and tendons provide stability and strength around the joint.”

You don’t need to run a marathon or lift weights for hours to increase strength, improve flexibility and reduce joint pain. There are many non-weight-bearing activities you can do to keep in shape, including:

Range-of-Motion Exercises

These exercises (also known as stretching or flexibility exercises) help to relieve stiffness and increase joint mobility. The goal is to get your joints moving in their normal range of movement. Examples include raising your arms over your head or rolling your shoulders back and forth. It is recommended that these exercises be done daily or at least every other day.

  • Yoga
  • Pilates
  • T’ai chi

Strengthening Exercises

Strong muscles help support and protect joints. A workout program that includes weight or resistance training can help to maintain current muscle strength or increase it. These type of exercises should be done every other day, but allow an extra day in between if joints become painful or swollen. Discontinue any exercise that continues to bring on discomfort.

  • Wrist curls
  • Overhead arm raises
  • Seated rows
  • Leg raises and dips

Aerobic or Endurance Exercises

These types of activities can improve your cardiovascular health, give you more energy and help to maintain or reduce weight. Having control of your weight reduces the pressure on affected joints. Try to include 20-30 minutes of aerobic exercise three times a week.

  • Walking
  • Bike-riding
  • Swimming

Have additional questions about how an exercise plan could help you fight arthritis? Or, are you interested in exploring other pain management 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

How to Improve Your Stamina

Article featured on Verywell fit

If you had to choose one—and only one—component of fitness to improve, what would you choose? You’re probably thinking you’d try to improve your strength, endurance, or speed, all of which are worthwhile goals to chase.

However, there’s one less-appreciated fitness factor that actually combines multiple components of fitness into one: stamina. If you want to most bang for your fitness buck, consider working to improve stamina.

What Is Stamina? 

Stamina is defined as “the ability to sustain prolonged physical or mental effort,” according to Oxford Dictionary. What this means in practical terms is that good stamina allows you to:

  • Run faster for longer distances
  • Lift heavier weights for more reps
  • Take longer, tougher hikes
  • Push through perceived pain, discomfort, and fatigue
  • Perform daily activities with high energy levels

The better your stamina, the more efficient you become at just about everything, mentally and physically.

Stamina vs. Endurance

People often use the words “stamina” and “endurance” interchangeably, and while the two terms are similar, they aren’t the same. Endurance is defined as “the fact or power of enduring an unpleasant or difficult process or situation without giving way,” and there are two types of endurance related to fitness: cardiovascular and muscular.

Cardiovascular endurance refers to the ability of your heart, lungs, and blood vessels to support rhythmic exercise such as swimming, cycling, and running. Muscular endurance refers to the ability of your muscles to sustain repetitive movements under a given load, such as during weightlifting or hiking. Both types of endurance are important and both represent a component of stamina.

Stamina vs. Strength

“Strength” has lots of different definitions, but in regard to fitness, it essentially defines how much weight you can lift. People who are very strong can lift heavier weights and can also lift lighter weights for many reps. People with less strength can’t lift as much and may not be able to lift as many reps.

Strength training contributes to your stamina because it conditions your body to sustain movement under heavy loads.

Improving your strength even helps for endurance-focused exercises because the stronger your muscles, the better they can handle repetitive movements.

Stamina vs. Speed

Speed, as you probably know, refers to how fast or slow you move while walking, running, swimming, or performing other cardiovascular exercise. Genetics may influence speed more than they influence strength and endurance, although you can improve your speed with hard work just like you can improve any other part of your fitness.

Stamina mainly comprises endurance and strength, because the definition refers to your ability to sustain a given effort. The stronger you are, the more reps you’ll be able to lift with a given load. The better endurance you have, the longer you can sustain a given speed during a run. Stamina is less of a function of speed, but speed certainly still plays a role in your overall fitness.

How to Improve Your Stamina

The key concept here is to challenge yourself. If you’re trying to improve your stamina (or any aspect of your fitness) you’ll need to follow the “principle of progressive overload,” a physiological rule that explains how the body gets stronger, faster, and fitter.

To put it simply, the principle of progressive overload says that you won’t improve in any capacity if you keep doing the same workouts at the same intensity over and over again.

You must change something, be it frequency, intensity, volume, weight, distance, speed, or rest intervals.

For example, if you can barbell squat 10 reps at 100 pounds, you should next try to squat 12 reps at 100 pounds or 10 reps at 105 pounds. Small tweaks like this lead to significant improvements over time.

Here are 15 ways to change up your workout routine and induce improvements in your stamina. 

1. Go for Long Walks 

Here’s a simple way to improve your stamina: Simply move your body for long periods of time. Going for long walks of 30 to 60 minutes is a phenomenal way to build endurance, especially for beginners. Even advanced exercisers can enjoy the stamina-boosting effects of long-distance walking if they amp up the speed and intensity.

2. Add Running Intervals

If you don’t feel walking is enough to improve your stamina, try tossing in a few running intervals throughout your walk. Interval training is proven to be one of the best methods for improving overall fitness, at least in a time-efficient sense. Next time you head out for a walk, add a 30-second sprint every three or four minutes.

4. Increase Your Running Distance or Time

Go the distance for stamina. Since stamina is a combination of endurance, speed, and strength, challenge yourself to maintain your usual running pace for a minute longer. When you can do that, add another minute. Your stamina should continue to improve this way for a while, although everyone has limits on how far and fast they can run.

5. Run Hills and Stairs

If increasing your running distance or time doesn’t sound fun (we don’t blame you), vary the type of running instead.

If you live near hills or hiking trails, adding hill runs to your routine can make a huge difference in your stamina.

Alternatively, stairs and bleachers work, too. Running in an uphill manner challenges your lungs and legs alike.

6. Try High-Volume Weightlifting

Studies show that volume is the number-one variable in resistance training that improves fitness. Volume refers to the total load you lift in a given session, day, or week. It’s calculated by multiplying weight by reps.

For example, if you perform three sets of 10 squats at 100 pounds, find your total volume by multiplying three by 10 by 100. The total volume comes out to 3,000 pounds. In general, continually increasing your volume benefits your fitness.

7. Practice Isometric Exercises

Isometric exercise refers to any exercise during which muscles fiber, but don’t extend or contract. Planks and wall-sits are two good examples of isometric exercises. Incorporating isometric work into your fitness routine can teach your muscles to sustain a position under stress for longer periods of time.

8. Decrease Rest Intervals During Workouts

One surefire way to improve your stamina is to allow yourself less rest time (unless you’re lifting very heavy weights, in which case you should rest three to five minutes between sets for optimal strength gains).

Studies show that decreasing rest intervals while performing moderate- to high-intensity exercise increases physical performance and body composition.

Shortening your rest interval forces you to perform more work in less time, which in theory should support improvements in stamina.

9. Try Cycling 

Riding a bike in any fashion—mountain biking, road biking, or indoor cycling—can improve your stamina if you push the pace (and the terrain if you’re outside).

Indoor cycling in particular is proven to increase aerobic capacity, a major contributor to stamina, as well as other health markers.

Mountain biking may be more effective at increasing muscular endurance and power due to the increased and variable resistance.

10. Swap Cycling for Rowing

If you’re already an avid cycler, you may want to add rowing to your workout rotation. Scientists have long hypothesized that rowing is a more effective workout than cycling because rowing recruits more muscle groups in a more intense fashion. Rowing seems to improve cardiovascular capacity more than cycling, so next time you have the opportunity to hop on an erg, go for it!

11. Have Dance Parties 

Dancing is a phenomenal mode of exercise that will leave your lungs and muscles burning—and it’s fun! Dancing may also require you to assume new positions and challenge your range of motion, which can improve your overall fitness.

Several scientific studies have shown dancing to have significant impacts on health and fitness, from better mobility and balance to improved cardiovascular endurance. Dance as exercise may also increase adherence for some people, because the cost and transportation barriers to entry are low.

12. Play Sports

Again, destructuring your fitness routine could, if counterintuitively, improve your stamina and fitness. Most sports require complex skill sets that may be outside of your comfort zone. If you’re used to lifting weights, running, or other relatively monotonous movements, swapping one workout each week for a sports game is a great way to hone other physical skills.

For instance, a game of soccer includes sprinting, jogging, walking, cutting, kicking, dodging, and even throwing, depending on the position you play. The intermingling of these different movements provides a fun and challenging way to improve your stamina.

13. Listen to Music While Exercising

Everyone knows a good song can pump you up for your workout. Listening to music brings people joy and energy, and this remains true during exercise. Listening to upbeat music during your workout might boost your performance in a number of ways, from reducing your perception of fatigue, distracting you from the strain of your workout, and making exercise feel easier.

14. Drink Caffeine Before Exercising

If you’re looking for a one-off way to improve your stamina, consuming a bit of caffeine before your workout might help. Studies show that caffeine acts as a great pre-workout supplement, because it can increase your energy, mood, and physical capacities, although the effect seems to be more significant in men than women, and you should be careful not to become reliant on caffeine.

15. Add Meditation to Your Fitness Routine

Remember how we mentioned that the word “stamina” refers to both physical and mental pursuits? This is where that tidbit of information comes in. Adding mindfulness practices such as meditation, deep breathing, or yoga to your overall wellness routine might improve your mental stamina.

If you’re used to fast-paced, engaging workouts, mindfulness practices will challenge you to push through perceived boredom and handle stress, two factors that play a role in how long you’re able to exercise at a near-maximal level. In fact, a 2016 study in the journal Evidence Based Complementary and Alternative Medicine found that medical students reported improved mental stamina (less stress and improved patience and wellbeing) after six weeks of yoga and meditation.

Don’t Forget to Rest and Recover

Finally, make sure you have recovery days scheduled into your workout routine. Contrary to popular belief, the actual act of exercising isn’t what improves your fitness—it’s the repair and rebuild phase that does. If you perform an intense workout every single day, your body never gets the chance to recover, thus it never has the opportunity to repair your muscles. Rest days are critical to your improvement over 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

Chronic Inflammation and Your Joints

Article featured on Harvard Health Publishing

Why the immune system is sometimes the culprit in joint pain.

When you suffer a joint injury — maybe a banged-up knee or a twisted ankle — a little inflammation is part of the healing process. Puffy, red, tender joints may indicate that your immune system is working to remove damage and promote the growth of new tissue, a healthy kind of inflammation. But sometimes the immune system launches unhealthy, chronic inflammation in the joints, for no apparent reason. This leads to pain, stiffness, and joint damage known as inflammatory arthritis.

The attack on joints

It’s often unknown what triggers the immune system to unleash an assault on the joints, but we do know what the cells are up to once they’re in action.

“In a common type of inflammatory arthritis like rheumatoid arthritis, a variety of immune cells can be found in the lining and fluid of the joint. These cells attract other immune cells and together lead to thickening of the joint lining, new blood vessel formation, and — ultimately — joint damage,” says rheumatologist Dr. Robert Shmerling, medical editor of the Harvard Special Health Report Fighting Inflammation (/ui).

Chronic inflammation in the joints can damage cartilage, bones, tendons (which attach muscle to bones), or ligaments (which hold joints together); irritate nerves; and produce a long list of symptoms, including pain, swelling, and stiffness. The joint damage may be progressive and irreversible.

Types

There are many types of inflammatory arthritis. Common ones include these:

  • Rheumatoid arthritis (RA): RA occurs when the immune system attacks the lining of the joints, especially in the hands, wrists, and feet. RA may also affect the heart, lungs, and eyes.
  • Gout: Gout is characterized by a buildup of uric acid, which can form crystals in the joints — especially in the big toe, and sometimes in the hands, wrists, or knees. The crystals activate a temporary inflammatory response that can become chronic.
  • Calcium pyrophosphate deposition disease (CPPD, or pseudogout): In CPPD, calcium crystals settle in the joints, especially the knee, wrist, shoulder, ankle, or elbow. Like the uric acid crystals in gout, the calcium crystals in CPPD prompt the body to respond with inflammation; over time, this may become chronic.
  • Psoriatic arthritis: About 30% of people with psoriasis (an autoimmune condition that causes raised patches of scaly skin) develop psoriatic arthritis, which can affect the knees, ankles, wrists, or fingers.

What about osteoarthritis?

Osteoarthritis, a wearing away of the smooth cartilage lining joints, has long been considered a noninflammatory form of arthritis. “But we now recognize that some inflammatory cells are present in osteoarthritis, although the inflammation is usually much less dramatic than in rheumatoid arthritis or other types of inflammatory arthritis,” Dr. Shmerling says.

The finding of mild chronic inflammation in osteoarthritis has been significant enough for researchers to begin investigating whether the condition can be treated with some of the same types of medications used to treat inflammatory arthritis.

Treatment

Many types of drugs are used to treat inflammatory arthritis. They include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce levels of prostaglandins — chemicals that promote inflammation
  • oral or injected steroids, which reduce inflammation and suppress the immune system
  • injections or intravenous infusions of nonbiologic disease-modifying antirheumatic drugs (DMARDs), which suppress the immune system
  • injections or infusions of biologic DMARDs, that suppress the immune system in a more targeted way than nonbiologic DMARDs
  • Janus kinase inhibitors, which interrupt inflammatory signals
  • drugs that lower uric acid levels (for gout).

Results with drug treatment are often good. “Medications to lower uric acid can essentially eliminate gout. And the development of newer drugs for rheumatoid arthritis, including biologics and Janus kinase inhibitors, makes it possible for far more people than in the past to experience remission and protection from ongoing joint damage,” Dr. Shmerling says.

Other ways to live with arthritis

Other ways to help reduce pain and inflammation include exercising, avoiding processed foods (which promote inflammation), reducing stress, not smoking, and getting enough sleep. Wearing a splint or brace on affected joints and seeking physical therapy may also ease your pain and keep you mobile and active.


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

Avoid Common Winter Injuries With These Helpful Tips

Article featured on Orthopedic Institute of Pennsylvania

If you’ve experienced an injury or pain while performing a wintertime activity, you are not alone. Personal injury during winter is likely to occur from performing simple activities, especially if you aren’t prepared to prevent an incident. From your back, shoulder and neck to joints and knees, pain and injury in these areas are commonplace during the winter.

The good news? Preventing winter injuries is possible, and you can enjoy the season without unnecessary pain and stiffness. Read on to discover information about winter back injuries, winter shoulder injuries, and — most importantly — health and safety tips to avoid any orthopedic winter injuries.

What Are the Most Common Winter Injuries?

Winter weather conditions bring with them a variety of potential risks for personal injury, as well as injury to others. Some of the most common winter incidents that lead to personal injury include:

  • Falling on ice and snow
  • Experiencing muscle strain from shoveling snow or scraping ice off the car
  • Driving and motor vehicle collisions
  • Accidents while playing winter sports and activities

Not all incidents will cause severe injury, but some winter accidents can be quite serious, especially for certain age groups and for people suffering from previous injuries.

SLIPPING AND FALLING ON ICE AND SNOW

Slipping and falling on ice can be a scary experience. Ice can be difficult to see both at night and during the day. What looks like water pooled on the pavement can actually be a sheet of ice. You could step off the curb and right onto a slippery ice patch. When this happens, severe injury can occur if you fall to the ground. You may be able to recover and only skid briefly, but even if you don’t end up falling, you can wrench your back or experience another kind of injury in your attempt to recover.

Anyone is in danger of injuring themselves by falling or slipping on ice or snow, but seniors are especially at risk. In fact, according to the CDC, falls are the leading cause of injury among older Americans, and winter weather conditions only exacerbate that concern.

There are a variety of potential injuries that can occur from falls on ice, but the most common include the following:

  • Bruises
  • Head or brain injuries, including concussions
  • Ankle strains and twists, and other kinds of muscle sprains and ligament strains
  • Broken bones, most commonly hip and wrist fractures
  • Back injuries, including spinal compression fractures
  • Injuries to the spinal cord

Prevention is always the best method to avoid a slip or fall on icy days, and there are a few things you can try to keep you and your family safer:

  • Wear proper footwear made for icy and snowy conditions.
  • Keep your stride shorter and avoid long steps.
  • Slow things down — try not to rush or run outdoors.
  • Keep de-icer or sand on hand for when things get slippery around your house.
  • In case of injury, always have your cell phone handy.
  • If you need to do outdoor chores, take your time and don’t hurry.

Unfortunately, even with the best preventative measures, accidents happen. Skeletal and muscular issues arise every winter when people fall on ice or snow. If the fall is serious, you may need to call 9-1-1 or go to the ER immediately.

However, some people are unaware that they have a severe injury. This may be because they don’t feel the effects of the fall immediately, or they believe their pain and discomfort will pass with time. Symptoms like pain or swelling should not be ignored, and it’s important to seek the advice of a medical professional to assess your condition.

If you experience an injury on the ice or snow, whether it’s from slipping and falling or from attempting to prevent a fall, make an appointment with a specialist as soon as possible to determine if there is a serious injury. They will also be able to offer an effective treatment plan that meets your individual needs.

SHOVELING SNOW

One of the most loathsome winter jobs is shoveling the driveway and sidewalk. It can take a long time and require a lot of physical exertion. The low temperatures make the task of shoveling snow even more unpleasant. The repetitive actions of twisting and lifting while shoveling can cause severe strain on the body. All it takes is one muscle to be pulled the wrong way for your back, neck or shoulders to seize up.

Snow shoveling can be a potentially risky duty that can cause severe injury. A national study found that over the course of eleven years, there was an average of 11,500 emergency room visits due to snow shoveling injuries. The most common injuries reported were soft tissue injuries mostly to the lower back region. Among the remaining injury reports, lacerations and fractures were also reported, including injuries to the hands, arms and head.

DRIVING AND COLLISIONS

Most of us must continue to work and carry on with our normal, everyday activities even in snowy winter weather conditions. But if you aren’t prepared for winter driving conditions and don’t take the proper safety precautions, you can put yourself and others at risk. A study found that over a period of ten years, there were over 445,000 people injured as a result of weather-related vehicle collisions. The winter weather brings with it all kinds of potentially hazardous road conditions, such as:

  • Wet pavement
  • Sleet and slush
  • Full coverings of snow and ice

FALLING OR COLLIDING DURING WINTER ACTIVITIES

One of the most enjoyable parts of winter is the fun you and your family can have with all kinds of winter activities and sports. From ice hockey and skating to skiing and snowboarding, there are plenty of ways to stay active and have fun in the winter. For kids especially, sledding and tobogganing are some of the best childhood memories of their winter seasons.

These winter activities can be quite risky if you aren’t practicing safety. Falls and collisions in many winter activities can cause several forms of injury. Broken bones and stiff muscles and joints are some of the most frequently reported injuries when it comes to outdoor sports and activities. Running outdoors along the sidewalk or on trails can also pose safety risks if the pavement isn’t salted and the trails aren’t properly cleared.

TYPES OF WINTER INJURIES

These incidents produce various types of injuries, which can range from mild and easily treatable to severe and long-term. Some of the resultant injuries from these winter accidents most commonly include:

  • Head injuries
  • Shoulder injuries
  • Back injuries
  • Neck pain and tension
  • Knee joint pain and soreness
  • Wrist sprains
  • Elbow fractures and dislocation
  • Ankle sprains and strains
  • Hip fracture and soreness

HEAD INJURIES

Head injuries occur during the winter as a result of any number of incidents. Most commonly, falling on ice and hitting your head on the pavement can lead to a potentially serious brain injury. If this occurs, it will need immediate treatment by a physician. A brain injury can be difficult to treat, and often the symptoms won’t be noticed until long after the injury has occurred.

Head injuries can occur during winter activities like tobogganing, snowboarding and skiing, or one can also occur as a result of a motor vehicle collision, which has the potential to lead to serious long-term health consequences.

SHOULDER INJURIES

Shoulder injuries commonly occur when you fall on icy pavement. When your shoulder meets contact with the hard ice-covered pavement, dislocation can occur. This damage to the shoulder joint can be quite severe and leave you suffering from soreness and bruising for a long time afterward.

A torn rotator cuff can happen as the result of repetitive overhead motions from winter sports or shoveling snow. This muscle tear can leave you feeling sore and stiff and may result in a chronic injury as well.

BACK INJURIES

There are plenty of winter incidents and activities that can cause a back injury. The most common injury associated with shoveling snow is to the back, specifically the lower back. Back injuries can also be the result of a serious fall on the icy pavement or on the stairs. Falls during winter sports and activities can also result in a back injury.

Another common way to injure your back during the winter time is by scraping your car’s windshield to remove ice and snow. The bending and leaning motion your body performs while reaching across to scrape the ice can result in pulled and strained back muscles.

Depending on the level of severity, treating a back injury with heat may help to relax sore muscles. An injury that is caused by a fall on ice may damage your spine, so treatment by a physician will be required.

NECK INJURIES

Like back and shoulder injuries, neck injuries can occur due to a number of different winter incidents. The repetitive motion of shoveling snow can certainly lead to stiffness and soreness in the neck muscles. Neck injuries can also happen when scraping snow and ice from your car’s windshield when your muscles become strained from leaning and reaching.

These injuries can usually be treated with a heating pad to relax tense neck muscles. If a neck injury is caused by a fall or a motor vehicle collision, it should be treated at the emergency room.

KNEE PAIN AND STRAIN

High-impact winter sports can be very damaging to your knees over a period of time. This type of injury usually occurs while performing activities and sports such as skiing and snowboarding, where your knees are absorbing the shock of hard landings. Running outdoors on pavement can also cause a similar injury to your knees. The best thing to do with a knee injury is to take it easy until it heals, avoiding any high-impact activities.

WRIST FRACTURES AND STRAINS

A fall on the icy pavement can cause wrist injuries such as fractures and strains. When you take a fall, your natural instinct is to extend your arms and brace your fall with your hands. The impact of the fall on your hands can cause a severe wrist strain or even fracture.

The result can be a serious injury if not treated properly. Your wrist may heal improperly, which could lead to chronic pain later in life.

ELBOW INJURIES

Like wrist injuries, elbow injuries can also arise from a fall on icy pavement. When you extend your arms to brace your fall, not only do your wrists take the impact but your elbows do as well. Your elbow could become dislocated if the impact is so significant that it pops your bone out of position. Otherwise, a more potentially severe injury could be an elbow fracture. This can lead to long-term pain if not treated properly.

ANKLE STRAIN

Falls on slippery, icy pavement can also cause ankle injuries. When you struggle to recover your balance after slipping on ice, you can easily roll and twist your ankle. This may end up being a muscle injury whereby the tendon has been strained. Otherwise, a certain type of fracture in the ankle bone can result if more impact has been felt. This type of fracture can be caused not only by a fall on iced-over sidewalks, but also due to winter sports injuries.

HIP FRACTURE

Slips and falls on icy roads and sidewalks can result in many different types of broken bones, fractures and injuries. But one of the more severe injuries occurs when a fall is so hard and sudden that it fractures the hip bone. This can be a very difficult injury to repair, and it can also cause chronic, long-term pain. This injury especially affects seniors who are predisposed to osteoporosis or previous hip injuries. This injury should certainly be treated as an emergency by a physician.

Age Groups and Demographics Most Affected

Certain incidents and their resulting injuries may affect certain age groups more than others. It’s important to apply appropriate safety measures, so everyone can stay safe during the winter.

CHILDREN

Children are susceptible to falls. They can easily fall and injure themselves if they can’t reach handrails or don’t have proper balance. If your child experiences a fall, it’s important to first assess their head for any injuries and then check for elsewhere, like wrists and elbows.

Children especially enjoy their time sledding and tobogganing, which can put them at risk for injury. Be sure to always supervise kids during winter activities and provide them with helmets to protect their heads.

SENIORS

Like children, seniors are also at a higher risk of slipping and falling on icy pavement. Seniors can easily lose their footing and take a fall that can put them in severe danger. Seniors who have suffered in the past from hip injuries could further damage their hips or back. Seniors should be accompanied and helped down driveways and across parking lots to ensure they are stable and have the support to walk safely. Seniors with mobility issues may want to consider motorized scooters during the winter months for extra safety precautions.

ADULTS WITH PREVIOUS MEDICAL CONDITIONS

Adults with previous back, neck and shoulder injuries are also at risk to be severely injured in any of these winter incidents. A slip or a fall can trigger a past injury and can cause further damage. Additionally, adults with a predisposition to osteoporosis are also at higher risk for broken and fractured bones if involved in a collision or a fall.

ACTIVE ADULTS

Adults who remain active throughout the winter months are also at greater risk for injuries if proper safety precautions aren’t followed. Adults who ski and snowboard should be advised that, without the proper equipment, they can be at risk for head injuries as well as neck, shoulder, knee and ankle injuries.

People who run in the winter should be advised to use properly cleared and salted trails and sidewalks, so they don’t risk slipping and falling.

WINTER INJURY PREVENTION TIPS

Though many of these winter accidents can be quite common, they are easy enough to prevent by following specific steps.

  • Thoroughly and regularly salt driveways, sidewalks and stairs
  • Walk carefully across parking lots and provide children and seniors with additional support
  • Stretch before performing any physical exercise
  • Stay hydrated while exercising and shoveling snow
  • Ensure proper footing when shoveling snow or scraping ice off the car
  • Wear a helmet and protective equipment during winter sports
  • Always supervise children playing outdoors in the snow
  • Before shoveling or scraping, make sure to properly stretch

Most businesses and shopping centers take precautions to salt their parking lots and sidewalks once winter hits. Even still, patches may be missed or ice may have formed since the last salting. When rushing into stores and shopping centers, slow down and take your time to carefully walk across the parking lot. Look for areas that have been clearly salted or do not appear wet. Hold onto children and seniors to help stabilize them as you walk across the parking lot or driveway and indoors.

For back injury prevention, it is advised to stretch lightly at first, then move into a deeper stretch. If you are going to be shoveling snow, then it’s important to stay well-hydrated and take frequent breaks so as not to exhaust your body and muscles.

When performing winter sports and activities, be sure to always have the proper protective equipment, like helmets, to prevent head and other serious injuries. If you have access to a gym or can use a treadmill at home, it will prevent any risk of slipping and falling while running outdoors during the winter.

If you choose to run outdoors, go with a buddy and be sure one of you carries a cell phone to call for help in the event of an injury. Familiarize yourself with your running route ahead of time to ensure it’s an area that has been salted and cleared of ice and snow.

WINTER DRIVING SAFETY TIPS

Winter weather can make driving more difficult, which means it can put yourself and others at risk of injury. In order to prevent motor vehicle collisions, follow these winter driving safety tips:

  • Have proper winter-grade tires installed on your car
  • Store an ice scraper in your car
  • Keep windshield washer fluid full
  • Have your vehicle inspected, especially breaks
  • Have a winter safety kit in your trunk, including a high-visibility safety vest, gloves and jumper cables
  • Keep a first aid kit in your car
  • Never drive without a cellphone
  • Limit the time spent driving in the dark

WHAT TO DO IF YOU SUFFER A WINTER INJURY

If you or a family member suffers a winter injury, it’s important to first assess the severity level. Sometimes muscle injuries can be treated with ibuprofen and by applying ice or a heating pad (whichever is more comfortable) or taking a warm bath. However, more severe injuries will need to be treated immediately by a professional. If you suspect broken or fractured bones or a head injury, report it to a physician right away, visit the emergency room or visit your orthopedic injury clinic.


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

Can Chronic Pain Be Prevented?

Article featured on WebMD

Our approach to pain management largely depends on what’s causing the pain. When it’s a byproduct of an ongoing health condition, our focus is finding a good pain management strategy to keep discomfort at a minimum. But when it’s rooted in an isolated event or injury, we can focus not only on treatment, but also the prevention of chronic pain. In situations like this, it’s worth asking – can we keep acute pain from becoming chronic?

The answer isn’t simple – pain is complex and unique to each individual – but there are some things that you can do to prevent pain from taking hold in the long-term. And, similar to other chronic diseases like diabetes and heart attacks, one of the keys to prevention is understanding the risk.

Certain events have been identified as being high risk for developing chronic pain:

  • Surgeries: Though most all surgeries are painful, some are particularly associated with developing chronic pain: mastectomies, thoracotomies (opening up the chest), joint replacements, amputations, and spine surgeries like laminectomies and fusions. With each of these different types of surgeries, it is  common to experience persistent nerve pain related to the operation. There are ongoing studies looking for ways to block excessive nerve irritation during these surgeries, including starting anti-neuropathic pain medications, like pregabalin, gabapentin, and venlafaxine prior to the surgery. If you have a procedure scheduled, talk to your surgeon ahead of time to see if this would be appropriate for your situation.
  • Acute trauma: Acute trauma, like motor vehicle accidents or fall injuries, carries an elevated risk of chronic pain. In my experience, there are usually multiple reasons for this, related to both physical and psychological factors. High-impact injuries from events like falling off of a ladder or getting rear-ended on the freeway cause significant jarring to joints, ligaments, tendons, and nerves of the body, causing a chain reaction that leaves the musculoskeletal system over-tensed and the nervous system over-activated in such an intense way that it may not let up. The emotional response to the injury only serves to further amplify this response. In my practice, behavioral health experts often work with patients to treat anxiety, and even PTSD, that is often associated with going through traumatic injuries. Reducing symptoms of distress early after an injury can play a key role in promoting a quicker recovery and diminishing the chances of progressing into chronic pain.
  • Low back pain: Unlike other acute injuries, like a sprained ankle, where rest is a necessary part of the recovery process, low back injuries don’t heal as well with prolonged bed rest. Recovery is quicker when appropriate movements and a return to typical daily activities are started early on after a back injury.  For added guidance on safe exercises and activities, consider working with a movement specialist such as a physical therapist, chiropractor, or Pilates instructor until you feel comfortable doing things on your own.

Past studies suggest that belief patterns also play a role in the development of chronic pain. For example, catastrophizing, when we think the absolute worst about a given situation, can lead to feelings of anxiety, depression, fear, and hopelessness. Catastrophizing is a known risk factor for developing chronic pain, while feeling more optimistic seems to be associated with improvements in health and well-being. One theory on how chronic pain can develop is known as fear-avoidance, where pain or even the anticipation of pain creates so much fear about further injury, that a person starts to shut down and avoids certain movements. These behavioral changes brought on by high levels of fear are felt to increase the likelihood of developing more widespread and lasting pain. One way that I help my patients change unhealthy perceptions is by approaching things in a very slow and deliberate fashion. Each little accomplishment along the way builds confidence, and the more confidence that is built, the easier it is to wash away negative feelings like fear and anxiety that stand in the way of recovery.

With so many different factors contributing to chronic pain, our approach to prevention should be multidimensional – better education, the right medications, exercise and physical therapy, counseling, and even good nutrition. If you are experiencing acute pain, talk to your doctor about how you might leverage these tools to keep your pain from transitioning into a chronic problem.


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

Helpful Tips for the First Week After a Total Knee Replacement Surgery

Article featured on Orthogate

The first knee replacement surgery took place in 1968 and since that time it has become more common with an estimated 600,000 total knee replacements (TKA’s) occurring annually in the United States. It is one of the most successful operations in all of medicine thanks to advances in the materials and surgical techniques used. These improvements have resulted in shorter hospital stays; however, this means that more responsibility is placed on the patient in managing their own recovery. The toughest period can be the first week after surgery so we thought it helpful to provide the following tips to help you make it through.

Keep the Joint Moving

This is arguably the single most important piece of advice to remember. Maintaining continual, mild movement of the joint is critical for several reasons. First, and this may sound counterintuitive, the movement will help to improve pain. Normally we may think that we need to rest joints and muscles to help relieve pain, but recently repaired joints will actually hurt less with motion. The gentle movement also serves to circulate blood and prevent clots and reduces swelling. Just keep this in mind – “The more you move, the faster your recovery will be.”

Focus on Knee Extension Range of Motion First

Knee extension also called the knee straight, is the most crucial motion that you need to focus on during your post-surgery recovery. After a total knee replacement, your leg will be prone to remain in a bent state and therefore resistant to being straightened out. However, investing the time into knee extension/straightening will be essential to building and maintaining knee stability, decreasing stress on the supportive ligaments around your knee, and to ensure proper functionality of the quad muscle.

Manage Swelling

While some swelling can actually be a good sign during recovery, too much swelling can increase pain and knee stiffness and lead to a decrease in range of motion. Therefore, knowing how to manage your swelling will be of the utmost importance. Just remember the acronym M.I.C.E. – that stands for Movement Ice Compression and Elevation. Your doctor will likely prescribe medications that will help in controlling inflammation so be sure to take them as directed in order to keep your swelling in check. You can also keep swelling at bay by applying ice and pressure (compression bandage) to the knee when you are resting it. Additionally, elevating the knee when you are resting can help temporarily reduce blood flow to the joint and thereby help to decrease swelling.

Get the Muscles Working

Surgery essentially shuts muscles “off” and it is your job during your recovery period to turn them back “on” and get them to working again. Don’t worry so much about building strength, focus instead on continual movement. You should bend, straighten, and squeeze the muscles at least once every waking hour. This will help them gain more function and gradually increase strength.

Don’t Ditch the Walker too Early

Everybody wants to ditch the walker early on because it reminds them of their own mortality. However, we highly encourage you to keep your walker at least until you are no longer limping. If you get rid of the walker before your body is ready, you could very well end up walking with a bent knee that will lead to scar tissue formation, muscle contractures, and damage to other joints nearby. So stick it out with the walker or a cane for a little while longer than you’d like and you’ll be rewarded by having fewer mishaps down the road.

Conclusion

The first week after a total knee replacement can be the toughest time period of the entire recovery process. However, if you implement the strategies we’ve outlined above you will be better equipped to handle whatever challenges you encounter and you will be well on your way to quickly regaining your knee function and quality of life.


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

How to Avoid Pain Flares During the Holidays: 5 Tips From a Doctor

Article featured on WebMD

The holiday season can be a challenging time for pain management. For many, the transition to colder and more blustery weather means extra aches and pains. Beyond just the winter weather, the holidays can also be a time of added stress, excessive travel, poor eating (and drinking) habits, and too little sleep. All of this can lead to inopportune pain flare-ups that put a big “bah humbug” into your season’s festivities.Here are some easy strategies to help you get through the holidays with less pain and more joy:

1. Have a Communication Strategy:

Holiday get-togethers with friends and family, or even meeting new people at parties, can sometimes lead to stressful social interactions. Whether it be awkward conversations about your health or heated arguments about politics, holiday chatter has the potential to escalate your anxiety and anger and tense up those already sore body parts. When you hear somebody start to press your buttons, try not to fire back; instead, take some slow deep breaths and transition the conversation topic or smile and move on to a different group. If you know you are going into a stressful situation, have a partner with you, where the two of you agree ahead of time to work together to unwind from toxic conversations. Keep in mind that you can’t control what others say or do, but you can control how you react to it!

2. Eat Plants First:

It’s no secret that many Americans put on a few pounds around the holidays. All of the yummy baked goods, along with social gatherings that involve eating, can take its toll. First, foods with added sugar or a lot of carbohydrates (cookies, cakes, etc.) create blood glucose spikes which promotes inflammation at a cellular level. Processed foods are likely high in salt and artificial ingredients which further increases swelling and bloating. And gaining just a few extra pounds can put added stress on painful joints and spines.  To avoid missing out on all of the goodies, start off by eating the healthy choices first, including vegetables, fruits, nuts, whole grains, and lean protein. Then when you move on to more decadent choices, you will be less likely to over-indulge.

3. Pace Yourself: 

Try not to schedule too many activities in one day and avoid putting yourself in situations that are too physically taxing. Set aside some time in your day to relax, meditate, exercise, or just go for a nice walk to avoid burnout. If you are traveling, check your bags at the curb and avoid the stress of lugging them on the plane or train and hoisting them into the overhead bin. Make a point to avoid prolonged sitting or driving if that bothers your back, and set a timer to take breaks when doing physical tasks like shoveling snow or hanging lights.

4. Watch Your Mood: 

For a variety of reasons, I see a lot of my patients struggle with extra levels of depression, anxiety, and stress this time of year. If you can relate, then consider doing some preventive work to avoid excessive mood swings. Spend a few minutes each day engaging in activities that calm your nervous system. That could mean pulling out an adult coloring book, listening to relaxing music, or trying some therapeutic breathing exercises. Avoid the winter blues by making a point of getting outdoors in the middle of the day, or try some phototherapy with a light box for 20 minutes. Be sure to unplug from your smartphone and social media, and try boosting your mood with 30 minutes of an activity you enjoy. Don’t hesitate to seek help from a counselor or trusted resource as opposed to fighting it alone.

5. Stay on Top of Your Sleep:

Poor sleep directly correlates with more pain, so burning the candle at both ends won’t do you any favors. Engage in healthy sleep hygiene habits during the holidays as much as possible and try to stick to your normal sleep cycle whenever possible. So, avoid shopping online at all hours of the night and don’t be the last one to leave a party. Alcohol consumption can interfere with high-quality REM sleep, so look for healthy alternatives like sparkling water. Poor sleep or too much alcohol can also set you up for a bad headache the next day.

For the next few weeks, try to slow down and be in the moment. “Enjoy the little things in life, for one day you’ll look back and realize they were the big things.” – Robert BraultWishing you a happy and healthy holiday season and a glorious New Year!

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

Lactic Acid Build Up: What It Means and How to Get Rid of It

Article featured on Verywell fit

Lactic acid is created when the body turns glucose into energy. The production of lactic acid occurs when oxygen levels are low, generally during high-intensity exercise. Lactic acid build-up can hinder your exercise routine, so it’s important to understand why it happens and how to prevent it.

What Lactic Acid Is

Lactic acid is produced in muscle cells and red blood cells. It forms when the body breaks down carbohydrates for glucose during exercise in certain conditions. “Lactic acid is a result of glycolysis (or the breakdown of glucose), an energy system that creates ATP energy in the absence of oxygen in muscle cells,” says Jenna Braddock, MSH, RD, CSSD, ACSM-CPT, owner of MakeHealthyEasy.com and OffSeasonAthlete.com.

Braddock also notes that there is a difference between lactic acid and lactate. Although the two words are used interchangeably, they are not technically the same.

Lactic acid has a hydrogen ion that is available to donate, while lactate is the molecule left after that hydrogen ion is cleaved from the molecule.

“This distinction helps us understand what is happening in the body; lactate is a fuel source for the body and has many important functions,” adds Braddock. During exercise, the working muscle cells can continue anaerobic energy production for one to three minutes, during which you can perform at high levels.

Why Lactic Acid Builds Up

During high-intensity exercise, muscles require more oxygen than the body can take in, causing anaerobic respiration and lactic acid build-up. When lactic acid develops depends on a person’s fitness level. The body clears lactic acid when it develops, but it may not be able to keep up when the levels start to increase rapidly.

“This is often termed “lactate threshold” for high-intensity aerobic activities (like running), but keep in mind lactate accumulation can also occur with strength training,” says Chrissy Carroll, RRCA Running Coach at Snacking in Sneakers.

When this increased acid builds, the muscles get tired and may not be able to contract as effectively. Some people may notice a burning sensation in the muscle during exercise.

“Interestingly, some experts believe the production of lactate actually helps the muscles delay fatigue during intense exercise,” says Carroll. She also notes that contrary to popular belief, the lactic acid buildup is not what’s responsible for delayed onset muscle soreness that occurs in the 24-48 hours after a workout.

How to Get Rid of It

“Decreasing the exercise intensity, resting from the activity, and taking deep breaths may all be helpful ways to clear lactic acid during an exercise session,” says Carroll.

Another proven method for clearing lactic acid is engaging in active recovery after exercise. Low-intensity movements, like yoga, walking, biking, or foam rolling, may clear lactic acid from the body.

A study compared active and passive recovery in 14 downhill skiers and found that active recovery caused a greater decrease in lactic acid. Skiers who performed the active recovery were able to move faster and complete more runs.

Ways to Get Rid of Lactic Acid

  • Decreased exercise intensity
  • Resting
  • Taking deep breaths during exercise
  • Active recovery or low-intensity movements, such as yoga, walking, biking, or foam rolling

How to Prevent Lactic Acid Build-Up

“The feeling of burning and fatigue that is associated with lactic acid can be improved most significantly through training,” says Braddock. She recommends increasing volume, intensity, and duration of training gradually to prevent lactic acid buildup.

But, “you do not have to avoid lactic acid build-up completely,” according to Carroll. “It’s normal for certain training regimens to include high-intensity intervals that are completed above the lactate threshold, couched between easier training days and/or rest days, to allow for proper training adaptations and recovery,” Carroll adds.

Braddock also notes that fueling properly for a workout can positively affect lactic acid levels. “Beta-alanine3 is a supplement that can be used to delay the impacts of lactate accumulation, but it may negatively impact other areas of performance,” says Braddock.

She also urges athletes to work with an experienced sports dietitian to develop a fueling and supplement plan that’s right for them.

How to Prevent Lactic Acid Build-Up

  • Increase volume, intensity, and duration of training gradually
  • Incorporate rest days and easier training days
  • Fuel your body properly
  • Consider working with a sports dietitian to develop a custom fueling and supplement plan

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

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

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

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

Phone:
503-224-8399

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

Hours
Monday–Friday

Tips for Describing Your Joint Pain to Your Orthopedic Surgeon

Article featured on Arkansas Surgical Hospital

Joint pain can be debilitating, limiting daily activities and draining you both physically and emotionally.  In many instances, joint discomfort is the result of some type of arthritis.  There are various treatment options, including medications, physical therapy, injections, alternative therapies, and surgical solutions, depending on the severity of your joint pain and the damage to the joints.

Is It Joint Pain or Bone Pain?

Accurately describing your joint pain to your orthopedic surgeon can help them determine what treatment is best for you.  Joint pain is different from bone pain and can vary in sensation and severity.  Clearly explaining the feeling is crucial to appropriate diagnosis and treatment.  Bone pain is typically sharp and localized to a specific area, while joint pain tends to be more of an ache and occurs only in the affect joints, not all along a bone.  However, if the joint damage is severe, it may feel quite intense due to missing or damaged cartilage leading to bones grinding against each other.  Joint pain often increases with overactivity or too much weight on the joint.

Be Accurate When Describing Joint Pain

Saying that your joints are stiff isn’t helpful to your doctor or surgeon because it is too vague.  Pinpointing how much pain you’re in, what kind of pain you’re feeling, and how it impacts your ability to use the joints are all part of describing pain accurately.  Osteoarthritis pain tends to feel different from rheumatoid arthritis and other sources of joint pain, so be precise and thorough.  The more detailed your description is, the easier it is for your surgeon to determine the root of the problem.

Where is the Pain Located?

If you have joint pain in your knees, explain whether you feel it in the kneecap area, the back of the joint, or on the sides.  The knee’s complex ligaments and bone structure mean there is more than one kind of knee joint pain.  If you have joint pain in the hands, tell your doctor which joints are affected.  For instance, osteoarthritis is more common in the joints at the end of the fingers, while rheumatoid arthritis isn’t as likely in these joints.  Narrow down the area as much as possible.

What Kind of Pain Is It?

There are many kinds of pain, and the form it takes is critical when diagnosing and treating joint issues.  Descriptive words are helpful, as are comparisons such as, “It feels like something is caught in the joint.”  Here are some excellent descriptions you can use:

  • Crunching or Grinding.  When bones are rubbing against each other, you may feel like the joint is grinding rather than moving smoothly.  It may feel like gravel in the joint.
  • Snapping, Crackling, or Popping.  This is the sensation of something releasing or popping out of place and is often accompanied by a popping sound.  Osteoarthritis often leads to snapping or crackling in the joints.
  • Throbbing.  If the joint pain feels like it pulses, make sure your surgeon knows.
  • Dull or Achy.  Your pain can be dull (rather like a bruise) but still be severe.  Dull pain or aching can be an underlying, constant pain with periodic flares of other kinds of pain such as stabbing or burning sensations.
  • Stabbing.  Does it feel like somebody stuck a knife in your joint?  Your surgeon needs to know if the stabbing pain is consistent, periodic, or linked to any activities or other circumstances such as standing for long periods.
  • Burning.  Some patients describe burning pain as the joint burning from the inside or a hot sensation in the joints.
  • Radiating.  If you have pain that starts in one area then travels toward another, it is described as radiating pain.  Some people experience hip pain that radiates down the leg when they try to put weight on it.  This may indicate nerve involvement in addition to problems with the joint itself.

The When and Why of Joint Pain

Joint pain isn’t always constant.  It can come and go depending on what you’re doing and the time of day.  Make sure your surgeon knows if your pain seems to flare when you participate in in certain activities or gets worse during specific times.  If your pain is more significant when you wake up in the morning or is aggravated after activities, tell your doctor.  Some forms of arthritis may cause greater pain after you’ve been moving around a lot, while others may be worse after you’ve been inactive for too long.  If your joints lock up, give way, or feel weak or unstable, your doctor needs to know this, particularly if increased pain results.

The duration of your pain is another element of the “when” of joint pain.  While your knees or hips may hurt a lot when you first wake up in the morning, how long it lasts can indicate whether you have osteoarthritis or rheumatoid arthritis.  It can also help define the severity of the problem.  Does the discomfort after exercising last 30 minutes or several hours?  Is the pain worse when walking up a hill or a flight of stairs?  Details like this can aid your surgeon in a correct arthritis diagnosis.

Finally, be sure to inform your doctor of any other elements that affect your joint pain.  Pain that flares during certain types of weather, when you’re under stress, or when you are tired may help pinpoint an arthritis diagnosis or indicate other underlying issues.

The Severity of Joint Pain

Many physicians use a pain scale of 1 to 10, with 1 meaning little to no pain and 10 meaning unbearable pain.  No one experiences pain the same way others do, but the pain scale helps doctors get an idea of how severe your discomfort is and how much it impacts your life.

  • 0 = No pain
  • 1 = Occasional, minimal pain
  • 2 = Mildly annoying, not constant
  • 3 = Painful enough to distract you if not busy
  • 4 = Maybe distracting even when occupied
  • 5 = Can’t be ignored for long stretches, but you can still do things (although uncomfortably)
  • 6 = Can’t ignore your pain
  • 7 = Difficulty sleeping, concentrating, and socializing
  • 8 = Physical limitations and difficulty with normal functioning, nausea, and dizziness
  • 9 = Crying, inability to speak, possibly passing out from the pain
  • 10 = Unconsciousness

Successfully Treating Arthritis Pain

The two most common forms of arthritis, osteoarthritis and rheumatoid arthritis, generally require different approaches, making the proper diagnosis critical when you’re suffering from joint pain.  Arthritis surgery is one of many options available to minimize discomfort and increase range of motion.  Still, your surgeon will usually recommend it only after you’ve tried other treatments such as medications and physical therapy.

Arthritis pain may be the result of a variety of triggers, including:

  • Cracks or chips in the affected bones
  • Inflammation of the tendons and muscles around arthritic joints
  • Bone spurs
  • Muscle spasms caused by irritation from damaged bone
  • Decreased blood flow in arthritic joints
  • Loss of synovium between the bones

With so many potential causes of joint pain and a wide range of treatment options, accurately describing your pain to your surgeon is the first step in finding the best treatment for you and getting you back to doing the activities you enjoy.


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

Keeping Your Spine Healthy

Article featured on Brigham Health Hub

While the COVID-19 pandemic has changed our lives dramatically, back and neck problems are still as common as ever. In fact, some people are experiencing pain and other discomforts for the first time due to changes in their work locations and equipment as they moved from the office to home. The good news is that most spine conditions improve with time, physical exercise and getting back to your normal activities.

During the pandemic, Michael W. Groff, MD, a neurosurgeon and the director of the Neurosurgical Spine Service at Brigham and Women’s Hospital, had a virtual visit with a patient who was having neck pain along with tingling and weakness in an arm. The patient had undergone a previous surgery with Dr. Groff and feared he might need another.

While an MRI showed more wear and tear in the man’s neck, Dr. Groff reassured his patient that the condition would likely improve without surgery. The best course of action included physical therapy and performing exercises at home.

“I’m not one hundred percent certain that this patient won’t need surgery again,” says Dr. Groff. “But I reassured him that the path to recovery was to get moving and return to his normal routine. And neither of these things would further hurt his neck.”

Dr. Groff is co-chair for the editorial board of Journal of Neurosurgery: Spine. In this role, he and others have been distributing timely information about providing safe care for spine patients during the pandemic.

Keep your back and neck strong with an exercise routine

To keep your back and neck healthy, Dr. Groff urges his patients to perform any physical activity that helps maintain fitness, strengthens the core muscles and includes stretching. If you have back issues, the best way to stay healthy is to stretch often and keep your core strong.

Many people have found virtual exercise classes or routines that include Pilates, yoga or cardio workouts. To stay in shape, you can also use elastic bands, hand weights and/or perform isometric exercises, like planks or squats at home.

“It’s especially important to avoid being sedentary for long periods of time,” says Dr. Groff. “Being inactive can cause muscles that support the spine to weaken. This can sometimes lead to back or neck pain or exacerbate an existing spine condition.”

Getting regular exercise can have other benefits, too. It can give your day structure and help break up the monotony of staying at home for an extended time. Physical exercise can also help you maintain a positive outlook while navigating this challenging period.

When to seek care for back or neck problems

If you have an acute injury, like a pulled back or neck muscle, your pain will likely only last a few days. However, if your symptoms last 2 to 3 weeks and you have weakness or tingling in an arm or leg, contact your doctor.

For pain relief, Dr. Groff recommends ice for the first 48 hours and then alternating between heat and ice for several days after. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), can also help reduce pain and lower inflammation.

For flare-ups of back or neck pain, most spine care providers recommend only staying in bed for about 3 days. In the past, doctors used to recommend a few weeks of bedrest for flare-ups until a pivotal 2016 study showed that 3 days of bed rest is all patients need before they should return to normal activity.

“Staying in bed any longer than 3 days may lead to muscle weakening that can actually worsen a pain episode,” says Dr. Groff. “If you’re having pain, I usually recommend that patients rest and recover over a long weekend and then resume their normal activities.”

Back or neck pain usually doesn’t cause physical damage

If you have back or neck pain, how you interpret it can often impact how disabling it can become. Many patients ask Dr. Groff whether their pain is “all in their heads.” It is, he says, because all pain is experienced in our minds.

“If you’re in pain, most patients find it helpful to know that their pain is most likely not causing physical damage to their spines,” says Dr. Groff. “If you know you aren’t hurting yourself, you can feel better about exercising and returning to your routines.”

Dr. Groff hopes to help patients understand their pain from this new perspective. Doing so often removes the fear of physical activity, because getting back to normal life is a common pathway out of pain for many patients.

“The experience I’ve gained during the COVID-19 pandemic gives me the confidence to say that the Brigham is providing care that’s compassionate, technically excellent and safe for you and your family,” says Dr. Groff.

Dr. Groff can see patients both in person and through virtual visits, which allow him to stay in contact with patients who prefer to connect from home.

“I can still meet with patients and discuss their symptoms during virtual visits,” says Dr. Groff. “I can review imaging and develop a care plan that’s tailored to their unique circumstances. I can also follow up with patients to see how they’re progressing.”


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