Foot, Leg & Ankle Swelling

Article featured on Mount Sinai

Painless swelling of the feet and ankles is a common problem, especially among older people.

Abnormal buildup of fluid in the ankles, feet, and legs can cause swelling. This fluid buildup and swelling is called edema.

Considerations

Causes

Home Care

What to Expect at Your Office Visit


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

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

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

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

Phone:

503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

Most Common Summer Injuries in Adults

Article featured on BenchMark Physical Therapy

As the warmer months arrive and the days get longer and sunnier, Americans are eager to make the most of the summer season. For many, that means resuming favorite outdoor sports and recreation activities and venturing out to explore new and familiar destinations.

But summer fun often comes with the added risk of injury. Emergency rooms across the nation report an uptick in visits during June, July, and August—more than 40,000 every day in fact. Here are the most common summer injuries in adults and tips to prevent them for a safe and memorable season.

Heat-Related Illness

In the United States and across North America, record-high temperatures are becoming more frequent, directly impacting human health. Extreme heat events pose a significant threat to human life. According to the CDC, more than 67,000 people visit emergency rooms annually for heat and more than 9,000 are hospitalized.

What is Heat-Related Illness?

Heat-related illness is an umbrella term that refers to several serious health conditions caused by exposure to prolonged or abnormal heat and humidity levels without relief.

Heat cramps are painful muscle spasms and cramps during or after intense physical activity in the heat. Heat cramps are the mildest type of heat illness, and generally improve with rest and hydration.

Heat exhaustion is more serious and occurs when the body loses salt and water from excessive sweating without replacing fluids and salt. As a result, the body is unable to cool itself. If left untreated, heat exhaustion can progress to heat stroke. Heat exhaustion symptoms include heavy sweating, cold, pale, clammy skin, nausea/vomiting, headache, or dizziness.

Heat stroke is the most serious type of heat illness that develops when the body’s internal regulating system is overwhelmed by high heat. A high body temperature, hot, red, dry or damp skin, dizziness, headache, and confusion are all potential signs of heat stroke. Heat stroke is life-threatening and requires immediate medical attention.

Tips to prevent heat illness:

  • Drink plenty of fluids throughout the day, not only during physical activity.
  • Wear light, breathable clothing on scorching summer days.
  • Plan sports and vigorous activities for the coolest time of the day.
  • Always use sun protection sunscreen, hats, sunglasses, and UPF clothing.
  • Warm up and cool down before and after intense activity.
  • Stay indoors on extremely hot and humid days.

Sports Injuries

Many adults have more free time to resume their favorite hobbies in the summer months. Plus, the weather is more conducive to outdoor fun playing golf, tennis, pickleball and other sports. But if it’s been a few months since you’ve dusted off that racquet, take proper precautions to safely return to exercise this summer.

Common sports injuries include:

  • Fractures: partial or complete break in any of the bones of the body from repeated stress or a single trauma
  • Dislocations: separation of two bones where they meet at the joint, often from a direct blow to the body from a fall or contact sport
  • Strains: tears or overstretching of the tendons that attach muscle to bone, or in the muscles themselves
  • Sprains: tears or overstretching of the fibrous connective ligaments that connect bones to other bones
  • Overuse injuries: damage to bone, ligaments, tendons, or muscles caused by repetitive stress on those structures

Sports Injury Prevention Tips

As we age, the body becomes more prone to musculoskeletal injuries, and it takes longer to recover from them. Prevention is key. Pre- and post-workout stretches prepare the body for activity and lower body temperature and heart rate after it to signal the body to begin the recovery process.

Adding some variety into your summer workout routine is also good for injury prevention. Cross-training allows you to focus on different muscle groups to avoid overuse injuries that can put a damper on your summer plans.

Hydration for Injury Prevention

Proper hydration aids with cooling down after activity, and it helps with circulation to deliver oxygen and nutrients throughout the body to enhance recovery. Hydration also keeps the joints properly lubricated to reduce injuries and improve range of motion.

While the ideal liquid intake varies slightly based on age, weight, and activity level, women should focus on getting at least 11.5 cups (or 2.7 liters) of water per day and men should try to consume 15.5 cups (or 3.7 liters) of water on an average day. Increase fluid intake in hot weather and when recovering from an illness.

Running Injuries

If you are a runner living in an area that experiences a four-season climate, you probably look forward to transitioning from treadmill to the outdoor track when the weather gets warmer.

There are plenty of benefits to walking or running outside. You burn more calories and boost your mood and vitamin D levels to start. But running on concrete is hard on the body’s joints and uneven surfaces increase the risk of falls and fall injuries. If you can, opt for asphalt, pea gravel, or dirt which are all gentler on the body.

If you experience ankle pain, knee pain, or hip pain, take these symptoms as a sign to dial back your running program and schedule a physical therapy appointment. Pain always has something important to tell us. You might have an underlying musculoskeletal injury or anatomical difference that can be overcome with personalized mobility and strengthening exercises.

In addition to stretching and strengthening with your physical therapist hydrating, stretching, and wearing a supportive, well-fitting running shoe can also be effective for preventing common running injuries.

Biking Injuries

Cycling is another activity that requires some care and preparation to move from indoors to outside. However, if you are an avid indoor cyclist, chances are you have already strengthened many of the structures that are vulnerable to injuries: particularly the kneecap (patella), upper and lower legs, ankles, and wrists and forearms.

Yet the risk of a concussion and other traumatic brain injuries (TBIs) from a bike accident increases significantly when you bike outdoors. Wearing a bike helmet reduces your risk of high injury by up to 85%. For helmet safety tips, visit NHTSAs bike helmet fit guide.

Water Injuries

If swimming, boating, or water sports are on your summer bucket list, be mindful of the risks associated with these activities. First, avoid running near pools and other wet surfaces to prevent falls. And never dive in shallow water, as diving accidents are a leading cause of spinal cord injuries.

Drowning occurs in seconds and is often silent. It can happen at any time and any location where there is water. While drowning is a leading cause of death among children ages 1-4, people of all ages and swimming abilities can drown. Those who survive a non-fatal drowning are often left with permanently disabling brain injuries. Fortunately, these injuries and fatalities are preventable.

The American Red Cross water safety guide offers some additional tips to prevent drowning and make water safety a priority for all:

  • Always swim with a buddy.
  • Never swim while impaired by alcohol or other substances.
  • Wear a U.S. Coast Guard-approved lifeguard jacket when fishing, boating, or using recreational watercraft, even if you do not plan to go in the water.

It is also important to be a “water-watcher” who looks out for others, especially children, who are in the water. The signs of drowning are not as obvious as you might believe. Someone in trouble can be quiet and calm.

If someone is bobbing up and down in the water, holding their arms out to the side or front attempting to “paddle,” and seemingly gasping for air, they may be drowning. Sometimes it is the look of panic that indicates trouble. Always err on the side of caution and provide immediate assistance.

Burns

Summer is the time for barbecues, camping, picnics, and fourth of July fireworks. Fire safety is essential to prevent painful burn injuries.

Always create a safety zone of at least three feet around campfires, grills, and firepits. Use long-handled tools and wear short sleeves when building a fire or cooking on the BBQ. Choose public firework displays and leave the lighting to the professionals.

If you or someone with you is burned, place the injured area in cool water for three to five minutes. Cover it with a dry, sterile cloth. Go to the emergency room for burns longer than the palm of your hand.

What Is Sunburn, and How Can I Prevent It?

Sunburn is skin damage caused by exposure to the sun’s ultraviolet (UV) rays. Initially, the skin feels hot, red, and sore. In the days that follow, the skin begins to peel and heal. Even though the skin appears to heal, a single burn can cause long-term skin damage and increase the risk of skin cancer.

Obviously, sunburns are more common during the summer months because we spend more time outside. Protect your skin with UV-resistant clothing, sunscreen, and shade when available. Apply sunscreen liberally and frequently over all exposed areas. Use water-resistant sunscreen if you are planning to swim.

Choose a sunscreen that has the “UVA” logo and has four-star protection against UVA rays which are linked to skin aging. The SPF should be at least SPF30 to protect against UVB rays which are associated with skin burning.

Bites and Stings

Insect bites and stings are another common summer hazard. Other than a bit of soreness, swelling, and itching, these injuries are typically nothing more than a nuisance. However, some people are highly allergic to bee stings or insect bites. Also, ticks, mosquitos, and some other insects can transmit diseases, so it’s best to prevent them as much as possible.

Use insect repellant outdoors and wear long sleeves and pants in areas of high insect activity. Check your body and clothing for ticks after spending time in woody or grassy areas. Keep bites and stings clean and watch for signs of infection.

Treat, Manage, and Prevent Common Summer Injuries with Physical Therapy

Your physical therapist may not be able to relieve your summer insect bites and stings, but they can be highly effective for treating and managing more serious musculoskeletal injuries. We have an extensive array of evidence-based techniques and treatments at our disposal to reduce pain and stiffness and improve the way your body moves and functions.

If you are getting ready to get back into action after a few months off, we can help you too. With targeted exercise therapy, together we will stretch and strengthen your muscles and joints so you can participate in your favorite activities safely and painlessly—while avoiding injuries.


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

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

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

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

Phone:

503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

Potential Causes & Common Treatment of Patella Alta

Article featured on Atlas Pain Specialists

You may be wondering , what are some causes and treatment of patella alta? Patella alta, also known as ‘high-riding patella,’ is a knee condition characterized by an abnormally high position of the patella or kneecap in relation to the femur, the thigh bone. This condition may lead to discomfort, knee pain, instability, and an increased risk of patellar dislocation or patellar subluxation.

A full understanding of patella alta requires a look at its potential causes, symptoms, diagnosis methods, and treatment options.

Possible Causes of Patella Alta

Patella alta is a condition that can result from various causes, both genetic and acquired. Here are some possible causes of this condition:

  1. Genetic Predisposition: Patella alta can be congenital, meaning a person is born with it. In these cases, the individual’s patellar tendon, which anchors the kneecap to the shinbone, is naturally longer than average, causing the kneecap to sit higher than usual.
  2. Growth Abnormalities: In children and adolescents, damage to the growth plate can cause the patellar tendon to grow longer than the femur, leading to patella alta. This is often associated with conditions that affect growth plates, such as Osgood-Schlatter disease and Sinding-Larsen-Johansson syndrome.
  3. Trauma or Injury: Any form of trauma to the knee that results in inflammation or damage can potentially lead to patella alta. This could include sports injuries, accidents, or falls that affect the knee region.
  4. Surgical Complications: Patella alta can also be an unintended consequence of knee surgeries. In particular, surgeries involving the patellar tendon, such as anterior cruciate ligament (ACL) reconstruction, may inadvertently lead to an elongation of the tendon, causing the kneecap to ride higher than normal.
  5. Chronic Conditions: Certain chronic conditions, including patellar tendinitis or jumper’s knee, can cause the patellar tendon to elongate over time. This progressive elongation can eventually lead to patella alta.
  6. Certain Medical Procedures: Some medical procedures, such as casting or bracing of the knee for extended periods, may lead to a temporary or even permanent elongation of the patellar tendon, which could result in patella alta.

In some cases, the exact cause of patella alta may remain unknown. It’s also possible for multiple factors to contribute to the development of this condition.

Diagnosing Patella Alta

Diagnosing patella alta involves assessing the patient’s medical history, conducting a physical examination, and using diagnostic imaging. The healthcare provider collects information about previous knee injuries, surgeries, and existing conditions while noting symptoms such as knee pain, instability, or recurring patellar dislocation. 

During the physical examination, the doctor evaluates the range of motion and stability and performs specific tests to assess the position and movement of the patella. Measurement ratios and indices like the Insall-Salvati ratio, the Caton-Deschamps index, and the Blackburne-Peel ratio are commonly employed to evaluate the patella position.

These measurements are obtained through X-ray imaging or specialized radiographic views of the knee. X-rays, MRI, or CT scans provide detailed images of the knee joint, enabling visualization of patellar alignment and any associated abnormalities. Dynamic imaging techniques such as fluoroscopy or specialized MRI sequences may assess patellar tracking during knee movements.

Following the diagnosis of the patella alta, the healthcare provider develops an appropriate treatment plan based on severity and individual needs. Accurate diagnosis is vital for effective treatment, so it is advised to consult a qualified healthcare professional for a thorough evaluation and personalized guidance toward suitable management options.

Treatment of Patella Alta

The treatment of patella alta typically depends on the severity of the symptoms and the degree of the patella’s displacement. Here are the possible treatment options:

  • Physical Therapy
  • Bracing and Taping
  • NSAIDs
  • Surgery
  • Lifestyle Modification

Physical Therapy

This is often the first line of treatment for patella alta, particularly for mild cases. Therapy exercises aim to strengthen the quadriceps muscle, which helps stabilize the kneecap and improves the flexibility and strength of the knee joint.

Bracing and Taping

Sometimes, a doctor might recommend wearing a knee or patellar stabilizing brace. These devices help hold the kneecap in a more normal position, which can help reduce discomfort and improve stability. Kinesiology taping techniques might also be used to offer support to the patella.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Medications can manage pain and inflammation associated with patella alta. This is typically an adjunct to other treatment modalities, such as physical therapy.

Surgery

For severe cases of patella alta, especially when conservative treatments have failed, surgery might be considered. The goal of surgery is to lower the position of the kneecap by shortening the patellar tendon. Surgical techniques include tibial tubercle osteotomy, where a section of bone where the patellar tendon attaches is moved downwards, and patellar tendon grafting, which involves using a graft to shorten the tendon artificially.

Weight Management

If the patient is overweight, weight loss can help by reducing pressure on the knees and alleviating the symptoms of patella alta.

Lifestyle Modification

Avoiding activities that strain the knee or incorporating exercises that strengthen the muscles around the knee can help manage the symptoms and prevent the worsening of the condition.

The treatment choice should be based on the individual’s specific symptoms, the extent of the patella alta, and the person’s overall health and lifestyle. Regular follow-ups with a healthcare provider are essential to monitor progress and adjust the treatment plan. 

Please note that this information is a general guide, and one should always consult with a healthcare provider for the most appropriate treatment plan for their specific condition.

Conclusion

Patella alta is a condition that requires proper medical attention, as it can potentially lead to more severe knee problems if left untreated. If you suspect that you or someone you know may have this condition, it is recommended to seek medical advice promptly. As with many health conditions, early diagnosis and treatment of patella alta can lead to more positive outcomes.


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

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

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

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

Phone:

503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

Home-Related Injuries

Article featured on FORM

Home-Related Injuries

According to the National Safety Council, home-related injuries account for nearly 150,000 unintentional deaths each year. Falls are among the top 10 most common home-related injuries.

Falls

Falls are the number one cause of home injuries in the U.S. The two groups most at risk for falls are children under the age of 5 and adults over the age of 70. Typical injury symptoms are sharp pain, swelling, bruising, and tenderness.

As you age, you become more susceptible to trips, slips and falls because eyesight, hearing, and balance tend to worsen. Medication can also cause imbalance and confusion, which can lead to falls. Slip, trips and falls can cause

How can you prevent falls?

There are simple, practical measures you can take to prevent slips, trips and falls in your house:

  • Clean up spills immediately in the kitchen and bathroom, or on hardwood floors.
  • Clear clutter and obstacles from hallways and walkways.
  • Close cabinet and desk drawers when not in use.
  • Replace burnt out light bulbs promptly.
  • Replace worn-out flooring, loose carpet, slippery throw rugs and wooden floorboards that are sticking up.
  • Install handrails and grab bars on stairways, in the shower, and near the toilet if possible.

To prevent slips and falls as you age, consider these safety tips:

  • Stay physically active to maintain strength, healthy bones and balance.
  • Have your eyesight and hearing checked regularly
  • Know the side effects of your medication. Talk to your doctor if your medicine makes you feel dizzy, sleepy or confused.
  • Get enough sleep.
  • Limit how much alcohol you drink.
  • Use a cane or walker as needed, especially when walking in an unknown area or an area with an uneven surface.
  • Wear non-skid shoes.

Cuts

Cuts from kitchen knives or other sharp objects, like scissors, tools, and saws, are another common home-related injury.

How should you treat a minor cut?

If your cut is minor, you can treat it at home. Here are some DOs and DONT’S to follow:

Do —

  • Apply pressure to stop the bleeding and elevate the injured area.
  • Clean the wound with soap and water if you can.
  • Apply some antibacterial ointment or spray to keep it clean.
  • Dress it with a bandage.
  • Reapply antibiotic ointment and a bandage several times a day.
  • Keep a close eye on it to monitor healing.

If your cut doesn’t appear to be healing and is causing you concern, visit your doctor right away.

Don’t —

  • Do not use hydrogen peroxide to clean a wound, as it can damage the tissue.
  • Do not use Steri-Strips at home. If you think you need to use a Steri-Strip, then you probably need stitches.

How do you know if you need stitches?

It is not always easy to tell if a cut will need stitches or not, so here are some guidelines to help you make that decision. You or a loved one should get stitches:

  • If the cut is deep enough to expose deeper tissue, bone, etc.
  • If the wound is gaping open and you can’t press the edges together.
  • If the wound is located on or across a joint (you may have damaged nerves, tendons, or ligaments as well).
  • If a foreign object, such as a stick or piece of metal is stuck in the wound.
    (Caution: Don’t remove any foreign objects from a wound, as you don’t know what the foreign object has struck underneath–such as an artery.)
  • If the cut is large, maybe more than a few inches in size.
  • If you are bleeding profusely (and flow doesn’t appear to slow).
  • If you were cut or punctured by something that is dirty or contaminated, such as a rusted piece of metal, a dog bite, etc. In such cases, a tetanus booster shot may be required, especially for adults who haven’t had one in the last 10 years.
  • If you are ever uncertain how serious the cut really is, seek immediate medical attention.

Also, note that children who need stitches should not eat or drink anything beforehand, as they may need to be sedated before suturing because they do not typically stay still during the process. If they eat or drink before stitches, it will only delay treatment.

When stitches are required, they should be done within approximately 6 hours to ensure proper healing. At FORM Ortho, we can provide stitches on-site during your appointment.


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

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

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

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

Phone:

503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

4 Common Orthopaedic Trauma Injuries & How We Treat Them

Article featured on MedStar Health

How We Treat Common Othropaedic Trauma Injuries

Lower Extremity Fractures

We see a large number of lower extremity injuries from individuals getting struck by cars, such as a tibial plateau fracture, which occurs when you break the bone on the top part of your tibia, right below your knee. This often happens because a car’s bumper strikes someone from the side at about knee level. Other common lower extremity injuries, such as a femur fracture and pelvic fracture, occur the most in the spring and summer, when people are out riding their motorcycles, bicycles, and motorized scooters.

Treatment for lower extremity fractures typically involves a surgeon realigning a patient’s affected bone and joints to their natural positions and holding them in place with plates and screws in a way that allows for them to heal properly.

While bones typically take about three months to heal, the hardware we insert during surgery sometimes is strong enough to support patients’ weight, allowing them to walk right after surgery. But speak to your doctor to see what to expect from your surgery, as some fractures, such as those close to joints, need to be fixed with hardware that is not designed to support the patient’s weight, resulting in people waiting weeks to months to put weight on their legs. Once patients are able to bear weight again, physical therapists can help them with strength and flexibility exercises to minimize stiffness and regain muscle loss. Social workers also can help patients plan for disability insurance or any time off work while they recover.

Wrist Injuries

We often see individuals with wrist injuries after they try to catch themselves when they slip and fall. This is especially common during the winter months, when snow and ice are on the ground. One of the most common wrist injuries we see is a fractured distal radius (broken wrist).

Treatment for a distal radius fracture typically involves patients either wearing a cast for around six weeks to allow the wrist to heal or undergoing surgery to better align the wrist and stabilize it  in order for it to heal properly.

Bones That Don’t Heal Properly

Some people are referred to us by their primary care doctors or other orthopaedic specialists because they’re having complications from previous fractures, such as a bone healing crookedly or not healing at all (nonunion).

To treat a nonunion, we first try to identify whether the patient’s bones aren’t receiving enough blood supply or the patient is lacking vitamins and minerals, such as vitamin D, which are necessary for proper bone healing. If neither is the case, we typically can get the bone to begin healing by retrieving bone from another part of the body and inserting it into the fracture site of the bone that isn’t healing properly.  We may need to also stabilize the bone differently from what was tried initially.

For bones that heal crookedly, we may need to cut the bone to realign it to the proper position.  We then stabilize it to hold it in that position. Depending on the situation, this can be performed all on the inside of the body or by using a system on the outside of the body that connects with a computer program.

Bone Infections

Some patients are referred to us because of osteomyelitis, a complicated bone infection. Osteomyelitis often can occur after trauma and can affect any bone. Without the proper treatment, osteomyelitis can spread to the tissues near the bone, kill the bone, and prevent any fractures from healing.

We treat these bone infections with surgery in which we open up the bone, remove as much of the infection as possible, and prescribe the patient antibiotics to both kill any remaining traces of the infection and keep it away long-term.

Can You Prevent Orthopaedic Trauma Injuries?

Unfortunately, many orthopedic trauma injuries are due to random events, such as someone running a red light and hitting another person’s car. There isn’t much we can do to prevent these types of events.

But it’s possible for you to avoid some traumatic injuries by carefully selecting what activities you want to participate in and understanding your physical limits. If you’re riding a motorcycle or bicycle, for example, make sure you’re moving at a safe pace and are always aware of your surroundings. If you’re on a ski trip, don’t ski on the hardest trail without having the appropriate skill level.

What Should People Do in an Emergency?

If an individual experiences an orthopaedic trauma injury, such as a severely injured limb, call 911 right away to request an ambulance. While the ambulance is on the way, it’s important for the injured person to stay calm and keep the affected arm or leg still. This can not only reduce the pain but also help prevent further injury to the soft tissues surrounding the injured bones. If there’s newspaper or cardboard nearby, try rolling it up to form a makeshift splint.

If someone has an open fracture—when there’s an open wound or break in the skin near the broken bone, what used to be referred to as a compound fracture—or has any injury that causes excessive bleeding, applying pressure on the area helps reduce the bleeding while they wait for emergency medical professionals to arrive.


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

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

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

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

Phone:

503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

10 Common Hiking Injuries and How to Prevent Them

Article featured on Austin Emergency Center

For hikers who plan on hitting the trail this summer, understanding the most common hiking injuries and how to prevent them is crucial for enjoying a safe and rewarding outdoor experience! This article will explore strategies for preventing and treating these common hiking injuries. By equipping yourself with knowledge and taking proactive steps, you can minimize the risks, maximize enjoyment, and ensure a memorable hiking experience.

1. Sprained Ankles

Ankle sprains occur when the ligaments surrounding the ankle joint are stretched or torn. This can happen to even the most experienced hikers due to uneven terrain, slippery surfaces, or missteps while traveling over diverse Texas landscapes.

Prevention:

Wear supportive footwear that provides ankle stability to prevent sprained ankles while hiking. Before hiking, warm up your muscles and perform ankle stretches.

Choose hiking trails that match your skill level, and be mindful of potential hazards, such as uneven surfaces or loose rocks—consider using trekking poles for added stability. Be sure to take smaller steps and avoid rushing.

Treatment:

To treat sprained ankles from hiking, follow the RICE method: Rest by avoiding weight-bearing, apply Ice for 15-20 minutes several times a day to reduce swelling, use Compression with an elastic bandage for support, and Elevate the ankle above heart level to minimize swelling.

You can also take over-the-counter pain relievers and gradually incorporate rehabilitation exercises under professional guidance.

2. Knee Injuries

Hiking involves strenuous and repetitive movements that can cause stress on the knees. Common knee-related hiking injuries include strains, sprains, and tendonitis.

Prevention:

To prevent knee injuries while hiking, practice proper hiking techniques and focus on maintaining good posture and taking shorter strides out on the trail.

Wear appropriate footwear with cushioning and support. Gradually increase the intensity of your hikes, and take regular breaks. Regulate the weight you carry in your pack, and listen to your body for any signs of injury.

Treatment:

When treating knee injuries caused by hiking, focus on resting the injured knee and avoid putting weight on it. Apply ice packs or cold compresses to reduce swelling and pain, and use compression bandages or wraps to support and stabilize the knee.

Elevate the injured leg above heart level to help reduce swelling, and take over-the-counter pain relievers if needed.

3. Blisters

Blisters are a common hiking nuisance caused by friction between the skin and footwear. Ill-fitting or wet shoes, as well as long hikes, can increase the likelihood of blisters.

Prevention:

To prevent blisters while hiking, wear properly fitted and broken-in hiking boots or shoes to reduce friction. Invest in moisture-wicking socks made of synthetic or wool materials that help keep your feet dry.

You can also apply lubricants or anti-blister products, such as petroleum jelly or specialized foot balms, to areas prone to blister formation.

Treatment:

Clean the affected area with mild soap and water, leaving the blister intact to protect the underlying skin and prevent infection. If the blister has already burst or is causing significant discomfort, gently clean the area, apply antibioticointment, and cover it with a sterile dressing or adhesive bandage.

4. Shin Splints

Shin splints are characterized by pain along the front or inner edge of the shinbone. They often occur due to overuse, improper footwear, or hiking on hard surfaces.

Prevention:

To prevent shin splints while hiking, wear proper footwear that provides adequate support and cushioning. Gradually increase your hiking intensity and distance to allow your body to adapt, avoid sudden terrain changes, and opt for softer surfaces when possible.

Treatment:

Rest and reduce or eliminate any weight-bearing activities that worsen the pain of shin splints. Apply ice packs to the affected area for 15-20 minutes several times daily to reduce inflammation and pain. You can also take over-the-counter pain relievers to alleviate discomfort.

Gentle stretching exercises for the calf muscles and the muscles in the front of the shin can help relieve tightness and promote healing.

5. Dehydration

Hiking in hot weather or at high altitudes can lead to dehydration and heat-related illnesses. Symptoms include dizziness, fatigue, nausea, and confusion.

Prevention:

To prevent dehydration while hiking, start by drinking plenty of water and staying hydrated before your hike. Carry an adequate water supply and drink regularly throughout your hike, even if you don’t feel thirsty.

Wear lightweight, breathable clothing and a hat to help regulate body temperature and reduce sweating. Avoid hiking during the hottest parts of the day and take regular breaks in shaded areas to rest and rehydrate.

Treatment:

When you are dehydrated, it’s crucial to replenish lost fluids and electrolytes. Immediately stop hiking and find a shaded area to rest. Drink plenty of water or rehydration fluids, taking small sips at regular intervals rather than gulping large amounts at once.

Applying cool, damp towels or using a misting fan with cold water can help cool your body and provide relief.

6. Sunburn and Heatstroke

Prolonged exposure to the sun without adequate protection can result in sunburns and, in severe cases, heatstroke. Heatstroke is a life-threatening medical emergency and requires immediate attention.

Prevention:

To prevent sunburn and heatstroke while hiking, wear sunscreen with a high SPF and apply it generously to all exposed skin. Wear a wide-brimmed hat and lightweight, breathable clothing that covers your arms and legs.

Plan your hike during cooler hours, such as early morning or late afternoon, to avoid the day’s peak heat. Consider using a moisture-wicking fabric or a cooling towel to help regulate body temperature.

Treatment:

When treating sunburn and heatstroke, move to a shaded area and protect your skin from further sun exposure. Apply a cool compress to soothe the burned skin, and moisturize with aloe vera gel or a gentle, non-irritating lotion to help alleviate discomfort.

Drink plenty of fluids to stay hydrated and replace lost electrolytes. For more severe sunburns with blisters, pain, or signs of infection, seek medical attention.

When treating heatstroke, it’s essential to cool the body down immediately. If possible, move to a shaded or air-conditioned area, remove excess clothing, and apply cool water or ice packs to the neck, armpits, and groin area.

Call emergency services or seek medical help promptly. Monitor vital signs and provide first aid measures while waiting for professional assistance. Remember, early intervention is crucial for both sunburn and heatstroke treatment.

7. Insect Bites and Stings

Hiking in areas with mosquitoes, ticks, or other insects can lead to unpleasant bites and stings that can cause itching, swelling, and even transmit disease.

Prevention:

Wearing long sleeves, long pants, and socks to minimize exposed skin while hiking. Tuck your pants into your socks and consider using insect repellent on exposed areas.

Choose to wear light-colored clothing, as insects are often attracted to dark colors, and avoid wearing strong fragrances, perfumes, or scented lotions, as they can attract unwanted attention from bugs. Stay on designated trails and avoid brushing against vegetation.

Treatment:

To treat bug bites, wash the affected area with mild soap and water to clean it. Use a credit card or a fingernail to gently scrape off the skin if there’s a stinger. Apply a cold compress or ice pack wrapped in a thin cloth to reduce swelling and alleviate discomfort.
Avoid scratching the bite to prevent infection. If needed, take an over-the-counter antihistamine to reduce itching and allergic reactions.

8. Overexertion

Pushing your body beyond its limits can lead to overexertion, resulting in muscle strains, fatigue, and exhaustion.

Prevention:

Listen to your body and know your limits when hiking! Plan your hike according to your abilities and choose trails that match your fitness level. Pace yourself and take breaks when needed, especially on long hikes or challenging terrain.

Treatment:

Allow your body to rest and recover when you begin to feel overexerted. Find a shaded area to sit or lie down and elevate your legs. Drink plenty of water or an electrolyte-rich beverage to rehydrate.

If you’re experiencing muscle soreness or stiffness, gentle stretching, and light massages may provide relief. Avoid further physical activity until you feel fully recovered. Pay attention to any lingering symptoms, such as persistent fatigue, dizziness, or rapid heartbeat, and seek medical attention if necessary.

9. Falls and Cuts

Trips, slips, and falls can happen while hiking, especially on uneven ground or steep slopes. Falls can result in cuts, bruises, and even more serious injuries like fractures.

Prevention:

To prevent falls and cuts while hiking, always stay alert and focus on the trail. Wear appropriate footwear with good traction to minimize the risk of slipping, and be sure to take your time and watch your step on uneven or rocky terrain. Be cautious when crossing streams or wet surfaces by using stable footholds and handholds if available.

Treatment:

When treating falls and cuts from hiking, it’s important to prioritize safety and address any injuries promptly. Carry a well-equipped first aid kit with essentials like adhesive bandages, antiseptic wipes, and sterile gauze to promptly address any cuts or injuries.

If bleeding is severe or the wound is deep, apply direct pressure with a clean cloth or bandage and seek medical attention. If a fall results in possible fractures or head injury, immobilize the affected area, keep the person still, and call for emergency medical assistance. It’s crucial to monitor for signs of shock, such as pale skin, rapid breathing, or weak pulse, and provide comfort and reassurance while waiting for professional help.

10. Poison Ivy

Brushing against poison ivy, poison oak, or other irritating plants can cause allergic reactions, including rashes and itching.

Prevention:

It’s essential to familiarize yourself with the plant’s appearance and avoid contact with it to prevent exposure to poison ivy exposure while hiking! Learn to recognize the three leaflets in a cluster characteristic of poison ivy.

Wear long sleeves, long pants, and closed-toe shoes to minimize skin exposure. As an added protection layer, consider applying a barrier cream or lotion containing bentoquatam to exposed skin areas. Always be cautious when sitting or leaning on surfaces that may have come into contact with poison ivy, such as fallen logs or rocks.

Treatment:

Wash the affected area with soap and cool water to remove the urushiol oil from the skin. Be sure to avoid scrubbing the area to prevent further skin irritation.

Apply a cold compress or take cool showers to soothe the itching and reduce inflammation. Over-the-counter hydrocortisone creams, calamine lotion, and oral antihistamines can help relieve itching and discomfort.

If symptoms are severe, widespread, or persistent, or if blisters or signs of infection develop, seek medical attention for further evaluation and treatment. Wash any clothing, gear, or tools that may have come into contact with poison ivy to remove any lingering urushiol oil.


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

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

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

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

Phone:

503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

How Does Exercising Keep the Brain Young?

Article featured on MedicalNewsToday

Exercise greatly benefits brain health, improving cognition, mood and reducing the risk of neurodegenerative diseases. Several new studies have demonstrated the profound impact of exercise on various biological systems, further explaining its ability to enhance health and fight disease. In this Special Feature, we explore the most recent research on how exercise can protect brain health as we age.

Exercise is linked to increased muscle strength, improved heart health, lower blood sugar and numerous other health benefits.

Activities such as running on a treadmill, biking up a steep hill, lifting weights or taking a brisk lunchtime walk offer a wide range of advantages that go beyond enhancing physical appearance or stamina.

Evidence from studies suggests that regular physical activity could boost mood, alleviate stress, and sharpen cognitive function, underscoring the deep connection between body and mind.

However, different people can respond quite differently to various forms of exercise, such as aerobic workouts or strength training.

While it is well-known that regular exercise is crucial for a healthy lifestyle, some older research has suggested that intense exercise might have negative effects.

More recent research, however, showed that elite athletes experienced slightly extended life expectancies over the decades.

Exercise significantly enhances brain health by improving cognition, mood and by reducing the risk of neurodegenerative diseases through promoting neurogenesis and synaptic plasticity.

What does the latest evidence and expert opinion have to say about the ways in which regular physical activity helps maintain brain, as well as general, health as we age?

How exercise affects the body at the molecular level

In a new collaborative effort led by Stanford Medicine, researchers have explored the underlying mechanisms through which exercise promotes overall health, particularly brain health.

By understanding how exercise affects different organs at the molecular level, health care providers could tailor exercise recommendations more effectively.

This knowledge could also pave the way for developing drug therapies that mimic the benefits of exercise for those who are unable to engage in physical activity.

The study — whose findings appear in Nature — involved nearly 10,000 measurements across almost 20 types of tissues to examine the impact of 8 weeks of endurance exercise in lab rats trained to run on tiny treadmills.

Its conclusion reveals remarkable effects of exercise on the immune system, stress response, energy production and metabolism.

The researchers identified significant connections between exercise and molecules and genes that are already known to be involved in numerous human diseases and tissue recovery.

How endurance training affects the body

The Nature study examined the effects of 8 weeks of endurance training on various biological systems, including gene expression (the transcriptome), proteins (the proteome), fats (the lipidome), metabolites (the metabolome), DNA chemical tags (the epigenome) and the immune system.

The researchers conducted analyses on different tissues in rats trained to run increasing distances and compared these with the tissues of sedentary rats.

They focused on mitochondria in the leg muscles, the heart, liver, kidney, white adipose tissue — which accumulates as body fat — as well as lungs, brain, and brown adipose tissue — a metabolically active fat that burns calories.

This comprehensive approach generated hundreds of thousands of results for non-epigenetic changes and over 2 million distinct epigenetic changes in the mitochondria, providing a rich database for future research.

Alongside the primary goal of creating a database, some notable findings emerged. For instance, the expression of mitochondrial genes changed with exercise across different tissues.

Researchers found that training upregulated genes in the mitochondria of skeletal muscle of rats that are downregulated in the mitochondria in the skeletal muscle of individuals with type 2 diabetes.

They also showed that training upregulated genes in the mitochondria in the livers of rats, that are down regulated in people with cirrhosis.

These two findings suggest that endurance training may help improve muscular function in diabetes, as well as boost liver health.

Does biological sex affect how we respond to exercise?

Finally, the researchers identified sex differences in how male and female rats’ tissues responded to exercise.

After 8 weeks, male rats lost about 5% of their body fat, while female rats did not lose a significant amount. However, the female rats maintained their initial fat percentage, whereas sedentary females gained an additional 4% body fat during the study.

The most dynamic difference was in mitochondrial gene expression after exercise in rats was in the adrenal glands.

The study authors propose that differences observed due to exercise are largely due to changes in mitochondrial genetic expression in organs and tissues responsible for maintaining energy balance.

Exercise’s rejuvenating effect on immune cells

Another study, this time completed by a research group from The University of Queensland in Australia, and published in Aging CellTrusted Source, demonstrated how exercise might deter or decelerate cognitive decline as individuals age.

Researchers examined gene expression in individual brain cells of mice, discovering that exercise profoundly influences gene expression in microglia, the immune cells supporting brain function in the central nervous system.

Specifically, exercise reverted the gene expression patterns of aged microglia to patterns akin to those seen in young microglia.

Experiments depleting microglia demonstrated their necessity for the beneficial effects of exercise on the creation of new neurons in the hippocampus, a brain region vital for memory, learning and emotion.

This study also revealed that providing mice access to a running wheel prevented or reduced the presence of T cells in the hippocampus as they aged.

These immune cells are typically absent in the youthful brain but increase with age.

Co-corresponding author Jana Vukovic, PhD, assistant professor and head of the neuroimmunology and cognition laboratory at The University of Queensland, explained the key findings to Medical News Today.

Vukovic explained that: “[T]he aging process affects all of the different cell types in the brain with the greatest impact on the resident immune cells: microglia. Importantly, exercise reverts the microglial gene profile back to their youthful state.”

Understanding how exercise supports brain health “is a key question for many scientists globally,” Vukovic noted, adding that she and her colleagues “propose that exercise alters the immune landscape in the ageing brain and therefore enables the immune cells to continue to support nerve cell function.”

Exercise strengthens brain cell connections

Ryan Glatt, CPT, NBC-HWC, senior brain health coach and director of the FitBrain Program at Pacific Neuroscience Institute in Santa Monica, not involved in these studies, told MNT they “underscore the multifaceted benefits of exercise on brain health, particularly through gene regulation, mitochondrial function, and immune response.”

“They offer valuable insights by merging molecular biology with practical health interventions for aging populations,” he added.

For example, “exercise enhances synaptic plasticity and blood flow while reducing inflammation and increasing the expression of neurotrophic factors like BDNFTrusted Source,” Glatt explained. “These effects can synergistically improve memory, learning, and overall brain health.”

The best forms of exercise for a healthy aging brain

Vukovic noted that “there are ongoing studies to optimise exercise programs for elderly; however, Pilates is a good starting point for those who are looking to engage their muscles.”

Glatt agreed, adding that “aerobic exercises like cardiovascular exercise, strength training, and balance exercises are particularly beneficial to brain health, in both shared and unique ways.”

“Activities combining physical and cognitive challenges, like dance or tai chi, can be especially effective for certain aspects of brain health,” Glatt said.

Nevertheless, he cautioned that: “While exercise benefits brain health, individual variability due to genetics and baseline health can affect outcomes. Further research is needed to determine the long-term sustainability and optimal exercise types and intensities for different populations.”


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

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

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

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

Phone:

503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

Summer Sports Injury Prevention

Article featured on U Chicago Medicine

Whether it’s because you’ve only done indoor workouts or because your winter involved too much Netflix-meets-couch time, warmer-weather sports injuries are common and can even sideline the most well-intentioned weekend warrior during what’s arguably the best time of the year.

Here are some of the most common questions my sports medicine colleagues and I often receive about how to stay safe when exercising – seasonally or otherwise:

What sports injuries are most common in the summer?

When the weather warms up, athletes tend to want to go back to their sports quickly to make up for the time they were inside. But increasing intensity and volume is a recipe of injury. Even for those less seasoned athletes, repetitive motion, particularly when you aren’t used to it during the winter months, can increase your risk of:

  • Stress fractures
  • Swimmer’s shoulder
  • Pitching elbow
  • Runner’s knee
  • Jumper’s knee
  • Achilles tendonitis
  • Shin splints
  • Tennis elbow
  • Rotator cuff injury
  • Pulled groin
  • Knee injuries (torn ACL, torn meniscus)
  • Dislocations

What causes sports injuries?

There are many causes of sports injuries. Everything from insufficient warm-up and stretching, poor conditioning and training techniques to previous injuries that have not properly healed or intense, high-level competition from contact (football, basketball) and noncontact (tennis, gymnastics) sports can lead to accidents. Common behaviors that can cause injuries this season include:

  • Working out too hard and/or overtraining, injuries are more likely if you are working out too often and/or for too long
  • Leveling up too quickly, changing the intensity of exercise or training too fast
  • Wearing the wrong shoes, such as shoes without enough support, increase risk of injuries
  • Poor training and/or incorrect technique can be very unsafe and ultimately lead to accidents and/or injuries
  • Not stretching before and after exercise
  • Dehydration can cause a range of symptoms, such as headache, fatigue, confusion and dizziness

Prevent Common Exercise Injuries this Summer

To perform the way you want and protect yourself from injuries, you need to take proactive steps to prepare your body properly. That means spending time during the off-season diversifying the types of activities you do.
You need to make sure you work your body in different ways. It’s important to help decrease the stress caused by repetitive motions, which goes a long way toward preventing injuries.

Prepare in the Off-Season/Winter

For anyone with warmer-weather sporting events lined up, or have plans to take up new sports this season, make sure your winter and/or off-season includes exploring new exercises that activate your core and build strength in the upper and lower body with cross-training activities, such as:

  • Pilates
  • Yoga
  • Swimming
  • Aqua jogging
  • Weight training

For runners and triathletes, strength training is not intended to build the muscle mass like a weightlifter, but instead to develop strength, power and endurance. Strength training can improve running performance and decrease injuries.

Build Up Exercise Overtime

Start with shorter distances (or a shorter duration for your workout) and build up progressively from there. Make sure you don’t increase your mileage or duration by more than 10% a week, especially if you’re running.

For example, if you ran three miles, three different times this week, your total weekly mileage is nine miles. Don’t run more than 10 total miles the following week. Build from there. Doing too much too soon means you may have to sit out the first weeks of spring nursing an injury. No one wants that.

Duration Before Speed

Speed should be the last thing you try to tack onto your training if you just started out. Once you’re comfortable with the mileage and/or duration of your workout, tempo runs or interval training will be the next steps.

Establish a Good, Consistent Stretching Routine

Make sure you stretch regularly and that the stretching encompasses your whole body. There are a lot of resources online if you’re unsure where to start. For whole-body workouts, the seven-minute workout has been scientifically validated to demonstrate benefits.

Incorporate Activity into your Workday

That could mean taking the stairs at work, do a walking meeting (weather permitting), sitting on an exercise ball at your desk, or doing calf raises and lunges while you’re on a conference call (nobody is watching you and will not think you are an exercise freak). Short bursts throughout the day can help maintain flexibility and strength when you can’t go outside. The goal is to work hard and smart with your time.

When is it time to see a sports medicine physician for a sports injury?

My best advice is to listen to your body. Working out is not about fighting through pain. Muscle soreness and the sensation of a good workout is what we are looking for. If pain has been persistent for more than two weeks even though you’ve been resting, icing and limiting your physical activity, it’s time to have your injury looked at. Swelling and bruising could indicate a more serious 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, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

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

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

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

Phone:

503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

Common Heel Pain

Article featured on OrthoInfo

Every mile a person walks puts 60 tons of stress on each foot. Feet can handle a heavy load, but too much stress pushes them over their limits. The result is often foot pain — the most common problem affecting the foot.

Anatomy

The bones of the feet are commonly divided into three parts:

  • The hindfoot (back of the foot)
  • The midfoot (middle of the foot)
  • The forefoot (front of the foot)

The heel bone is the largest bone in the foot. It lies at the back of the foot (hindfoot).

  • The Achilles tendon extends down from the calf muscle and attaches to the back of the heel.
  • The plantar fascia is a thick band of tissue that runs along the bottom of the foot and attaches to the plantar surface of the heel bone.

Both of these attachments — the places where soft tissues attach to bone — can become inflamed and be the source of heel pain.

Cause

Heel pain can have many causes, which generally fall into two categories.

Pain beneath the heel may be caused by:

  • Stone bruise. Stepping on a hard object, such as a rock or stone, can bruise the fat pad on the underside of the heel. The bruised area may or may not look discolored.
  • Plantar fasciitis. Too much running or jumping can inflame the tissue band (fascia) connecting the heel bone to the base of the toes. This inflammation can be worsened by performing these activities in older shoes with worn-out cushioning. Learn more: Plantar Fasciitis and Bone Spurs
  • Heel spur. When plantar fasciitis goes untreated for a long time, a heel spur (calcium deposit) may form where the fascia tissue band connects to the heel bone. A heel spur is usually the result of the problem (long-standing plantar fasciitis) and not the cause of the pain.
  • Calcaneus stress fracture. Repetitive stress to the calcaneus from high impact activities can eventually wear out and fracture the bone. Learn more: Stress Fractures of the Foot and Ankle
  • Nerve entrapment. Repetitive impact activities can cause swelling and nerve inflammation underneath the heel bone.

Pain behind the heel may be caused by:

  • Retrocalcaneal bursitis. People who have pain behind their heel may have inflamed the area where the Achilles tendon inserts onto (attaches to) the heel bone. This can be the result of running too much, or wearing shoes that rub or cut into the back of the heel.
  • Insertional Achilles tendinosis. This condition results from the breakdown of collagen in the Achilles tendon at the place where the tendon attaches to the heel bone. Over time, the tendon becomes thickened, causing pain.

Whatever the cause, continued impact on a sore heel will only worsen the pain and may lead to additional problems.

Symptoms

  • Symptoms of heel pain often include swelling and tenderness.
  • With plantar fasciitis, the pain is centered under the heel and may be mild at first. The pain flares up when taking first steps out of bed in the morning or when stepping out of a car after a long drive.  Even rising from a chair after sitting for awhile can cause pain.
  • Pain behind the heel may build slowly over time, causing the skin to thicken, get red, and swell. The pain flares up when first starting an activity after resting. Wearing normal shoes often also causes pain.
  • People with pain behind the heel may also develop a bump on the back of the heel that feels tender and warm to the touch. People born with this bump are more likely to experience heel pain as they get older.

Doctor Examination

Medical History and Physical Examination

During the appointment, your doctor will:

  • Ask you about your heel pain and symptoms.
  • Examine the bottom and back of your heel, looking and feeling for signs of tenderness and swelling that may indicate plantar fasciitis or retrocalcaneal bursitis.
  • Possibly squeeze your heel to determine if you have a stress fracture.
  • Possibly ask you to walk, stand on one foot, or do other physical tests to help your doctor pinpoint the cause of your pain.
  • Check your range of motion and flexibility.

Imaging Tests

X-rays. When heel pain continues for a long time, your doctor may order X-rays to evaluate the root cause of the pain. X-rays can help your doctor diagnose heel pain due to plantar fasciitis, calcaneus stress fracture, insertional Achilles tendinosis, and other issues that cause heel pain.

Magnetic Resonance Imaging (MRI) Scan. An MRI is rarely needed to diagnose heel pain. However, if initial nonsurgical treatment is not effective, and X-rays do not reveal the cause of your heel pain, your doctor may order an MRI scan. An MRI can help your doctor better evaluate the Achilles tendon, or diagnose a calcaneus stress fracture, retrocalcaneal bursitis, plantar fasciitis, or other soft tissue-related sources of pain.

Treatment

If your heel hurts, see your doctor right away to determine why it hurts and get treatment.

Treatment will depend largely on the cause of the pain.

Nonsurgical Treatment

Heel pain rarely requires surgery. Conservative (nonsurgical) treatments include:

  • Rest. Rest your foot as much as you can until the pain goes away. Heel pain that is the result of a stone bruise will gradually go away completely with rest.
  • Icing. If your pain is located behind the heel, consider placing ice on the back of the heel to reduce inflammation. Apply ice 20 minutes on/20 minutes off. Do not apply ice directly to the skin; use an ice pack, or wrap the ice in a towel or cloth.
  • Non-steroidal anti-inflammatory drugs (NSAIDs). Your doctor may recommend you take an NSAID, such as ibuprofen, to reduce swelling.
  • Tape. Placing tape around the heel may help reduce pain and promote healing in patients with plantar fasciitis.
  • Shoe inserts. Your doctor may recommend that you wear heel pads or heel cup inserts. Patients with a torn Achilles tendon may also want to wear open-backed shoes.
  • Night splinting: Your doctor may prescribe a splint for you to wear at night, which can be effective in reducing pain first thing in the morning.
  • Exercises. Your doctor may suggest special exercises. For example, leaning forward against a wall with your foot flat on the floor and heel elevated with the insert to stretch the Achilles tendon. Restoring flexibility in the calf muscle, Achilles tendon, and plantar fascia is a critical step in relieving heel pain and keeping symptoms from coming back.

Note: Heel pain that has been going on for a long time often requires a long time to improve. Your doctor will likely recommend several of these conservative treatments and explain that it may take several months of treatment before your symptoms improve.

Surgical Treatment

Most heel pain can be treated without surgery. If your heel paint has not improved after months of conservative treatment, your doctor may recommend surgery.

Surgical solutions target the anatomic source of the heel pain. Learn more about specific surgical treatment for:

Conclusion

Heel pain is a common foot problem. There are multiple causes of pain on the back, side, or bottom of the heel.

Clinical evaluation with a thorough exam is needed to diagnose the root cause of heel pain and to determine an appropriate treatment plan.

A sore heel will usually improve on its own without surgery — if you avoid placing significant impact on the heel and perform exercises to improve the damaged tissue.


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

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

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

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

Phone:

503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm

What is Patellar Subluxation

Article featured on Nationwide Children’s

Subluxation means partial dislocation of a bone. Kneecap (patellar) subluxation means the kneecap has briefly slid out of its normal place in the groove at the center of the bottom end of the thigh bone.


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

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

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

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

Phone:

503-224-8399

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

Hours
Monday–Friday
8:00am – 4:30pm