Article featured on Harvard Health Publishing
Many nutrients play a role in bone health, such as calcium, vitamin D, protein, magnesium, phosphorous, and potassium. If you eat a healthy diet (with lots of fruits, vegetables, legumes, nuts, seeds, and lean proteins), you’ll get enough of most nutrients needed to keep your bones healthy and functioning well. But some nutrients require extra effort to ensure adequate intake when we’re older.
Calcium
Calcium is one of the main ingredients of bone, and it’s essential for cell, muscle, heart, and nerve function. We don’t make calcium on our own — it comes from dietary sources (which are the safest and most effective) or calcium supplements. If there isn’t enough calcium in the bloodstream, the body raids the bones for supplies, thinning the bones.
“The parathyroid gland sends a message commanding cells called osteoclasts to chew up bone and spit out calcium. If that’s how calcium levels are sustained, it takes a toll on your bones. It’s like going to the bank and taking out $100; if you do it every day, you’ll run out of money. So think of dietary calcium not as building bone, but as preventing calcium from being sucked out of bone,” explains Dr. Harold Rosen, an endocrinologist and director of the Osteoporosis Prevention and Treatment Center at Harvard-affiliated Beth Israel Deaconess Medical Center.
Calcium goals and sources
The Recommended Dietary Allowance (RDA) of calcium for people ages 51 or older is 1,200 milligrams (mg) per day for women, and 1,000 to 1,200 mg per day for men.
Rich sources of dietary calcium include dairy foods (milk, cheese, yogurt), nuts, seeds, beans, soy, certain vegetables (leafy greens, rhubarb, artichoke, squash), fruits, and seafood.
“As a rough rule of thumb, I tell patients that a cup of milk, yogurt, calcium-fortified orange juice, almonds, beans, or certain greens [kale, spinach, broccoli] has about 300 milligrams [mg] of calcium. I think that’s easy to remember,” Dr. Rosen says.
Fortified juices and nut milks have extra calcium. For example, fortified orange juice contains about 300 mg of calcium per cup, compared with 27 mg in regular orange juice. A cup of almond milk has 450 mg of calcium.
If you can’t get enough calcium in your diet, take a low-dose calcium supplement to reach your daily RDA goal, but not more. Some studies show that large doses of calcium pills may increase the risk for developing kidney stones and possibly increase the risk of having a heart attack.
Vitamin D
Vitamin D is important for many body systems, especially bones. Vitamin D helps our bodies to absorb calcium (in the gut, which sends it to the bloodstream), and to regulate blood levels of calcium and phosphorus (which are needed to build bone).
Our bodies make vitamin D when sunlight turns a chemical in the skin into vitamin D3, which the body then transforms into an active form of vitamin D. But be careful about sun exposure; if it’s longer than a few minutes, you’ll need sunscreen to reduce your risk of skin cancer.
It’s possible to get some of your vitamin D from food, but few foods contain it. “A 6-ounce portion of salmon has about 1,000 international units [IU] of vitamin D. You can drink vitamin D–fortified milk or orange juice, and certain mushrooms also have vitamin D,” Dr. Rosen says.
It’s easier (and safer than sun exposure) to take a vitamin D3 supplement. “Healthy older adults who don’t have the bone-thinning disease osteoporosis, and those who have the precursor condition to osteoporosis called osteopenia, should take 600 to 800 IU per day. If you have osteoporosis, take 1,500 to 2,000 IU per day,” Dr. Rosen advises.
Protein
We call proteins the building blocks of life. They give cells structure; power chemical reactions throughout the body; and build and repair skin, muscles, and bones.
In bone, protein makes up a major part of the mass and volume, creating a meshwork of fibers that lay the foundation for growth. “Protein is like scaffolding. Calcium and phosphorous form on it and stiffen up,” Dr. Rosen explains.
To support the body’s needs, we need to consume healthy sources of protein: dairy products, fish, poultry, legumes, whole grains, nuts, seeds, and some vegetables such as corn, broccoli, and asparagus. But appetite can decline with aging, and you may find you’re cutting back on protein — perhaps eating just a tiny portion of fish or chicken rather than the larger helpings you once enjoyed.
“If you’re protein-deficient, you can’t build muscle, skin, or bones,” Dr. Rosen warns. “You need protein for strength and stability.”
To figure out how much protein you need, multiply your weight in pounds by 0.36. For example, a 170-pound person would need to eat about 61 grams of protein per day (170 × 0.36 = 61.2).
That may sound like a lot, but protein adds up quickly if you eat the right foods. For example, a breakfast of one-and-a-half cups of bran cereal with a cup of skim milk starts you out with 14 grams of protein. A midmorning snack of half a cup of low-fat cottage cheese and some blueberries adds another 12 grams. For lunch, a small spinach salad with half a cup of cooked lentils and 3 ounces of salmon or chicken gives you another 30 grams. That’s already 56 grams before dinner! But don’t overdo it on protein intake; the jury is still out on whether too much dietary protein is safe for bones.
Two-for-one
You get a two-for-one benefit when you eat proteins that are also calcium-rich. Examples include canned salmon (with the bones) or sardines, beans, dairy products (cheese, yogurt, cottage cheese, milk), leafy greens, and nuts.
And the best way to ensure healthy bones is not only eating right but also maintaining a healthy lifestyle that includes daily weight-bearing exercise (such as brisk walking and weight training), limiting alcohol intake, and not smoking. All of those lifestyle habits are linked to another benefit: warding off chronic disease. Take advantage of these “two-fers” and protect your bones if you aren’t already doing it.
The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, 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 Ways to Prevent Osteoporosis
in Osteoporosis, PreventionArticle featured on Yale Medicine
Osteoporosis, a serious condition that weakens and thins your bones, mainly affects older women. But there are key steps anyone can take to help prevent it—or lessen further bone loss if they already have the condition.
Preventing or mitigating the effects of osteoporosis is important because it is considered a silent disease—sometimes, the first sign is a fracture from a minor slip or fall. A broken bone, especially if it’s the hip, can have serious consequences, including loss of mobility, independence, and even death, for an older person.
Although osteoporosis affects an estimated 10 million Americans, women account for 80% of those affected. Women tend to have bones that are less dense than men, and low bone density increases the risk of bone breakage. What’s more, estrogen helps to preserve bone density, which is why women are particularly susceptible to osteoporosis after the loss of ovarian estrogen production due to menopause.
There is no cure for osteoporosis, but bone loss can be slowed down.
How does osteoporosis occur?
Bones are living tissues that are continually “remodeling.” This involves the resorption, or breakdown, of old bone and the formation of new bone.
As kids and young adults, our bones typically grow faster than they break down. By ages 25 to 30, our bones will reach peak mass—or the greatest amount of bone tissue an individual can produce. Bone mass plateaus from around ages 30 to 50. After age 50, our bones begin to break down quicker than they regenerate, leading to an aging-related loss of bone mass. As bone mass decreases, bone structure changes, too—leading to less dense, thinner, and more fragile bones.
“Osteoporosis is defined as bone loss beyond a threshold that quadruples the fracture risk compared to a healthy 35-year-old woman,” says Dr. Bergwitz.
For people with severe osteoporosis, simple actions, such as bending over, coughing, or bumping into furniture, can lead to a broken bone. Wrist, hip, and spine fractures are among the most commonly affected areas, but fractures can occur anywhere in the body.
How is osteoporosis diagnosed?
Doctors can measure bone density with tests called dual-energy X-ray absorptiometry (DEXA) scans. DEXA scans use low-energy X-rays to measure how tightly minerals are packed in a bone segment. Health care providers recommend routine DEXA scans starting at age 65 for women and age 70 for men. The test is repeated every few years or more often if necessary. If patients have additional risk factors, physicians may suggest beginning DEXA scans earlier.
Some of those risk factors include smoking, excessive alcohol consumption, having an inflammatory disease, such as rheumatoid arthritis (the drugs—steroids—often used to treat it can also weaken bones), using hormone blockers to treat breast or prostate cancer, having low testosterone (in men), and being thin (because fat protects bones from injury).
The DEXA scans can also detect osteopenia, a condition in which your bone density is lower than normal but not severe enough to be considered osteoporotic.
DEXA scan results are presented as “T-scores” and “Z-scores.” T-scores, which are used for postmenopausal women and men ages 50 and older, compare a patient’s bone mineral density to that of a healthy 35-year-old woman.
T-score results can fit into one of several categories:
Z-scores are used for children, young adults, premenopausal women, and men younger than 50. These scores compare patients’ bone density to the average bone density of healthy people of the same age, ethnicity, and sex. Z-scores of –2.0 or lower indicate a low bone density—essentially, you may have lost bone more rapidly than others your age.
While DEXA scans can show bone strength, they are only one factor that predicts the likelihood of a fracture. Health care providers may use the Fracture Risk Assessment Tool—or FRAX—to calculate the 10-year probability of bone fracture in a patient and include other risk factors (more on that below).
How is osteoporosis prevented and managed?
Whether you are trying to prevent osteoporosis or lessen its effects if you have it, Dr. Bergwitz advises focusing on what he calls the four pillars of bone health: nutrition, weight-bearing exercise, fall prevention, and medication, if needed.
Nutrition
In addition to overall healthy nutrition, getting proper amounts of calcium and vitamin D are important to bone health, Dr. Bergwitz says. Calcium hardens and strengthens bones, and almost all calcium in the body is stored in the bones and teeth. Vitamin D helps the body absorb the calcium people get from food.
“Through a blood test, we can measure vitamin D levels, and typically, we are looking to see them between 30 to 50 nanograms per milliliter,” he says.
Doctors can also order a parathyroid function, blood, and urine calcium test to measure the body’s calcium levels, which, if low, can cause reduced bone density and loss.
If the vitamin D and calcium levels are low, Dr. Bergwitz recommends that patients take a supplement for both if they can’t reach the ideal amounts in their diet. “Before menopause, we recommend women get 1,000 milligrams of calcium and 800 units of vitamin D a day from their diet and/or supplements,” he says. (This is also the recommended daily amount for adult men.) “After menopause, it’s 1,200 milligrams of calcium and 1,000 units of vitamin D.”
Vitamin D is not found naturally in many foods, but good sources are alfalfa sprouts, mushrooms, yeast, wild-caught mackerel, salmon, and tuna. It is also added to milk and other dairy products, as well as to orange juice, soymilk, and some cereals. Calcium is easier to find in foods; some that are rich in the mineral include collard greens, kale, broccoli, dried figs, oranges, and dairy products.
While many health experts generally advise people to get their calcium and vitamin D from food sources, Dr. Bergwitz acknowledges this can be difficult if someone is trying to watch their calorie intake, as it takes about four servings of dairy to reach the daily calcium recommendations.
If people choose to take supplements, Dr. Bergwitz suggests taking them with food to improve calcium absorption.
Weight-bearing exercise
Putting stress on your bones through impact and weight-bearing exercises can strengthen them. Activities such as brisk walking, running, dancing, climbing stairs, and sports, such as tennis, badminton, and pickleball, apply stress to the bones, which stimulates bone formation, increases bone density, and slows down bone loss.
“Join a gym, talk to a trainer, and find things that are right for you,” Dr. Bergwitz says. “You want to incorporate weight-bearing activities. Things like swimming and cycling are great for cardiovascular health, but they don’t put much or any stress on the bones.”
Resistance training (lifting weights or using weight machines or resistance bands) can also help strengthen bones. Such movements make the muscles work harder and become stronger. He adds that strong muscles also support balance, thereby lowering fall and fracture risk.
How much activity you should do each day or week is highly dependent on your fitness level, overall health, and goals. Everyone should consult with their family physician before starting a new routine, he notes.
Fall prevention
When exercising, it’s also important to concentrate on balance because poor balance increases the risk of falls and, therefore, bone fractures.
Yoga, tai-chi, balance classes, and even simple home exercises, such as standing on one foot, walking backward, and doing lunges, are just a few ways to improve your balance.
“People can also decrease their fall risk by inspecting their homes for safety. This might entail adding handrails in the bathroom or non-slip coating in the shower and tub, and removing clutter or obstacles from your general living space,” Dr. Bergwitz says.
Medication
The last pillar to treating osteopenia and osteoporosis is medication. In addition to a DEXA scan, doctors often use the Fracture Risk Assessment (FRAX) tool from the University of Sheffield in the United Kingdom. As mentioned above, the tool has an algorithm to predict someone’s 10-year probability of hip fracture or breaking other major bones.
These scores combine DEXA results with other factors, such as family and personal history, which can help decide whether the benefits of using medication outweigh the risks. All the medications, Dr. Bergwitz notes, have both immediate and long-term side effect risks, the latter of which typically occur after 10 years of using the same therapy.
There are many different types of drugs to treat osteoporosis, and they work in different ways, including inhibiting bone loss (thereby increasing or maintaining bone density) and increasing bone formation. They include a class of drugs called bisphosphonates (Actonel®, Fosamax®, Boniva®, and Reclast®), estrogen therapy (Evista®, for postmenopausal women), a synthetic version of parathyroid hormone (Forteo® and Tymlos®), and two monoclonal antibodies (Prolia® and Evenity®). They are also delivered in different ways, including by pill, injection, or infusion.
Because there are so many different options, each with its own set of side effects or contraindications, an individual with osteoporosis should discuss all options with their physician, who could be their primary care provider or a specialist, such as an endocrinologist.
“The big picture is that the benefits of these medications outweigh the risks, and their use merits a serious discussion between the patient and the provider,” Dr. Bergwitz says. “Many people are reluctant to take these medications because osteoporosis doesn’t hurt you until you have a fracture. But a hip fracture can be life-threatening, cause permanent mobility issues, and a loss of independence for older people.”
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 Are ACL, MCL, and PCL Injuries?
in ACL Injuries, Knee Injuries, Knee Pain, UncategorizedArticle featured on Seattle Children’s Hospital
What are ACL, MCL and PCL injuries?
ACL, MCL and PCL injuries are damage to ligaments that keep the knee from wobbling or giving out when you move. These ligaments are the anterior cruciate ligament (ACL), medial collateral ligament (MCL) and posterior cruciate ligament (PCL). When the knee is forced into an unusual position, 1 or more of the ligaments can tear, either part way or all the way.
What are the symptoms of ACL, MCL and PCL injuries?
If the knee of a child, teen or young adult suddenly swells after an accident or injury, they may have a torn ACL, MCL or PCL or another serious knee problem. Other symptoms of knee ligament injuries include:
How are ACL, MCL and PCL injuries diagnosed?
To help prevent further injuries to the bones and joints, it is important to get a thorough evaluation and proper treatment.
At our clinic, the doctor will:
We cannot be sure that a knee ligament is torn until the swelling in the knee has gone down. This usually takes 7 to 10 days. At that time, we may take:
How are ACL, MCL and PCL injuries treated?
Young people with a torn ACL need surgery to repair or reconstruct the ligament and then physical therapy (PT) to help them get back to their usual activities. If they are still growing, it’s important to receive care from a pediatric orthopedic surgeon who knows how to protect their .
For MCL and PCL injuries, we use nonsurgical methods like PT, including sports PT, whenever possible. Those who have an MCL injury may need to wear a hinged knee brace along with doing PT.
Surgery for ACL, MCL and PCL injuries
Surgery is the usual treatment after an ACL injury to make the knee stable again.
During ACL surgery, the surgeon replaces the torn ligament with new tissue that will turn into ligament over time. This tissue (called a graft) is taken from another body site and transferred to the new area. Graft tissue can be taken from the patient’s own body or from a donor (cadaver). The surgeon will talk with you in advance about the pros and cons of different types of grafts.
We drill small holes in the shinbone and the thighbone. Then, we pass the new ligament through the drill holes and secure it to the bones.
This surgery requires only small incisions. The surgeon inserts a small tool called an arthroscope into the knee. They use pictures displayed on a large monitor to guide their actions.
A young person who has both an MCL injury and an ACL injury probably will need surgery to reconstruct the ACL.
Surgery is not usually used to treat PCL injuries that happen by themselves. But surgery may be needed if:
Physical therapy for ACL, MCL and PCL injuries
PT is an important part of getting better after surgery for any knee ligament injury. It will help strengthen the muscles around the knee and make the joint stable.
If an MCL or PCL injury is mild, a child, teen or young adult may be able to recover with PT alone. Our staff is expert at devising and teaching exercise programs to help patients:
Most patients will have PT sessions with us a couple of times a week until they meet their goals for returning to their sport or other usual activities. Afterward, our therapists may also recommend exercises to keep doing at home.
To prevent new or repeat injuries, we have a strong focus on return-to-sport testing. Our PTs know how to check when a patient is ready to be more active or go back to their sport. We have done a great deal of research to understand how to make these decisions so each patient gets the best possible results.
One of the most important ways to prevent repeat injuries is to modify activities that might hurt the knee as it heals. These activities include high-level athletics that require:
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
6 Common Myths and Misconceptions About Orthopedic Health
in Orthopedic Sports Medicine NewsArticle featured on South Shore Orthopedics
Have you heard some crazy theories regarding orthopedic health? Orthopedic health encompasses the well-being of our bones, joints, muscles, ligaments, and tendons. However, several myths and misconceptions surrounding this field can lead to misunderstandings and potentially harmful beliefs.
Common Myths and Misconceptions
Myth 1: Only Athletes and Older Adults Need Orthopedic Care
One prevalent misconception is that orthopedic care is only necessary for athletes or older adults. While athletes and older individuals are more prone to orthopedic injuries and conditions, people of all ages and activity levels can experience orthopedic issues. Genetics, lifestyle, occupational hazards, and even accidents can contribute to orthopedic problems. Everyone needs to pay attention to their orthopedic health and seek appropriate care when needed.
Myth 2: Rest Is the Best Treatment for Orthopedic Injuries
Rest is an essential component of the recovery process for orthopedic injuries; however, it is not always the sole or best treatment. Depending on the nature and severity of the injury, a comprehensive treatment plan may include physical therapy, exercises, bracing, medications, or even surgery. Rest alone may lead to muscle weakness, joint stiffness, and delayed healing. It is crucial to consult a healthcare professional to determine the most appropriate treatment approach for each injury.
Myth 3: Orthopedic Surgery Should Be Avoided at All Costs
There is common myths that orthopedic surgery should be the last resort and avoided whenever possible. While surgery is not always necessary for orthopedic conditions, it can provide significant benefits in some instances. Advances in surgical techniques, minimally invasive procedures, and improved recovery protocols have made orthopedic surgery safer and more effective.
In some instances, surgery may be the most effective option to restore function, alleviate pain, and improve quality of life. Decisions regarding surgery should be made in consultation with a qualified orthopedic surgeon based on individual circumstances and medical advice.
Myth 4: Exercise Aggravates Orthopedic Conditions
Some people mistakenly believe exercise can worsen orthopedic conditions or lead to further damage. Appropriate exercise and physical activity are often prescribed as part of the treatment plan for orthopedic conditions. Exercise helps strengthen muscles, increase flexibility, promote joint stability, and improve overall function. However, it is crucial to engage in activities suitable for the specific condition and follow the guidance of a healthcare professional or physical therapist to ensure proper form and technique.
Myth 5: Orthopedic Conditions Are Inevitable with Aging
Aging is often associated with orthopedic conditions such as osteoarthritis. However, it is one of the common myths that these conditions are inevitable and nothing can be done to prevent or manage them. While age-related changes in our musculoskeletal system are natural, adopting a healthy lifestyle, engaging in regular physical activity, maintaining a balanced diet, and avoiding excessive strain on joints can help prevent or delay the onset of orthopedic conditions.
Additionally, early intervention, proper treatment, and lifestyle modifications can effectively manage orthopedic conditions and improve quality of life.
Myth 6: Over-the-Counter Medications Are Always Sufficient for Orthopedic Pain
Over-the-counter (OTC) pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help manage mild to moderate orthopedic pain. However, they may not always be sufficient for severe or chronic pain.
A healthcare professional should evaluate persistent pain or pain that interferes with daily activities to determine the underlying cause and appropriate treatment options. Prescription medications, physical therapy, injections, or other interventions may be necessary for effective pain management.
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
Essential Nutrients Your Body Needs for Building Bone
in Bone Health, Nutrition & General HealthArticle featured on Harvard Health Publishing
Many nutrients play a role in bone health, such as calcium, vitamin D, protein, magnesium, phosphorous, and potassium. If you eat a healthy diet (with lots of fruits, vegetables, legumes, nuts, seeds, and lean proteins), you’ll get enough of most nutrients needed to keep your bones healthy and functioning well. But some nutrients require extra effort to ensure adequate intake when we’re older.
Calcium
Calcium is one of the main ingredients of bone, and it’s essential for cell, muscle, heart, and nerve function. We don’t make calcium on our own — it comes from dietary sources (which are the safest and most effective) or calcium supplements. If there isn’t enough calcium in the bloodstream, the body raids the bones for supplies, thinning the bones.
“The parathyroid gland sends a message commanding cells called osteoclasts to chew up bone and spit out calcium. If that’s how calcium levels are sustained, it takes a toll on your bones. It’s like going to the bank and taking out $100; if you do it every day, you’ll run out of money. So think of dietary calcium not as building bone, but as preventing calcium from being sucked out of bone,” explains Dr. Harold Rosen, an endocrinologist and director of the Osteoporosis Prevention and Treatment Center at Harvard-affiliated Beth Israel Deaconess Medical Center.
Calcium goals and sources
The Recommended Dietary Allowance (RDA) of calcium for people ages 51 or older is 1,200 milligrams (mg) per day for women, and 1,000 to 1,200 mg per day for men.
Rich sources of dietary calcium include dairy foods (milk, cheese, yogurt), nuts, seeds, beans, soy, certain vegetables (leafy greens, rhubarb, artichoke, squash), fruits, and seafood.
“As a rough rule of thumb, I tell patients that a cup of milk, yogurt, calcium-fortified orange juice, almonds, beans, or certain greens [kale, spinach, broccoli] has about 300 milligrams [mg] of calcium. I think that’s easy to remember,” Dr. Rosen says.
Fortified juices and nut milks have extra calcium. For example, fortified orange juice contains about 300 mg of calcium per cup, compared with 27 mg in regular orange juice. A cup of almond milk has 450 mg of calcium.
If you can’t get enough calcium in your diet, take a low-dose calcium supplement to reach your daily RDA goal, but not more. Some studies show that large doses of calcium pills may increase the risk for developing kidney stones and possibly increase the risk of having a heart attack.
Vitamin D
Vitamin D is important for many body systems, especially bones. Vitamin D helps our bodies to absorb calcium (in the gut, which sends it to the bloodstream), and to regulate blood levels of calcium and phosphorus (which are needed to build bone).
Our bodies make vitamin D when sunlight turns a chemical in the skin into vitamin D3, which the body then transforms into an active form of vitamin D. But be careful about sun exposure; if it’s longer than a few minutes, you’ll need sunscreen to reduce your risk of skin cancer.
It’s possible to get some of your vitamin D from food, but few foods contain it. “A 6-ounce portion of salmon has about 1,000 international units [IU] of vitamin D. You can drink vitamin D–fortified milk or orange juice, and certain mushrooms also have vitamin D,” Dr. Rosen says.
It’s easier (and safer than sun exposure) to take a vitamin D3 supplement. “Healthy older adults who don’t have the bone-thinning disease osteoporosis, and those who have the precursor condition to osteoporosis called osteopenia, should take 600 to 800 IU per day. If you have osteoporosis, take 1,500 to 2,000 IU per day,” Dr. Rosen advises.
Protein
We call proteins the building blocks of life. They give cells structure; power chemical reactions throughout the body; and build and repair skin, muscles, and bones.
In bone, protein makes up a major part of the mass and volume, creating a meshwork of fibers that lay the foundation for growth. “Protein is like scaffolding. Calcium and phosphorous form on it and stiffen up,” Dr. Rosen explains.
To support the body’s needs, we need to consume healthy sources of protein: dairy products, fish, poultry, legumes, whole grains, nuts, seeds, and some vegetables such as corn, broccoli, and asparagus. But appetite can decline with aging, and you may find you’re cutting back on protein — perhaps eating just a tiny portion of fish or chicken rather than the larger helpings you once enjoyed.
“If you’re protein-deficient, you can’t build muscle, skin, or bones,” Dr. Rosen warns. “You need protein for strength and stability.”
To figure out how much protein you need, multiply your weight in pounds by 0.36. For example, a 170-pound person would need to eat about 61 grams of protein per day (170 × 0.36 = 61.2).
That may sound like a lot, but protein adds up quickly if you eat the right foods. For example, a breakfast of one-and-a-half cups of bran cereal with a cup of skim milk starts you out with 14 grams of protein. A midmorning snack of half a cup of low-fat cottage cheese and some blueberries adds another 12 grams. For lunch, a small spinach salad with half a cup of cooked lentils and 3 ounces of salmon or chicken gives you another 30 grams. That’s already 56 grams before dinner! But don’t overdo it on protein intake; the jury is still out on whether too much dietary protein is safe for bones.
Two-for-one
You get a two-for-one benefit when you eat proteins that are also calcium-rich. Examples include canned salmon (with the bones) or sardines, beans, dairy products (cheese, yogurt, cottage cheese, milk), leafy greens, and nuts.
And the best way to ensure healthy bones is not only eating right but also maintaining a healthy lifestyle that includes daily weight-bearing exercise (such as brisk walking and weight training), limiting alcohol intake, and not smoking. All of those lifestyle habits are linked to another benefit: warding off chronic disease. Take advantage of these “two-fers” and protect your bones if you aren’t already doing it.
The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, 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
Signs, Treatment and Prevention of Tendonitis
in Tendon InjuriesThe 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
Why It’s Important to Warm-Up Before Exercise With Osteoarthritis
in Health & Wellness, OsteoarthritisThe 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
The Connection Between Stress and Musculoskeletal
in MusculoskeletalArticle featured on Focus Physiotherapy
Stress is a normal part of life, and it can take many forms, including emotional, physical, and psychological stress. While stress can have a wide range of effects on the body, one of the most common is musculoskeletal pain. This type of pain is caused by tension in the muscles, tendons, and ligaments, and it can manifest in different areas of the body, such as the back, neck, and shoulders.
The connection between stress and musculoskeletal pain is well-established. Stress can cause the muscles to tense up, which can lead to pain, stiffness, and soreness. When the body is under stress, the nervous system releases a hormone called cortisol, which can increase inflammation and cause pain. Stress can also lead to poor posture and inactivity, which can further contribute to muscle pain.
One of the most common causes of musculoskeletal pain from stress is tension headaches. Tension headaches are caused by a tightening of the muscles in the head, face, and neck, and they can be triggered by emotional stress, such as anxiety or depression. Other common stress-related musculoskeletal pain includes: fibromyalgia, myofascial pain syndrome, and temporomandibular joint (TMJ) disorder.
There are a few ways to help alleviate stress-related musculoskeletal pain. Regular exercise can help to release tension in the muscles and improve overall physical and emotional well-being. Yoga, tai chi, and other mind-body practices can also be effective in reducing stress and pain. Additionally, stress management techniques such as deep breathing, meditation, and cognitive-behavioral therapy (CBT) can be beneficial in reducing pain and stress.
It is also important to have good sleep hygiene and maintain a balanced diet can help to manage stress and reduce pain.
In conclusion, the connection between stress and musculoskeletal pain is well-established. Stress can cause the muscles to tense up, leading to pain, stiffness, and soreness. Regular exercise, stress management techniques, good sleep hygiene, and a balanced diet can help to alleviate stress-related musculoskeletal pain. If pain is persistent or chronic, it is important to consult with a healthcare professional to determine the best course of treatment.
The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, 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
The Importance of Foot Health: Everything You Need to Know
in Feet, Foot PainArticle featured on Santiam Hospital & Clinics
Have you ever stopped to think about just how vital our feet are? They’re our primary mode of transportation and are essential in facilitating our mobility. However, we often overlook their health, even when we experience pain.
Our feet are important and we need to take better care of them. In this blog, we’ll talk about the importance of foot health and how to maintain healthy feet.
Why Foot Health Matters
Our feet are composed of 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments. When these parts work together in unison, we can stand, walk, run, and jump without any problems. However, when some of these parts are out of sync, it can cause a variety of foot problems.
Ignoring foot pain can cause the problem to worsen, leading to more severe discomfort and pain. Worse yet, untreated foot problems can lead to long-term joint or muscle damage, making it harder to walk and move.
That’s why it’s essential to take good care of our feet because they play a significant role in our overall well-being.
How to Maintain Healthy Feet
There are many things you can do to maintain your feet’s health. Here are some tips:
Choose the Right Shoes – Wearing the right shoes that fit correctly and offer support is essential in preventing foot problems. When shopping for shoes, look for those that provide adequate arch support, a firm heel counter, and room for your toes to move. Avoid shoes with pointed toes and high heels.
Keep Your Feet Clean and Dry – Wash your feet daily with lukewarm water and mild soap, making sure to dry them thoroughly, especially between the toes, to prevent fungal infections.
Trim Your Toenails Regularly – Trim your toenails straight across and avoid cutting them too short, as this can lead to ingrown toenails. File your nails gently afterward to smooth any rough edges.
Maintain a Healthy Weight – Being overweight can put additional pressure on your feet, leading to foot pain and discomfort. Exercise regularly, eat a healthy diet, and maintain a healthy weight to avoid these problems.
Visit a Podiatrist for Regular Check-ups – Podiatrists are foot and ankle specialists trained to treat a wide range of foot conditions. They can assist you in maintaining healthy feet and address any problems that arise.
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 Joint Replacement Surgery?
in Joint Pain, Joint ReplacementArticle featured on National Institute of Arthritis and Musculoskeletal and Skin Diseases
Joint replacement surgery is a procedure in which a surgeon removes a damaged joint and replaces it with a new, artificial part. A joint is where two or more bones come together, like the knee, hip, and shoulder. The surgery is usually done by a doctor called an orthopaedic (or-tho-PEE-dik) surgeon. Sometimes, the surgeon will not remove the whole joint, but will only replace or fix the damaged parts.
The doctor may suggest a joint replacement to improve how you live. Replacing a joint can relieve pain and help you move and feel better. Hips and knees are replaced most often. Other joints that can be replaced include the shoulders, fingers, ankles, and elbows.
What Can Happen to Joints?
Joints can be damaged by arthritis and other diseases, injuries, or other causes. Arthritis or simply years of use may cause the joint to wear away. This can cause pain, stiffness, and swelling. Diseases and damage inside a joint can limit blood flow, causing problems in the bones, which need blood to be healthy, grow, and repair themselves.
What is a New Joint Like?
A new joint, called a prosthesis (praas-THEE-sis), can be made of metal, plastic, or ceramic parts. It may be cemented into place or not cemented, so that your bone will grow into it. Both methods may be combined to keep the new joint in place. Your doctor will discuss these options with you.
When Should Joint Replacement Be Considered?
Your doctor may recommend joint replacement surgery when other treatments are not effective in relieving pain and helping you move. These include walking aids such as braces or canes, physical therapy, medicines, exercise, and weight loss.
Your doctor may also consider a different surgery that does not involve replacing the whole joint.
Joint replacement is often the answer if you have constant pain and can’t move the joint well—for example, if you have trouble with daily activities such as walking, climbing stairs, and taking a bath.
What Happens During Surgery?
First, the surgical team will give you medicine so you won’t feel pain (anesthesia). The medicine may block the pain only in one part of the body (regional), or it may put your whole body to sleep (general). The surgical team will then replace the damaged joint with a new artificial joint.
Each surgery is different. How long it takes depends on how badly the joint is damaged and how the surgery is done. Your doctor or someone on your doctor’s team will inform you how to prepare for surgery, how long it will take, and what to expect in the hours after surgery.
What Happens After Surgery?
Several things affect how soon you will be able to return home after joint replacement. These include the type of surgery that you have, your medical history and your support network at home. You may have some temporary pain in the new joint because your muscles are weak from not being used. Also, your body is healing. The pain can be helped with medicines and should end in a few weeks or months.
Physical therapy may help strengthen the muscles around the new joint and help you regain motion in the joint.
As you move your new joint and let your muscles grow strong again, pain will lessen, flexibility will increase, and movement will improve.
Are There Risks Associated with Joint Replacement?
Any surgery has risks. The risks of joint surgery will depend on your overall health and the health of your joints before surgery, and the type of surgery done.
After surgery, it is important to follow your doctor’s advice about what to eat, how to take your medicines, and how to exercise. Talk with your doctor about any pain or trouble moving.
Joint replacement is usually a success in most people who have it. When problems do occur, most are treatable. Possible problems include: infection, blood clots, loosening of the new joint, and nerve and blood vessel 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
Relationship Between Poor Posture and Spinal Degeneration
in SpineArticle featured on McNulty Spine
Poor posture not only looks sloppy, but it can also significantly impact your spinal health, leading to a degeneration of your intervertebral discs.
Why do discs degenerate?
Intervertebral discs are the shock-absorbing pads that sit between the vertebrae in our spine. They help distribute the forces on our spine during movement, such as walking or running. Over time, these disks can begin to degenerate, which can cause pain and discomfort.
Disc degeneration is a natural part of aging, but certain lifestyle factors can accelerate the process.
How poor posture leads to disc degeneration
One of the biggest factors that contribute to disc degeneration is poor posture. When you slouch or hunch over, you put more pressure on your lumbar spine, which can cause your discs to wear down more quickly. And when your discs lose their cushioning ability, your vertebrae lose their protection and rub against each other, leading to further damage and pain.
Sitting for long periods, especially if you slouch, exacerbates the problem. Plus, when you sit, you put more pressure on your discs than when you stand or walk, causing the discs to compress.
The bottom line is that poor posture can accelerate natural disc degeneration.
The link between sitting and disc degeneration
Unfortunately, most folks spend most of their day sitting at a desk or on the couch. If you sit a lot, it affects your spine in two ways.
Sitting reduces the amount of muscle activity in your lower back, which can cause the discs to bear more weight.
Sitting also places more pressure on your lower back than standing or walking, further contributing to disc degeneration.
How we treat posture-related disc degeneration
There’s no cure for disc degeneration — posture-related or otherwise — but Dr. McNulty can relieve your pain and other symptoms and slow the disease’s progression. You can do your part by adopting proper posture. As for our part, here are a few of the treatments Dr. McNulty uses, depending on your unique condition and symptoms.
Poor posture can significantly impact our spinal health, but you can avoid the problems by keeping your spine straight and neutral and taking breaks from prolonged sitting.
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