Article featured on Time
Orthopedic doctors have a bone to pick with all the people who forget they’re carrying a very important skeleton around every day. We might not be able to see our ribs or tailbone or humerus, but it’s still important to make bone health a priority—because it’s tied to every other aspect of well-being.
“Your bone health and joint health is really tied to your overall wellness and health,” says Dr. David Shau, an orthopedic surgeon and assistant professor at the Burnett School of Medicine at Texas Christian University. Consider, for example, that about 54 million Americans have osteoporosis, low bone mass, or both, and 2 million osteoporotic fractures occur annually. That number will exceed 3 million per year by 2040, researchers predict. “When that happens, you have a period of time where you have to heal and recover,” Shau says. “You can’t be active with your family. You can’t travel. You can’t exercise, so your cardiovascular health goes down, and you start seeing metabolic issues and other health issues.” It’s a potentially devastating chain of events, he says, that can spell trouble far into the future.
It’s never too early to start thinking about preserving your bones. Your bone density is highest when you’re in your mid-20s, Shau says, after which it typically starts to decline. That can lead to osteopenia, or decreasing bone density that isn’t yet low enough to be considered full-blown osteoporosis but is still associated with an increased risk of fractures. Once someone develops osteoporosis, they’re prone to experiencing fractures from even minor incidents—but since it’s a silent disease, many people don’t realize they have it until their bones start breaking.
With that in mind, we asked four orthopedic doctors what we can all do every day to protect and preserve our bone health.
1. Keep moving
People tend to think of bones as a static part of the body—but they’re actually dynamic, with old bone constantly breaking down and being absorbed into the bloodstream, and new bone forming. That process, called remodeling, is affected by lots of factors, including mechanical stress from weight-bearing exercise. For example: walking, climbing the stairs, playing sports like pickleball, doing push-ups, and jumping rope. “You’ll increase your bone density in the areas where the bone is seeing force,” says Dr. Jack Steele, an orthopedic surgeon at the University of Maryland St. Joseph Medical Center. “In areas where you’re not putting stress on the bone, your body will start to resorb that bone, and you’ll lose bone density—and that can lead to osteopenia or osteoporosis.” While these conditions aren’t reversible, they are treatable with a range of medications, and progression can be slowed, minimizing damage.
Patients often ask Steele how much they need to exercise; some like walking for 30 minutes a day, while others squeeze in two hours of tennis on the weekend. Either approach works. The most important thing, he tells them, is to be consistent and move around as regularly as possible, rather than allowing days to pass by without any activity.
2. If you’re in menopause, prioritize strength-training
A growing body of research suggests that menopause takes a toll on bone health. It can lead to a decline in bone density—increasing the risk of osteoporosis—as well as muscle loss from decreasing estrogen. One way to counteract that damage: lift weights. “It’s very important for women to add strength training into their routine, because there’s so much muscle and bone loss as you get into those perimenopausal and menopausal years,” says Dr. Pamela Mehta, an orthopedic surgeon and founder of Resilience Orthopedics in San Jose, Calif. If you’re new to weight lifting, consider doing some squats while holding free weights, or experiment with beginner-friendly moves like bicep curls and chest presses.
3. Focus on two essential nutrients
Lots of minerals and nutrients play a role in strengthening bones—but two deserve special attention. Calcium, which you can only get from food or supplements, is particularly important; if you don’t get enough, your body will start to pull it from your bones, making them weaker. Vitamin D, meanwhile, helps the body absorb calcium and plays a key role in preventing osteoporosis. “You really need to have a good quantity of both,” Shau says. Depending on age, most adults need 1,000 to 1,200 mg of calcium per day, and 15 to 20 mcg of vitamin D.
To boost your calcium intake, focus on dairy products like milk, cheese, and yogurt; almonds; dark leafy greens like kale; and soy products including tofu, he advises. Foods high in vitamin D, meanwhile, include egg yolks, tuna, sardines, salmon, and cheese.
4. Try to get sunlight every day
Basking in the sun is a great move for bone health. “When sunlight hits your skin, your body produces vitamin D,” Steele says. “You can get some vitamin D through your diet, but you get the majority through sunlight.” Of course, the sun can lead to plenty of negative effects, as well, so it’s important to proceed carefully: Aim to go outside when the UV Index is under 8, ideally in the early morning or evening hours, and always wear sunscreen. “It doesn’t need to be hours and hours,” he adds. “Even 30 minutes walking outside and being in the sun will produce vitamin D.” Plus, a sunny walk doubles as weight-bearing exercise—a win-win for your bones.
5. Consider calcium and vitamin D supplements
If you’re not getting enough calcium or vitamin D, you might benefit from supplements. How do you know if that’s you? Try keeping a food diary, suggests Dr. Christine Jablonski, who leads the bone health and osteoporosis program at Orlando Health. “You can look over it and see, on a typical day, what am I doing?” she says. If you’re getting at least 1,000 mg of calcium, you’re in good shape. If you’re consistently falling short, you can either make some dietary tweaks or talk to your doctor about starting a supplement.
Vitamin D is a little trickier to track, Jablonski acknowledges, especially since much of it comes from sun exposure. “A lot of people are deficient without knowing it,” she says. If you already have osteoporosis, your doctor should be doing regular blood draws to monitor your levels. If you haven’t been tested lately, bring it up at your next check-in with your primary care physician, especially if you’ve noticed symptoms of a possible deficiency, like bone pain, fatigue, or mood changes.
6. Double-check your medications
Certain medications are associated with poor bone health. For example: proton pump inhibitors (which are used to treat heartburn), selective serotonin receptor inhibitors, anticonvulsants that control seizures, glucocorticoids (steroid hormones), and the blood thinner heparin. “If you need them, you need them,” Jablonski says. But it’s possible you could talk to your doctor about switching to a different medication, or only staying on for a short time. “Always ask questions and do your own research with reliable sources,” she advises.
7. Go easy on the alcohol and caffeine—and quit smoking
Your caffeine or cocktail habit could be detrimental to your bone health. “Those things basically limit the ability of the body to heal,” Steele says. “The bone is always breaking down, and you’re always building new bone and then breaking it down.” Consuming too much alcohol or caffeine could disrupt that process, he adds, and cause you to lose bone mass over time.
The same goes for smoking: Research suggests that older adults who smoke are 30% to 40% more likely to break their hips than non-smokers. In addition to increasing the risk of osteoporosis, smoking slows the production of bone-forming cells and decreases the amount of calcium that’s absorbed. Some surgeons even refuse to operate on patients who smoke, Mehta points out, since smoking has a negative effect on post-op fracture healing; plus, smokers have more complications after surgery than nonsmokers. That’s why it’s always a good idea to try to quit, even if you’ve attempted before and failed.
8. Reduce your risk of falling
Taking steps to minimize your risk of falling is a terrific way to look out for your bones. “Especially as you get older, you want to be mindful of how your home is set up to reduce the risk of falling,” Shau says. That might mean removing hazards like boxes and electrical cords from walkways; employing nonslip mats in the shower; repairing loose floorboards; and placing night lights in hallways.
Shau hopes more people prioritize keeping their bones strong and healthy. “I want people to not blow off bone health,” he says. “It’s easy to think about things you can see, and to visualize things you can feel. But your skeleton is the foundation—the structural support of your whole body. We know the impact of bone health goes beyond the bones, and into the whole well-being of an individual.”
5 Do’s and Don’ts of Working Out After Injury
in RecoveryArticle featured on Hospital for Special Surgery
It can be tough to know how to safely return to exercise after you’ve been hurt.
Here’s how to get back to exercising after an injury.
1. Do check in with your doctor for a game plan.
First things first: If you have a persistent injury that you haven’t yet seen a doctor for, that’s step one. “The most important thing to do after an injury is to get the right diagnosis for treatment and a recovery plan,” Dr. Carr says. He explains that he customizes treatments and recovery programs based on his patients’ injuries and sports of choice. “Every injury is unique, and there are different demands on your body based on the activities you’re involved in. I won’t give the same advice to an equestrian that I would give to a soccer player, even for the same kind of knee injury.”
2. Don’t rush back too quickly.
If you were off for a week because of a shoulder injury, plan to take two weeks to get back to where you were before the injury,According to Dr. Carr, your recovery should last twice as long as the time that your injury kept you out of commission. “If you were off for a week because of a shoulder injury, plan to take two weeks to get back to where you were before the injury,” he says.
Keep in mind that the period in which you weren’t able to exercise or participate in sports affected more than just the injured area. “After a break, you lose strength, coordination and flexibility — not only where you were injured but also elsewhere in your body,” Dr. Carr says. That deconditioning, combined with adjusting your movements to compensate for weaker or painful areas, is how many people get hurt. “It’s common to come back from an injury and then get an injury in a different spot,” he says. “People with a hurt right knee will put more weight on their left side, for instance. That sets you up for another injury.”
3. Do start with small goals.
A journey of 1,000 miles starts with a single step — so do yourself a favor and make it a small one. “Go gradually, with the aim of slowly getting back to normal,” Dr. Carr says. Start with some easy stretching and strength training. “There are a variety of things you can do to regain flexibility and range of motion,” he adds, like Pilates or yoga. If you’re working out at home, try some flexibility training with dynamic (active) stretching.
As for strengthening, Dr. Carr advises starting with bodyweight or band exercises, cable machines or light weights. “Avoid Olympic weights and bench presses,” he says. “Increase your strength without loading your body too much. Then gradually work your way up to more weight.”
4. Don’t ignore pain.
Though we may enjoy the physical and mental challenges of being uncomfortable when we exercise, post-injury is not the time to push through pain. “Don’t be a hero,” Dr. Carr says. “Rehab is not the time to push it — don’t ignore pain, discomfort or other reactions in your body.”
Check in with your body before you exercise. “I tell patients that they need to have normal function for daily activities before they start exercising,” he says. “If you twinged your knee, and it hurts when you’re doing the dishes or walking up and down stairs, it’s going to hurt if you go for a four-mile run. Make sure you have no pain and full range of motion before loading the joint again. And if you’re feeling discomfort two days after exercise, or persisted through an activity despite pain, you’ve pushed too hard. Cut back on the effort.”
5. Do get back to what you love, once you’re ready.
Ultimately, you want to return to the exercises and activities you love — and you should! Once you’re pain-free, hit the courts or links for some limited play. “If you play tennis, for example, start with a few groundstrokes — but no serves,” Dr. Carr says. “See how you’re feeling during and after. The next time you go out, work the baseline a bit, maybe hit a couple serves. Work your way into it. Next time out, play a few points — a game or two. Then, by all means, test it out and play a match.”
Similarly, if your sport of choice is golf, start with chipping and putting. “Then play nine,” he says. “If that feels OK, go ahead and play 18 next time.”
“You want a nice, gradual return,” Dr. Carr says. “That’s how the pros do it. The skills will come back.”
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 to Select the Best Athletic Shoes for You
in Ergonomics, FeetArticle featured on Foot Cared MD
How Do I Pick Athletic Shoes?
Gym shoes, sport shoes, sneakers — whatever you call them, proper-fitting athletic shoes can enhance performance and prevent injuries. Follow these fitting tips from foot and ankle orthopaedic surgeons when purchasing your next pair.
What Type of Athletic Shoe Should I Get?
Athletic shoes can vary in design, material, and weight. These differences have been developed to protect the areas of the feet that are most stressed during a particular athletic activity.
What Should I Look for in an Athletic Shoe?
Running Shoes
Conventional thinking suggests that a good running shoe should have ample cushioning to absorb shock, but there are advocates for minimalist running shoes that have almost no cushioning. No data exist to say which type of shoe is better.
If you choose a cushioned shoe, look for overall shock absorption, flexibility, control, and stability in the heel counter area (a hard insert used to reinforce the heel cup of a shoe), as well as lightness and good traction. These features may help prevent shin splints, tendinitis, heel pain, stress fractures, and other overuse injuries.
Walking Shoes
If walking is your activity of choice, look for a lightweight shoe with extra shock absorption in the heel of the shoe and especially under the ball of the foot. This will help reduce heel pain as well as burning and tenderness in the ball of the foot. A shoe with a slightly rounded or rocker sole (the entire part of the shoe that sits below the foot) also helps to encourage the natural roll of the foot during the walking motion. You should also look for a comfortable soft upper (the entire part of the shoe that covers the foot) and smooth tread (the part of the sole that touches the ground).
Aerobic Shoes
Shoes for aerobic conditioning should be lightweight to prevent foot fatigue and have extra shock absorption in the sole beneath the ball of the foot, where the most stress occurs. If possible, work out on a soft surface (e.g., a carpet).
Tennis Shoes
Tennis players need a shoe that supports the foot during quick side-to-side movements or shifts in weight. Look for a shoe that provides stability on the inside and outside of the foot. Flexibility in the sole beneath the ball of the foot allows repeated, quick forward movements for a fast reaction at the net. On soft courts, wear a softer soled shoe that allows better traction. On hard courts, you want a sole with greater tread.
Basketball Shoes
If basketball is your sport, choose a shoe with a thick, stiff sole. This gives extra stability when running on the court. A high-top shoe may provide added support but won’t necessarily decrease the risk of ankle sprain or injury.
Cross Trainers
Cross-training shoes, or cross trainers, combine several of the above features so that you can participate in more than one sport. A good cross trainer should have both flexibility in the front of the foot needed for running and lateral control necessary for aerobics or tennis.
You do not necessarily need a different pair of shoes for every sport in which you participate. Generally, you should wear sport-specific shoes for sports you play more than 3 times a week.
You may need a special shoe to address specific foot and ankle problems. For example, if your ankles turn easily, you may need to wear a shoe with a wide heel. If you have trouble with shin splints, you may need a shoe with better shock absorption. Talk to your foot and ankle orthopaedic surgeon if you have concerns.
Other Design Features
Special features in construction will make athletic shoes more comfortable as well as help prevent injury:
What If I Develop Foot Problems?
If you begin to develop foot or ankle problems, simple adjustments in the shoes may relieve the symptoms. Many of these devices are available without prescription.
Talk to your foot and ankle orthopaedic surgeon if you are experiencing foot or ankle problems. Working with your surgeon along with pedorthists and orthotists (specialists trained to make and modify shoe inserts) will ensure you get the right shoe for the best possible 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
Identifying and Treating Early Orthopedic Conditions in Children
in Health & Wellness, Nutrition & General Health, PreventionThe 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
Nourishing Your Body for Optimal Orthopedic Surgery Recovery
in Nutrition & General Health, Surgery RecoveryThe 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 Hand Conditions or Injuries That May Require Surgery
in Carpal Tunnel, Finger Injuries, Hand Diseases, Hand Fractures, Hand 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
3 Common Running Injuries and Prevention
in Joint Replacement, Prevention, Sports Related Injuries, Wellness TipsThe 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
Emergency Orthopedic First Aid: How to Handle Traumatic Situations
in General Orthopedics, Nutrition & General Health, PreventionThe 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
8 Tips for Stronger Bones
in Bone HealthThe 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
A Guide to Managing Arthritis Pain Throughout the Body
in Arthritis, General OrthopedicsThe 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 to Stay Healthy When Exercising
in Health & WellnessThe 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