Common Swimming Overuse Injuries

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Article featured on Physiopedia

Swimming is a great sport enjoyed by all age groups at all levels of ability. It is a unique sport, in that it combines upper and lower extremity strength exercises with cardiovascular training in a non-weight bearing environment. Swimmers are unfortunately prone to injuries. Most swimming injuries are classed as overuse injuries and relate to faulty biomechanics. The most common swimming injury regions are the shoulder, neck, lower back and knee.

Swimming overuse injuries usually arise from one or a combination of the below:

  • Poor stroke mechanics
  • Poor breathing technique
  • Poor flexibility or range of motion of neck or lower back
  • Hyper flexibility of joints with insufficient muscular stabilisation
  • Decreased rotator cuff or scapular muscle strength
  • Insufficient core strength/stability
  • Decreased hip muscle strength
  • Overtraining
  • Insufficient rest periods

Stretching is important for swimming because of the great range of muscles used when you’re in the water.  Unprepared muscles don’t perform as well as muscles which have been warmed up ahead of exercising. A good stretching regime including at a minimum:

  • posterior shoulder stretch
  • pectoral stretch
  • long head biceps stretch
  • upper thoracic spine mobility stretch
  • latissimus dorsi

Note – The above list gives a guide to what to look for in each of the specific conditions listed below. This page does not give full physiotherapy procedures, instead providing great links to the sites that will have relevant information.

Swimmers Shoulder

Shoulder pain is the most frequent orthopaedic injury in swimmers, with a reported prevalence between 40% and 91% in elite swimmers. Swimmer’s shoulder is a condition with a gradual onset due to repetitive activity and can be classified as microtrauma. Swimmer’s shoulder usually presents as subacromial impingement involving the rotator cuff tendon, bicipital tendon, or subacromial bursa.

Primary subacromial impingement involves compression of these structures between the acromion and greater tuberosity (due to usually a tight posterior capsule causing the humeral head to migrate anteriorly) or abnormal acromial morphology. However, primary impingement syndrome is less common in competitive swimmers than secondary impingement.

Secondary impingement occurs through a series of impairments, usually in a swimmer with increased anterior glenohumeral laxity (shoulder ROM in swimmers often exhibit excessive external rotation and limited internal rotation). This shift in ROM towards increased external rotation is an adjustment to the demands on the glenohumeral joint allowing anterior laxity and greater demand on the rotator cuff and the long head of the biceps to reduce humeral head elevation and anterior translation.

Chronic swimmer’s shoulder can result in pathology of the rotator cuff, glenoid labrum, and long head of the biceps.

Swimmers Back

The spine is also a recognized site predisposed to injury in the elite swimmer, mainly associated with butterfly swimmers ( 33.3%-58%) and breaststroke swimmers (22.2%- 47%), figures varying from differing studies.

As swimming athletes are positioned horizontally in the water, gravity and buoyancy forces are traveling through the body with the potential to cause changes at the lumbar spine. Due to the undulating motion (lumbar extension) utilised in butterfly and breaststroke, there is potential for developing pain secondary to stress on the joints.

Causes include:

  • Hyperextension of the lumbar spine during freestyle and butterfly
  • poor kick technique
  • stress fractures are a potential cause in young swimmers
  • disc degeneration and facet joint degeneration in the older swimmer. A 2007 study hypothisising that “Excessive competitive swimming activities accelerate lumbar disk degeneration” this activity may exaggerate lumbar intervertebral disk degeneration, especially in the L5-S1 intervertebral segment.
  • improper timing of this butterfly stroke increases strain on low back the possibility of neck, shoulder, or back pain.
  • poor flexibility of the spine and low back
  • insufficient core strength to maintain straight alignment of body in water
  • aggressive weight training using poor techniques
  • overuse of devices e.g. paddles on hands, fins, kick boards- exposing the open kinetic chain of swimming to different loads and exaggerating lumbar lordosis
  • tightness in the hip flexors or inadequate body roll during swimming may lead to compensation at the lumbar spine.

Swimmers Knee

Knee pain figures range from 34% to 86% for a single knee episode, being highest in breaststrokers.

Knee pain is caused mainly during breaststroke swimming. Repetitive stress is placed on the medial knee produces pain during the whip-like motion. The breaststroke kick is a high valgus load produced during sudden flexion-extension, adduction and external rotation of the knee against the hydrodynamic environment, resulting in stress to the medial compartment. Hence a strain occurs to the medial collateral ligament and compression on the lateral knee (possibly causing sprain on the MCL; irritation of the medial plica; bursal irritation at the muscular insertions of the adductor and hamstring muscles). Strain injuries may also present in the adductor muscles (adductor magnus and brevis, especially). Other knee injuries include patellofemoral pain, and medial synovitis. Treatment will focus on elimination of inflammation. Rehabilitation should focus on stabilisation exercises for hypermobile joints, postural correction, strengthening and flexibility.

A 2008 study found the 200 – 400 m breaststroke events increase the risk for knee overuse injuries more than other strokes or distances. Additionally training for more than four times a week increases the risk twofold for knee and fourfold for shoulder overuse injuries.

A 2004 study looking at competitive swimmers interestingly reports that breaststroke swimmers are at significant risk of: groin injury; groin injury is positively correlated with increased magnitude of breaststroke training; and groin injury may prevent participation in practices and competitions. So take the time to assess then groin and complete length of hip adductors, not just distally.

Swimmers Neck

Neck pain is mainly seen in the older athlete It may be due to facet joint arthritic change, and disc degeneration +/- nerve root irritation.  Muscle innervation and sensation to the shoulder region is predominantly derived from the C5/C6 nerve roots.  If these nerve roots are irritated due to degenerative change in the neck, shoulder complaints can arise.  Arthritic change may limit neck rotation making correct breathing patterns difficult.  Swimmers who unilaterally breath are more prone to neck pain.  Looking forward rather than directly downward and extending the head too high when taking a breath increases the load on the neck and create pain.

Conclusion

Swimming can be a great sport for recreational swimmers up to elite swimmers. As a physiotherapist help swimmers overcome their injuries and liaise with trainers, coaches and physicians for the best results.

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 Connection Between Your Posture & Physical Health

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Article featured on Watauga Orthopedics

Have you ever observed a ballet dancer’s poise, a yogi’s alignment, or an athlete’s stance? All these individuals have one thing in common – good posture.

Posture is more than just standing tall; it refers to maintaining the correct alignment of your body parts supported by the right amount of muscle tension against gravity. It plays a significant role in our overall physical health.

In this blog, we’ll delve into the connection between posture and physical health and share some practical tips for improving posture with the help of physical therapy.

Understanding Posture

Posture is more than just standing straight—it’s the position in which you hold your body while sitting, standing, or lying down. Good posture refers to the correct alignment of body parts supported by the right amount of muscle tension against gravity.

It can reduce the chance of injury or long-term health issues, but in practice, it’s a habit that’s challenging for most to maintain.

The Connection Between Posture and Physical Health

Poor posture can lead to numerous health issues, some of which may seem unrelated at first glance. Let’s delve deeper into how posture affects our health.

  • Back and Neck Pain: Poor posture is one of the leading causes of back and neck pain. Slouching or hunching over can put extra stress on the muscles and ligaments that support the spine, leading to discomfort and pain over time.
  • Joint Wear and Tear: Incorrect posture can lead to abnormal wearing of joint surfaces, which could result in conditions like arthritis.
  • Fatigue: When we don’t use our bodies efficiently, we end up expending more energy. This can make us feel tired and fatigued.
  • Breathing Issues: Poor posture can also affect your lung capacity. Slumping or slouching can compress your lungs, making it harder for them to expand fully when you breathe.
  • Digestive Problems: Believe it or not, your posture can even impact your digestion. Sitting or standing improperly can compress your organs, slowing down the digestive process.

How Physical Therapy Can Help Improve Your Posture and Physical Health

Here is how physical therapy can help improve your posture and overall physical health.

Posture Assessment

The first step in improving your posture through physical therapy is a thorough posture assessment. During this evaluation, a physical therapist will observe you from different angles as you sit, stand, and move. This comprehensive assessment allows them to identify any postural deviations or imbalances that may be contributing to discomfort or potential health issues.

For instance, they may check if your shoulders are level, if your head is straight, and if the spaces between your arms and sides are equal. They might also assess the alignment of your knees and ankles. These observations help the therapist understand your body’s unique mechanics and pinpoint any areas of concern.

Personalized Exercise Program

Once the physical therapist has a clear understanding of your postural habits, they can design a personalized exercise program tailored to your needs. This program typically includes specific exercises aimed at strengthening weak muscles and stretching tight ones, both of which contribute to poor posture.

For example, if your assessment reveals a forward head posture (common among people who work on computers), your physical therapist might suggest exercises to strengthen your neck and upper back muscles.

Similarly, if you have a slouched posture, exercises focusing on opening the chest and strengthening the core could be beneficial.

Ergonomic Recommendations

Another critical aspect of improving posture through physical therapy is making ergonomic adjustments. Ergonomics refers to the science of designing and arranging things individuals use so that the people and things interact most efficiently and safely.

A physical therapist can provide recommendations for setting up your workspace, home, or even car in a way that supports good posture. This might include suggestions for the right type of desk chair, the positioning of your computer monitor and keyboard, or even the kind of shoes you should wear.

These modifications can significantly reduce strain on your body and improve your posture over time.

Education

A physical therapy provider can also offer necessary education on improving posture. Typically, they recommend tips such as:

  • Practicing Mindful Sitting: A physical therapist can instruct you on the correct way to sit. This typically involves keeping your feet flat on the floor, your back straight, and your shoulders relaxed.
  • Maintaining a Healthy Weight: Excess weight can put additional strain on your muscles and ligaments, leading to poor posture. A physical therapist can provide advice on diet and exercise to help you maintain a healthy weight.
  • Being Mindful of Your Posture Throughout the Day: It’s easy to forget about your posture during the course of a busy day. A physical therapist can teach you techniques to remind yourself to check your posture regularly, such as setting reminders on your phone or associating posture checks with specific daily activities.
  • Getting Regular Sleep: Poor sleep can contribute to muscle fatigue and tension, making it harder to maintain good posture. Your physical therapist can provide tips on creating a sleep-friendly environment and establishing a regular sleep schedule.
  • Avoiding Prolonged Static Positions: Staying in one position for extended periods can lead to muscle fatigue and strain. Your physical therapist can advise you on taking regular breaks to move and stretch your body.

Regular Follow-ups

Like any treatment plan, improving posture through physical therapy requires consistent effort and regular follow-ups. These sessions allow the therapist to monitor your progress, address any new concerns, and adjust your treatment plan as needed.

During these follow-ups, your physical therapist may reassess your posture, review your exercise program, and make necessary modifications based on your progress. They also provide an opportunity for you to discuss any difficulties or challenges you’re experiencing, ensuring a smooth and successful posture correction journey.

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

Microdiscectomy: A Modern Fix for Disc Herniation

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What is microdiscectomy?

Microdiscectomy is a surgical procedure for the relief of pain and other symptoms that occur when a herniated disc in the spine presses on an adjacent nerve root. During the operation, the surgeon frees the nerve by removing small fragments of disc, bone and ligament.

Microdiscectomy is sometimes described as a minimally invasive spine surgery, because it requires only a small incision and the use of a microscope or surgical glasses, called loupes, to magnify the site where the injury has occurred. The surgeon also uses smaller tools and instruments to work in the restricted space of the spine. Microdiscectomy is a type of spinal decompression surgery, and the term microdecompression – which describes the surgical removal of any bone or ligament that is compressing a nerve – may also be used to describe the procedure. However, the term “microdiscectomy” is more specific to the removal of the fragment of herniated disc tissue that is causing the patient’s symptoms.

Because most patients will recover from a herniated disc without surgery, microdiscectomy is recommended only after conservative treatment, including physical therapy, cortisone shots, and other medication have been tried for a period of at least 6 to 12 weeks, without bringing relief. In some cases, motor weakness may be a reason to have this surgery sooner. Patients with cauda equina syndrome require immediate surgical intervention. This is a condition in which pressure on the nerves in the lower portion of the spine affects bladder and bowel function, but it affects less than 1% of people.

How does a surgeon perform a microdiscectomy?

Microdiscectomy surgery may be approached using one of three minimally invasive techniques to gain access to the herniated disc and nerve: a midline, tubular or endoscopic microdiscectomy.

Historically, a traditional discectomy required a large incision and involved removal of the entire disc. Today, with the availability of advanced techniques and equipment, almost all spine surgeons perform microdiscectomies. The procedure usually results in rapid, and sometimes immediate, pain relief.

Microdiscectomy techniques

  • A midline microdiscectomy, in which the surgeon makes a one to two-inch vertical incision in the back, lifts the surrounding muscles off the vertebrae, and uses instruments to hold apart the layers of tissue during the procedure.
  • A tubular microdiscectomy, in which the surgeon inserts a series of small tubes or dilators through a small incision to create a corridor through the muscle in which to operate, thereby causing less disruption to this tissue.
  • Endoscopic microdiscectomy (sometimes also known as microendoscopic discectomy), in which an even smaller incision is made and the surgeon employs a miniaturized camera and instruments; this approach also involves less disruption to surrounding tissues.

What are the benefits of a microdiscectomy?

Regardless of which particular microdiscectomy technique selected, the surgical goal is the same: to remove the disc fragment and any bone or ligament that may be compressing the nerve root. To do so, the surgeon creates a small window in the vertebra (a procedure also called a laminotomy) and pulls away the ligamentum flavum, the underlying tissue, to reveal the dura (the covering of the spine) and the nerve root. The herniated part of the disc is then removed to complete the nerve decompression.

Imaging techniques, including X-rays, are used before, and sometimes during, the surgery to ensure localization of the correct operative site.

While herniated discs may occur in almost any level of the spine, lumbar microdiscectomy – surgery in the lower portion of the back – is the most common site for this procedure.

How long does a microdiscectomy take?

On average, microdiscectomy surgery takes between 30 to 60 minutes to complete. However, because patients are given general anesthesia and must spend time afterward in the recovery room for a period of monitoring, the total time usually extends to about two hours.

In almost all cases, people undergoing microdiscectomy may return home the same day. Upon discharge from the hospital, patients are typically given a small amount of pain medication – including acetaminophen or small dose of opioid medication – and a muscle relaxant with instructions regarding postsurgical care and how to taper these medications appropriately. Special emphasis is given to symptoms that signal the need for immediate medical attention, including muscle weakness, change in bladder or bowel function, and extreme and unexpected back or leg pain.

What complications can occur with microdiscectomy?

During surgery, multiple safety measures are followed to control bleeding, prevent infection and avoid injury to any surrounding tissues. Rarely, a tear in the dura (the tissue surrounding the spinal nerves) may occur. The surgeon repairs this with a suture or a patch made of collagen.

What is the expected microdiscectomy recovery time?

Following a two-week period of rest to allow the soft tissues to heal, many patients feel well enough to return to work. However, microdiscectomy recovery typically requires a six-week period of modified activity and includes a course of physical therapy starting at week two or three.

Physical therapists focus on helping patients strengthen core muscles and loosen stiff joints, as well as creating a home exercise program to help protect the spine. All patients are cautioned to ease back into their previous routines gradually, especially those whose work requires physical labor. Because sitting in a chair and leaning forward places pressure on the spine, people with more sedentary jobs also need to be attentive to their posture and take a short walk or do some gentle exercise every hour or so.

Patients who plan to resume driving after surgery must wait until they are pain-free, finished with any medication that causes drowsiness, and able to both shift their foot between pedals and turn in their seats easily and without pain. To test individual comfort, a practice drive in a parking lot or other safe space, in the company of another driver is recommended before returning to regular roadways.

Is a microdiscectomy painful?

Following surgery, most patients do well with a small amount of non-opioid pain medication and a drug that relaxes the muscles. While there is some discomfort associated with the surgical incision, many patients experience rapid relief of the pain caused by the herniated disc.

In patients who have experienced nerve compression and associated symptoms over an extended period, pain relief may take longer. When leg pain has been the primary symptom, the pain typically retreats up the leg over time. In addition, patients may experience muscle cramping or mild numbness or tingling after surgery which typically resolves with time.

Who is eligible for microdiscectomy?

Most patients with herniated discs that do not respond to a trial of medication and physical therapy over time, are eligible for a microdiscectomy. While the condition is usually seen in individuals aged 30 to 50, it does occur outside this age range.

Herniated discs are rare in children and young adults, who are more frequently able to recover without surgical intervention. Microdiscectomy may be appropriate for adults in their 80s or 90s, though they should be cautioned that there is an increased chance of medical or surgical complications in this population.

How successful is microdiscectomy?

Overall, microdiscectomy success rates are excellent, with many patients expressing a high degree of satisfaction with the outcome. Careful presurgical screening and evaluation, as well as patient commitment to maintaining good spine health following microdiscectomy, contribute to the success of the surgery.

It should be noted that some people with herniated discs are also found to have other issues in the spine that are causing nerve-related pain and disability. In such cases, additional procedures such as a laminectomy – removal of the lamina (bony roof over the spinal canal) in one or more vertebrae, may be required if it is felt that these issues are contributing to their disability.

Can microdiscectomy be used on a disc that herniates a second time?

In cases of disc reherniation, microdiscectomy can be performed for a second time on the same disc, often with good results. However, if herniation occurs in the same disc a third time, a different type of treatment will be recommended.

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

Does a Herniated Disc Need Surgery to Heal?

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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 Back Pain Myths

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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

 

Inventive Kyphosis Treatment Through Personalized Plan

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Article featured on Rothman Orthopedics

Kyphosis, commonly referred to as a forward curvature of the spine, is a condition that can cause significant discomfort and affect the quality of life. It can result from various factors, including poor posture, spinal abnormalities, or conditions such as osteoporosis. Fortunately, advancements in medical science and personalized treatment plans are revolutionizing the way we address this condition. In this blog post, we will delve into the journey of kyphosis correction and the pioneering personalized treatment plans that are transforming patient outcomes.

Understanding Kyphosis: More Than Just a Hunch

Kyphosis presents as an exaggerated forward rounding of the upper back, often leading to a noticeable hunch. While mild kyphosis may not cause major issues, severe cases can result in pain, breathing difficulties, and limited physical function. This condition can affect individuals of all ages, though it is particularly prevalent among older adults and adolescents experiencing growth spurts.

The Importance of Early Diagnosis

Early diagnosis is crucial in managing kyphosis effectively. Comprehensive evaluations involving physical examinations, patient history, and imaging studies (like X-rays or MRIs) help in determining the severity and underlying causes of the curvature. Recognizing the condition early allows for timely intervention, which can prevent further progression and complications.

Personalized Treatment Plans: A Game Changer

No two patients are the same, and neither are their kyphosis conditions. Personalized treatment plans consider the individual’s specific condition, overall health, and lifestyle. This tailored approach ensures that each patient receives the most effective and appropriate care. Here’s how personalized treatment plans are transforming kyphosis correction:

  • Holistic Assessment: A thorough assessment of the patient’s medical history, lifestyle, and specific kyphosis characteristics forms the foundation of a personalized treatment plan. This holistic approach allows for a comprehensive understanding of the patient’s needs. Factors such as the severity of the curvature, the patient’s age, activity level, and overall health are all considered to create a plan that is uniquely suited to the individual.
  • Non-Surgical Interventions: For many patients, non-surgical options are the first line of defense. These may include physical therapy to strengthen the back muscles, improve posture, and increase flexibility. Bracing can also be effective, especially in younger patients whose bones are still growing. Customized exercise programs and ergonomic adjustments can also play a significant role in managing symptoms and improving quality of life.
  • Minimally Invasive Procedures: Advances in medical technology have led to the development of minimally invasive procedures that can correct kyphosis with reduced recovery times and fewer complications. Techniques such as vertebroplasty or kyphoplasty involve stabilizing the spine with small incisions, offering a quicker return to normal activities. These procedures are particularly beneficial for older adults or those with osteoporosis, where traditional surgery may carry higher risks.
  • Surgical Solutions: In severe cases where non-surgical methods are insufficient, surgery may be required. Modern surgical techniques are highly precise, aiming to correct the curvature while minimizing risks. Personalized surgical plans ensure that each patient’s unique anatomy and needs are considered, leading to better outcomes. Advanced surgical techniques, including spinal fusion and osteotomy, are tailored to correct the specific type and location of the curvature.
  • Post-Treatment Rehabilitation: Recovery doesn’t end with treatment. Personalized rehabilitation programs, including physical therapy and lifestyle modifications, are essential for maintaining the correction and preventing recurrence. Continuous monitoring and follow-ups ensure that the patient’s progress is on track. Rehabilitation may also involve pain management strategies and patient education to promote long-term spinal health.

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

Scoliosis: Causes and Treatments

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Article featured on Johns Hopkins Medicine

What is scoliosis?

The spine is made up of a stack of rectangular-shaped building blocks called vertebrae. When viewed from behind, the spine normally appears straight. However, a spine affected by scoliosis is curved — often appearing like an S or C — with a rotation of the vertebrae. This curvature gives the appearance that the person is leaning to one side.

Scoliosis is determined when the curvature of the spine measures 10 degrees or greater on an X-ray. Spinal curvature from scoliosis may occur on the right or left side of the spine, or on both sides in different sections. Both the thoracic (mid) and lumbar (lower) spine may be affected by scoliosis. Scoliosis is a type of spinal deformity.

In more than 80 percent of cases, the cause of scoliosis is unknown — a condition called idiopathic scoliosis. In other cases, scoliosis may develop as a result of degeneration of the spinal discs, as seen with arthritis, osteoporosis or as a hereditary condition that tends to run in families.

What are the different types of scoliosis?

Congenital Scoliosis

In congenital scoliosis, spinal curvature develops because of misshapen vertebrae. The diagnosis of congenital scoliosis may be made in early infancy if outward signs are present, but many cases are diagnosed later in childhood.

As a child grows, scoliosis may worsen, and asymmetries in the body may develop. Typically, congenital scoliosis is treated with a “watch and wait” approach. Surgery is considered only if a curve is clearly getting worse and the child is facing ongoing deformity and risk of future pain.

Idiopathic Scoliosis

Doctors, nurses and scientists have been studying the natural history and genetics of scoliosis for decades, but to this day, the cause of idiopathic scoliosis is still unknown. But we do know that the most common time for idiopathic scoliosis to develop is at the onset of adolescence, or around the age of 10. We also know that growth can make it worse, and we should be most concerned about scoliosis in a child that has significant growth remaining.

When diagnosed in children 2 or younger, this type of scoliosis is called infantile idiopathic scoliosis.

Neuromuscular Scoliosis

A child with an underlying neuromuscular condition is at higher risk for developing scoliosis. A straight spine requires normal muscle balance and strength in the torso. In conditions such as cerebral palsy, spina bifida and muscular dystrophy, the muscles are often weak and unbalanced, leading to the development of a spinal curvature.

A child with neuromuscular scoliosis is given the option of wearing a scoliosis brace that may slow or prevent the worsening of the condition. Surgical intervention is offered when the curve has reached the tipping point of 50 degrees. Over time, these curves will continue to worsen, leading to progressive imbalance of the torso. Beyond 80 degrees, breathing challenges develop as space for the lungs decreases.

What are the symptoms of scoliosis?

The following are the most common symptoms of scoliosis. However, each individual may experience symptoms differently. Symptoms may include:

  • Difference in shoulder height
  • The head isn’t centered with the rest of the body
  • Difference in hip height or position
  • Difference in shoulder blade height or position
  • When standing straight, difference in the way the arms hang beside the body
  • When bending forward, the sides of the back appear different in height
  • Prominence or asymmetry in the ribs seen from the front or back

The symptoms of scoliosis may resemble other spinal conditions or deformities, or may be a result of an injury or infection. Always consult your doctor for a diagnosis.

Symptoms that are not commonly associated with idiopathic scoliosis are back pain, leg pain, and changes in bowel and bladder habits. If a person is experiencing these types of symptoms, he or she requires immediate further medical evaluation by a doctor to determine the cause of the symptoms.

How is scoliosis diagnosed?

Early detection of scoliosis is most important for successful treatment. In addition to a complete medical history and physical examination, an X-ray is the primary diagnostic tool for scoliosis. In establishing a diagnosis of scoliosis, the doctor measures the degree of spinal curvature on the X-ray.

The following additional diagnostic procedures may be performed for nonidiopathic curvatures, atypical curve patterns or congenital scoliosis:

  • MRI. This diagnostic procedure uses a combination of large magnets and a computer to produce detailed images of organs and structures within the body.
  • CT scan. This diagnostic imaging procedure uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays.

How is scoliosis treated?

The goal of treatment is to stop the progression of the curve and prevent deformity. Observation and repeated examinations — also referred to as the “watch and wait” approach — may be necessary to determine if the spine is continuing to curve. These are used when a person has a curve that is less than 20 degrees and who is still growing.

For actively growing children with scoliosis curves between 20 and 50 degrees, bracing is recommended. An external torso brace, or TLSO, is worn for a prescribed number of hours. The brace applies corrective pressure to the growing spine, preventing further worsening of the scoliosis. Surgery is a recommended treatment option for a child with severe scoliosis or a curve that has worsened to more than 50 degrees.

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

Posture Perfect: Improving Alignment for Back Health

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Article featured on Orthopaedic Associates

In our busy lives, we often forget the significance of good posture. Did you know that maintaining proper alignment can have a profound impact on your spinal health and overall quality of life?

In this article, we will explore the importance of posture and how you can work toward having better posture for a healthier you.

The Importance of Good Posture

Good posture does more than just keep you looking confident. It ensures that your body functions optimally by:

  • Reducing the risk of pain and injuries.
  • Improving breathing.
  • Aiding digestion.

When it comes to back health, posture plays a pivotal role. A well-aligned spine reduces stress on muscles and ligaments, decreasing the risk of chronic pain and degenerative diseases.

Steps to Improve Posture

Improving your posture is a proactive approach to maintaining a healthy back and overall well-being. Here are steps you can take to enhance your posture:

1. Awareness and Identification

The first step to better posture is self-awareness. Pay attention to how you sit, stand, and move throughout the day and identify any habits that contribute to poor posture. This may include:

  • Slouching
  • Hunching over devices
  • Leaning to one side while sitting

2. Regular Posture Checks

Set reminders to check your posture regularly, especially if you have a desk job or spend hours on a computer. Ensure that:

  • Your shoulders are relaxed.
  • Your spine is aligned.
  • Your feet are flat on the floor.

Making these adjustments a habit can significantly improve your posture over time.

3. Core Strengthening

Maintaining a strong core is an essential component of good posture. Incorporate core-strengthening exercises into your fitness routine. Planks, bridges, and leg raises are all effective exercises that target the muscles supporting your spine.

4. Stretching Exercises

Stretching helps alleviate muscle tension and promotes flexibility. Focus on stretching your:

  • Chest
  • Shoulders
  • Hip flexors
  • Hamstrings

These stretches can counteract the effects of prolonged sitting and contribute to better posture.

5. Proper Ergonomics

If you have a desk job, make sure that your workspace is ergonomic. Level your chair, desk, and laptop or computer monitor to promote good posture. You should ensure that your chair supports your lower back and that your screen is at eye level to reduce strain on your neck.

6. Posture-Friendly Furniture

Invest in furniture that encourages good posture. Supportive chairs with lumbar support, ergonomic pillows, and standing desks can all contribute to maintaining proper alignment.

7. Mindful Sitting and Standing

Be mindful of your posture while you are sitting or standing. Imagine a string pulling the top of your head toward the ceiling to help you sit or stand tall. You should also distribute your body weight evenly between both feet when standing to prevent favoring one side.

8. Use Props

Consider using props, like cushions or lumbar rolls, to maintain correct spinal alignment while sitting. These props can help you maintain the natural curve of your lower back.

9. Regular Breaks

Don’t forget to pause and rest frequently throughout the day, particularly when your work involves minimal movement. Take a moment to stand up, stretch out your muscles, and walk around every hour. This can ward off tight muscles and encourage healthier posture.

10. Consult a Professional

If you are struggling with posture issues or experiencing persistent back pain, consult a healthcare provider or physical therapist. They can provide personalized guidance, exercises, and therapies to address your specific posture-related concerns.

By incorporating these steps into your daily routine and being mindful of your posture, you can make significant progress toward achieving better alignment and a healthier back.

When to Seek Medical Attention for Back Pain

While self-care can help with back pain, certain signs warrant a visit to a healthcare provider. Common signs you should seek medical attention for your back pain include:

  • Persistent or Severe Pain: If back pain persists or worsens over weeks, consult a doctor.
  • Leg Pain and Numbness: Pain radiating down the leg with numbness or weakness may signal nerve issues.
  • Recent Trauma: After an accident or injury, get a medical evaluation to rule out serious damage.
  • Loss of Bladder or Bowel Control: Sudden loss of control requires immediate medical attention.
  • Unexplained Weight Loss: Weight loss with back pain may indicate underlying health problems.
  • History of Cancer: Back pain in cancer survivors should be discussed with a healthcare provider.
  • Fever or Infection Symptoms: Back pain with fever or signs of infection needs medical assessment.
  • Difficulty Walking: If back pain impairs walking or causes leg weakness, consult a doctor.
  • Previous Spinal Surgery: Post-surgery pain changes should be discussed with your surgeon.

In these cases, seeking medical advice is essential for a thorough evaluation and appropriate treatment.

Remember, early detection and intervention can lead to better outcomes for back pain and related conditions.

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

Scoliosis in Children

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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

Back Pain After Pregnancy

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Article featured on Spine-Health

Persistent or newly developed pain in the lower back after pregnancy, also known as postpartum back pain, usually lasts for 6 months but may continue up to a decade. Postpartum back pain mostly occurs while performing activities that involve body movements, such as walking, lifting, bending, and/or carrying the new baby, and may be relieved with rest, exercise, and home treatments. The type and severity of pain depend on the underlying cause.

Causes of Postpartum Back Pain

The vast majority of women who experience postpartum back pain develop the symptoms due to pregnancy-related changes in the musculoskeletal system that persist after delivery. In some cases, women may undergo bodily trauma during childbirth that directly involves the lower back and pelvic bones, joints, and/or soft tissues, causing additional pain and discomfort. The type of delivery—vaginal, instrumental, or cesarean section (C-section) may also have a role to play in postpartum back pain.

Loss of muscle tone and joint instability

The effects of pregnancy on the muscles and joints in the lower body vary. A surge in the levels of relaxin, estrogen, and progesterone hormones causes considerable joint relaxation during pregnancy. After delivery, the levels of these hormones decline significantly, causing the joints to return to the pre-pregnant state. It takes an average of 6 to 8 weeks for the joints and surrounding tissues to stabilize and bear weight effectively.

The sudden decrease in hormone levels may cause localized and/or overall effects, such as:

  • A general feeling of tiredness
  • Activity intolerance
  • Pain in the lower back and hip
  • Back pain while walking or performing an exercise

If unsupported posture and body mechanics are used at this time, the risk of further trauma to the lower back and hip are higher.

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