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Texas Orthopedics, Sports & Rehabilitation Associates

Monday, December 19, 2011

Welcome South Austin Orthopaedic Clinic to our Team!

Texas Orthopedics is proud to welcome South Austin Orthopaedic Clinic to our team effective January 1, 2012.

Doctors J. Clark Race, David Savage, Robert Blais and Greg Westmoreland will see patients at our South Austin office located at 3755 South Capital of Texas Hwy., Ste. 160. Their current location on Westgate Blvd. will close.

Thursday, December 8, 2011

Shoulder Pain

Post provided by Dr. John McDonald

Many active patients are disappointed that while trying to stay fit by working out, exercising with a trainer, or playing weekend sports, they actually can develop pain in the shoulder. This type of pain can be a debilitating problem for many recreational athletes. There are several common causes that force even fit people to cut back on their activities. The most common cause of pain in these patients is a combination of rotator cuff tendinitis and impingement syndrome.

There is a small fluid filled sack called a bursa above the ball and socket shoulder joint but underneath the acromion (bone you can feel at the top of the shoulder). Everyone has these bursa sacks almost anywhere in the body where there is a bony prominence, but they do not get inflamed unless a trauma is sustained. The rotator cuff is a group of tendons that attach the small muscles in the shoulder to the humerus (upper arm bone). When active people constantly do things above shoulder level (weight lifting, aerobics, throwing a ball) often this bursa and these tendons can be pinched between the acromion and the humerus. This phenomenon can be worsened by a narrowed space for the bursa due to the shape of the acromion. Repetitive overhead activities cause the bursa to fill with fluid and become inflamed and painful. The pain is typically in the front and side of the shoulder and can radiate to the upper arm. Often, patients have difficulty even with daily activities including washing their hair, reaching for something in the cupboard, or reaching behind their backs.

There are many effective treatments which include physical therapy for rotator cuff strengthening, icing, and anti-inflammatory medicines. Occasionally, a steroid injection can calm down the inflammation in the bursa which can improve the outcomes of physical therapy. Arthroscopic surgery is sometimes necessary if the symptoms fail to resolve. It can be done through several small incisions with the use of a camera. The inflamed bursa is removed and the underside of the acromion is removed to create more space for the rotator cuff. The rehabilitation from surgery typically allows for return to full activities by 6-8 weeks.

The key for recreational athletes is not to ignore shoulder pain. Impingement can become a nagging problem and can significantly affect not only your recreational sports but also your daily life.

Monday, November 28, 2011

FREE joint replacement seminar

Learn more about non-surgical arthritis treatment options as well as total hip and total knee replacement surgery at Arthritis Camp! Refreshments are served. Bring your friends and family!

Date: Thursday, December 1st
Time: 5 PM to 7 PM
Location: Northwest Austin, 4700 Seton Center Pkwy, Ste. 200, Austin, TX 78759
Speaker: Marc DeHart, MD

Please RSVP by registering online or call 439-1100.This FREE informative seminar is held the first Thursday of every month so if you can't make it this Thursday, plan to attend our next seminar on January 5th!

Wednesday, November 23, 2011

Happy Thanksgiving!

Texas Orthopedics would like to wish everyone a happy and safe Thanksgiving! We will be closed on Thursday and Friday. Normal business hours will resume on Monday, November 28th.

Monday, October 31, 2011

FREE joint replacement seminar this Thursday

Learn more about non-surgical arthritis treatment options as well as total hip and total knee replacement surgery at Arthritis Camp! Refreshments are served. Bring your friends and family!

Date: Thursday, November 3rd
Time: 5 PM to 7 PM
Location: Northwest Austin, 4700 Seton Center Pkwy, Ste. 200, Austin, TX 78759
Speaker: Tyler Goldberg, MD
Please RSVP by registering online or call 439-1100.

This FREE informative seminar is held the first Thursday of every month so if you can't make it this Thursday, plan to attend our next seminar on December 1st!

Tuesday, October 18, 2011

Texas Orthopedics partners with Bikes for Kids

Each year Texas Orthopedics employees donate to an Austin charity during the holidays. This year we have partnered with JB and Sandy's Bikes for Kids to be a community donation site. Anyone can stop by any of our 5 Austin area locations to donate money to help children receive a bike, helmet and bike lock for Christmas! We have locations in Northwest Austin, Central Austin, South Austin, Cedar Park and Round Rock!

Over the past 14 years, JB and Sandy's Bikes for Kids program has reached an amazing milestone; over 11,000 bikes donated and more than $1.1 million raised. Join Texas Orthopedics in providing children the experience of getting a brand new bike, helmet and bike lock for Christmas. Stop by and donate today!

Monday, October 3, 2011

FREE Joint Replacement Seminar this Thursday

Learn more about non-surgical arthritis treatment options as well as total hip and total knee replacement surgery at Arthritis Camp! Refreshments are served. Bring your friends and family!

Date: Thursday, October 6th
Time: 5 PM to 7 PM
Location: Northwest Austin, 4700 Seton Center Pkwy, Ste. 200, Austin, TX 78759
Speaker: Marc DeHart, MD

Please RSVP by registering online or call 439-1100.

This FREE informative seminar is held the first Thursday of every month so if you can't make it this Thursday, plan to attend our next seminar on November 3rd!

Monday, September 19, 2011

Stretching Before a Run Does Not Prevent Injury

Post provided by the American Academy of Orthopaedic Surgeons

According to a study presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons, stretching before a run neither prevents nor causes injury.

The study also found that the most significant risk factors for injury include:

- history of chronic injury or injury in the past four months
- higher body mass index
- switching pre-run stretching routines (runners who normally stretch stopping and those who didn't stretch starting to stretch before running)

"The more mileage run or the heavier and older the runner was, the more likely he or she was likely to get injured," said Daniel Pereles, MD, study author and orthopaedic surgeon. "Although all runners switching routines were more likely to experience an injury than those who did not switch, the group that stopped stretching had more reported injuries, implying that an immediate shift in regimen may be more important than the regimen itself," he added.

Monday, September 12, 2011

Total Knee Replacement Patients Functioning Well After 20 Years

Post provided by American Academy of Orthopaedic Surgeons

A research study revealed at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons shows that more than 90 percent of individuals who undergo total knee replacement (TKR) experience a dramatic reduction in knee pain and a significant improvement in the ability to perform common activities. Most patients who undergo total knee replacement are age 60 to 80.

The study evaluates patient functionality 20 years after knee replacement. Although aging may cause a gradual decline in physical activity, a remarkable functional capacity and activity level continues 20 years or more after TKR.

John B. Meding, MD, study author, said "this research refutes any perception that the importance of a well-functioning TKR diminishes over time because of an overall declining functional status. Elderly people are using their surgically replaced knees for fairly active lifestyles many years after surgery."

Patients considering knee replacement should talk to their orthopaedic surgeons about the implant's life expectancy.

Monday, August 29, 2011

Free Joint Replacment Seminar this Thursday

Learn more about non-surgical arthritis treatment options as well as total hip and total knee replacement surgery at Arthritis Camp! Refreshments are served. Bring your friends and family!

Date: Thursday, September 1st
Time: 5 PM to 7 PM
Location: Northwest Austin, 4700 Seton Center Pkwy, Ste. 200, Austin, TX 78759

Please RSVP by registering online or call 439-1100.

This FREE informative seminar is held the first Thursday of every month so if you can't make it this Thursday, plan to attend our next seminar on October 6th!

Monday, August 8, 2011

Taking Care of Your Neck

The key to taking care of your neck is good posture of the neck always! The correct posture for you neck is when looking at the neck from the side you should have a slight inward "C" curve called the cervical lordosis. Your head should be directly over your shoulders.

Forward head posture is one of the most common cervical alignment problems. Your head should not be forward of your shoulders, tilted to one side and your chin should not be tilted up.

Here are a few tips to taking care of your neck:

- Computer/desk: The monitor should be directly in front of you witout you having to look down or up to see it. You should sit with your back against the back of the chair with support for your low back. Your forearms should be supported on armrests and your feet should touch the ground. Your keyboard should be at an appropriate height to maintain good alignment with your forearms. Standing up every 30 to 60 minutes to stretch is good for your entire body. Set up a pop up reminder on your computer to help you remember!

- Telephone: Do not talk on the phone with your head bent to one side and your shoulder elevated to hold the phone. A headset or speaker phone is a better alternative.

- Driving: The back rest should allow you to sit up straight. The back of your head should be 2 to 4 inches from the back of the head rest. The top of the head rest should be as high as the top of your head.

- Reading: Sit in a chair that promotes good alignment of the entire spine. Keep your forearms supported on armrests or pillows at an appropriate height to avoid slouching. Hold the book so you do not have to lean your head forward. Place a pillow in your lap if needed. If you like to read in bed sit with your back supported with pillows, place another pillow in your lap to support the book and another pillow under your knees. It is ok to read in a sidelying postion as long as your head and neck are level and not tilted to one side.

Monday, August 1, 2011

Free Joint Replacement Seminar this Thursday

Learn more about non-surgical arthritis treatment options as well as total hip and total knee replacement surgery at Arthritis Camp! Refreshments are served. Bring your friends and family!

Date: Thursday, August 4th
Time: 5 PM to 7 PM
Location: Northwest Austin, 4700 Seton Center Pkwy, Ste. 200, Austin, TX 78759
Speaker: Marc DeHart, MD

Please RSVP by registering online or call 439-1100.

This FREE informative seminar is held the first Thursday of every month so if you can't make it this Thursday, plan to attend our next seminar on September 1st!

Friday, July 15, 2011

New Physicians Join the Team in August

Dr. Koval will see patients starting August 1st at the Cedar Park and Northwest Austin locations.

Robert J Koval, Jr, MD, is board certified in Internal Medicine and completed Fellowship training in Rheumatology in 2011. Dr. Koval graduated from the University of Texas at Austin with a degree in Biology, after completing high school in Laredo, Texas. He graduated from the University of Texas at Houston Medical School, where he was accepted into the prestigious Alpha Omega Alpha (AOA) Honor Society, graduating near the top of his class.

After completing his internship and residency in Internal Medicine at the University of Colorado in Denver, Dr. Koval worked for a year in hospital medicine at Denver Health Hospital. He then returned to the
University of Colorado for Rheumatology specialization training. He has a special interest in autoimmune disorders, arthritis, and osteoporosis. After moving to Austin to join Texas Orthopedics, Dr. Koval will be starting an infusion center to assist in the treatment of various Rheumatologic diseases. He is a member of the American College of Rheumatology and the International Society for Clinical Densitometry.

In his spare time, Dr. Koval enjoys spending time with his wife Erin and young son Joshua. He also enjoys watching and attending sporting events (Hook 'em Horns!), traveling, and many outdoor activities.

Dr. McDonald will see patients starting August 22th at the Northwest Austin and South Austin locations.

John E. McDonald Jr., M.D. is a native of Houston, TX. He graduated cum laude from Georgetown University in Washington, DC where he played NCAA Division I tennis for the Hoyas. He went on to attend medical school at UT Southwestern Medical School in Dallas where he was named to the Alpha Omega Alpha Honor Society, an honor given to those graduating in the top 10% of their class. Dr. McDonald completed his residency training in orthopaedic surgery at UT Southwestern and Parkland Hospital in Dallas. After being selected as one of two Chief Residents, he spent time overseas in Norwich, England where he worked exclusively with knee and shoulder surgeons and learned a tremendous amount about cost effective medicine.

In order to further specialize after his training, Dr. McDonald was selected to attend a one year fellowship in sports medicine and arthroscopy at the prestigious Steadman Clinic and Steadman-Philippon Research Institute in Vail, Colorado. While in Vail, he trained directly under many of the world's top experts in the field of orthopaedic sports medicine and hip, shoulder, and knee arthroscopy and reconstruction. Additionally, he had the privilege of providing care to numerous professional athletes from the NBA, NFL, MLB, NHL, PGA tour, and professional tennis as well as collegiate, high school, and recreational athletes. He served as the team physician for the US National Snowboard team at the 2011 World Championships and was one of the team physicians for a local high school in Colorado.

Throughout his clinical training, Dr. McDonald has been involved in research in the field of orthopaedics. He has been published in peer-reviewed journals including the Journal of Bone and Joint Surgery and has co-written several book chapters and review articles on a variety of topics including hip arthroscopy, multi-ligament knee injuries, and traumatic should and hip injuries. He has presented his research at multiple national meetings.

Dr. McDonald specializes in hip, knee, and shoulder arthroscopy and orthopaedic sports medicine. A sports enthusiast all his life, Dr. McDonald encourages a team approach with each of his patients. When patients, their families, physical and occupational therapists, and physicians all work together, the patient can achieve a quicker recovery and the success that they desire through both surgical and nonsurgical means. Patients enjoy his friendly, open, and personalized approach to care. He encourages questions and always takes the time to get to know his patients and thoroughly understand their concerns.

Currently, Dr. McDonald is a team physician for the US Ski and Snowboard teams. He is a member of the American Academy of Orthopaedic Surgeons, the Arthroscopy Association of North America, and a candidate member of the American Orthopaedic Society for Sports Medicine. In his free time, he enjoys running, golf, hiking, skiing, and basketball. He is joined in Austin by his wife, a University of Texas alumna and dermatologist, Halliday (Hallie) McDonald, MD, and their daughter.

Tuesday, July 12, 2011

Texas Ortho doctor speaks at national orthopedic meetings

John McDonald, Jr., MD, who will join Texas Orthopedics this August, has been busy giving presentations at national orthopedic meetings this summer. He was selected to give a podium presentation at both the 2011 Annual Meeting of the Arthroscopy Association of North America and the annual meeting of The American Orthopaedic Society for Sports Medicine. The presentations were focused on findings related to two recent studies of elite athletes who returned to play quickly and at a high performance level following arthroscopic microfracture surgery of the hip. To learn more about Dr. McDonald, visit his bio on our website!

Tuesday, July 5, 2011

Free Joint Replacement Seminar this Thursday

Learn more about non-surgical arthritis treatment options as well as total hip and total knee replacement surgery at Arthritis Camp! Refreshments are served. Bring your friends and family!

Date: Thursday, July 7th
Time: 5 PM to 7 PM
Location: Northwest Austin, 4700 Seton Center Pkwy, Ste. 200, Austin, TX 78759
Speaker: Marc DeHart, MD

Please RSVP by registering online or call 439-1100.

This FREE informative seminar is held the first Thursday of every month so if you can't make it this Thursday, plan to attend our next seminar on August 4th!

Monday, June 27, 2011

Texas Orthopedics Celebrates 25 Years of Providing Orthopedic Care

Founded July 1, 1986 by two orthopedic surgeons and one physical medicine and rehabilitation specialists, Texas Orthopedics has grown into the largest provider of orthopedic services in Central Texas, now comprised of twenty-one physicians and six locations.

We'd like to thank all of our loyal patients and referring physicians for letting us care for your orthopedic needs over the last 25 years. We look forward to continuing our relationship with all of you!

Monday, June 20, 2011

Congratulations to our doctors listed in Super Doctors!

Nine Texas Orthopedics physicians have been named by his/her peers to the Super Doctors list.

- Bradley Adams, DO
- Barbara Bergin, MD
- Donald Davis, MD
- Robert Foster, MD
- Peter Garcia, Jr., MD
- Tyler Goldberg, MD
- Richard Lutz, MD
- Scott Smith, MD
- Archie Whittemore, MD

To learn more about the physicians at Texas Orthopedics, click here!

Monday, June 13, 2011

Be Kind to Your Hands

Post provided by Barbara Bergin, MD

Here are some tips on how to ease the load on your hands. Follow these recommendations and maybe I’ll be seeing less of you!

1) Invest in a nice electric can opener. It’s hard to open cans and once you get arthritis, it’s nearly impossible. So why not start using the electric can opener before you get it? I used to hate electric can openers because of that greasy, black coagulum of old tomato juice and pork and bean gravy that collected in its little gears. But now you can remove that piece and wash it! Using an electric can opener will spare your thumb a lot of stress over the decades.

2) Use jar opening gadgets and bang the lids on the counter top before trying to open them. Spreading your hands out and doing something as strenuous as opening large jar lids and tight bottle tops really strains those delicate joints. Again, once you have arthritis, you won’t even be able to try. Don’t wait until you have pain to start using these handy little devices. I also like to use those little rubber pads.

3) Notice how you grab the steering wheel in your car. Do you hold it with your four fingers wrapped tightly around the wheel and your thumb hyper-extended like a hitch hiker? Try to relax your hands on the wheel. This position puts a lot of pressure on the base of your thumb also. Many of my patients have pain when they drive. I encourage them to wear driving gloves and even to put a sheepskin cover on the steering wheel. You can grab tightly while using these items, but they’ll create a subconscious reminder to loosen your grip.

4) Get smaller milk cartons, or the cartons with a handle instead of the big square half gallon cartons. Again, that wide grip is the perpetrator of harm to your thumb.

5) Same goes for big books, notebooks, dictionaries, and family Bibles. Don’t just grab them with one hand from the shelves. Lift them with two hands; one pulling from the top and the other supporting the bottom of the book.

6) Use an electric toothbrush rather than an old school brush. Again, that grip with the thumb hyper-extended should be minimized. You grab an electric toothbrush with your fist and you don’t have to manually move it up and down like you do with the old school brush. Cavemen didn’t brush their teeth.

7) I’m going to pull my first plug against pushups and I know I’m going to get loads of hate mail, just like I did when I came out against squats. I love the idea of pushups. It’s a cheap, easy way to get a full body workout. You can do it when you’re out of town and have no access to a gym. You can do it if you don’t want to go to a gym or buy your own weights. You can use them to help count scores at a football game, even when the scoreboard works just fine. They’re just fun! But I see tons of patients who have injured their hands and wrists doing pushups. I know someone will ask about using pushup bars. Yes, they help reduce some of the stress of pushups by loading the wrist in a more biomechanically advantageous way, but there are other issues to be further discussed later. Remember, our little hands and wrists evolved away from being weight bearing structures to being dexterous structures; best used for delicate manipulations. So don’t go four-legged on me.

8) Use gloves when doing dirty or heavy work; weight lifting, gardening, construction. They protect your hands from injury and infection, but also allow you to loosen your grip.

9) Don’t try to carry 10 bags of groceries from your car to the kitchen. I used to sling one bag on every finger, two on some if the bag was light. Believe it or not, I’ve seen patients develop finger tendonitis and “tennis elbow” from doing just that. Take your time. Frankly, taking your time is a good adage in general. Often we injure ourselves because we’re in just too dang much of a hurry.

10) Don’t persevere with any activity that causes pain in your hands, thinking you can just work through it. Give it a rest. I’m thinking of my patients who spend an entire day cutting paper or fabric with scissors, all the while developing a numb spot on the side of their thumb. That can cause permanent damage. Stop. Use different scissors. Rest. Get some gloves. Let someone else do it for awhile.

11) Always try to negotiate with others by using your words and not your fist. The fist almost always loses against teeth, walls and windows. It sometimes wins against noses and tummies.

Monday, June 6, 2011

Transitional Stretching

Post provided by Barbara Bergin, MD

One of the most common complaints I hear from patients is that they experience pain in transitions; going from sitting to standing, standing to sitting, getting out of chairs, getting out of bed. Now let me say, I never hear that complaint from 20 year olds. I only hear it from those over forty.

As you age your soft tissues get toughened, thinned and stiff. They’re in a state of degradation. So my recommendation is that you begin to develop a habit of doing a little stretching before transitioning from one position to another. After forty. Now look, you don’t have to do some thirty minute Jack LaLane stretching program every time you get out of your car or out of bed. Just make sure the joints are ready for it.

Bend and straighten your knees and your back. Just a covert movement. You don’t have to pull your ankle around your neck or do a sun salutation. Just bend and straighten your knees. Make sure they’re ready to go there.

When I’m riding my horse, going around in circles or whatever, I never just take off and make a big sliding stop with my horse. I sort of introduce his body (and his mind) to the fact that we’re going to start making big stops. I do a slow gentle stop first. Then bigger and bigger. That seems logical, doesn’t it?

Frankly, when you’re 60 and you’ve been sitting for an hour, you’ve got to introduce your body to the idea that you’re going to be standing up in a few seconds. And getting out of bed is a major culprit. People are always so surprised that they hurt when they get out of bed in the morning! Think about it. You’ve spent the whole night horizontal to gravity. Most of the night you’ve been curled up in some variation of the fetal position. Now you want your body to just jump up and stand. Hello disagreement.

And you can actually hurt yourself getting out of bed. That’s the beginning of the curse of plantar fasciitis for many people. It’s the movement that results in a degenerative meniscus tear for others. So introduce your body to the fact that you’re going to be standing up now. Again, this doesn’t have to be a thirty minute program.

-Roll over onto your back.
-Bend and straighten your knees and hips.
-Rotate your hips in and out.
-Stretch your feet up and down.
-Then turn over on your side, curl up a little and push yourself up into a seated position. This is important. Most of us use our legs and weak abdominal muscles to kind of yank ourselves from a face up position in bed to a seated position. This really aggravates the muscles and joints in your pelvis and back.
-Now wait for a few seconds. Stretch your feet and knees again.
-Then stand.

If you get into the habit of doing this when getting out of bed, I promise it will improve the quality of your rising!

I know that if you try to do more of this kind of quick stretching, and I frankly wouldn’t even go so far as to call if officially stretching… more of an introduction or preparation for what is to come…it will improve the experience of going from one position to another and lessen your likelihood of suffering pain…not all pain…but some.

Tuesday, May 31, 2011

Free Joint Replacement Seminar this Thursday

Learn more about non-surgical arthritis treatment options as well as total hip and total knee replacement surgery at Arthritis Camp! Refreshments are served. Bring your friends and family!

Date: Thursday, June 2nd
Time: 5 PM to 7 PM
Location: Northwest Austin, 4700 Seton Center Pkwy, Ste. 200, Austin, TX 78759
Speaker: Scott Smith, MD

Please RSVP by registering online or call 439-1100.

This FREE informative seminar is held the first Thursday of every month so if you can't make it this Thursday, plan to attend our next seminar on July 7th!

Tuesday, May 24, 2011

More on Plantar Fasciitis

Post provided by Barbara Bergin, MD

Let me say first off, that if you’re not the kind of person who would floss their teeth to prevent tooth decay, you probably won’t be interested in this or most of what I have to tell you.

Why is the morning a time when we often experience pain and stiffness? Think about it. Name one other time when you spend several hours in basically the same position. It’s particularly so for the feet. There is not one single moment during the night when you bring your feet to a neutral position or a dorsiflexed (pointed up) position. Your foot is pointed down ALL NIGHT LONG. And honestly, it’s not just pointed down in a relaxed pose. It is POINTED down. Sometimes when people wear splints or casts to bed at night, they get numbness in their toes. Sometimes they can even get blisters. The toes want to point down and the muscles are actually pulling them down. So after 6-8 hours of that, you go and immediately stand up…well, sometimes the feet balk a little. Give them a break. Stretch them. Say “good morning” to your feet. They’re at the bottom of your body and over a lifetime they take a lot of abuse. Give them a little TLC.

I also recommend that you stretch the bottom of your feet before standing up after you’ve been sitting for awhile. Many of my patients complain of plantar foot pain in the morning when they first wake up and less so after they’ve been sitting awhile. Once again, notice where your feet go when you sit, especially if you’re sitting for an hour or more; like while you’re watching a movie, or in church. They relax and they point down. The plantar fascia begins to seek its shortened position. When you stand up, you strain it with the pressure of your body weight bearing down on that tender band. So make it a habit to wiggle your feet up and down a little. Push your feet back against the floor, as if you were trying to stretch your Achilles tendon. Cross your leg and push back your big toe, like I described for your morning stretch.

Wednesday, May 18, 2011

Plantar Fasciitis

Post provided by Barbara Bergin, MD

Stretch your feet every morning before you get out of bed.

I see at least one woman every day in my office with this problem. I have 19 partners who collectively probably see similar numbers of patients with plantar fasciitis every day. Do a little extrapolation and you can begin to imagine the amount of plantar fascial pain out there and then the cost of treating that pain. And with a couple of simple preventive measures, I really believe this pain could be eradicated. I’m looking for a Nobel prize here.

I know you were probably thinking I’d tell you about some life changing vitamin or some extract that would put cartilage back in your knees. Maybe I have a special exercise that will keep you from tearing your ACL. This foot stretching thing is so…mundane. So uncomplicated. But let me tell you that I’ve been doing it for about 10 years. I started the morning after the first morning I woke up with the dreaded heel pain. And I never experienced a second morning of waking up with heel pain. But don’t wait until you have heel pain to start stretching your feet in the morning.

I think there are a lot of preventive measures we can utilize which don’t affect the quality of our lives and may keep you from experiencing pain and some disease. It just so happens that foot stretching to prevent plantar fasciitis is a great example; a very simple example of that kind of preventive measure. It takes about two minutes to stretch your feet and there’s really no downside to it. I love that kind of prevention. Lots of potential benefit…little downside.

Let’s compare it to a mammogram. Now there’s a test with lots of potential benefit, but it comes with some downside. It’s uncomfortable. A complete stranger has to grapple with your breasts. It takes at least four years to get a little used to it. There’s a little radiation exposure. Plus it takes a couple of hours out of your day and you can’t put on deodorant that morning. You see where I’m going with this?

Let’s compare it to taking a baby aspirin every day. There’s a preventive measure with potential benefit, but in some people taking a baby aspirin can cause ulcers. If you are taking aspirin, it could be risky to take other anti-inflammatories like ibuprofen or Aleve, Celebrex or Lodine.

As you begin to realize that full wakefulness is imminent, begin to wiggle your feet up and down. Don’t be too aggressive. No need to wake anyone up. Take hold of the top of your flat sheet and gently pull it snug. Then press your toes against the firm sheet, using the sheet to assist in stretching the bottom of your foot. You’re trying to stretch the plantar fascia.

Okay, now there’s your 30 second stretch with a lot of benefits and few to no side effects or diminished quality of life. But if you want to take it one step further, and I would recommend that you do, then sit up and swing your feet around to the floor. Take one foot and pull your big toe backwards, just to tolerance. Don’t try to dislocate the joint.

While doing this you’ll be able to feel a little band on the bottom of the foot. It will feel like a bowstring. Some of that is your plantar fascia; the thing that gets so tight and causes so much misery. Massage it with your other hand. Do the same thing on the other foot. Then put your feet on the floor. If you feel pain in your heel, then start over with the stretch and massage. Repeat as needed.

What I’m really hoping for is prevention. If you already have heel pain, this might not make it go away instantly, but these stretches are an integral part of the treatment regimen for plantar fasciitis. Just keep doing that every morning before you get out of bed. If you do this before you have pain, in other words, you use it as a preventive measure, you will likely never experience the misery of heel pain.

Wednesday, May 11, 2011

You Can Prevent Osteoporosis Related Fractures: Part One

Post provided by Marc DeHart, MD

Osteoporosis is a growing problem in our maturing population. It is the most common bone disease in humans. It is commonly confused with osteoarthritis because it starts with the greek prefix “osteo” which means “bone”. Osteo-arthritis is the wear and tear arthritis that loudly announces itself with achy sore joints. Osteo-porosis is the word used to describe thin or porous bones. Osteoporosis is known as a “silent disease” because it has no warning symptoms. The underlying problem in osteoporosis is the decrease in the amount of calcium structure in the bone. When looked at through a microscope, bone looks a lot like a sponge with many tiny bridges forming the stuff of bone. Bones with osteoporosis have fewer bridges and thinner bridges. As a result, thin bones are at risk to fail when overstressed. Osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, and approximately 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures at other sites. What starts as a “silent disease” can lead to major life altering fractures of the hip, spine and wrist. After a hip fracture only half of patients return to the same level of performance. Fractures are certainly not limited to a major joint like your hip. Fractures are even more common in the bones of your back – the vertebrae. Osteoporotic fractures of the spine can lead to height loss, round back deformity, chronic pain and death.

Fractures of the wrist come from attempts at breaking the fall using your hands. Wrist fractures can lead to deformity and arthritis that make the routine daily activities of the hands painful and difficult.

It is clear that as we all become “less young” the amount of calcium in our bodies goes down. As our bones’ density decreases the risk of fracture climbs exponentially. This is much more of problem for women. As women go through menopause, their bones can lose as much as 3% of their calcium per year. Overly thin women have less bone to lose and are at even higher risk.

Thursday, May 5, 2011

Dr. Goldberg Speaking at International Orthopedic Meetings

Tyler Goldberg, MD, will travel to Stresa, Italy in the coming weeks to speak at the International Hip and Knee Symposium. Following his lecture, Dr. Goldberg will teach an anterior hip replacement course to fellow orthopedic surgeons in Paris.

In June, Dr. Goldberg will be in London speaking at the International Society for Computer Assisted Orthopaedic Surgery on MyKnee, a patient-specific cutting block that allows the surgeon to realize his pre-operative 3D planning based on CT images of the patient's knee.

An innovator, designer, and educator, Dr. Goldberg is involved in many professional organizations for advancement of technology intended to benefit patient care. To learn more about Dr. Goldberg, click here.

Monday, May 2, 2011

Free Joint Replacement Seminar this Thursday

Learn more about non-surgical arthritis treatment options as well as total hip and total knee replacement surgery at Arthritis Camp! Refreshments are served. Bring your friends and family!

Date: Thursday, May 5th
Time: 5 PM to 7 PM
Location: Northwest Austin, 4700 Seton Center Pkwy, Ste. 200, Austin, TX 78759

Please RSVP by registering online or call 439-1100.

This FREE informative seminar is held the first Thursday of every month so if you can't make it this Thursday, plan to attend our next seminar on June 2nd!

Wednesday, April 20, 2011

Tips for Fitness Goals

You went out to the local court over the weekend and played a few of your best pickup games ever. Now it is Monday, and your shins are stiff and painful, your back is aching, and your knees are starting to swell. If this scenario sounds familiar, then you have experienced what I call an “under fit” injury. I do not like to call them overuse injuries because that implies you should not use the muscles. “Under-fit” means you were not prepared for whatever activity you engaged in. You played three games of basketball instead of one. Basketball is an excellent sport for overall conditioning. It offers intense aerobic workout while strengthening muscles throughout the body. But it can also cause finger and ankle injuries, sprains, tendinitis, back spasms, and knee problems. Here are some tips on how to get the gain without the pain.

• Know your body’s limits. “Do not go out and try to ride like Lance Armstrong unless you have been training for a decade,” says Dr. Smith. “Gradually build up to your goal level. That might take six to 12 months, depending on your age.”

• Resist being a weekend warrior. Exercise some during the week as well, even if it is just a brisk, 30-minute walk. “The problem is we are episodic exercisers,” says Dr. Smith. “We tend to ping-pong back and forth between activity and inactivity rather than having a baseline.”

• Warm up. Begin with low-intensity aerobic activity before getting into the heat of the game. Stretching, however, is only recommended after playing. Stretching beforehand can actually make muscles weaker by fatiguing them.

• Use the right gear. Make sure shoes fit properly and offer the right support. If you have had wrist, knee, or ankle injuries before, it might be helpful to wear a brace. If you do feel you have overdone it, remember the acronym RICE — rest, ice, compression, and elevation. If pain persists, increases significantly with activity, or causes swelling, limping, or limited range of motion, see a physician immediately.

Monday, April 4, 2011

Your Fitness Threshold: The Key to Injury Prevention

Post provided by Scott Smith, MD

Many patients come to the doctor with aches and pains that “started out of nowhere” apparently without an injury. They have experienced a stress to their system that was above some undefined threshold and resulted in an injury.

Everyone has heard the term overuse. I don’t like it because it implies that there is something wrong with using our bodies. Our bodies are built to be used. I prefer to think more in terms of underfitness, meaning that the activity performed was above the fitness threshold resulting in damage to some part of the musculoskeletal system. In every case there are two options. One option would be to stop or limit the activity performed. This is not only no fun it’s unhealthy. The second option is raise the fitness threshold such that it is never surpassed and no injuries are incurred. This would be great except that it is unlikely that anyone can obtain and more importantly maintain their perfect maximum fitness level. Therefore it is inevitable that we all will have some aches even if we have a high fitness threshold.

These aches should be very mild, short lived and self limited. In fact most will resolve if the body is allowed to repair itself. Daily or at the very least weekly physical activities to “stress” your system will strengthen it. As the fitness level increases so will the amount of activity required to cause pain.

The inertia of being out of shape makes it extremely difficult to make any significant commitment to exercise. By exceeding our threshold in our first few workouts we become sore or even painful where we can no longer perform. This stops us in our tracks physically not to mention what it does to our mental outlook. The next re-initiation of a workout program is more difficult and less likely to succeed. A more gradual approach is much more effective. This allows the body to repair the “damage” from a work out and stepwise progress toward healthy fitness is made. If significant soreness is present don’t stop workouts just decrease intensity and persists at a lower level. Then make slower progress as the discomfort subsides. If problems persist seek professional help.

Tuesday, March 22, 2011

Specialists Who Treat Back & Neck Pain

There are many types of health practitioners that care for patients with spinal conditions, and each has a slightly different role. Selection of the most appropriate type of health professional—or team of health professionals—largely depends on the patient’s symptoms and the length of time the symptoms have been present.

There are three broad groups of health providers who treat back pain:

Primary care providers are often the first port of call for patients when back pain strikes:
Primary care physicians (Family practice doctors, Internists, Pediatricians)
Doctors of osteopathy

Spine specialists have a specific area of expertise in diagnoses and/or treatments for back pain:
Surgeons (Orthopedic surgeons and Neurosurgeons)

Therapists for back pain or psychological help for chronic pain:
Physical therapists
Clinical psychologists

A Physiatrist is a Medical Doctor who specializes in Physical Medicine and Rehabilitation (PM&R). Essentially, physiatrists are nerve, muscle, and bone experts who treat injuries or illnesses that affect how you move.

Physiatrists diagnose and treat both acute and chronic pain and musculoskeletal disorders. They can order and interpret all types of spine imaging (x-ray, CT myelogram, MRI, bone scan) and perform specialized nerve tests (EMG and NCS) to help assess the location and severity of nerve damage. Typical treatments may include:

o Referral to Physical Therapy (e.g. exercise, stretching, heat/ice, TENS units)
o Prescription medications
o Electromyographic studies
o Interventional procedures (e.g. epidurals, joint injections)

Physiatrists treat a wide range of problems from sore shoulders to spinal cord injuries. Their goal is to decrease pain and enhance performance without surgery. Physiatrists take the time needed to accurately pinpoint the source of an ailment. They then design a treatment plan that can be carried out by the patients themselves or with the help of a team. This medical team might include other physicians and health professionals, such as neurologists, orthopedic surgeons, and physical therapists. By providing an appropriate treatment plan, physiatrists help patients stay as active as possible at any age. Their broad medical expertise allows them to treat disabling conditions throughout a person’s lifetime.

Texas Orthopedics has two physiatrist, Dr. Kenneth Bunch and Dr. Ai Mukai, that work closely with our orthopedic surgeons to provide comprehensive musculoskeletal care.

Tuesday, March 8, 2011

Back Pain

Post provided by Ai Mukai, MD

What can cause back pain?

There are many structures in the back area that can cause pain. Some of those structures are:
• Muscle – muscle strain and sprain – usually achy, may have spasms
• Disc – usually sudden pain, can pinch nerve, twisting and bending makes it worse
• Bone – fracture of the back bone or smaller bony structure in back – usually constant, may be sharp or achy
• Ligament – strain or sprain, usually worse with movement
• Nerve – pinched nerve – can shoot pain to one side or another, feels like burning, shooting, tingling pain
• Joint – sacroiliac joint – near the base of spine and buttock area, worse with transitional movements like sit to stand
• Joint – facet joints – “knuckles” of the back, pain with bending backward or twisting.
• Coccyx – tailbone pain- worse with prolonged sitting, feels achy and inflamed

How do you figure out what is causing the pain?

X-rays can show broken bones or alignment issues. MRI is usually needed if soft tissue injury or cause is suspected like disks, pinched nerves, and ligaments. Information about how the symptom started, what it feels like, what makes it better or worse and physical examination can help narrow down the possibilities. Sometimes, there are multiple causes for the pain and one pain can cause another. Lab work can diagnose issues that may be preventing you from healing or causing more widespread pain and inflammation.

What are some possible treatment options?

Physical therapy is the key to improving alignment, taking pressure off areas of pain, and preventing future injuries. For the spine, McKenzie method and looking at the stabilizing the pelvis seems to give the best long term results. To help with the symptom relief of pain, different types of medications aimed at the different causes of pain (nerve pain medicine, muscle relaxers, anti-inflammatories) can be taken short term while undergoing physical therapy. For more severe pain or long term issues, non-surgical procedures such as injections into joints, epidural space (space where discs and nerves live), and muscles may help. There are more specialized procedures geared towards specific structures like radiofrequency ablation (burn the small nerves that supply joints) and spinal cord stimulators. Sometimes, the procedure can help diagnose the cause of the pain. Lastly, if all options fail, or there is something that needs to be addressed surgically, spine surgery is an option.

Wednesday, February 23, 2011

Texas Orthopedics Physical Therapist qualifies for Boston Marathon

Amber Anderson, PT ran in the Austin Marathon with a final time of 3:39:56 placing 19th in her age group and 525 overall out of 4,796 finishers for the full marathon.

This was Amber's first full marathon! Congratulations Amber!

Monday, February 14, 2011

The Squat Debate

Post provided by Barbara Bergin, MD

There were many negative comments regarding my “Do No Squats” blog. I wasn’t surprised because the exercise industry is very invested in that exercise form. One has only to read a copy of SHAPE magazine and see that about every 10 pages has a product to assist in doing squats or a program using squats as its staple exercise.

Squats are an efficient way to strengthen the quads and gluteal muscles. Because they are the largest muscle masses in the body, exercising them results in more sweating, caloric expenditure and a great burn.

But I honestly do believe that the world would be a better place without the squat as a form of exercise. I see patients in my office 3 full days a week and every week I will estimate that I see 4 people a day, therefore 12 people a week with injury related to doing squats, deep knee bends or lunges. If you extrapolate that number, minus a few weeks for vacation then you have about 600 people a year! I’ve been doing this for over a quarter of a century so I would say I’ve probably seen 15,000 patients with disease related to doing squats. Most of them are women but many are men. All ages are affected.

I cannot think of another single activity which so consistently sends people to my office with complaints of pain in one specific place (the knee). There are other issues which are frequently associated with orthopedic problems. Motorcycles, for example, consistently injure people in an unfortunately predictable way, and obesity, which is associated with all sorts of lower extremity and bodily disease. I will also someday blog away on those two subjects as well. But right now, I’m addressing squats again because that blog made a lot of people very angry.

Sure, squats can be done without caution by some people. Some healthy people. Who defines a “healthy person” before the deed is done. One could also say that healthy people can eat all the sugar they want or drink all the alcohol they want. But who preemptively defines a healthy person? Define the healthy knee before a person starts a squatting program. Who knows what a healthy knee alignment is…before the fact? Does that person have any patellar malalignment? Do they have chondromalacia patella already? Do they have a meniscus weakened by former injury, age or genetics?

There are people who can probably do squats with abandon. Men are more likely to be able to do them without issue than women. Young men better than older men. A person with no existing crunching or grinding under their knee cap would be better at them! A thin person more so than a heavy person. These are very general categories and if a person came to me to ask if they could start a squatting program, I might be able to make a generalized prediction, but I could never give the recommendation because there would be liability for me in that recommendation.

If one has to squat for a living, then one should be conditioned to squatting. But I have seen many plumbers, electricians, welders and computer repair specialists who must discontinue that line of work because of patellofemoral disease related to their squatting job description. And as for the comment regarding the need to strengthen the muscles in order to be able to get off and on the toilet…well, most of us have been adequately conditioning those muscles since we got out of diapers.

But if one doesn’t have to squat to put food on the table, then one should proceed with a squatting exercise program with caution. Be aware of the presence of pain during and AFTER the exercises. Be aware of the development of crunching under the kneecap and swelling of the knee. Make sure you follow good instruction with regard to the positioning of your hip, knee, ankle and foot, and the depth of the squat.

One comment suggested that doctors bug off with the prevention and stick to curing disease once it has manifested itself. Most doctors practice prevention every bit as much as the curing of disease and it’s the purpose of my blog. I want this information to go out to the public for the purpose of prevention as well as cure.

In blogging about a controversial issue there is always the possibility that what I say might cause some readers to seek advice elsewhere. That’s a risk I must take. If more business was what doctors were all about, we would encourage squatting, motorcycle riding and overeating.

Tuesday, February 8, 2011

Dr. Bergin honored as She! Women of Influence

Dr. Bergin was recently honored as Women of Influence in She! a supplemental magazine in the Westlake Picayune and Lake Travis View. The magazine focused on women of influence in the Austin area. According to the magazine, these are the ladies that do it all, make a difference and change the world. Women who are devoted, engaged and striving to make themselves and their communities better.

Pictured above: Carol de Cardenas, Dr. Barbara Bergin, Susan Combs and Jerri Ward

Thursday, February 3, 2011

Joint Replacment Seminar Rescheduled

Due to the possibility of snow, tonight's Arthritis Camp has been rescheduled to Tuesday, February 8th at 5 pm.

Monday, January 31, 2011

Free Joint Replacement Seminar at Texas Orthopedics

Learn more about non-surgical arthritis treatment options as well as total hip and total knee replacement surgery at Arthritis Camp! Refreshments are served. Bring your friends and family!

Date: Thursday, February 3rd
Time: 5 PM to 7 PM
Location: Northwest Austin, 4700 Seton Center Pkwy, Ste. 200, Austin, TX 78759

Please RSVP by registering online or call 439-1039.

This FREE informative seminar is held the first Thursday of every month so if you can't make it this Thursday, plan to attend our next seminar on March 3rd!

Monday, January 24, 2011

FREE joint replacement seminars this week!

If you are interested in learning more about the advancements in hip and knee joint replacement, attend one of the following seminars provided by Texas Orthopedics physicians.

Tuesday, January 25, 2011 6:00 PM

Speaker: Tyler Goldberg, MD

St. David's North Austin Medical Center
12221 MoPac Expressway North
Austin, TX 78758
Room: Classroom B, 2nd Floor

New Advancements in Knee and Hip Replacement: Learn how new techniques, such as the anterior approach to hip replacement, are utilized to spare muscle tissue, providing a quicker recovery. Discover how we are using Computer Assisted Navigation for both hip and knee replacement to provide the least invasive surgical option.

Register today!

Thursday, January 27, 2011 6:00 PM

Speaker: Christopher Danney, MD

Cedar Park Regional Medical Center
1401 Medical Parkway
Cedar Park, TX 78613
Room: CPRMC Cafe

If hip or knee pain is keeping you from doing the things you love, find out about the advanced orthopedic treatsments at this seminar.

Register today by calling (512) 528-7100

Friday, January 21, 2011

Do Not Do Squats!

Post provided by Barbara Bergin, MD

That’s a good New Year’s Resolution. If a bunch of folks could read this and follow it, I’d see a lot less of you because I can predict that I’ll see 2-3 patients every week this year for knee pain related to starting some kind of a squatting exercise program!

DO NOT DO SQUATS! Let me emphasize the point. DO NOT DO SQUATS!

And learn to recognize deceptive forms of the squat; the deep knee bend, the lunge and its particularly egregious variations, the weighted lunge and especially the forward-moving-weighted-lunge. I don’t know what it is called but I want to put a red circle with a cross hatch on those.

A lot of people are going to hate me, including most trainers, coaches and promoters of video training programs. I’ve got to admit that squats are a good way and maybe the best, most efficient and cheapest way to build gluts, quads and hamstrings. They utilize some of the biggest muscle groups in the body and so you can work up a good sweat and feel the burn. So doing them accomplishes a goal and maybe for football players, it’s the best way. But it’s dangerous for their knees, their cartilages and particularly their knee caps. There are some individuals who are biomechanically sound to do squats but they are rare and there’s really no way to identify those people and predict how long they can tolerate it. So, there are some people who tolerate smoking cigarettes just fine. But more of us can’t and so in general we say, “Don’t smoke.” And in general I like to say, “Don’t do squats!”

Here’s how it works. When you squat you put tremendous pressure on your knee cap since it’s the fulcrum through which you bend and straighten your knee. That puts pressure on the delicate cartilage that lines the knee cap. When you do a deep squat it also put tremendous pressure on the meniscus cartilage (the rubbery shock absorber cartilages between the two bones). Over a period of time (years for some…one squat for others) that can cause wearing of these delicate and important structures in the knee. Once that happens, arthritis begins to develop. And that can even happen at a young age.

For most of us, there are a lot of other exercises we can do to gently strengthen those muscle groups; straight leg raises, quarter squats, leg curls and extensions with low resistance, stationary bike, elliptical trainers, swimming, and the list goes on. I see so many patients with knee pain and in quite a few, particularly those with knee cap pain, I can elicit a history of doing squats…or one of its varieties. So when your personal trainer says he’s going to get your butt into shape…beware of the squat and just say “no.”

Monday, January 17, 2011

Diagnosis and Treatment of Arthritis

Post provided by Marc DeHart, MD

In last week’s blog post we used a car tire analogy to help explain arthritis. This post focuses on the basics of diagnosis and treatment alternatives available for people who suffer from the pain, stiffness and loss of function that goes along with arthritis.

Diagnosis: Do I have it?

Most patients suspect they have arthritis when their joints ache and are stiff in the morning. Frequently their stiffness improves with gentle motion but may come back after they sit still for some time (“gelling” phenomena). Pain often improves with light activity but is usually gets worse later in the day after harder activity, walking long distances or standing for a prolonged time. Over months or years the ability to bend or straighten the joint (“range of motion”) may decrease. Joints may swell from fluid collecting in the joint or from the growth of bone spurs (osteophytes) as the cartilage wears away. Fingers and knees may become “knobby”. The most important finding is a major decrease in the function of the joint.

A simple x-ray is the first diagnostic test to prove arthritis of most joints. X-rays can show the bone spurs and decreased space between the bones that can be found with severe end stage arthritis. Lab studies are rarely needed to diagnose the most common types of arthritis, but blood tests are helpful in diagnosing inflammatory arthritis such as rheumatoid arthritis, lupus, or ankylosing spondylitis. A MRI study is the best diagnostic test for viewing the soft tissue of bones and joints. However, it is an expensive test that is useful only if x-rays don’t make the diagnosis.

Treatment: What do I do about it?

Experts in arthritis concede that although there is no known cure for arthritis, we can help manage the symptoms. The treatment of arthritis begins with exercise to keep the joint moving and to maintain the strength of the muscles around the joints. Experts in arthritis recommend continuous motion exercise beginning with 15 – 30 minutes each day. Fitness walking, low tension stationary biking, low angle treadmill walking and water aerobics are tolerated well by most patients.

Patients are often interested in medications to help manage the pain from arthritis. Acetaminophen (Tylenol) is a pain medicine that is a first choice drug for arthritis because it is available without a prescription and is safe when used at recommended doses. Anti-inflammatory medicines such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve) help many patients with arthritis.

When exercise and the usual drugs don’t adequately relieve pain, patients are often willing to try more invasive means to help. Cortisone injections have been used for over fifty years and can be a safe and effective way to temporarily reduce pain for most people. Newer injections made with hyaluronic acid are commonly used to decrease the inflammation and pain for knee joints. These shots are sometimes called “chicken shots” because hyaluronic acid is a protein found both in rooster combs and in normal joints.

Finally, if x-rays show end stage arthritis and other treatments fail to control symptoms, surgery for arthritis may be necessary. The most common surgery for arthritis is joint replacement (total joint arthroplasty). The procedure involves cutting out the destroyed cartilage and bone then replacing it with metal and plastic parts. Hips and knees are some of the most commonly replaced joints and over 90% of the patients who get them get rid of 90% or more of their arthritis pain and are able to maintain their range of motion and function for 10 to 20 years or more.

Treatment for your arthritis depends on the cause of your arthritis, your age, the severity of your symptoms and your willingness to accept the risks of the treatment. When picking a course of travel on new highways, having a good map helps guide your path. The best resources are your family doctor, rheumatologist or orthopedic surgeon. Schedule a visit so they can help get you back on the road!

Monday, January 10, 2011

Why Do I Have Arthritis?

Healthy Knee

Arthritic Knee

Arthritic Hip (left) Healthy Hip (right)

Post provided by Marc DeHart, MD

If you have joints that are stiff, painful and have lost mobility, you are probably one of the 46 million Americans who have arthritis. Arthritis is the wearing out of the surface on the end of the bones and affects both large joints (hips, knees and shoulders) and smaller joints in the hand, feet and spine. Arthritis can come from injury and aging as well as specific problems with the soft tissues around the joints. Wherever it is found in the body and whatever causes the damage to the cartilage, it is the painful, swollen, and stiff joints which keep you from being active and moving on down the road.

All joints have a smooth white slippery covering called cartilage which acts as the bearing surface for movement. It is where the “rubber hits the road” for the movement of joints. There are over 100 various disorders which cause damage to the cartilage. The most common arthritis, osteoarthritis, results from stresses on cartilage that are greater than the tissue can withstand. This can be routine forces on weakened cartilage or from excess forces on normal cartilage. Researchers have found that an inherited weakness of the main protein in cartilage (collagen) frequently leads to early osteoarthritis. Hormones that help make women’s tissues soft, supple and more flexible for pregnancy may be a reason women have twice the osteoarthritis of men. It is easy to understand how the forces of direct trauma can damage cartilage and its underlying bone. Motor vehicle accidents, falls or severe sports injuries, especially those that tear ligaments, are well known causes of arthritis later in life. Using a tire example, driving recklessly over potholes or across sharp metal objects will clearly tear up your tires! Excess force on the joint over the long term can also wear out healthy cartilage.

People with crooked legs from bowlegs or knock-knees or from poorly healed fractures of the leg bones, wear out their cartilage on the high stress side of their joints. People with straight legs can also overload their cartilage with continuous loads that crush their cartilage. Participation in high level sports like soccer and football has also been associated with more frequent arthritis of the hip and knee. Occupations where heavy loads are lifted repeatedly, such as farming and ranching, can also lead to arthritis. Being overweight causes heavy loads across your joints with every step. Obesity is not only a common cause of hip, knee, and ankle arthritis, but it also makes your symptoms worse.

Other causes of arthritis are uncommon diseases like rheumatoid arthritis, psoriatic arthritis and lupus. These autoimmune arthritis disorders result when the body’s immune system goes awry and attacks its own cartilage. Using the car tire example, you can think of autoimmune disorders as a bad battery acid leak on the tires where the rubber slowly dissolves away!

Treatment for all arthritis is to decrease pain and improve the function. Treatment depends on the cause of your arthritis, your age, the severity of your symptoms and your willingness to accept the risks of the treatment. Avoiding high demand activities, weight loss, gentle exercises, canes or walkers, pills, injections and various surgical procedures can all be effective treatments. Your best resource for the diagnosis and treatment of arthritis is your family doctor who can refer you to a specialist should the need arise.