Vegan Sources for Calcium

Mac and cheese. Moo juice (milk). Tubs of yogurt. These are all yummy options for getting your daily calcium fix. But what if you are one of the many vegans around town who forgo animal products in their diet, including dairy? What's a vegan to do in order to get the recommended amount of calcium?

Calcium is essential for healthy bones and to fend off painful conditions such as osteoporosis, something we treat frequently here at Texas Orthopedics. The National Institutes of Health recommends 1,000-1,300mg of calcium daily for adults over eighteen years of age.

While it is commonly found in most dairy products, it also pops up in many other foods you may not know about.

Take a look at these 25 surprising vegan sources for calcium:

1. Kale (1 cup contains 180 mg)
2. Collard Greens (1 cup contains over 350 mg)
3. Blackstrap Molasses (2 tablespoons contains 400 mg)
4. Tempeh (1 cup contains 215 mg)
5. Turnip Greens (1 cup contains 250 mg)
6. Fortified, non-dairy milk (1 cup contains 200-300 mg)
7. Hemp milk (1 cup contains 460 mg)
8. Fortified orange juice (1 cup contains 300 mg)
9. Tahini (2 tablespoons contains 130 mg)
10. Almond butter (2 tablespoons contains 85 mg)
11. Great northern beans (1 cup contains 120 mg)
12. Soybeans (1 cup contains 175 mg)
13. Broccoli (1 cup contains 95 mg)
14. Raw fennel (1 medium bulb contains 115 mg)
15. Blackberries (1 cup contains 40 mg)
16. Black Currants (1 cup contains 62 mg)
17. Oranges (1 orange contains between 50 and 60 mg)
18. Dried apricots (1/2 cup contains 35 mg)
19. Figs (1/2 cup contains 120 mg)
20. Dates (1/2 cup contains 35 mg)
21. Artichoke (1 medium artichoke contains 55 mg)
22. Roasted sesame seeds (1 oz. contains 35 mg)
23. Adzuki beans (1 cup contains 65 mg)
24. Navy beans (1 cup contains 125 mg)
25. Amaranth (1 cup contains 275 mg)

If you have questions about your bone health or would like to discuss calcium supplements with one of our physicians, please contact us for an appointment.

(Adapted from Care2-Healthy Living)

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Dr. Gueramy Interview in Physician Health Tech Insight

Texas Orthopedics' own Dr. Tim Gueramy was recently featured in an article written by Dan Greenfield for Physician Health Tech Insight. Dr. Gueramy speaks about the emergence of physician entrepreneurs and their growing role in the tech industry. You can find the entire article at:

http://www.physicianhealthtech.com/2016/08/tim-gueramy-md-entrepreneur-meets-physician/

Vitamin D and Muscle Strength

Having trouble hitting your stride at the gym? you may need to up your intake of Vitamin D.

A surprising study reveals that a Vitamin D deficiency could hinder athletic performance. Vitamin D plays a vital role in helping muscles release calcium, which allows them to work more efficiently when exercising.

Researchers at the University of Tulsa evaluated 100 college athletes and put them through the following paces while recording their outcomes:

• Sprinting for speed
• Jumping for height and distance
• Squatting for high reps

One in three of these athletes were found to have inadequate levels of Vitamin D (determined via blood tests).

So what can you do to make sure your muscles are performing at their max and that you are not down on your "D"?

Get at least 1,500 to 2,000 IU daily of the vitamin (according to the Endocrine Society). Good sources include fatty fishes, fortified milk, and dark leafy greens. Supplements are another option if diet is not enough.

If you notice any muscle issues, such as intense pain or swelling when you work out, contact us for an appointment.

(Adapted from Men's Health)

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5 Fast Facts about RA

Rheumatoid arthritis (RA) is the most common form of arthritis, and it's also one of the most painful and debilitating. Symptoms include joint pain and stiffness as well as compromised mobility in the more than one million American suffering from it. It is very manageable though with the right treatment, and it is a condition that we handle all the time here at Texas Orthopedics.

Here are five interesting facts to know about RA:

1. It can come and go.

Mild cases may show up for only a few months with the disease pretty much disappearing after a while. Others experience flare-ups that consistently wax and wane over a long period of time.

2. The heart is not immune.

Similar to high cholesterol or high blood pressure, RA can also cause stress on your heart. The same inflammation that attacks joints can spread to the heart as well. To keep your ticker in tip-top shape when suffering from RA, adopt a healthy lifestyle through diet and regular exercise.

3. Surgery can be a savior.

Many RA symptoms can be alleviated through modern surgery. Repairing damaged joints and tendons, or replacing them all together, is easier than ever due to new and improved surgical procedures that are minimally invasive with far less recovery times.

4. Easing stress can soothe joints.

Stress and anxiety have been linked to increased RA flare-ups. Relaxing more, both mentally and physical, can help relieve pain and restore motion.

5. Kicking butts can go a long way.

Research reports that nearly 1/3 of those suffering from severe cases of RA are also smokers. Smoking is not a healthy choice for anyone, but for RA patients, kicking the cigarette habit can greatly decrease symptoms.

If you suspect that you are newly suffering from RA, or need help managing your current condition, please contact us for an appointment.

(Adapted from Healthgrades)

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Artificial Turf and Football Injuries

It's mid-August and besides scorching temperatures, you know what that means - football season is here! And while we all get excited about football, we're also starting to see a lot of injuries at Texas Orthopedics in August like sprains and strains, fractures, and concussions.

Full contact with another player is the main reason for these injuries, but another culprit is the actual playing surface - specifically artificial turf. While some high school fields around Central Texas are still natural grass, many are artificial.

AOSSM (The American Orthopaedic Society for Sports Medicine) recently shared results from a study that looked at football injuries as they relate to the infill weight of artificial turf.

Infill is the material that literally fills the gaps between the blades of artificial grass. A higher turf infill weight provides more cushion, or padding, for players when they hit the ground.

Researchers evaluated 52 different high schools spanning five sports seasons (2010-2014). Infill studied was made up of sand and/or rubber, and was measured in four separate categories based on pounds per square foot.

Findings include:

• As the artificial surface weight decreased, the incidence of game-related high school football injuries greatly increased.
• Injury totals were significantly lower when infill rates were at a level of more than nine pounds per square foot.

The key recommendation from the study is that high school football fields made up of artificial turf should contain a minimum of six pounds per square foot of infill weight to optimize player safety.

AOSSM and it's STOP Sports Injuries initiative is dedicated to the prevention of traumatic and overuse injuries in youth athletics.

(Courtesy of AOSSM)

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Antibiotics and Workout Injuries

A warning to those on antibiotics who are also working out - The FDA (U.S. Food and Drug Administration) recently issued an update about a surprising side effect.

A new study from the University of Toronto discovered that antibiotics called fluoroquinolones can increase your risk for tendonitis, a common condition we treat at Texas Orthopedics, or even a full-blown tendon rupture, if taken while continuing to work out rigorously. The most common of these antibiotics, such as Cipro and Levaquin, can triple your risk for tendon rupture according to the research.

Antibiotics prevent certain cells in your body from multiplying, mainly the ones you are trying to fend off, but they can also stop your tendons from repairing their cells following strenuous exercise. Specifically, physical activity that involves weight-bearing force, like running or cross training, can be the most harmful.

In addition, if you are also on a corticosteroid, typically used to treat asthma or arthritis, your risk for a tendon injury rises by as much as 43 percent.

When you are following a serious training/workout regiment, it is a good idea to ask your doctor about different options for antibiotics, other than fluoroquinolones, for your treatment.

If you experience any muscle or tendon pain or swelling while on antibiotics, be sure to inform your physician.

Adapted from Men's Health.

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Backpacks and Female Back Pain

A recent study published in The Spine Journal reveals that adolescent girls have the highest risk of suffering from back pain due to schoolbags/backpacks.


The Don Carlo Gnocchi Foundation (Italy) conducted a study involving 5,318 students aged 6 to 19 years. The goal was to examine back pain as it related to schoolbag use. The study was administered via in-person questionnaires, and findings include:

• More than 60 percent of participants reported pain
• Pain increased significantly from children to adolescents despite a decrease in bag load
• More frequent and severe pain was noted by girls than boys
• Adolescent girls proved to be at the greatest risk of suffering from intense pain
• Schoolbag load scarcely dictated back pain, but the amount of time carrying a bag was very influential

Results suggest that other factors (anatomical or physiological) might impact the difference in pain perception between males and females.


This news comes just in time for back-to-school shopping, and serves as a good reminder, for both boys and girls, when purchasing a new backpack. A few features to look for are:

• Lightweight fabric such as canvas
• Two wide, padded, and adjustable shoulder straps
• A padded back to protect from things poking through from inside
• Multiple compartments to help distribute and balance the weight of objects

(Courtesy of Physician's Briefing)


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Gamer's Thumb

If you're a parent, there's no way around it...your kids have likely spent entirely too much time on their tablets, smartphones and any other kind of electronic devices this summer.

But doctors have a warning: Too much time spent on handheld devices may lead to painful hand, and even neck and spine issues. Anone specific condition: 'Gamer's Thumb', also known as DeQuervain's tendonitis. It's caused by an inflammation of tendons connecting the wrist and thumb and is typically brought on by constant quick, repetitive thumb movements.

Symptoms of this include a shooting pain, clicking, locking, or tightening sensation in the thumb or wrist.

With summer coming to a close soon, the American Academy of Orthopaedic Surgeons (AAOS) suggests parents begin cutting back on screen time now in preparation for the start of school.

But for those last few moments of summer gaming joy, AAOS recommends the following tips:

• Take breaks. Alternate gaming/screen time with a physical activity such as playing a sport or swimming. Also look into setting a timer to alert when it's time to take a break.
• Use good posture. Sit in an upright chair that encourages good posture, as opposed to slouching, while sitting in front of a computer or television screen.
• Stop gaming if there is any pain. Walk away completely from the device if there is any pain in the hand, neck, back, or vision becomes blurry. This is your body telling you it is time to stop.
• Stretch. Perform gentle stretches by bending the tip of the thumb down toward the base of the index finger. Hold for 30 to 60 seconds. Repeat 10 times.

If your child, however, experiences consistent or severe pain in their thumb/hand, please contact us for an appointment.

(Adapted from AAOS)

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Zika and the Olympics

The global buzz surrounding the Zika virus has been epic, with its potential impact on the upcoming Summer Olympics (Rio de Janeiro, August 5-21) being played out in the world news daily.

Although Rio has come under intense scrutiny for many other issues related to the health and safety of athletes and spectators, it is the Zika virus that has proven to be the most worrisome.

The virus is primarily spread to humans from a bite via an infected mosquito. It is also transmitted through blood transfusions, sexual intercourse, and pregnancy. Brazil, and most of South America, have proven to be a rampant breeding ground for these infected mosquitos.

While typical Zika symptoms are relatively mild--fever, rash, joint pain, red eyes--it is the threat it poses to pregnant women and its harm on an unborn fetus causing many athletes to stay away. Most notable are several high-profile golfers who have recently declined to compete out of fear of contracting the virus during the many hours spend outdoors.

If Zika is transmitted during pregnancy, it may result in a medical condition known as microcephaly, characterized by an undeveloped brain and abnormally small head in newborns. While the Brazilian government and IOC (International Olympic Committee) have taken numerous precautions to protect athletes, many athletes are passing on the trip to Rio, feeling it is too strong a risk to take of either passing it on to their female partner or women contracting it themselves who might later wish to become pregnant.

To get the latest information about Zika, visit the CDC website at http://www.cdc.gov/zika/.

(Adapted from Stop Sports Injuries)

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Common Gymnastics Injuries

Gymnasts are often dubbed the unofficial darlings of the Summer Olympics. Their events are slotted for prime time coverage, and tickets are among the toughest to come by.

But just like with any other athletes, gymnasts are not immune to injury. The U.S.'s own John Orozco, a standout star on the men's team, recently suffered a torn ACL having to withdraw from the upcoming Rio games.

More than 85,000 gymnastics-related injuries are treated each year in U.S. hospitals, doctors' offices, and clinics. While highly skilled routines showcase a gymnast's supreme strength, balance, and coordination, they also render them highly susceptible to injury. Most injuries occur when a gymnast falls of a piece of equipment or lands improperly after a tumble or dismount.

Common gymnastics injuries include:

• Angle and wrist sprains/strains, breaks, or fractures
• ACL (anterior cruciate ligament) injury: a complete tear or painful wearing down of the knee ligament connecting the thighbone to the leg bone
• Achilles tendon injury: a tear or soreness (tendonitis) located at the tendon between the calf muscle and heel
• Lower back injuries: often due to muscle strains, ligament sprains, or disc issues caused by excessive arching movements

Overuse injuries are also typical in gymnastics where the repetitive motions can take a damaging toll on muscles and bones.

(Adapted from Stop Sports Injuries)

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