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Texas Orthopedics, Sports & Rehabilitation Associates

Monday, May 29, 2017

Why you need to take a rest day

The time hardcore fitness buffs or gym goers spend in the gym may be cut down with summer around the corner.

If this strikes a chord with you and you think your body will suffer from a less intense training schedule, new research points to just the opposite. Your body actually needs rest and frequent, definitive breaks in training to benefit from the hard work you are putting in.

A recent study from Brock University in Canada looked at blood samples from 15 female Olympic rowers during their most intense workout weeks (averaging 18 hours a week of dedicated training) followed by samples taken on recovery days without rowing.

Here’s what they found:

Rowers showed lower levels of osteoprotegerin (OPG)—a protein that protects against bone loss—during heavy workout days.

They exhibited higher levels of sclerostin (SOST)—a protein that hinders new bone formation—during high-intensity training weeks.  

Rigorous training leads to inflammation throughout the body, which likely contributes to higher levels of SOST.

These results suggest that prolonged high-intensity training may cause bone damage over time. This could ultimately lead to decreased bone density and osteoporosis, broken bones and fractures, or other overuse injuries.

In addition, muscles are said to grow bigger and stronger if you factor rest days into your weight-bearing (such as weight-lifting) routine. As pressure mounts within a muscle during a workout, tiny tears occur in the tissues…and time is the best remedy for allowing these tears to heal and mend properly so that the muscle can recover and then function even stronger than before.

If weight-lifting is in your regular rotation, alternate the amount of reps you do each week between high, medium, and low volume, as well as varying the amounts of the weights themselves.  

Also, plan a few days to “deload” every four to eight weeks where you do nothing weight-bearing or of high-intensity for several days in a row. Instead opt for walking, light swimming, or a leisurely jog to stay active.

If you have chronic bone, muscle, or joint pain due to your heavy workouts, please contact us for an appointment.

 (Adapted from Men’s Health)

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Yogurt for Bones

However you prefer your yogurt—frozen, Greek-style, or fruit on the top or bottom—new research says to keep eating it for its healthy bone benefits.

A recent study out of Ireland published in the journal, Osteoporosis International, tracked the bone density and joint deterioration of more than 4,300 adults 60 years and older. Data was collected via X-rays and MRIs over several years.

A questionnaire regarding diet and lifestyle habits (such as smoking and drinking) was also completed by the participants.

Those who indicated that they ate dairy yogurt daily had a three to four percent increase in bone density. The study also showed that the yogurt consumers had:
  • A 39% lower risk for osteoporosis in women
  • A 52% lower risk for osteoporosis in men
Additionally, the participants who reported a regular yogurt intake also performed better during the physical fitness portions of the study.

The results strongly support what other research has shown for years:  yogurt is beneficial to bone (and overall) health due to its rich blend of Vitamin D, B Vitamins, calcium, protein, and probiotics.

Other dairy-rich foods high in these bone-boosting nutrients include cottage cheese, kefir, and plain milk.

One important note:

The study cautioned that many of the processed yogurts available have added sugars and food dyes. Experts recommend choosing plain versions and putting your own spin on it by adding fruit, nuts, natural honey or agave sweeteners, and a sprinkling of cocoa powder, cacao nibs, or cinnamon.

If you have questions about osteoporosis, or would like to schedule a bone density exam, please contact us for an appointment.

(Adapted from The New York Times)

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Monday, May 22, 2017

Updated Guidelines for Osteoporosis Medications

If you’re one of the estimated 54 million Americans suffering from osteoporosis (a condition that weakens bone density), you’ll want to know about new guidelines just issued on some of the most widely prescribed medications.

The journal Annals of Internal Medicine recently published an update on the American College of Physicians’ widely followed recommendations from 2008, specifically addressing the previous belief that certain types of osteoporosis medications carry harmful risks including atrial fibrillation and additional joint pain.

Research now shows the risks are minimal and that taking these medications to protect bones over the long-term are extremely beneficial. As the typical age of someone suffering from osteoporosis is over 50 years, and as your risk for a traumatic fall, ending in broken bones, fractures, and even death, increases as you get older, strong bones are essential. 

The new advisory suggests doctors continue to prescribe bisphosphonates or denosumab medications for at least five years following an initial diagnosis, especially for women. (Many patients tend to go off their medications after a short while if they haven’t experienced a recent injury.)

Bisphosphonates help decrease the resorption, or breakdown, of older bones. Common brands of bisphosphonates include Fosomax, Reclast, and Zometa

Denosumab drugs are engineered antibodies designed to combat the onset and early effects of osteoporosis, prescribed under the Prolia and Xgeva brands.

In addition, the advisory panel suggested avoiding estrogen replacement therapy for women in favor of other treatments that offer greater bone health benefits and less unpleasant side effects.

To help alleviate your symptoms of osteoporosis, we recommend taking your medications as prescribed by your orthopedist, and also adopting a diet rich in calcium and Vitamin D. Use supplements as directed, and exercise regularly to keep muscles and joints in good shape.

If you have questions about your osteoporosis medication, or would like to schedule a bone density exam with one of our specialists, please contact us for an appointment.

(Adapted from CNN-Health)

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Noisy Knees and Arthritis

Could noisy knees that go snap, crackle, and pop when you straighten or bend them point to arthritis (an inflammatory condition that causes joint pain, stiffness, and immobility) in your future?

Noisy knees, or the cracking of knee joints, is a condition known as crepitus.

A new study published in Arthritis Care & Research, and supported by the National Institutes of Health, examined data from nearly 3,500 participants who reported crepitus over a four-year period.  Participants were selected on specific risk factors associated with arthritis including a family history of the disease, being over the age of 45 years old, or having a high BMI (body mass index).

About 18 percent of those who reported crepitus at the start of the study went on to receive a formal diagnosis of arthritis at some point during those four years or shortly after. For some people, the cracking does result in a weakening of cartilage between bones and irritation or inflammation at the site of joints, especially when coupled with already existing risk factors.

For many of the participants though, their knees remained in stable condition even with the crepitus. Their noisy knees were simply noisy knees.

However, experts suggest that if you experience frequent popping or cracking sounds of the knee joint, even if there is no pain, you should get it checked out by an orthopedist just to rule out arthritis or any other underlying issue. If a diagnosis is discovered early, there are many treatments to keep the disease at bay and your joints functioning as close to normal as possible.

Exercise, weight loss, and an inflammatory diet also contribute greatly to reducing painful arthritic symptoms.

If you have trouble with your knees, or hear a frequent popping or cracking sound, please contact us for an appointment.

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Monday, May 15, 2017

Swimming Injury Prevention

As our temps start to rise, more Central Texans will be swimming. And while it’s an excellent workout for the entire body, if you haven’t been in the pool since last summer and start full-on sprints in the lap lane, you could find yourself in deep water with an injury.

The most common injuries are to the shoulder/rotator cuff and lower body extremities.

Shoulder impingement, or swimmer’s shoulder, occurs when tendons become inflamed or irritated due to overuse. This could stem from swinging your arm up over your head as you complete a stroke. You could also hurt your knee or hip joints – also from overuse from kicking.

Here are some tips to help make your transition to a summer swim workout a smooth one:
  • Start doing focused exercises targeting the shoulder at least ten days to two weeks before hitting the pool to build up strength.
  • Before getting in the pool, warm up with light stretches, or something like jumping jacks.
  • Consider meeting with a certified swimming instructor for a few sessions to get feedback on your strokes.
  • Alternate your strokes every few laps to give your body a break by activating different muscles in various sequences. 
  • Take regular breaks from lap swimming, every few days, just as you would with any other sport to let your body rest and recover. Fill in non-swimming days with walking, slow running, or cycling.
Other tips for safe swimming are:
  • Never dive in shallow water
  • Always make sure there is a lifeguard present, or someone else around.
  • Wear properly-fitting goggles and ear plugs to protect eyes and ears from infection or irritation from the chlorine.
  • Don’t forget to use waterproof sunscreen, and reapply often.
  • Avoid swimming if you are sick, overheated, chilled, or exhausted.
If you experience any pain in your shoulders, knees, or hips from swimming, please contact us for an appointment.

(Adapted from STOP Sports Injuries)

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Can Collagen Improve Joint Pain?

Collagen is touted as a miracle with “medicinal qualities” for a number of health and beauty issues including wrinkles and sagging skin, thinning hair, difficulty with digestion, and even common joint pain associated with arthritis or other inflammatory conditions. 

Our own bodies produce collagen, but as we age, production decreases and robs skin of plumpness and elasticity. This translates to brittle hair and sore and aching joints because the spongy cartilage between our bones weakens.

In a recent study that examined the effects of collagen hydrolysate on fitness-related joint pain, researchers found that of the 147 participants who took the supplement (versus those who were given just a placebo), all reported less joint pain at rest, and while walking, standing, and lifting/carrying objects.

These results show there could be future possibilities for using collagen to treat other joint pain like that related to arthritis and its many different forms. However, experts urge that more research on collagen therapy is still needed.

In the meantime, to ease common joint pain, we suggest a combination of:
  • healthy diet (with a focus on anti-inflammatory foods such as seeds, nuts, certain seafoods like salmon, olive oil, and plenty of fruits and vegetables)
  • regular exercise, like walking or swimming, to keep joints well-lubricated and flexible
  • maintaining a healthy weight so there is less pressure put on joints
If you do experience severe or consistent joint pain, please contact us for an appointment with one of our orthopedic specialists to discuss other treatment options.

(Adapted from

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Friday, May 5, 2017

Most Common Athletic Injuries in Women

This month we celebrate Mother’s Day and all of the women who are important in our lives. At Texas Orthopedics, we are ever grateful for our female physicians and all of the strong women who complete our staff and family.

Did you know that men and women suffer from injuries differently? Specifically, when it comes to sports injuries. A woman’s anatomy and movement patterns make them more vulnerable to certain types of injury than men, no matter how in shape or flexible they might be.

Here are three of the most common sports injuries in women, and ones that we treat all the time in our offices:

Women are nearly four times as likely as a man to suffer from an ACL tear, especially if participating in sports that involve quick pivoting and jumping, like soccer and basketball. Women have wider pelvises than men which creates a bigger angle between the knees and hips, often forcing the knees to turn inward and placing greater strain on the joint and ligaments.

Women tend to be more flexible than men, allowing them to stretch longer and higher when serving a tennis ball, or go deeper into a complicated yoga pose…but with added flexibility comes an added risk for injury. It is easy to overuse the shoulder joint, or even hyperextend it, unknowingly because movement seems so fluid and easy. With overuse comes tendon irritation (tendonitis) or the potential for a more serious injury such as a rotator cuff tear.

As with the vulnerability to ACL tears, ankle sprains are also common in women due to the excess pressure put on the ankle joint as a result of a widened pelvis. Ankle injuries are also very common in runners whether due to an exhausted joint or unfortunate tripping or a fall on an uneven path…and the sheer number of women who are fiercely loyal to the sport of running these days leads to a greater awareness of this particular injury among them.

Texas Orthopedics encourages dedicated prevention to avoid these injuries by properly warming up before sports, and resting as much as possible in between sessions to allow joints and muscles to sufficiently heal and recover.  

(Courtesy of

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Electrical Stimulation for Muscle Recovery

Neuromuscular electrical stimulation (NMES) devices have been around for some time and used on everyone from professional athletes to your hometown high school’s leading scorers. These discreet, portable devices are meant to rehabilitate muscles following injury, or enhance muscle performance, via tiny electrical impulses transmitted directly through the skin. Electrical stimulation has been shown to improve muscle contraction and increase blood flow.

At Texas Orthopedics, we often recommend electrical stimulation to reactivate the quadriceps muscles after ACL repair surgery. Sometimes it is also helpful for rehabilitation of the neck or shoulder muscles as well. Benefits of electrical muscle stimulation include:

  • Faster recovery times when coupled with a regular physical rehabilitation program
  • Decreased muscle atrophy frequently accompanying a serious injury, or after surgery
  • Less muscle pain and soreness leading to improved mobility and range of motion

While it may be tempting to purchase and administer use of one of these popular devices on your own, it is best to consult with your board-certified orthopedic surgeon or physical therapist before doing so. If the electrical currents are not carefully monitored, further tissue damage can easily occur...unfortunately setting back your recovery time that you initially sought to speed up.

If you have questions about whether an electrical stimulation device is right for you, please contact us for an appointment.

(Courtesy of STOP Sports Injuries)

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Dr. Joseph Martinez Joins Texas Orthopedics

Texas Orthopedics is proud to announce that Dr. Joseph Martinez has recently joined our team.

Dr. Martinez is one of only a handful of rheumatologists throughout Central Texas. He specializes in treating all types of rheumatological disorders including rheumatoid arthritis, lupus, osteoarthritis, vasculitis, scleroderma, spondylitis, and other autoimmune deficiencies.

Additionally, he is certified by the American College of Rheumatology to perform musculoskeletal ultrasound—a highly sophisticated imaging system used in diagnosing various conditions.  

Dr. Martinez has been published in many peer-reviewed medical journals, and he is a frequent presenter at local, national, and international symposiums.

He obtained his medical degree and completed his residency at the University of Texas Health Science Center at Houston which was followed by his fellowship training at the LSU Health Science Center in New Orleans.  He has also traveled extensively to support numerous medical missions worldwide.

Dr. Martinez is seeing patients in our newly-opened Kyle office, as well as at the Central Austin location. To schedule an appointment with Dr. Martinez, please contact us. 

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Monday, May 1, 2017

Texas Orthopedics is Expanding

The Texas Orthopedics family just got a little bigger. We are excited to share the opening of our permanent location in Kyle on May 2nd, 2017. Along with the new office, we are proud to welcome three new physicians, Dr. Ryan Tibbetts, Dr. Joseph Martinez, and Dr. Benjamin McArthur who will be treating patients there.

The new Kyle location (4215 Benner Rd., Ste. 300, Kyle, TX 78640; Phone: 512-439-1007) meets the demand of the rapidly surging population in Hays County, located south of Austin. Hays County is currently the fastest growing county in the state of Texas (
U.S. Census Bureau).

Dr. Ryan Tibbetts specializes in shoulder and elbow reconstruction, sports medicine, and joint replacement. He graduated from Texas A&M University and earned his medical degree from the University of Texas Medical School in Houston. Dr. Tibbetts later performed his orthopedic resident training at Scott & White Memorial Hospital in Temple, and completed a shoulder and elbow fellowship at the University of Texas Health Science Center in San Antonio.   He has been practicing in the Kyle area for seven years.

As one of only a handful of rheumatologists in the Central Texas area, Dr. Martinez’s focus is on rheumatologic disorders, including rheumatoid arthritis, lupus, scleroderma, vasculitis, gout and osteoporosis. He received his medical degree and completed his residency at the University of Texas Health Science Center at Houston and subsequently completed his fellowship training at the LSU Health Science Center in New Orleans.  Dr. Martinez has also authored medical articles and abstracts and presented his findings at several scientific meetings.

In June, Dr. Benjamin McArthur will be joining the practice in Kyle. Dr. McArthur’s expertise is in complex hip and knee replacement surgeries, hip preservation surgery, and corrective revisions of prior surgeries. He graduated from both Rice University and Baylor College of Medicine before completing his orthopedic residency at the Hospital for Special Surgery in New York City. Dr. McArthur fulfilled a fellowship in adult lower extremity reconstruction at the Mayo Clinic.

Services that will be offered at the new Kyle location include general orthopedics, sports medicine, joint replacement, rheumatology, infusion therapy, physical therapy, and onsite X-rays.

Screening for ACL Injuries

With more and more kids participating in youth sports these days, the risk for injury is climbing higher and higher. ACL injuries are among the most commonly occurring sports injuries in children and adolescents. We see these injuries daily at Texas Orthopedics when the ACL (anterior cruciate ligament) snaps or tears rendering the knee joint dysfunctional and causing a great deal of pain.

An ACL injury at such a young age can lead to a number of serious issues later on, including lack of mobility, chronic knee, hip, and back pain, and even obesity.

For this reason, innovative screening programs are being developed to help identify which young athletes may be at greatest risk for an ACL injury. Kids who play sports that involve running, jumping, quick cutting, and pivoting – like basketball, football, and soccer – are the most vulnerable, as are kids who play the same sport across multiple seasons.

Sophisticated 3D imaging has been designed to evaluate movement patterns of an athlete and diagnose current and potential wear and tear to the knee joint and surrounding ligaments.  Through initial screenings, examiners have been able to determine that while some ACL injuries are due to physical contact, the majority of them (up to 70 percent) are non-contact and likely could have been prevented.

As development of the screening technology is still in its early stages, experts agree that taking great measures to prevent an injury before it actually happens is the next best thing to a proactive screening.

The more coaches, athletic trainers, and parents encourage their athletes, and children, to properly stretch and warm up before playing, as well as taking time to rest afterwards, the less chance there is for injury. Many sports organizations and school teams already have dedicated injury prevention programs in place specifically addressing the knee and ACL.

Texas Orthopedics encourages all parents to take an active role in their children’s sports to ensure their utmost safety. If you have any concerns about an ACL, or other youth overuse injury, please contact us for an appointment.

(Courtesy of STOP Sports Injuries)

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