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!

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.

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.

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.

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.

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!

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.