Many people are affected by joint pain as they get older and this is more prevalent in menopausal women. Typical symptoms of menopausal joint pain include aches, stiffness and swelling around the joint that may be worse in the morning but improve as the day continues.

Hips and knee joints which experience high impact tend to be most affected by this “menopausal arthritis” although hands and fingers can also be affected. In the past, high impact exercise like jogging was considered to be harmful for the integrity of articular cartilage. It was believed that it could worsen the problem although this has never been proved scientifically.

According to a recent study, high-impact loading – jumping type of exercise – and a rapid change of movement directions are shown to be the most efficient exercise modality to improve bone strength.

Nearly any form of arthritis can affect the knee and cause knee pain and swelling. Cartilage breakdown and infections in the joint are some of the problems that trigger pain in the knees. Knee arthritis occurs when there is a breakdown of the cartilage that cushions the ends of the bones where they meet to form the knee joints. This causes the bones to rub against each other causing stiffness, pain and loss of movement in the joint.

There are cases where knee replacement also referred as knee arthroplasty may be needed in order to help relieve pain and restore function in the seriously diseased joints. This happens when medical cures are not satisfactory and knee replacement surgery is considered to be an effective treatment.

A study was carried out in the Department of Health Sciences at the University of Jyväskylä, Finland on the effects of high-impact exercise in postmenopausal women. The effects of high-impact exercise on knee cartilages, osteoarthritis symptoms as well as physical function in postmenopausal women with mild knee osteoarthritis were examined.  The study revealed that progressive high-impact training enhanced the patellar cartilage quality of postmenopausal women who may be susceptible to osteoporosis (bone loss) and also in danger of osteoarthritis.

The study enrolled 80 eligible postmenopausal women aged between 50 to 65 years and having knee pain during most days of the month, who were then randomly assigned into a training group or a control group. Before the randomization and intervention was done by radiographs, all the participants had their mild knee osteoarthritis confirmed. The training group exercised as per supervised progressive high-impact exercise program thrice every week for 12 months. The control group was however left to continue with their normal physical activity.  The impact of exercise on the texture of patellar cartilage and the quantity of liquid were measured using T2 relaxation time at MRI imaging.

According to Jarmo Koli, a Doctoral Student and OMT –physiotherapist from the Department of Health Sciences, the breaking of collagen network and increased free water in the articular cartilage is thought to signify the onset of osteoarthritis degenerative process.  The disease progression might be slowed down if those cartilage breaking changes can be delayed, stopped or even improved by the quality of the cartilage through physical activity.

The study established that training improved the patellar cartilage’s quality as well as physical functions like the strength of knee extensors and cardiorespiratory fitness. However, the most significant finding was that high-impact jumping exercise enhanced the biochemical composition of cartilage as shown by MRI in those with mild knee osteoarthritis.  The 12-month training was reportedly well tolerated and it didn’t induce any knee pain or stiffness. The training compliance was also generally high.

If you have knee pain or would like a second opinion, contact our specialists at Orthopedic Surgery San Diego to schedule an appointment to determine a treatment measure best suited to your needs.

A Healthy Eating Program Plan for Schools.
Through the Healthy, Hunger-Free Kids Act, supported by the First Lady, Michelle Obama, and signed into law by President Obama, the U.S. Department of Agriculture (USDA) set out nutrition standards for school meals. The aim is to help raise a healthier generation of children who will be less vulnerable to adverse effects from obesity and poor dietary habits.
These innovative reforms will impact positively on children’s health in a way that is achievable in schools across the nation.
Children who participate in sports will benefit from more stamina and better performance levels when nutritious meals are eaten on a regular basis. Kids in general will also be more resistant to succumbing to colds and flu and other infections when the new nutrition standards for school meals is fully under way.

Putting nutritious and healthy food on the plate is not enough if the kids don’t eat!
The results of a recent study in Utah suggested that a simple solution of moving lunchtime until after recess prompted kids to eat more and waste less. The theory is that children are hungrier after recess, and as they were not in a rush to get out and play, were inclined to eat more. The lunchroom also became a much calmer, more orderly area.
Researchers noted that after conducting studies at some schools which had switched the order of lunch/recess, there was a measurable per child improvement in the consumption of fruit and veggies.
Children who came from less affluent homes where fruit and vegetables are not in plentiful supply, were encouraged to eat healthy meals which afforded nutrition that they might not be getting at home.

The future generation.
The children of today are the generations of tomorrow. Improving the quality of school meals for every child across the nation is an important step in building a healthy future for our kids. Parents at home need to do their part a by encouraging their children to eat more healthily. Reducing the amount of junk food consumed is also critical.
Schools should also strongly consider changing the lunch/recess order which could motivate students to eat better meals.
The implementing of this simple suggestion could be the answer to years of struggling to get children to finish eating the school lunches and so put an end to the frustrations of the lunch ladies.

If you have questions about proper nutrition for you or your family, contact our specialists at Orthopedic Surgery San Diego.

Our hip can be injured in various ailments. Arthritis is one of the primary reasons for hip pain. Osteoarthritis is due to the natural wear and tear of the joint that occurs in individuals as age progresses. Rheumatoid arthritis is another form arthritis that occurs in case of an overactive immune system. Out body starts destructing our own bone and joint cells thereby leading to a debilitating condition. In case of hip injury there may be a significant amount of hip pain and discomfort. Such cases cannot be left unattended as it can interfere with the normal day-to-day activities. Hence the best way to manage such conditions is to go for hip replacement or total hip arthroplasty.
Infection is one of the major complications one has to face after THA. It is a serious matter of concern for the health provider and the patient as well. The chances of infection have been reported to be on a rise in individuals with BMI higher than 35 or 40.

Morbid obesity is a condition in which a person has a Body Mass Index (BMI) greater than 40 or fall in the range of 35 to 40. To make it easy to understand, one can say that in case of morbid obesity a person will have a weight at least 100 pounds more than the normal level. Morbid obesity is an alarming issue as it has a lot of complications associated with it like development of infection and failure of implant placement.
A study was conducted between two groups of patients who were morbidly obese and non-obese. The study was aimed to achieve a comparison between the results of two-stage revision THA (total hip arthroplasty) done for periprosthetic joint infection. For this purpose a total of 653 patient records were studied. For this study their preoperative BMI was taken into consideration. A total of thirty-three patients who were morbidly obese were in one group and in another group 66 non-obese patients were taken into consideration.
After the completion of study, the results were compared and it was observed that the rate of reinfection was extremely high in morbidly obese patients (18%) when compared to the non-obese patients (2%). Almost a similar response was seen in case of revision as it was 42% in morbidly obese patients and 11% in non obese patients. Reoperation for any specific reason was seen in 61% of morbidly obese patients and 12% in case of non obese patients.
To conclude, the study determined the fact that morbidly obese patients are at a significantly higher risk of developing complications of reinfection or reoperation after total hip arthroplasty for periprosthetic joint infection as compared to those who are non obese.

Contact our specialists at Orthopedic Surgery San Diego to discuss your options if you are faced with hip pain.

As we grow older, our bodies begin the inevitable process of breaking down. Our bones become weaker and more brittle, our reflexes slow, and our hearing and vision leave a lot to be desired. During our younger days, a fall down a few steps wasn’t usually a cause for alarm, and we could easily bounce back from trips, injuries, cuts, and bruises. Around the age of 65, when we are considered “elderly”, falling can often mean a more traumatic and painful event, resulting in broken joints, fractures, and head wounds.
Unfortunately, every year, millions of senior adults will suffer from a fall. Statistics show that this is equal to ⅓ of the elderly population, or one out of three adults. Falls are the most common cause for injury, fatal or nonfatal, to those 65 and older. These injuries often result in a visit to the Emergency Department (ED) for treatment. In 2006, there were 2.1 million visits to the ED for falls of an elderly adult that resulted in an injury, and each year the numbers rise, and at a cost of around 20 billion annually.

Hip Fractures
Not surprisingly, 95% of all hip fractures in elderly adults are caused by a fall. In 2010, there were 258,000 hip fractures recorded in the United States. Hip fractures almost always require hip surgery, especially in older adults. Those adults who suffer from osteoporosis are even more likely to fracture their hip than those who do not suffer from the disease. Surgery on hip fractures are more successful the quicker they are performed, so it is important to see a doctor as soon as possible.

Are you at Risk?
Seniors 75 and older at least four times more likely to be admitted for a year or more to a care facility from a fall than those ages 65-74. Elderly Caucasian men are at the most risk for fall-related deaths. The CDC notes that statistically, they are 41% more likely than women to die from a fall, and 2.7 times more likely to die than elderly black men. Women, however, go to the ED for a fall more than men, and are 50% more likely to suffer from fractures from falling, with white women suffering a higher number of hip fractures than black women.

How to Prevent a Fall ?
While no one certainly tries to fall and accidents can and will happen, many falls can actually be prevented. Seniors can take care to keep exercising regularly to keep their bones as strong as possible. Exercises that work on keeping good balance is especially helpful as we grow older. Older adults should have their vision and hearing tested regularly, go for 6 month checkups with their family doctor, take vitamin D, and be careful to keep medications that cause sleepiness or dizziness to a minimum. Home preventions can include using handrails, installing rails in the bathroom, and keeping the floors in the home free from clutter. Being proactive and realistic about your age and abilities are key to injury prevention.

If you have questions about injury prevention, contact our specialists at Orthopedic Surgery San Diego.

Athletes have individual “biological clocks,” so they reach peak performance at different times of the day, according to researchers.

The journal “Current Biology” recently published a British study involving “competition-level” athletes. Scientists concluded that choosing the right time to work out could be more beneficial than taking testosterone or performance-enhancing drugs.

The research showed that night owls who sleep late into the morning are able to sprint up to 26 percent faster when they wait until evening to do so.

Those findings came as a surprise to many experts, according to The New York Times, because past studies suggested nearly everyone performs better in the evening. The new data indicates early birds exercise more effectively at about noon. “Intermediate risers” are at their best in the afternoon.

The study, led by Dr. Roland Brandstaetter of England’s University of Birmingham, tracked 20 field-hockey players and 22 squash players who engaged in their sports six times per day.

The Times reported: “The early risers tended to wake up, on average, around 7 a.m. on weekdays and 7:30 on weekends; intermediate risers got up about 8 on weekdays and 9:10 on weekends; and the late risers awoke about 9:30 on weekdays and 11 on weekends. The researchers evaluated their performances with measures involving sprinting tests and, for the squash players, a test of concentration and alertness in which the athletes had to hit a ball into a small area.”

The results make sense, according to Dr. Benjamin D. Levine, director of the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital in Dallas, Texas. “Every athlete knows that there are times of day when they perform best,” he told the Times.

Others, however, noted that the study was small in terms of the number of participants. They called for further research, with better performance testing methods, to confirm the findings.

As the Times pointed out, experts already were aware of the role a person’s biological clock plays in body temperature, heart rate, reaction time and concentration. The researchers’ conclusions provide confirmation, according to Kenneth P. Wright Jr., director of the sleep and chronobiology laboratory at the University of Colorado.

Fortunately for competitive athletes, their biological (or circadian) clocks can be adjusted. They can alter peak performance times by adjusting the light in their homes and eating meals at different times of day, Brandstaetter reported. Another technique is to get up earlier or later in the morning, which requires changing the bedtime to ensure adequate sleep.

Hirofumi Tanaka, an exercise researcher at the University of Texas, told the Times: “There is no question that circadian rhythms affect sports performance.” But he cautioned that studying the phenomenon is difficult because “we cannot replicate the highly motivated and competitive situations in the laboratory.”

Another expert joked that “it would be handy (for sports coaches) to know the phenotype of all (their) team members, (to) predict who would be playing well at various times of day.”

If you have questions about your exercise routine, contact our specialists at Orthopedic Surgery San Diego today for an evaluation.

We all know that exercise is good for us. It keeps the heart beating, the joints moving, the weight off, and muscles strong. As we get older we are told time and time again how important it is for our health. So why is it so tedious? It’s boring, sweaty, time-consuming, and sometimes painful, awkward, and downright embarrassing when we do it wrong. What’s the point?

The point
is that approaching exercise as if it were the enemy is harmful to building an exercise regime, or thinking positively about keeping healthy habits.  Many people view exercise as a chore and are unable to stick to a regime for very long. So what is the secret to all of those people that actually like to exercise?

Scientists have theorized many reasons as to why certain people exercise consistently.  It could be due to upbringing, genes, motivations, and convenience. The most common reason found over years of study was that people who keep exercising gain pleasure from the task. While this might seem an obvious reason, it may be easier said than done. Simply telling yourself to love it isn’t enough. Rather, having a mindfulness about the act is what is important.

Dutch researchers, curious to whether mindfulness is that important, conducted a survey to see. They used 400 adults, who are physically active to fill out an online survey and questionnaire based on their exercise regime, feelings towards exercise itself, and mindfulness of the act. Volunteers were asked to rate the questions given, such as: “How satisfied are you when exercising?” on a scale of totally agree to totally disagree. The results showed that those who exercised most enjoyed it the most, and those who enjoyed it the most, were mindful during physical activity. They encountered feelings of satisfaction and accomplishment that are necessary to keep working towards a goal.

Having mindfulness is the process of being cognizant of what you are doing, aware of the effect, and focusing on the moment. Zoning in on the feeling of your body moving, how you are doing your part to stay healthy, and even visualizing the calories burning away, can give a positive mindset. That’s not to say that exercising isn’t hard work, painful, and occasionally annoying, but accepting the good and bad of exercise, will help you mentally, and physically.

Exercise is very important to our overall health and well-being, and can come in many forms, from walking around the block a few times a week, to weight training for the Mr. Wonderful Muscle contest. Moving our bodies reduces risks for many issues, like blood pressure, diabetes, or heart disease.

Doctors involved with sports medicine, such as orthopedic surgeons, recommend exercise to their patients with joint and arthritis issues. Those with knee pain, back pain, shoulder or wrist pain can benefit from daily exercise, more so than by not exercising. Keeping up a habit of exercise not only lowers pain but also improves appearance and mental health.

If you have questions about developing a healthy exercise routine or suffer from knee pain or a shoulder injury contact our sports medicine specialists at Orthopedic Surgery San Diego to develop a plan that is best for you.

Alex Rodriguez, the popular New York Yankees third baseman, is no stranger to hip pain and surgery. A-Rod, as he is famously known, suffered from a hip condition called femoroacetabular impingement (FAI), which typically affects young and middle aged adults. This condition is caused when the head of the femur is abnormally shaped and can become caught in the hip socket. This can also occur due to the rim of the socket sticking into the thigh bone. The grinding due to the abnormalities causes bone spurs to form and a labral tear to occur, which catch painfully on the joint.
Rodriguez, as a young athlete, began to notice limited functional range of motion in his hip joint. This was due to his left femur becoming misshapen over an extended period of time. His hip was also not perfectly rounded, causing the bone to not fit securely in the socket. Our bodies try to make up for complications by compensating or overworking other areas. When this happens, we tend to focus on the problems created by compensation, rather than the underlying serious issue. Many patients with FAI end of undergoing spine injections or surgery for ongoing low back pain. Unfortunately the spine surgery doesn’t alleviate the pain brought on by the hip joint.
In Rodriguez’s case, the compensation led to his first major hip injury in 2009. He suffered a second hip injury in 2012 that occurred due to the cartilage breaking down inside the hip joint. Rodriguez eventually underwent hip arthroscopic surgery to repair the torn labrum in his left hip in January of 2013. Hip arthroscopy can provide the patient with an improved range of motion. Rodriguez was fortunate that his cartilage damage was not too extensive, and he was able to complete rehabilitation and physical therapy. This allowed him to gain strength in his hip and teach the muscles how to work properly.
Even though the surgery was successful, he was still put on a 60 day disabled list for the start of the 2013 MLB season. Two days before he was scheduled to go back to the Yankees in July, he suffered a Grade 1 quad strain, extending his disability time. Fortunately, he was able to resume playing ball in August.
xcBefore having hip surgery, orthopedists generally recommend non-surgical treatments, such as rest, physical therapy, ice, NSAID’s and injections. If these treatments do not adequately control the pain and inflammation, hip arthroscopy is then recommended. In order to proceed with surgery, a physical examination and an MRI are done first to assess the patient’s health. The orthopedist will use tests and medical history to determine if any problems or health risks could interfere with the surgery. If so, a more in-depth evaluation will be conducted.
Following the procedure, the surgeon will formulate a rehabilitation plan based on the type of surgery performed. In some cases, crutches are necessary. More extensive procedures might require crutches for one to two months. The complete recovery process is typically around five to six months in duration. Physical therapy, which involves case specific exercises, is necessary to recover strength and mobility.

Fractures of the distal radius are the most widespread bony injuries in the upper extremity. There are several treatments that have been suggested. However, external fixation remains an extremely versatile method to treat various types of fractures involving the distant radius.   The major indications for external fixation include unstable extra-articular fractures as well as the majority of intra-articular fractures.
Distal radius fractures were frequently referred to as “Colles’ fractures”.  Several decades back, a very popular treatment method was using manipulation, pinning, and casting, following a concept proposed then by Abraham Colles and generally accepted. According to the concept, the functional deficit would be acceptable even though these fractures would heal with deformity.
With enhanced understanding of the different types of fractures, there were certain classifications that were developed, including Frykman,  Melone, and AO.  A better method of treatment was required after a careful study of the specific fracture pattern. Newer methods of treatment have been developed in an attempt to come up with better outcomes in these fractures. The only goal is not merely fracture union. The ultimate goal of this treatment is to restore the normal anatomy with quick functional recovery and also full and painless motion of the wrist.
In a study, a randomized comparison was made between Volar Plate and External Fixation for intra-articular distal radius fractures. The purpose of the study was to compare the surgical outcomes of VP (volar locking plates) and EF (external fixation). This was whether it was with intra-focal fixation or not for both AO-type C2 and C3 fractures of the distal radius.

Methods
The first group consisted of 92 patients who had AO-type C2 and C3 distal radius fractures. These patients were signed up in a prospective, randomized study in which a comparison was to be made between volar plate fixation and external fixation (whether with intra-focal fixation or not).  Out of this group, 74 patients were studied. Every time the patient visited the doctors, the investigators evaluated functional assessments such as wrist range of mobility, the strength of the grip, as well as Michigan Questionnaire. They also measured radiographic assessment at 1 year.
Results
The results indicated that the VP group’s grip strength exceeded that of the EF group at 3 months and 6 months by far. Moreover, the VP group registered a significantly greater range of motion than the EF group at 3 months. However, when it came to the range of motion and grip strength between both groups, no major differences were recorded at 12 months. The Michigan Hand Questionnaire score tended to be higher in the VP than in the EF group at 3 months, but it was similar at 1 year. As regards the volar tilt or radial predisposition, no important differences were registered. In terms of the ulnar variance, the VP group exhibited superior radiologic results. One patient in the VP group and 3 in the EF group were found to have an intra-articular deformity that was more than 2mm. But this variance did not attain to any statistical significance.
Conclusions
These findings for functional recovery following distal radius surgery provide a better understanding into treatment choices as well as interpretations of treatment results for patients with this type of fractures.