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Osteoporosis: The Silent Disease

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Osteoporosis is a bone disease characterized by a decrease in bone tissue. Low bone mass leads to fragile bones. It also increases your risk of fractures, especially your spine, hips, and wrists. While there is no cure for osteoporosis, it is largely preventable in most people. There are many treatment options available for those affected.

Who gets it?

This condition is most common in older women. Women who experience early menopause or have their ovaries removed before age 45 and don’t undergo hormone therapy are more likely to develop osteoporosis. Cigarette smoking, excessive alcohol, and caffeine intake contribute to the problem.  So do problems with calcium absorption in the intestines. There are also some drug treatments that can induce osteoporosis.

The Silent Disease

Osteoporosis is sometimes called the “silent disease”. This is because there are so few symptoms in the beginning associated with bone loss. Many people do not even know they have osteoporosis until they start getting broken bones. In severe cases of osteoporosis, symptoms include aching pain in your bones, especially in your spine. Fractures can occur without any trauma at all.  The pain can be severe. But usually you don’t have the radiating pain into your arms or legs as you would with other back conditions. After repeated crush fractures in your spine, you may develop an excessive curvature in your neck or increased mid back forward bending. Hip and wrist fractures are common, especially when associated with minor falls.

Bone density testing and X-rays are the main ways to detect osteoporosis. Your doctor can order them for you.

Treatment

Treatment of osteoporosis includes the following preventive measures:

  • Exercise – Daily weight-bearing and resistance training exercise helps reduce bone loss. It also helps you maintain good muscle tone. Walking, jogging, hiking, tennis, yoga and strength training are good-weight bearing exercises.

 

  • Nutrition – Calcium and vitamin D are needed for healthy bones. Most adults require 1000-1500 mg of calcium and 600 units of vitamin D per day. You should, however, ask your doctor to determine the right amounts for you.

 

  • Avoid tobacco, alcohol, excessive protein, and caffeine. All of these increase your risk of developing osteoporosis. Protein is an important part of your diet and is vital for good health, but taking in high amounts of protein can cause your body to lose calcium. Caffeine in large amounts can make it hard for your body to retain calcium. Do not use tobacco. Limit your alcohol and caffeine intake.

 

  • Medication – Hormone therapy and medications developed specifically to slow bone loss may be prescribed by your doctor.

 

Written by Clint Bunker PT

That’s a Stretch

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Stretch Yourself

When life gets crazy, it’s easy to forget to take care of ourselves.  Setting aside a few moments to do something to better your health and the way you feel can make a big impact on your day.  One quick and simple thing you can do for your health is stretch. There are many effective stretches that target certain muscle groups and issues.  Below you’ll find a couple common stretches that you can do daily that target muscles that often get overworked and strained in our day to day lives.

Neck

First on the stretch list is the neck.  Let’s face it, you probably do things throughout your day that are not very kind to your neck. Whether it’s hunching over your phone, cleaning up after the kids, or straining over your work computer, your neck puts up with a lot.   Give your neck a stretch by tilting one ear towards your shoulder while standing upright.  Once you’ve stretched you neck as far as feels comfortable, open your hand on the side you’re tilting away from, turning your palm outward.  This allows your neck to stretch a little bit further.

Calf

Next, is a calf.  For those of us who spend a lot of time on our feet this stretch can be a lifesaver.  Sore feet are caused in part by tight calf muscles.  And for those who may suffer from plantar fasciitis this stretch can be especially helpful.  You’re going to need one extra item: a towel.  Place your heel on a soft but stable surface like a rug or yoga mat. Roll up a towel and place the ball of your foot on it. Step forward with the other foot. Do this with your knee straight instead of bent.  Hold it for a good half a minute and then switch to your other foot.

Give yourself a few minutes to stretch.  You’ll feel better.

Written by Tom Farnsworth PT

Knee Time

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Back to Sports

The sports world is beginning to return following the pandemic. But, athletes in all sports are finding that they are not in playing shape. After taking several months off, getting back into shape has been more of a challenge than expected. Unfortunately, this has led to several injuries. The knee is one of the most injured body parts not only for professional athletes, but the weekend warriors as well.

Knee Trouble

The meniscus in the knee is a cartilage space that sits between your shin bone, or tibia, and your femur.  The meniscus is C shaped and redistributes forces between the two bones. It does this when you are walking, running, or doing other sports related activity. People injure their meniscus when bearing weight and rotating, or twisting. This can lead to swelling and stiffness in your joint. People often complain about a clicking in their knee, as well as the inability to fully extend their knee. A lack of strength and stability in your knee is also common. There are different types of tears, however an X-ray and MRI are most effective to see what the issues are.

Treatment

Treating a torn meniscus depends on the location of the tear as well as the severity or size of the tear. Often, treatment is effective and include cortisone injection and physical therapy to help restore range of motion and strength.  If it’s serious enough, you will need arthroscopic surgery, in which the torn area of the meniscus is removed. After the surgery, physical therapy is required to help restore the motion and strength so you can return to normal activity.

Therapy for a torn meniscus focuses on the range of motion, or straightening of your knee. This often limits your motion. This is motion you need for all activities including walking and running for sports related activity and everyday life. Physical therapy will also focus on strengthening and stability of your quadricep muscle as well as stability of your hip and ankle as well. Over time, moving into sports related activity will happen to help you make a safe transition back to on field activity. A meniscus will heal in 6-12 weeks depending on the severity and whether or not you need surgery.

Written by Casey Badder PT

Little League Elbow

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As a state, Arizona is beginning to see a decrease in numbers of people who are diagnosed with the Corona Virus. There are beginning to be less restrictions and people are cautiously returning to activities. One activity my children participate in is youth baseball. They are between the age of 10 and 13, and children in these ages are normally pretty healthy. There have been several instances that have come up with my children’s friends and teammates which can be extremely painful and reduce their ability to participate in athletics. These are problems in the growth plate. I have witnessed this mostly in one body part: the elbow.

What is it?

The issue at the elbow almost exclusively occurs due to the repetitive action of throwing. This is why this is commonly called Little Leaguer’s Elbow. The medical term for this is Medial Epophysitis. This is basically an irritation on the inside of your elbow joint caused by repetitive motions. Excessive throwing causes a lot of stress on the inside part of the elbow which can be sometimes too much for growing bones and muscles. In extreme cases, part of the bone can actually break off. This typically happens in youth athletes between the ages of 8-17, when bone and muscle growth is most likely to occur.

Does my kid have it?

Typically, there is no specific incident that leads to this injury, but there can be. Usually, the young athlete will begin feeling pain on the inside of the throwing elbow where the bump is. This is where several muscles attach. The pain will worsen with the activity and if it gets bad enough, they will not be able to throw anymore. It will be fairly tender to the touch and you may notice swelling.  Pain when extending their elbow or wrist flexion is also a common occurrence.

What do we do about it?

If you notice your child has this, there are two things to immediately do.

  1. STOP THROWING!!! With repetitive stress injuries, the very first thing is to stop doing what is causing the pain. In this case, throwing. It is very important to not push through and play with this injury as it can lead to a much more serious condition.
  2. ICE: Ice at the initial stages can reduce swelling and irritation.

With all injuries that deal with soft tissues (muscle, tendon, ligament) there are several stretches and exercises which can be done. Almost always, the muscles on the palm side of your athlete’s forearm will be very stiff, and most times weak. These muscles should be stretched lightly and strengthened. The two stretches which are important are these:

With your elbow extended, gently extend your wrist to where you feel a gentle stretch on the palm side of your forearm. Hold for about 30 seconds and repeat 3 times.

Now, do the exact opposite. Hold for the same amount of time about 3 times.

Strengthening the forearm, wrist, and shoulder muscles of your throwing arm is extremely important. These should be prescribed specifically for the individual athlete.

How long does it take to heal?

The answer to this question really depends on the severity. It can be anywhere from a few weeks, to 1-3 months.  Coaches and leagues take special care with pitch counts depending on ages and this is an excellent thing to do, however any position player who throws often can be at risk. If you want to prevent this, a doctor or a physical therapist can identify the most important activities to do in order to prevent.

Weightlifter’s Shoulder

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Weightlifter’s Shoulder is a term that describes painful wear and tear of one end of your collar bone. It’s an injury that happens due to overuse.  It causes small fractures that can be quite painful and effect your range of motion. In some instances, something called osteolysis or bone breakdown occurs.

It’s called Weightlifter’s Shoulder because weightlifters are commonly affected due to the repetitive motions and heavy weight put on the shoulder joint when lifting weights. However, they are not the only ones affected. Jackhammer operators, baseball and football players and even soldiers can develop this problem.

Symptoms

The symptoms of this condition include tenderness over the front of the shoulder. You may also have pain while doing bench presses or dips, or you may be unable to do a push up due to the pain.  If you’re experiencing these symptoms it is very important that you do not try and push through the pain.  This will only lead to further damage and a longer healing process.

(Not being able to do a pushup due to lack of exercise is not a symptom.)

What Causes this Condition?

Repetitive stress from training and lifting can be a cause. For example, when your elbows drop below or behind your body during bench press, excessive traction on the AC (acromioclavicular) joint occurs. As a result, your shoulders extend too far.  If the bone does not have a chance to heal prior to your next workout, your shoulder can become painful and suffer from reduced strength and range of motion.

How to Treat It

Treatment for weightlifter’s shoulder usually starts with physical therapy and no surgery. This may include rest and changes in weight-training activities. You have to avoid over-training so that your joint can heal.  We can also help with suggesting modifications and design strength training for your condition.

(Rest is very important)

For those who don’t improve with therapy alone, or have a lot of damage to the shoulder joint, an arthroscopic surgery may be recommended. During the surgery, the surgeon removes portions of the damaged end of the collarbone in a procedure known as “distal clavicle excision”.  It is usually an outpatient procedure.  Most patients are able to return home the same day.

Physical Therapy is often recommended after surgery to improve strength and restore range of motion. Fortunately, most patients suffer no loss of function in the shoulder after surgery and are able to resume normal activities following rehabilitation.

Written by Travis Rohner PT

 

Complex Regional Pain Syndrome

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Complex Regional Pain Syndrome (CRPS) is a syndrome that affects the nervous system. It has been called by many names including, Reflex Sympathetic Dystrophy (RSD), Sudek’s atrophy and shoulder/hand syndrome. The condition is more prevalent in women, but can be present in all age groups and genders. The exact cause is unknown, although it usually associated with an injury or physical trauma such as a fracture, crush injury or surgery. CRPS also tends to show up in the extremities; but it can happen anywhere. Early treatment may improve the long-term outcome but doesn’t guarantee complete recovery.

 

CRPS can become functionally limiting both in terms of range of motion and strength. The constant pain associated with the syndrome can make work and activities of daily life very difficult and frustrating.

 

Signs and Symptoms

 

CRPS symptom progression has 3 stages. The first stage begins as burning pain, swelling, stiffness, excessive sensitivity, and increased sweating in the area. This stage can last from 1-3 months.

 

As CRPS progresses into the second stage, which may last for 3-6 months, the pain becomes more intense and the swelling increases and may spread out from the affected area. Hair growth in the area may decrease. In the hands or feet, nails may become brittle and cracked. On X-rays the bone may show loss of density. The muscles begin to atrophy or diminish in size.

 

Stage 3 begins any time after 6 months. The condition may be permanent and some of the muscle changes may become irreversible. The pain may progress to such intensity that it is incapacitating. Bone density continues to decrease. Range of motion continues to decrease as a result of avoiding motion due to pain.

 

Treatment

 

The goals of treatment are to decrease swelling and pain, maintain or improve range of motion, educate about the condition to reduce or eliminate frustration associated with it, and restore function.

 

Swelling can be decreased with cold compresses, contrast baths, compressive wrapping or massage. Massage, however, may be difficult because of the pain and sensitivity.

 

 

Decreasing the pain and sensitivity is done through several methods. Moist heat can sometimes help. Desensitization is another means. Desensitization can include the use of electrotherapy. Gradual acclimation is another way. It begins by touching the area lightly with a soft material such as tissue paper for several minutes at a time throughout the day. As the area of sensitivity decreases, the tissue is switched to a soft cloth with slightly more pressure. As the sensitivity decreases again, the material is changed to a rougher type and the pressure is increased.

 

Therapeutic exercise can be help to return strength, range of motion and function. Your health professional can show you the specifics of the rehabilitation program. Quite often the exercises involved with CRPS will include weight-bearing activities to help.

 

It is important to understand the psychological problems associated with this condition so you can cope with any emotional stress. Because of the constant nature of the pain associated with CRPS, counseling may help. Your health professional can refer you to the proper source.

 

The use of all the treatment methods as stated above may help to break the pain cycle, decrease pain and improve overall function. It is important for you to maintain independence in the activities of the day, both in work and leisure activity.

Written by Clint Bunker PT

 

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Areas Served:

Mesa, Gilbert, Chandler, Phoenix, Queen Creek, Apache Junction, Tempe, Globe, Gold Canyon

Postal Address

Gilbert Office
730 N. Greenfield Rd.
Gilbert, AZ 85234
Phone: (480) 633-0666

Mesa Office
342 N Val Vista Dr. Suite 106
Mesa, AZ 85213
Phone: (480) 325-3310