October 2021 - Comprehensive Orthopaedics

What to Do If You Wake Up in Pain

by Comp Ortho | Oct 26, 2021 | Anti-aging, Wellness

Feeling achy and stiff in the morning? Try these seven techniques to ease into the day.

Nothing is more restorative than a good night’s sleep. You wake up refreshed and ready to take on a new day. Yet, for some people, the early morning hours bring unwelcome neck and back pain.

Movement during the day promotes fluid secretion from your tissues, which in turn keeps your joints mobile. When you’re asleep, however, you’re not moving for an extended period of time, which can cause your joints and muscles to stiffen up.

For some people, morning pain and stiffness go away as the day goes on. For others, the pain lasts all day. If you find yourself waking up constantly in pain, try these seven tips for a pain-free morning:

1. Stretch

When you wake up, do some simple stretches to unlock your joints and muscles. Here are two to try:

Knee to Chest Stretch: Remain on your back in your bed, and pull both knees toward you until your feet are flat on the bed. Grab your right knee with both hands and pull toward your chest. Do the same with the left knee. Hold for about 30 seconds. Repeat two to three times.
Shoulder/Upper Back Stretch: Stand up and hold your right elbow with your left hand. Stretch your right arm across the front of your body, keeping your arm straight. Do the same with your opposite arm. Hold for 30 seconds, and do two to three repetitions.

2. Change Your Mattress and Pillow

Your morning pain and stiffness could be caused by your bed or pillow. Be sure to choose a pillow that aligns your neck parallel to the mattress so it isn’t bent up or down. As for your mattress, it should be firm, but not too firm.

3. Change Your Sleep Position

Sleeping on your stomach may be the root of your pain. If so, switch to your back and prop up your knees with a pillow to keep your spine in a neutral position. Side-sleepers can try inserting a pillow between their knees.

4. Exercise Regularly

An intense workout just before you slip under the covers is not advisable. However, a brisk walk or relaxing yoga during the day can loosen up your muscles and joints, setting you up for a pain-free morning. Typically, thirty minutes of exercise a day will tire you out so you can fall asleep faster.

5. Stay Hydrated

During the night, you lose water when you sweat, which can lead to dehydration. Dehydration stiffens your muscles and joints as your tissues are deprived of fluids. So instead of going for that cup of morning coffee, drink two glasses of water first to rehydrate your body.

6. Take Vitamin D

Most people don’t get enough vitamin D in their diet. But the vitamin is essential for bone and muscle health. Have your doctor test your vitamin D levels, and if you are deficient, take a vitamin D supplement regularly.

7. Visit a Physical Therapist

Lingering morning pain should be checked out by a physical therapist. Keep a log of where the pain is strongest and which actions seem to aggravate it. Your physical therapist can show you how to adjust your sleeping position to prevent pain and improve your posture. He or she can also recommend the right pillow and mattress for a restful night’s slumber.

Don’t Live With Pain

If you’re experiencing pain and stiffness in the morning, the orthopedic specialists at Comprehensive Orthopaedics can review your symptoms to determine the source of your discomfort.

Understanding the Different Types of Bone Fractures

by Comp Ortho | Oct 25, 2021 | Wellness

Not all bone fractures are the same. Discover the different types of fractures to determine the right treatment program for you.

A broken bone is a serious orthopedic injury that requires immediate medical attention. Unlike muscles and ligaments, bones are stiff, making them vulnerable to fractures from accidents or sports injuries. Bones may also crack from everyday activities if you suffer from a bone-thinning condition like osteoporosis.

Although a bone break is typically accompanied by pain, swelling, and bruising, each type of fracture has different characteristics and therefore requires different treatment. An orthopedist can X-ray your injury to determine which type of fracture you’ve suffered. Once you know the nature of your fracture, you’ll begin a recovery program tailored to you.

Types of Bone Fractures

To classify your bone fracture, your doctor will see where the bone has been broken and the shape or pattern of the break. A bone fracture can take several different forms, which will ultimately dictate your treatment. Here are some of the most common:

Open Fracture. In this injury, the bone breaks through the skin, causing a severe wound. Also called a compound fracture, an open fracture should be tended to immediately to prevent infection.

Stress Fracture. Stress fractures look like a hairline crack in the bone and can be hard to see on a regular X-ray. Runners are prone to stress fractures because of the repetitive motion of hitting the pavement.

Greenstick Fracture. In a greenstick fracture, the bone bends and breaks, but remains in one piece. This is often seen in children due to their softer, more flexible bones.

Transverse Fracture. A transverse fracture is characterized by a horizontal break across the bone. It is often the result of a traumatic event like a car accident.

Oblique Fracture. In an oblique fracture, the break has a curved or angled pattern within the bone.

Comminuted Fracture. When the bone shatters into three or more pieces it’s known as a comminuted fracture. Sometimes, bone fragments break away and embed in the site of the fracture. High-impact trauma such as a car accident typically causes a comminuted fracture.

Linear Fracture. Instead of a horizontal break across the bone, a linear fracture is vertical and parallel to the sides of the bone.

Compression Fracture. Compression fractures are the result of a crushing of the bone. This type of fracture typically occurs in the spine when the vertebrae collapse because of bone loss due to osteoporosis.

Displaced Fracture. In most fractures, the bone breaks but remains in alignment. With a displaced fracture, the bone breaks in two or more pieces and is shifted out of alignment due to the force of the trauma.

Spiral Fracture. The defining characteristic of a spiral fracture is a break that spirals around the bone. It’s frequently seen in the long bones of the body, such as the femur, tibia, or fibula in the legs. The most common causes of a spiral fracture are accidents or sports injuries.

Treating Bone Fractures

Bone fractures typically respond well to non-surgical treatments. After a break, bone cells form around the fracture. As these cells multiply, the fracture is eventually repaired. To aid in that healing process, your leg, arm, or other body part will be placed in a cast after the bones have been aligned so the two ends can connect once again. For some fractures, you may be able to wear a functional cast or brace that allows some movement of the joints.

Casts may not be appropriate for all fractures, however. In some instances, traction may be needed to put the bone back into alignment. This is done either by tape adhered to the skin below the fracture or a pin inserted through the bone. Weights are applied to the pin as the patient is placed in an apparatus to encourage traction.

If surgery is required, a surgeon will place screws or metal pins above and below the fracture that are then attached to a metal bar outside the skin. That’s known as external fixation. In an internal fixation, the broken bone is positioned back into its normal alignment and held together with screws or metal plates secured near the bone’s surface.

You can expect a recovery period of several weeks or months. After the bone has healed, you’ll slowly return to normal activities as your bone becomes accustomed to the stress. It’s recommended that you undergo rehabilitation to strengthen your muscles, as well.

The doctors at Comprehensive Orthopaedics have helped thousands of patients heal their bone fractures (and other orthopedic injuries) and return to an active lifestyle. Contact us today for a consultation.

One-Third of Americans With Arthritis Get No Exercise

by Comp Ortho | Oct 18, 2021 | Anti-aging, arthritis, Wellness

Many American arthritis sufferers aren’t getting any exercise despite its benefits for reducing pain and improving their quality of life, new research shows.

Sixty-seven percent of U.S. adults with arthritis engaged in physical activity in the past month, most often walking, according to a new data analysis by the U.S. Centers for Disease Control and Prevention. The findings were drawn from national health surveys from 2016 through 2018.

“With 33% of U.S. adults with arthritis who are not physically active, there is still room for public health action,” said lead researcher Dana Guglielmo of the CDC’s National Center for Chronic Disease Prevention and Health Promotion.

And that action starts with frank talk between arthritis patients and their health care providers, she said.

Guglielmo suggested patients ask their doctors about arthritis-friendly physical activities and self-management programs to help ease symptoms such as joint pain.

“Providers should check in with patients about their physical activity levels and talk to them about physical activity and arthritis self-management programs,” she added.

Arthritis is the most often reported cause of disability among Americans over age 15.

U.S. National Health Interview Survey data showed that 71% of respondents got their exercise through walking, 13% from gardening and 7% by lifting weights.

Guglielmo urged anyone with arthritis to walk.

“Walking is an ideal physical activity for adults living with arthritis, because it is low-cost, convenient and adaptable to various settings,” she said.

To get the most benefit, however, adults with arthritis should engage in an activity that combines aerobic, muscle-strengthening and balance exercises, Guglielmo said.

“Any activity is better than none,” she added. “Evidence-based physical activity programs can support adults with arthritis in getting and staying active by helping them overcome common barriers to physical activity. These programs can even improve their mental and physical health and quality of life.”

Dr. Jeffrey Schildhorn, an orthopedic surgeon at Lenox Hill Hospital in New York City, said everyone with arthritis pain should be encouraged to be active.

“People with arthritis ask me what can I do, and I tell them … you want to move your body,” he said. “When people stop moving their bodies, they get stiffer, they start quitting, they get fat.”

The best way to prevent these consequences is to be active, Schildhorn said. Even people who suffer the most pain can benefit from walking. Being physically active helps keep joints lubricated, he explained.

“Most people with arthritis wake up stiff, and sometimes they wake up in more pain, and as they get going, joints tend to lubricate, they get more mobile and the pain is less,” he noted. “So, walking or anything that gets your body moving actually helps.”

Schildhorn emphasized that he’s not talking about deep squats, but about keeping the body going. Plus, getting outside, getting sunshine and socializing can keep people healthy, he said.

Being inactive can become its own self-defeating loop, Schildhorn said: If you aren’t active, you feel worse, and feeling worse makes it less likely that you’ll exercise.

“People stop working out, they get stiffer because they spend so much time sitting on a chair with a pillow behind them because it feels better. To me, that is the opposite of health,” he said.

Being active can extend the time before a knee or hip replacement is needed.

“What people don’t understand is just how valuable physical activity is,” Schildhorn said. “It’s good for your immune system, it’s good for your attitude, it won’t wear out the joints faster, and you can cope with the symptoms longer.”

When you reach a point when you can’t walk as far as you once did because of the pain, then it might be time for surgery, he added.

The study was published Oct. 8 in the CDC’s Morbidity and Mortality Weekly Report.

More information

For more about arthritis pain relief, visit the Arthritis Foundation.

SOURCES: Dana Guglielmo, MPH, National Center for Chronic Disease Prevention and Health Promotion, U.S. Centers for Disease Control and Prevention; Jeffrey Schildhorn, MD, orthopedic surgeon, Lenox Hill Hospital, New York City; Morbidity and Mortality Weekly Report, Oct. 8, 2021

Watch Their Backs — Don’t Overload Those Schoolbags

by Comp Ortho | Oct 4, 2021 | Spine, Wellness

After more than a year at home, children are heading back to classrooms across the country. But they’re also toting heavy bags on their backs again.

A backpack that fits properly — and is not overloaded with binders and books — will help prevent injury.

“With a focus on getting back in the classroom and returning to ‘normal,’ it’s easy to overlook possible injuries caused by everyday school supplies,” said Dr. Emily Dodwell, a pediatric orthopedic surgeon at the Hospital for Special Surgery (HSS) in New York City and spokesperson for the American Academy of Orthopaedic Surgeons.

“Backpacks might not seem that high on the list of safety hazards for children, but if too heavy or worn improperly, they can cause pain or injury to muscles and joints,” she said in a hospital news release.

Backpacks should never weigh more than 10% to 20% of a kids’ body weight, the American Academy of Pediatrics advises. (For example, a child who weighs 50 pounds should carry no more than 10 pounds, max.)

Heavy backpacks are often to blame when pediatric orthopedic surgeon Dr. John Blanco sees more kids and teens with back and shoulder pain at the start of the school year.

All pain should be taken seriously, Blanco said. But, he cautioned, there is no evidence that carrying a heavy backpack could lead to long-term problems such as scoliosis or a hunchback, as some parents fear.

“It’s not uncommon for students to lug around 30 pounds, which is usually too heavy based on their body weight,” said Blanco, who practices at HSS Long Island in Uniondale, N.Y. “Most families have a scale at home and can use it to weigh the backpack and take out items that are not needed for the school day.”

Dodwell and Blanco offered these additional suggestions for selecting and using a backpack to keep kids injury-free.

Choose a sturdy backpack with wide, padded shoulder straps and a padded back. Tighten straps to keep the pack close to the body, which strains the back less.
A waist strap prevents the backpack from moving side to side.
Wear the pack properly, over both shoulders. This distributes the weight evenly. Put heaviest items closest to the middle of the backpack, rather than in front compartments.
Choose a rolling backpack if the school allows it and doesn’t have stairs.
Encourage kids to use their lockers, rather than lug everything throughout the day.
Teach young people how to pick up a backpack properly. They should bend their knees, rather than bending at the waist.

Over time, the kids’ muscles will get stronger, Blanco said.