lower leg Archives - Comprehensive Orthopaedics

Get Moving: Exercise Can Help Lower Older Women’s Fracture Risk

by Comp Ortho | Nov 21, 2019 | Anti-aging, Exercise, Hip, lower leg, pain, Wellness

FRIDAY, Oct. 25, 2019 (HealthDay News) — Older women who get even light exercise, like a daily walk, may lower their risk of suffering a broken hip, a large study suggests.

A number of studies have linked regular exercise to a lower risk of hip fracture — a potentially disabling or even fatal injury for older adults. Each year, more than 300,000 people in the United States aged 65 or older are hospitalized for a broken hip, according to the U.S. Centers for Disease Control and Prevention.

The new study, of more than 77,000 older U.S. women, took a deeper look at the types of exercise that are related to the risk of hip fracture and other bone breaks.

The researchers found that, on average, women who regularly exercised at any intensity — from walking, to doing yard work, to jogging — had a lower risk of hip fracture over 14 years, compared to inactive women.

It all suggests that even light activity is enough to curb the risk of these serious injuries, said study leader Michael LaMonte, a research associate professor at the State University of New York at Buffalo.

“We were happy to see a strong relationship between walking and lower hip fracture risk,” he said. “As we get older, we naturally do less-strenuous physical activity. This suggests that to lower your risk of hip fracture, you don’t need to do anything fancy. It can be as simple as walking.”

The findings “strongly support” longstanding recommendations for people to fit physical activity into their daily routine, according to Dr. Richard Bockman.

“Get out there and walk,” said Bockman, chief of the endocrine service at the Hospital for Special Surgery, in New York City.

Lower-impact activities do not have a big effect on bone density. But Bockman, who was not involved in the study, said that while bone density matters in hip fracture risk, other factors are also involved. They include muscle strength in the lower body, balance and agility, since broken hips are almost always the result of a fall.

The findings, published online Oct. 25 in JAMA Network Open, come from the Women’s Health Initiative — a study begun in the 1990s at 40 U.S. medical centers. It involved more than 77,000 women who were between the ages of 50 and 79 when they enrolled.

At the outset, the women reported on their usual physical activities, among other lifestyle factors.

Over an average of 14 years, one-third of the women suffered a bone fracture. When it came to hip fractures, women who’d reported higher amounts of physical activity at the study’s start typically had a lower risk.

For example, women who regularly got moderate to vigorous exercise, such as brisk walking or jogging, had a 12% lower risk of hip fracture than those who were less active. But there was also a link between “mild activity” — like slow dancing, bowling or golfing — and lower hip fracture risk. And the more often women walked, at any speed, the lower their risk of a broken hip.

The news wasn’t all good: Women who exercised at moderate to vigorous intensities had a relatively higher risk of a wrist or forearm fracture, compared to less-active women.

It’s not clear why, but LaMonte offered a guess: When women with more “functional ability” do fall, they may be more likely to stretch out an arm to break the fall, which is how wrist and forearm fractures often happen.

One question the study cannot address, LaMonte said, is whether starting exercise at an older age reduces hip fracture risk. Study participants who were physically active may have been active their whole lives.

But, he said, it is clear that “sitting less and moving more” is key in older adults’ overall health, with benefits such as better control of blood pressure and diabetes, and a lower risk of heart disease.

Besides exercise, older adults can take other steps to reduce their hip fracture risk, LaMonte noted. They include getting bone mass measurements as recommended by your doctor, and following a healthy diet with adequate amounts of calcium and vitamin D.

More information

The American Academy of Orthopaedic Surgeons has more on hip fracture prevention.

SOURCES: Michael LaMonte, Ph.D., M.P.H., research associate professor of epidemiology and environmental health, State University of New York at Buffalo; Richard Bockman, M.D., Ph.D., chief of endocrine service, Hospital for Special Surgery, and professor of medicine, Weill Cornell Medical College, New York City; Oct. 25, 2019, JAMA Network Open, online

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Health Tip: Preventing Stress Fractures

by Comp Ortho | Jul 1, 2019 | anatomy, Foot, lower leg, Wellness

(HealthDay News) — Stress fractures are overuse injuries and usually occur in the lower leg.

Typically, they are triggered by increasing the amount or intensity of an activity too quickly, says the American Academy of Orthopedic Surgeons.

To prevent stress fractures, the AAOS suggests:

Set incremental goals for sports and activities.
Cross-train, rather than repeat the same exercise daily.
Maintain a healthy diet, including vitamin D and calcium.
Stop and rest if pain or swelling occurs.

Tips for preventing ski injuries

by Comp Ortho | Feb 1, 2018 | Knee, lower leg, pain, Shoulder, Spine, Wellness

Ski season is in full swing — but an injury can put you out of commission until next year’s first snowfall. Here’s how to stay safe on the slopes all winter long.

While many people huddle inside during the winter months, away from “bomb cyclones” and blizzards, a select few know that the best way to beat wintry weather is to embrace it — on the ski slopes, that is!

As any seasoned skier will tell you, however, their beloved sport does come with the risk of injury. Fortunately, taking some simple precautions before you hit the slopes can help you stay in peak condition regardless of how many tumbles you take.

We’ve outlined some of the most common injuries that afflict skiers, and what you can do to prevent them.

MCL Injuries

A number of injuries can affect the medial collateral ligament (MCL), but the most common by far is an MCL tears. In skiing, MCL tears most often occur when the skier falls while attempting to slow or stop in a snowplow position, in which the tips of the skis are pointed toward each other. To avoid injury in this position, make sure to always keep your weight balanced. In addition, sticking to runs with which you’re comfortable can reduce the need to enter the snowplow position at all.

ACL Injuries

A variety of falls on the slopes can result in a tear of the anterior cruciante ligament (ACL). It most commonly happens after a forward fall, during which the inner edge of the front of the ski becomes embedded in the snow, trapping the leg in the process. It can also occur when the top of the back of the boot pushes the tibia (the weight-bearing bone in the leg) forward, away from the femur. On other occasions, it arises when the skier leans back on the skis, loses balance, and falls backward. Strengthening the hamstrings, wearing proper bindings, and using shorter skis can all reduce the risk of sustaining an ACL tear.

Fractures

Like torn ligaments, fractures are most commonly caused by falls while skiing. The wrist and ankles are particularly susceptible to breaks. To help avoid broken bones, always wear adequate protective gear and practice proper techniques for falling. Increasing cardiovascular endurance and developing the surrounding muscles can also be beneficial.

Shoulder Dislocations

Most shoulder dislocations happen when skiers fall, either directly onto the shoulder or onto an outstretched hand or arm. This injury results in heavy, immediate pain, significantly restricts the shoulder’s range of motion, and can leave it misshapen. Since dislocations are caused by sudden trauma, they can be difficult to anticipate, but strengthening the rotator cuff muscles, especially if you have previously dislocated your shoulder, can lower the risk of a dislocation. As with other common skiing injuries, employing proper form will also minimize the possibility of a dislocation.

Spinal Injuries

Aside from protecting the spinal cord, the spine ensures the strength and stability of the back. It is made up of various bony segments called vertebrae separated by pieces of fibrocartilaginous tissue called intervertebral discs, any of which can be injured while skiing. Some ways to avoid spinal injuries include using spine protectors, sticking to trails on which you are comfortable, using proper equipment, and learning the technique for “safe” falls.

While some ski injuries are immediately apparent, others can be more subtle, slowly progressing with time. Fortunately, the talented team of specialists at New York Bone and Joint has extensive experience working in sports medicine and can quickly diagnose and treat any of these common problems. If you think you may have suffered an injury during your latest trip to the mountain, call us today to schedule a consultation, or if the injury has been recent, stop in to our Orthopedic Urgent Care!

Being Thin Could Boost Stress Fracture Risk in Female Runners

by Comp Ortho | Jun 28, 2017 | lower leg, pain, Wellness

Female runners with a low body weight are more likely to have stress fractures and take longer to recover from them, according to a new study.

Researchers from the Ohio State University Wexner Medical Center reviewed data on dozens of injuries suffered by female college runners. They found that runners with a body mass index (BMI) below 19 were more likely to suffer stress fractures than others. BMI is an estimate of body fat based on weight and height.

Women with a low body weight were also sidelined longer after an injury. Among those with the most severe stress fractures, recovery time was 13 weeks for women with a BMI of 19 or higher. That compared to more than 17 weeks for those with a BMI below 19, the study found.

“We found that over time, we were able to identify the factors that put female runners at an increased risk of developing a stress fracture,” said study co-author Dr. Timothy Miller, assistant professor of clinical orthopedic surgery and sports medicine.

“One of the most important factors we identified was low body weight, or low body mass index,” he said in a hospital news release.

Having too little lean muscle mass to dissipate the impact of repetitive pounding on hard surfaces makes the bones of runners’ legs vulnerable to injury, according to Miller.

“When body mass index is very low and muscle mass is depleted, there is nowhere for the shock of running to be absorbed other than directly into the bones. Until some muscle mass is developed and BMI is optimized, runners remain at increased risk of developing a stress fracture,” he explained.

Female athletes should maintain a BMI of 20 to 24, Miller suggested.

A woman who is 5 feet, 5 inches tall and weighs 120 pounds has a BMI of 20, according to the U.S. Centers for Disease Control and Prevention.

The BMI for an average American woman is 26, the CDC says.

To prevent injury, Miller said women should stay at a healthy BMI and include resistance training in their workout regimen to strengthen their lower legs, “even if that means adding weight from additional muscle mass.”

The study was published recently in the journal Current Orthopaedic Practice.

Stress Fractures in Young Athletes

by Comp Ortho | Feb 27, 2017 | anatomy, Foot, lower leg, Wellness

Competitive sports can give some young athletes an edge over their peers. When fun, teamwork, and good sportsmanship are the top goals, sports can improve young kids’ physical and emotional health, self-esteem, and even their relationship skills. Unfortunately, young athletes must also compensate for still-growing bones, tendons, and muscles. Sometimes sports injuries happen.

The most common type of sports injury is an overuse injury such as a stress fracture. Overuse injuries are becoming more common in young athletes Playing sports year-round without time off doesn’t give young bodies enough time to rest and recover.

How stress fractures happen

Stress fractures happen when muscles are too tired to take on the impact of exercise, and the bones absorb the added stress. When those bones become too strained, they develop a tiny break known as a stress fracture.

Most stress fractures affect the bones in the lower leg. Stress fractures are also common in the feet.

These are the most common causes of stress fractures:

Increasing the frequency or intensity of exercise too quickly
Suddenly changing the workout surface
Getting sudden and significantly more playing time
Using or wearing gear that doesn’t offer enough support, such as shoes that are worn out
Insufficient periods of rest between practice or events

Stress fractures can happen during any number of sports, but they tend to be most frequent in young athletes who participate in sports that involve running and jumping, such as basketball, gymnastics, and track and field. These sports involve repetitive movements that strain the muscles and bones. This increases the risk for a stress fracture.

Preventing stress fractures

Parents and coaches can do many things to help reduce the risk for stress fractures in growing bones. Make sure that your young athletes follow these guidelines:

Eat a balanced, nutritious diet rich in calcium and vitamin D for strong, healthy bones.
Participate in conditioning practice for sports.
Do cross-training (alternating types of physical activities).
Stick to sports that are age-appropriate.
Always warm up before practice or games and cool down afterward.
Get a complete physical exam before participating in sports.
Wear athletic shoes (and any other needed gear) that are appropriate for the sport and that offer plenty of protection and cushioning.
See a healthcare provider for any persistent pain or limp.
Drink plenty of fluids and stay hydrated for practices and games.
Don’t resume sports or exercise too quickly after a stress fracture or other injury.

Also, make sure that your child’s coach is aware of the signs of stress fracture. This may be milder in nature than a more severe sports injury. Pain, particularly pain that gets better when the child is allowed to rest, is the most common symptom of a stress fracture.

Stress fractures typically heal with rest alone, but injured athletes may need to take off from their sport for as long as 6 to 8 weeks to properly recover. If your child complains of any pain that persists during sports, schedule a visit with your child’s healthcare provider.