Aches and Pains From Too Much Standing

Sitting at your desk too long is no good experts say, and now research shows standing too long on the job can be detrimental to your health, as well.

Close to half of all workers worldwide stand for more than three quarters of their work day. Prolonged standing can lead to fatigue, swollen feet, leg cramps, shoulder, neck and back pain, and even varicose veins.

While these health issues are problematic for those suffering from pain, employers should also take note. Ongoing pain can cause poor performance in the workplace and missed days of work.

A new study, published in Human Factors: The Journal of the Human Factors and Ergonomics Society, evaluated men and women in two age groups. They were asked to stand for five-hour periods with timed, seated breaks (up to five minutes) and a 30-minute lunch break. Muscle fatigue was monitored while participants reported their levels of pain or discomfort.

The study results showed that at any age, too much standing leads to fatigue.

If your job requires standing for extended periods of time, you can help lessen the effects by:

• Sitting down for breaks whenever possible
• Taking quick walks, if permissible
• Wearing comfortable shoes that fit properly
• Treating sore areas with ice or heat therapy, gentle stretching, and over-the-counter-pain medication, as needed

But, if your pain is severe and persistent, it may be time to see a doctor.

(Adapted from Medical News Today)

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Becker's Review Interviews Dr. Bergin on Obesity and Orthopedics

Texas Orthopedics' own Dr. Barbara Bergin was recently featured in Becker's Spine Review for an article titled, "Obesity & the Orthopedic Industry: Key thoughts for surgeons today."

According to the CDC (Centers for Disease Control and Prevention), more than one-third of all adults in the U.S. are obese, accounting for a very large percentage of the nation's healthcare spending.

Obesity is a serious condition often triggering a host of medical conditions, but not often mentioned are the many orthopedic implications including chronic back, knee, and hip pain, as well as arthritis.

Dr. Bergin notes that many of her patients experiencing bone or joint pain, or early symptoms of arthritis, are also overweight. "When I see 45 year olds with degenerative joint disease and no history of injury or connective tissue disorder, I must draw the conclusion that their weight has had a causative effect on this process."

Excess body weight typical of someone who is obese can lead to painful pressure on the joints and even broken bones.

Because surgical options are also limited, the real challenge Dr. Bergin says is getting a patient to lose weight. With obesity being such a sensitive issue though, doctors are often met with denial or resistance when they suggest weight loss as treatment.

For some patients, proper diet and exercise can make a great difference in the pain they are experiencing. For others, where weight loss has proven ineffective, she urges doctors to simply offer their heartfelt patience and support.

You can read more of Dr. Bergin's interview at Becker's Spine Review.

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Picking the Right Backpack for Your Kid's Back

Choosing the right backpack for your child can play an important part of school success just as having a healthy breakfast each morning, or getting a good night's sleep before a test. And we don't mean just by picking out the one with the hottest color or coolest superhero...

Backpacks that do not fit properly, worn incorrectly, or are too heavy can create aches and pains for children and teens, especially as their young bones are still forming and delicate.

Features you want to look for include:

• Wide, padded shoulder straps as opposed to narrow ones that can cut into the skin
• Two shoulder straps - one shoulder strap, or messenger bags, can put too much weight on one shoulder
• A padded back to protect sharp edges on the inside of the bags
• Rolling backpacks are also a good choice for kids who do not have to climb stairs during their school day

Tips for wearing your backpack properly are: 

• Always use both shoulder straps. Draping a backpack over one shoulder can increase curvature of the spine.
• Tighten shoulder straps so the backpack is snug and close to the body (versus hanging low down the back)
• Pack light, and check that the weight of the backpack is never more than 10 to 20 percent of your child's total body weight
• Use the side pockets and compartments
• Encourage your kids to make frequent pit stops at their locker to swap out books throughout the day so they are never carrying a full load

And remind your kiddos to let you know if they ever experience neck, back or shoulder pain, especially at the start of the school year when wearing a backpack every day is new again.

(Courtesy of HealthyChildren.org)

Dr. Smoot on KXAN: Ankle Replacement Surgeries Take a Step Forward

We often hear about knee or hip replacment surgeries. But did you know that there are also ankle replacement procedures?

Dr. Brannan Smoot, Orthopedic Surgeon at Texas Orthopedics, says that while ankle replacement surgery is still an uncommon procedure, because of recent refinements, we will likely see more of these types of surgeries in the future.

Watch Dr. Smoot's interview with KXAN-TV to learn more about this procedure.

Texas Orthopedics Announces Bundled Payment Initiative

 Texas Orthopedics, Sports and Rehabilitation Associates’ patients in Central Texas will now be able to take advantage of a value-based approach for major joint replacement surgeries of the lower extremities. The program is a part of an innovative ‘Bundled Payments’ model through the Centers for Medicare and Medicaid Services (CMS) made possible through a collaboration with AccentCare Health Management in Dallas, Texas.

Bundled Payment “single price” models encourage doctors, hospitals and other healthcare providers to work more closely together to improve patient experience, patient outcomes, and reduce costs in the healthcare system, according to CMS.

“This innovative approach helps us to evolve from a fee-for-service to a value-based payment model which is overall better for patient care,” said Randall Schultz, MD, Orthopedic Surgeon, Texas Orthopedics.

Under this partnership, effective July 1, 2015, Texas Orthopedics and AccentCare take on financial and performance accountability for each patient. Medicare patients will pay a lower price for applicable replacement surgeries while benefiting from a coordinated care approach.

“In a model like this, we are rewarded for providing excellent care and penalized for anything less. It means higher quality care, with fewer complications, and a better overall patient experience while also reducing the costs to Medicare,” explained Schultz. Schultz expects to see cost savings to Medicare between 10 and 20-percent.

AccentCare will address Texas Orthopedics’ joint replacement patients with recovery-related needs two days prior to hospital admittance through 90 days after patients’ discharge from the hospital. A patient care manager will be assigned to every patient and will assist via in-person visits and follow-up phone calls.

These care managers, who are registered nurses with AccentCare, guide patients on how to better manage their health by reviewing discharge instructions, medications, diet and cues to recognize changes in their condition that may require prompt attention. They will also focus on patient safety with home assessments and the coordination of other resources including minor home modifications, equipment, or transportation to follow-up medical appointments.

“AccentCare initiated this partnership with Texas Orthopedics to give qualifying patients an advantage,” said Dr. Greg Sheff, Executive Vice President and Chief Medical Officer at AccentCare. “Together with Texas Orthopedics, we offer an innovative program in an industry evolving to help mitigate the risk of complications that might otherwise result in costly setbacks to recovery.”

The organizations consulted with health policy experts in developing the bundle payment program including Kevin Bozic, MD, Chair of Surgery and Perioperative Care at the Dell Medical School at University of Texas at Austin. Bozic says the Bundle Payment program is in line with Dell Medical School's efforts to facilitate value-based care delivery models for providers and patients throughout Central Texas.

“I applaud the Texas Orthopedic leadership team for taking this bold step. Episode-of-care payment models are opportunities to bring diverse groups of stakeholders together to improve the value of care on what matters most: optimizing outcomes for patients,” said Bozic.

Freescale Employees Receive Sports Injury Tips from Dr. McDonald

Nearly 120 Freescale employees attended online and in person for a special presentation from Texas Orthopedics' Dr. John McDonald on common sports injuries.

Dr. McDonald was invited by the Austin, Texas-based semiconductor company to discuss injuries that often occur among active adults, from weekend warriors to elite athletes.

In addition to reviewing why sports injuries commonly occur and where on the body they are most frequent (the answer is the knee), Dr. McDonald touched on prevention strategies.

While the potential for injuries often increases with age, explained Dr. McDonald, listening to your body stretching, increasing strength training and incrementally adding activity (versus jumping in and out of intense routines) are several examples for reducing your chance of injury.

Most importantly, if any pain persists, don't be afraid to call the doctor.

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Dr. Tyler Goldberg, Jard Bush, PA-C, Gives Back Through Haiti Medical Mission Trips

Dr. Tyler Goldberg and Jared Bush, PA-C, recently traveled to Haiti on separate medical mission trips.

Dr. Goldberg went with My Life Speaks, a nonprofit organization that provides community in Neply, Haiti through orphan care and prevention, education and public health. Dr. Goldberg's wife and daughter accompanied him on his second trip to Haiti.

He visited with a Haitian pediatric orthopedist and discussed complex patient cases, helped develop care plans and set broken bones for local residents.

Physician assistant, Jared Bush, went to Haiti with Mission of Hope and River Rock Bile Church. Jared worked with the Clinic of Hope, a division of Mission of Hope, which currently consists of a fully operational outpatient clinic, mobile clinic, prosthesis lab, and a community health program. It's currently expanding into a hospital focused on emergency care and maternal health. Jared served alongside Haitian physicians and medical students. This is Jared's second trip to Haiti.

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Flat Feet and Lower Back Pain

Flat feet may not be a big deal for some, but research shows that persistent lower back pain may be a direct result of the shape of your foot's arch. About one in five people have lower back pain, and those who have "flat feet," or "fallen arches," are 50 percent more likely to suffer than those with normal or high arches.

So how do you know if you are flat-footed and susceptible to these aches and pains?

Here is a simple test you can perform:

1. Wet your feet.
2. Stand on a flat surface where your footprint will be visible, such as a concrete floor.
3. Step away, then look at the prints. A complete imprint of the bottom of your foot indicates you have flat feet, if there is a gap or space in the middle between the toes and heel, you have more normal arches.
   
   Here are some causes of flat feet: 

• an abnormality present at birth
• stretched or torn tendons
• broken/dislocated bones
• arthritis
• nerve complications

In addition to low back pain, some people may also get tired, achy, or swollen feet, along with limited range of motion in the ankle and toes. That's because people with flat feet don't have arch support so they're saddle with the full force of your body's weight every time you stand. 

To help alleviate some of this pain, try:

• ice therapy
• routine stretching exercises for feet or physical therapy
• over-the-counter pain relief medications
• orthotic devices for shoes or braces
• injections such as corticosteroids to combat inflammation
• limiting activities that put excessive stress on your feet, such as running on hard surfaces, or high-impact sports like basketball, hockey, soccer and tennis
• keeping risk factors like diabetes, high blood pressure and obesity in check, which can all make flat feet worse

If your foot, or lower back pain persists, contact us.

(Courtesy of WebMD)

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Triathlon Training Tips

Triathlon training is tough and grueling for even the strongest athletes. So it's no surprise that a recent study revealed more than half of the triathletes monitored suffered an overuse injury during their course of training. While competing in triathlons is a great way to get fit, you are at risk for injury if you don't pace yourself.

Here are a few tried and true training tips to help get the most out of your triathlon experience and help you safely cross the finish line:

Make a plan

• Select a competition/distance that is right for you 
• Start your training gradually, begin with shorter distances and work up to longer ones with faster sprints and greater intensity
• Check out websites such as USA Triathlon to locate training groups or routes in your area

Consider a coach or training partner 

• Enlist a coach to check or correct your technique at the start of your training to help prevent injuries later on down the road
• Have a friend or partner help to keep you on track with your goals

Eat properly

•  Consume foods rich in nutritional content and high in complex carbohydrates
• Increase your intake closer to race time, and supplement with energy gels and sports drinks as needed

Choose proper equipment

• Research water temps to see if you need a wetsuit
• Make sure your bike chains and pedals are working properly, and don't forget your helmet
• Wear comfortable training shoes, and avoid sporting a brand new pair that can lead to blisters

Finally, and most importantly, listen to your body. If you miss a training session, don't try to overcompensate and go at it harder next time. Build rest days into your training schedule to relax and recuperate. Tendonitis, sprains and strains, knee and hip pain, and unfortunately fractures, are all too common in triathletes. 

If you experience severe or persistent pain while training, contact us before a more serious injury can occur.

(Adapted from STOP Sports Injuries)

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