Author Archive

Women, Exercise, and Bone Health

Posted on: May 21st, 2022

Joanne Baird, MD

Regular exercise has been part of my life since college. As part of a nationally ranked soccer team at William & Mary, we ran drills every afternoon. And on weekends, I hit the trails around Williamsburg as a great stress release from class.   My routine over the last 20 years has grown from roads to reps – with circuit training, yoga, and paddle boarding thanks to life here on the Gulf Coast.

William & Mary Women's Soccer Team 1999
College of William & Mary Women’s Soccer Team 1999- Joanne Elston #23

We all know the benefits of exercise, like improving muscle strength and endurance, reducing risk of stroke or heart disease, and preventing unhealthy weight gain. But exercise isn’t just a value-add to life. For women, exercise and bone health are inseparable. Regular physical activity is essential to building and maintaining healthy bones. In fact, we’re losing bone strength every day if we’re inactive. Sedentary isn’t an option.

Our bones are naturally growing weaker over time if we’re not doing something to maintain bone density. Osteoporosis is a condition that leads to fragility and the potential for fracture, most prevalent in women after menopause.  This bone-thinning disease creates risk of broken bones, which can seriously limit mobility and independence.  We also tend to lose muscle as we age – a conditioned called sarcopenia.  Those who develop osteoporosis or sarcopenia are considered frail: more likely to fall and more likely to break a bone. 

Bone Health – Use it or Lose It

Our bones benefit from exercise just as muscles do – it makes them stronger.  Young girls and teens should begin exercising and eating well to build strong bones. As we age, we focus on maintaining bone strength.  Because a bone is a living tissue, it changes over time in response to the forces placed on it.  How does bone density grow?  As muscles move over bones when you exercise, they get the signal to produce more bone mass. Consider it a healthy nudge!  Bones build and become denser – a benefit that increases as you add good nutrition, including adequate calcium and Vitamin D.   

Yet another benefit of exercise is better balance and coordination.  As we age, balance helps to prevent falls and the broken bones that may result.  Studies find one fracture (not caused by trauma like a car accident or blow) often leads to another.  The “fragility cycle” is the downward slide we all want to prevent.

What’s the Best Exercise for Strong Bones?

Most all exercise offers positive health benefits.  Yoga and Pilates lengthen muscles and boost mental health and focus.  Swimming, kayaking, hiking, or anything outdoors soaks up healthy Vitamin D while toning muscles, too.

The two types of exercise we recommend most for building strong bones are weight-bearing exercise and strength-training exercise.  Improving bone strength is site-specific. For instance, walking boosts bone strength in arms and spine but not the wrist.  For stronger hands, wrists and arms, resistance bands are a better option.

Have you ever had a Pilates instructor remind you to “keep your shoulders in your back pockets”?  Women tend to slump as we age, yet good posture is essential to the health of our entire musculoskeletal system.  Postural stretching and strengthening not only prevents slumping, but the spine fractures some older people may suffer from simply bending over to tie shoes or pick up something off the floor.  

Weight-Bearing Exercise

Weight-bearing doesn’t mean lifting weights, but any activity you do on your feet that works your bones and muscles against gravity. When your feet and legs carry your body weight, more stress is placed on your bones, making your bones work harder. Pushups and plank position are easy (equipment free!) options with great results.  

Examples of weight-bearing exercise include:

  • Brisk walking and hiking
  • Jogging/running
  • Dancing
  • Jumping rope
  • Hopscotch
  • Tennis, pickleball, and ping pong
  • Team sports, such as basketball, soccer, and volleyball
  • Stair climbing

The more weight you place on bones, the greater the bone-strengthening benefits.  Jogging and jumping rope would top the list.  However, if you’ve been diagnosed with thinning bones or qualify as frail speak to your doctor about what type of physical activity is best for you. 

Strength-Training Exercise

During strength-training activities, resistance is added to movement to make muscles work harder and, over time, become stronger.  Even though muscle mass is the primary focus of resistance exercises, the stress on bones results in bone-building capacity.   

Common types of strength training include weight machines, free weights, and exercises (such as push-ups) that use your own body weight. Elastic bands are inexpensive, travel easily, and can also be used to add resistance to exercises.

A general guideline for strength training is to exercise each major muscle group at least twice a week. Be sure to rest for a full day between strength sessions.

Other Forms of Exercise

I encourage my patients to add non-impact exercise to the mix not only for strength but balance training benefits.  Did you know the top complaint that sends a patient to their doctor is dizziness? Followed quickly by… lack of energy.  Menopause again is a primary culprit.  A body in motion stays in motion, and a body at rest stays at rest.  That old physics lesson applies to our lives today, and the need for healthy movement to fuel the energy to… keep moving!   Building flexibility and balance not only feels good, but strengthens muscles, heart, and lungs.  If you have a musculoskeletal condition, such as arthritis, that limits your weight-bearing activities, swimming, cycling, and chair exercise are great alternatives.  

How Do I Start a Bone Health Exercise Plan?

Thirty minutes of weight-bearing activity, four or more days a week, is an effective gameplan for bone health.  Choose something you enjoy!  You won’t stick with it otherwise.   Those 30 minutes of exercise can be done in one stretch or broken up into shorter intervals. A 10-minute brisk walk three times a day (if that fits your scheduled) is a smart way to get started. Have a dog? She’ll love it!

If walking outdoors isn’t an option, climbing stairs indoors or even walking in place qualifies, too.  

To really reap the benefits of exercise, flexibility and balance training should be in the mix.  Just as I’ve added strength training and yoga to my passion for running, you should commit to plenty of time for stretching and balance-building moves to the end of your workout.  Not only will you reduce the risk of injury but taking time to stretch thoroughly clears the mind before you hit the rest of your day.

Don’t let your aspirations get ahead of your capabilities.  Before choosing any activity, consider your risk of falling. Talk to your doctor or physical therapist before developing an exercise program, especially if you’ve been diagnosed with severe osteoporosis.  Spine compression can happen with upright weightlifting, and you should avoid any exercise that bends or twists the back. Stationary bikes and rowing machines are not the best options. Opt for chair and corner wall exercises instead. 

Age and Bone Health Fitness

Adolescents and Young Adults

Healthy bones start in the lunchbox. Childhood is the age when bones are building, and it’s critical we fuel our children’s bone density during these years of rapid growth. A diet rich in Vitamin D and C from leafy greens, veggies and dairy is key. The skeleton that lasts our lifetime is essentially developed between the ages of 10 and 18 years old!  In fact, our peak bone mass in maximum strength and density is reached in our late 20’s. 

Weight-bearing exercise during the teen years is essential to reach maximum bone strength. A teen’s physical activity should include 20 to 30 minutes of weight-bearing exercise at least 3 to 4 days each week.

Adults

By our mid-20’s, physical activity alone can no longer increase overall bone mass dramatically. Exercise now is all about preventing or slowing bone loss, maintaining muscle mass to preserve and strengthen surrounding bone, and reducing the risk of falling. Both men and women also need good nutrition, calcium, and Vitamin D to preserve their bone mass.

Women and some men in middle age may require hormonal supplementation (estrogens or androgens) to improve or maintain bone mass as they age. For older people, however, these hormones are generally not recommended. Typically, bone-building medications are better options for those with significantly weakened bones.  

Fractures in elderly adults are most common in the wrist, spine, and hip. All can have long-term consequences that may include permanent disability. The statistics are troubling. Six months after a hip fracture, only 15% of those over 50 can cross the room without assistance.  And of that same age group, one in four of those who fracture a hip will die within the following year. *

Body Weight and Bone Health

When people lose weight, they also lose bone. Low body weight at any age is associated with a greater risk for bone problems and fractures.

Very low body weight has serious red flags for women.  While sports and exercise are healthy activities for girls and women of all ages, too much of a good thing can quickly become health-threatening.  Is your daughter too focused on being thin? Consumed with exercise? Have a friend who fits this description?  Long-term health problems and bone damage could be at risk without intervention. 

If young women exercise excessively, they can lose enough weight to cause hormonal changes that stop menstrual periods (amenorrhea). This loss of estrogen — the hormone that is necessary for maintaining bone mass — can cause bone loss at just the age when young women should be adding to their peak strength.

A woman who misses several menstrual periods, sustains a stress fracture in sports, continuously focuses on her weight, or has a distorted body image should see her doctor right away.

Conclusion

Exercise and healthy bones are a winning combination at every age.  While bone-building for children and adolescents and bone-preserving for adults, exercise is just one element of a program to prevent bone loss and reduce the risk of fracture.  Make sure you understand your individual risk for osteoporosis (Bone Density Scans should start by age 50), know your genetic factors and family history, and feed your body what it needs. A balanced, calcium-rich diet, adequate Vitamin D, and a healthy overall lifestyle (limited alcohol or nicotine) are key ingredients in bone health for a lifetime.

 *Bone Health Foundation

 American Academy of Orthopaedic Surgeons/AAOS

Elbow Pain? What Parents Should Know

Posted on: September 1st, 2021

Jason Determann, MD (September, 2021) Fall baseball is back in swing along with elbow aches and pains for young throwers. The throwing motion creates repetitive stress that often leads to a variety of both simple and complex conditions. Understanding the disorders that lead to elbow pain in children may help explain why your little guy or girl starts holding their elbow.

First of all, don’t think you’re alone. Nearly 30% of 8-12 year old baseball players will have elbow pain. That number jumps to 45% by age 14. While tendons and ligaments may be strong, they’re still growing. Growth plates around the elbow are called a physis: cartilaginous connection of immature bone often making up the weakest link that can lead to throwing problems

Little League Elbow

Little League Elbow is one of the most common conditions that affects the pediatric growth plates. Also called medial apophysitis, the inflammatory condition stems from repetitive traction or pull from the muscles and ligaments on the inside growth plate.  The inside bump on the elbow will likely be sore to the touch, but should improve with a period of rest, ice, and over the counter NSAIDs such as ibuprofen or naproxen.

Another condition is known as Osteochondritis Dissecans : fragmentation of elbow cartilage and bone due to a repetitious compressive load.  Loss of motion and symptoms such as locking or catching in the elbow are usually involved. X-rays are needed to confirm the diagnosis and often MRI is used to determine the severity of cartilage injury.

As children continue to grow, the concern of ulnar collateral ligament injury (UCL) comes into play. This ligament is the primary stabilizer of the inside of the elbow and is needed in overhead athletes. This ligament can get strained, develop partial tearing, or even complete tearing in severe cases. Due to sport specialization at a young age and year-round competition, the incidence of UCL problems in pediatric throwers is rising.

Elbow Injury Prevention

Regardless of the problem, the first step is a simple one: stop throwing!  Most elbow pain in children we encounter stems from overuse: the body is telling our child it needs a short break. This break can range anywhere from 2 to 6 weeks, and is often shortened with NSAIDS and physical therapy. Continuing to play or throw through the pain should be avoided to prevent even more serious injury.

In sum, the key treatment to elbow pain in children is prevention. We all share this responsibility. Emphasis should be placed on an adequate warm up and cool down. Additionally, proper throwing mechanics should be taught at a relatively early age and constantly re-evaluated. Most youth leagues, including ours here on the Eastern Shore, have pitch counts per game, week, and season. Adhering to these guidelines is critical to maximizing the health of your child’s arm.

Beat the Backpack Blues

Posted on: August 5th, 2021

Dr. Joanne Baird (August 2021) Can you believe we’re turning the calendar already? Back to school is around the corner. August brings excitement, a busier schedule (especially for parents), a return to academic and sporting activities, heavy backpacks, and computer time.  We can still avoid the aches & pains of back to school with thoughtful conditioning and healthy habits!

Conditioning

Injuries often occur when athletes suddenly increase the duration, intensity or frequency or their activities.  Before organized sports begin, young athletes should gradually increase activity toward a higher fitness level, especially if out of shape from other summer activities. Proper technique is important, and coaches are great resources in a conditioning plan.   In addition, our Gulf Coast temps stay peak-of-summer hot well through August, so staying properly hydrated is critical to preventing heat-related illnesses. Finally, a healthy, well-balanced diet is key in optimizing bodies and brains for a new school year.  

Back Pain Prevention

Even with the growth of laptop learning, millions of children each year are walking to school with a backpack full of heavy books and materials. This backpack strain can often impact the back, neck, and shoulder muscles.  Usually, the discomfort is short-term but heavy weight to the back can produce lingering issues.  

  • Distort the natural curves in the middle and lower backs, causing muscle strain and irritation of the spine joints and rib cage.
  • Lead to rounding of the shoulders.
  • Cause a person to lean forward, reducing balance and making it easier to fall.
  • Habitually carrying backpacks over one shoulder will strain muscles to compensate for the uneven weight and the spine will lean to the opposite side.  This muscle imbalance can cause muscle strain, spasm, and back pain.

A smart guideline is to limit the weight of the backpack to 10-15% of your child’s body weight.   Usually, pain will diminish with a period of rest, and there is no evidence backpack use can lead to permanent injury or structural spinal deformity.   

Helpful Hints to Prevent Backpack Strain

  • Choose a pack with lightweight material (nylon vs leather), padded back, wide (2-inch adjustable shoulder straps and individualized compartments.
  • Help distribute weight from shoulders with a hip strap or waist belt.  
  • Consider a separate bag for the laptop or heavy electronics.
  • Use both shoulder straps and wear the backpack on the back rather than over one shoulder.
  • Pack the heaviest objects into the backpack first so they are carried lower and closest to the body and distribute the load between compartments.
  • Lift the backpack using the leg muscles, keeping close to the body.
  • Try not to lean forward when walking. If this is necessary, it’s time to lighten the load.

In sum, what’s the backpack bottom line? If your child complains of discomfort, reduce the weight. Have them carry only what is necessary and encourage frequent trips to the locker during the day.  Back to school brings enough butterflies…without aches and pains, too!

*for more information: AAOS/orthoinfo.org

Youth Sports? Best to Mix it Up

Posted on: April 6th, 2021

Joey F. Carter, MD

(April, 2021) Need a sure sign of spring? You’ll find it on Saturday mornings at the ballpark and soccer fields these days.   Some of these young athletes may be playing not just during a traditional season but year-round, with club travel leagues starting as early as 7.  But is sports specialization in children a healthy choice?

What is Sports Specialization?

The past twenty years have brought a significant shift from unstructured free play and school-based sports to what’s called “sport specialization.” The numbers are astounding:  close to 30 million children between the ages of 6 and 18 and close to 60 million in organized programs are participating in year-round sports.   

Conventional wisdom may lead us to think kids will fall behind their peers if not putting in the “10,000 hour rule” of practice making perfect.  But the growing intensity of this early specialization may lead to more harm than good. The American Orthopaedic Society for Sports Medicine * has found the trend alarming enough to define a list of risk factors associated with overuse injuries in young athletes.

Know the Risk Factors for Overuse Injuries

  1. Participation in intense training and/or competition in their sport more than eight months per year.
  2. Participation in one sport to the exclusion of others or free play.
  3. Playing their sport for more hours per week than their age.

Do any of these hit close to home?   Overuse injuries we see in young athletes include knee disorders with soccer, basketball, and volleyball players. Shoulder injuries include “Little League Shoulder” due to repetitive pitch counts for pitchers and the intensity of throws catchers must make during a game.  “Little League Elbow” often results from high-throwing volume.  Racket sports and gymnastics also fall into the year-round sport specialization/overuse injury loop. 

Mix it Up – and Don’t Forget Free Time Too

Finding the right balance in training and competition is a tough topic for coaches and parents, who may feel pressured to keep up… and keep their child’s spot on the team.    Clearly, our children find enormous benefit from individual and team sports – with physical development, socialization, teamwork, and a strong work ethic.  But too much of a good thing also leads to psychological burnout and loss of motivation. What’s the answer? Limit practice, ensure plenty of rest, and keep it fun! Mix up other sports, and find time for free play, too.   We all want our children to succeed on the field of play – without preventable injuries. 

*www.sportsmed.org.

Ankle Pain? Don’t Tough it Out.

Posted on: March 29th, 2021

Joanne M. Baird, MD

(February 2021) Training for early spring sports unfortunately brings some quite common injuries. We see ankle strains and sprains in children and teens whether from overuse, lack of conditioning, or just because they are back on the field of play again!

What Sports Produce the Most Strains?

Ankle sprains are common, especially in sports that involve cutting like soccer or lacrosse. In addition, these ankle-impacting sports usually involve uneven ground. A sprain occurs when the strong ligaments in the ankle stretch beyond their limit and tear.

Most ankle sprains are minor and will heal with home treatment including rest, ice and elevation.  If serious swelling and pain make it too painful to walk, seek medical attention.  Severe sprains that are not properly treated early on and rehabilitated appropriately can potentially weaken the ankle and make it prone to reinjury.   

How Do I Know if I Have an Ankle Sprain?

The lateral ligaments on each side of the joint are impacted in ankles strains and sprains as the foot or ankle twists unexpectedly.   We grade sprains on the amount of tearing, from mild and microscopic to high ankle sprains that may require surgery.    

Symptoms:

  • Swelling
  • Bruising
  • Tenderness to the touch
  • Instability – when there is a complete tear of the ligaments
  • May hear or feel a “pop”

A severe sprain may feel much like a fracture or broken bone, and you should have a physician examine the ankle as soon as possible.  How much can you move? Where is it tender? A physician may call for X-rays to rule out a fracture.

How Do I Treat a Sprained Ankle?

Most ankle strains and sprains are treated successfully without surgery – even a complete tear.   Home treatments include the RICE protocol:

R = Rest your ankle by not walking on it.  Crutches may be recommended for a few days.

I = Ice immediately to help with swelling.  Use 20-30 minutes, three to four times a day, do not apply ice directly on the skin.

C = Compression dressing with bandages or ace wraps to immobilize and support the ankle.

E = Elevate the ankle above the level of the heart as often as able in the first 48 hours.

Non-steroidal anti-inflammatory medications, like ibuprofen or naproxen, can help alleviate pain and swelling.  For moderate or severe sprains your doctor may recommend a removable boot or air-cast and sometimes a cast may be recommended.  Physical therapy and rehabilitation exercises are important to prevent stiffness, improve strength and prevent chronic ankle problems.  Balance training – or proprioception – will ensure a steady return to action.  No need to just grin and bear it– we’re here to help!

Bone Health for a Lifetime

Posted on: January 28th, 2021

Trevor M. Stubbs, MD

(February, 2021) As parents, we all want our children to be happy and healthy, both now and when they are adults. Typical advice sounds something like “eat a healthy diet and get plenty of exercise.” While completely true, some of us might need a little more instruction! Bone health in children starts far earlier than you might imagine, and is essential to preventing fractures in the future.

When Does Bone Health Begin?

Bone health begins in childhood and is essential through adolescence. Research shows that building bone mass early reduces the risk of osteoporosis later in life. This common disorder leads bones to become very fragile and more likely to break. Older adults with osteoporosis are most vulnerable to breaks in the wrist, hip, and spine. These fractures can seriously limit mobility and independence. We reach peak bone mass by our 20’s, meaning we need to invest in bone health well before then with three important variables:

Calcium

Calcium is a mineral required to build and maintain strong bones. Because our body cannot make calcium, we must get it from the foods we eat. If we don’t ingest enough, the gradual loss of calcium from our bones makes them weak. 

Good Sources of Calcium:

  • Dairy products like milk & yogurt
  • Leafy vegetables like kale & broccoli
  • Calcium-fortified foods like cereals & juices
family drinking milk

Sweetened carbonated beverages can decrease the body’s ability to absorb calcium – another reason (as your dentist agrees) to avoid sodas. Reaching the healthy calcium target of 1300mg a day would require 1 cup of yogurt, milk, orange juice, and cereal plus 1 slice of cheese every day.  Is your child packing that much in? If not – consider an over-the-counter calcium supplement. Typical multivitamins don’t contain enough.   

Vitamin D

Vitamin D ensures our body can absorb calcium in our intestine.  Children develop brittle and bowed bones – or rickets – when the body is short on Vitamin D.   Despite the name, Vitamin D is technically a hormone, because our body can make it when exposed to sunlight. Some studies suggest 10-15 minutes of sun exposure without sunscreen several times per week. Of course, the need for sunscreen and cold weather can make that sunshine goal a challenge.        Fish and fortified milk are the best sources of Vitamin D in food, but your child is likely not getting enough.   Optimal Vitamin D takes 100 IU in 1 cup of milk. If your little one is drinking less than 4 cups per day and not spending much time outdoors, consider supplementing with 400 IU of Vitamin D in common multivitamins.  

Exercise

Get moving!  Kids need at least 35 to 60 minutes of physical activity every day. Bones respond to this exercise by building more bone.  Besides the bones, staying active is good for the heart and lungs, decreases obesity and improves overall mental health.   How to get kids off the video games and outdoors?

  • Make it fun! Consider a team sport, racquet sport, dancing, skating, hiking or just playground time
  • Be a role model and plan activities together like a family walk
  • Look for toys that require physical activity

Here’s a breakdown on just what we need at each age. If you’re over 50 and concerned about your own bone health, consider an evaluation with our Bone Health Clinic. Own your bones early! Your body will thank you later.

Age GroupRecommended Daily Calcium (mg)Recommended Minimum Vitamin D (IU)
1-3700 mg600 IU
4-81000 mg600 IU
9-181300 mg600 IU
19-501000 mg600 IU
51-70 (Men)1000 mg600 IU
51-70 (Women)1200 mg600 IU
71+1200 mg800 IU

*American Association of Orthopaedic Surgeons 

WKRG The Doctor is In

Posted on: November 16th, 2020

Jay Savage, MD discusses arthritis of the hip and joint replacement with Devon Walsh on “The Doctor is In” on WKRG. (October 2019)

Knee Pain and the Female Athlete

Posted on: November 14th, 2020

By Joanne Baird, MD

(November 2020) Amidst this ongoing pandemic, fall sports are back in full swing. With the disruption of our routine training and activities during the last several months, we are seeing an unfortunate increase in injuries in our athletes across all age groups. Knee pain in female athletes is especially common.

What Kinds of Knee Pain are There?

Anterior knee pain is one of the most common complaints with one of every ten musculoskeletal patients to our office. Adolescent anterior knee pain often occurs in healthy athletes, and can be extremely common in females. Typically athletes complain of pain in the front of the knee, usually underneath the kneecap (patella). Pain more distally (upper shin bone area) or proximally (lower thigh) are different conditions related to the tendons or secondary growth centers (apophyses) of the leg including quadriceps or patella tendinitis or Jumper’s Knee, Osgood­ Schlatter Disease, or Sinding-Larsen-Johansson syndrome.

Adolescent anterior knee pain is particularly common after changes in training routine without adequate stretching or strengthening. Fortunately, there is usually no physical abnormality and in most cases it will improve with simple treatments.

What are the Symptoms of Anterior Knee Pain?

  • Dull, achy activity-related pain that begins gradually
  • Popping when climbing stairs or standing from sitting
  • Pain at night
  • Pain during activities that involve repeated knee bending (jumping , squatting, running, weight-lifting)

What to do? If your knee pain will not go away after and interferes with activity, see your doctor to examine the knee and rule out other problems with X-ray and potentially MRI if internal joint problems are suspected.

How do I Treat Anterior Knee Pain?

  • Stop and limit the activities that make your knee hurt until the pain goes away
  • Change training routines
  • Pursue low-impact activities that put less stress on the knee joint (biking, swimming)
  • Weight loss may help if overweight
  • Change training techniques with the guidance of a certified trainer or physical therapist
  • Gradually return to higher impact sports and activities
athlete in physical therapy for knee injury

Physical therapy exercises may be recommended to help improve your range of motion, strength, and muscle endurance. Additionally, ice may relieve discomfort after activities and over-the-counter nonsteroidal anti-inflammatories such as ibuprofen and naproxen may help alleviate pain .

In sum, knee pain in female athletes is common but preventable and usually improves with simple treatments. Make sure to condition muscles with changes to training and activities to keep the pain at bay. Whether evaluation, treatment or physical therapy is needed – we’re here to help.

* American Academy of Orthopaedic Surgeons: orthoinfo.org

Avoiding the Physical Pitfalls of Working from Home

Posted on: April 29th, 2020

By Joey Carter, MD

(May 2020) Coronavirus (COVID-19) has thousands of Baldwin County children suddenly “schooling” from home. And that means thousands of Baldwin County parents are unexpectedly at home alongside them. Avoiding the physical pitfalls of working from home takes some planning.

Fortunately, technology and new software platforms like Zoom and Google Classroom keep us connected to teachers and co-workers.  But those same tools come with pitfalls, when we’re suddenly on a keyboard or tablet several hours a day.  Overuse of handheld devices can lead to unintended problems with the hand, wrist and arm. And poor desk posture without breaks to stretch can leave you slouched and strained with the potential for musculoskeletal injuries.   

Tips for a Healthy Home Work Space

If you’re working from home for the first time, it’s important to set up a healthy work space:

  • Check the height of your desk  – should be elbow level when sitting
  • Make sure you have a natural posture – no hunching  or twisting
  • Find a chair that adjusts and supports the curve of your lower (lumbar) back

Good posture is essential:

  • Spine: Keep ears in line with tops of shoulders and shoulders in line with hips
  • Shoulders: Upper arms hang relaxed and close to the body
  • Wrists: Hands are in straight lines with lower arms

How Do I Know if I Have Carpal Tunnel Syndrome?

Repetitive use of a computer keyboard and mouse can sometimes lead to Carpal tunnel syndrome. Symptoms are tingling or numbness in the fingers, caused by pressure on your median nerve. This nerve gives you feeling in your thumb and all fingers (except the pinky).  When the median nerve goes through your wrist, it passes through a narrow path – the carpal tunnel – that’s made of bone and ligament. If you have any swelling in the wrist, this tunnel gets squeezed and pinches the median nerve, which causes your symptoms.

Avoid the PItfalls of Working from Home - tips from Bayside Orthopaedic

While there’s no surefire way to prevent Carpal tunnel, a lighter touch helps.   Keep your fingers relaxed while typing and using a mouse.  Avoid holding a pen or anything else in your hands while you type.   Keep your hands stretched and relaxed: make a tight fist then relax your fingers and spread them out. Repeat 5-10 times.

Your Smartphone May Be the Culprit

You might be surprised how many patients we see with “smartphone tendinitis” – caused by repetitive typing and swiping that irritates the thumb flexor tendon.     Did you know many of us type hundreds of text messages a day? Not exactly what our hands were designed to do.    Holding a smartphone with the wrist in an awkward position for a prolonged period of time can irritate forearm tendons and lead to a painful condition known as “DeQuervain’s tendinosis.”  

The primary treatment includes common sense changes like texting less frequently, improving posture, and modifying the way you hold your phone or tablet.  If symptoms don’t improve with rest, options include splints, medications, hand therapy or a cortisone injection.

Using a laptop?  Its design can be inherently problematic for our posture.  Either your head/neck bends to see the screen or your hands/wrists use poor posture at the keyboard.  If your laptop has become the “home office”, consider buying either an external monitor or keyboard.

Remember, our bodies weren’t designed to sit still – even in correct position – for long periods of time. Take a break!  Change your seated position occasionally, stand up and stretch every 30 minutes or walk around outside.  These are challenging times – staying home means staying well for all of us.

https://orthoinfo.aaos.org/en/diseases–conditions/carpal-tunnel-syndrome/

Joey F. Carter, MD

Dr. Carter received his MD from the University of Mississippi School Of Medicine in Jackson, MS. He is Board Certified in Orthopaedic Surgery and a Fellow of the American Academy of Orthopaedic Surgeons.

The Limping Child

Posted on: March 29th, 2020

Gregg Terral, MD

(May 2019) Limping is a common complaint that prompts parents to seek medical attention for their child. Usually the limp is caused by minor injury that will get better by itself. However, limping that last longer than a week and that is not improving may indicate a more serious condition requiring medical evaluation. The challenge for both the parent and the physician involve the difficulty in young children at describing their symptoms as well as with older children trying to play through their pain even when it is not safe.  As a parent, it’s important to understand a limping child.

What is Causing My Child to Limp?

Injury:

Minor injuries such as contusions, low-grade sprains and strains will resolve quickly. Pain and limping related to more serious ligament sprains and muscle strains as well as traumatic and stress fractures will however persist.

Overuse injuries:

Overuse injuries to various sites of growth can also occur – typically the heel, mid foot, leg, kneecap, as well as the pelvis. These causes of pain fall under the general diagnosis of apophysitis. Patella maltracking as well as patella tendinitis or jumpers knee may also be a concern.

Infection and inflammatory disease:

Viral and bacterial infections can settle in growing bones and adjacent joints causing significant pain at times. Several types of inflammatory disease such as juvenile arthritis can also be a cause.

More Serious Issues Behind a Limp

Other less common causes of leg pain or limping can be related to congenital abnormalities such as a congenital hip dislocation or congenital foot deformities

Legg-Perthes disease is caused by insufficient blood supply to the hip, leading to a flattening of the ball within the ball and socket joint of the hip. This condition usually occurs between the ages of 4 and 10 in otherwise healthy children.

Slipped capital femoral epiphysis occurs just before puberty and is a slippage of the growth plate within the hip socket.

Diskitis is an inflammation of the disc spaces within the spine which can also cause painful limping.

Nervous system disorders create a problem with the nerve signals that control walking. Disorders of the nervous system can cause weakness or tightness in the muscles which can also cause a child to walk differently.

Tumors of various types can grow into bone and soft tissue and cause pain locally.

A thorough history and physical exam by your physician accompanied by appropriate imaging which may include studies such as x-rays, ultrasound, bone scans, MRI, or CT scan can readily provide a diagnosis. Occasionally bloodwork will also be needed to make the appropriate diagnosis and develop a treatment plan.

If your child has an issue lasting more than a few days, we’re here to help.

https://orthoinfo.aaos.org/en/diseases–conditions/the-limping-child/

Dr. Terral received his MD from Louisiana State University Medical Center in New Orleans, followed by residency in the Department of Orthopaedic Surgery at the University of Mississippi Medical Center in Jackson, MS.  He is Board Certified and Fellowship Trained in joint reconstruction.