According to new research published in JAMA Network Open, prehabilitation can significantly improve outcomes for patients undergoing orthopedic surgery.

Why Is Prehabilitation Important?

Musculoskeletal disease is the leading cause of global disability, and surgeons perform an estimated 310 million procedures yearly. An aging population, complicated by the global pandemic, resulted in delays in surgical procedures for millions of Americans. Patients are waiting much longer for routine operations, which can negatively impact them mentally and physically.

Waiting for surgery can be tiresome, but it offers an opportunity for prehabilitation: to improve muscle strength, function and quality of life before the procedure occurs. These three factors significantly contribute to post-surgical outcomes for orthopedic patients. Physicians and therapists have used prehabilitation since the 1940s, but only in the last two decades have they examined how prehabilitation can improve postoperative outcomes.

Benefits of Prehabilitation before Surgery

A group of researchers from Anglia Ruskin University (ARU), Addenbrooke’s — Cambridge University Hospitals NHS Foundation Trust (CUH) and Western University in Ontario, Canada, conducted a meta-analysis of 48 clinical trials that used prehabilitation methods like exercise, acupuncture and pain management among patients who were preparing for orthopedic surgery.

The study found prehabilitation can reduce pre-operative pain, improve muscle strength and increase quality of life for patients awaiting total hip and total knee replacement, as well as lower back surgery.

Benefits of Prehabilitation after Surgery

Prehabilitation also helped with surgery recovery. The study found that patients who prehabilitated had improved joint function in the short and medium term compared with patients who did not prehabilitate. The benefits of prehabilitation were particularly favorable at six-week postoperative visits for knee replacement patients and at six-month postoperative visits for lower back surgery patients.

Researchers suggested at least two sessions per week for four to six weeks for patients awaiting orthopedic surgery. Prehabilitation programs may include supervised and unsupervised sessions, and patients can be confident that there are minimal risks.

“While the results of the study are encouraging and support prehabilitation, it is also important that patients engage in postoperative exercise programs appropriately to achieve optimal outcomes,” said Leica Claydon-Mueller, PhD, associate professor of health services research at ARU (Medical Xpress).

Do You Need Prehabilitation before Your Surgery?

Talk to your orthopedist about prehabilitation programs if you are considering total joint replacement. You certainly want to maintain your mobility and joint strength while waiting for your surgery day. Being conditioned and prepared for surgery will help you manage your pain and streamline your recovery so you can resume your active lifestyle!

Outdoorsman Craig Moody enjoys whitewater kayaking and hunting with his family near his home in Port Huron, Michigan.

In recent years, the 78-year-old struggled with these activities because of pain and irritation in his left knee.

Moody stopped kayaking because it was difficult to get in and out of the boat. His knee problems also disrupted turkey and deer hunting excursions with his son and grandsons.

“Usually, I have to go [hunt] in a different place [than] where they are [hunting] because I make so much noise getting down on a stool or sitting on a cushion,” he said. “And then it’s comical to watch me try and get up after that.”

As his knee discomfort increased, his daily two-mile walks with his wife, Gaye, decreased in distance.

“It was slowing him down a lot,” Gaye said about her husband’s knee pain. “There was so much that he used to do.”

Over a five-year period, Moody tried nonsurgical treatments, including cortisone injections, physical therapy, weight loss and activity modification. These methods failed to sustain pain relief or improve his mobility.

“His knee was very stiff and very painful, and it interfered with his activities of daily living,” said Moody’s orthopedic surgeon, Raj B. Makim, MD. “He couldn’t enjoy the things that he wanted to do.”

X-rays verified that Moody’s knee was in the advanced stage of arthritis. After reviewing treatment options, he underwent robotic-assisted knee replacement surgery this past summer at an ambulatory surgery center.

“My knee wasn’t going to get any better,” he said. “Even with physical therapy before, it was just bone-on-bone. I just couldn’t move.”

Robotics and Knee Replacement

Approximately 790,000 knee replacement procedures are performed annually in the United States. The American Academy of Orthopaedic Surgeons reports that the number of these surgeries will increase to 3.5 million annually by 2030.

In traditional and robotic-assisted surgery, surgeons replace the knee’s damaged bone and cartilage with prosthetic joint components called implants.

For Moody’s procedure, Dr. Makim used a robotics platform. The system uses a CT scan of a patient’s joint to develop a personalized surgical plan. During the surgery, the surgeon guides a robotic arm to remove arthritic bone and cartilage from the knee.

Orthopedic surgeon William Braaksma, MD, said robotics is a “very sophisticated tool” used under the guidance of the surgeon.

“It is not a substitute for judgment or skill in the operating room,” he said. “It requires skill, and the surgeon has to know what they’re doing to make it work.”

According to Dr. Braaksma, the use of robotic technology helps improve precision and accuracy in medical procedures, leading to reduced pain and swelling and faster patient recovery.

Surgery Yields Positive Results

Moody was released from the center to begin his home recovery hours after his knee replacement surgery. Two days later, he returned for a post-operative exam with his surgeon. He also scheduled physical therapy sessions as part of his rehabilitation to strengthen his knee.

Two weeks after surgery, Moody had regained his range of motion and his strength in his knee. He transitioned from using a walker to a cane and then to walking unassisted.

Four to six weeks after knee replacement surgery, patients generally resume daily household activities, including walking, sitting, standing and climbing stairs.

Other low-impact activities patients may enjoy include golf, biking, swimming, hiking and even some dancing. Patients should avoid high-impact activities like jogging, skiing, tennis and other sports that involve contact or jumping.

Within an eight-week period post-surgery, Moody had resumed day-to-day activities, started driving again and returned to mowing his lawn. He said he was “100 percent better” after his knee replacement.

“I’m ahead of the curve of rehabbing,” Moody said. “I’m doing more things […] than I did a year ago.”

Most people who have knee replacement surgery experience significant pain relief, improved mobility and a better overall quality of life.

“That’s one thing about knee replacement — it’s basically one of the most successful operations in orthopedics, and it’s one of the most life changing for people,” Dr. Makim said.

Months after her husband’s surgery, Gaye celebrates his recovery.

“I’m excited because it’s good to see him excited and not hurting,” she said. “He’s back, and it’s wonderful.”

As his activity level increases, Moody said he views the prominent scar on his knee as “a success story.”

“This knee was shot, and now it’s not,” he said, smiling.

Don’t Delay Your Diagnosis

During Bone and Joint Health Awareness Month, it is important to evaluate your quality of life. If you experience any chronic pain, stiffness or tenderness in your knee, hip, shoulder or back, don’t ignore your symptoms.

Contact your orthopedist, who will evaluate your symptoms and make suggestions for the best treatment options. Treatments may include at-home remedies like hot or cold therapies and massage, physical therapy or even surgery.

If you are advised to have surgery, opt for an ambulatory surgery center for your orthopedic treatment. ASCs offer patients a more comfortable environment at a lower expense, convenient parking, shorter wait times and a decreased ratio of patients to nurses. Patients are sent home on the same day as the procedure to recuperate.

Before deciding on any treatment plan for your chronic pain, request an appointment today for an evaluation.

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This article is designed for educational purposes only. The information provided should not be used for diagnosing or treating a health concern or disease. It is not a substitute for professional care. If you have or suspect you may have a health concern, you should consult your healthcare provider.

Yoga is one of the best activities for maintaining flexibility, improving joint health and reducing chronic pain.

September is National Yoga Month. It’s a time to celebrate yoga’s health benefits and promote a peaceful and wellness lifestyle. More than 10 percent of American adults have tried yoga at some point in their lives. Many people try yoga to boost their mood, relieve stress and enhance concentration. However, studies are showing yoga may have a significant impact on overall mind and body wellness.

Yoga Combines Physical and Mental Wellness

“Yoga” comes from the Sanskrit word “yuj,” meaning “to unite, join or connect the mind, soul and body.” It originally began in India as a spiritual practice, but now, it’s an $80 billion industry.

The power of yoga may lie in its integration of physical poses (asanas), breathing techniques (pranayama) and meditation (dyana). Yoga, tai chi and qigong are all known as “meditative movement” practices because they combine physical and mental techniques.

Recent research shows that yoga may provide the following benefits:

• Relieve back pain, neck pain and osteoarthritis
• Promote weight loss
• Help people to quit smoking
• Reduce depression and anxiety symptoms
• Improve mood, sleep and emotional balance
• Relieve symptoms of menopause

In one study, untrained volunteers improved their muscular strength at the knee and elbow by 10-30 percent after just eight weeks of practicing yoga. The participants also improved their hip, ankle and shoulder strength by 13-188 percent.

Benefits and Risks of Yoga

Many types of yoga styles exist, and all promote health benefits. Some styles of yoga, like hatha yoga and Iyengar yoga, focus on holding various poses for several breaths. Alignment of the body is essential, and it requires time and practice to learn the correct form.

Vinyasa yoga connects movements and teaches you to “flow” from one pose to the next. Ashtanga yoga includes a specific sequence of postures to progress through and emphasizes meditation.

It is important to learn yoga from a qualified instructor and talk to your doctor before you begin. Using correct props like straps and blocks can help you maintain balance and avoid falls and sprains.

One of the most popular types of yoga is hot yoga, practiced in 104-degree heat. Although some people love to “sweat it out,” dehydration and overheating are risks.

If you have pre-existing conditions like knee or hip injuries, hypertension, lumbar spine disease or balance problems, you may not be a good candidate for yoga. Your doctor may recommend a different type of physical activity.

Call Your Orthopedist for an Appointment

Yoga may help reduce joint pain and enhance flexibility, but it may not be enough to restore joint mobility. If you are experiencing joint pain, call your orthopedist to make an appointment. Your doctor can suggest treatment options and help you make the best decision for your health. If you require surgery, your doctor will go through all the procedure details so you fully understand the risks and benefits.

Staying physically active is essential to maintain a healthy weight and prevent chronic conditions; however, over-exercising can lead to injury and mobility loss.

What is an overuse injury?

Exercise is one of the healthiest choices you can make. People of all ages need regular physical activity for overall health and disease prevention, but it is important to exercise safely.

Over-exercising and poor form can cause tenderness and pain. An overuse injury occurs when bones, muscles, ligaments or tendons are continually stressed and do not have time to rest. Although there are many types of overuse injuries, some are quite common.

Runner’s knee

Runner’s knee develops when muscle tightness pulls the kneecap in the wrong direction and causes friction between the kneecap and the bone behind it. If you do not stretch your hamstrings, hip flexors or IT band, you could be at risk for runner’s knee. Some symptoms of runner’s knee include dull pain and weakness in the kneecap.

You can prevent runner’s knee by proper stretching before and after activities like running and biking. Strengthening the quadriceps can also keep the knee in alignment and prevent injury.

ITBS

Iliotibial band syndrome, or ITBS, is one of the most common overuse injuries of the leg. The iliotibial band is a tendon that goes from the hip to just below the knee. ITBS can take a long time to heal, often one to two months.

You can prevent ITBS by stretching the IT band before and after exercise and wearing athletic shoes with good support.

Plantar fasciitis

The plantar fascia joins the toes to the heel bone and provides support to the foot arch. Similar to shin splints, plantar fasciitis develops from tight calf muscles. Weakness in the knees, hips or ankles can also cause plantar fasciitis, as well as limited mobility of the big toe. This condition can cause inflammation and pain in the heel area. The best way to prevent this condition is to wear shoes that allow you to fully extend your big toe at the joint.

Symptoms of overuse injuries

Anyone can develop an overuse injury, but senior adults are affected the most. As we age, tendons and ligaments lose elasticity and joints become less lubricated. If you experience any of these symptoms, you should call an orthopedist:

• Pain during or after exercise
• Shooting pain, burning or aching
• Weakness in the limbs
• Difficulty sleeping because of pain
• Pain with daily activities like cooking, climbing stairs or doing yard work

Visit an orthopedist to treat overuse injuries.

Don’t wait for your pain to subside before calling to make an appointment. Your doctor can advise you on whether your injury is caused by overuse or improper exercise techniques. You may be able to make modifications to your daily activities to bring healing and restore full mobility.

Sometimes it is necessary to have an orthopedic procedure to get relief from your symptoms. If you need to schedule surgery, consider an ambulatory surgery center (ASC). ASCs are a wise option because they provide high-quality patient care in a comfortable setting at a reduced cost. Ask your orthopedist about scheduling your orthopedic procedure.

You may think visiting an orthopedist is unnecessary unless you have a problem, but you might want to reconsider. Bone and joint health are essential to your overall wellness, just like a physical exam and preventive screenings. Here are three reasons to visit an orthopedist, regardless of your age.

Our bone tissue changes with age

Years of daily activity can take its toll on bones, joints and ligaments. Over time, bones lose minerals and density. They become more brittle, which increases the risk of falls and injury. Calcium, the mineral your body needs to build and maintain healthy bones, can decrease to low levels and affect bone strength.

Arthritis can develop at any time

Arthritis is a common condition that develops when joints get inflamed and swollen. According to the CDC, about 15 million Americans (one in four) have severe joint pain because of their arthritis. Also, about half say they experience persistent pain.

Anyone can develop arthritis, but older people are more susceptible. Daily wear and tear can erode the soft cartilage that cushions the joints, resulting in osteoarthritis. Athletes can develop arthritis by joint overuse or injury.

Osteoporosis affects everyone

Osteoporosis is a bone disease that develops when bone mass and bone mineral density decrease. It can also develop when the strength or structure of bone changes. Many people assume osteoporosis only affects females, but this is incorrect. While post-menopausal women are at increased risk for bone loss, all people lose bone density with age. About 25 percent of all bone fractures in adults older than 50 are men. Common fracture sites are the hip, spine and wrist.

Make your bone and joint health a priority

Life is busy, but your bone and joint health are worth the investment. A yearly appointment with an orthopedist can help ensure your joints function well and you maintain bone strength. Your doctor can recommend exercises, dietary changes, supplements or therapy.

Sometimes, your doctor may suggest a procedure like a total hip replacement, shoulder surgery or knee arthroscopy. Often, treatment plans combine an array of options. Your doctor will fully explain your choices and the pros and cons during your appointment.

Schedule your surgery at an ASC

If you have been considering an orthopedic procedure like a knee or hip replacement, scheduling your surgery in the second half of the year may make financial sense. Studies show most patients meet their deductible by May, so you might have already met your annual deductible.

If this is the case, don’t delay scheduling your procedure. Call your insurance company to verify whether you have met your deductible or are close to meeting it. You can also ask for an estimate of benefits to get a complete picture of out-of-pocket costs.

Another way to reduce costs is to choose an ambulatory surgery center (ASC) for your procedure. ASCs are accredited and certified by industry organizations for quality and safety, and they provide personalized care in a home-like setting. When deciding where to schedule your procedure, ask about facility and surgeon fees, and select an in-network surgery center.

A visit to your orthopedist does not have to be time-consuming or expensive. With some planning, you can prioritize your joint health, even when you’re pressed for time!

One of the best ways to stay healthy and spend time together as a family is to take a walk together. Daily walks can improve your cardiovascular fitness, reduce joint pain and support overall wellness.

On a practical level, walking is an inexpensive activity. It requires no equipment besides supportive, comfortable athletic shoes. Walking is a good social activity, providing opportunities for conversation with friends and family.

Benefits of a 30-minute walk

According to the U.S. Centers for Disease Control and Prevention, moderate to vigorous walking can reduce anxiety and increase memory, sleep and brain function. A recent study published in the Journal of Applied Physiology found walking or jogging for 30 minutes five times per week helps blood flow in and out of the brain. It does not matter whether you walk on a treadmill or take a walk in your neighborhood — the benefits are the same.

“Both will provide similar benefits, so the best option between treadmill vs. track is the one you enjoy doing and have regular/easiest access to and will, therefore, be the best option to help you stick with your walking routine,” said Amanda Paluch, assistant professor in the department of kinesiology and Institute for Applied Life Sciences at the University of Massachusetts, Amherst.

Walking is easy on your joints

If you have arthritis, walking is one of the best activities you can do. Consistent walking can help you lose weight or maintain a healthy weight. Staying within the recommended body mass index (BMI) reduces strain on joints and reduces symptoms of joint pain and arthritis.

How much should you walk? Remember the FIT Formula:

Frequency — Try to walk three to five times per week. Talk to your doctor if you are just beginning your routine.

Intensity — You may need to begin with a lower level of intensity and gradually increase over time. Try to work up to a moderate to vigorous level of intensity. Don’t overdo it; an injury will set you back and may take a long time to heal.

Time — Try to walk for 30 minutes per day. If you can’t walk for 30 minutes, just begin with five minutes. Every day, you will get stronger and have more endurance.

Parks as recreational options

Living close to parks, playgrounds and recreational facilities are related to increased levels of physical activity for adults and children. Parks also help people connect to nature, which can relieve stress and improve mental health and mood. According to NRPA Park Pulse, 86 percent of adults think it is important to spend time outside in nature when things get stressful.

Whether you are walking, jogging or playing with your family in the park, exercise can accomplish the following:

• Relieve joint pain
• Boost immunity
• Fight obesity
• Reduce breast cancer risk
• Decrease sugar cravings
• Help maintain body weight
• Lower blood pressure
• Reduce the risk of type II diabetes
• Strengthen the musculoskeletal system

Family Fitness Day is June 10

You can celebrate your renewed commitment to health on June 10 — Family Health and Fitness Day. You and your family can participate in this initiative by participating in recreational programs and activities in your community. There are limitless possibilities, from a game of kickball to a family 5K. You can always begin with a leisurely outdoor walk at a park in your hometown.

Call your orthopedist to manage joint pain

Are you living with joint pain? Call your orthopedist to make an appointment to discuss your mobility and activity level. Your doctor can determine the cause of your joint pain and provide treatment options. Get active on Family Health and Fitness Day and have fun with your family!

Osteoarthritis is a degenerative joint disease that affects more than 32.5 million U.S. adults. It is the most common form of arthritis.

OA is known as “wear and tear” arthritis. The cartilage within a joint breaks down and the underlying bone changes, according to the Centers for Disease Control (CDC). Without treatment, this disease may cause long-term damage to joints, causing pain and reducing mobility.

Two health organizations recommend patients with moderate-to-severe osteoarthritis should not delay joint replacement surgery. These patients have not responded to nonsurgical therapies.

In March, the American College of Rheumatology and the American Association of Hip and Knee Surgeons released new guidelines for the “optimal timing of elective hip or knee replacement.”

Susan M. Goodman, MD, an attending rheumatologist at the Hospital for Special Surgery, was a co-principal investigator of the guidelines.

“There is no evidence that delaying surgery for any of the additional nonoperative treatments studied, including physical therapy, gait aids, oral anti-inflammatories or injections, leads to improved outcomes, and [such delays] may burden patients without clear benefit,” Dr. Goodman said in the release.

A panel, which included rheumatologists, orthopedic surgeons and patient representatives, developed 13 recommendations. These recommendations included guidelines for surgical candidates with high BMIs, diabetes and nicotine dependence.

The guidelines issued are “conditional” or based on a case-by-case basis. A patient should discuss any treatment with his or her doctor.

“This shared decision-making process should comprehensively discuss the unique risks and benefits of the procedure for the individual patient,” Dr. Goodman said. “Patients with medical or surgical risk factors as described in this guideline should be counseled as to their increased risks, and preoperative attempts to modify these risk factors through efforts such as weight loss, glycemic control or smoking cessation should be encouraged.”

The full manuscript will be published later this year in Arthritis & Rheumatology, Arthritis Care & Research and the Journal of Arthroplasty.

Factors affecting arthritis

May is National Arthritis Awareness Month. During this observance, it is important to highlight factors affecting or leading to an osteoarthritis diagnosis.

Symptoms of osteoarthritis may include pain or aching, stiffness, decreased flexibility or swelling in your knees, hips or hands.

The risk of developing osteoarthritis (OA) increases as we age. According to the CDC, people who have family members with OA are more likely to develop the disease. Women are more likely to develop OA than men, especially after age 50.

The CDC notes that repetitive stress on a joint can damage and increase the risk of OA in that joint. Carrying extra weight puts more stress on joints, particularly the hips and knees.

When to seek a doctor’s care

If chronic pain interrupts daily activities like bending over to tie a shoe, rising from a chair or taking a short walk, you should schedule an appointment with your healthcare provider.

A routine physical exam and some tests will help to determine if you have osteoarthritis. To better evaluate your condition, your doctor will ask questions about your symptoms, general health, family history and daily habits.

Once diagnosed, your doctor can educate you on your medication plan and teach you how to manage your arthritis daily.

The Arthritis Foundation recommends staying active with low-impact activities such as walking, biking, swimming, yoga and water aerobics as part of your treatment plan.

If you are overweight, losing 10 to 20 percent of your body weight improves pain, function and quality of life, according to the Arthritis Foundation.

Don’t delay your care

If you suffer from chronic pain possibly caused by arthritis, do not ignore these symptoms or your condition may worsen.

Depending on your condition, treatment plans may vary. The Arthritis Foundation recommends at-home remedies like hot or cold therapies and massage for pain relief.

• Applying a heating pad and taking a warm bath can improve blood flow and ease joint stiffness. Using cold packs (such as a bag of frozen vegetables placed on the painful joint) reduces pain and swelling.
• Rubbing and kneading of muscles and joints can help reduce OA pain, improve joint function and ease stress.

Other treatments may include physical therapy or even hip or knee replacement. If a doctor recommends joint replacement surgery, the goal is to reduce your pain and increase your range of motion. During surgery, the damaged bone and cartilage will be replaced with prosthetic components, called implants.

If you are experiencing joint pain, don’t delay your care. Request an appointment today for an evaluation.

Morehead City, North Carolina, resident John Bolt III has enjoyed dancing with his wife since their wedding day 54 years ago.

That feeling changed about three years ago when he started experiencing chronic pain in his right hip and back.

“For the last three years, prior to surgery, I pretty much wasn’t able to really get out there and dance,” Bolt said. “It was just too painful.”

His chronic pain also limited his time outdoors playing golf with his friends.

“I had to quit golf. It was just too painful to do that hip movement in a golf swing,” Bolt said. “And I really missed that because, you know, that’s a social activity as well as some physical activity.”

Walking around his neighborhood with his dogs and other daily activities proved challenging for Bolt because of joint pain.

“I wasn’t able to walk as much. I continued to try to walk just because I felt like I needed to do it, but it just got more and more painful,” he said. “It wears you down mentally and emotionally over time.”

Initially, doctors thought Bolt may have had a sciatic nerve problem in his back, but X-rays revealed the problem was actually in his hip.

Explore treatment options

Bolt had a successful knee replacement a few years ago, so he consulted his orthopedic surgeon, Thomas E. Bates, MD, about treatment options for his hip.

Generally, initial treatments to manage chronic pain may include physical therapy, activity modification, anti-inflammatory drugs and sometimes injections in joints, Dr. Bates said. A doctor may recommend hip replacement surgery if a person has one or more of the following:

• Pain that limits everyday activities
• Pain that continues while resting
• Stiffness that limits the ability to move or lift the leg or
• Inadequate pain relief from anti-inflammatory drugs, physical therapy or walking supports

Hear More From Dr. Bates on The Surg Podcast

Based on his diagnosis, Bolt opted for total hip replacement surgery. This procedure replaces damaged bone and cartilage with prosthetic components called implants.

“The pain had gotten chronic, and it just never goes away. And that’s pretty mentally debilitating as well as physically debilitating,” Bolt said. “I was really ready to try to get something done to get rid of the pain and to become active again.”

Surgery relieves pain and improves mobility

According to the Agency for Healthcare Research and Quality, more than 450,000 total hip replacements are performed each year in the United States.

In February 2022, Bolt underwent the procedure in an outpatient setting. He was discharged from the surgery center the same day to start his recovery and physical therapy at home.

Within three weeks after surgery, Bolt had transitioned from using a walker to a cane and then to walking unassisted. After six weeks, doctors released him to play golf.

“I was pleasantly surprised how quickly I was able to recover,” he said. “If you have the opportunity to recover at home, I mean that seems like a win-win … I certainly got back into our own lifestyle much quicker and with a lot less frustration and tension.”

More than a year later, Bolt has significant pain relief and improved mobility. The Bolts enjoy date nights and dancing together again.

“One of the first things after I got released is we went to one of the local performances and actually got out there and danced for a couple hours. So, that was a good feeling,” Bolt said.

He and his wife walk about two miles every day with their dogs, and he plays golf sometimes twice a week when the weather is suitable.

“I love to hear a patient tell me ‘I wish I would have done this sooner.’ We hear that frequently,” Dr. Bates said. “I love to hear the fact that they get back to the things they love to do in life.”

Don’t delay your treatment

After his successful hip replacement, Bolt said it’s important not to delay treatment when you suffer from daily chronic pain. Before deciding on any treatment plan, it is important to discuss options with your doctor.

“When [hip pain keeps] you from doing anything that involves any type of walking or movement … that’s just not a way to live,” Bolt said. “Get [surgery] done, and then really work at the rehab part. I think that’s important. It gets you back to normal as quickly as possible.”

If you are considering joint replacement, Dr. Bates recommends talking to patients who have had the surgery to gain some insight into their experience.

“Most people have excellent experiences and they’re very happy with their decision,” he said. “It definitely is a personal decision.”

Our specialists always keep the patient in mind and look for the least-invasive and best way to repair your joints. If surgery is needed, our doctors use improved surgical techniques to increase your mobility and return you to an active lifestyle.

If you suffer from chronic pain in the knee, hip, shoulder or back, do not ignore these symptoms, or your condition may worsen. Request an appointment today for an evaluation.

This is designed for educational purposes only. The information provided should not be used for diagnosing or treating a health concern or disease. It is not a substitute for professional care. If you have or suspect you may have a health concern, you should consult your healthcare provider.

Shoulder pain is one of the most common conditions people experience as they age. It is wise to call an orthopedist about shoulder problems because pain and injuries can impact your daily activities. Shoulder pain could indicate tendonitis, arthritis, a rotator cuff tear or shoulder instability.

How can you know when you should try to manage your pain at home or seek medical intervention? It may depend on the cause of the pain or injury. You may get some relief from adjusting your activities and doing shoulder stretches if you have mild pain. If your pain does not subside or you have any of these symptoms, you should call an orthopedist:

• Limited range of motion
• Increasing weakness of the shoulder
• Pain in the shoulder when you are at rest
• Numbness or tingling in the shoulder or arm
• Pain that is getting worse over time

Initial Treatment Options for Pain Management

At your visit, your doctor will perform a physical exam and may take an X-ray to determine the cause of your shoulder problem. In some instances, you may need an MRI as well.

After reviewing your results, your orthopedist will develop a customized treatment plan to relieve your pain and help you recover. Some initial treatment options may include the following:

• Resting of the affected shoulder or arm
• Icing the shoulder
• Taking over-the-counter anti-inflammatory medications
• Modifying your activities to avoid further injury
• Doing physical therapy to strengthen the muscles of the shoulder and arm
• Undergoing steroid injections

If your discomfort persists, your doctor may recommend surgical intervention. Our surgery centers offer many procedures and treatments, such as a shoulder conditioning and recovery program, injection therapy for the shoulder or elbow, and shoulder surgery.

One of the most common causes of pain is a rotator cuff tear. If an MRI reveals a rotator cuff tear, you may require surgery. In most cases, shoulder surgery is an outpatient procedure that allows you to go home the same day. During the procedure, a surgeon will enter through a small incision and use a tiny camera and tools to reattach the torn rotator cuff to the bone.

Call Your Orthopedist if Shoulder Pain Persists

You don’t have to live with constant shoulder discomfort. Whatever the cause of your shoulder pain may be, an orthopedist can help you manage your pain and prevent further damage. Call your orthopedist to schedule an appointment and get relief so you can resume the activities you enjoy.

Have you already given up your New Year’s Resolution to exercise more? If you have, you’re not alone. Almost two-thirds of people give up on their New Year’s goals within a month.

Long-term fitness habits must be reasonable and sustainable. The best way to incorporate exercise into your day is to commit to a few minutes of strength exercises each day.

The frequency of exercise can improve muscle strength

According to a study published in the Scandinavian Journal of Medicine & Science in Sports, people can improve muscle strength with just a single muscle contraction five days per week. Another study in the same journal found small amounts of exercise throughout the week produced better results than one extended workout, even if the overall duration of physical activity was the same.

The research team instructed participants to do 30 arm curls weekly for four weeks. One group did 30 curls once weekly, and another did six curls five days weekly. The group that did all the curls in one day did not increase their muscle strength, but the group that spread out their exercises improved muscle strength by 10 percent.

Exercise prevents chronic disease

Skeletal muscle tissue declines as we age, which affects our independence and function. A sedentary lifestyle increases the risk for many chronic conditions:

• Diabetes
• Heart disease
• Cancer
• Osteoporosis
• Depression
• Anxiety
• Dementia

Make daily activities into exercise

Experts suggest adults get 150 minutes of moderate exercise every week. Unfortunately, if you work a full-time job, finding time to be physically active can be challenging. Here are some easy ways to incorporate exercise at work:

1. Take the stairs. Instead of waiting for the elevator, take the stairs. You can build leg muscle and increase your heart rate at the same time.
2. Take a walk during lunch. Use your lunch hour to take a walk outside. In addition to the benefits of increased muscle mass, you will get a daily dose of vitamin D that will boost your mood.
3. Do eccentric activities in your office. “Eccentric” movements lengthen and activate muscles in the body, and they can lower blood pressure and cholesterol levels. Everyone sits down on a chair daily. By sitting down slowly in your chair, you will do at least 10 eccentric contractions that extend the knee joint.
4. Use a headset. Instead of sitting during a conference call, you can move around your office or down the hallway using a headset or headphones.
5. Keep weights at your desk. Purchase a set of hand weights that you can keep under your desk. Take breaks throughout the day and do some biceps curls, lateral raises or triceps kickbacks.
6. Purchase an exercise ball and use it for stretching. Take breaks throughout the day and sit on the exercise ball to build core strength.

Talk to your doctor before beginning a new exercise routine

Are you motivated to make small steps to bring about a change in your health? Before starting a new exercise regimen, talk to your doctor for recommendations and suggestions. Your doctor can customize your workouts to prevent injury or joint pain.