The Road to Orthopaedics

the surgeon's path Feb 14, 2019

Even halfway across the globe, the love story with orthopaedic surgery has common themes. I've had the luck to be acquainted with Dr. Michelle, an amazing mom of young children who is not only a PhD but also an orthopaedic surgery resident in Europe. She is guest blogging for NancyMD today about her road to the specialty. I see echoes of what I found so satisfying about going into this surgical specialty in what she writes. 


Which specialty fits?

As a medical student I thought I wanted to get into plastic surgery. I liked the artistic aspect of shaping body parts. I thought the heavy machinery (and more specifically the drilling into bones) in trauma surgery would make me faint. I dreaded my first fracture fixation. When I was there, I noticed that it was not fear but a weird fascination that got to me so much. I simply loved it. Then I thought if I'd first see a dislocated joint I would need to sit down and breathe into a bag. But a weird thing happened...

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Nothing to Fear, Just a Dislocation Here!

bone and joint health Feb 09, 2019

Obviously going through medical school, we study a lot of very tethnical things - like the Krebs Cycle. But sometimes the practical aspects of specialties other than our own escape us. I was honored to have Dr. Bradley Block ask me to make a guest appearance on his podcast, Physicians Guide to Doctoring, where we talk about the common sports and orthopaedic injuries tat are encountered. 


Take a listen right here:


You can learn more about what Dr. Bradley Block  and other great podcast episodes at Physicians Guide to...

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Injury Prevention on the Slopes

bone and joint health Jan 28, 2019


Ski season is here, and it's time to think about how we can avoid injuries on the slopes. As an orthopaedic surgeon, I most often see knee injuries, but also plenty of wrist, elbow and shoulder injuries as well. 

Hopefully you've done some pre-season conditioning - but if not, go ahead and start now! Obviously avoid a heavy workout the day prior to your first ski day, but if you have time to become more regularly active with your cardio, strength and flexibility routine, get started with that. It's important to increase intensity, duration and weight slowly to avoid injury. Don't let your injury avoidance plan injure you! Always talk to your doctor about starting an exercise program. 


Morning Warm Up

Before you start down the mountain, you will want to make sure all your muscles are properly warmed up to avoid injury. The glutes, hamstrings, quads and core are great stabilizing muscles that protect the rest of your body from injury. Make sure these are...

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Kitchen Mishaps! Knives and Avocados

bone and joint health Jan 14, 2019


Love avocados, but hate cutting them…..they are slippery little rascals and are responsible for many nasty hand injuries.

Stab wounds from using knives in the kitchen are not fun but are reported daily. Accidental self-inflicted knife injuries to digits are a common cause of tendon and nerve injury requiring hand surgery.

Many of us do not think about how much you use “your hands for your senses”!

Until you lose that ability of sensation, not just functional implications, but how else do you recognize hot, cold or pain but by touch.


Kitchen Knife and Avocado Statistics

The Consumer Product Safety Commission estimates over 137,000 people receive hospital treatments for injuries from kitchen knives every year.

There has been an apparent increase in avocado injuries due to the way people hold the fruit in the hand. Therefore, dubbed “avocado hand”, has spread as one plastic surgeon in England says, into an epidemic and suggests that avocados...

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My shoulder’s my...biceps???

bone and joint health Dec 21, 2018


Patients are often confused when I inform them that the biceps (long head of the biceps) is to blame for their shoulder pain. Most think of their biceps as the “Popeye” muscle at the mid portion of the upper arm.

To understand why the biceps can play a role in shoulder pain, we need to understand a little anatomy. The long head of the biceps takes a right-hand turn as it dives into the shoulder joint, attaching at the labrum, which is a cartilage rim around the cup, or the glenoid, of the ball and cup shoulder joint.

The reason the long head is susceptible to injury is because it is vulnerable in its journey. There are two parts to the biceps tendon - the long and the short head. The short head does not tear often and isn’t a part of the actual shoulder joint. Because of the short head, most sedentary people can still use their biceps even if the long head is completely torn - though cosmetically there may be an asymmetry in the appearance of the biceps. It...

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Should I sit or should I stand…are standing desks good for you?

bone and joint health Oct 30, 2018

Sit-stand desks are becoming increasingly popular, and have been touted as solutions for reducing obesity, combating cardiovascular disease, premature death.

The British Medical Journal published a study this month that looked at a sit-stand desk and its effects on prolonged sitting and physical activity as well as psychological and work-related health. They found that giving the worker this desk promoted less sitting, and using self-reported evaluations, the workers noted a positive change in work engagement, occupational fatigue, daily anxiety and quality of life. 

It’s important however when studies come out, to look at them with a critical eye. When a study uses self-reports, that always introduces the possibility of bias. Reporting one's own experience is very subjective. 

Also - it’s important to note that while there were some positive benefits reported in this study, it doesn’t necessarily measure whether one is less likely to be obese, have heart...

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Staying Active and Injury-Free...At Any Age!

bone and joint health Oct 10, 2018

No one can argue that staying active can have multiple benefits. Adults that maintain a regular exercise program will find that exercise can help them: 

  • Maintain healthier weight
  • Have healthier cholesterol and blood pressure levels
  • Be at lower risk of suffering a heart attack
  • Lower their risk of type 2 diabetes and some cancers
  • Have stronger bones, muscles and joints
  • Have a lower risk of falls
  • Improve mood
  • Improve sleep patterns



One of the tricks of starting and sticking to an exercise program is to avoid injury.
There's nothing more frustrating than finally getting over inertia to start a fitness program, only to be sidelined by injury.
In my personal journey, I'm frequently discovering new sports and hobbies - or rediscovering. And if I find something I love, I tend to overdo it. As I got into my forties, I found out first-hand that charging hard at one sport without balancing that with cross-training resulted in some of the common overuse...
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ACL Injuries in the (ahem) “Older” Athlete

bone and joint health Sep 18, 2018

Over the last twenty years, physical fitness as a means to improve overall health has increased among the over-40 set. This is great, right? Yes, absolutely. Athletes who remain active as they age do a better job than non-athletes in retaining lean muscle mass. They also show improved bone density, bone structure and bone strength. However, what physicians are seeing are injuries related to the increased level of activity. 

One area of interest is anterior cruciate ligament injury in the over-40 age group. The anterior cruciate ligament, or ACL, is one of the ligaments that connect the femur (thigh bone) to the tibia (shin bone), and it controls the back and forth motion in the knee. Specifically, it keeps the tibia from sliding too far forward, while also avoiding too much rotation in the knee. 

Injuries of the ACL occur when there is a rapid change of direction or acceleration, a direct collision with the knee, or an awkward land from a jump or a height. Some ACL...

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Has the Scooterpocalypse Arrived?

bone and joint health Aug 27, 2018
A number of major cities have seen shared e-scooters, or electrical scooters, take over their streets. It's certainly popular with the riders, but it is creating waves with a lot of critics as well. In Portland, Oregon, there are four companies trialing the scooters over a several-month period.  Driving around my city, I find that we are being inundated with scooters - being used on the sidewalk, on the streets, in bike lanes. 

Some of the 75 plus cities that have tried to adopt this new concept of convenient transportation have already kicked these companies out, and I'm curious what will occur here in Portland.

So what about the orthopaedic surgeon’s take on the e-scooter craze? When I first saw these people zipping down the street on these motorized scooters, my first thought was, "Why is no one wearing any protective gear?". We wear helmets when we ride bikes, a wise roller blader wears knee pads, wrist guards, elbow pads with helmet. Why are these scooters...
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Your Orthopaedic Surgeon Will Tell You That You Should DEFINITELY Smoke Cigarettes If...

bone and joint health Aug 11, 2018 want to wait extra loooong for your fracture to heal want to have a higher risk of surgical complications, like infection or problems healing your wound're okay with developing osteoporosis want to be more likely to develop overuse injuries, like bursitis or tendonitis - and take longer to recover want to have a detrimental effect on your athletic performance want to have more pain after a surgery

Sound attractive? I would guess not for most.

As an orthopaedic surgeon, I treat many acute and chronic musculoskeletal conditions, including fractures, sprains, strains, tendon/ligament injuries and bursitis.  I often discuss with smokers the risks above - not to mention the risks of smoking that first come to mind...the damaging effects on the heart and lungs.  Many individuals are unfamiliar with the fact that smoking can even affect the health of the bones and joints.


The quick and dirty on why smoking affects musculoskeletal...
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