All posts by admin

Bone Health

5 Ways to Prevent Osteoporosis

Osteoporosis is a concern among many people, especially as they age. Osteoporosis is a disease in which bone density and quality decrease. Bones become fragile and porous, increasing the risks of fractures. Bone mass is lost gradually with age, and often there are no symptoms until there is a fracture.

Bones are made of living tissue that changes and grows as we age. Peak bone mass is achieved during childhood and adolescence. After that, bone strength is maintained by a process called remodeling, in which old bone is removed by resorption, and new bone is formed. As adults age, resorption begins to happen at a higher rate than formation, which can lead to bone thinning, or osteoporosis.

While adults do not necessarily build bone mass, following certain lifestyle guidelines can help limit remodeling and resorption so that bone strength is maintained as much as possible. If you are concerned about bone loss, we’ve outlined five ways to prevent osteoporosis: 

1. Choose the Right Sources of Calcium

The International Osteoporosis Foundation (IOF) has a guide for you to find the right amount of calcium-based on age and sex. The best way to get calcium is through food. Dairy products are the most common foods associated with calcium, and they are a good readily-available source. Dairy is also a good source of protein and other nutrients, making it a good choice. Make sure you check to see if you should be using low-fat options, as those are often recommended in many diets.

If you can’t or don’t eat dairy, then there are other sources. People who eat fish may consider canned fish that include edible bones like sardines. The bones are where the calcium comes from. Vegetarians, vegans, and people who don’t like fish can also find calcium in plant-based foods and fortified alternatives:

  • Green vegetables like broccoli, bok choy, and curly kale
  • Nuts (almonds and Brazil nuts in particular)
  • Some fruits including apricots, dried figs, and oranges
  • Calcium-set tofu
  • Fortified grains, breads, and cereal
  • Fortified beverages including fruit juices, mineral water, and soy drinks

Note that some produce has high calcium content, but are not good sources for it because they also contain “oxalates” which prevents the calcium in those foods from being absorbed. Spinach is the most common example of this. Some dried beans and seeds have “phytates,” which have the same effect. 

Aim to meet your calcium requirements through dietary choices and only supplement if you can’t meet the recommended amount with what you eat. However, if you need extra calcium and it’s not possible to eat enough calcium-rich foods to get enough, supplements are an option. 

Talk to your doctor about the best supplements to use and make sure there are no possible negative interactions with any medications you are currently taking.

2. Get Enough Vitamin D

Getting the right amount of calcium isn’t enough when trying to prevent bone loss. You need to make sure to meet vitamin D requirements in order for the calcium to be absorbed. Exposure to sunlight prompts the skin to make vitamin D3. For most children and adults being exposed to sunlight for 10 to 15 minutes each day is sufficient. Certain foods are also sources of vitamin D3, while other plant sources provide vitamin D2, which is closely related. Check this guide from IOF to see how much vitamin D you might need, and where you can get it.

Food sources of vitamin D are pretty limited, especially if you follow a vegetarian or vegan diet. The best sources are oily fish (salmon, sardines, mackerel), liver, and eggs. In some places, you can also find dairy products and grains fortified with it as well. When it comes to vitamin D supplements, also read labels and consult your doctor about which varieties they recommend (if they don’t prescribe them to you).

3. Make Healthy Lifestyle Choices

Making good choices for your overall health will usually also benefit your bone health. Along with making sure you get enough calcium and vitamin D, you need to pay attention to general nutrition and have a balanced diet. Get enough protein and eat plenty of fruits and vegetables for vitamins, minerals, and antioxidants. Other vitamins and minerals you need to get enough of include zinc, vitamin A, vitamin K, magnesium, homocysteine, and B vitamins.

There are also certain things you should avoid to prevent osteoporosis. Caffeine can interfere with calcium absorption and have a “leaching” effect. Some people have linked carbonated beverages to calcium leaching as well, but there is no proof of this. However, limiting soda is a good idea anyway, as other beverages are healthier (like milk for bone health). Alcohol should also be limited or avoided.

Smoking has also been found to be detrimental to bone health, as well as the health of many other organs and systems. To reduce the risk of bone loss, stop smoking and avoid being exposed to secondhand smoke.

4. Get Regular Exercise

You already know that exercise is good for keeping muscles strong, but did you know it is also important to bone health? Getting certain types of exercise can stimulate the cells that build bones, which will prevent bone loss and maintain strength. But you need to make sure you get the right kind of exercise.

Weight-bearing and resistance exercises can help children build bone density and adults maintain it. Weight-bearing exercises focus on carrying your own body weight against gravity. Examples of weight-bearing exercises include walking, running, dancing, hiking, tennis, and aerobics.

Resistance, or muscle-building, exercises use objects to create an opposing force for your body to work against. Weights and resistance bands are probably the most commonly used tools in resistance training. Water is also a good resisting force, so doing exercises in the pool an option, with the added benefit of being low-impact.

5. Watch Out for Under-Nutrition

While maintaining a healthy weight is important, some people take dieting and food restriction too far in an effort to be thin and suffer from under-nutrition. Young girls and women are at a higher risk for this. Many weight-loss diets result in deficiencies of certain nutrients, including those important to bone health (vitamin D, calcium, and protein).

If you are struggling with disordered eating or undernutrition, seek help from medical professionals and counselors. The National Eating Disorder Association (NEDA) has resources to get you started.

Make an Appointment

Paris Orthopedic and Sports Medicine provides patients in Northeast Texas and Southeast Oklahoma with comprehensive orthopedic services, including managing bone health. If you have concerns about bone loss and ways to prevent osteoporosis, call us at (903) 737-0000 to make an appointment. You can also request an appointment online. 

 

Sports Medicine

Most Common Types of Running Injuries

Humans have been running for thousands of years, and we’ve been injuring ourselves for all of them. The truth is, running is a high-stress, high-impact form of exercise that can take a serious toll on our muscles, joints, bones, tendons, ligaments, and spine. Here are some of the most common injuries that may arise from running.

1. Runner’s Knee

Runner’s knee is usually the result of overuse and can occur when your kneecap gets out of alignment, causing excessive wear and tear on the cartilage in your kneecap. When you’re affected by runner’s knee, you’ll not only experience knee pain when running, but also when squatting, going up and down steps, or after sitting with a bent knee for extended periods of time.

2. Pulled Muscle

A pulled muscle is actually a small tear in the fibers of your muscle, sometimes called a muscle strain. It can be caused by a muscle that is overstretched. When a pulled muscle occurs, you may hear or feel a popping sensation followed by a sharp pain.

3. Shin Splints

Shin splints happen when you experience pain in the shin area, typically around the front or inside of the lower leg area along the tibia bone. They are usually the result of substantial changes to your workout without adequate adjustment periods, such as greatly increasing your running distance or reducing rest periods abruptly. Pain from shin splints may feel similar to a stress fracture; however, the pain from shin splints is usually felt along a more spread out area along the shin. 

4. Achilles Tendinopathy or Tendinitis

Achilles Tendinopathy is when the Achilles tendon becomes inflamed, causing stiffness and pain in and around the area of the Achilles tendon. Achilles Tendinopathy is typically the result of excessive and repeated stress to the tendon. Treatment for Achilles tendinopathy usually involves stretching, ice, and rest.

5. Plantar Fasciitis

The plantar fascia is a band of tissue in the bottom of your feet that goes from your toes to your heel. When the tissue becomes inflamed, it’s referred to as plantar fasciitis. Treatment for plantar fasciitis involves rest, stretches, icing the soles of your feet, and using shoes with good support.

6. Stress Fracture

A stress fracture is a small crack in one of your bones that causes mild discomfort and pain. Runners that develop stress fractures usually develop them in their shins or feet. Similar to shin splints, they can be the result of abrupt changes to your workout without a sufficient adjustment period. If you continue to exercise and put additional strain on the bone that is affected by a stress fracture, it can turn into a more serious injury or fracture.

Contact Paris Orthopedics

If you have experienced an injury as a result of an activity or sport, including running, it is wise to be evaluated by a professional, especially if the pain has not subsided after a few days. Even if you consider your condition to be minor, it may be more severe than what meets the eye.

The experts at Paris Orthopedics and Sports Medicine strive to offer solutions to treat patients and prevent future injury. Whether you are a competitive athlete or a weekend warrior, let Paris Orthopedics help. Contact our office today at 903-737-0000 to schedule an appointment. 

Sports Medicine

6 Ways to Avoid Workout Injuries

Regardless of whether you’ve exercised for years or are new to it, it’s important to familiarize yourself with how to avoid workout injuries.  After all, workout injuries can deter you from your health and wellness goals and leave you with a great deal of pain and discomfort. Here are six ways to stay clear of workout injuries.

1. Work with a Trainer

If you’re just beginning your fitness journey, it’s a good idea to work with a trainer who can design an individualized routine for you and show you how to perform each exercise correctly. Proper form is the key to injury prevention so a trainer can be an invaluable resource, especially if you haven’t had much experience with exercise in the past. 

2. Warm-Up

Get into the habit of warming up before you begin any exercise routine. This way, you can bring blood flow to your muscles and mentally prepare yourself for the workout to come. Some of the best warm-up exercises include jumping jacks, lunges, squats, and light jogging in place.

3. Switch Things Up

While it may be tempting to do the same exercise routine every day, doing so can wear your muscles out and hinder your results. Instead, switch things up and try to diversify your workouts. For example, one day you can take a cardio class at your local gym while the next day, you can do yoga in your living room.

4. Eat Healthily

The key to strong bones, which can prevent injuries is healthy eating. Be sure to fill your diet with nutrient-rich foods like fruits, veggies, whole grains, and lean proteins. Stay away from processed foods and sweets as much as possible. Remember, you can’t outrun a bad diet so what you eat matters, regardless of how much you exercise.

5. Stay Hydrated

Hydration is just as important as healthy eating. Every time you work out, make you drink plenty of water. Doing so will ensure that your body receives the vital fluids it needs to make it throughout the entire exercise routine. Keep a water bottle with you so you remember to hydrate.

6. Cool Down

Avoid ending a workout with 50 burpees or a 3-mile sprint. Instead, cool down and gradually lower your heart rate. Try a slow walk or gentle stretching exercises to maintain optimal strength and flexibility. 

Contact Paris Orthopedics

Paris Orthopedic and Sports Medicine provides comprehensive orthopedic and musculoskeletal services for patients of all ages throughout Northeast Texas and Southeast Oklahoma. We offer surgical and non-surgical treatments for a broad range of bone, muscle, and joint problems, including broken bones. Contact our office today at 903-737-0000 for more information or to schedule an appointment with a physician.

Pediatric Ortho

What To Do When Your Child Breaks A Bone

As parents, it is natural to do everything possible to protect one’s child from injury. However, the nature of youth implies that it will be nearly impossible to do all the time. Even if they are not involved in sports, children by nature are constantly exploring the world around them which inevitably leads to bumps, bruises and scrapes. In some cases, it may even lead to a broken bone. Did you know that a broken bone, or fracture, is the fourth most common injury among children under the age of six?

Because it’s not a matter of if, but when your child gets injured, it’s important that you’re able to assess their injury and respond appropriately. Since fractures are so common, let’s discuss what to do when your child breaks a bone. 

1. Know the Symptoms

Being able to tell when a bone is broken is not always as easy as one might think, especially if your child is too young to communicate how he or she is feeling. The most common signs that your child may have broken a bone include: 

  • Hearing an audible “snap” or a grinding noise at the time of injury
  • Swelling, bruising or tenderness
  • The injured part is difficult to move or hurts when moving, being touched, or bearing weight

Keep in mind that just because your child can move the bone doesn’t mean that it is not broken. If you suspect a fracture, notify your pediatrician immediately.

2. What to Do

Until your child can be seen by a medical professional such as your pediatrician, urgent care center or emergency room, it’s very important that you know how to respond appropriately. First of all, try your best to stay calm. Your child is likely both scared and in pain and losing your cool can worsen their fear and worry. 

First and foremost, keep the injured bone in the position that you find it. To stabilize the injury and hold the bones still, you can carefully place a simple splint using a small board, piece of cardboard or rolled-up newspapers secured with an elastic bandage or tape.

The American Academy of Pediatrics also advises: 

  • Not to give the child anything by mouth to drink or to relieve pain without first consulting the doctor. If your child is older, you can use a cold pack or a cold towel, placed on the injury site, to decrease pain. Extreme cold can cause injury to the delicate skin of babies and toddlers, so do not use ice with children this young.
  • Call 911 if your child has broken his or her leg. Don’t try to move them yourself. Instead, let the paramedics supervise his transportation and make the child as comfortable as possible.
  • If part of the injury is open and bleeding, or if bone is protruding through the skin, place firm pressure on the wound; then cover it with clean (preferably sterile) gauze. Do not try to put the bone back underneath the skin. After this injury has been treated, be alert to any fever, which may indicate that the wound has become infected.

3. Follow Treatment Protocol

The good news is that children’s bones are more flexible compared to adults, making them better able to absorb shock. They are also less likely to require surgical repair. 

In most cases, when a child breaks a bone it can be treated with the use of a molded cast. If the fracture is minor, they may only need an immobilizing splint.

For a displaced fracture, an orthopedic surgeon may have to realign the bones. This is done using one of two methods: 

  • Closed Reduction, in which the surgeon manipulates the bones until they are straight before applying a cast. Local or general anesthesia is used. 
  • Open Reduction is a surgical procedure that takes place in an operating room. Fortunately, open reductions are rarely necessary for children.

Regardless of the treatment plan, it’s important to follow all instructions from your provider. This includes keeping the cast dry and making sure your child uses any necessary equipment such as crutches to avoid bearing weight. This also means following recommendations regarding participation in any extracurricular activities.

Call your doctor if: 

  • Your child has an increase in pain, numbness, or pale or blue fingers or toes. These are signs that the extremity has swollen and requires more room within the cast. If the cast is not adjusted, it can result in permanent damage.
  • The cast breaks, becomes very loose or if the plaster gets wet and soggy. A proper, secure fit is essential to hold the broken bone in position in order for it to heal correctly.

4. Focus on Prevention

As we mentioned, not all injuries can be prevented. Accidents happen. But, there are things that you can do to reduce the risk of your child breaking a bone. Some tips include: 

  • Choose playgrounds with cedar chips or a rubber floor surface instead of unforgiving concrete.
  • If your child plays sports or participates in any organized physical activity, get a preseason checkup even if it is not required. Your child’s pediatrician will make sure they don’t have any injuries or health issues that might be risky.
  • Make sure your child knows that safety equipment isn’t optional. Follow helmet and safety gear recommendations for young athletes and any child riding a bicycle, tricycle, skateboard, scooter, or any type of skates and rollerblades.
  • Eat well and stay active. Proper nutrition and regular physical activity help build sturdy bones and strong muscles to support them. 

About Paris Orthopedics and Sports Medicine

Paris Orthopedic and Sports Medicine provides comprehensive orthopedic and musculoskeletal services for patients of all ages throughout Northeast Texas and Southeast Oklahoma. We offer surgical and non-surgical treatments for sports injuries and a broad range of bone, muscle, and joint problems, including broken bones. Contact our office today at 903-737-0000 for more information or to schedule an appointment with a physician.

Sports Medicine

How To Avoid Shoulder Pain While Golfing

For most people, the game of golf is one that is traditionally played to relax. The ability to go play nine to eighteen holes, regardless of age, can be just what you need to recharge, disconnect or even blow off some steam.

Common Golf Injuries

Whether competing with others or trying to top their previous personal best, golfers sometimes have the tendencies to overdo shots or maybe give a little more than what is actually left in the tank. This increases the risk of injury, with the shoulder being the most susceptible.

Additionally, many golfers have come to understand that one cannot become competitive or even proficient at the game without playing regularly. For those who play routinely, chronic injuries are a very real and daunting possibility. Most golf injuries are the result of muscular imbalances, overuse or poor mechanics. 

Golf is unique among competitive sports in that the action of swinging the club offers relatively little risk for acute, or immediate, injuries. However, one of the areas most at risk for injury are the shoulders. 

Most commonly, individuals will experience pain of the rotator cuff. The rotator cuff is a combination of four separate muscles that act to support and direct certain shoulder movements on a smaller level than muscles such as the deltoids and trapezius. As they are commonly used in movements such as throwing a ball or hitting a tennis ball, they share a similar function to stabilize and move the shoulder when hitting a golf ball.

Cartilage in the shoulder joints may also be affected by repetitive golfing as it does produce some degree of stress on the joints, especially on drives and other powerful swings. In the backward strokes, the acromioclavicular joint on the back shoulder experiences some degree of stress while the glenohumeral joints of both shoulders are stressed through varying degrees of rotation on both the backswing and front swing. This may cause shearing at the cartilage around the labrum in both shoulders, causing pain. 

Tips To Avoid Shoulder Pain While Golfing

  1. Warm-Up

Just as a baseball pitcher or a soccer player would, it is important to warm-up all parts of the body that will be used in activity prior to starting. This may include both static and dynamic shoulder, trunk, and hip stretches in order to activate the muscles that will be worked while playing.

  1. Use Proper Form

Incorrect form is the most common precursor to one developing chronic injuries. Improper form often leads to compensations along the kinetic chain, forcing certain muscles to work harder to pick up the slack for others. Working with a skilled golf coach can help minimize the risk of such injuries as well as improve one’s game. 

  1. Strengthen the Shoulder

The shoulder complex, especially the rotator cuff, should be engaged in a proper strengthening program to avoid energy. This is something common to all athletes and golfing should be no different. Specific focus should be on deceleration stabilizers at the shoulder.

  1. Recognize When to Seek Help

Golf is a game that is meant to be enjoyed. If your shoulder pain is preventing you from doing what you love, it is advisable that you take to you consult with your physician to figure out an approach that will get you back in the game. 

We can all expect to experience a little discomfort after a long day on the course. However, when this discomfort progresses to pain and does not give way within a few days, it is time to seek counsel as soon as possible to diagnose any underlying shoulder pathologies that may be holding you back. 

At Paris Orthopedics and Sports Medicine, no injury is too large or too small. Whether you are a weekend warrior or competitive athlete, our experts strive to offer solutions to treat patients and prevent injury. Call (903) 737-000 to schedule an appointment.

Uncategorized

The History of Paris Orthopedic Clinic

Written by Dr. Clarence Temple

Paris Texas in 1969 was a many-faceted city. In addition to being the county seat of Lamar County, it was also the retail hub for a large part of northeast Texas and southeast Oklahoma. It was known as an important medical center with a reputation for having outstanding primary care and specialty physicians. Paris also had two new 150 bed hospitals: St. Joseph’s Hospital, located just east of downtown, and McCuistion Medical Center on North Loop 286.

The city had for years been home to prominent state political figures, led by Senator A.M. Aiken, longtime chairman of the Senate Finance Committee.

Paris had many industries, including Babcock and Wilcox, Uarco Printing, Philips Lighting, National Hardware and others. It was also the site of Campbell Soup’s newest plant.

Education in Paris was led by Paris Junior College recognized as an outstanding two-year institution. School systems included Paris ISD, North Lamar, Prairiland, Delmar, West Lamar, and Roxton ISD’s.

Water supply is critical to the success of any community. Pat Mayes Reservoir was just completed and provided outstanding recreational facilities for the region as well as a secure water source.

While the medical community was composed of excellent physicians throughout the city, the doctors by and large confined their practice to one hospital or the other, but rarely both. The physician’s office was usually located near the hospital in which he or she practiced. This rift extended to some degree to the city as a whole with some people saying, “We go to St. Joseph’s” and others saying, “We use McCuistion”.

St. Joseph’s hospital was owned and administered by the Sisters of Charity, a Catholic organization. McCuistion Medical Center was owned and operated by L.P. McCuistion Foundation for whom the hospital was named after.

Competition between the two hospitals, each opening in 1968 and each replacing outmoded facilities, was strong, but maintained at a highly respected level. The Lamar-Delta County Medical Society met monthly and was well attended by members of both hospital staffs. At this meeting, members of the two staffs melded into one organization if only for that evening.

Both hospitals had increasingly busy emergency rooms with coverage provided by members of their medical staffs. Neither hospital had emergency physicians or hospitalists, and the admitting physician made rounds on his or her patients once or twice daily.

With excellent physicians on each staff providing coverage in primary care, internal medicine, general surgery, obstetrics and gynecology, pediatrics, ophthalmology, otolaryngology, radiology, pathology, and doing so in the new state of the art hospitals, people in Paris and surrounding cities were provided with a level of medical care typically found only in cities two or three times the size of Paris.

Although Paris at that time had no trained orthopaedic surgeon, routine fracture care was provided by family physicians and general surgeons in the community. If more advanced care was required it was usually provided by Dr. Bernard McConnell of Greenville, Texas. Dr. McConnell was a superb orthopaedist who would travel to hospitals in the area surrounding Greenville, including Clarksville, Mt. Pleasant, Sulphur Springs and other towns. He also maintained a very busy practice in Greenville. He was held in high regard by patients and physicians alike.

In 1969, orthopaedic surgeons were usually found only in larger cities in Texas outside of metropolitan areas in the state (populations of fifty thousand or more). Only Greenville, Lufkin, Nacogdoches, Kerrville, and possibly one or two other cities had an orthopaedist in residence. Paris joined that group in 1969.

Dr. Clarence Temple, a native of Mt. Pleasant completed his residency in orthopaedic surgery at Vanderbilt University Hospital in Nashville in June 1969. He and his wife Carolyn with their four sons moved to Paris in order to be back in northeast Texas and to live in a smaller city. While his office was located adjacent to McCuistion, he wanted to be a Paris orthopaedist and to work in both hospitals. He was accepted to the staff of both St. Joseph’s and McCuistion. His office opened July 11, 1969.  Dr. Clarence Temple provided excellent orthopedic care to his patients for thirty-six years and retired from Paris Orthopedic Clinic on December 31, 2005.

The practice grew rapidly drawing patients from surrounding communities in Texas and Oklahoma. Both Paris hospitals were very supportive in developing the new practice.

The reputations of the Paris hospitals and the excellent physicians on their staffs were primary factors in the successful beginning of what was to become Paris Orthopedic Clinic.

In 1974, Dr. Frank Wood and Michael Milek joined Dr. Temple. They were graduates of the Vanderbilt program. The three orthopaedists having outgrown the initial clinic facility, moved into a new clinic building at 785 Lewis Lane. This building not only provided much needed examination and office space, but included expanded radiology facilities and later physical therapy under the leadership of Douglas Wehrman, LPT.

After three years, Dr. Milek returned to Vanderbilt to direct the hand surgery program. Dr. Gary Forster joined Drs. Wood and Temple. Dr. Forster, a native Californian, completed his orthopaedic training at Baylor College of Medicine in Houston.

The practice continued to grow and Dr. Mark Nardone, a native of Pennsylvania and a graduate of Bowman Gray University orthopaedic program joined POC. His strong backing of the Philadelphia Eagles led to some interesting non-medical discussion.  Dr. Nardone left POC on February 29, 2004

Dr. Forster then decided to return to the west coast, moving to the state of Washington. Dr. Robert Schneider, a native of Illinois who did his orthopaedic training at the University of Texas Southwestern Medical School in Dallas, joined POC. His first year in practice was named by his being a primary provider in the superb response of our medical community to the disaster of the Paris tornado on April 2, 1982. Dr. Schneider was part of the face of Paris medicine in his interviews on Dallas television channels.  Dr. Schneider left POC on December 31, 2009.

The increasing need for orthopaedic care in our part of the state led to the opening of a second office. This located on the St. Joseph’s campus. Dr. Wood and Schneider were in practice at the new location while Drs. Nardone and Temple remained at the Lewis Lane location.

Dr. Steven Rowlan is a native Oklahoman. He grew up in Oklahoma City, graduated from the University of Oklahoma, the OU Medical School and completed his orthopaedic residency at University Hospital. He joined POC in 1983. Like each doctor who has joined POC, Dr. Rowlan made an immediate and lasting contribution to the improvement of services and to the character of this clinic.

Dr. Jeffrey Neilson, also an Oklahoman, did his residency in orthopaedics at Scott & White Clinic in Temple. He joined POC in 1989. Dr. Neilson was the primary orthopaedist in developing the POC Clinic in Sulphur Springs.  Dr. Neilson left POC on December 31, 2011.

Dr. Thomas Carrell joined POC in 1990. He also completed his orthopaedic training at Scott & White in Temple. Dr. Carrell is a strong advocate of personal physical fitness and he has participated in triathlon activities.   Dr. Carrell left POC on September, 10, 2007.

At this point, the offices at St. Joseph and at Lewis Lane were becoming crowded. A new clinic was planned and construction at the present location at 3435 Northeast Loop 286 was begun. The new POC building was constructed by Harrison Walker and Harper and was finished in 1993. The new clinic allowed all the orthopaedists to office in one location exactly halfway between the two hospitals. It also provided the presence of at least one orthopaedist in each hospital at any time during the day.

In 1992, Dr. Drew Temple joined Paris Orthopedic Clinic. He is a graduate of Texas A&M, Texas A&M School of Medicine, and did his residency at University of Arkansas. He has provided a stimulus to continued improvement which is reflected in the entire clinic. He also has a secondary specialty in sports medicine.

Dr. David De la Garza joined POC in 2001. Dr. De la Garza is a graduate of Texas A&M and completed his residency at Texas Tech School of Medicine. He has been the source of many original approaches to challenging cases.

In 2003, Dr. Greg Green joined POC having completed his residency at Duke. A native of Colorado and graduate of Stanford and Baylor School of Medicine, Dr. Green is a strong addition to the Paris medical community.

Dr. Mark Gibbs is a native Parisian. He is a graduate of University of Texas Medical Branch and completed his residency at the University of Tennessee Campbell Clinic. He joined POC in 2011 and has a secondary specialty of sports medicine.

Dr. Michael Elliott is a native of Arizona. He is a graduate of University of North Texas Health Sciences Center –Texas College of Osteopathic Medicine and completed his residency at John Peter Smith Hospital in Fort Worth. He has an orthopedic subspecialty in sports medicine. He joined POC in 2014.

Leah Baldwin, PA-C joined POC in 2011.  Leah is a graduate of University of Wisconsin Physician Assistant Program.  Leah was a Second Lieutenant in the Wisconsin Army National Guard prior to joining Paris Orthopedic Clinic.

Carmen Holmes, PA-C joined the POC team in 2014. She is a Paris native and graduate of University of Texas Southwestern Medical Center Physician Assistant Program. While practicing general orthopedics, she also has a special focus on osteoporosis treatment.

With the addition of sports medicine subspecialties, Paris Orthopedic Clinic’s name was changed to Paris Orthopedics and Sports Medicine in 2016.

Paris Orthopedic Clinic has been fortunate in having strong leadership in its business managers. Bill Mercy was the first and was followed by David Eisele. Michael Miller is now the POC business manager.

The employees of Paris Orthopedic Clinic are the foundation of the smooth day-to-day functioning of the clinic. The supportive care given by them to each patient is an important factor in their treatment.  In addition to providing orthopedic care to a large part of northeast Texas and southeast Oklahoma for the past fifty years, physician members of the clinic have provided leadership in our hospitals and city. POC has been prominent in the Texas Orthopaedic Association and in the American Academy of Orthopaedic Surgery, and two members of POC have served as examiners for Part II of the ABOS Boards.

Paris Orthopedic Clinic has been recognized as a one of the premier general orthopaedic surgery clinics in the state of Texas. Its physicians and staff look forward to the next fifty years.

Bone Health

Types of Osteoporosis

Osteoporosis is a condition that many of us will experience at some point in our lives. According to recent statistics from the International Osteoporosis Foundation, worldwide, 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime.

When we think about osteoporosis, we may commonly associate it with an elderly individual breaking a hip from what seems like a minimal intensity fall, but we understand that this is a possibility due to age and bone health. While the condition may seem fairly straight forward, many aren’t aware that there are four different types of osteoporosis.

1. Primary Osteoporosis

Primary osteoporosis makes up the vast majority of the cases. There are many factors that contribute to its severity such as age, nutrition and activity level. Gender is often also a factor, as primary osteoporosis is more prevalent in women than men.

As bones reach their peak density around age 30, there is a gradual decline over time that occurs if one’s activity level does not help offset the amount breakdown-taking place. This occurs secondary to hormone levels decreasing, mainly testosterone (which promotes bone growth) and estrogen.

While we often associate this type of osteoporosis with the elderly population, it can happen in younger adults as well if activity levels are not enough to stimulate bone growth activity. Additionally, if hormone levels drop secondarily to overtraining or malnutrition, bone breakdown may also start as early as high school such as is seen in conditions associated with the Triad in male and female student-athletes.

2. Secondary Osteoporosis

Secondary osteoporosis is very similar to primary except that it occurs in response to a particular disease, normally one that will affect hormone levels within the body such as conditions that interfere with thyroid health. While primary may be addressed through a gradual change in activity levels and diet, secondary osteoporosis is often treated by hormone replacement therapy and other more extreme measures.

It is important to note that secondary osteoporosis may occur subsequently with primary, but must have an etiological mechanism to be classified as secondary.

3. Osteogenesis Imperfecta

Osteogenesis imperfecta is a condition that is the result of a genetic mutation, affecting roughly 6-7 out of every 100,000 people. It has eight known types ranging from mild to severe and mainly affects bone health, causing conditions to manifest similar to traditional osteoporosis.

The condition will normally exist with other symptoms such as respiratory issues, height defects, and an abnormally small rib cage. Depending on the severity, bones can break often with very little stress applied. Also, in severe cases, the associated respiratory issues may decrease life expectancy in accordance with all of the other comorbidities present.

4. Idiopathic Juvenile Osteoporosis

This pediatric condition has no known cause and usually has an onset just before puberty. In essence, it is brittle and porous bones with no other associated symptoms and will usually resolve without medical treatment after a relatively short amount of time.

If this condition is found to be present, it is recommended to have children monitor their activity or follow their physician’s guidelines for maintaining general health.

When to Seek Help

If you are suffering from osteoporosis, call (903) 737-000 to schedule an appointment with the Paris Orthopedic Bone Health Clinic today. Our experts are committed to providing diagnosis, treatment and education for the primary and secondary prevention of osteoporosis. For more information, you can contact our office or visit The National Osteoporosis Foundation.

Sports Medicine

4 Ways to Prevent Water Sports Injuries

As spring turns to summer, people flock to their favorite beach or lake for a little rest and relaxation as well as some fun in the sun. While water sports are nothing new, it seems that each year they get more and more intense with new devices and accessories always hitting the market like the increasingly popular water jet packs that look.

The problem is that activities that are supposed to be fun and relaxing, like water skiing or wakeboarding, can take a sharp turn if injuries occur. Here are four ways to help prevent water sports injuries so you can make the most of your time on the water:

  1. Know Your Limits

When engaging in new watersports, it is easy to look at them with a degree of ease and not understand just how taxing they may be or how much physical exertion is required. This is especially important for sports such as water skiing and jet skiing in which a high velocity may be involved, requiring extreme body control.

Like any sports, it is best to learn the basics before progressing to more advanced and challenging stages. While it may seem like a good idea to “go big or go home” while on vacation with friends, it is essential to treat one’s body with respect, paying attention to limits and understanding the consequences of not doing so.

  1. Don’t Forget to Warm-Up

Just like going for a run or engaging in other strenuous physical activity, loosening up the muscles and getting the blood flowing prior to activity may help to prevent muscle pulls and ligament strains by preparing the central nervous system for exercise. A light bout of stretching is better than nothing, but performing a small dynamic warm-up is best. This includes getting in the water to swim and move around a bit so your body can adjust to the temperature.

You never run a marathon without warming up and participating in water sports is no different.

  1. Use the Buddy System

Freak accidents happen each and every day. When they do occur, especially in the water, it is necessary to have another trusted individual, preferably someone trained in water rescue, to be there in the event things go awry. While it may seem like an unnecessary precaution to have a lifeguard present while wakeboarding, it is far better to have someone there and not need them opposed to the opposite.

Having someone nearby to assist if needed can help reduce the risk of extensive injuries following a water sports accident due to a timely response rate. Even if a lifeguard is not present, even having a friend who can recognize an issue or call EMS is a far better option than being alone.

  1. Wear Protective Equipment

Regardless of the intensity of water sport activity you’re participating in, wearing a life jacket is suggested even for strong swimmers. Any time water is involved, drowning is always a risk. Wearing a jacket, especially when on any form of vessel, will be extremely beneficial in the event one falls off and potentially hits their head, causing possible confusion or even a lack of consciousness.

Additionally, wearing a helmet may be advised for a number of watersports. While its use may not fully prevent a concussion, it does have the ability to help protect the head from the trauma associated with high impact, high-velocity sports.

When to Seek Help

Despite your best efforts to prevent water sports injuries, accidents can still happen. If you suffer an injury, the experienced team at Paris Orthopedic specialize in the diagnosis and treatment of some of the most common water sports injuries such as strains, sprains and fractures. To request an appointment, call (903) 737-0000.

General Ortho

6 Tips to Prevent Spring Yard Work Injuries

As the grass finally starts to grow back from the winter months, it becomes a gentle reminder that a lot of work is ahead for you. Every year, thousands of injuries result from poor mechanics when performing yard work and many other injuries result from general mistakes.

While you get prepared to start your spring cleaning outdoors, it is important to consider ways to keep your body healthy and running strong all summer long. Proper consideration now can prevent many unwanted and unneeded medical bills, allowing your time in the yard to be relaxing opposed to causing additional stress.

The following are some helpful tips to prevent yard work injuries this spring and throughout the year:

1. Pay attention to the details

It is extremely common for individuals to get distracted with their thoughts while out in the yard. When this happens, it becomes easy to overlook rocks or debris which can quickly become dangerous projectiles when they come in contact with a lawn mower or weed eater.

It is also important to look for uneven ground that may cause an ankle or knee injury when carrying heavy objects or mowing the lawn. This uneven ground may be tough to see if the grass is too high, therefore a walk through prior to starting work is recommended. Flagging uneven ground may prove to be helpful in preventing a number of injuries.

2. Don’t forget to warm-up

Warming up prior to doing yard work may seem like a ridiculous idea. However, similar to performing any athletic activity it is important to get the body loose prior to engaging in strenuous physical activity. Failing to do so will leave the muscles cold and susceptible to injury when starting out, especially if carrying heavy materials.

It is not essential to perform an overly dynamic warm-up as you would before going for a run or hitting the gym, but light stretching of the major muscle groups in addition to moving the limbs and trunk around will help to get the blood flowing. This will prepare the body for physical activity, preventing and minor muscle strains from becoming nagging injuries over the next few months.

3. Use proper mechanics

Using proper mechanics when performing any physical activity including yard work is the best way to prevent injury. We all know the saying “lift with your legs and not your back” but not many actually put this saying into practice outside of the gym. Keep this in mind as you move pavers or larger plants around the garden. Bracing your core and thinking about proper movement will help keep you healthy, especially when considering back injuries.

If you do not possess the proper range of motion to use proper lifting and movement mechanics, it is important that you start a flexibility program that uses a combination of static and dynamic stretching. The inability to get in certain positions because of range of motion will greatly increase your risk of injuries, both minor and more substantial, such as in the case of a herniated disc.

This applies to both big movements as well as things that require a longer period of postural control, such as gardening. If you feel yourself starting to tighten-up while mending to your flowers or vegetables, it is a good idea to get up for a few minutes to get the blood flowing, assess your position, and get back to work in a healthy spine neutral position.

4. Read equipment manuals

While proper mechanics are important, many yard work injuries are the result of improper or negligent equipment use. Before operating new lawn care equipment or equipment you may not already be familiar with, read the manual to understand all of its safety features and instructions for use.

Always be mindful of your fingers or other extremities any time you are operating any equipment that has a blade including lawn mowers, edgers, chainsaws or hedge trimmers. Remember, sharp blades have the potential to cause injury even when they are not in motion.

5. Know your limits

Whether you’re 20 or 65 years old, there’s a good chance you don’t want to think of yourself as having limits when performing yard work duties. Whether you are trying to carry two bags of grass clippings in one trip or save money by scaling a ladder to clean the gutters yourself, pushing past your limits and comfort zone increase your risk of injury.

As with anything in life that requires a physical demand, be honest with your capabilities when it comes to yard work. There’s no shame in outsourcing these tasks to a professional especially when it helps you avoid an unexpected trip to the emergency room.

6. Have a plan if things go south

Taking the proper precautions can help you to get the most out of your body, achieve the tasks you need done and keep you healthy in the process. But, accidents can happen to even those who go to great lengths to prevent them.

The experienced team at Paris Orthopedic specialize in the diagnosis and treatment of a variety of injuries and conditions, including the most common yard work injuries such as strains, sprains and fractures. To request an appointment, call (903) 737-0000.

Sports Medicine

What’s the difference between ACL and MCL tears?

Knee injuries rank among the most common sports-related injuries. Whether you play high school football, hit tennis balls on the weekends or enjoy jogging or hiking to clear your mind, anyone is at risk of injuring their knee at any age.

As weight-bearing joints that endure a lot of impact, participation in sports is not a prerequisite for knee injury. you don’t even have to participate in substantial physical activity to injure your knees. And as we age, the risk only increases.

Two of the most common knee-related injuries are ACL and MCL tears. Though you’ve undoubtedly heard the acronyms used before, what’s the difference between them? Understanding how these injuries occur can help you take steps to prevent them or at least reduce the risk of getting hurt.

Understanding the Knee Ligaments

The first step to understand the difference between ACL and MCL tears is to first understand the complexities of the knee.

While there are four major knee ligaments, the two most common injuries involve either the medial collateral ligament (MCL) and the anterior cruciate ligament (ACL).

The MCL serves the purpose of providing medial stability to the inside of our knee and the ACL prevents anterior, or forward, translation of the tibia. It is very possible to injure both ligaments, in addition to other important structures in the knee, at the same time.

Roughly 70% of ACL injuries are non-contact related that involve sudden deceleration such as cutting, pivoting or landing on one leg. Sports that often require these types of movement include basketball, soccer, football, volleyball, downhill skiing, lacrosse, and tennis. This type of injury can also happen as a result of a direct blow to the outside of the leg or knee.

The MCL is torn by a force to the lateral side of the leg, forcing the ligament to tear as the femur and tibia are separated in the joint line. This can happen playing contact sports such as football, sports that quick stops and turns such as soccer or basketball, or even a non-sport related slip and fall. MCL tears can also occur as a result of repeated stress, which causes the ligament to lose its normal elasticity much like a worn-out rubber band.

Difference Between ACL and MCL Tears

These ligaments differ most based on their location in the knee joint. The MCL is a superficial ligament that is surrounded by the musculature of the medial knee. The ACL, however, is deep within the knee and stands as the main stabilizer of the joint because it has no muscle directly surrounding it.

When the ACL tears to any extent, the stability it provides to the knee is completely compromised, causing a great deal of instability that makes activities like running and walking downstairs very difficult.

The MCL does provide additional stability but the joint does not suffer greatly without it, as long as the demands of the individual do not require a great deal of stability on the medial aspect of the knee. Activities that require this additional support for proper function are usually athletic in nature, such as kicking a ball.

Signs and Symptoms

One of the most common signs of a knee ligament tear is hearing an audible “pop.” Even if you don’t hear this sound, you can typically feel a sudden shift in the joint. Other common symptoms of an ACL or MCL tear include:

  • Knee instability
  • Swelling
  • Pain, which can range from mild to severe
  • Tenderness
  • Feeling that the injured knee may give way under stress
  • Feeling that the injured knee may lock or catch

Severity of ACL and MCL Tears

Both are extremely painful but may result in a number of different treatment options, depending on the severity of the tear.

A ligament tear is classified according to the following criteria:

  • Grade 1 – stretching of the ligament
  • Grade 2 – partial tearing of the ligament
  • Grade 3 – complete rupture of the ligament

A grade 1 or grade 2 tear of the ACL may be surgical but can be treated non-operatively, at times, with conservative rehabilitative interventions. In most cases, an MCL tear will not warrant surgery unless it is a full grade 3.

How ACL and MCL Tears are Treated

The type of treatment required for ACL or MCL tears will depend on a variety of factors including the severity of the tear, age, and personal medical history.

If you take the necessary steps in allowing a torn ACL or MCL ligament to heal, in some cases surgery may be avoided. However, if the injury is severe enough, there is always the possibility that surgery will be necessary.

For an MCL tear, the first step in the healing process is rehabilitation, or physical therapy. Therapy can take two or more months before the ligament is fully healed. It’s important to be patient and not rush this process, otherwise, you may risk further damage or reinjury.

An ACL injury is more complex due to the fact there are multiple ligaments within the ACL. In more than half of injuries involving an injured ACL it won’t heal by itself and will often require surgery, with an estimated 350,000 ACL reconstructions performed annually in the United States. During this procedure, called ligament reconstruction, tendons from the patellar or hamstring are used to reconstruct the ACL ligament. The recovery time for this type of surgery is 8-12 months.

When to Seek Help

Knee injuries are very common when it comes to all sports and physical activities, but most cases aren’t serious. Identifying a severe knee injury and acting quickly by having a sports medicine physician look at it can make all the difference when it comes to getting you back on your feet and minimizing the risk of further damage.

The signs and symptoms of an ACL or MCL tear are not always the same, so it is important to see a doctor if you experience knee pain or swelling that lasts more than 48 hours, trouble standing or walking on the affected knee, inability to support your weight on the affected knee, or noticed a deformed or odd appearance of one side of the knee compared to the pain-free side. If you experience any of these symptoms, call Paris Orthopedics and Sports Medicine at (903) 737-0000 to schedule an appointment today.