Only a physician can give you a definite “yes” or “no” to the question, “Do I have arthritis?” However, it’s important to understand what arthritis is and what the symptoms are so you know when it’s time to see a doctor for a diagnosis.

Recently, Dr. William Enright and Dr.Paul Utrie were on Living with Amy for National Arthritis Month. Check out the video to learn more about arthritis and its symptoms.

Arthritis Symptoms

• Joint pain
  • Pain that has lasted several weeks
  • Pain that comes and goes multiple times a month
  • Pain can be felt in one or multiple joints
• Stiffness and soreness
  • Joint stiffness in the morning or after periods of rest/inactivity
  • Soreness after activity or toward the end of the day
  • Joint stiffness that results in loss of mobility or difficulty with movement
• Swelling
  • Skin around the joint looks swollen or red
  • The joint feels warm
• Clicking, cracking, or grinding sensations when bending a joint

Why an Early Diagnosis is Important

Overtime, arthritis damages the joint’s cartilage, leading to increased pain, swelling, stiffness, and loss of mobility. If arthritis is diagnosed early, orthopedic or rheumatology physicians can provide treatments and management techniques that relieve symptoms and help reduce the amount of joint damage over your lifetime.

Download our early signs of arthritis checklist!

Dr. James Grace, orthopedic surgeon, answers 10 of the most common questions people ask after having a joint replacement.

See all of our educational videos here.

Since September is National Yoga Month, we talked with a couple of local instructors to learn more about the many benefits of yoga.

Some of the most commonly talked about benefits are the physical ones, like improved flexibility, increased strength, and better balance. These are why many people have started to include yoga in their fitness regimens. But beyond being a good workout, yoga has other physical benefits.

“Practicing yoga can help increase respiratory capacity, improve circulation, and enhance digestion,”‘ says Jackie Schechinger, a Green Bay yoga instructor and wife of OSMS physician Dr. Steve Schechinger.

Yoga also has a positive effect on a person’s mental health.

“The increased awareness to mindfully breath helps calm the nervous system and increase oxygen flow in the blood, which causes this wonderful duality of feeling calm yet energized,” says Jen Berres, owner of and instructor at Jenstar Yoga and Dance in De Pere.

While everyone can benefit from the strengthening and stress-reducing outcomes of yoga, it can be especially beneficial for two types of OSMS patients – athletes and those living with arthritis.

Yoga and Athletes

Competitive athletes are always looking to improve athletic skills and reduce the risk of injury. Yoga can help with both!

“Athletes tend to have a ‘go hard’ mentality about training, and a yoga practice brings balance to this mindset by teaching athletes to slow down and be in the moment,” says Jen. “It also creates better body awareness, which allows athletes to gain more range of motion, fluidity of movement, strength, stamina, and coordination. It is definitely a game changer, and many of the best athletes in the world are incorporating yoga into their routines.”

Yoga can also help with injury prevention and recovery.

“The improved body mechanics, balance, stability, and flexibility that an athlete can experience from yoga all work together to reduce the risk of injury,” says Jackie. “But perhaps the most important benefit for athletes is the increased mental awareness and focus to overcome an injury and elevate training and performance to the next level.”

Yoga and Arthritis

Despite the pictures of headstands, arm balances, and intricate twists that you may see on social media, yoga can be gentle enough for people living with arthritis.

“Yoga helps those with arthritis see better overall physical functioning, in particular increased joint range of motion, flexibility, and balance,” says Jackie.

Together, these outcomes can help reduce joint stiffness and pain so that people can continue to live actively.

“Joint pain is uncomfortable, but if you stop being active it can only get worse,” says Jen. “I have seen clients with arthritis feel a world of difference after only a few yoga classes.”

Learn more about yoga and arthritis from the Arthritis Foundation.

If you are new to yoga – no matter your age or activity level – it’s important to find a style and instructor that fits your needs and allows for appropriate modifications for individual restrictions, limitations, or injuries.

Since October is National Physical Therapy Month, we wanted to discuss the important role physical therapy plays in the treatment and recovery of many of the injuries and conditions that we care for at OSMS. So we sat down with Andy Taber from one of our partners, Advanced Physical Therapy and Sports Medicine, to learn more about how physical therapy and orthopedics work together. Andy is a Doctor of Physical Therapy, Board Certified Orthopedic Clinical Specialist, and Board Certified Strength and Conditioning Specialist.

If you sustain an orthopedic injury like a torn meniscus or broken elbow, or you are diagnosed with a condition like arthritis, your orthopedic physician might recommend physical therapy as a starting point for treatment. Physical therapy can often be an effective nonsurgical treatment to relieve pain and restore function.

“Physical therapy can assist the body in the natural healing process,” Andy says. “Through physical therapy, we can address mechanical faults to help an injury heal. We also develop prevention strategies to reduce the risk of injury in other limbs that may try to overcompensate for the injured area during the healing process.”

For example: if a person is dealing with pain, stiffness, and inflammation from osteoarthritis, a physical therapist can help relieve symptoms by:

• Evaluating, diagnosing, and correcting gait and posture abnormalities that may increase the breakdown of a joint or cause injury to another area of the body.
• Improving strength, range of motion, and flexibility around an arthritic joint to reduce pain and improve overall function.
• Implementing joint protection strategies in an effort to conserve the remaining cartilage in a joint.

When an orthopedic surgery is needed to treat an injury or condition, physical therapy continues to play an important role.

Whether it’s repairing a torn ACL or replacing a hip joint, the ultimate success of a patient’s recovery after surgery is partially dependent on the condition of the patient going into surgery.

“Doing physical therapy before an orthopedic surgery can help improve flexibility and build strength around the injured or arthritic area,” Andy says. “And as range of motion and strength increases prior to surgery, the patient is likely to have an easier time recovering these aspects of mobility and function after surgery.”

Once an orthopedic surgery is performed, physical therapy helps the recovery process in several ways, including:

• Implementing interventions designed to reduce pain and improve comfort in the hopes of reducing the need for long-term use of pain medications.
• Helping patients understand how to properly use assistive devices such as crutches, walkers, and canes.
• Restoring range of motion and strength of the surgical area.

“Once the body gets through the initial post-operative inflammation, and the healing process is well established, physical therapy continues to help patients return to their previous level of function,” Andy says. “This is done through progressive, individualized retraining of motions, postures, and activities related to what a patient wants to get back to.”

They say a dog is man’s best friend. Owning a dog brings you companionship, improves your mood and causes you to exercise more. Taking your dog for a walk, and walking in general, is good for you. Let’s explore some of the benefits walking brings.

It’s good for heart health, boosts your mood, helps maintain a healthy weight, but it also helps keep your muscles and joints strong and healthy. You’re less susceptible to injury and reduce your risk of osteoporosis or other bone-density related conditions when you have strong and healthy muscles and joints.

The American Academy of Orthopaedic Surgeons (AAOS) recommends incorporating at least 30 minutes of walking each day for five days a week to see the benefits of walking for your muscles, bones, ligaments, tendons and joints.

Benefits of walking for Bone Health include:

• Easy and gentle on joints
• Builds and strengthens muscles
• Helps maintain bone mass
• Slows the development of arthritis
• Reduces risk of osteoporosis
• Increases joint flexibility and range of motion
• Aids in joint fluid circulation, which provides essential oxygen and nutrients
• Reduces risk of hip fracture
• Lowers the likelihood of musculoskeletal injuries
• Increases spinal stability

Getting Started

To get started, give yourself about five minutes walking at a casual pace as a warm-up. Start to increase your walking pace but keep good posture and a comfortable stride. Point your toes forward and your weight should be distributed evenly. The AAOS recommends a gradual approach to begin a walking program.

Stay Hydrated

Like with any exercise, it’s important to stay hydrated. Drink plenty of water when walking to avoid dehydration, fatigue, and help lubricate joints.
Before beginning any new exercise routing, we recommend you speak with your physician.

Mall Movers

Are you interested in walking more? OSMS is proud to sponsor Mall Movers, a free mall walking program designed for Bay Park Square Mall. Find out more by visiting the Mall Office, located in the ShopKo wing.

Request an appointment.

According to the American Podiatric Medical Association, nearly eight out of ten people have experienced foot pain and those who suffer from chronic foot pain are significantly more likely to have pain in other parts of their body.

“Feet are easy to overlook but if you take care of them, it will make a big difference,” said Dr. Gregory Kirwan, Orthopedic Foot and Ankle Surgeon at Orthopedic & Sports Medicine Specialists (OSMS). “As we age, chronic foot pain and common foot problems such as tendinitis, bunions, and arthritis can increasingly limit your mobility.”

During National Foot Health Awareness Month, Kirwan wants to remind people of a few simple steps to keep your feet in the best shape possible.

1. Keep a healthy weight. The more you weigh the greater the impact on your feet with each step you take. Being overweight can also increase arthritis or other problems in the foot.
2. Wear good shoes. Choose supportive or comfortable shoes if you will be on your feet a lot. If you are a runner or exercise regularly, invest in an athletic shoe to keep your feet as protected as possible to minimize the consistent impact on them.
3. Keep your feet moisturized. The skin of the feet tends to get thinner and drier with age which, if not taken care of, it can cause cracking, bleeding or pain. Keep skin soft by rubbing moisturizing lotion into your feet after showers or baths.
4. Practice good foot hygiene. Clean your feet in the shower or bath and dry them thoroughly when done. If you put nail polish on your toes, let the nails breathe for a few days after polish is removed before adding more.

If pain continues or you experience chronic pain in your foot, cortisone shots or surgery may be necessary.

“Every patient I see is different,” said Kirwan. “Because of the consistent impact the foot receives, you can’t treat it like other joints.”

Kirwan points to the fact that cortisone shots, in particular, may not be as effective in the foot as they are in other joints. This is due to the amount of force that is place on the foot and ankle during walking or running.
“There are so many joints in the foot that it is impossible to inject cortisone into every joint,” said Kirwan.

According to Kirwan, some of the most common foot problems people experience include:

• Bunions. Bony lumps that develop on the side of your foot and at the base of your big toe. They are the result of a condition called hallux valgus, which causes your big toe to bend towards the other toes and become deformed. If symptoms carry on over a long period, your toe may need to be surgically corrected.
  Hammer toe. Like bunions, hallux valgus can cause your other toes to become clawed or permanently bent, or hammer toe. This typically requires surgery to correct.
  Arthritis. Usually caused by osteoarthritis. This is where the cartilage covering the ends of your bones gradually roughens and becomes thin, and the bone underneath thickens. It can also be caused by damage from other rheumatic conditions, for example if you have rheumatoid arthritis, or if you’ve had a previous injury to the area. This leads to pain, swelling and occasional deformity of the joint. You may need surgery if your symptoms are severe.

Just like the term “shoe” is an all-encompassing description of hundreds of types of footwear ranging from tennis to pumps, flats to sandals, cleats to horse, so is the term “arthritis.” Arthritis is the general term that describes varying diseases that cause inflammation and pain – sometimes to the point of debilitation.

There are more than 100 forms of arthritis and related diseases. According to the Centers for Disease Control and Prevention, 25 percent of those who have arthritis say it causes severe pain as defined as seven or higher on a zero- to 10-point pain scale.

The four most common types of arthritis are: osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), and gout. They all cause pain in differing ways, from mild to severe to everywhere in between, and sometimes enough of it to affect daily well-being and happiness.

Osteoarthritis

This is the type of arthritis that occurs when your joints are overused. It usually happens with age due to the “wear and tear” of life, but it can also come from an injury or from being overweight.

With osteoarthritis, or OA, the material that covers and protects the ends of your bones gradually breaks down. This is called cartilage. As it disintegrates, it loses its protective value and shock absorbency, leaving the bones bare. This makes bending of the joints painful because the bones are rubbing against each other.
Knees, hips, and feet are the most common places osteoarthritis affects, and it usually comes on gradually.

Rheumatoid Arthritis

Rheumatoid arthritis, or RA, is an autoimmune disease. The immune system is designed to protect a person from viruses and bacteria, but with an autoimmune disease the opposite happens. The immune system actually attacks itself, and in the case of RA, attacks healthy cells and tissue in the joints. It causes inflammation, stiffness, swelling and pain in your hands, wrists, elbows, shoulders, knees, ankles, and feet.
Rheumatoid arthritis usually affects multiple joints and is symmetrical; if knuckles on one hard are inflamed and painful, the knuckles on the other hand will probably be, as well. Symptoms can be sudden or can develop gradually, and they are usually more severe than with osteoarthritis.

Psoriatic Arthritis

People who have Psoriatic Arthritis, or PsA, have arthritis two-fold: inflammation of the skin (psoriasis) and inflammation of the joints (arthritis).
Psoriasis is when areas of the skin, usually elbows, knees, the scalp, the belly button and genital area get inflamed, presenting itself with crusty and scaly red and white patches. The skin part of the disease usually starts before the arthritis of the joints set in and can occur as early as childhood.

Gout

Gout is a buildup of uric acid crystals in a joint. It is a form of inflammatory arthritis, but it is centralized, usually to a big toe. It happens when too much uric acid builds up in the body, and the excess isn’t removed fast enough. It can build up in the blood and create uric acid crystals in your joints. This results in extremely painful joint inflammation.

Gout comes in the form of an “attack” or “flare” – severe joint pain and swelling that can last anywhere from three to ten days. You can go to bed feeling just fine, and wake up in pain the next morning. It comes on that quickly!

Being In Pain Hurts

Arthritis pain isn’t something you have to “just deal with.” It is manageable. And it doesn’t have to prevent you from living a full, active life. Arthritis pain may not always be curable, but you and your OSMS doctor can work together to create a comprehensive pain management plan that will bring you relief and get you back to the things you love.

Don’t let the symptoms (joint pain, stiffness, swelling, difficulty moving the joint through its normal range of motion, redness and warmth) persist. The Arthritis Foundation suggests you see your doctor:
• When joint symptoms last three days or more
• When several episodes of joint symptoms happen within one month

If you have any of the scenarios discussed above, request an appointment or call 920-430-8113. We’ll help you get back to the life you love.

By Dr. Paul Tuttle, Pediatric and Adult Rheumatologist

Those who suffer with rheumatoid arthritis (RA) know the discomfort, pain, and debilitation it can cause. This inflammatory disease affects the joints, and it gets worse over time unless the inflammation is managed, slowed or in best cases, stopped.

Anti-inflammatory medication, which prevents joint deterioration, is vital to controlling the progression of, and relieving the symptoms of, rheumatoid arthritis. That means this medication helps RA patients feel better and live more mobile, pain-free lives.

Taking medication for rheumatoid arthritis, or any condition, is not without risk, however. Watch any TV commercial for medication, and you hear the announcer rattle off a litany of possible side effects. Yes, medication that helps people who have rheumatoid arthritis can have side effects. But it is “can,” not “will” produce side effects — and that makes all the difference.

For Better or Worse: Talk about it.

When discussing medications, patients and doctors should talk about the potential risks in light of the benefits. We work closely with our patients to assure they have the absolute best care. That includes making sure they receive the most effective medication to help alleviate the inflammation and pain of arthritis with the least amount of side effects. We weigh the positives with any potential negatives and decide together what would be best for optimal health and wellness.

Rheumatoid arthritis medication falls into several categories, each with its pros and the possibility of some cons:

• Nonsteroidal anti-inflammatory medications (NSAIDs). These work by blocking pathways that promote inflammation. By reducing inflammation, NSAIDS help reduce swelling and pain.
• Disease-modifying antirheumatic drugs (DMARDs). These target the immune system to slow the progress of rheumatoid arthritis. They are not pain medications, but over time as joint tissue becomes less inflamed, pain will be reduced.
• Cortiocosteroids. These are hormones that are either produced by the body or are man-made. They offer strong anti-inflammatory effects in conditions that are related to immune system functions, such as rheumatoid arthritis.
• Biologic agents. Used with patients who suffer from moderate to severe RA and don’t respond to traditional disease-modifying antirheumatic drugs (DMARDs), biologics zero in on specific areas that control the inflammation process.

Different medications cause different side effects in different people. That makes it nearly impossible to create a comprehensive list of medications and there possible effects. However, there are some common side effects for the different categories of arthritis medications:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). Swelling of feet, heartburn, upset stomach, and ulcers.
• Disease-modifying antirheumatic drugs (DMARDs). Upset stomach and increased susceptibility to infection.
• Cortiocosteroids. Increased appetite, cataracts, elevated blood sugar levels, bone loss, and increased susceptibility to infection.
• Biologic agents. Injection site reactions, infusion reactions like difficulty breathing, nausea or vomiting, and increased risk of serious infections.

The above list of potential side effects can be scary. But it doesn’t have to be. There is a lot patients can do to assure side effects pass them by:

• Let your doctor know about any other medications you are taking; over-the-counter (OTC) ones as well as nutritional supplements.
• Find out if there are certain foods you should eat or avoid while taking a medication. Some medication should be taken with food, some with no food.
• Pass on the cocktails. Consuming alcohol can add to the side effects of some drugs.
• Take the drug at the time designated. Take mediation at the optimum time and you may be able to reduce the dose and the risk of side effects.
• Never stop taking any medication without consulting your doctor. Your doctor prescribes the medication to help you, so of course, it needs to be taken in order to do so.
• Let your doctor know if you suspect a side effect. Communicating concerns is the best way to stay on top of your pain management, side effects, and your overall health.

Open and honest communication between physician and patient is the best way to assure the patient is receiving the correct medicine and dosages for the most effective rheumatoid arthritis treatment. At OSMS, we apply all our expertise to monitor our patient’s medications. But we also need our patients to talk to us about how they are feeling. Together, we establish a plan to getting them feeling the best they can.

Dr. Tuttle is a Pediatric and Adult Rheumatologist who sees patients at the OSMS Rheumatology and Infusion Therapy Clinic in Appleton and Green Bay.

Editor’s note: This post is from a presentation Mira put together for her class at school and is her own words. It is being published with written permission. Mira is a junior ambassador for the Arthritis Foundation.

Before I tell you about my day when I have infusions, here is a little about me. I’m 13 years-old and was diagnosed with Poly JIA (Polyarticular Juvenile Idiopathic Arthritis) a year and a half ago. I am a very active teenager and my hobbies include playing saxophone, flute, soccer, gymnastics, and running. My favorite saying that I try and live by is “Impossible stands for I’m Possible.”

When I was diagnosed I realized doctors will have traditional medicines or injections to try and if they are not working well to help relieve your symptoms, an option might be infusions (biologics). Infusions are given by an IV through your hand and are relatively painless. Depending on the medicine, it can take a few hours to many hours and depending on the medicine and dose you may get them every four to eight weeks. You may still take other oral medicine or injections to help you as your doctor sees necessary.

The places you can get infusions include:

• Home – with a nurse coming to your house
• Doctor’s Office – few hours
• Hospital – most of the day

Here is a day in the life of me getting infusion at Dr. Tuttle’s office at OSMS.

• Check in at doctor’s office (2pm)
• Get seated in a reclining chair and nurse does temperature and blood pressure
• One needle poke and nurse puts medicine in bag with saline
• Get good snacks and drinks – even hot chocolate in winter!
• Get warm blankets and can watch TV, watch videos, or color (I have even done homework!)
• Every 20 minutes they open the flow up faster (you don’t feel anything different)
• As the medicine finishes, they take your temperature and blood pressure to make sure you are feeling ok (about 4:15pm)
• Go home! (less than 2.5 hours)

I love infusions because they help me and I only spend a few hours in the doctor’s office every seven to eight weeks. I feel tired for the first day, but my energy is back then. One to two weeks before my next one I can feel it wearing off. I’m so glad I get infusions at a doctor’s office because:

• Same nurse
• Not all day
• Doctor stops to see me sometimes
• It costs less for my mom

Infusions have helped me get back to the sports and hobbies I love by reducing my pain and fatigue.  I am thankful for medicines like this and a great doctor who continues to make sure the medicines are allowing me to live an active teenage life!

Dr. Paul Tuttle is a Pediatric and Adult Rheumatologist at OSMS serving patients in Appleton and Green Bay.

Read more blog posts about arthritis by clicking here.

Register for “Living Your Yes with RA: A Personalized Goal-Setting Event” presented by the Arthritis Foundation and OSMS on Tuesday, July 24th by clicking here.

Knee pain, hip pain, really any joint pain can significantly impact your motivation to exercise. You may even think that exercise could make your arthritis worse.

But staying active with arthritis is possible. The truth is, exercise is a very important part of managing the joint pain, swelling and stiffness that goes along with arthritis. By keeping the joints flexible and the muscles around the joints strong, exercise can reduce the amount of stress put on the joints, and therefore, help reduce joint pain.

However, working out with arthritis typically requires switching to lower-impact, “joint-friendly” activities.

Let’s talk about the 4 exercises to keep you active with arthritis.

Walking
Walking is free, easy and provides so many health benefits. Here are a few reasons you should start walking:

• It keeps your joints healthy by improving the circulation of oxygen and nutrients in joint cartilage.
• It keeps leg muscles strong, which can take some of the stress off of arthritic knees or hips.
• It strengthens bones and can help prevent bone loss that may lead to osteoporosis.
• It helps with weight loss.
• It works the cardiovascular system and helps strengthen the heart.

Water Exercise
Water helps support your body’s weight while exercising, which reduces the amount of stress put on weight-bearing joints like the hips and knees. According to the Arthritis Foundation, doing water aerobics (as opposed to a class on a hard floor) reduces the impact on joints by 75 percent.

Water allows for greater freedom of movement. Since the water is helping to support your body, water exercise isn’t limited by your ability to balance. You can move through full range of motion without fear of falling.

Water also provides more resistance than air, so water exercise is a great way to strengthen muscles and improve cardiovascular stamina.
Types of water exercise include:

• Swimming
• Water walking (taking your walk from the park to the pool)
• Water aerobics

Cycling
An important component to any exercise routine is cardiovascular activity. These help keep your heart strong and play a key role in weight loss. Some types of cardio exercise, like running or fast-paced fitness classes, are probably too high-intensity if you suffer from arthritis joint pain. That’s why cycling is a great option. Cycling works your lower body muscles as well as your cardiovascular system, but it doesn’t put significant stress on weight-bearing joints.

Cycling can be done outside or on an indoor stationary bike, which can be helpful if you have difficulties with balance.

Yoga
Yoga is an activity that strengthens muscles and improves flexibility. And with the use of chairs, blocks and other props, it can be gentle enough on the joints to do daily.

However, to ensure that no unnecessary stress is put on your joints, it is important to find an appropriate style of yoga, learn how to do yoga poses properly, and understand when modifications may be needed.

Dr.  Dan Linehan is an Orthopedic Surgeon with OSMS and sees patients in Green Bay and Sturgeon Bay.

Think back to when you were 12 years old. What was your favorite thing to do? For Mira, it’s being active in things like gymnastics and soccer. Unfortunately, after doing a front handspring at gymnastics, she tore her meniscus. Little did she know this would lead to a life changing diagnosis.

Mira tore her meniscus in 2016 and saw Dr. Hein, an OSMS orthopedic surgeon to get it repaired. The surgery went well, but after the surgery, it was taking a longer than normal time to recover.

“Nothing was healing or feeling better,” Mira says. “We didn’t know what was wrong, and then all my joints started to get swollen and started hurting so, Dr. Hein referred me to Dr. Tuttle.”

After going through tests with Dr. Tuttle, one of the only pediatric rheumatologists in Northeast Wisconsin, Mira was diagnosed with juvenile idiopathic arthritis (JIA). According to the Arthritis Foundation, “Juvenile idiopathic arthritis is the most common type of arthritis in children where the immune system mistakenly attacks the body’s tissues, causing inflammation in joints and potentially other areas of the body.” This was why she was unable to properly heal after the meniscus surgery.

Mira explains, “I was really tired, I was in pain, and I would literally limp to the bathroom in the morning.”

After the diagnosis, Mira started her treatment plan at OSMS. Part of Mira’s treatment plan includes infusions. These usually take a little more than two hours, but patients are offered heated blankets, snacks, and drinks, and are also able to watch TV, do homework, read, or play games to help pass the time.

When asked what it is like to have arthritis, Mira explains, “There are good days and bad days; you don’t know which one tomorrow is going to be. You have fatigue, pain and some weakness and have to do daily medications, injections and infusions. I have a lot of needle pokes in a year. The right medicine helps though.”

She continues, “The hardest part is I don’t look sick. I don’t have a cast or brace on so it’s not obvious. Sometimes people don’t understand why I can’t stand or sit in the same position for a while or understand that I am in pain.”

By following her treatment plan, Mira is feeling better and is able to do the things all kids enjoy, like sleep overs and hanging out with friends. She was also able to play in the soccer season last year.

After having to miss out on some of this while going through treatment, Mira is excited she is getting back to the life she loves.

Read about Mira’s account of a day of infusion at OSMS.

Find more I’m Back stories.

Since October is National Physical Therapy Month, we wanted to discuss the important role physical therapy plays in the treatment and recovery of many of the injuries and conditions that we care for at OSMS. So we sat down with Andy Taber from one of our partners, Advanced Physical Therapy and Sports Medicine, to learn more about how physical therapy and orthopedics work together. Andy is a Doctor of Physical Therapy, Board Certified Orthopedic Clinical Specialist, and Board Certified Strength and Conditioning Specialist.

If you sustain an orthopedic injury like a torn meniscus or broken elbow, or you are diagnosed with a condition like arthritis, your orthopedic physician might recommend physical therapy as a starting point for treatment. Physical therapy can often be an effective nonsurgical treatment to relieve pain and restore function.

“Physical therapy can assist the body in the natural healing process,” Andy says. “Through physical therapy, we can address mechanical faults to help an injury heal. We also develop prevention strategies to reduce the risk of injury in other limbs that may try to overcompensate for the injured area during the healing process.”

For example: if a person is dealing with pain, stiffness, and inflammation from osteoarthritis, a physical therapist can help relieve symptoms by:

• Evaluating, diagnosing, and correcting gait and posture abnormalities that may increase the breakdown of a joint or cause injury to another area of the body.
• Improving strength, range of motion, and flexibility around an arthritic joint to reduce pain and improve overall function.
• Implementing joint protection strategies in an effort to conserve the remaining cartilage in a joint.

When an orthopedic surgery is needed to treat an injury or condition, physical therapy continues to play an important role.

Whether it’s repairing a torn ACL or replacing a hip joint, the ultimate success of a patient’s recovery after surgery is partially dependent on the condition of the patient going into surgery.

“Doing physical therapy before an orthopedic surgery can help improve flexibility and build strength around the injured or arthritic area,” Andy says. “And as range of motion and strength increases prior to surgery, the patient is likely to have an easier time recovering these aspects of mobility and function after surgery.”

Once an orthopedic surgery is performed, physical therapy helps the recovery process in several ways, including:

• Implementing interventions designed to reduce pain and improve comfort in the hopes of reducing the need for long-term use of pain medications.
• Helping patients understand how to properly use assistive devices such as crutches, walkers, and canes.
• Restoring range of motion and strength of the surgical area.

“Once the body gets through the initial post-operative inflammation, and the healing process is well established, physical therapy continues to help patients return to their previous level of function,” Andy says. “This is done through progressive, individualized retraining of motions, postures, and activities related to what a patient wants to get back to.”

The post How Orthopedics and Physical Therapy Work Together appeared first on OSMS - Orthopedic and Rheumatology Services in Wisconsin.

Since September is National Yoga Month, we talked with a couple of local instructors to learn more about the many benefits of yoga.

Some of the most commonly talked about benefits are the physical ones, like improved flexibility, increased strength, and better balance. These are why many people have started to include yoga in their fitness regimens. But beyond being a good workout, yoga has other physical benefits.

“Practicing yoga can help increase respiratory capacity, improve circulation, and enhance digestion,”‘ says Jackie Schechinger, a Green Bay yoga instructor and wife of OSMS physician Dr. Steve Schechinger.

Yoga also has a positive effect on a person’s mental health.

“The increased awareness to mindfully breath helps calm the nervous system and increase oxygen flow in the blood, which causes this wonderful duality of feeling calm yet energized,” says Jen Berres, owner of and instructor at Jenstar Yoga and Dance in De Pere.

While everyone can benefit from the strengthening and stress-reducing outcomes of yoga, it can be especially beneficial for two types of OSMS patients – athletes and those living with arthritis.

Yoga and Athletes

Competitive athletes are always looking to improve athletic skills and reduce the risk of injury. Yoga can help with both!

“Athletes tend to have a ‘go hard’ mentality about training, and a yoga practice brings balance to this mindset by teaching athletes to slow down and be in the moment,” says Jen. “It also creates better body awareness, which allows athletes to gain more range of motion, fluidity of movement, strength, stamina, and coordination. It is definitely a game changer, and many of the best athletes in the world are incorporating yoga into their routines.”

Yoga can also help with injury prevention and recovery.

“The improved body mechanics, balance, stability, and flexibility that an athlete can experience from yoga all work together to reduce the risk of injury,” says Jackie. “But perhaps the most important benefit for athletes is the increased mental awareness and focus to overcome an injury and elevate training and performance to the next level.”

Yoga and Arthritis

Despite the pictures of headstands, arm balances, and intricate twists that you may see on social media, yoga can be gentle enough for people living with arthritis.

“Yoga helps those with arthritis see better overall physical functioning, in particular increased joint range of motion, flexibility, and balance,” says Jackie.

Together, these outcomes can help reduce joint stiffness and pain so that people can continue to live actively.

“Joint pain is uncomfortable, but if you stop being active it can only get worse,” says Jen. “I have seen clients with arthritis feel a world of difference after only a few yoga classes.”

Learn more about yoga and arthritis from the Arthritis Foundation.

If you are new to yoga – no matter your age or activity level – it’s important to find a style and instructor that fits your needs and allows for appropriate modifications for individual restrictions, limitations, or injuries.

The post The Benefits of Yoga appeared first on OSMS - Orthopedic and Rheumatology Services in Wisconsin.

They say a dog is man’s best friend. Owning a dog brings you companionship, improves your mood and causes you to exercise more. Taking your dog for a walk, and walking in general, is good for you. Let’s explore some of the benefits walking brings.

It’s good for heart health, boosts your mood, helps maintain a healthy weight, but it also helps keep your muscles and joints strong and healthy. You’re less susceptible to injury and reduce your risk of osteoporosis or other bone-density related conditions when you have strong and healthy muscles and joints.

The American Academy of Orthopaedic Surgeons (AAOS) recommends incorporating at least 30 minutes of walking each day for five days a week to see the benefits of walking for your muscles, bones, ligaments, tendons and joints.

Benefits of walking for Bone Health include:

• Easy and gentle on joints
• Builds and strengthens muscles
• Helps maintain bone mass
• Slows the development of arthritis
• Reduces risk of osteoporosis
• Increases joint flexibility and range of motion
• Aids in joint fluid circulation, which provides essential oxygen and nutrients
• Reduces risk of hip fracture
• Lowers the likelihood of musculoskeletal injuries
• Increases spinal stability

Getting Started

To get started, give yourself about five minutes walking at a casual pace as a warm-up. Start to increase your walking pace but keep good posture and a comfortable stride. Point your toes forward and your weight should be distributed evenly. The AAOS recommends a gradual approach to begin a walking program.

Stay Hydrated

Like with any exercise, it’s important to stay hydrated. Drink plenty of water when walking to avoid dehydration, fatigue, and help lubricate joints.
Before beginning any new exercise routing, we recommend you speak with your physician.

Mall Movers

Are you interested in walking more? OSMS is proud to sponsor Mall Movers, a free mall walking program designed for Bay Park Square Mall. Find out more by visiting the Mall Office, located in the ShopKo wing.

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According to the American Podiatric Medical Association, nearly eight out of ten people have experienced foot pain and those who suffer from chronic foot pain are significantly more likely to have pain in other parts of their body.

“Feet are easy to overlook but if you take care of them, it will make a big difference,” said Dr. Gregory Kirwan, Orthopedic Foot and Ankle Surgeon at Orthopedic & Sports Medicine Specialists (OSMS). “As we age, chronic foot pain and common foot problems such as tendinitis, bunions, and arthritis can increasingly limit your mobility.”

During National Foot Health Awareness Month, Kirwan wants to remind people of a few simple steps to keep your feet in the best shape possible.

1. Keep a healthy weight. The more you weigh the greater the impact on your feet with each step you take. Being overweight can also increase arthritis or other problems in the foot.
2. Wear good shoes. Choose supportive or comfortable shoes if you will be on your feet a lot. If you are a runner or exercise regularly, invest in an athletic shoe to keep your feet as protected as possible to minimize the consistent impact on them.
3. Keep your feet moisturized. The skin of the feet tends to get thinner and drier with age which, if not taken care of, it can cause cracking, bleeding or pain. Keep skin soft by rubbing moisturizing lotion into your feet after showers or baths.
4. Practice good foot hygiene. Clean your feet in the shower or bath and dry them thoroughly when done. If you put nail polish on your toes, let the nails breathe for a few days after polish is removed before adding more.

If pain continues or you experience chronic pain in your foot, cortisone shots or surgery may be necessary.

“Every patient I see is different,” said Kirwan. “Because of the consistent impact the foot receives, you can’t treat it like other joints.”

Kirwan points to the fact that cortisone shots, in particular, may not be as effective in the foot as they are in other joints. This is due to the amount of force that is place on the foot and ankle during walking or running.
“There are so many joints in the foot that it is impossible to inject cortisone into every joint,” said Kirwan.

According to Kirwan, some of the most common foot problems people experience include:

• Bunions. Bony lumps that develop on the side of your foot and at the base of your big toe. They are the result of a condition called hallux valgus, which causes your big toe to bend towards the other toes and become deformed. If symptoms carry on over a long period, your toe may need to be surgically corrected.
  Hammer toe. Like bunions, hallux valgus can cause your other toes to become clawed or permanently bent, or hammer toe. This typically requires surgery to correct.
  Arthritis. Usually caused by osteoarthritis. This is where the cartilage covering the ends of your bones gradually roughens and becomes thin, and the bone underneath thickens. It can also be caused by damage from other rheumatic conditions, for example if you have rheumatoid arthritis, or if you’ve had a previous injury to the area. This leads to pain, swelling and occasional deformity of the joint. You may need surgery if your symptoms are severe.

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Just like the term “shoe” is an all-encompassing description of hundreds of types of footwear ranging from tennis to pumps, flats to sandals, cleats to horse, so is the term “arthritis.” Arthritis is the general term that describes varying diseases that cause inflammation and pain – sometimes to the point of debilitation.

There are more than 100 forms of arthritis and related diseases. According to the Centers for Disease Control and Prevention, 25 percent of those who have arthritis say it causes severe pain as defined as seven or higher on a zero- to 10-point pain scale.

The four most common types of arthritis are: osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), and gout. They all cause pain in differing ways, from mild to severe to everywhere in between, and sometimes enough of it to affect daily well-being and happiness.

Osteoarthritis

This is the type of arthritis that occurs when your joints are overused. It usually happens with age due to the “wear and tear” of life, but it can also come from an injury or from being overweight.

With osteoarthritis, or OA, the material that covers and protects the ends of your bones gradually breaks down. This is called cartilage. As it disintegrates, it loses its protective value and shock absorbency, leaving the bones bare. This makes bending of the joints painful because the bones are rubbing against each other.
Knees, hips, and feet are the most common places osteoarthritis affects, and it usually comes on gradually.

Rheumatoid Arthritis

Rheumatoid arthritis, or RA, is an autoimmune disease. The immune system is designed to protect a person from viruses and bacteria, but with an autoimmune disease the opposite happens. The immune system actually attacks itself, and in the case of RA, attacks healthy cells and tissue in the joints. It causes inflammation, stiffness, swelling and pain in your hands, wrists, elbows, shoulders, knees, ankles, and feet.
Rheumatoid arthritis usually affects multiple joints and is symmetrical; if knuckles on one hard are inflamed and painful, the knuckles on the other hand will probably be, as well. Symptoms can be sudden or can develop gradually, and they are usually more severe than with osteoarthritis.

Psoriatic Arthritis

People who have Psoriatic Arthritis, or PsA, have arthritis two-fold: inflammation of the skin (psoriasis) and inflammation of the joints (arthritis).
Psoriasis is when areas of the skin, usually elbows, knees, the scalp, the belly button and genital area get inflamed, presenting itself with crusty and scaly red and white patches. The skin part of the disease usually starts before the arthritis of the joints set in and can occur as early as childhood.

Gout

Gout is a buildup of uric acid crystals in a joint. It is a form of inflammatory arthritis, but it is centralized, usually to a big toe. It happens when too much uric acid builds up in the body, and the excess isn’t removed fast enough. It can build up in the blood and create uric acid crystals in your joints. This results in extremely painful joint inflammation.

Gout comes in the form of an “attack” or “flare” – severe joint pain and swelling that can last anywhere from three to ten days. You can go to bed feeling just fine, and wake up in pain the next morning. It comes on that quickly!

Being In Pain Hurts

Arthritis pain isn’t something you have to “just deal with.” It is manageable. And it doesn’t have to prevent you from living a full, active life. Arthritis pain may not always be curable, but you and your OSMS doctor can work together to create a comprehensive pain management plan that will bring you relief and get you back to the things you love.

Don’t let the symptoms (joint pain, stiffness, swelling, difficulty moving the joint through its normal range of motion, redness and warmth) persist. The Arthritis Foundation suggests you see your doctor:
• When joint symptoms last three days or more
• When several episodes of joint symptoms happen within one month

If you have any of the scenarios discussed above, request an appointment or call 920-430-8113. We’ll help you get back to the life you love.

The post The Pain of Arthritis – It’s Real. In So Many Different Ways. appeared first on OSMS - Orthopedic and Rheumatology Services in Wisconsin.

By Dr. Paul Tuttle, Pediatric and Adult Rheumatologist

Those who suffer with rheumatoid arthritis (RA) know the discomfort, pain, and debilitation it can cause. This inflammatory disease affects the joints, and it gets worse over time unless the inflammation is managed, slowed or in best cases, stopped.

Anti-inflammatory medication, which prevents joint deterioration, is vital to controlling the progression of, and relieving the symptoms of, rheumatoid arthritis. That means this medication helps RA patients feel better and live more mobile, pain-free lives.

Taking medication for rheumatoid arthritis, or any condition, is not without risk, however. Watch any TV commercial for medication, and you hear the announcer rattle off a litany of possible side effects. Yes, medication that helps people who have rheumatoid arthritis can have side effects. But it is “can,” not “will” produce side effects — and that makes all the difference.

For Better or Worse: Talk about it.

When discussing medications, patients and doctors should talk about the potential risks in light of the benefits. We work closely with our patients to assure they have the absolute best care. That includes making sure they receive the most effective medication to help alleviate the inflammation and pain of arthritis with the least amount of side effects. We weigh the positives with any potential negatives and decide together what would be best for optimal health and wellness.

Rheumatoid arthritis medication falls into several categories, each with its pros and the possibility of some cons:

• Nonsteroidal anti-inflammatory medications (NSAIDs). These work by blocking pathways that promote inflammation. By reducing inflammation, NSAIDS help reduce swelling and pain.
• Disease-modifying antirheumatic drugs (DMARDs). These target the immune system to slow the progress of rheumatoid arthritis. They are not pain medications, but over time as joint tissue becomes less inflamed, pain will be reduced.
• Cortiocosteroids. These are hormones that are either produced by the body or are man-made. They offer strong anti-inflammatory effects in conditions that are related to immune system functions, such as rheumatoid arthritis.
• Biologic agents. Used with patients who suffer from moderate to severe RA and don’t respond to traditional disease-modifying antirheumatic drugs (DMARDs), biologics zero in on specific areas that control the inflammation process.

Different medications cause different side effects in different people. That makes it nearly impossible to create a comprehensive list of medications and there possible effects. However, there are some common side effects for the different categories of arthritis medications:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). Swelling of feet, heartburn, upset stomach, and ulcers.
• Disease-modifying antirheumatic drugs (DMARDs). Upset stomach and increased susceptibility to infection.
• Cortiocosteroids. Increased appetite, cataracts, elevated blood sugar levels, bone loss, and increased susceptibility to infection.
• Biologic agents. Injection site reactions, infusion reactions like difficulty breathing, nausea or vomiting, and increased risk of serious infections.

The above list of potential side effects can be scary. But it doesn’t have to be. There is a lot patients can do to assure side effects pass them by:

• Let your doctor know about any other medications you are taking; over-the-counter (OTC) ones as well as nutritional supplements.
• Find out if there are certain foods you should eat or avoid while taking a medication. Some medication should be taken with food, some with no food.
• Pass on the cocktails. Consuming alcohol can add to the side effects of some drugs.
• Take the drug at the time designated. Take mediation at the optimum time and you may be able to reduce the dose and the risk of side effects.
• Never stop taking any medication without consulting your doctor. Your doctor prescribes the medication to help you, so of course, it needs to be taken in order to do so.
• Let your doctor know if you suspect a side effect. Communicating concerns is the best way to stay on top of your pain management, side effects, and your overall health.

Open and honest communication between physician and patient is the best way to assure the patient is receiving the correct medicine and dosages for the most effective rheumatoid arthritis treatment. At OSMS, we apply all our expertise to monitor our patient’s medications. But we also need our patients to talk to us about how they are feeling. Together, we establish a plan to getting them feeling the best they can.

Dr. Tuttle is a Pediatric and Adult Rheumatologist who sees patients at the OSMS Rheumatology and Infusion Therapy Clinic in Appleton

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By Dr. Michael Avery, Rheumatologist

My patients ask me if there’s anything they can do to make their arthritis better. Their faces light up when I say, ‘Yes, in fact there is.’

I am referring to their diet.

Certain foods have been shown to exhibit anti-inflammatory characteristics based on the compounds of which they are made, all which ease the symptoms of the disease and in turn, ease the pain of the disease. In fact, a 2017 survey conducted by the US National Library of Medicine National Institutes of Health indicated that 24% of those with rheumatoid arthritis reported their diet had an impact on the severity of their symptoms.

Even better news is that the foods that offer anti-inflammatory aid range throughout the food groups, so those who suffer from arthritis are sure to find something that will please their palettes while helping ease their arthritis pain.

Fish

Certain types of fish are packed with inflammation-fighting omega-3 fatty acids, including salmon, tuna, trout, mackerel and herring. Experts recommend at least 3 to 4 ounces of fish twice a week to help ward off inflammation.

Soy

Soy carries the same inflammation-battling omega-3 fatty acids as fish, but without the fins. Soybeans, tofu, and edamame are a few examples of anti-inflammatory soy.

Oils

Extra virgin olive oil and walnut oil are at the top of the list for fighting inflammation in the oil category. Extra virgin olive oil is packed with oleocanthal, which has a make up similar to non-steroidal, anti-inflammatory drugs. Walnut oil is loaded with omega-3s.

Tart Cherries

Cherries are particularly helpful in reducing the frequency of gout flares. Anthocyanins in cherries, which also give cherries their color, have an anti-inflammatory effect. Anthocyanins can also be found in other red and purple fruits like strawberries, raspberries, blueberries and blackberries.

Broccoli

Broccoli, Brussels sprouts and cabbage are all rich in vitamins K and C. As part of the cruciferous family, they are also full of a compound called sulforaphane. Sulforaphane helps slow cartilage damage in joints due to osteoarthritis. Broccoli is also rich in calcium, known for its bone-building benefits.

Green Tea

Green tea is loaded with polyphenols, antioxidants believed to reduce inflammation and slow cartilage destruction. Epigallocatechin-3-gallate (EGCG) is another antioxidant in green tea and is believed to block the production of molecules that cause joint damage.

Fruit

Citrus fruits – like oranges, grapefruits and limes – are rich in vitamin C. So are strawberries, kiwi, pineapple, and cantaloupe. Eating these foods helps prevent inflammatory arthritis and maintain healthy joints.

Beans

Beans help lower C-reactive protein (CRP) in the blood, which rises in response to inflammation in the body. Red beans, kidney beans and pinto beans are especially beneficial to lowering CRP.

Garlic

Garlic, along with onions and leeks, are part of the allium family. Studies have shown that people who regularly ate foods from the allium family showed fewer signs of early osteoarthritis. Researchers also believe the compound diallyl disulphine found in garlic may limit cartilage-damaging enzymes.

Ginger

Gingerol is the main bioactive compound in ginger and is responsible for much of its medicinal properties and anti-inflammatory effects.

It really comes down to eating healthy foods. Working some of the anti-inflammatory fruits, veggies, spices and fish into your diet can have a positive effect on your arthritis symptoms and on your arthritis pain. Eating these foods also can help you lose weight, which helps take pressure off the joints. You’ll feel the benefits with your arthritis and your overall health.

Dr. Avery is a Rheumatologist who sees patients at the OSMS Rheumatology and Infusion Therapy Clinic in Appleton and Green Bay.

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Editor’s note: This post is from a presentation Mira put together for her class at school and is her own words. It is being published with written permission. Mira is a junior ambassador for the Arthritis Foundation.

Before I tell you about my day when I have infusions, here is a little about me. I’m 13 years-old and was diagnosed with Poly JIA (Polyarticular Juvenile Idiopathic Arthritis) a year and a half ago. I am a very active teenager and my hobbies include playing saxophone, flute, soccer, gymnastics, and running. My favorite saying that I try and live by is “Impossible stands for I’m Possible.”

When I was diagnosed I realized doctors will have traditional medicines or injections to try and if they are not working well to help relieve your symptoms, an option might be infusions (biologics). Infusions are given by an IV through your hand and are relatively painless. Depending on the medicine, it can take a few hours to many hours and depending on the medicine and dose you may get them every four to eight weeks. You may still take other oral medicine or injections to help you as your doctor sees necessary.

The places you can get infusions include:

• Home – with a nurse coming to your house
• Doctor’s Office – few hours
• Hospital – most of the day

Here is a day in the life of me getting infusion at Dr. Tuttle’s office at OSMS.

• Check in at doctor’s office (2pm)
• Get seated in a reclining chair and nurse does temperature and blood pressure
• One needle poke and nurse puts medicine in bag with saline
• Get good snacks and drinks – even hot chocolate in winter!
• Get warm blankets and can watch TV, watch videos, or color (I have even done homework!)
• Every 20 minutes they open the flow up faster (you don’t feel anything different)
• As the medicine finishes, they take your temperature and blood pressure to make sure you are feeling ok (about 4:15pm)
• Go home! (less than 2.5 hours)

I love infusions because they help me and I only spend a few hours in the doctor’s office every seven to eight weeks. I feel tired for the first day, but my energy is back then. One to two weeks before my next one I can feel it wearing off. I’m so glad I get infusions at a doctor’s office because:

• Same nurse
• Not all day
• Doctor stops to see me sometimes
• It costs less for my mom

Infusions have helped me get back to the sports and hobbies I love by reducing my pain and fatigue.  I am thankful for medicines like this and a great doctor who continues to make sure the medicines are allowing me to live an active teenage life!

Dr. Paul Tuttle is a Pediatric and Adult Rheumatologist at OSMS serving patients in Appleton and Green Bay.

Read more blog posts about arthritis by clicking here.

Register for “Living Your Yes with RA: A Personalized Goal-Setting Event” presented by the Arthritis Foundation and OSMS on Tuesday, July 24th by clicking here.

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Knee pain, hip pain, really any joint pain can significantly impact your motivation to exercise. You may even think that exercise could make your arthritis worse.

But staying active with arthritis is possible. The truth is, exercise is a very important part of managing the joint pain, swelling and stiffness that goes along with arthritis. By keeping the joints flexible and the muscles around the joints strong, exercise can reduce the amount of stress put on the joints, and therefore, help reduce joint pain.

However, working out with arthritis typically requires switching to lower-impact, “joint-friendly” activities.

Let’s talk about the 4 exercises to keep you active with arthritis.

Walking
Walking is free, easy and provides so many health benefits. Here are a few reasons you should start walking:

• It keeps your joints healthy by improving the circulation of oxygen and nutrients in joint cartilage.
• It keeps leg muscles strong, which can take some of the stress off of arthritic knees or hips.
• It strengthens bones and can help prevent bone loss that may lead to osteoporosis.
• It helps with weight loss.
• It works the cardiovascular system and helps strengthen the heart.

Water Exercise
Water helps support your body’s weight while exercising, which reduces the amount of stress put on weight-bearing joints like the hips and knees. According to the Arthritis Foundation, doing water aerobics (as opposed to a class on a hard floor) reduces the impact on joints by 75 percent.

Water allows for greater freedom of movement. Since the water is helping to support your body, water exercise isn’t limited by your ability to balance. You can move through full range of motion without fear of falling.

Water also provides more resistance than air, so water exercise is a great way to strengthen muscles and improve cardiovascular stamina.
Types of water exercise include:

• Swimming
• Water walking (taking your walk from the park to the pool)
• Water aerobics

Cycling
An important component to any exercise routine is cardiovascular activity. These help keep your heart strong and play a key role in weight loss. Some types of cardio exercise, like running or fast-paced fitness classes, are probably too high-intensity if you suffer from arthritis joint pain. That’s why cycling is a great option. Cycling works your lower body muscles as well as your cardiovascular system, but it doesn’t put significant stress on weight-bearing joints.

Cycling can be done outside or on an indoor stationary bike, which can be helpful if you have difficulties with balance.

 Yoga
Yoga is an activity that strengthens muscles and improves flexibility. And with the use of chairs, blocks and other props, it can be gentle enough on the joints to do daily.

However, to ensure that no unnecessary stress is put on your joints, it is important to find an appropriate style of yoga, learn how to do yoga poses properly, and understand when modifications may be needed.

Dr.  Dan Linehan is an Orthopedic Surgeon with OSMS and sees patients in Green Bay and Sturgeon Bay.

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