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Osteocytes: the ignored but crucial multitasking bone cells and how to activate them

For decades, scientific studies and writings on the cells that determine bone health have focused on two types of cells: osteoblasts and osteoclasts. But it turns out that a third type of cell, long overlooked and underestimated, could be the key regulator of bone remodeling.

Today we will highlight this often overlooked bone cell. You’ll gain an in-depth understanding of how it manages the strength and quality of your bones, along with its surprising role in other body systems.

Then we look at an overview of scientific studies that give you concrete steps to improve the bone-building ability of these powerful cells.

A mystery of bone biology solved

Osteocytes make up 90 to 95 percent of all bone cells, making them the most common type. Despite their ubiquity, they have received relatively little attention and scientific research compared to osteoclasts and osteoblasts.

Osteoclasts are the cells responsible for reabsorbing old or damaged bone mass. Osteoblasts create and deposit new bone mass. These two easily observable actions have dominated the study of bone health and our understanding of the mechanisms of bone loss and osteoporosis.

However, several questions remained unanswered. How do osteoblasts and osteoclasts communicate? How do they know how much bone to resorb or build? We can see that bone adapts to use, as stated in Wolff’s law: the more you use the muscles connected to a bone, the more mass that bone will add. But what do bones feel like when muscles are used?

Over the past decade, the consensus among scientists has pointed to osteocytes as the answer to these questions.^1,2

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Osteocytes are the most common type of bone cell, but their function was unknown for decades. Meanwhile, questions remained about how the body regulates bone remodeling. Recent research suggests that osteoclasts are responsible for regulating the cells that carry out bone remodeling.

Osteocytes are the center of bone regulation

Until recently, scientists thought that osteocytes were just a passive placeholder in the structure of bone. Unlike short-lived osteoblasts and osteoclasts, osteocytes live for years or even decades.

Osteocytes are distributed throughout the bone, in small cavities known as lacunae. They have tentacle-like dendrites that extend and connect to the surface of bones, other cells and even blood vessels.

All these observable features turned out to be clues to the function of these cells. Due to their even distribution and interconnectedness, they are well positioned for their primary task: monitoring the condition of the bones and regulating bone formation locally and systemically.³

The mechanisms by which osteocytes fulfill this task remained unnoticed for decades. However, research has now shown that osteocytes sense mechanical pressure on bones and receive hormonal messages about bone quality.¹

In response, osteocytes produce and release compounds that stimulate the development and function of osteoblasts, the cells that build new bone, and osteoclasts, the cells that resorb old or damaged bone.

They can send these chemical signals directly to other cells, or release them into the extracellular fluid, causing the production and activation of osteoblasts and osteoclasts.

They can even release compounds into the bloodstream to send instructions to distant organs.³ This multitude of functions is unusual for a single cell, which typically has a more limited range of actions. Osteocytes are truly unique and powerful cells.

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Recently, osteocytes have been discovered to perform several important functions in bone and body systems. They monitor the condition of the bones and regulate bone formation by releasing compounds that stimulate the production and function of osteoblasts and osteoclasts, the cells responsible for creating and resorbing bone mass.

Osteocytes collect information and provide instructions

Osteocytes, distributed throughout mineralized bone, have the unique ability to sense mechanical pressure on bone, making them mechanosensitive. That pressure is usually the result of the force exerted on the bones by muscles.

With every movement we make, the muscles must contract and pull on the bone. Osteocytes sense this mechanical load and respond by releasing compounds called paracrine factors. These factors activate the bone remodeling process, ultimately resulting in the addition of bone mass in locations where bones are in use.

This is the mechanism behind Wolff’s law, which states that bones adapt to use by adding mass. This principle also explains why exercise is so important for building bones

Osteocytes also respond to hormonal information from other bone cells about the condition of those cells, such as damage and cell death. Osteocytes use that information to direct the production of osteoclasts to remove damaged or dead bone cells, and osteoblasts to replace them with healthy new bone mass.

In addition, osteocytes release compounds that instruct the kidneys on the release of phosphate. In this regard, they function as endocrine cells and produce factors that regulate phosphate transport.³ Phosphate is an important building block of the bone mineral matrix. It combines with calcium to form hydroxyapatite crystals that strengthen bone.

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Osteocytes can sense mechanical pressure on bones and receive information from hormones about the condition of bone cells. They respond to this mechanical and hormonal information by releasing paracrine factors that generate and activate osteoblasts and osteoclasts. They also communicate with the kidneys to regulate the release of phosphate to be used for the production of new bone mineral matrix.

How osteocytes regulate bone remodeling

Osteocytes regulate the bone remodeling cycle through the release of many different factors and compounds. They contain:³

Savers will likely recognize some of these factors. Several of these are targeted by anti-osteoporosis drugs that artificially intervene in the regulation of the bone remodeling process.

For example, the osteoporosis drug Prolia (denosumab) works by mimicking osteoprotegerin to inhibit RANKL and ultimately render osteoclasts inactive. The drug Evenity (romosozumab) inhibits sclerostin, a substance that limits bone formation. By inhibiting sclerostin, Evenity changes the instructions of the osteocytes, leading to increased bone formation.

However, these pharmaceutical interventions have many negative side effects and are only temporarily able to overpower the body’s natural bone remodeling system. At best, the result is a short period of denser but less healthy bones.

As savers know, bone mineral density is not the only or even the most important measure of bone health and fracture risk.

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Osteocytes generate the factors involved in bone formation and resorption. These same factors are mimicked by drugs that artificially intervene in the regulation of the bone remodeling process to increase bone mineral density.

How to improve osteocyte function

As we age, more osteocytes die than are produced, and the function of the osteocytes declines. This is an underlying cause of bone remodeling imbalances, leading to bone loss and osteoporosis.⁴

However, research has shown that regular, strenuous physical activity has a strong positive effect on bone health through the activation of osteocytes.⁵ This activation of osteocytes is essential for their function, and we can activate it through exercise.

Many studies have proven the positive end results of regular exercise, including increasing strength, building bone, and preventing falls.⁶ Now we understand more about how that cause and effect goes through osteocytes.

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The number and function of osteocytes decreases with age, but research has shown that regular, strenuous physical activity activates osteocytes and has a positive impact on bone health.

What this means for you

Activate your osteocytes through consistent weight exercises. These powerful cells are responsible for receiving information about what your body needs. Exercise tells your osteocytes that you need strong and durable bones. Through SaveTrainer you have access to all the support you need to build your ideal training routine.

The Save Institute has specially designed the SaveTrainer to adapt to your needs. Professional trainers will guide you through exercises and activities at your level, and a wide variety of disciplines and workouts are available, from yoga to strength training and meditation classes. Take advantage of what SaveTrainer has to offer today.

Upcoming research could reveal even more fascinating information about the capabilities of osteocytes. As you continue to learn, you will continue to apply your new knowledge to live the healthiest and fullest life possible.

References

¹ https://www.annualreviews.org/doi/full/10.1146/annurev-physiol-021119-034332

² https://rmdopen.bmj.com/content/1/Suppl_1/e000049

³ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3366431/#:~:text=They%20produce%20the%20soluble%20factors,kidney%20to%20regulate%20phosphate%20transport

⁴ https://www.nature.com/articles/s41419-020-03059-8

⁵ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705732/

⁶ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3812467/

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October 24, 2023
Few definitive CTE cases have been detected with and without history of brain injury and collision sports
Chronic traumatic encephalopathy Neuropathological changes are uncommon in men who played amateur American football

Iverson GL, Jamshidi P, Fisher-Hubbard AO, Deep-Soboslay A, Hyde TM, Kleinman JE, deJong JL, Shepherd CE, Hazrati LN, Castellani RJ. Anterior neurol. June 19, 2023; 14:1143882. doi:10.3389/fneur.2023.1143882. PMID: 37404944; PMCID: PMC10315537.

Full text freely available

Take home message

Among the brain tissue of men over 50, none showed a definitive neuropathological change in chronic traumatic encephalopathy (CTE). However, three or more authors found that 5% of brains showed ‘signatures’ of neuropathological changes in CTE, arising from cases with and without a history of collision sports.

Background

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that cannot be diagnosed until death. An update was recently published on defining cases. Rather than a general absence or presence, screeners may note the level of components or “signatures” of neuropathic CTE change.

Study aim

The authors evaluated brain tissue from the Lieber Institute for Brain Development Tissue Bank to examine CTE neuropathological changes in relation to a history of American football youth participation and suicide as a mode of death.

Methods

The authors assessed 186 donated male brains in a tissue bank enriched with samples from people with neuropsychiatric problems and suicide (~66 years old; 58 participated in a contact sport, 67 died by suicide). Two authors screened the brains. Five authors then examined the selected brains for signs of CTE using the 2016 and 2021 consensus definitions. The authors also reviewed clinical documents and interviewed relatives to determine their medical, social, demographic, family and psychiatric history. In addition, they took into account their history of head/brain trauma/injury and their personal history of participation and concussions in sports.

Results

No brain definitively met the criteria for neuropathic CTE change based on the 2016 or 2021 definition. Furthermore, the five authors never unanimously agreed on a case with “hallmarks” of neuropathic changes in CTE. However, three or more authors found 10 cases (5.4%) with “features” of one or both definitions for neuropathic change in CTE.

The authors found no differences between CTE neuropathic change and personal history of playing American football or contact sports (contact sports = 9%, no contact sports = 4%). Furthermore, there was no difference between CTE tissue samples with neuropathic change and samples with a history of brain injury (brain injury = 4%, no brain injury = 6%), mood disorder (mood disorder = 6%, no mood disorder = 6.0%). ), or manner of death (suicide = 6%, non-suicide = 5%).

Viewpoints

Overall, no definitive case of CTE was identified in this sample. Some authors found ‘signatures’ of neuropathic changes in CTE in 1 in 20 brains. Therefore, this condition was very uncommon in men who played amateur football, in people with mood disorders during life and in people with suicide as the cause of death. One of the notable strengths of this study was that the authors used a different brain bank, focusing around the brain tissue donations on psychiatric conditions and not on sports history. The findings at this bank were consistent with low rates at other banks, such as 4% of cases at the Military Brain Tissue Bank. However, these former banks do not represent the general population. It remains unclear how common CTE and “signatures” of neuropathic changes in CTE occur in the general population. This is essential to understand how prevalent CTE is in society and to accurately assess who is at risk for CTE and what the “signatures” of CTE are.

Clinical implications

Medical professionals can reassure people that, despite recent media attention, the prevalence of CTE and its characteristics are relatively small. That said, we need to point out to our stakeholders (e.g. parents, patients) that the level of evidence in this area is weak and there is much for us to learn. Doctors should promote positive brain health by limiting repetitive head impacts by improving rules and regulations in contact sports and limiting contact during exercises.

Questions for discussion

Do you believe that there would be an increased risk of CTE pathology in those who have played contact sports in the past or have a history of repetitive brain injury? How do you inform your patients about CTE?

related posts
1. Treatable conditions should be explored in former athletes with CTE-like symptoms
2. CTE found in people with no history of contact sports
3. When it comes to Chronic Traumatic Encephalopathy (CTE), Mom may not know best
4. Can playing contact sports in high school and college increase the risk of CTE?
5. Disconnect between concussion education and CTE
6. Most military members don’t have to worry about CTE
Written by Jane McDevitt
Reviewed by Jeffrey Driban
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October 24, 2023
Understanding osteoarthritis: symptoms, causes and treatment options

Osteoarthritis is painful for many people and affects their daily activities and quality of life. The progression of this degenerative joint disease can be slow and gradual, leading to discomfort and movement limitations. Despite its prevalence, there is still much to learn about osteoarthritis and how to treat it effectively.

Our blog article explores the symptoms, causes and treatment options of osteoarthritis. Whether you’re just starting to experience symptoms or have been struggling for a while, there is hope for relief. So let’s take a look at this common form of arthritis.

What is osteoarthritis?

Osteoarthritis is a common form of arthritis that affects millions of people around the world. It is a degenerative joint disease that causes the cartilage in the joints to wear out, leading to pain, stiffness and movement problems. Although it can occur in any joint, it is most common in weight-bearing joints such as the hips, knees and spine.

Symptoms of osteoarthritis

The symptoms of osteoarthritis can vary from person to person, but common symptoms include joint pain, stiffness, swelling, and a grinding or grinding sensation when moving the affected joint. These symptoms may be mild at first and only occur during certain activities, but may worsen over time and become constant.

Causes of osteoarthritis

Several factors can increase the risk of developing osteoarthritis, including age, obesity, genetics, joint injury and overuse of the joint. As we age, the natural wear and tear on our joints can lead to osteoarthritis, and excess weight can put extra strain on the joints, leading to the development of the disease. Genetics may also play a role, as some people are prone to developing osteoarthritis.

Treatment options for osteoarthritis

Treatment for osteoarthritis depends on the severity of the disease, but several options are available to control symptoms and improve quality of life. These options include physical therapy, pain management, joint injections, and in some cases, surgery. It is critical to work with a healthcare provider to determine the best course of treatment for your specific situation.

Schedule a consultation

Do you have complaints of osteoarthritis and would you like to know more about your treatment options? Contact Bone and Joint Specialists in Indiana at 219-795-3360 to schedule a consultation today!

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October 24, 2023
7 things I want my daughter to know within 24 hours of tearing an ACL

As my daughter continues to process the injury, I would do my best to gauge where she is mentally. Is she still focused on the injury itself, or has she opened a window to talk about the recovery process? If I feel like a window has opened to talk about the recovery process, here’s what I want her to know.

5. Throughout your life you will realize that life is not about what happens to you, but about how you respond to it. This is one of those moments.

6. Recovering from an ACL injury involves the same principles that made you such a great athlete. You will apply the same hard work, discipline, focus and mental strength to get back to full health.

7. At some point you will decide whether or not you want to put the same energy you put into your sport into this recovery. If you choose, you can come back from this bigger, faster, stronger (and smarter, too).

The more technical article will come at some point (I still have my list of 20+ items). For me at least, it is my natural instinct as a parent to help my daughter through difficult moments in life (in my case, at 19 months, it is telling my daughter: “It’s okay, no problem” right after she falls is ). I suppose this is why I moved so quickly to technical information in my first approach.

But for now, in these first 1-7 days after my daughter was injured, I just want her to know that she is supported, and that ultimately it is her choice what perspective she has on the recovery process. Once she comes to the conclusion that she is ready to put her full mental and physical energy into the recovery process, the technical information awaits… and we get to work.

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October 24, 2023
THINK Surgical’s TMINI System Receives Special 510(k) Clearance from the FDA for Use with Complementary Implants

FREMONT, Calif., Oct. 23, 2023 /PRNewswire/ — THINK Surgical, Inc., an innovator in orthopedic surgical robots, today announced that its TMINI™ Miniature Robotic System has received special 510(k) clearance from the U.S. Food and Drug Administration (FDA) for use with implants from three additional implant manufacturers.

The TMINI system includes a wireless robotic handpiece that helps surgeons perform total knee replacements and received its first 510(k) clearance from the U.S. FDA in April 2023 for use with an implant from a single implant manufacturer.

THINK Surgical is committed to an open implant library. The addition of the Classic^® Knee System (Total Joint Orthopedics Inc.), Balanced Knee System (BKS^®) and BKS TriMax^® Knee System (Ortho Development Corporation) and U2™ Knee (United Orthopedic Corporation) to THINK Surgical’s Implant Data Hub (ID-HUB), a proprietary database of implant modules for use with the TMINI System, opens access and choice to surgeons.

“We are excited to expand the number of implant modules supported by the TMINI system, giving more customers and patients access to robot-assisted technology for knee replacement.” said Stuart Simpson, president and CEO of THINK Surgical. “We are currently working on adding more implant modules to the TMINI system to continue our mission of an open implant library.”

About THINK Surgical, Inc.

THINK Surgical, Inc. is a privately held, US-based technology innovator that develops and commercializes orthopedic robots. THINK Surgical robots are open platforms that support implant brands from multiple manufacturers, allowing the surgeon to determine the implant choice.

THINK Surgical actively works with healthcare professionals around the world to refine our orthopedic products to improve the lives of people suffering from advanced joint conditions with accurate, precise and intelligent technology. Refer to the TMINI Miniature Robotic System Instructions for Use for a complete list of indications, contraindications, warnings and precautions. For additional product information, please visit www.thinksurgical.com.

THINK Surgical and TMINI are trademarks of THINK Surgical, Inc.

Media contacts:

THINK surgical
Nick Margree
nmargree@thinksurgical.com

SOURCE THINK Surgical, Inc.

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October 24, 2023
Understanding the genetics of rheumatoid arthritis and its implications

Introduction

Rheumatoid arthritis (RA) is an autoimmune disease that affects millions of people worldwide. Although the exact cause of RA remains unknown, research has shown that the genetics of rheumatoid arthritis play an important role in its development. In this article, we will delve deeper into the genetics of RA, examining the key genetic markers associated with the disease and their implications.

Genetic markers associated with RA

HLA-DR4: Revealing the dominant gene

The HLA-DR4 human leukocyte antigen gene stands out as the gene most closely linked to RA. Individuals who possess this gene are more predisposed to developing the disease and often experience more severe symptoms. The HLA-DR4 gene encodes proteins responsible for distinguishing between self and foreign cellular materials, including viral and bacterial proteins.

STAT4: The immune system regulator

Another important genetic marker associated with RA is STAT4. This gene plays a crucial role in regulating and activating the immune system. Abnormalities in STAT4 function have been observed in individuals with RA, underscoring its significance in disease development.

TRAF1 and C5: key players in chronic inflammation

The genes TRAF1 and C5 have been identified as major contributors to chronic inflammation, a feature characteristic of RA. These genes play a crucial role in initiating and perpetuating the inflammatory response that leads to joint damage in individuals with RA.

PTPN22: Influencing the progression of RA

PTPN22 is a gene that influences the progression and expression of RA. Although the precise mechanisms by which it affects the disease are not yet fully understood, researchers have identified its involvement. Further studies are underway to unravel the complexity of PTPN22’s role in the development of RA.

The complexity of genetic heredity and RA

Although some of the genetics of rheumatoid arthritis are known and the above genetic markers are strongly associated with RA, it is essential to note that not everyone who possesses these genes will develop the disease, and conversely, not all individuals with RA have these genetic possess markers. This complexity suggests that other genetic and environmental factors may also contribute to the development of RA.

The need for further research

Although significant progress has been made in identifying genetic markers associated with RA, there is still much to learn. Researchers have discovered more than 100 regions in the genome that are linked to the risk of developing RA in different ethnicities. To understand why some individuals with these genetic markers develop the disease while others require no further investigation.

Conclusion

Genetics undoubtedly plays a crucial role in the development of rheumatoid arthritis. The HLA-DR4 gene is emerging as the primary genetic marker associated with RA, alongside other notable genes such as STAT4, TRAF1, C5 and PTPN22. However, the complexity of genetic inheritance suggests that additional factors contribute to the development of this debilitating autoimmune disease. Continued research in this area will provide valuable insights into the underlying mechanisms of RA, ultimately leading to improved diagnostic tools and targeted therapies for those affected.

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October 24, 2023
Dr. Brown’s crystal ball predictions for 2023
1. Muscle testing will become as important as bone density testing as doctors understand the intertwined aging loss of both bone and muscle.
2. “Everything is energy” will become a well-known concept and the popularity of energy medicines will increase enormously. You’ll see more homeopathy, acupuncture, Qi Gong, Reiki and many other treatments including Chakra balancing and even alignment of the invisible energy fields around the body.
3. Researchers will discover how to turn sound into bone by identifying the vibrational frequency capable of converting stem cells into osteoblast bone-building cells.
4. Globally, there will be a push for universal vitamin D testing as the world absorbs the lessons from the recent flu epidemic.
5. Government subsidies to the fossil fuel industry will be converted into subsidies for local fruit and vegetable production programs.
6. The limitations of bone density testing by the current DEXA X-Ray system will become increasingly apparent, fueling a search for better ways to assess bone strength.
  The use of the new Italian ultrasound device for testing bone fragility will gain popularity in Europe. However, in the US, the medical industry will not embrace radiation-free ultrasound examination of bone, but will promote bone examination with CAT scans, despite the radiation exposure.
7. In the world of bone drug therapy, this is the abbreviation NNT (Number needed to address) will be the question you ask. By popular demand, the marketing of pharmaceutical products will have to make the NNT public, that is, they will have to report the number of people treated to obtain one positive result.
  For example, they will have to report that 21 high-risk women need to be treated with Prolia for 3 years to prevent 1 vertebral fracture, and that 230 high-risk women need to be treated for 3 years to prevent 1 hip fracture.
8. Scientists will highlight the link between the dangerous acidification of our environment (oceans, rivers, soils and air) and the health-threatening acidification of the human body.
9. Bone health will be seen as both an indicator and a predictor of overall body health.
10. “May I become as smart as my body” will become the new mantra as science explains to the public the great intelligence within each of us.
11. Measuring the pH of urine the first morning will become as common as brushing your teeth as it becomes known that this simple measurement can reveal whether you are getting enough minerals or not.
The message Dr. Brown’s Crystal Ball Predictions for 2023 appeared first on Better Bones, Better Body.

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October 24, 2023
Walking tips for a happy and healthy trail

Hiking in Arizona is a breathtaking experience, with its rugged landscapes, beautiful canyons and diverse flora and fauna. As the weather cools in Arizona, more people are hitting the trails for a hike. To maximize your hiking adventures and avoid injuries, follow our six hiking tips to trailblaze happily and healthily!

6 essential walking tips

1. Add dynamic warm-ups

Incorporating dynamic warm-ups into your walking routine should be a non-negotiable practice. Preparing your body for a few minutes before heading out can significantly improve your hiking experience, improve your performance, and reduce your risk of injury. So before you embark on your next hiking adventure, take the time to warm up dynamically – your body will thank you for it.

Related content >> Dynamic warm-up exercises

2. Choose the right shoes for walking

Choose a pair of walking shoes that suit your fitness level and needs. A sturdy sole to prevent slipping, ankle coverage to promote stability, and adequate arch support are critical to preventing injuries along the way.

3. Start slowly

It is crucial that you allow enough time for your walk to avoid rushing and fully immerse yourself in the outdoor experience. Hiking on uneven terrain requires unique skills, including balance and endurance, that take time to develop. Allow yourself to adjust to the rhythm of the trail, enjoy the sights and sounds of nature, and connect with the environment around you. Rushing a walk can lead to missed opportunities for exploration, discovery and appreciation.

4. Carry a cane

Carrying a walking stick or a trekking pole can greatly improve your hiking experience. These sticks provide stability and balance, reduce stress on the joints and increase strength and efficiency by activating the muscles of your upper body. They are cherished for navigating uneven terrain, steep slopes and stream crossings. In addition, trekking poles can serve as protection against wildlife, as support for makeshift shelters, and as an aid in measuring depth and distance. Whether you choose to use them depends on your personal preference and the specific demands of your trail adventure. Still, they can be valuable tools to improve safety and comfort on the road.

5. Stay alert while walking

It should go without saying, but walking is a highly involved physical activity. Even though the beauty of nature surrounds you, make sure you pay attention. Research the trail you plan to hike, including its difficulty, length, and potential hazards. Familiarize yourself with the rules and regulations of the area you are exploring. Take a break and pull over to the side of the trail to take photos, or just take it all in.

6. Don’t ignore your pain

Pain is certainly not gain in this case. It is a signal sent to your brain that something is wrong. If you start to feel pain during your walk, don’t ignore it and keep going. This can often worsen the injury, even if it is relatively minor.

Physiotherapy benefits for walkers

Physical therapy (PT) can be a game-changer for hikers, whether they are seasoned hikers or beginners. PT is crucial in preventing injuries, improving performance, and improving your overall walking experience. Consider consulting a physical therapist to optimize your walking.

At Foothills Sports Medicine we offer physical therapy Rapid Recovery® Injury Assessments for anyone concerned about an injury and curious about whether physiotherapy should be used during treatment. Working with a physical therapist will ensure you are prepared and in the best shape for your next hiking adventure.

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October 24, 2023
Steamed Chicken Shiitake | GF, DF | BoneCoach™ Recipes – BoneCoach™

Looking for a healthy alternative to your favorite takeaway meal?

You’ve found it!

Tender, flavorful and comforting, that’s what our steamed chicken shiitake recipe demands little effort deliver great taste.

Plus, thanks to the shiitake mushrooms, this dish is a… nutritional powerhousepacked with essential vitamins and minerals, including potassium, copper, B vitamins and inflammation-fighting antioxidants.

Our steamed chicken shiitake recipe is sure to become a favorite for your family.

Treat yourself tonight!

SERVES: 2

TOTAL TIME: 30 minutes

Ingredients

340 g skinless, boneless chicken thighs, cubed

5 dried shiitake mushrooms, soaked in hot water for 2 hours

1 teaspoon (5 ml) grated ginger root

2 teaspoons (10 ml) arrowroot starch

2 teaspoons (10 ml) coconut aminos

1 teaspoon (5 ml) molasses

Pinch of ground white pepper (optional)

1 tablespoon green onions (15 ml), thinly sliced

Directions

1) Thinly slice the shiitake mushrooms and discard the stems. Reserve the water.

2) Place the chicken pieces in a bowl. Add the sliced mushrooms, ginger, arrowroot starch, coconut aminos, molasses, white pepper and 3 tablespoons mushroom water. Mix well. Place the chicken mixture in a shallow dish. Let it marinate for 15 minutes before steaming.

3) Fill a steamer with enough water to steam continuously for 10 minutes without evaporating. Bring to the boil and steam the chicken for 10 minutes.

4) Turn off the heat and leave the chicken in the steamer for another 2 minutes. Sprinkle with green onions and serve immediately with cauliflower rice.

Recipe created by BoneCoach™ Team Dietitian Amanda Natividad-Li, RD & Chef.

Medical disclaimer

The information shared above is for informational purposes only and is not intended as medical or nutritional therapy advice; it does not diagnose, treat or cure any disease or condition; it should not be used as a substitute or substitute for medical advice from physicians and trained medical professionals. If you are under the care of a healthcare professional or are currently taking prescription medications, you should discuss any changes in your diet and lifestyle or possible use of nutritional supplements with your doctor. You should not stop prescribed medications without first consulting your doctor.

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October 24, 2023
What is a patient-reported outcome measure or PROM and the KOOS?

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A patient-reported outcome measure (PROM) is a self-reported questionnaire that you typically complete before and after surgery or treatment.^[1] It allows you to report your symptoms, level of disability and your health-related quality of life, all from your perspective.^[1]

The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a PROM specifically designed for people with various knee conditions, including those with ACL injuries, meniscal injuries, focal cartilage lesions, knee osteoarthritis, and many others.^[2]^[3] It takes approximately 10 minutes to complete and rate five of the following dimensions: pain (nine items); symptoms (seven items); activities of daily living (17 items); sports and recreational function (five items); and knee-related quality of life (four items).^[2]

By completing the KOOS you will gain insight into the course of your knee injury and you and your healthcare provider can monitor the effects of the treatment over time.^[4] For example, if you have just had total knee replacement surgery or ACL surgery, to help gauge your recovery progress and your level of disability at any given time, you can compare your preoperative KOOS scores to your postoperative scores. compare your KOOS scores with those of others who have undergone the same injury or surgery.^[5]

For more information about PROMs and the KOOS, check out our blog where we explain what a PROM is and what the KOOS is.

Learn what a patient-related outcome measure or PROM is and why it is important for you to complete this form. Also learn what the Knee Injury and Osteoarthritis Outcome Score or KOOS is in this YouTube video presented by Joey Wong, kinesiologist.

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October 24, 2023