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bone muscle and joint health

The Orthopedics team at Welia Health is here to stop letting joint pain disrupt your life.

It’s easy to procrastinate on decisions in life that feel major. Joint surgery certainly falls into that category.

Many people who put off joint care do it because they worry that the care itself will disrupt their lives. The truth is, your joint issues likely have already disrupted basic daily activities like running errands, stairs, sitting for the length of a movie and even your sleep. These disturbances get in the way living the way you want to.

So when your pain gets to the point where you feel you need to address the issue, you should know that the staff at Welia Health are here to talk through your options. And yes, you have options.

Reach out with any questions you may have.

Because Welia Health has offered leading joint care for decades—with an expert team, cutting-edge diagnostics, robot-aided surgery, and comprehensive rehab—we have a wealth of knowledge around hip and knee care. With our extensive experience, we’ve seen it all, and can answer any questions you may have.

Our hope is that you know what to expect and have clarity around your individual needs. We want you to have a clear forward-view for your own particular situation, not what you might have heard from a friend or neighbor. Today’s care is increasingly personalized for much better outcomes.

Different options for every person.

Long gone are the days of a single course of action for those dealing with joint pain. At Welia Health, we explore your personal experience with your joints and pair that with detailed imaging and analysis to come up with nuanced care that’s tailored to you—in consultation with you.

Because, just as every joint is different, so is every life and lifestyle. Those running to the grocery store have different needs than those skiing the Vasaloppet. Our aim is to provide great care for every situation, with a continuum that can range from physical therapy and exercise to medication and surgery.

Does dealing with my joints mean a lifestyle change?

Let’s be honest: the fact that you’re reading this means you’re already dealing with a lifestyle change thanks to a wonky joint. It may have slowed you down. It might have made things you love—like gardening or playing with grandkids—more difficult. Your joint is likely actively changing your life.

Surgery can offer a fix in some cases. But there may be other things you can do as well to stay on your feet. (And yes, it could mean changing the patterns of how you live your life.)

If the path to a working joint—a joint that gets you back to the things you love—is a lifestyle change, you can be the judge if it’s worth it. It might simply mean caring for yourself in new, healthy, and loving ways as you age. We could all use a walk. Most of us could lose a few pounds. And regular visits to Welia Center or Hinckley Finlayson Fitness Center for a fitness class or a health screening wouldn’t hurt either.

Need a guide on that quest? We can walk alongside you as you explore how to keep your joints well functioning for the things you want to do.

You can also be your own best friend.

It’s easy, as healthcare providers, to offer a lot of well-meaning suggestions in posts like this one. Caring is our job, after all, but we can see how a constant drumbeat of advice might get tiring.

So consider this. At one time or another, you’ve probably said to a friend, “Maybe you should get that looked at.” As much as we give this kind of advice to others, we don’t often care for ourselves in the same way.

But if we’re struggling to get out of the car, or need an extra minute getting dressed, we should find the same words for ourselves. Pause and say, “Maybe I should get that looked at.” Joint care and therapy is so advanced today that we can quickly regain the parts of life that we forgot were easy.

Advocate for yourself. Advocate for the things you still want to do, the trips you want to take, and the dancing you want to do at the next wedding. Advocate for the freedom to be in the moment to walk down the coffee shop or to take out the boat, rather than thinking about the discomfort it might cause.

Advocate for living life well. And let’s talk about how to get there.


Orthopedics at Welia Health

Call us at 320.679.1313 and let’s start the conversation.

bone muscle and joint health

Watching the iconic 1960s cartoon The Jetsons, many viewers thought that by now families would have their very own Rosie the Robot to do household chores and help make life easier. Although robotic maids are not yet real, robots are helping to make many activities safer and more predictable, including performing some orthopedic surgeries.

Orthopedics is the medical specialty that focuses on diagnosing and treating conditions and injuries to the musculoskeletal system, or our body’s bones, muscles and connective tissues. Welia Health recently became the first rural healthcare provider in Minnesota to add a Stryker Mako, a robotic-arm assisted machine used for total hip, total knee and partial knee replacement surgeries.

Mako does not perform the surgery; rather, it’s a device used by orthopedic surgeon Dr. Chad Holien to help him perform surgery. Dr. Holien, an orthopedic specialist with St. Cloud Orthopedics, has completed approximately 1,100 surgeries using Mako in St. Cloud, and has been providing specialty services for patients in the East Central region for the past 17 years. As part of the long-term partnership with St. Cloud Orthopedics, Welia Health welcomes Mako to its Mora campus.

How it works

Mako robotic arm used for knee and hip replacements at Welia Health
Mako, Robotic-Arm Assisted Surgery

Before surgery, a CT scan is performed, and the results are entered into Mako. A CT scan is a type of imaging using multiple X-ray measurements at different angles to produce cross-sectional (tomographic) images, described as virtual slices of a specific area.

Because each patient’s body measurements can differ, this allows Dr. Holien to correctly size the knee or hip implant and lets him know the precise angles he’ll be operating on before the surgery even begins.

Mako’s robotic arm has surgical tools attached but it’s not automated. Dr. Holien has full control of the robotic arm and manipulates the arms where they need to go. Once the system is loaded with the unique patient information, a surgery plan is made in the Mako system allowing Dr. Holien to know where everything is.

Once surgery begins, Dr. Holien places a tracker device on the patient, so it can map several points matching the CT scan measurements taken the day before. The precise system lets him know during surgery how any changes could affect the patient’s mobility by showing the patient’s virtual function of normal range of motion.

“Mako system allows my patient’s surgeries to become streamlined, predictable and more precise resulting in better patient outcomes. I cut where I need to because the system won’t let me deviate from the surgery plan.”

Dr. Chad Holien, orthopedic surgeon

Mako benefits

Mako helps in planning, especially when patients have had significant injuries, and lets the surgeon know, for example, if a rod that was previously inserted will be a problem. Unless Mako indicates it’s a problem, the surgeon just needs to follow the plan, and not worry about a rod or other hardware that might be present.

The system has a safety feature called AccuStop haptic control technology. It sets a range and guides the surgeon to cut what is precisely planned for each patient and will shut off cutting tools if the surgeon counteracts the set plan.

This technology prevents errors by recognizing soft tissue and healthy bone by not allowing the surgeon to cut outside the parameters of what was designated to be cut. It can also protect surrounding soft tissues by eliminating the need to introduce and remove instruments multiple different times during a surgery.

Innovative care

It is unusual for a hospital in a smaller community to invest in this type of device, but Welia Health is committed to providing excellent patient care. The goal in implementing the robot is to improve patient outcomes, increase operating room efficiency, and provide the best technology for our patients.

“I wasn’t thinking about robots helping me perform surgery when I was in medical school 20 years ago, but we’ve come a long way,” adds Dr. Holien. “Mako is a new, leading-edge tool that streamlines and reduces time in surgery because I know the precise size of the implant the patient needs and exactly where to begin.”

“Welia Health is proud to support our community with innovative care. We want our patients to live their lives to the fullest, and that means not having to travel to a bigger city to receive excellent care and rehabilitation following surgery.”

Randy Ulseth, Welia Health CEO

For questions or to learn more about Mako and how it can aid your surgery, contact Welia Health at 320.679.1313 to schedule an appointment with Dr. Holien.


bone muscle and joint health

Sports medicine is a branch of medicine that deals with physical fitness and the treatment and prevention of injuries related to sports and exercise. Sports medicine is not just for professional athletes.

Welia Health’s Dr. Thomas Mullin talks about sports medicine.

When you injure yourself during exercise or while playing a sport, you want to return to your routine and athletic pursuits as soon as possible. Sports medicine doctors have specialized training to help you do just that. They’re also experienced with preventing illness and injury in active kids, adults, and people with physically demanding jobs.

Promoting a team approach in sports medicine

A physician often leads a sports medicine team. Most sports medicine doctors are board-certified in a specialty such as family medicine, orthopedics or pediatrics, and then they pursue additional training in sports medicine.

There are other non-physician medical professionals who are critical to delivering care in sports medicine. They include physical therapists, certified athletic trainers and nutritionists. They each play an essential role in your care:

  • Physical therapists help you rehabilitate and recover from injuries.
  • Certified athletic trainers offer rehabilitative exercises to help you regain strength and develop programs to prevent future injury.
  • Registered dieticians help you with needed weight loss or weight gain, and they offer dietary advice to help you improve how well your body is functioning.

Sports medicine doctors, physical therapists, certified athletic trainers and dieticians work together to help you get back to your physical activities as quickly as possible.

Common injuries treated in sports medicine

Being active and playing sports are so good for you physically and mentally. But there is an inherent risk of injury. Below are some of the common injuries we see in sports medicine:

  • Ankle sprains
  • Fractures
  • Knee and shoulder injuries
  • Tendonitis
  • Exercise-induced asthma
  • Heat illness
  • Concussions
  • Eating disorders
  • Cartilage injuries

After we treat your injury, we will also help you prevent future problems. We can also help you maximize your performance with the proper nutrition and exercises.

If you think you can benefit from seeing a member of our sports medicine team, please call us at 320.679.1313.


bone muscle and joint health

Have you ever sat on an old couch and felt the metal springs through the cushion? It’s unpleasant and uncomfortable. Cushions are key.

Cartilage is the cushion for our joints. As we age, cartilage becomes brittle and wears away. When this happens, the end of the bones rub together, and it’s much more painful than springs on an old couch.

If your joint pain is unbearable, you could be a candidate for joint replacement. With the procedure, your surgeon replaces the damaged joint with an artificial one. While it might sound complicated, it’s a simple and safe procedure that improves the lives of those who struggle with painful joints.

Are you a candidate for joint replacement?

Joint replacement doesn’t make sense for all patients. Only your provider can determine whether joint replacement is a good treatment option. But here are some factors to consider on your own.

You have pain limiting daily functioning

If you’re having significant pain in joints such as your hip, shoulder or knee, and you’re experiencing a limited range of motion, you might have a damaged joint. Sometimes, simple rehabilitation exercises might help. However, in more severe situations, joint replacement might be best.

Non-invasive surgical treatments haven’t worked

There are a number of first-line, non-surgical treatments for joint pain that your doctor will recommend. They include physical therapy, injection therapy, bracing devices and nonsteroidal anti-inflammatory drugs (e.g. ibuprofen).

If those options haven’t worked, your joint damage may just be too severe, and joint replacement might be right for you.

You’re in overall good health

Joint replacement recovery requires diligent rehabilitation. The procedure itself also requires anesthesia. Your doctor will determine if you’re healthy enough for both the surgical procedure and the rehabilitation before scheduling. Joint replacement is considered major surgery and is typically a last resort to reduce pain and discomfort.

Your joint pain prevents a good night’s sleep

If your joint pain is severe enough that it prevents you from sleeping well and receiving restful sleep, you might be a good candidate for joint replacement.

If you answered “yes” to most of these factors, you might be a good candidate for joint replacement. First, schedule an appointment with your primary physician to discuss your overall health and initial candidacy for the procedure. Your physician will then refer you to orthopedics for a more detailed examination into whether you’re a good fit for joint replacement.

Welia Health provides orthopedic services including surgery. Learn more by talking to your primary care provider who can refer you to an orthopedic surgeon at Welia Health. Call 320.679.1313 to schedule.


bone muscle and joint health

Milk does the body good whether you’re 10 or 50, and for a similar reason: bone health. The big difference is that at 10 years old you’re building bone strength, at 50, you’re trying to preserve it.

Osteoporosis is a condition that causes bones to become brittle and fragile, and it’s more common in women than men. Bone fractures attributed to osteoporosis affect an estimated 1.5 million people annually. They can seriously impact one’s health and quality of life.

Bone density and osteoporosis

Doctors can screen for osteoporosis by testing your bone density or how strong your bones are. Bone density, or bone mineral density (BMD), is the amount of bone mineral in bone tissue. Testing BMD is the only way to know for sure that you have osteoporosis. At Welia Health, we use a dual energy X-ray absorptiometry or DEXA, which is the most common test for osteoporosis. Doctors measure bone density at the hip and spine, as these areas provide a good idea of whether you’re likely to fracture other bones in your body.

Screening recommendations

There has been some controversy over osteoporosis screening, largely surrounding a perception that pharmaceutical companies were pushing to lower recommended screenings to increase demand for osteoporosis drugs to drive profits. Medical associations such as the American Academy of Family (AAFP) Physicians and the American College of Obstetrics and Gynecology (ACOG) and have similar guidelines, which we follow at Welia Health.

American Academy of Family Physicians

  • Recommends against DEXA screening in women younger than 65 years and men younger than 70 years with no risk factors

American College of Obstetrics and Gynecology
(2012/Reaffirmed 2014)

  • Recommends BMD testing with DEXA beginning at age 65 years in all women
  • Recommends selective screening in postmenopausal women younger than 65 years who have osteoporosis risk factors or an adult fracture

Risk factors for osteoporosis

Around age 50, both women and men experience increased bone loss. Women tend to lose more bone as they transition into menopause, given the loss of estrogen. The hormone plays an important role in replacing older bone with newer dense bone, throughout a woman’s life. (In men, testosterone converts to estrogen to build bone mass.)

Osteoporosis in 4 stages
Osteoporosis in four stages.
From left to right: healthy bone, osteopenia, osteoporosis, severe osteoporosis.

Although bone loss starts to occur around 50, the medical guidelines don’t call for screening until age 65, unless there are risk factors beyond sex, age and race (you’re at greatest risk if you’re white or of Asian descent). Your Welia Health provider can help you determine whether you have risk factors that merit a screening before 65 years old. Some of the risk factors include:

Family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father fractured a hip.

Body frame size. Women (and men) with small body frames are at higher risk because they might have less bone mass to draw on as they grow older.

Thyroid problems. Too much thyroid hormone can cause bone loss, which can occur with an overactive thyroid or taking too much thyroid hormone medication to treat an underactive thyroid. Osteoporosis has also been associated with overactive parathyroid and adrenal glands.

Dietary factors. Osteoporosis is more likely to occur in people who have had low calcium intake throughout their lives, as the latter contributes to lower BMD. Eating disorders or severely restricting food intake can also weaken bones. Gastrointestinal surgery can also increase osteoporosis risk because when you reduce the size of your stomach or remove part of the intestine, it limits the amount of surface area available to absorb nutrients, such as calcium.

Steroids and other medications. Long-term use of oral or injected corticosteroid medications (e.g. prednisone and cortisone) disrupts the bone-rebuilding process. Other medications connected to osteoporosis risk include medications used to treat:

  • Seizures
  • Gastric reflux
  • Cancer
  • Transplant rejection

Medical conditions. Osteoporosis can also be more common in people who have:

  • Celiac disease
  • Inflammatory bowel disease
  • Kidney or liver disease
  • Cancer
  • Lupus
  • Multiple myeloma
  • Rheumatoid arthritis
  • Alcoholism

Lifestyle choices. Many of the risk factors above are out of your control. But some are not. The lifestyle choices that affect your osteoporosis risk include:

  • Inactivity: People who are sedentary have a higher risk of osteoporosis. Any weight-bearing exercise and activities that promote balance and good posture are helpful for your bones. But walking, running, jumping, dancing and weightlifting seem particularly helpful.
  • Excessive alcohol consumption: Regularly drinking more than two alcoholic drinks a day increases your risk of osteoporosis.
  • Tobacco use: Tobacco contributes to weak bones, though its exact role in osteoporosis isn’t clear.

If you’re concerned about osteoporosis, talk to your Welia Health provider and learn what you can do today to lower your risk or to determine if a screening is right for you.


bone muscle and joint health

Concussions in youth sports are increasingly considered a public health crisis. As a result, there are multiple public health efforts aimed at combating the effects of youth concussions. These initiatives range from modifying individual safety behaviors such as underreporting concussions to changing the rules of sports to reduce exposure to potentially harmful head impacts.

National guidelines

In 2015, the U.S. Soccer Federation issued guidelines that children 10 years or under are not allowed to head the ball in practice or games. Players 11 to 13 are only allowed to head the ball during practice, not games.

That same year, the American Academy of Pediatrics released a policy statement about football after its national conference that includes seven recommendations, from proper enforcement of game rules by officials and coaches to delaying the age at which tackling is introduced. (See the National Football League website for the entire list of recommendations.)

In March 2019, USA Hockey updated its concussion management program and its return-to-play forms for the 2019-2020 season. To learn more about the changes, how they’ll be implemented and how they’ll enhance the youth hockey experience, see USA Hockey’s website.

HEADS UP initiative

The Centers for Disease Control and Prevention developed a program called the HEADS UP Concussion in Youth Sports initiative to ensure the health and safety of young athletes. The initiative provides information and training around concussions for coaches, parents, and athletes alike. The HEADS UP initiative provides critical details related to preventing, recognizing, and responding to a concussion.

Many Minnesota youth sports associations, such as the Minnesota Youth Soccer Association, require their coaches to complete the HEADS UP free online course.

Welia Health, prevention and treatment

Welia Health’s Sports Medicine specialists work with young athletes, local coaches, and high school athletic departments to prevent injuries including concussions.

In the event that a concussion is suspected, our team is experienced in concussion management. A comprehensive assessment includes memory testing, cognitive function, balance, and a vestibular assessment (commonly known as VOMS). In addition, an advanced, scientifically validated computerized concussion management system called ImPACT® (Immediate Post-Concussion Assessment and Cognitive Testing) is also offered.


bone muscle and joint health

If you have a child in middle school or high school, you’ve likely seen their overloaded backpack. There’s a growing concern that kids are developing back, neck and shoulder pain and injury because of heavy backpacks.

  • One in four students report having back pain for 15 days or more during the school year.
  • In 2013, there were 5,415 backpack-related injuries treated at U.S. emergency rooms
  • 60% of students between ages 12 and 17 are carrying backpacks that weigh 10% (or more) of their body weight.

A loaded backpack should never weigh more than 10% of the child’s body weight (15% at absolute max). So a 100-pound child’s backpack shouldn’t weigh more than 10 pounds. A study in California showed that some textbooks weigh nearly five pounds each!

How to choose and wear a backpack safely

There are many ways to reduce back pain associated with backpacks that are too heavy. Here are some suggestions for you and your child to consider:

  • Never carry more than 10% of body weight.
  • Place the heaviest items close to the back.
  • Always use both straps.
  • Wider and more padded straps are better.
  • Don’t use leather straps as they add extra weight.
  • Keep the backpack above the hollow of the back.
  • Pick the smallest backpack that will work so it doesn’t get overloaded.
  • Use digital textbooks when possible.
  • Pack only what’s necessary.

As the school year continues, be sure to monitor your child’s backpack load. Listen for complaints about back, shoulder and neck pain. Watch to see if your child is struggling to get the backpack on or off or has to lean forward to carry the pack. These are signs that your child’s backpack is too heavy.


bone muscle and joint health

An Anterior Cruciate Ligament (ACL) tear is a dreaded season-ending injury. The recovery is long and challenging. Any athlete participating in high-intensity contact sports has the potential to sprain, tear or even rupture the ACL, a flexible band of tissue that runs diagonally in the middle of the knee and provides the knee the stability it needs to rotate.

Female athletes are between two and 10 times more likely than male athletes to tear their ACL. There isn’t one specific reason this is the case, and it has been a source of great debate. Orthopedic experts are starting to agree that differences in how a woman’s body is structured (anatomy) and how it moves (biomechanics) both contribute to women’s increased risk of ACL injury.

Anatomical Factors: There are anatomical differences between men and women that might cause women to have more ACL injuries for several reasons. They include:

  • Pelvis width
  • Q-angle or the angle at which the femur meets the tibia
  • Size of the ACL
  • Size of the intercondylar notch (where the ACL crosses the knee joint)

Women also have more elastic ligaments than men do, and this greater flexibility makes the ACL more prone to being stretched and twisted.

Technical or biomechanical factors: Some orthopedic researchers believe that the most conclusive evidence shows that ACL injury rates are most influenced by biomechanical differences between men and women. Some of these include:

  • Landing position: When landing from a jump, women tend to land with their knees straight, which transfers the force of impact to the knee joint. Because they tend to land with their knees bent, men tend to absorb more of the energy.
  • Flat-footed landings: When they jump, women also tend to land with the soles of their feet instead of on the balls of their feet. By landing flat-footed, the knee has to absorb most of the shock.
  • Quadricep vs. hamstring strength: Because women tend to have stronger quadriceps than hamstrings, female athletes tend to rely on their quads for movement. The knee compensates for this by putting added stress on the ACL.
  • Running upright: Women tend to run in a more upright position than men do, giving them less control over how the knee rotates.

Lowering the risk of ACL injuries

The Welia Health team can help female athletes lower their risk of ACL injuries. Preventing ACL injuries is most effective with a comprehensive approach. To lower a female’s risk of an ACL injury, it’s important to:

  • Increase leg muscle strength and core muscle strength
  • Improve or learn proper jumping and landing techniques
  • Improve balance and speed
  • Wear proper footwear specific to the sport

The most effective methods to reduce ACL injury risk is to strengthen the muscles that support the knee, including the quadriceps, hamstrings, hip adductors, and gluteus muscles and to do plyometric training. Plyometric training involves various jumping techniques, lateral bounding and lunges, sprinting and resistance training and helps to build strength, speed, agility and coordination.

Athletes will also want to consider an evidence-based, sport-specific training program. These programs will not only help athletes lower their risk of injury but will also improve their performance.

What to do when you experience an ACL injury

Even with proper prevention programs, injuries can occur. If you suspect an ACL injury, contact Welia Health’s orthopedics department. Early treatment is critical to reducing pain and swelling and to recovering quickly.


bone muscle and joint health

Medical disciplines have their own set of procedures designed to treat their specific area of the body. A prefix often identifies the part of the body involved. Cardiologists have angioplasty, orthopedics have arthroscopy.

Angioplasty is a procedure to remove something blocking an artery and is most common for cardiologists to perform. “Angio” denotes blood or lymph vessels. Meanwhile, “arthroscopy” is a procedure using special cameras and equipment to visualize, diagnose and treat problems inside a joint. “Arthro” means “joint.”

Another example in orthopedics is “osteotomy,” the correction of bone deformity by cutting and re-positioning the bone. “Osteo” means bone.

Arthroscopy and osteotomy are two common procedures in orthopedics that we perform here at Welia Health. Other common orthopedics procedures we perform include:

  • Fusion: A “welding” process by which bones are fused together with bone grafts and internal devices (such as metal rods) to heal into a single solid bone.
  • Internal Fixation: A method to hold the broken pieces of bone in proper position with metal plates, pins or screws while the bone is healing.
  • Joint Replacement: A procedure in which an arthritic or damaged joint is removed and replaced with an artificial joint called a prosthesis. Procedures include partial, total and revisions.
  • Soft Tissue Repair: The mending of soft tissue, such as torn tendons or ligaments.

If you have any questions about these or other orthopedic procedures, please contact us at 320.679.1313. As your partner in health, we are here for you.

Resource

American Academy of Orthopaedic Surgeons


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