Altman Orthopedic & Functional Medicine

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Altman Orthopedic & Functional Medicine Treating the Root-Cause. Restoring Function. Optimizing Health. Advancing Physical Longevity.

Bone healing depends on more than a cast, brace, or surgery. This meta-analysis found that smokers had substantially hig...
10/24/2026

Bone healing depends on more than a cast, brace, or surgery. This meta-analysis found that smokers had substantially higher odds of nonunion than nonsmokers.

This is a classic OFM example of why chemistry and healing capacity matter. The biologic environment can strongly influence how well tissue recovers, and smoking status should absolutely be part of the orthopedic conversation.



Reference
Patel RA, Wilson RF, Patel PA, Palmer RM. Do smokers have greater risk of delayed and non-union after fracture, osteotomy and arthrodesis? A systematic review with meta-analysis. BMJ Open. 2016;6(11):e010303. doi:10.1136/bmjopen-2015-010303.

Stiffness is your body's response to something. The important question is: what is it trying to protect you from?Sometim...
10/23/2026

Stiffness is your body's response to something. The important question is: what is it trying to protect you from?

Sometimes stiffness comes from a true mobility restriction. Sometimes it reflects pain, guarding, weakness, neurologic protection, compensation, or irritation somewhere else in the movement system.

If we only stretch the stiff area without understanding why it became stiff, we may temporarily change the symptom without changing the driver.

I want to know whether the stiffness is the problem - or the body's attempt to manage another problem.

NEXT: Why inflammation is not automatically the enemy.

Fear of movement is common, but this research is reassuring: recreational running does not appear to simply 'wear out' t...
10/23/2026

Fear of movement is common, but this research is reassuring: recreational running does not appear to simply 'wear out' the joints. In fact, OA prevalence was lower in recreational runners than in controls.

That does not mean context does not matter. Load history, injury history, recovery, and training dose all matter. OFM helps patients think in terms of intelligent loading rather than fear-based avoidance.



Reference
Alentorn-Geli E, Samuelsson K, Musahl V, Green CL, Bhandari M, Karlsson J. The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017;47(6):373-390. doi:10.2519/jospt.2017.7137.

If a muscle tests weak, the obvious answer is:Strengthen it.But first I want to know why it is weak.There's a difference...
10/22/2026

If a muscle tests weak, the obvious answer is:
Strengthen it.

But first I want to know why it is weak.

There's a difference between a muscle that lacks strength and a muscle that the nervous system is not fully recruiting.

If pain, joint dysfunction, neurologic irritation, or protective inhibition is limiting activation, simply adding more resistance may not address the underlying problem.

Sometimes the first goal isn't making the muscle stronger.

It's getting the nervous system to use it normally again.

Fueling is not a side issue—it is part of bone health. This prospective study showed that as Female Athlete Triad-relate...
10/22/2026

Fueling is not a side issue—it is part of bone health. This prospective study showed that as Female Athlete Triad-related risk factors accumulated, bone stress injury risk rose dramatically.

This is a perfect OFM example of structure, chemistry, and energy all interacting. Menstrual health, nutrition, bone density, and training load all belong in the injury-prevention conversation.



Reference
Barrack MT, Gibbs JC, De Souza MJ, et al. Higher incidence of bone stress injuries with increasing Female Athlete Triad-related risk factors: a prospective multisite study of exercising girls and women. Am J Sports Med. 2014;42(4):949-958. doi:10.1177/0363546513520295.

We hear this a lot:“I feel better when I rest, but the pain comes right back when I start moving.”If walking, standing, ...
10/22/2026

We hear this a lot:

“I feel better when I rest, but the pain comes right back when I start moving.”

If walking, standing, lifting, or exercise keeps bringing the same discomfort back, it may be time to look beyond temporary relief.

SoftWave Therapy is one option we may use for persistent musculoskeletal pain.

It’s designed to support circulation and the body’s natural repair response in the area being treated.

📞 Contact our office to explore your treatment options.

This study challenges a very common assumption: removing abnormal tissue does not always solve the problem. At 5 years, ...
10/22/2026

This study challenges a very common assumption: removing abnormal tissue does not always solve the problem. At 5 years, arthroscopic partial meniscectomy was linked to more osteoarthritis progression without meaningful symptom benefit.

In Orthopedic Functional Medicine, imaging findings have to be given the right diagnostic weight. A meniscus tear may be present, but that does not automatically mean it is the true pain generator—or that removing tissue will improve outcomes.



Reference
Sihvonen R, Paavola M, Malmivaara A, et al. Arthroscopic partial meniscectomy for a degenerative meniscus tear: a 5 year follow-up of the placebo-surgery controlled FIDELITY trial. Br J Sports Med. 2020;54(22):1332-1339.

An injured tendon, ligament, joint, muscle, or disc does not recover in isolation.Structure matters. Movement matters. T...
10/21/2026

An injured tendon, ligament, joint, muscle, or disc does not recover in isolation.

Structure matters. Movement matters. The nervous system matters. And the body's overall recovery environment matters.

That is why two people with very similar imaging can have completely different symptoms, healing timelines, and responses to treatment.

I look at the full picture: what is injured, how the body is moving, what the nervous system is doing, and whether the environment supports recovery.

All four influence outcomes. All four deserve attention.

Follow for more ways to understand why an injury may not be healing as expected.

Where pain is felt, where the main dysfunction lives, and what keeps recreating demand may not be the same place. Good c...
10/21/2026

Where pain is felt, where the main dysfunction lives, and what keeps recreating demand may not be the same place. Good care often begins when we stop assuming they are.

More surgery does not automatically mean more recovery. This long-term placebo-controlled research showed that subacromi...
10/20/2026

More surgery does not automatically mean more recovery. This long-term placebo-controlled research showed that subacromial decompression did not provide a meaningful clinical benefit over placebo surgery or exercise therapy.

OFM is all about matching intervention to mechanism. If surgery is going to be done, it should add clear value beyond simply changing anatomy. This study reminds us to carefully weigh the true driver of symptoms and the expected benefit.



Reference
Paavola M, Kanto K, Ranstam J, et al. Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: 10-year follow-up of the randomised, placebo surgery controlled FIMPACT trial. Br J Sports Med. 2024.

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1086 Long Ridge Road
Stamford, CT
06903

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(914)7145300

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