What is Patellofemoral Pain Syndrome?

Posted April 10, 2015 by Orthopaedic Specialists

Patellofemoral Pain Syndrome is a term that describes pain experienced in the front of the knee known as the patella or kneecap, and in the femur (thigh bone). This aching pain can develop into a sharp stabbing or a burning sensation with increased activity. Patellofemoral Pain Syndrome is particularly common among athletes, teenagers and people doing physical labor.

Most of the time, Patellofemoral Pain Syndrome originates from the softening of cartilage in the knee caused by overuse, injury, excess weight and the improper alignment of the kneecap. This syndrome may also be referred to as retropatellar pain, anterior knee pain, and chondromalacia patellae.

Most patients describe their pain with activities that involve the bending of the knee. Sudden stabbing pain comes with stair climbing and activities where squatting or kneeling is present. The burning sensation frequently follows prolonged sitting that is accompanied with office work or riding for an extended period on an airplane. A pseudo effect of Patellofemoral Pain Syndrome is felt when patients feel like their knee is going to give out. This is most likely to happen when moving down stairs. Oftentimes, these symptoms are associated with the start of a new activity or increasing the intensity level of recurring activities.

Is it Patellofemoral Pain Syndrome?

Patellofemoral Pain Syndrome is generally diagnosed with a physical exam. This typically includes a patient history to determine the cause of this pain. In some cases, x-rays or MRI imaging tests may be used to view the tissues inside the knee. These tests will help rule out structural damage with the connected tissues inside the knee.

The treatment for this syndrome is very direct and typically takes two approaches. First, avoiding the activities that are aggravating the symptoms associated with Patellofemoral Pain Syndrome is generally recommended. This includes changing physical activities to prevent sitting, squatting, or kneeling for a prolonged period of time. Sometimes non-prescription anti-inflammatory drugs may be helpful. These help decrease stiffness, swelling, and pain. Secondly, using ice and resting the affected area are frequently advisable.

Oftentimes, physical therapy exercises can help alleviate symptoms from Patellofemoral Pain Syndrome as well. These exercises focus on stretching and increasing flexibility in the knee. (more…)

What is A Stress Fracture?

Posted March 29, 2015 by Orthopaedic Specialists

$learn more about what is a stress fracture$ A stress fracture has become one of the most common injuries in sports. The popularity of this injury tends to stem from the overuse and stress an athlete puts on his or her lower limbs. More than 50 percent of all stress fractures occur in the lower leg, either in the tibia (shin bone) or in the foot.

A stress fracture is a tiny crack in the bone, often caused by increasing the amount or the intensity of an activity too quickly. Some stress fractures may happen when you compete on different types of surfaces or you do not wear the right type of footwear for your activity.

Athletes and women tend to be the groups more susceptible to developing stress fractures. The repetitive movements associated with tennis, track and field, gymnastics, and basketball tend to leave athletes feeling muscle fatigue which can lead to stress fractures. Runners are especially susceptible to stress fractures because of the constant pounding on hard pavement, or the transitioning between several surfaces during one workout. Oftentimes when athletes push themselves too hard, too quickly, their bodies need more time to rest. Getting back out on the court or field too early could potentially result in a stress fracture.

Female athletes tend to have a higher rate of developing stress fractures than male athletes. Medical studies have proven that female athletes are more likely to experience more stress fractures than male athletes when competing in activities like running. As a woman’s bone density decreases, her chances of developing a stress fracture increases.

Diagnosing A Stress Fracture

Oftentimes, stress fractures are diagnosed based on symptoms. Pain is mostly dull around the site of the fracture and usually worsens with exercising, walking, or standing. Sometimes swelling is common around the site. If you suspect a stress fracture, it is important to seek a doctor’s attention immediately. Continuing to run on the affected leg or foot will only worsen the cracked bone and make the recovery process longer.

Most stress fractures are determined with a simple X-Ray, or in some cases, an MRI. Stress fractures are treated best with periods of rest. Staying off of the affected area for six weeks is generally protocol, however depending on the severity, more time may be added. In addition to resting, bracing or shoe inserts may be necessary to treat the affected area.

After getting adequate rest, it is important to return back to one’s sport slowly and cautiously. Getting back to the field or court should be a gentle process in order to keep that area healed and prevent reoccurring fractures.

Stress fractures can be quite debilitating for athletes, so it is extremely important to practice prevention activities like: Cross-training, setting realistic goals, and maintaining a healthy diet. Using proper (more…)

Why Do My Knees Make Clicking Sounds?

Posted March 24, 2015 by Orthopaedic Specialists

During specific bending movements such as squats or kneeling, your knees may make an audible sound of a crack or click. Typically this isn’t something to be too concerned about, as there are several reasons why our joints tend to make these sounds. Popping and cracking start to become a normal noise after years of physical activity and even normal aging. The time to grow concerned is if the popping or cracking noises result in a swollen knee or painful area to touch or move.

According to Dr. David McAllister, Director of the UCLA Sports Medicine Program, “A lot of joints crack and the knees are a really common joint to crack. Most people have knees that crack when they squat down or go through the full arc of motion. We generally don’t worry about cracking or popping when it isn’t associated with pain or swelling.”

So, just out of curiosity, what does that sound mean? Well throughout your life, tissues that cover the bones, otherwise known as cartilage, becomes uneven in certain areas. Standing up after squatting sometimes produces a noise made from the rougher surfaces of cartilage rubbing together. There is also another reason for that sound, and it comes from the ligaments which connect bone to bone in the body. During movement, these ligaments tighten, causing the joint lining to move over bones and create popping sounds. It’s all related to the way our inside structures work together with external body parts.

If the knee clicking starts to become painful and frequent, you should seek the help of a qualified physician. This condition might be associated with several knee ailments including: Runner’s Knee, arthritis, damage to the meniscus, and in severe cases — an ACL or MCL tear. In these cases, there are certain symptoms to look out for including: stiffness, bruising, inflammation, and chronic pain.

Knee clicking without pain is very common in adults and children. Many times this noise comes from the sound of excess air escaping the joint. It’s similar to the sound and feeling felt after cracking knuckles. Although this sound may be irritating, there is no real cause for concern. There are several home remedies that can help prevent this problem.

If there is a certain activity that is known to make this audible noise in your knee, you may consider modifying or avoiding this activity. If the activity is not easy to avoid, wearing a band around your knee may prevent this clicking noise as well. Performing strengthening exercises for your knees and hamstrings can help provide more support to this area and may be helpful as well. (more…)

University of Louisville’s Teena Murray Makes A Huge Difference For Student Athletes

Posted March 13, 2015 by Orthopaedic Specialists

Raised in a small town of about 1,600 people in the Canadian province of Quebec, Teena Murray is making a big influence on student athletes at the University of Louisville (U of L). As the Director of Sports Performance, Teena is in charge of the athletic performance for students involved in 21 sports programs at U of L. This includes working as the head performance specialist for the women’s basketball and softball programs.

Describing her childhood days, Teena explains that she grew up playing hockey with the boys, since there weren’t a lot of organized sports for girls at that time. During high school and college she enjoyed playing competitive basketball and she was also a high level softball pitcher. After completing undergraduate degrees in Kinesiology and Education, her keen interest in human athletic performance, nutrition, and exercise physiology, led her to Greensboro, North Carolina, where she earned a Master’s degree in Exercise Physiology from UNC, Greensboro.

Teena has now spent more than two decades in the sports performance industry. She is a Master Coach with the Collegiate Strength & Conditioning Coaches’ Association, and is also certified by numerous organizations including the National Strength and Conditioning Association, Functional Movement Systems, United States Weightlifting and Precision Nutrition.

Prior to joining U of L in 2004, she gained valuable experience working at Cornell University and the University of Connecticut. With normal work days spanning before the crack of dawn to long after dusk, Teena describes the commitment and passion she has for her job working with college student athletes. “I’ve had a taste of working with Olympic level athletes and athletes in pro sports, but one of the things I love about working in college athletics is the opportunity I have to watch the athletes grow and develop over a four year period. It’s just amazing to see the evolution of their bodies, minds, and personalities, how they mature, and then to feel like over the course of working together, we’ve really prepared them for life after sports. We have the opportunity to make a major impact, and I love that.”

As an adjunct faculty member in University of Louisville’s Exercise Science program, Teena has focused her research and writing on performance profiling with elite athletes. The field of sports performance is continually evolving and advancing. In order to optimize athletic performance, Teena and her team use different kinds of technologies to monitor and assess the physical stress on each athlete. Teena explains: “I like working with each individual athlete, I love the variety…Our goal is to make sure that each athlete is as fresh as possible on game day so they can perform at their highest level.”

Not only does this involve a carefully planned and rigorous training schedule, but nutrition is also a big focus. Teena and her team have an influence on the meals and snacks the athletes eat, both in terms of timing and nutritional content. The athletes take all of this very seriously, too, as Teena explains that it is not uncommon for her to receive text messages from players with pictures of their meals — “Is this OK to eat?” they might ask her.

Though Teena’s position at the University of Louisville is extremely exciting and rewarding, she has had some other pretty incredible experiences in her career. Teena worked as the strength and conditioning coach for the U.S. Women’s National and Olympic ice hockey teams between 2006 and 2010. During this period, which Teena describes as “an opportunity of a lifetime,” the teams won two World Championships and a silver medal at the 2010 Vancouver Olympics. Given this, and all that she does, it is not surprising that Teena was awarded the 2012 Guiding Woman in Sport Award by the National Association of Girls and Women in Sport (NAGWS).

While Teena explains that her days participating as a competitive athlete have passed, she still makes time to work out almost every single day. She enjoys a wide variety of activities, including trail running, hiking, mountain biking, weight-lifting and yoga. She also has a lot of fun keeping up with her two young children, ages 3 1/2 and 8.

When asked about her personal role models, Teena is quick to refer to the important influence of her family. Her uncle Bryan Murray has had an incredible career in the National Hockey League. He currently serves as the General Manager of the Ottawa Senators, having previously worked as the head coach for numerous NHL teams including the Florida Panthers and the Detroit Red Wings. Teena also mentions her parents who, she explains, taught her the meaning of hard work as self-employed business owners back in her home town. (more…)

Achilles Injury and Genetics

Posted March 8, 2015 by Orthopaedic Specialists

If you’ve ever had an Achilles injury, you know how painful these can be. Oftentimes Achilles injuries are accompanied by extreme pain shooting through the back of the foot and heel, tenderness and swelling. Stiffness, loss of mobility and sometimes popping noises are also typical if you’ve torn or ruptured your Achilles tendon.

This springy tissue located at the back of your ankle, connecting to the muscle in the calf, is responsible for varied movements and flexibility in your foot and ankle. Achilles injuries are extremely painful and have been known to leave athletes and even amateurs on the side lines for many months.

There are certain degrees of tendon injuries one can sustain. In some cases, the tendon might not completely tear or rupture, leaving the tendon partially torn. For those types of injuries, it is suggested to treat with anti-inflammatory medication, ice and lots of rest. When the tendon is completely ruptured, a person might face surgery or casting options to encourage a fast and efficient recovery.

Achilles injuries are most often caused by overuse, miscalculated movements or wearing improper footwear. However, there are several studies being released that acknowledge a connection between genetics and Achilles tendon injuries. The collagen proteins giving the tendons and ligaments their structure and support are produced by various genes. Researchers have found that the some genes may leave individuals with weakened structures that may be unable to repair themselves after injury.

Physicians from the University of Cape Town, located in South Africa, have studied Achilles tendon injuries and the internal predispositions linked to this type of injury. At the Research Unit for Exercise Science and Sports Medicine, Dr. Mokone and his colleagues have discovered that the tenascin- C gene is associated with these types of injuries. This gene is mapped with chromosome 9q32-q34, which provides the encoding that it is responsible for the structural components of tendons.

The study conducted at the University of Cape Town demonstrated that subjects possessing 12 and 14 guanine-thymine repeats have a significantly higher result of Achilles injuries than subjects containing 13 and 17 repeats. Because it’s hard to associate a specific injury with a certain variant found in gene, (more…)

Featuring Brooke Vernon, Louisville Fitness and Health Enthusiast

Posted February 27, 2015 by Orthopaedic Specialists

Brooke Vernon is a Louisville-based fitness and health enthusiast who inspires others through her dedication and passion. She is certified by the National Association of Sports Medicine (NASM). She also completed her TRX certification. She teaches Pure Barre classes and loves training for and running marathons. Due to all the work she does in the Louisville community to promote health and fitness, it is not surprising that she was recently asked to serve as an ambassador for lululemon athletica.

Growing up in Louisville, Kentucky, Brooke has been involved in sports for as long as she can remember. At a young age she tried many different sports, developing an early passion for cheerleading and gymnastics. After graduating from college with a nursing degree, Brooke worked full-time as a cardiac nurse for six years. And it was during this time that her interest in fitness training, running, health and nutrition really developed. Her academic training in human anatomy and physiology served as an excellent springboard for her progression towards becoming a personal trainer.

A few years ago, with two young children at home, and encouragement and support from her husband, Brooke started seriously considering pursuing her dream job – a personal trainer. She made the move to become a Certified Personal Trainer in 2012. She also began teaching Pure Barre classes during this time, and has taught at the Pure Barre Summit location since it opened.

Over the past 3 years, Brooke has learned a tremendous amount about working with clients as a personal trainer. She truly enjoys working with male and female athletes who are trying to improve their skills and overall performance. She has noticed that many athletes are not adequately strengthening their bodies for their particular sport or activity. Because of this, Brooke’s main focus inside personal training is to help strengthen and educate athletes in order to minimize the risk of injury.

In addition to her work as a personal trainer, Brooke is very involved in working in the Louisville community to promote a healthy lifestyle. This past summer, Brooke received her running coach certification and she has enjoyed working with (and even starting) a variety of fitness programs around the city. She likes working with people of all ages including young children, teenagers and adults. Right now she is having fun preparing to host a Daisy scout meeting for a local troop. There she’ll share healthy snack ideas and teach a miniature workout session designed specifically for kindergarten girls.

A typical day for Brooke begins at 4:15 a.m. She wakes up to join her marathon training group for a 7 to 10 mile morning run. Following her morning run, Brooke goes home to shower and get her kids ready for school. After dropping her daughters off at school, Brooke heads to Pure Barre to teach an early morning class. From there, she goes to the Blairwood Tennis, Swim & Fitness club to train with clients. During the afternoon, Brooke enjoys spending time with her daughters, working out and having fun. She typically spends the afternoon and evening preparing for the following day which includes plenty of time planning and doing research on a wide variety of health and fitness topics… and then it starts all over again when her alarm goes off at 4:15! Her life may sound a bit rigorous for some, but Brooke explains, “I am doing all of this because I truly love it. Working as a personal trainer brings me so much happiness. I want to be able to make a big difference in people’s lives…to really help my clients improve their fitness and health.”

Brooke’s dedication to an active lifestyle has already led her to accomplish 12 marathons. This year she’ll compete in the 2015 Boston Marathon for the 6^th consecutive year. Brooke and her husband were present for the Boston Bombing, fortunate to be safely away from the finish line but still very affected by the experience. Looking back, Brooke shares how this unimaginable day continues to impact her life, encouraging her to focus on what’s really important, and to put the small things into perspective. (more…)

Meet Louisville Fitness Expert and Certified Personal Trainer Cindy Geer

Posted February 18, 2015 by Orthopaedic Specialists

Growing up with a background in sports, coaching and maintaining a healthy lifestyle, perhaps it is not surprising that Cindy Geer’s career path is built around fitness training and mentoring. At 54 years old, Cindy Geer has always been an active woman. For years, she kept busy with the responsibilities of raising three children, teaching, and enjoying her own athletic pursuits. Now, Geer spends much of her time training young women of Louisville to become healthier, stronger individuals.

Along with offering private fitness training to Louisville-area residents, Geer runs a unique program called Train Like A Girl through The Training Studio at 1348 River Road. This fitness training program offers a fun and supportive environment for young women ages 12 to 18 with diverse athletic backgrounds. Geer’s main goal is to create fun and supportive environment while helping girls improve in areas of strength, power and core stability.

When Geer’s youngest started college, she began training for half marathons and working with a personal trainer of her own. Her trainer, Dale Benedict, whom she still works out with, was the first to approach her and encourage her journey into fitness training. Geer was skeptical at first because of the extra education involved, but as her own body transformed through fitness training, her passion for sharing her knowledge with others pushed her to earn numerous certifications. She is a Certified Personal Trainer through the American Council on Exercise and a certified TRX trainer.

With the help of The Training Studio, Geer has developed her Train Like A Girl program into a growing business. She began working with five field hockey players, focusing on strengthening the whole body as well as sports injury prevention. Now Geer works with 10 girls every session, featuring an interval style of training that includes cardio and strength. Geer says, “It started being geared towards athletic girls to help them in their sports, but now it is more about girls that want to get into shape and feel good about themselves.”

Many Train Like A Girl participants haven’t had an athletic upbringing, but that doesn’t make a difference. Geer sees her training style as something available for everyone and she works towards offering individual attention in each class. Her program is open to people at any level of athleticism. Although some might be more advanced, every girl has the ability to train and improve.

In addition to her career as a fitness trainer, Geer is currently working on a nutrition degree though Precision Nutrition. She encourages the girls that she works with to lead a healthy lifestyle outside of the training facility, by getting enough protein, eating plenty of fruits and vegetables, and drinking lots of water. Her program isn’t about weight loss or some number on the scale, but more about improving health, strength and fitness, while cultivating esteem and self-confidence. Geer explains: “You want to be fit and strong like a girl. I’m a girl. I’m strong and fit.”

Along with being a fitness trainer, Geer finds herself in the role of mentor as well. She likes to provide a comfortable place for girls to work out and have fun. She has a close relationship with every girl in her studio, and she has a great time seeing the improvements participants make over the course of the six week program. (more…)

Genetics and ACL Injuries in Women

Posted February 15, 2015 by Orthopaedic Specialists

ACL Injuries in Women – Do Genes Play a Role?

There has been a potential identification of the genes that may control the higher risk of the ACL injury in women compared to men. It is estimated that over 200,000 ACL injuries occur in United States every year.

There is a disproportionate number of non-contact injuries occurring in the female athlete compared to the male athlete. A non-contact ACL injury is the most common type of ACL tear mechanism.

Non-contact ACL injuries occur when an athlete tears their ACL without colliding or being tackled by another player. A common example of a non-contact ACL injury occurs when a basketball player is dribbling the ball down the court and stops and quickly changes direction. When the athlete stops and changes direction the knee gives way and the ACL tears.

Another example of a non-contact ACL tear is when a basketball player is jumping and lands. As the player lands, the knee gives way and the ACL tears. Some studies have reported a two to eightfold greater incidence of a non-contact ACL injury in the female athlete compared to male athletes playing the same sport. Why is this? What explains the higher rate of ACL injuries in women?

We do not know. There are many theories.

This is one of the hottest research areas in sports medicine. We know that an ACL injury can be devastating for any athlete. Return to the same level of pre-injury play following an acl injury is about 65% and the risk of early onset osteoarthritis involving the injured knee is 85%. We also know that the risk of re-tearing the ACL after surgery can be very high in the athlete who is under the age of 20 and returns back to a twisting, turning, jumping type sports such as soccer.

Researchers Look At Gene Expression To Understand ACL Injuries in Women

An excellent article published in the January 2015 American Journal of Bone Joint Surgery looked at comparing the gene expression in athletes with a non-contact ACL injury and comparing men and women.

The research team was led by Dr. Jeffrey Johnson from the University of Akron Ohio. The article title is: Gene Expression Differences Between Ruptured ACL’s in Young Males and Female Subjects .

The research team analyzed the DNA from ACLs that were resected at the time of surgery.

The different DNA patterns were separated via computer software. There were several statistical methods used to examine gender related differences. What the researchers found was very interesting. They found in the group of athletes that had a non-contact ACL injury, there was an up regulation (increased) in females compared to males of the gene ACAN (aggrecan) and FMOD (fibromodulin). They also found that WISP2 (WNT1 inducing signaling pathway protein 2) was down regulated (decreased).

Aggrecan is a proteoglycan molecule within the extracellular matrix of ligaments and many other musculoskeletal tissues. In other words, it is found in the makeup of ligaments. The ACL is the major stabilizing ligament in the knee joint. Aggrecan also plays a critical role in mediating chondrocyte and chondrocyte-matrix interactions: it helps to controls the basic cells that make up ligaments. It is also a major structural component of human cartilage and fibrocartilage. (more…)

Lower Back Pain

Posted February 9, 2015 by Orthopaedic Specialists

Does Your Lower Back Hurt? Learn Common Causes of Lower Back Pain and Lower Extremity Radiculopathy

Lower back pain can be caused by many different conditions including a herniated disc or sciatica. The Journal of the American Academy of Orthopaedic Surgeons recently published an excellent article on the common causes of lower back pain. This included lower back pain that radiates into the lower extremity. Dr. Bennett Douglas Grimm is the lead author of the Jan 2015 article. A summary of this very informative article is below.

Lower back pain that radiates into the leg is known as lumbar radiculopathy. The prevalence of true lumbar radiculopathy in the general population is approximately 3–5%. The two most common causes for these symptoms are a herniated disc or, less commonly, spinal stenosis.

A lumbar disc herniation most frequently occurs in patients younger than age 50. Symptoms of a herniated disc typically start with severe low back pain that will then radiate into the lower extremity. There may or may not be a traumatic or inciting event that causes the symptoms to start. Initially the low back pain occurs because a tear in the annulus surrounding the disc occurs.

The annulus is richly innervated by nerves which will cause severe pain when torn. After the annulus tears, disc material leaks out and compresses the nerve root going to the lower extremity causing leg pain. It is typically a two-step process. Some people hear or feel a pop at the time of injury which is the annulus tearing.

Once the nerve root is compressed, there may be symptoms of numbness, tingling and weakness involving the lower extremity. Symptoms usually worsen from sneezing or bending forward. Any action that increases intradiscal pressure will cause increased pain such as listed above.

The Physical Exam for Lower Back Pain

An important portion of the physical examination for low back pain is a positive nerve root tension test, also known as a straight leg raise test. This will be present 60% of the time in people who have disc herniation at L4-L5 and L5 and S1. A femoral stretch test may be positive for this condition at L2-3 and L3-4. There may be a decrease in reflexes at the patella tendon or Achilles’ tendon. The patellar tendon represents L4 and the Achilles tendon represents S1.

If there is bowel or bladder dysfunction, or saddle anesthesia is present, there is concern for cauda equina syndrome. This occurs with a very large disc herniation. This is a surgical emergency and requires urgent surgical decompression or permanent nerve damage can occur.

An MRI scan is the best imaging study for the above-mentioned diagnoses.

Spinal Stenosis and Lower Back Pain

Spinal stenosis is another common cause of low back pain and this typically occurs in patients older than 65. Spinal stenosis is caused from osteoarthritis involving the lumbar spine. Typically there is a history of chronic low back pain that radiates into the buttuck and legs.

With spinal stenosis, it is not as common to have only one leg affected, which is typically seen with the disc herniation. Only 20% of the people that present with spinal stenosis would have a positive straight leg raise test. People will complain of pain with ambulation. Their pain will typically stop when they bend forward or sit down. Plain X-rays and an MRI scan are used to help to diagnose this condition.

Additional Causes of Lower Back Pain

There are other causes of lower back pain that occur that have nothing to do with the anatomy of the back but can cause pain in that region of the body. This can be caused from other anatomical structures in the body that are near the low back such as the pelvis and the hip joint.

Conditions such as hip osteoarthritis, osteonecrosis, femoral acetabular impingement, femoral neck stress fractures, pelvic insufficiency fractures, trochanter bursitis of the hip, and sacroiliac joint pain can mimic low back pain. (more…)

A Bone Doctor Offers A Review of Bone

Posted January 30, 2015 by Orthopaedic Specialists

A Review of Bone from a Bone Doctor

What cells make up bone?

Bones are made up of the following types of cells: osteoclasts, osteoblasts and osteocytes

Where do osteoclasts, osteoblasts and osteocytes originate?

Osteoclasts, which are bone resorbing cells, come from the fusion of monocytes.
Osteoblasts, which are bone forming cells, come from bone marrow.
Osteocytes are the mature cells of bone that help to regulate the osteoclasts and osteoblasts.

Osteoclasts are found in something called resorption bays – these are indentations or pits along the surface of the bone. Certain hormones work to regulate osteoclasts. These include calcitonin which originates in the thyroid,and parathyroid hormone or PTH from the parathyroid gland.

Osteoblasts create a mineral from calcium and phosphate that forms into a durable, compact tissue. Osteoblasts are responsible for mineralizing most of the bone matrix. Active osteoblasts play an essential role in active bone formation. When bone synthesis is not actively occurring, osteoblasts are referred to as inactive.

Osteocytes make up greater than 95% of bone cells. They are encased in bone matrix. Bone matrix is a reservoir for many proteins including: collagen, osteocalcin, osteopontin, transforming growth factor and bone morphogenic protein.

Shaped like a star, osteocytes are generally located in mature bone. While the size of osteocytes varies, they are reported to have an average half life of about two and a half decades. (more…)