Better Body Fitness

Working Around an Injury

Whether your injury is minor (muscle strain) or major (torn ligament) ranging from temporary strains to ACL, MCL, LCL, and PCL injuries, you're not doomed to weeks of riding the couch and watching television. The decision to continue exercising is up to you and your doctor and only requires a little planning and a lot of common sense.

When it comes to exercise and sports related injuries, your first step is always to see your doctor for diagnosis and treatment. Exercising with chronic pain is a recipe for disaster and may turn a temporary problem into a permanent one. Once you visit your doctor, talk to him or her about how to work around your injury.

Below are some ideas to put to your doctor so you won't lose all the strength gains you've worked so hard for.

1.     Don't do any activity involving your injured body part.

If you have a knee, shin or foot injury you may not be able to run or ride your bike, but there's no reason you can't continue exercising your upper body.

Your focus should be on modifying your workout so that you perform the exercises while seated or laying down so as not to put pressure on the injured joint or muscle. If you have an upper body injury, why not concentrate on lower body exercises? You can modify by doing exercises that don't involve holding weights in your hands or on your shoulders and simply stick with machines that don't involve your upper body.

2.     If it Hurts, Don't Do it

This seems simple but, if you're anything like me, you tend to exercise even when your body is telling you to stop. Even if you're following an exercise plan recommended by your doctor, if you feel any pain in the joints or anywhere else, stop. You may be able to move on to a different exercise that doesn't hurt, or you may have to stop altogether. Either way, learning to listen to your body is vital to staying injury and pain free.

3.     Follow Your Doctor's Advice

If you're determined to exercise, ask your doctor for a list of activities you can do to stay active without injuring yourself further. He or she may be able to recommend a physical therapist or trainer to help you determine what exercises you can do to both heal your injury and strengthen the rest of your body.

4.     Prevention of injury

Obviously, prevention is the best choice when it comes to injuries. Once you experience the pain of an injury, you might want to educate yourself on ways to avoid them in the future. One simple way is to maintain core flexibility and balance. Tight muscles can cause imbalances in your body that could lead to injuries. For example, if your quadriceps (front of the leg) are stronger than your hamstrings (back of the leg), you risk a strain or even a rupture of your hamstrings. Another way to prevent injuries is to avoid overtraining.

When your muscles are tired, they "do a poor job of protecting their associated connective tissues, increasing the risk of damage to bone, cartilage, tendons and ligaments." To fortify yourself even more against injuries, make sure you incorporate regular weight training into your weekly routine. Strengthening ALL of your muscle groups will reduce any muscle imbalances that may cause other muscles of your body to overcompensate for that weakness.

Here are a few tips for recognizing simple injuries:

• First, joint pain, particularly in the joints of the knee, ankle, elbow and wrist, should never be ignored. This type of pain typically originates from the joint rather than the muscle and may be a sign of something serious. Another warning sign is tenderness at a specific point in the body.
• If you can elicit pain at a specific point in a bone, muscle or joint, by pressing your finger into it, you may have a significant injury.
• Another symptom never to ignore is swelling.

Swelling is always a sign of some type of injury. You can also experience swelling within the joint, which may be harder to see. If you do have swelling in the joint, your range of motion will be reduced and your joint may feel tight.

It is recommended that we compare both sides of the body. If one side acts differently than the other, you may have joint swelling. Finally, never ignore numbness or tingling in your body. This may be a sign of nerve compression, which might be a prelude to a serious injury.

If you experience any of these symptoms your first step is to stop what you're doing and call your doctor. Never work through the pain! Dealing with an injury right away may mean a little recovery time, but that's better than having a permanent condition. While waiting to get in to see your doctor, you can also start a little treatment on your own. The usual treatment involves R.I.C.E. (Rest, Ice, Compression, and Elevation).

All this means is that you should stop what you're doing and use a bandage to compress the injured area (which can help reduce swelling). Then put an ice pack on the affected area for about 15 or 20 minutes at a time, making sure to give the injured area plenty of time to warm up between icing sessions. Then, elevate the area.

Always consult your Doctor when questioning pain, injury or any “nagging” experience with possible injury. This and any article in our website on injury, disease or dysfunction is intended to inform - not to diagnose, treat or advise.

Shin Splints

"Shin splint" is a term used to describe pain in the lower leg that occurs during exercise. This condition has many causes and can affect athletes at all fitness levels.

One common cause of shin splints is posterior tibial syndrome (PTS). The pain associated with PTS occurs on the medial (inside) border of the tibia (shin bone). The pain present when you start exercising becomes less severe as you warm up but becomes worse than ever after you stop exercising. Posterior tibial syndrome often occurs in beginning runners, who are unaccustomed to the activity and running surface, but can occur in seasoned athletes when they change running surfaces, exercise in different shoes, or increase their intensity or duration of exercise.

The exact cause of PTS is unknown. Some experts believe that it is caused by posterior compartment syndrome, which means there is increased pressure within the thick sleeve of tissue containing the deep muscles of the leg. Others believe that PTS is caused by periostitis, which means the periosteum (bone covering) of the tibia is inflamed where the muscles attach to it.

To diagnose the cause of your shin splints, your doctor may measure compartment pressure in your aching leg before and after you exercise to see if pressure in the posterior muscle compartment increases with exercise. This type of pressure increase can also occur in the muscles in the front of the leg (anterior compartment), causing pain on the lateral (outside) side of the lower leg.

Stress fractures

This condition most commonly mistaken for PTS is a stress fracture. A stress fracture of the tibia is a crack that develops in the shin bone over time from repetitive stress on the bone. Normally, your muscles absorb the shock put on your legs during activity. Continuously "pounding" your legs during an activity, such as distance running, soccer, or basketball can cause your muscles to tire and lose much of their ability to absorb shock. When your muscles do not absorb shock well, stress on the bone increases. The bone cannot endure the increased stress so it begins to crack. To help detect a stress fracture, your doctor may take x-rays or a bone scan. However, these fractures can be quite difficult to diagnose because they may not show up on x-rays when they first develop.

How are shin splints treated?

The treatment for shin splints must be tailored for each person according to whether the cause is PTS or a stress fracture and considering the persons exercise habits. The most important form of treatment for PTS is rehabilitative exercises. Stretching before and after running, particularly the calf muscles, and strengthening your leg muscles through progressive resistance exercise usually help relieve the symptoms of PTS.

In addition to rehabilitative exercises, your doctor and physical therapist may recommend some combination of changes in footwear, exercise intensity and duration, and running surface. Also, taking anti-inflammatory medications, such as aspirin or ibuprofen, and applying ice to the tender area immediately after exercise can help relieve symptoms. Your doctor may recommend you use orthotics (shoe inserts) to help support your foot and relieve stress in your leg. A person with compartment syndrome occasionally needs surgery to relieve the pressure in the muscle compartment.

Stress fractures will heal in several weeks with rest, although you may need to wear a cast or brace. Your doctor may suggest swimming or riding a bicycle during this time to maintain cardiovascular activity while allowing the bone to heal. Patience is important because returning to exercise, such as running, too soon can send you back to square one.

Don't let shin splints spoil the fun of exercising. If you have shin splints, ask your doctor to recommend a treatment program for you.

What Are the Structures of the Shoulder and How Does the Shoulder Function?

The shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone).

Two joints facilitate shoulder movement. The acromioclavicular (AC) joint is located between the acromion (part of the scapula that forms the highest point of the shoulder) and the clavicle.

The glenohumeral joint, commonly called the shoulder joint, is a ball-and-socket type joint that helps move the shoulder forward and backward and allows the arm to rotate in a circular fashion or hinge out and up away from the body. (The ball is the top, rounded portion of the upper arm bone or humerus; the socket,” or glenoid, is a dish-shaped part of the outer edge of the scapula into which the ball fits.) The capsule is a soft tissue envelope that encircles the glenohumeral joint. It is lined by a thin, smooth synovial membrane.

To better understand shoulder problems and injuries, you may want to review the anatomy and function of the shoulders. The shoulder is a ball-and-socket joint with three main bones: the upper arm bone (humerus), collarbone (clavicle), and shoulder blade (scapula). These bones are held together by muscles, tendons, and ligaments. The shoulder joint has the greatest range of motion of any joint in the body. Because of this mobility, the shoulder is at risk for injury and problems. The acromioclavicular (AC) joint, which lays over the top of the shoulder, is also at risk for injury.

Shoulder problems can be minor or serious and may include symptoms such as pain, swelling, numbness, tingling, weakness, or changes in temperature or color. Shoulder injuries most commonly occur during sports activities, work-related tasks, projects around the home, or falls. Home treatment often can help relieve minor aches and pains.

Knee Injuries

According to the American Academy of Orthopedic Surgeons, more than 4.1 million people seek medical care each year for a knee problem. Some knee problems result from wear of parts of the knee, such as occurs in osteoarthritis. Other problems result from injury, such as a blow to the knee or sudden movements that strain the knee beyond its normal range of movement.

How Can People Prevent Knee Problems?

Some knee problems, such as those resulting from an accident, cannot be foreseen or prevented. However, a person can prevent many knee problems by following these suggestions:

• First warm up by walking or riding a stationary bicycle, then do stretches before exercising or participating in sports. Stretching the muscles in the front of the thigh (quadriceps) and back of the thigh (hamstrings) reduces tension on the tendons and relieves pressure on the knee during activity.
• Strengthen the leg muscles by doing specific exercises (for example, by walking up stairs or hills, or by riding a stationary bicycle). A supervised workout with weights is another pathway to strengthening leg muscles that benefit the knee.
• Avoid sudden changes in the intensity of exercise. Increase the force or duration of activity gradually.
• Wear shoes that both fit properly and are in good condition to help maintain balance and leg alignment when walking or running. Knee problems may be caused by flat feet or over-pronated feet (feet that roll inward). People can often reduce some these problems by wearing special shoe inserts (orthotics). Maintain appropriate weight to reduce stress on the knee. Obesity increases the risk of degenerative (wearing) conditions such as osteoarthritis of the knee.

Lower Back Pain

It should be remembered that it is not uncommon for doctors to be unable to make a precise diagnosis of the cause of low back pain. Common causes of low back pain include lumbar strain, nerve irritation, lumbar radiculopathy, bony encroachment, and conditions of the bone and joints. Below is an overview of a few of the potential causes:

Lumbar Strain (Acute, Chronic):

A lumbar strain is a stretching injury to the ligaments, tendons, and/or muscles of the low back. The stretching incident results in microscopic tears of varying degrees in these tissues. Lumbar strain is considered one of the most common causes of low back pain. The injury can occur because of overuse, improper use, or trauma. Soft tissue injury is commonly classified as "acute" if it has been present for days to weeks. If the strain lasts longer than 3 months, it is referred to as "chronic."

Lumbar strain most often occurs in persons in their forties, but can happen at any age. The condition is characterized by localized discomfort in the low back area with onset after an event that mechanically stressed the lumbar tissues. The severity of the injury ranges from mild to severe, depending on the degree of strain and resulting spasm of the muscles of the low back.

The diagnosis of lumbar strain is based on the history of injury, the location of the pain, and exclusion of nervous system injury. Usually, x-ray testing is only helpful to exclude bone abnormalities.

The treatment of lumbar strain consists of resting the back (to avoid re-injury), medications to relieve pain and muscle spasm, local heat applications, massage, and eventual (after the acute episode resolves) reconditioning exercises to strengthen the low back and abdominal muscles. Long periods of inactivity in bed are no longer promoted as this treatment may actually slow recovery. Spinal manipulation for periods of up to 1 month has been found helpful in some patients that do not have signs of nerve irritation. Future injury is avoided by using back protection techniques during activities and support devices as needed at home or work.

Nerve Irritation:

The nerves of the lumbar spine can be irritated by mechanical impingement or disease any where along their paths--from their roots at the spinal cord to the skin surface. These conditions include lumbar disc disease (radiculopathy), bony encroachment, and inflammation of the nerves caused by a viral infection (shingles).

Injury to The Bones and Joints

Fractures (breakage of bone) of the lumbar spine and sacrum bone most commonly affect elderly persons with osteoporosis, especially those who have taken long-term cortisone medication. For these individuals, occasionally even minimal stresses on the spine (such as bending to tie shoes) can lead to bone fracture. In this setting, the vertebra can collapse (vertebral compression fracture). The fracture causes an immediate onset of severe localized pain that can radiate around the waist in a band-like fashion and is made intensely worse with body motions. This pain generally does not radiate down the lower extremities.

Vertebral fractures in younger patients occur only after severe trauma, such as from motor vehicle accidents. In both younger and older patients, vertebral fractures take weeks to heal with rest and pain relievers. Fractures associated with osteoporosis can also be treated with hormone therapy to stimulate the formation of new bone.