Muscle Cramps
A muscle cramp — the sudden involuntary contraction of one or more muscle groups — usually results in intense pain. The exact cause of muscle cramps is unknown. However, overuse, heat, dehydration, and salt and mineral depletion are considered triggers. In general, overuse, injury, and exercise in hot weather often lead to cramps. Occasionally, muscle cramps can signal other serious medical conditions, such as narrowing of the arteries to the legs (atherosclerosis), nerve compression because of lumbar spine narrowing (spinal stenosis), or potassium depletion.
Just about everyone experiences muscle cramps in their lifetime. They often occur when you’re exercising, although they can happen while you’re sitting or sleeping. They are very common in endurance athletes and other people who perform strenuous activities. Athletes most often experience muscle cramps in the preseason of their sport, when their bodies are not yet conditioned. The most commonly affected muscles are the lower leg (calf) and the thigh (hamstring and quadriceps).
Muscle cramps usually go away on their own and don’t require medical treatment. There are a few things you can do to help relieve the pain and even prevent the cramps. The most important home-care management technique is to stay hydrated with salt-replenishing fluids. Other methods you can use to get rid of your cramps include:
- Gentle stretching and massaging of the cramping muscle
- Holding the muscle in a stretched position until the cramp stops
- Applying heat to tense or tight muscles or cold to sore or tender muscles
Regular flexibility exercises can also help you prevent cramps from starting. Flexibility exercises are best done before and after you work out to stretch muscle groups that are prone to cramping.
Please see our sports medicine doctor if your muscle cramps are severe, occur often, respond poorly to treatment, or have no obvious cause. Our doctor may choose to evaluate for possible problems with circulation, nerves, medications, or nutrition.
Shoulder Injuries
AC Joint Sprain
This is where the clavicle (collar bone) meets the acromion process of the scapular. It is a bony bit on the top of the shoulder. This joint can be injured by falling onto the shoulder, elbow or an outstretched arm.
Dislocated Shoulder
This is one of the most common traumatic sporting injuries and occurs frequently in contact sports such as rugby or judo. Shoulder dislocations can be either anterior or posterior dislocations.
Fracture of the Clavicle
Fracture of Shoulder injury involving a fracture of the collar bone or clavicle. This bone is usually fractured as a result of falling badly onto an outstretched arm or onto the shoulder.
Glenoid Labrum Injury
Shoulder pain resulting from damage to the lining of the cavity the end of the upper arm bone sits in.
Inflammation of Muscle Attachments to the Clavicle
Pain along the front of the collar bone.
Impingement Syndrome
Impingement syndrome is when the rotator cuff tendons become trapped in the shoulder joint. Repeated impingement can lead to inflammation and thickening, which in turn will result in more impingement and trapping of the inflammed tendons.
Inflammation of the Supraspinatus Tendon
The supraspinatus muscle runs along the top of the shoulder blade and inserts via the tendon at the top of the arm (humerus bone). This muscle is used to lift the arm up sideways and is also important in throwing sports.
Inflammation of the Subscapularis Tendon
The subscapularis muscle originates from the underside of the shoulder blade and inserts at the front of the upper arm (humerus). It is mainly throwers that injure this muscle. A partial rupture of the muscle is more common than a complete rupture but the partial rupture will often heal with inflammation.
Pectoralis Major Muscle / Tendon Strain
The pectoralis major muscle is a large powerful muscle at the front of the chest. It used to rotate the arm inwards, pull a horizontal arm across the body, pull the arm from above the head down and pull the arm from the side upwards. It is most likely to rupture at the point where it inserts into the arm (humerus).
Pectoralis Major Tendon Inflammation
The tendon where it inserts into the arm (humerus) can become inflammed. It is common in racket players, rowers, swimmers, throwers and weight trainers.
Rotator Cuff Injuries / Rotator Cuff Strain
The rotator cuff muscles control rotation of the shoulder.These muscles are put under a great deal of strain especially in throwing events and racket sports where your arm is above your head a lot.
Rupture of the Supraspinatus Tendon
The supraspinatus muscle runs along the top of the shoulder blade and inserts at the top of the arm (humerus bone). This muscle is used to lift the arm up sideways and is also important in throwing sports as it is the muscle that holds the arm in the shoulder joint when you release what you are throwing.
Rupture of the Long Head of the Biceps
The biceps muscle splits into two tendons at the shoulder. A long one and a short one. The long tendon runs over the top of the humerus bone (upper arm) and attaches to the top of the shoulder blade. A rupture of this tendon is rare in young athletes but more common in older ones.
Subacromial Bursitis
Over the supraspinatus tendon is a bursa (small sack of fluid used to help lubricate the moving tendon). This bursa can become trapped in the shoulder causing pain and inflammation. The athlete is more prone to this injury if they overuse the shoulder particularly if the arm is at or above shoulder level. Or if the athlete has had a rupture of the supraspinatus tendon.
Deltoid Muscle Strain (front)
The deltoid muscle is the big muscle on the shoulder. It has three parts – the front (anterior), middle and back (posterior). The muscle lifts the arm up sideways. The front part helps to lift the arm up forwards (flexion) and the back part helps to lift the arm up backwards (extension).
Deltoid muscle Strain (back)
The deltoid muscle is the big muscle on the shoulder. It has three parts – the front (anterior), middle and back (posterior). The muscle lifts the arm up sideways. The front part helps to lift the arm up forwards (flexion) and the back part helps to lift the arm up backwards (extension).
Dislocation of the Sterno-Clavicular Joint
The clavicle (or collar bone) connects to the sternum (or breast bone) in the middle of the chest at the top. If the shoulder is subjected to a hard impact this joint can become damaged.
Fracture of the Neck of the Humerus
A fracture to the neck of the humerus is often caused by falling onto an outstretched hand or direct impact to the shoulder. It is seen more often in young adults, adolescents and the elderly.
Frozen Shoulder / Adhesive Capsulitis
A frozen shoulder (known also as adhesive capsulitis) is a condition that occasionally occurs in older athletes. It is this joint and the surrounding capsule that becomes inflammed and eventual there is a significant loss in mobility.
Inflammation of the Long Head of the Biceps
Inflammation of this tendon is a fairly common complaint especially with swimmers, rowers, throwers, golfers and weight lifters.
Winged Scapula
A winged scapula is a shoulder injury or condition in which the scapula or shoulder blade sticks out at the back, particular when pushing against something such as a wall.
Suprascapular Neuropathy
Aching or burning diffuse pain which may radiate through the arm.
|
No. |
Condition |
Common Signs & Symptoms |
|||||
|
Pain |
Swelling |
Stiffness |
Weakness |
Instability |
Locking |
||
|
1 |
AC Joint Sprain |
x |
|
x |
x |
x |
|
|
2 |
Dislocated Shoulder |
x |
x |
x |
x |
x |
|
|
3 |
Broken Collar Bone/Clavicle |
x |
|
x |
x |
x |
x |
|
4 |
Shoulder Bursitis (Shoulder Impingement Syndrome) |
x |
|
|
|
|
|
|
5 |
Rotator Cuff Injury (Shoulder Tendonitis) |
x |
|
|
x |
|
|
|
6 |
Frozen Shoulder |
x |
|
x |
x |
|
x |
Many patients ignore temporary minimal shoulder symptoms with few bad effects. In the case of an acute injury, if the pain is intense, you should seek medical care as soon as possible. If the pain is less severe, it may be safe to wait a few days to see if time will alleviate the problem. If symptoms persist, a Sports Doctor will provide timely diagnosis and treatment. Sports Doctors are specifically trained in the workings of the musculoskeletal system, including the diagnosis, treatment and prevention of problems involving muscles, bones, joints, ligaments and tendons.
Treatment for Shoulder Injuries
Treatment generally involves altering activities, rest and physical therapy to help you improve shoulder strength and flexibility. Medication may be prescribed to reduce inflammation and reduce pain. Injection of drugs may also be used to treat the pain.
Surgery may be required to resolve some shoulder problems such as recurring dislocation and some rotator cuff tears.
Elbow Injuries
Tennis Elbow
Tennis elbow or lateral epicondylitis is an extremely common injury that originally got its name because it is a frequent tennis injury, appearing in a large proportion of tennis players. Nevertheless it commonly manifests in a vast proportion of people who do not play tennis at all.
Golfers Elbow
Golfer elbow is a similar injury to tennis elbow only it affects the inside of the elbow instead. Golfer elbow is more common in throwers and golfers hence the ‘nicknames’. Also known as flexor / pronator tendinopathy this elbow pain is seen in tennis players who use a lot of top spin on their forehand shots.
Inflammation and Rupture of the Triceps Tendon
The triceps tendon is the one at the back of the upper arm – as shown opposite. It inserts into the back of the elbow. If you fall onto your hands you can rupture this tendon. If you over-do the weights or try to push something too heavy you can also rupture the tendon or it could become inflamed through over use.
Bursitis / Students Elbow
The elbow pain originates from below the tip of the elbow where there is a sack of fluid called a bursa. A bursa is used to help lubricate the movement of tissues in joints. However if you take a hard impact onto the back of the elbow or are constantly leaning on the elbows the bursa can become inflamed or bleeding can occur in the bursa. The result is elbow pain and swelling on the bony bit at the back of the elbow.
You would need to see the doctor if you notice the following symptoms.
- Inability to carry objects or use your arm
- Elbow pain that occurs at night or while resting
- Elbow pain that persists beyond a few days
- Inability to straighten or flex your arm
- Swelling or significant bruising around the joint or arm
- Any other unusual symptoms
Treatment for Elbow Injuries
Treatment generally involves lifestyle modification, simple exercises to control the symptoms, and changing strokes mechanics. Medication may be prescribed to reduce inflammation and control pain. Injection of cortisone may also be used to treat the pain.
Elbow Brace and Exercises
An elbow orthosis, called an elbow clasp, can be worn. The theory behind using an elbow clasp is that the brace will redirect the pull of misaligned muscles. Patients often find relief of pain when using the clasp during activities.
Surgery
There are several possible surgical treatments that have been successful. These include removing a portion of the damaged tendon or releasing the attachment of the affected tendon. A repair of the healthy portion of tendon is sometimes carried out as well. In addition, arthroscopic elbow surgery has become an option for some patients with tennis elbow.
Knee Injuries
Knee injuries can result from running or exerting too much or too hard, without proper warm up. It can also result from twisting injury or improper landing, as well as from the impact of the knee against another object.
Injury to the knee joint can range from mild to severe.
Mild injuries include:
- Chondromalacia patellae
- Iliotibial band syndrome
- Patellar tendinitis
More severe injuries include:
Injuries to the ligaments surrounding the knee including the anterior and posterior cruciate ligaments, and the medial and lateral collateral ligaments.
Anterior Cruciate Ligament (ACL) Tear
Ligaments are tough, nonstretchable fibers that hold your bones together. A tear to the anterior cruciate ligament (ACL) of your knee joint is among the most common sport-related injuries. The ACL connects the thighbone (the femur) to the shinbone (the tibia) and acts to prevent your thighbone from moving too far forward over the knee joint. This ligament also helps stabilize the shinbone from rotating out of the knee joint.
The ACL can tear when it’s stretched beyond its normal range. This typically happens by sudden twisting movements, slowing down from running, or landing from a jump. You may hear a popping sound at the time of injury. Your knee may give way and begin to swell and hurt.
Because the ACL is not capable of healing itself (ligaments, unlike muscles, do not have their own blood supply), it can only be reconstructed (that is, replaced) surgically — it cannot simply be repaired. Less active people may choose to treat a torn ligament non surgically with a rehabilitation program focusing on muscle strengthening and lifestyle changes. Surgical reconstruction, however, may help many people recover full function after an ACL tear. Your doctor can discuss these different options with you and help choose what is right for you.
After ACL reconstruction, performing rehabilitative exercises may gradually return full flexibility and stability to your knee. Building strength in your thigh and calf muscles to support the reconstructed knee is a primary goal of rehabilitation. You may also need to use a knee brace for a short time, and it is important not to return to full activity too soon to prevent re-injury.
Meniscal Tear
A meniscal tear is a common injury of the knee. The meniscus is a wedge-like, shock-absorbing piece of cartilage found within your knee joint. It is shaped like a C and curves inside and outside the joint to stabilize your knee. It also allows your thigh (the femur) and your shin (the tibia) bones to glide and twist over each other with movement, as well as provide cushioning support for the weight-bearing job of your legs.
Injury to the meniscus often happens during sport activity, when a sudden twisting of the knee, pivoting, or deceleration causes a tear in your cartilage. A meniscal tear can also occur simultaneously with injury to other ligaments of the knee (in particular, the anterior cruciate ligament which helps to connect the upper and lower leg bones).
You may hear a popping sound at the time of injury to the meniscus, and you may still be able to bear weight and walk on the injured knee. Pain, swelling, and redness of the joint then develop over the next 12 to 24 hours. In some cases, a piece of cartilage can interfere with knee movement, and you may notice that your knee will “lock” or “pop” with attempted movement. Your doctor may choose to evaluate a possible tear with an MRI scan, a form of imaging that uses a large magnet to view changes in tissue.
Initial treatment of a meniscal tear follows basic home care management — “RICE,” which stands for Rest, Ice, Compression, and Elevation. Nonsteroidal anti-inflammatory medications (NSAIDs) are helpful to relieve pain and inflammation. This may be all that is needed for minor tears that have occurred in the outer edges of the meniscus.
Surgery may be recommended for tears that are central, cause locking or instability of your knee, or for injuries that don’t heal on their own. Surgery may involve using a small, pen-sized camera (called an arthroscope) to trim torn flaps in the cartilage and repair any other damaged ligaments. Often, a brace or cast is needed after surgery, and physical therapy is an important part of recovery to relieve pain and strengthen and stabilize the muscles around your knee.
If you suspect that you have signs or symptoms of a meniscal tear, please see call us for further evaluation and treatment option at 64796822. We are committed to care for you, your family and friends.
Shinsplints
The term “shinsplints” refers to the pain that develops along the inside of your shin (the tibia bone). Also known as medial tibial stress syndrome (MTSS), it commonly affects runners, aerobic dancers, and people in military boot camp because it is an exercise-related overuse injury. In such injuries, your repeated movements during exercise cause muscle fatigue. This fatigue leads to additional forces applied to the tissue (called the fascia) that attaches muscles to the bone. The muscles that attach to the tibia, which include the soleus muscle (ankle flexor) and the flexor digitorum longus (toe flexors), are what actually hurt during MTSS (injury to the bone itself does not cause pain).
Early in the condition, pain is experienced at the beginning of a training session and disappears as the exercising continues. As your injury progresses, the episodes of pain lengthen.
With repeated stress-related injuries, the bone itself can be affected and may eventually develop multiple microfractures — what is referred to as a stress fracture. The pain associated with a stress fracture will be sharp and focused on a very small area of your bone. Stress fractures are more serious and typically require you to restrict your activities to ensure proper healing.
Treatment of MTSS involves rest and often requires you to completely stop training for a period of time. It’s important to follow your doctor’s guidance and begin with lengthened rest time scheduled between training sessions. Your doctor may recommend that you take anti-inflammatory medications or use cold packs and mild compression to relieve the pain. For severe conditions that do not respond to the usual treatment, surgery may be an option. However, a full return to sports is not always achieved following surgery.
You may be more likely to develop MTSS if you:
- Have flatfeet or abnormally rigid arches
- Have “knock-knees” or “bowlegs”
- Are a frequent runner
- Are an aerobic dancer
If you suspect that you have signs or symptoms of MTSS, the pain is prolonged, or if there is no improvement with rest, see our doctor for further evaluation and treatment.
Stress Fracture
Stress fractures are tiny cracks in a bone caused by the overuse and the repetition of movements during exercise. When your muscles are fatigued, they become unable to absorb additional shock during exercise and transfer the overload of stress to the bone. This constant process causes tiny “microcracks” in the bone.
Stress fractures are most common in the weight-bearing bones of your lower legs. They result from increasing the amount and intensity of activity or from an impact on unfamiliar surfaces. For example, a tennis player who changes from a soft to hard court may experience a stress fracture. Athletes participating in tennis, basketball, track and field, and gymnastics are most susceptible to stress fractures, especially if they are not resting enough between training sessions.
Studies have shown that women are more at risk for stress fractures than are men. This appears to be related to nutritional deficiencies and a woman’s propensity for decreased bone mass density.
The most common signs and symptoms include swelling and pain that decrease with rest, and increase with activity. Also, there may be a spot that feels tender or painful when pressure is applied. A stress fracture is sometimes mistaken for a shinsplint (an inflammation of the tibia or shinbone that commonly affects runners). However, stress fractures are more serious.
The most important factor in managing your pain and healing the fracture is rest, which may be needed for 4 to 12 weeks. You may also have to modify other daily activities during these weeks. The next step, rehabilitation, includes a program of muscle strengthening and generalized conditioning. If pain persists, careful use of nonsteroidal anti-inflammatory medications (NSAIDs) may be helpful. However, these medications may limit bone repair and are therefore should be used cautiously. In most cases, stress fractures can be managed with these conservative measures. However, more severe fractures may require surgery to fix and prevent further injury to the bone, as well as to ensure proper healing. Recovery from this kind of surgery is approximately six months.
You may be at risk for a stress fracture if you:
- Participate in high-impact sports
- Have been told you have low bone density
- Suddenly begin an intense training schedule
- You are an adolescent (bones are not fully mature)
