What Is A Stress Fracture?
Each day, the body makes new bone to replace the bone that is broken down by the stress of everyday living. Usually, this process is balanced, with the body replacing the equal amount of bone lost. However, this balance may become upset. The body, due to several factors, may not produce sufficient bone. As a result, micro cracks, called stress fractures, can occur in the bone.
Factors that my affect the building process are too little sleep, a diet with inadequate calcium, a rapid increase in activity. Sometimes stress fractures may result from minor trauma, like accidentally kicking one leg when running.
How Will I Know If I Have A Stress Fracture?
Stress fractures produce pain in a limited area directly over the point of the bone where the fracture has occurred. The pain is made worse by activity and is improved with rest.
On physical examination, there is pain when pressure is applied to the injured area. Hopping or jumping on a leg with a stress fracture will cause increased pain. Frequently, but not always, there is swelling around the injured area.
X-rays are not usually helpful in diagnosing an early stress fracture because the bones will look normal and the micro cracks are not visible. After several weeks of rest to allow the bone to repair itself, a healing reaction callus can be seen on an X-ray.
The diagnosis of an early stress fracture can usually be confirmed by a bone scan. In this procedure, a substance normally used by the bone for repair is injected into the patient's bloodstream. After 2 or 3 hours, the patient is placed under a scanner to detect the amount of substance distributed throughout the bones. All of the bones will absorb some of the substance, but if a bone is repairing a stress fracture, it will absorb more of it at the fracture site, and will appear darker than the other bones. An MRI may also be used to confirm the diagnosis.
How Is A Stress Fracture Treated?
A cast is usually not required for a stress fracture. Unlike a fracture caused by a blow to the body which injures the skin, muscle, and bone, a stress fracture involves only the bone.
If pain occurs while walking, crutches or a cane should be used to keep weight off the injured extremity. Returning to activity will be a gradual process. Swimming or biking, both non-weightbearing activities can be done to maintain cardiovascular and muscle conditioning in the early period after the stress fracture.
Gradually, impact activities like walking can be added. When the patient can walk rapidly without pain, running can be started. Jumping should only be done when running does not cause any pain. A gradual increase of stress to the bone is the key. Each increase in activity should be done slowly and for short amounts of time. After a while, the activities can be done at a higher intensity and a longer duration. Eventually the level of activity can be increase (see charts 1 and 2).
If, when advancing to the next level of intensity, pain occurs, the patient should return to the lower level for several days before trying again. The physician will guide the patient through these steps and can monitor the degree of fracture healing with X-rays.
It should be noted that while the normal amount of calcium required for bone repair is 1500 milligrams in postmenopausal women and 1000 milligrams for all other adults, increasing calcium intake above this level will not help the stress fracture heal more rapidly.
Msportsinfo
Tennis Elbow
What Is Tennis Elbow
Tennis elbow is localized pain over the bony prominence called the lateral epicondyle on the outside of the elbow. It may also be referred to as lateral epicondylitis.
What Causes It?
Tennis elbow is caused by repetitive stress on the muscles that are connected to the lateral epicondyle. These muscles extend along the top, or dorsal, side of the forearm to the wrist and are responsible for extending or bending back the wrist and fingers. If too much stress is placed on these muscles, micro tears can occur. These micro tears become inflamed and cause pain that is usually localized at the muscle's origin but can occasionally radiate down the forearm.The pain increases with activities that require contraction of these muscles: shaking hands, turning doorknobs, picking up objects with the palm down, or hitting a backhand in tennis.
How Do I Know If I Have Tennis Elbow?
No special tests are needed to make the diagnosis. This diagnosis is made by history and physical examination of the patient. The patient may present symptoms consistent with tennis elbow and has pain when pressure is applied to the outside of the elbow. The patient frequently cannot remember an injury, but will have noticed the pain either at the beginning or end of inactivity that requires wrist and elbow movement,
X-rays are not always required when evaluating a patient with tennis elbow symptoms, but a doctor may wish to order them, just to make certain that the bone structures of the elbow are normal.
How Is Tennis Elbow Treated?
Like many overuse injuries of sport, there is no sure fire treatment. Rest itself does not necessarily cure the problem, even though it may decrease the pain. With use of the elbow again, however, the pain returns. Some physicians believe that the key to healing this overuse injury lies in increasing the circulation to the area while decreasing the tightness of the muscles. Therefore, stretching and strengthening exercises are frequently helpful. The following exercise my help. Support the forearm on a flat surface with the wrist and hand free. Hold a 1-2 pound weight in the hand. Keeping the palm down, slowly extend the wrist. Bring it backward, or up, and then bend it forward, or down. The muscles on the top of the forearm should contract when the wrist is moved upward and stretch when the hand is moved downward.
To balance the forearm muscles, these exercises should be repeated with the palm facing up. Each exercise should be repeated ten times slowly. A loop of rubber tubing, with one end attached to a table leg or held on the floor with a foot can be used to provide resistance instead of the weight. This will also increase circulation to the area.
A snug but not tight strap worn around the top of the forearm often decreases the pull of the muscles on the lateral epicondyle and lessens pain. When symptoms are present during everyday activities, the band should be worn during all waking hours. Occasionally, an elbow sleeve with a pad specially designed to put gentle pressure on the forearm muscles can be used. This sleeve has the advantage of not only changing the pull of the muscles, but keeping them warm as well which increases their flexibility and circulation.
A physician may also prescribe ultrasound or electrical stimulation to increase circulation to the area. Nonsteroidal ant-inflammatory medications, like aspirin, ibuprofen, ketoprofen, or various prescription drugs, may decrease the irritation caused by the inflammation. However, if there is diminished circulation to the area, these oral medications may not provide enough dosage to alter the symptoms. Icing the joint after activity may also decrease the inflammation and relieve the pain.
Tips For Preventing Injury
• Warm up well before play. Muscles are like Silly Putty™ and stretch more when they are warm. Make sure to keep the muscles warm as you play
• Choose appropriate equipment and maintain it properly. A racquet handle that is too big or too small, strung too tightly or loosely, or has a too big or too small head, may increase stress to the elbow and wrist during play.
• Condition for the activity by stretching and strengthening all the muscles used in the sport. Also evaluate play techniques to make sure that they are not irritating the condition.
Tennis elbow is localized pain over the bony prominence called the lateral epicondyle on the outside of the elbow. It may also be referred to as lateral epicondylitis.
What Causes It?
Tennis elbow is caused by repetitive stress on the muscles that are connected to the lateral epicondyle. These muscles extend along the top, or dorsal, side of the forearm to the wrist and are responsible for extending or bending back the wrist and fingers. If too much stress is placed on these muscles, micro tears can occur. These micro tears become inflamed and cause pain that is usually localized at the muscle's origin but can occasionally radiate down the forearm.The pain increases with activities that require contraction of these muscles: shaking hands, turning doorknobs, picking up objects with the palm down, or hitting a backhand in tennis.
How Do I Know If I Have Tennis Elbow?
No special tests are needed to make the diagnosis. This diagnosis is made by history and physical examination of the patient. The patient may present symptoms consistent with tennis elbow and has pain when pressure is applied to the outside of the elbow. The patient frequently cannot remember an injury, but will have noticed the pain either at the beginning or end of inactivity that requires wrist and elbow movement,
X-rays are not always required when evaluating a patient with tennis elbow symptoms, but a doctor may wish to order them, just to make certain that the bone structures of the elbow are normal.
How Is Tennis Elbow Treated?
Like many overuse injuries of sport, there is no sure fire treatment. Rest itself does not necessarily cure the problem, even though it may decrease the pain. With use of the elbow again, however, the pain returns. Some physicians believe that the key to healing this overuse injury lies in increasing the circulation to the area while decreasing the tightness of the muscles. Therefore, stretching and strengthening exercises are frequently helpful. The following exercise my help. Support the forearm on a flat surface with the wrist and hand free. Hold a 1-2 pound weight in the hand. Keeping the palm down, slowly extend the wrist. Bring it backward, or up, and then bend it forward, or down. The muscles on the top of the forearm should contract when the wrist is moved upward and stretch when the hand is moved downward.
To balance the forearm muscles, these exercises should be repeated with the palm facing up. Each exercise should be repeated ten times slowly. A loop of rubber tubing, with one end attached to a table leg or held on the floor with a foot can be used to provide resistance instead of the weight. This will also increase circulation to the area.
A snug but not tight strap worn around the top of the forearm often decreases the pull of the muscles on the lateral epicondyle and lessens pain. When symptoms are present during everyday activities, the band should be worn during all waking hours. Occasionally, an elbow sleeve with a pad specially designed to put gentle pressure on the forearm muscles can be used. This sleeve has the advantage of not only changing the pull of the muscles, but keeping them warm as well which increases their flexibility and circulation.
A physician may also prescribe ultrasound or electrical stimulation to increase circulation to the area. Nonsteroidal ant-inflammatory medications, like aspirin, ibuprofen, ketoprofen, or various prescription drugs, may decrease the irritation caused by the inflammation. However, if there is diminished circulation to the area, these oral medications may not provide enough dosage to alter the symptoms. Icing the joint after activity may also decrease the inflammation and relieve the pain.
Tips For Preventing Injury
• Warm up well before play. Muscles are like Silly Putty™ and stretch more when they are warm. Make sure to keep the muscles warm as you play
• Choose appropriate equipment and maintain it properly. A racquet handle that is too big or too small, strung too tightly or loosely, or has a too big or too small head, may increase stress to the elbow and wrist during play.
• Condition for the activity by stretching and strengthening all the muscles used in the sport. Also evaluate play techniques to make sure that they are not irritating the condition.
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