Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Previously, two different treatment management
strategies were used: total rest or a "run through it" approach. The total rest was
often an unacceptable option to the athlete. The run through it
approach was even worse. It often led to worsening of the injury and
of the symptoms.
Currently, a multifaceted approach of "relative rest" is
successfully utilized to restore the athlete to a pain-free level of
competition.
What is the multifaceted "relative rest" approach?
The following steps are part of the multifaceted approach:
Workouts such as stationary bicycling or pool running:
These will allow maintenance of cardiovascular fitness.
Application of ice packs reduces inflammation.
Anti-inflammatory medications, such as ibuprofen
(Advil/Motrin); naproxen (Aleve/Naprosyn), are also a central part of rehabilitation.
A 4-inch wide Ace bandage wrapped around the region also
helps
reduce discomfort.
Calf and anterior (front
of) leg stretching and strengthening address the biomechanical
problems
discussed above and reduce pain.
Pay careful attention to selecting the correct running shoe based
upon the foot type (flexible pronator vs. rigid supinator).
This is
extremely important. In selected cases, shoe inserts (orthotics) may
be necessary.
Stretching and strengthening exercises are done twice a day.
Run only when symptoms have generally resolved (often about
two
weeks) and with several restrictions:
A level and soft terrain is best.
Distance is limited to 50% of that tolerated
preinjury.
Intensity (pace) is similarly cut by one half.
Over a three- to six-week period, a gradual increase in
distance is allowed.
Only then can a gradual increase in pace be
attempted.
Caveat!
The extent of injury that occurs prior to any
rehabilitation program plays a significant role in determining the
time frame necessary for complete recovery.
Shin splints are a type of "overuse injury" to the
legs.
The pain is characteristic and located on the outer
edge of the mid region of the leg next to the shinbone (tibia). It can be
extreme and halt workouts.
The diagnosis requires a careful focused examination.
A multifaceted approach of "relative rest" can restore
a pain-free level of activity and a return to competition.
The "relative rest" approach includes a change in the workout, ice, rest, anti-inflammation medications, stretching exercises, possible change in footwear, and gradual increase in running activities.
Additional resources from WebMD Boots UK on
Shin Splints
REFERENCES:
Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.
Ruddy, Shaun, et al., eds. Kelley's Textbook of Rheumatology, 6th ed. Philadelphia: Saunders, 2001.
Shin Splints - Length Symptoms LastedQuestion: How long did the symptoms of your shin splints last? Was there anything in particular that helped with pain/symptom relief?
Muscle cramps are involuntarily and forcibly contracted muscles that do not relax. Extremely common, any muscles that have voluntary control, including some organs, are subject to cramp. Since there is such variety in the types of muscle cramps that can occur, many causes and preventative medications are known. Stretching is the most common way to stop or prevent most muscle cramps.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
There are several bones in the foot, and these bones can be broken (fractured) in a variety of ways. Falling from heights, dropping heavy objects on the foot, or stress fractures from running or walking. Treatment of a broken foot depends on what bone in the foot is broken.
Compartment syndrome is a condition in which swelling and an increase in pressure within a limited space presses and compresses blood vessels, nerves, or tendons that run through the compartment. There are two types of compartment syndrome, acute compartment syndrome is treated with surgery (fasciotomy) and chronic compartment syndrome, which is treated with rest and modality to the affected limb. Symptoms of compartment syndrome include pain, change in sensation, change in color, paralysis, or numbness in the affected limb.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
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