Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
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.
Sprains and strains occur when the body is put under physical stress. In these situations, muscles and joints are forced to perform movements for which they are not prepared or designed. An injury can occur from a single stressful incident, or it may gradually arise after many repetitions of a motion. Usually, the mechanism of injury involves placing the muscle tendon unit or the ligament under excessive stretching, causing damage to the muscle, tendon, or ligament fibers.
Where do sprains and strains usually occur?
The ankle is one of the most common joints that is sprained. Usually, the mechanism of injury is rapidly "rolling" or "twisting" the ankle and turning it inward so that the sole of the foot starts to point upward. This causes stretching and damage to the ligaments on the outside part of the ankle that hold the joint stable.
Knee sprains are common football injuries and often make headlines because of their potential for ending professional athletes' playing career. There are four ligaments of the knee that allow it to act as a hinge joint, flexing (bending) or extending (straightening). The medial and lateral collateral ligaments and the anterior and posterior cruciate ligaments keep the knee in alignment and are assisted by the quadriceps and hamstring muscles. As an example of characterization of an injury, when a player completely tears the anterior cruciate ligament (ACL) in the knee, it is described as a grade 3 injury of that cruciate ligament.
Neck injuries are common, for example, after a car accident. While whiplash is a non-medical term, it accurately described the head and neck movement when violently flexed forward and backward as the car abruptly stops while the rest of the body is held in place with a
seat belt and/or air bag. Both muscles and ligaments hold the neck bones (cervical vertebrae) in place and the stresses placed on both can cause pain and damage. Sometimes, the vertebrae are not damaged but the ligaments that support and stabilize the bones are torn, causing significant pain and swelling. On occasion, these injuries can cause the neck to become unstable and put the spinal cord at risk for injury.
Wrist injuries are common because we use our hands to perform many tasks. Usually, the wrist is damaged because of a fall, but repetitive tasks and a single aggressive move can cause pain. Some sports are more prone to wrist injuries because of the forces that are asked to be placed on the joint. These include throwing sports like baseball and football, bowling, skateboarding, snowboarding, and tennis.
The thumb and fingers can also be injured. Skier's or gamekeeper's thumb describes a sprain at the base of the thumb where a ligament attached to hold the thumb stable when grasping. It is most often injured in a fall where the thumb is forced away from the palm of the hand, like when a skier falls and the ski pole pushes the thumb in an awkward direction.
Muscles strains may involve any body area that is required to perform work. Lower back pain and spasm is a common result of repetitive lifting injuries, but it only takes one twist or turn at the wrong time or in the wrong position to cause muscle fibers in the back to tear and go into spasm.
Muscles of the legs can be damaged from overuse or imbalance. For example, the quadriceps muscle in the front of the thigh extends the knee and is balanced by the hamstring muscles of the back of the thigh, which flex the knee. Excess bending or straightening can cause the muscle fibers to tear. Muscles that move and stabilize the hip are prone to injury. Groin injuries or groin pulls are strains of the hip muscles that allow the hip to pull inward. When the leg is pulled away from the body like doing the splits, the adductors are potentially damaged.
We use our arms and hands for a variety of activities and the arm muscles (biceps and
triceps muscles) and the forearm can be strained because of lifting, pushing, pulling grabbing, twisting, and any other activity that you can imagine the arm and hand trying to accomplish.
Chest wall muscles can be pulled because of activities as aggressive as lifting or as seemingly harmless as sneezing or coughing. Strains of the large muscles on the outside of the chest (pectoralis muscles) or the muscles between the ribs (intercostal muscles) can cause significant pain and even can mimic the pain of a broken rib.
The core muscles of the torso of the body, including the abdominal wall muscles and those of the back, lend stability to the trunk and are often the source of power for the arms and legs to lift and push. These muscles can be strained from many different activities that require the torso to bend, stretch, or twist.
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.
The knee joint is composed of three compartments and ligaments which stabilize the joint. Causes of knee pain may include injury, degeneration, infrequently infection and rarely bone tumors. Although routine x-rays do not revel meniscus tears, they can be used to exclude other problems of the bones and tissues. The knee joint is the most commonly involved joint in rheumatic disease, as well as immune diseases that affect various tissues of the body.
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
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.
Elbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Treatment includes ice, rest, and medication for inflammation. Inflammation, redness, warmth, swelling, tenderness, and decreased range of motion are other symptoms associated with elbow pain. Treatment for elbow pain depends upon the nature of the patient's underlying disease or condition.
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
A broken toe is one of the most common fractures among individuals. There are many causes of a broken toe, whether it is the big toe, middle toes, or little toe (pinky). Common symptoms of a broken toe include pain, swelling, stiffness, and bruising. A broken toe can be treated with buddy taping the toe. There are instances where a physician should be consulted for a broken toe.
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.
Myofascial pain syndrome is muscle pain in the body's soft tissues due to injury or strain. Symptoms include muscle pain with tender points and fatigue. Treatment usually involves physical therapy, massage therapy, or trigger point injection.
Whiplash is a common injury to a person's neck following a car accident (in most cases). Symptoms include: headache, neck pain, neck and shoulder stiffness, shoulder pain, fatigue, dizziness, jaw pain, arm pain, weakness of the arm(s), visual disturbances, and tinnitus. Diagnosis is generally with a physical exam, x-rays, or possibly an MRI. Treatment generally includes physical therapy and time.
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.
The time when boys and girls begin the process of sexual maturation is called puberty. During this time, both sexes undergo a series of biological changes that include a rapid increase in height, bone growth, weight increase, the growth of pubic hair, breast development and the onset of menstruation in girls, and testicle, penis, and muscle enlargement in boys.
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.
Growth plate fractures and injuries occur in the area growing tissue near the end of the long bones of children and teens. Both boys and girls are susceptible to growth plate fracture and injury. Common causes include: a fall while playing sports or playing on furniture or playground equipment, overuse injury from sports, injuries from competitive sports, child abuse, frostbite, and juvenile arthritis. Growth plate fracture and injury are classified into five categories according to the Salter-Harris Classification.
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