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.
The first symptom of a sprain or strain injury is usually pain, though there may be a delay in onset of the symptom and the person who is injured may not recall the specific event that caused the injury. For example, a person who paints a room may develop shoulder pain the day after the repetitive effort of brushing overhead. This is because inflammation, swelling, and spasm can take time (from minutes to hours) to develop.
Pain is always a symptom that indicates that there is something wrong with the body. It is the message to the brain that warns that a muscle or joint should be protected from further harm. In work, exercise, or sport, the pain may come on after a specific incident, or it may gradually progress after many repetitions of a motion.
Swelling almost always occurs with injury, but it may take from minutes to hours to be noticed. Any time fibers of a ligament, muscle, or tendon are damaged, some bleeding occurs. The bleeding (such as bruising on the surface of the skin) may take time to be noticed.
Because of pain and swelling, the body starts to favor the injured part. This may cause the muscles that surround the injured area to go into spasm. Hard knots of muscle might be felt near the site of the injury.
The combination of pain, swelling, and spasm causes the body to further protect the injured part, which results in difficulty with use. Limping is a good example of the body trying to protect an injured leg.
How are sprains and strains diagnosed?
The diagnosis of a muscle strain or joint sprain is usually made by history and physical examination. The health-care professional may want to know the circumstances of the injury and whether the body sustained damage other than the sprain or strain that brings the patient to seek care. For example, if a person injured was involved in a significant fall or car accident, the strain or sprain may not be a priority in caring for the patient with a potential internal bleeding or head injury.
Physical examination may focus on the part of the body that is injured: the tender muscle or the swollen joint. It is important to know whether or not there are broken bones or other associated injuries with the sprain or strain and the health-care professional may evaluate the pulses and sensation beyond the injury site to be certain that there is no associated nerve or artery damage.
X-ray tests may be used to detect broken bones. CT or MRI may be considered in certain situations where either the diagnosis is in doubt or if surgery is contemplated and the test will help further identify the injured structures. Most often CT and MRI tests are performed electively at a future scheduled time.
Sometimes X-rays are not recommended. In patients with low back pain who have not had a significant fall, car accident, or injuries and there is little concern that a broken bone exists, routine
X-ray tests may not helpful and the health-care professional may wish to minimize the exposure to radiation by avoiding these.
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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