STRAINED OR PULLED MUSCLES
Muscle strain (pull or tear) implies damage to a muscle or its attaching tendons. A sprain, in contrast, is an injury to a joint and its ligaments. Undue pressure on muscles can occur during the course of normal daily activities, with sudden heavy lifting, during sports, or while performing work tasks.
Muscle damage can be in the form of tearing (part or all) of the muscle fibers and the tendons attached to the muscle. The tearing of the muscle can also damage small blood vessels, causing local bleeding (bruising) and pain (caused by irritation of the nerve endings in the area).
Muscle Strain Symptoms
- Swelling, bruising or redness, or open cuts due to the injury
- Pain at rest
- Pain when the specific muscle or the joint in relation to that muscle is used
- Weakness of the muscle or tendons
- Inability to use the muscle at all
Bursitis is the inflammation or irritation of the bursa, a fluid-filled sac located between bone, muscle, tendons, and skin, causing rubbing, friction, and irritation. It is most often caused by repetitive, minor impact on the area, or from a sudden, more serious injury, and most often is found in elbows, shoulders, hips, knees, and the Achilles tendon. Bursitis, which is painful, is more common in people over 40.
Symptoms of Bursitis
- Pain, inflammation, and swelling in the shoulders, elbows, hips, or knees, particularly during stretching or extending the joint during exercising, lifting, or otherwise pushing the joint to its limits.
- Restricted or lost range of motion in a joint, especially affecting the shoulder, with or without immediate pain.
- Muscle weakness due to pain.
Tendinitis (also called tendonitis) is an inflammation or irritation of a tendon, a thick cord that attaches bone to muscle. Tendinitis is most often caused by repetitive, minor impact on the affected area, or from a sudden more serious injury that includes:
- Abnormal or poorly placed bone or joint (such as length differences in the legs or arthritis in a joint) that stresses soft-tissue structures
- Stresses from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorders, or unusual medication reactions
- Overuse or doing too much too soon when the tendons are not used to a movement or to the task taken on. Tendinitis is common in “weekend warriors,” people that play and exercise hard only on weekends.
Tendinitis can occur in almost any area of the body where a tendon connects a bone to a muscle. The most common places are: base of the thumb, elbow, shoulder, hip, knee, and Achilles tendon.
- Pain at the site of the tendon and surrounding area. Pain may gradually build up or be sudden and severe, especially if calcium deposits are present.
- Loss of motion in the shoulder, called “adhesive capsulitis” or frozen shoulder.
Foot pain is a common complaint, and it can have many causes. Pain in the foot can be due to a problem in any part of the foot. Bones, ligaments, tendons, muscles, fascia, toenail beds, nerves, blood vessels, or skin can be the source of foot pain. The cause of foot pain can be narrowed down by location and by considering some of the most common causes of foot pain such as Plantar fasciitis (heel pain), heel spurs, ball of foot pain (Metatarsalgia, Morton’s neuroma, Sesamoiditis), arch pain or toe pain. Foot pain can also be caused by improper foot wear or care of the feet, Arthritis, gout or diabetic neuropathy or tendinitis.
Although heel spurs are often painless, they can cause heel pain. They are frequently associated with plantar fasciitis, a painful inflammation of the fibrous band of connective tissue (plantar fascia) that runs along the bottom of the foot and connects the heel bone to the ball of the foot. Heel spurs occur when calcium deposits build up on the underside of the heel bone, a process that usually occurs over a period of many months. Heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Heel spurs are especially common among athletes whose activities include large amounts of running and jumping.
Risk factors for Heel Spurs Include:
- Walking gait abnormalities, which place excessive stress on the heel bone, ligaments, and nerves near the heel
- Running or jogging, especially on hard surfaces
- Poorly fitted or badly worn shoes, especially those lacking appropriate arch support
- Excess weight and obesity
Symptoms of Heel Spurs
Heel spurs often show no symptoms. However, heel spurs can be associated with intermittent or chronic pain — especially while walking, jogging, or running — if inflammation develops at the point of the spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it.
Many people describe the pain of heel spurs and plantar fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning — a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand up after sitting for a prolonged period of time.
Plantar fasciitis is the most common cause of heel pain. The plantar fascia is the flat band of tissue (ligament) that connects the heel bone to the toes. It supports the arch of the foot. If the plantar fascia is strained, it becomes weak, swollen, and irritated (inflamed) resulting in the heel or the bottom of the foot to hurt when standing or walking Plantar fasciitis is common in middle-aged people. It also occurs in younger people who are on their feet a lot, like athletes or soldiers. It can happen in one foot or both feet. Plantar fasciitis is caused by straining the ligament that supports the arch. Repeated strain can cause tiny tears in the ligaments which can lead to pain and swelling. This is more likely to happen if:
- Feet roll inward too much when walking (excessive pronation)
- High arches or flat feet
- Walking, standing, or running for long periods of time, especially on hard surfaces
- Wearing shoes that don’t fit well or are worn out
- Tight Achilles tendons or calf muscles.
Other Risk Factors Associated with Plantar Fasciitis Include:
- Increasing age, which decreases plantar fascia flexibility and thins the heel’s protective fat pad
- Spending most of the day on one’s feet
- Frequent short bursts of physical activity
- Having either flat feet or high arches
Symptoms of Plantar Fasciitis
Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. There can be less stiffness and pain after moving or walking. However, the foot may hurt more as the day goes on. It may hurt the most when climbing stairs or after standing for long periods time. If foot pain occurs at night, it may be signs of arthritis or a nerve problem such as tarsal tunnel syndrome.
Shin splints are a condition that causes pain and sometimes swelling in the front part of the lower leg (shin). The pain is most likely from repeated stress on the shinbone (tibia) and the tissue that connects the muscle to the tibia. They are common in people who run or jog. Activities that involve repeated pounding on hard surfaces during sports activities such as running, basketball or tennis, can also lead to this painful condition. Shin splints can also occur when:
- Change to new running or workout shoes or wear shoes that don’t have enough support. This can happen when shoes are worn too long and are worn out.
- Running or walking on different surfaces or unfamiliar surfaces. For example, switching from running on a trail to concrete or asphalt.
- Work out harder than usual or train too hard or too fast instead of working up to a training level gradually.
- Some people have flat arches in their feet, which can make the feet roll inward when running. This may also lead to shin splints.
Symptoms of Shin Splints
- Feeling pain on the front lower part of the leg.
- Sometimes mild swelling occurs
- Noticeable pain at the start of exercising workout that feels like a dull ache or soreness. If left untreated, the pain can become sharper and last during exercise. In severe cases, the pain can continue after workout.
Knee pain is the most common musculoskeletal complaint that brings people to their doctor. With today’s increasingly active society, the number of knee problems is increasing. Knee pain has a wide variety of specific causes and treatments. The knee joint’s main function is to bend, straighten, and bear the weight of the body along with the ankles and hips. The knee, more than just a simple hinged joint, however, also twists and rotates. In order to perform all of these actions and to support the entire body while doing so, the knee relies on a number of structures including bones, ligaments, tendons, and cartilage.
The nerves that provide sensation to the knee come from the lower back and also provide hip, leg, and ankle sensation. Pain from a deeper injury (called referred pain) can be passed along the nerve to be felt on the surface. Knee pain, therefore, can arise from the knee itself or be referred from conditions of the hip, ankle, or lower back. In general, knee pain is either immediate (acute) or long-term (chronic). Acute knee pains can be caused by an acute injury or infection. Chronic knee pain is often from injuries or inflammation (such as arthritis) but can also be caused by infection.
Ankle injuries are often thought of as sports injuries. The truth is ankle injuries can happen to anyone at any age. While half of all ankle sprains occur during an athletic activity, many times something as simple as walking on an uneven surface can cause a painful, debilitating sprain. Every day in the U.S., 25,000 people sprain their ankle. And more than 1 million people visit emergency rooms each year because of ankle injuries. The most common ankle injuries are sprains, tear or strain of a tendon and fractures, which involve ligaments and bones in the ankle.
Sprains, Strains, and Fractures
Ankle injuries are defined by the kind of tissue — bone, ligament, or tendon — that’s damaged. The ankle is where three bones meet — the tibia and fibula of your lower leg with the talus of your foot. These bones are held together at the ankle joint by ligaments, which are strong elastic bands of connective tissue that keep the bones in place while allowing normal ankle motion. Tendons attach muscles to the bones to do the work of making the ankle and foot move, and help keep the joints stable.
A fracture describes a break in one or more of the bones. A sprain is the term that describes damage to ligaments when they are stretched beyond their normal range of motion. A ligament sprain can range from many microscopic tears in the fibers that comprise the ligament to a complete tear or rupture. A strain refers to damage to muscles and tendons as a result of being pulled or stretched too far.
Muscle and tendon strains are more common in the legs and lower back. In the ankle, there are two tendons that are often strained. These are the peroneal tendons, and they stabilize and protect the ankle. They can become inflamed as a result of overuse or trauma. Acute tendon tears result from a sudden trauma or force. The inflammation of a tendon is called tendinitis. Microscopic tendon tears that accumulate over time, because of being repeatedly over stretched, and don’t heal properly lead to a condition called tendinosis. Tendons can also rupture. Subluxation refers to a tendon that slips out of place.
An ankle injury occurs when the ankle joint is twisted too far out of its normal position. Most ankle injuries occur either during sports activities or while walking on an uneven surface that forces the foot and ankle into an unnatural position. The unnatural position of the ankle in high-heeled shoes or walking in unstable, loose-fitting clogs or sandals is also a factor that may contribute to ankle injuries. In addition to wearing faulty footwear, an ankle injury can happen as a result of:
- Tripping, falling or landing awkwardly
- Walking or running on uneven surfaces
- A sudden impact such as a car crash
- Twisting, rolling or rotating the ankle
Tennis Elbow is a common term for a condition caused by overuse of arm, forearm, and hand muscles that results in elbow pain. Although tennis elbow commonly affects tennis players, it also affects other athletes and people who participate in leisure or work activities that require repetitive arm, elbow, wrist, and hand movement, especially while tightly gripping something. Examples include golfers, baseball players, bowlers, gardeners or landscapers, house or office cleaners (because of vacuuming, sweeping, and scrubbing), carpenters, mechanics, and assembly-line workers. Tennis elbow most commonly affects people in their dominant arm (that is, a right-handed person would experience pain in the right arm), but it can also occur in the nondominant arm or both arms.
Tennis elbow is caused by either abrupt or subtle injury of the muscle and tendon area around the outside of the elbow. Tennis elbow specifically involves the area where the muscles and tendons of the forearm attach to the outside bony area (called the lateral epicondyle) of the elbow. Doctors may refer to this condition lateral epicondylitis. Another common term, “golfer’s elbow,” refers to the same process occurring on the inside of the elbow or medial epicondylitis. Overuse injury can also affect the back or posterior part of the elbow as well.
Symptoms of Tennis Elbow
- Pain slowly increasing around the outside of the elbow. Less often, pain may develop suddenly.
- Pain is worse when shaking hands or squeezing objects.
- Pain is made worse by stabilizing or moving the wrist with force. Examples include lifting, using tools, opening jars, or even handling simple utensils such as a toothbrush or knife and fork.