The intuitive answer for most people facing this question would be, yes. Perhaps, you figured
that you injured your quads in the first place because you haven't stretched them out enough in the past, so you should start stretching now. Bad idea. what?! but, why?
If you've strained your quads (or any muscle for that matter), then at the micro-level,
you've torn some of your muscle fibers; essentially, a strain is equated to damage to a muscle because it was either overloaded or overstretched during activity. Stretching the muscle right after an injury can actually worsen the strained muscle.
WWJD (What Would Jerry Do)? From a nutritional standpoint- Focus on getting the injured muscle healthier by drinking plenty of water, upping your protein intake (I would focus on whey and egg whites due to their high absorption rate into muscle), and
active rest. What's active rest? Avoiding activities that caused the injury in the first place.
Seeing a physical therapist can accelerate your recovery with a combination of modalities,
taping techniques to calm the muscle, and professional guidance. Stretching can be implemented after 10 days (past the acute stage of an injury) in a slow and gradual manner. After the acute stage, I recommend holding your stretches for at least 1 minute and perform the stretch for 3-5 times, several times a day because lengthening is best achieved with longer duration stretches performed throughout the day. There should be no pain when you stretch.
At the same time, if you're doing a pre-game warm-up, then shorter duration (10-30 seconds) is the way to go, because you don't want your muscles to lose their game-ready tone!
Tuesday, October 26, 2010
Monday, October 4, 2010
Is Surgery Needed to Treat a Rotator Cuff Tear?
Is rotator cuff surgery always necessary to treat a tear? The quick answer is no. One must distinguish a full-thickness tear from a partial-thickness tear before arriving at a more accurate decision. Full-thickness tears typically result in a patient unable to lift his/her arm and is associated with significant weakness during muscle testing; partial-thickness tears, on the other hand, vary in their presentation and may require an MRI study (see below).
Clinical evaluation is necessary in ruling in or ruling out a tear and more importantly, as to whether or not surgery is absolutely indicated. A thorough review of the patient's history is necessary to begin shedding some light on the prognosis. The examination performed by a physician (usually, orthopedist or sports medicine) or physical therapist provides valuable information about the patient's movement restrictions and limitations via range of motion testing, special clinical tests, and muscle/joint testing.
Is an MRI necessary? In some cases, yes. Partial-thickness tears, determined by clinical examination, may warrant the need for an MRI study, especially if the patient's signs and symptoms do not improve after a few weeks of physical therapy. Again, a good clinical examination will usually reveal the severity of a tear based on the functional limitations and impairments noted. If I see a patient for a diagnosis of "rotator cuff tear", and the patient is able to perform movements and tests without restriction, I usually tell the patient to rehab (or "prehab") the shoulder, and if the symptoms don't dramatically improve in 2-3 weeks, then I'll go ahead and refer the patient to the appropriate physician for further testing.
Can a rotator cuff tear "heal" on its own? Again, it depends on the size the tear. Full-thickness tears will not heal on their own. Partial thickness tears may scar down with time.
Gender, age, activity level, lifestyle, occupation, and diet are all factors that can influence general tissue healing and post-surgery recovery.
Clinical evaluation is necessary in ruling in or ruling out a tear and more importantly, as to whether or not surgery is absolutely indicated. A thorough review of the patient's history is necessary to begin shedding some light on the prognosis. The examination performed by a physician (usually, orthopedist or sports medicine) or physical therapist provides valuable information about the patient's movement restrictions and limitations via range of motion testing, special clinical tests, and muscle/joint testing.
Is an MRI necessary? In some cases, yes. Partial-thickness tears, determined by clinical examination, may warrant the need for an MRI study, especially if the patient's signs and symptoms do not improve after a few weeks of physical therapy. Again, a good clinical examination will usually reveal the severity of a tear based on the functional limitations and impairments noted. If I see a patient for a diagnosis of "rotator cuff tear", and the patient is able to perform movements and tests without restriction, I usually tell the patient to rehab (or "prehab") the shoulder, and if the symptoms don't dramatically improve in 2-3 weeks, then I'll go ahead and refer the patient to the appropriate physician for further testing.
Can a rotator cuff tear "heal" on its own? Again, it depends on the size the tear. Full-thickness tears will not heal on their own. Partial thickness tears may scar down with time.
Gender, age, activity level, lifestyle, occupation, and diet are all factors that can influence general tissue healing and post-surgery recovery.
Friday, October 1, 2010
why is a meniscus tear hard to treat?
The causes of knee pain are many- consider diagnoses like meniscus tears, ITB syndrome, patellofemoral syndrome, ACL, PCL tears, tendonitis, and you get an idea for what needs to be teased out of that pack.
To properly diagnose a meniscus tear through clinical examination, the pain symptoms and signs must be further qualified- Did the injury occur during a twisting type activity? Is there pain at the joint line? Does the pain occur during knee bending and/or the very end of knee bending? Is there associated knee buckling or a "giving way" sensation? Is there clicking or "catching" sensation? Most likely a meniscus tear may be the culprit.
Is an MRI absolutely necessary in diagnosing a meniscus tear? Usually not. A thorough clinical examination by an orthopedist or physical therapist is usually sufficient. People often wonder, "how do you diagnose a tear without being to see it?" I can attest that a good examination not only quickens access to necessary care, but also is may be more accurate at times than an MRI (seeing isn't always believing, since MRIs can produce a false positive- ask any radiologist!).
Meniscus tears are particularly a problem for athletes since the cutting, pivoting, rapid stop and go movements can cause these tears to occur. Menisci lesions may or may not heal on their own due to the fact that the meniscus (lateral and medial) are particularly avascular (less blood supply to the area). The menisci rely on joint movement and some compression to receive nourishment for repair and general health.
Physical therapy can be effective in treating menisci lesions through specific manual techniques and activities, and many athletes and non-athletes are able to return to their activities unhampered. In cases where symptoms become more constant, surgery is generally recommended and then resumption of physical therapy is needed for proper return to sports and activities of daily living.
To properly diagnose a meniscus tear through clinical examination, the pain symptoms and signs must be further qualified- Did the injury occur during a twisting type activity? Is there pain at the joint line? Does the pain occur during knee bending and/or the very end of knee bending? Is there associated knee buckling or a "giving way" sensation? Is there clicking or "catching" sensation? Most likely a meniscus tear may be the culprit.
Is an MRI absolutely necessary in diagnosing a meniscus tear? Usually not. A thorough clinical examination by an orthopedist or physical therapist is usually sufficient. People often wonder, "how do you diagnose a tear without being to see it?" I can attest that a good examination not only quickens access to necessary care, but also is may be more accurate at times than an MRI (seeing isn't always believing, since MRIs can produce a false positive- ask any radiologist!).
Meniscus tears are particularly a problem for athletes since the cutting, pivoting, rapid stop and go movements can cause these tears to occur. Menisci lesions may or may not heal on their own due to the fact that the meniscus (lateral and medial) are particularly avascular (less blood supply to the area). The menisci rely on joint movement and some compression to receive nourishment for repair and general health.
Physical therapy can be effective in treating menisci lesions through specific manual techniques and activities, and many athletes and non-athletes are able to return to their activities unhampered. In cases where symptoms become more constant, surgery is generally recommended and then resumption of physical therapy is needed for proper return to sports and activities of daily living.