Musculoskeletal Care

MUSCLE STRAINS

Strains are stretches or tears in the muscle fibers or tendons that connect muscles to bones. Symptoms include pain, spasm, tenderness and weakness in the injured area. In addition, strains may range from few muscle fibers being torn to large muscle tears and possible internal bleeding.

1. Reduce your activity and avoid movements that place stress on the injured area(s).
2. For the first 24 to 48 hours after injury, apply cold or ice packs 20 minutes on and 20 minutes off for two to three hours. After the third day, heating pads, whirlpools or analgesic balms may be applied if the swelling has gone down.
3. Apply an elastic bandage to the injured area.
4. Elevate the injured area for the first 24 to 48 hours.
5. Aspirin, ibuprofen or naproxen (e.g. Aleve™) may be used to reduce pain and inflammation. Be aware of the dosages and side effects.
6. If the strain is mild (use your best judgment on severity of strain -- i.e., if you are able to get around with the pain, it is probably mild) try slow, gentle stretches. However, avoid stretching for a few days if the injury is moderate (i.e. if you need crutches to get around) to severe (i.e. the pain is so severe that you can't even walk), but be sure to maintain circulation by performing general movements such as walking.

Note: Consult your doctor or nurse practitioner if pain prevents you from moving at all, or if swelling persists over three days.

Source: Pfeiffer & Douma, 1996

ANKLE INJURIES

An ankle strain occurs if the muscle or tendon is stretched beyond its normal limits or torn. An ankle sprain occurs when ligaments have been stretched too far or become partially or completely torn. Twisting your ankle can happen by placing your foot down the wrong way or by suddenly stopping.

1. Rest: rest ankle for 12 to 24 hours and avoid putting weight on it.
2. Ice: apply cold or ice packs 20 minutes on and 20 minutes off for two to three hours or until swelling has gone down.
3. Compression: if the injury has significant swelling, wrap the ankle firmly in an elastic bandage and keep it wrapped for 24 to 48 hours. Make sure this is comfortable, does not restrict your circulation, and does not bring you more pain or discoloration of the toes.
4. Elevation: keep ankle elevated if swelling occurs.
5. Aspirin, ibuprofen or naproxen (e.g. Aleve™) may be used to reduce pain and inflammation. Be aware of the dosages and side effects.
6. Use crutches if bearing weight is too painful.
7. Once the pain and swelling have gone away, slowly begin rotating, extending and flexing your ankle. Gradually add strengthening exercises.
8. Look into footwear that provides firm ankle support and make sure your shoes fit you well.

Note: If you suspect a fracture, keep the ankle immobilized, apply ice, and consult your doctor or nurse practitioner immediately. Also, if pain and swelling worsen after 24 hours, or the pain continues after three days and you are unable to bear weight on it, seek medical attention.

Source: Pfeiffer & Douma, 1996

KNEE PAIN

1. Avoid activities that place stress on the knee.
2. For the first 24 to 48 hours after injury, apply cold or ice packs 20 minutes on and 20 minutes off for two to three hours. After the third day, heating pads, whirlpools or hot baths may provide relief.
3. Aspirin, ibuprofen or naproxen (e.g. Aleve™) may be used to reduce pain and inflammation. Be aware of the dosages and side effects.
4. A cane or crutches may be used to aid in keeping weight off the injured knee.
5. Avoid keeping the injured knee in a fixed position for a long time. Every hour or so, try to gently flex and straighten the knee. Also, experiment with different ways to sleep so you can find a position of comfort. Once the knee has healed, you can begin a strengthening program (this may include walking, swimming and leg exercises).

Note: Seek medical attention if the injury prevents you from walking, if swelling persists after three days, and/or if you have pain or swelling in your calf muscle.

Source: Pfeiffer & Douma, 1996

BACK PAIN

1. Limit activities that place stress on your back or neck.
2. If you have just injured your back, apply ice packs for 20 minutes every hour for the first 24 to 48 hours. After the first few days, applying heat may aid in healing. Warm baths and light massages can also be helpful.
3. For severe back pain, rest on a firm surface with your back flat for the first 24 to 48 hours. Placing a pillow under your knees may provide some relief.
4. Aspirin, ibuprofen or naproxen (e.g., Aleve™) may be used to reduce pain and inflammation. Be aware of the dosages and side effects.
5. Practice gradual stretching exercises and learn proper back-protecting techniques for performing tasks.

Note: Notify your doctor or nurse practitioner if you have an injury in which you are unable to move your legs or pain and numbness occur. Also, if your leg muscles become weak or if low back pain is associated with loss of bladder or bowel control, if painful urination occurs, or if abdominal pain occurs.

Source: Pfeiffer & Douma, 1996

MENSTRUAL CRAMPS

1. Ibuprofen can be a highly effective treatment. Use as directed.
2. Try applying a heating pad to your stomach to reduce cramping and to relax muscles. In addition, a hot bath may help.
3. During your period, and especially a week prior to it, reduce your intake of salt and sodium-containing products such as cured, smoked, and processed foods. Also, reduce your caffeine intake.
4. Physical activity can be very effective in reducing cramping.
5. Try using sanitary napkins instead of tampons.

Note: Consult your doctor or nurse practitioner if cramping is severe during menstruation, or if cramping continues after your period is over or if you have a fever, diarrhea or rash during your period. If your cramping occurs with signs of major intestinal problems such as black or bloody stools, seek immediate medical attention.

Source: Pfeiffer & Douma, 1996

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