The Best Way to Ice a Muscle

Putting ice on an acute soft tissue injury (like a strain or sprain) can prevent further tissue damage, limit the appearance of new swelling, and decrease pain. However, it’s important to remember that using ice, like most injury treatment techniques, is best utilized in moderation and in combination with complimentary treatment methods.

Shoulder Injuries in the Performing Arts: "Separations"

This is the second article in a series on shoulder injuries in the performing arts. This series of articles will address fairly damaging acute shoulder injuries. Unless otherwise noted, these injuries are substantial enough that they should not be self-treated until after you've seen a medical professional who has instructed you to do so. These traumatic shoulder injuries should be treated as emergencies, since there is a high risk of significant complications if they are improperly or incompletely cared for (these complications can include nerve damage, internal bleeding, and nonunion fractures). Some of the injuries discussed in this series can be caused by accidental falls or collisions, but these articles will focus on other mechanisms of injury.

Hamstring Strains

The hamstring muscle group is located on the back of the thigh, running from the ischial tuberosity (the “butt bone”) to either side of the front of the tibia (shin bone), just below the knee joint. There are three muscles that make up the hamstrings muscle group (on each side) – the biceps femoris, semitendinosis, and semimembranosis. For the purposes of this article, “hamstrings” indicates all three of these muscles collectively. The hamstrings are 2-joint muscles, crossing and affecting movement at both the hip and knee joints.

Primary functions of the hamstrings are to:

• flex the knee (bend the knee by bringing the heel up toward the butt)
• extend the hip (bringing your leg backwards)
• control lowering the trunk when bending forward
• decelerate leg swing during walking and running

High Ankle Sprains

In the lower leg, the two bones, the tibia and fibula, meet twice: once near the knee and once just above the ankle joint. The distal tibiofibular joint (the one just above the ankle joint) has ligaments that connect the two bones in the front and back of the joint. These ligaments blend together with the connective tissue that runs between the two bones throughout the lower leg (called the syndesmosis or the syndesmotic ligament). Injuries to the distal tibiofibular ligaments are referred to as “high” ankle sprains due to their location in relationship to the rest of the ankle joint. Syndesmosis sprains often occur with high ankle sprains either at the same time that the high ankle sprain occurs or shortly afterward due to the syndesmosis having to absorb higher forces than usual after the tibiofibular ligaments are sprained.

Lateral Ankle Sprains

The body’s joints get their static and dynamic stability through a combination of bony architecture, tightness and orientation of ligamentous structures (ligaments and the joint capsule), and muscular contractions. The amount of a joint’s stabilizing forces coming from each of these factors at any given time is dependent on the specific joint and the current position of that joint. Joints are most stable when the majority of the joint’s stability comes from the bony architecture, and they are often least stable when the ligamentous structures are left to contribute the most to the joint’s stability.

The ankle joint is most stable in a combined position of dorsiflexion (lift up your toes and front of your feet so you can walk only on your heels) and eversion (try to “aim” the soles of your feet as far away from each other as you can without rotating your legs) and least stable in a combined position of plantarflexion (point your feet and toes) and inversion (soles of the feet turned toward each other).

Is it a Sprain or a Strain? (part 2)

Find out the specifics of sprains and strains in this 2-part article

Part 2: Strains

There is a plethora of information surrounding sprains and strains. As a result, the information presented here has been split into 2 articles. This is part 2 – be sure to check out Part 1: Sprains.

What is a Strain?

When a muscle, tendon (what attaches muscles to bones), or its associated fascia is torn or suffers a stretching-based injury, it is called a strain. A tendon’s collagen fibers, which are what allow the tendon to become taut when its muscle pulls on it, break after a 6%-8% increase in length. However, a tendon is usually twice as strong as its associated muscle, so when a musculotendinous unit is strained, the injury is usually located within the center of the muscle (referred to as the muscle belly) or at the spot where the muscle fibers blend into the tendon (called the musculotendinous junction).

Is it a Sprain or a Strain? (part 1)

Find out the specifics of sprains and strains in this 2-part article

Part 1: Sprains

There is a plethora of information surrounding sprains and strains. As a result, the information presented here has been split into 2 articles. This is part 1 – be sure to check out Part 2: Strains.

The Basics

Sprains and strains are often discussed together and thought of as being essentially the same. This most likely is due to the fact that initial treatment for mild strains and sprains are so similar. However, there are differences between the two injuries, and the full course of treatment and rehabilitation after a severe strain is not the same as it would be for a severe sprain.