Are your workouts leaving you with tender, aching shins?
You may have “shin-splints” – a painful condition most often caused by overworked muscles.
Left untreated, shin splints can become debilitating, and even result in stress fractures of the tibia.
The good news is that if symptoms are recognized early and treated properly, prognosis is excellent for a full recovery.
Athletes often develop shin splints when they increase the duration or intensity of their workouts. Risk factors include flat feet, tight or weak muscles, rigid arches, or a tendency to run with toes pointed outward. External risk factors – such as running on hard surfaces, uneven terrain or inclines, or use of improper or worn-out footwear – can also cause shin splints.
Treatment involves rest, ice, compression and elevation – a formula often referred to by the acronym R.I.C.E.
REST: It is important to give the leg muscles some time off, which will allow tissues to heal. During this period, athletes can maintain their fitness with non-weight-bearing activities such as swimming, cycling, or running in water.
COMPRESSION: Wrapping the lower leg with elastic bandages or braces can help decrease symptoms. Various taping techniques can also help.
ICE: Ice should be applied for 20 minutes three to four times a day while symptoms persist. Rubbing ice directly over the tender area for about five minutes — until the skin turns pink and cold to touch — can help reduce inflammation. Moist heat can also aid healing by dilating blood vessels, which increases blood flow to the tissues.
ELEVATION: By elevating the leg it aids in reducing swelling by increasing blood circulation to the area.
Finally, massaging the calf, shin and foot can also ease shin splints. Many people use a foam roller or stick roller to self-massage calf or shin muscles, and a tennis ball or golf ball to massage the arch of the foot.
Although shin splints can often be self treated, it is important to contact a sports medicine physician if pain persists after a period of rest, since more serious diagnoses can also cause lower leg pain. It’s also necessary to address the risk factors that led to the problem in the first place. Seek help from a physical therapist or athletic trainer to correct physiological abnormalities and learn about stretching and strengthening techniques, as well as appropriate training regimens.
As always, prevention is even better than treatment. Remember to:
• Gradually increase the intensity or duration of your workout
• Warm up before exercise
• Use shoes that provide proper support or are fitted with orthotics for your type of foot
• Avoid hard surfaces, uneven terrain, and inclines
And most importantly, listen to your body when it needs a little more TLC.
• Health Fair, presented by the Staff Nurse III and IV Committee
• Mini Massages and Tea for the Soul
• Free CE Day: Soft Skills for Solid Results: The Joy of Effective Communication and Self Care
• The 27th Annual Cheryl Fama Distinguished Nurse Lecture and Dinner.
Guest speaker Garry Johnson, RM, MSN, CCRN, Assistant Professor Samuel Merritt University, School of Nursing spoke on the “Joys of Nursing.”
• Night Shift Breakfast
• BBQ for all Hospital Staff, Physicians and Volunteers
• Ice Cream Treats
Additionally thank you to The Saint Francis Foundation for their continued support of Nursing Week Events.
Among athletes, a concussion is known as “getting your bell rung.” It’s an
evocative and amusing phrase, but it downplays the seriousness of the injury.
On-field or off, a blow to the head should never be “walked off” or
underestimated. Concussion can disrupt brain function, and continued play
after an initial head injury can even lead to death.
Derived from the Latin word “concutere,” which means to shake violently, a concussion can also be caused by even a mild bump to the head. It does not necessarily result in a loss of consciousness. In fact, although symptoms of concussion usually occur right away, they also can occur over the course of several days.
Recognizing symptoms is particularly important, because a concussion doesn’t necessarily show up on CAT scans or MRIs. That’s because a concussion is not an injury of the brain itself, which is what scans are designed to reveal. Rather, it’s an injury of brain function at a neurological level.
Symptoms vary greatly and are highly individualized, because each concussion is unique. I tell my patients to think of their concussion as a fingerprint: It is unlike any other in the world, because the brain performs so many functions on a daily basis and varies from person to person.
Typical symptoms include:
• Physical: Headaches, balance disorders, visual disturbances, sensitivity to light , sensitivity to noise, dizziness, nausea, vomiting
• Cognitive: Feeling sluggish, fogginess, amnesia, difficulty concentrating, confusion
• Emotional: Sadness, anxiety, irritability, depressed, feeling more emotional than usual
• Insomnia: Difficulty falling asleep, sleeping more than usual
Concussions have been getting more media attention in recent years, and for good reason. The Centers for Disease Control estimate that up to 3.8 million concussions occur each year in the Unites States, and more than 300,000 involve sports-related activities.
Athletes who sustain a concussion are at extra risk, because a second insult to the brain occurring soon after the original injury can produce irreversible brain damage known as “Second Impact Syndrome,” which can be fatal.
Do helmets prevent concussions? Absolutely not! Helmets decrease the incidence of skull fractures, but they will not ward off concussions.
What should you do if you see an athlete receive a blow to the head? REMOVE THEM FROM PLAY IMMEDIATELY! Make certain that he or she is evaluated by a physician who has expertise in treating concussions. Athletes should not return to play until they have received medical clearance from their physician.
Education is the best way to prevent a concussion from becoming a life-threatening injury.
Proper techniques that avoid using the head when tackling an opponent on the field should be mandated. Before the start of any sport season, meet with parents, coaches and athletes to discuss the dangers of concussions and the long- term consequences if they are not treated appropriately. Remind athletes to look out for one another, and to report to an adult immediately if they suspect that they or one of their teammates has sustained a concussion.
As a coach or parent, your role is vital. To prevent fatalities, it is imperative to take a team approach that involves coaches, parents, teachers, athletes and athletic trainers. This way we can create a better and safer environment for student athletes to enjoy the pleasure of their respective sports.
By Artemio A. Perez, DO, AOBFP, CAQSM
Saint Francis Memorial Hospital
Center for Sports Medicine
Today, May 7, 2013, is National Stroke Alert Day. San Francisco Department of Emergency Management’s Emergency Medical Services Agency is partnering with Bay Area emergency and health organizations to educate our community about the warning signs of stroke and the necessity of calling 9-1-1 if symptoms are present.
Nurses from California Pacific Medical Center, Saint Francis Memorial Hospital and University of California at San Francisco joined forces with ambulance providers American Medical Response, ProTransport-1 and the Emergency Medical Services Agency to distribute multilingual Stroke Alert postcards with stroke information at Embarcadero BART station. This is a part of a regional effort to spread good medicine at BART stations throughout Alameda, Contra Costa, San Francisco and San Mateo Counties.
Using the FAST acronym is an easy way to recognize a stroke and know what to do if you see someone exhibiting the signs, according to Jenny Fung, R.N., the coordinator of Mills-Peninsula’s Stroke Program.
Face: Look for an uneven smile
Arm: Check if one arm is weak
Speech: Listen for slurred speech
Time: Call 9-1-1 immediately if there is any one of these symptoms
“Look for sudden changes – a facial droop, arm weakness, change in speech,” Fung says. “If you see any one of these stroke signs, call 911 – don’t try to drive the person to the ER yourself. Time is brain. Every minute counts.”
A stroke is a brain attack in which blood and oxygen are cut off to a part of your brain. It can strike anyone, at any age. If you smoke, have high blood pressure, high cholesterol or diabetes you may be at an elevated risk for stroke.
“Getting treatment as fast as possible is key to decreasing disability from a stroke,” Fung says.
Nearly 800,000 Americans have a new or recurrent stroke every year. Of these, 130,000 die as a result of stroke.
The City and County of San Francisco has a system in place to respond to strokes. Emergency first responders alert the closest of seven certified stroke centers that a patient is on the way, ensuring the hospital’s stroke team is ready when the patient arrives.
The FAST stroke information also is available in a free mobile app for iPhone, iPad and Android. Search for “stroke FAST app.”
Saint Francis is a Certified Stroke Center.
Thank you to Ben Tanner, Hospital Liaison, San Francisco Emergency Medical Services Agency.
Ultrasound has several advantages over MRI. (1) Examination is done in the office by a trained physician (2) It is usually significantly less expensive (3) It allows for dynamic, rather than merely static imaging (i.e. the physician can watch a joint move) (4) It is more patient-friendly because the patient is not confined to a claustrophobic narrow tube (5) The patient can interact with the physician to direct the imaging to the area of concern during the examination. Ultrasound waves cannot penetrate bone so MRIs are still recommended to evaluate structures inside a joint.
Ultrasound also offers advantages in injection procedures. It can be used to guide injections into joints, tendon sheaths, bursa, and to treat nerve conditions. Studies have shown improved accuracy with the use of ultrasound to guide injections into joints. Ultrasound can be used instead of fluoroscopy or CT scans to guide deep injections into such areas as the hip joint. This helps save the patient from radiation exposure and contrast dye.
With all of the advances in ultrasound technology, perhaps an ultrasound is in your future!
Selina Shah MD, FACP
Sports Medicine and Dance Medicine
Center for Sports Medicine
1777 Botelho Dr
Walnut Creek, CA 94596
(925) 934 – 3536
Meet Kate Smith, nurse, mother, wife, Saint Francis Foundation Board Member and volunteer. Kate organized a group of 25 volunteers to take over a 4-bed ward on the Acute Rehabilitation Unit. They repainted the ward, added new curtains, artwork and furniture and made the environment fashionable and inviting. Kate has also been very involved with the Raphael House, a non-profit that helps homeless families with temporary housing and keeps children in school.
Thank you Kate for all that you do for Saint Francis.
Congratulations to Allison Shuttleworth, RN, ER nurse extraordinaire. The San Francisco Business Times honored her this morning with theHealth Care Hero Award in the category of Nursing. Allison is a nursing veteran with a degree from State University of New York and a Masters degree in family practice from University of North Carolina. When she isn’t saving lives and caring for patients in the ER, she can be found Hula Hoop Dancing or collecting toys for homeless children. Allison has also started a community resource assessment program, or as she likes to call it, “the community clinic traveling Show.” Allison describes her work as “A labor of Love. The more you do the more you can do.” Allison is pictured here with her award and her husband David Shuttleworth.
Congratulations Allison — Well Deserved!
Best Wishes from your Saint Francis Hospital friends, Dr. Goodman. RUN HARRIS RUN!!!
Saint Francis is proud of its Nursing Staff and to show their appreciation during National Nurses Week, the Hospital along with the Saint Francis Foundation hosted the Annual Cheryl Fama Distinguished Nurse Lecture with guest speaker Rosemary Bergin, RN, MSN. Ms. Bergin is a nurse Instructor at City College of San Francisco. Her talk was entitled “46 Years of Nursing in San Francisco.” She took the audience on a journey down memory lane beginning with the Summer of Love back in late 60′s. Bergin has had a very distinguished career, including helping UCSF start their first Critical Care Unit in 1969, her involvement in the first liver transplant surgery in the early 70s and the treatment and diagnosis of AIDS beginning in 1980. After all her years in the profession she is as passionate about nursing and nurses as she was 46 years ago. She ended her presentation with “At the end of the day we know we have made a difference. Nurses Rock!”
Pictured here l to r: Moira O’Brien, Nursing student at CCSF, Tom Shieh, RN in the Saint Francis ER, Rosemary Bergin, RN, MSN and Susan Arevado, RN in Telemetry. Both Susan and Tom are graduates of the CCSF Nursing School. Kudos to the Staff Nurse III/IV Committee for their work in coordinating today’s event.
Congratulations to all our Saint Francis Nurses — You do ROCK!