Predictors of Outcome from the MARS Cohort: Physical Therapy, Rehabilitation and Bracing Factors

Cupping? Why Michael Phelps and others are doing it. Read about it here.

If you are wondering why Michael Phelps and other swimmer and athletes have those purplish circles over their body it's called cupping and aimed at improving recovery following workouts or competition. Read more details HERE

Oblique Muscle Strains

Once again this season baseball players have been affected by oblique muscle strains. Most recently it impacted the St. Louis Cardinals when their All Star infielder Matt Carpenter sustained the injury missing a month of games including the All Star Game. Why are these such significant injuries for some sports and playing positions while you never hear about them in other sports?

The oblique muscles reside on both sides of the abdomen and chest running from the pelvis to the chest and ribs in the front and chest and spine in the back. There are 2 muscle groups on each side--- the internal and external obliques. Rather than running straight vertically or horizontally they run “obliquely” across the body and thus their name is derived.

These muscles are critical for rotational activities and that is why they are more impactful for certain sports. While challenging for any athlete an oblique muscle strain is the worst for those athletes that repetitively rotate. Thus baseball pitchers and hitters are highly affected. Hockey players are also bothered by it while shooting especially during slap shots.

We have had several with the St. Louis Blues over the years that resulted in several man games lost. It much less frequently affects sports that are more linear such as track, swimming, football or basketball. It is an infrequent injury even for quarterbacks and I can’t remember a significant oblique injury with loss of time for any of the Rams quarterbacks.

Treatment is similar to other muscle strains and involves conservative management with ice, NSAIDs and rehabilitation including stretching and strengthening. Nothing seems to shorten

the recovery which for baseball position players is typically a month. If anything more than a minor strain for a pitcher it can cost 6-8 weeks. Cortisone injections can be utilized, but still time is the best ally and cortisone is relatively a quick fix. These muscle strains typically are diffuse over a relatively large area and thus difficult to pinpoint for an injection. Likewise there is no scientific evidence that platelet rich plasma (PRP) or stem cell injections will speed recovery. That is why these are difficult injuries for the athletes and the fans that follow them. It is hard to be patient.

Ankle Sprains Can Be More Than They Appear

Ankle sprains represent one of the most common reasons people present to Emergency Rooms for musculoskeletal complaints. While nearly everyone has sustained a sprain in their lives if ignored they can present significant disability. Ankle sprains as depicted in this picture are tears of the ligaments around the ankle. The most common type is depicted here as an inversion sprain with the ankle rolling in on itself.

Typically significant swelling is noted and there may be dramatic bruising.

Frequently when seen in the Emergency Room patients are given crutches, instructed to ice and elevate and little else is done. In reality all ankle sprains severe enough to go to the ER should undergo physical therapy for range of motion, strengthening and balance training. Additionally, the patient may need to braces during recovery.

Upon returning to sports it may be a good idea to wear a functional brace which may be as effective or more effective than taping.

A significant ankle sprain may continue to ache with activity for several weeks. Read HERE for several more facts regarding ankle sprains. Always take these seriously.