Scripps Health

Injured? Don't "though it Out"

By Dr. Arnold Cuenca, D.O., Scripps Health

It’s been a few days since your last run, and that twinge in your knee still hasn’t gone away. Or maybe you took a blow to the head while surfing, but you don’t think it’s anything to worry abut. It’s common for men—especially weekend warriors who try to get in as much playtime as possible before the workweek starts—to “tough out” the discomfort of an injury rather than get it checked by a physician.

That’s usually a bad idea. Common sports-related injuries include stress fractures, muscle sprains and strains, head injuries and lacerations. While many of these seem like they can be treated at home, it can be difficult to tell how serious an injury really is. By delaying needed treatment, you’re much more likely to end up with complications or a chronic condition.

Stress fractures occur over time from repeated stress on the bone, such as from running or basketball, and most often affect the feet or legs. Stress fractures may not cause pain at first; however, as the fracture becomes more severe, the pain may increase every time weight is placed on the injured bone, and the area may become swollen. Though rest is usually the main treatment for stress fractures, they should be diagnosed by a physician to ensure there is nothing else going on with the bone or surrounding tissue.

Sprains are often confused with strains, but they are different injuries. A sprain occurs when a ligament, a band of connective tissue that joins one end of a bone to another, is stretched or torn. Sprains can range from a minimal stretch to a complete tear, and are characterized by tenderness or pain, bruising and swelling. Sprains often cause instability or immobility in the affected area as well. Unless a sprain is minimal, it’s a good idea to get medical attention. You can’t always tell right away if an ankle, for example, is sprained or actually broken, and the sooner a broken bone is set, the more likely it is to heal correctly without complications. Even if there is no break, severely stretched or torn ligaments may heal more quickly if they are immobilized or supported with the proper brace.

A strain is a pull or tear of a muscle or a tendon that connects muscle to bone. Strains are usually caused by overstretching; symptoms include pain, muscle spasm, and weakness. If your symptoms are anything but minor, don’t write it off. A severe strain that is not correctly treated by a medical professional can lead to long-term damage and loss of function.

Sprain or strain, never try to “shake it off” or play through an injury. Pain is your body’s way of telling you to stop. Listen to the warning and you may avoid more serious problems later. Unless you are sure an injury doesn’t need treatment, it’s better to err on the side of caution and get a professional opinion. Always see a physician if a sprain or strain causes severe pain, swelling, or numbness, or you can’t put weight on the injured area.

If you don’t have any of these symptoms, you may be able to treat the injury at home with RICE: rest, elevation, compression and elevation. Ibuprofen can help with pain and swelling. If symptoms do not improve or worsen, seek medical care.

Injuries to the head should almost always get medical attention, sooner rather than later. A blow to the head may seem like no big deal, but we are learning more every day about the debilitating long-term impact of concussions on brain function. If you are hit in the head, don’t be fooled into thinking you’re okay because you didn’t pass out. Contrary to popular belief, most people who suffer a concussion do not lose consciousness. There is no such thing as a “minor” concussion, and you should not try to determine the seriousness of your injury. Call a physician right away or go to a hospital emergency room for evaluation.

Lacerations are another type of injury that is too easily ignored. Deep cuts may require stitches to stop bleeding, prevent infection and speed healing; a bandage won’t always do it. Plus, you may be due for a tetanus shot.

Fortunately, most sports injuries can be treated effectively, and you should be able to return to your activities. By taking the right precautions, such as properly warming up, using safety equipment and not pushing too hard, you can help prevent injuries.

Arnold Cuenca, D.O., is a family medicine specialist with Scripps Health. “To Your Health” is brought to you by the physicians and staff of Scripps. For more information or for a physician referral, please visit www.scripps.org or call 1-800-SCRIPPS (1-800-727-4777).

Are you one of the 18.8 million adults and children in the United States who has been diagnosed with diabetes—or perhaps one of the 7 million yet to be diagnosed?

Now considered a nationwide epidemic, diabetes is a disease that affects the body’s ability to produce or use insulin, a hormone made by the pancreas that helps transport glucose (blood sugar) into the body's cells so it can be used for energy. Without enough insulin, the body cannot use sugar properly. Because the sugar cannot get into the cells, it builds up in the bloodstream instead and upsets normal body functions. When blood sugar remains high for prolonged periods, it may damage organs such as the eyes, kidneys, heart and limbs--even if no symptoms are present.

People with diabetes either cannot produce enough insulin to process sugar, or cannot correctly use the insulin they do have. The exact cause of diabetes is unknown, although both genetics and environmental factors such as over eating which can lead to obesity and lack of exercise may be factors. A number of factors can affect your risk for diabetes. Your risk may be higher if you: are African-American, Latino, Native American, Asian-American or Pacific Islander; have a family history of diabetes; are overweight; lead a sedentary lifestyle; or develop diabetes during pregnancy.

There are two main types of diabetes. Type 1 diabetes occurs most often in children and young adults. It is an autoimmune disease, which means the body’s immune system mistakenly attacks and destroys its own insulin-producing (beta) cells. Thus, the pancreas stops making insulin, or makes only a tiny amount. People with type 1 diabetes must use insulin every day to keep their bodies functioning properly. About 5 to10 percent of Americans who are diagnosed with diabetes have type 1.

Type 2 diabetes is the most common form of diabetes, affecting 90 percent of Americans who are diagnosed with diabetes. While type 2 usually occurs in adults, it is rising at alarming rates in young adults and children. Type 2 diabetes develops over time as a result of lifestyle factors such as obesity and lack of exercise; it often begins as a condition known as prediabetes, in which a person’s blood glucose levels are higher than normal, but not yet elevated enough to qualify as diabetes. Prediabetes is likely to lead to type 2 diabetes within 10 years; in the meantime, many people with prediabetes will develop health problems commonly associated with diabetes itself.

If not treated, diabetes can lead to serious complications, including heart disease, stroke, high blood pressure, kidney disease, blindness, infection of the lower limbs that may lead to amputation, and damage to the peripheral nervous system

Fortunately, once diabetes is diagnosed, it can be treated. While there is no cure to date, diabetes researchers have made significant advancements in the understanding and treatment of the disease. Through proper diabetes management, including medication and lifestyle changes, people with diabetes can lead full, healthy lives.

Early detection of diabetes is vital to decreasing the likelihood of complications later on. Some of the most common symptoms of diabetes include frequent urination, excessive thirst or hunger, unusual weight loss, increased fatigue, blurry vision, wounds that do not heal, and frequent infections. If you have any of these symptoms, contact your physician right away.

Diabetes screening tests, such as lab tests that measure the level of glucose in your blood, can identify diabetes and determine the best course of treatment. There are several types of tests. Two require fasting for at least eight hours before testing to ensure that you don’t consume anything that may affect the test results, as eating or drinking may raise your blood glucose levels. The fasting plasma glucose test (FPG) measures your glucose levels first thing in the morning after you have fasted during the night. The oral glucose tolerance test (OGTT) measures your blood glucose once after you have fasted. Then, you will be given a special high-glucose beverage to drink; two hours after you finish it, your blood glucose levels will be measured again. A newer non-fasting test, HbA1C, has been used to measure how well your average blood glucose has been controlled over a period of two to three months. This test measures the percentage of glycated hemoglobin, or HbA1c, in your blood.

If you have any of the risk factors for diabetes, including a family history of diabetes, high blood pressure, low HDL cholesterol, high triglycerides, or a history of gestational diabetes, ask your physician if testing is right for you.

Athena Philis-Tsimikas, MD, specializes in endocrinology with Scripps Health and is corporate vice president of the Scripps Whittier Diabetes Institute. Scripps Mercy Hospital will host a free event for those living with diabetes and those at risk of diabetes on Feb. 4, 2012, from 9 a.m. to 2 p.m. Screenings, education and the chance to talk with health care professionals will be offered to all those who attend. For more information, please call 1-800-SCRIPPS.