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Medial Tibial Stress Syndrome (MTSS) is also known as shin splints. It happens because of the overuse of or stress in the shin area (front of the lower leg between the knee and ankle). MTSS is pain and discomfort in the shin area of the leg from repetitive running on hard surfaces or forcible, excessive use of the foot flexors.

MTSS often occurs in athletes who have increased their exercise and training routines. These increased activities overwork the tendons, bone tissues, and muscles. Most of the MTSS cases can be treated with ice packs, rest, self-care and modification of the exercise routine.

Is MTSS common? 

MTSS is a common sports injury with an incidence rate of around 4% to 20% in the athletic population and around 4% to 35% among the military population. It is common among runners and jumping athletes when there is a change in their training regime. Changes include increases in intensity, duration, and distance of physical activities.

What are the causes of MTSS?

Continuous stress in the shinbone and the tissues that connect the muscles to the bone, leads to MTSS.

What are the common symptoms of MTSS?

Soreness, pain, or tenderness on the inner side of the shinbone and mild swelling in the lower leg are some common symptoms of MTSS.

What are the risks involved with MTSS?

MTSS is usually caused due to repetitive stress on the shinbone and the connective tissues that attach the muscles to the bone. You are at risk of suffering from MTSS if:

•  You are beginning running training to become a runner
•  You have suddenly increased the frequency, intensity, or duration of exercise/workouts
•  You run on uneven surfaces such as hills, mountains, concrete area, or any other hard surfaces
• You are in military training
• You have flat feet or high arches
• There is an imbalance in your leg
• There is tightness in your calf muscles

MTSS is diagnosed in people who are active in high impact sports activities such as:

• Basketball
• Running
• Gymnastics
• Military training
• Dancing

How is MTSS diagnosed?

MTSS is diagnosed with a physical examination while considering medical history. In some cases, healthcare professionals can ask for an X-ray or imaging scans to help identify the possible causes of MTSS such as stress fracture.

MTSS treatments?

In the majority of cases, MTSS can be treated with simple self-care steps. Some of the self-care treatment options for the treatment of MTSS are:

• Acute phase: This treatment phase includes  rest of around 2 – 6 weeks with medications in order to resume your activities at the earliest. Here are some of the treatment options
  – Ice – Apply ice packs to your injured shin for around 15 to 20 minutes. Follow the same routine four to eight times a day for a few days. This will help with relief from the pain. To protect the skin, you can wrap the ice pack in a cloth or thin towel.
• Rest – When you feel pain, rest for some time. However, you should not give up physical activities completely. Rest can heal the pain caused to the shin bone in a few weeks.
• Over-the-Counter Medicines – If the pain is severe, you can opt for over-the-counter medicines such as ibuprofen, naproxen sodium, and acetaminophen to reduce the pain.
• Sub-acute phase: This treatment phase requires modification in the training routine to address the ISSUE . The treatment options include:  
• Modify your training routine – After the basic treatment,  you should modify your training regimens. Also, address the problem  by reducing the duration and intensity of the activities.
• Stretching and strengthening exercises – Focus on calf stretching and eccentric calf exercises to prevent muscle fatigue.
• Footwear – Opt for  footwear that include appropriate shock-absorbing soles and insoles to prevent the occurrence of MTSS.
• Bracing – A pneumatic brace is recommended for severe MTSS cases and stress fractures
• Other treatment options
• Extracorporeal Shock Wave Therapy – This therapy is used for the treatment of various tendon disorders of the lower extremity.
• Injections – Various injections, such as cortisone, are used for the treatment of MTSS.
• Acupuncture – Acupuncture is also identified as one of the treatment options for MTSS.

However, the efficacy of these other treatment options is unclear due to conflicting results.

Thus, you should consult a healthcare professional if the treatment options such as ice packs, over-the-counter medications, and rest do not help to relieve the pain.

How to Prevent MTSS?

An individual can seek professional help if the pain is severe. However, self-analysis and observation of the variations in your physical exercise routine can help you to prevent MTSS. You can follow the following steps to avoid MTSS:

• Opt for the right pair of shoes – The shoes help to increase your activity speed. If you are a runner, it is advised to change your shoes after every 600 to 800 kilometers.
• Avoid overdoing  – Running too much or any other high-impact activity performed for a long time can increase the load on shin.
• Analyze movement – A video analysis of your  running technique can help you to identify the movement pattern that leads to shin splint. A slight change in the running movement can help to decrease the event of MTSS.
• Opt for shock-absorbing insoles – Shock-absorbing insoles reduce the symptoms of MTSS and also prevents recurrence of the pain
• Consider arch supports – Arch supports can help to prevent MTSS, especially if you have flat feet
• Lower  impact activities – To get trained for a sport, often start with lower impact activities such as walking, swimming, or cycling. Always start new activities slowly and gradually increase the time and intensity of the activities.
• Add strength to the workout routine – Strengthening exercises will help to stabilise ankles, hips, and legs, it will also help to get you prepared for high-impact sports

The people suffering from MTSS are highly susceptible to re-injury especially due to training errors, poor technique, and alignment abnormalities. Thus, physicians, therapists, coaches, and others should educate athletes and patients about injury prevention and work on ways to prevent the re-occurrence of MTSS.

Conclusion

The rising popularity and need for physical and sports activities leads to an increase in the number of people suffering from sports injuries such as MTSS. It usually occurs due to a change in the technique and duration of regular physical activities and exercises. MTSS can be treated with self-care that includes the application of ice packs, rest, and pain killers. If the pain persists and increases with the time one should immediately consult the healthcare professionals.

Are Knee Injuries in CrossFit Common?

As CrossFit becomes more popular, we are finding a larger number of patients that present to us with injuries that they sustained while doing CrossFit activities. This is particularly true in the young and middle-aged adult population, whereby a lot of stress in the knee can cause cartilage damage, which is effectively a localized area of arthritis, a meniscus tear, or an ACL tear.

Therefore, it is important that one be careful about their activities when they do participate in CrossFit and ensure that they do not injure their knee and endure a lifelong problem that limits their activities going forward.

What can be the Most Common Knee Injury in CrossFit?

One of the most common CrossFit knee injuries that we see is a meniscus tear. In these circumstances, often the athletes will injure themselves when their knee is in deep flexion, either with squatting, using kettlebells or with very deep leg presses or with other activities. In this circumstance, the back of the knee will push against the meniscus and it can tear either at the joint lining attachment or it can tear at its attachment to bone. The ones that tear that attach to the bone is particularly worrisome because if one does not have these fixed in a timely fashion, there is a very high risk for the rather rapid development of osteoarthritis.

Therefore, if one feels a pop at the back of their knee when they are doing CrossFit activities, such as squatting or deep kneeling, they should be seen relatively quickly by a specialist to ensure that they do not have a meniscus root tear. Meniscus root tears particularly hurt when one squats down and the meniscus will actually start to slip or extrude out of the knee. Studies have shown that when one does have a meniscus root tear, that it is equivalent to having no meniscus and some patients will develop arthritis within weeks and certainly months, so early diagnosis and treatment is essential to ensure that one does not have a lot of arthritis before the problem is recognized.

Other meniscus tears can include tears at the joint lining, where the meniscus is squished forward with deep flexion and it tears away from the joint lining. These are definitely repairable-type meniscus tears and one should certainly see a knee specialist ensure that they have a proper diagnosis and then have the meniscus tear treated before it goes on to be a bigger problem. Other meniscus tears, such as degenerative tears or radial tears, may or may not be repairable, but it is certain that the earlier one presents for an examination and evaluation, the better chance that some of the more complex meniscus tears may be able to be repaired instead of taken out.

Why Do ACL Tears Occur in CrossFit?

Another CrossFit injury that may occur is an ACL tear. This can occur when one is doing box jumps, either up or down, or when they are carrying heavy weights on their shoulders and they twist, turn or pivot. An ACL tear is a very problematic injury because it will make one’s knee unstable, and if the knee stays unstable for a period of time, one will develop arthritis and often will have meniscus tears.

If one injures their knee and feels a pop, injures their knee and has it swell up within a few hours, or injures their knee and it feels unstable when they twist or turn, prior to the onset of pain with injury, one has to be particularly concerned that they have a tear of their ACL. Many ACL tears are associated with meniscus tears, so it important to obtain a proper diagnosis so that one does not ignore the tear and then have the meniscus tear become non-repairable over time. This will certainly doom the health of your knee over the long term and is not advised.

Do Squats and Lunges Cause Knee Injuries?

Other common CrossFit activities include those that put a lot of stress on the front of the knee, such as lunges, squats, or knee extension exercises with heavyweights. When one does leg presses, the force is distributed through the whole knee. As soon as they lift their knee up with a knee extension exercise, the fulcrum of all the force becomes the kneecap joint and this extra force can cause the cartilage to wear down.

Lunges and squats also put up to 9 times one’s body weight across their knee, so repeated lunges and squats can also damage the cartilage at the kneecap joint.

If one has difficulty with lunges and squats, feels some crunching when they do it, or develops swelling after these activities, they have to be worried that they have some underlying kneecap arthritis and should be seen by a specialist to determine what type of activity modification they should do, if treatment is necessary, and to figure out what type of activities to avoid going forward in the future so they do not further progress the amount of arthritis that they have in their knee.

Outlook

CrossFit activities can be inconvenient and may contribute to knee injuries. Therefore, it is important that one use common sense when they do activities, not overly stress their knees when they are not prepared for it, and to back off if their knee starts to have some swelling or pain. Trying to work through pain or swelling with these types of activities may cause a much bigger problem over the long term and ultimately result in you losing good health of your knee joint and requiring to cut back on your activities permanently.

The human body allows for movement through the complex system of bones, muscles and joints. A break in the bone is medically known as a fracture and can be caused by constant stress, pressure or impact. It is common knowledge that with age, the bone strength decreases and incidence of fractures (osteoporotic fracture) increases.

Based on the affected bone and impact, different types of fractures are commonly identified as a Bonebone specialist in Hyderabad

1. Complete: When the breakage of the bone is complete, producing two or more pieces, it is referred to as a complete fracture.
2. Incomplete: When the breakage is incomplete, where the bone has cracked but does not break into pieces, it is known as an incomplete fracture. bone specialist in Hyderabad
3. Another type would be the open or closed fracture:
   • Open fracture: When the skin is exposed and the bone breaks through this exposed skin, it is known as compound or open fracture.
   • Simple or closed fracture: The bone breaks, but the skin continuity is maintained. Again, there are different types including hairline, greenstick, oblique, etc.

What is the reason behind a fracture?
A bone will fracture when force is applied to it that is stronger than the bone itself. A key factor in a bone’s susceptibility to fracturing is age. Both children and older people are prone to bone fractures. Children’s bones are constantly growing and have not reached their full strength. Elderly people have brittle bones with old age and are prone to develop bone diseases, making them susceptible to fractures.

How they are treated?
Splint and pain medications are commonly used. Closed reduction where the fracture is reduced without opening up the tissues and open reduction, where the tissues are opened up are common approaches to managing fractures.

Can they be prevented?
Especially with children and in the elderly, extra precaution should be taken to avoid any kind of injury and fracture.

1. Develop an exercise routine to strengthen the muscles
2. Manage weight
3. Use the right footwear and exercise gear
4. Watch your medications (avoid sleep-inducing ones)
5. Increase lighting in the room/home to improve the clarity of vision for the elderly
6. Make the home/living area fall-proof by reducing clutter, using railing in the bathroom and bedrRhinoplastyoom, using rubber mat, etc.
7. While a fall may seem inevitable, taking the above steps can help reduce the incidence and severity of a fall, thereby minimizing damage. If you wish to discuss any specific problem, you can consult an orthopedist.

Frozen shoulder is a condition where the patient encounters continuous shoulder stiffness and pain. It could last for several weeks. Inflammation around the shoulder increases the inability to move or stretch properly. This happens when somebody is recovering from an injury. Frozen shoulder can also occur when somebody is wearing a sling or a cast. It also occurs if someone is recovering from surgery or experiencing joint pain. It may also be experienced as a symptom of thyroid, joint disorders or diabetes.

Some of the causes and risk factors for creating a frozen shoulder are as follows:

1. If you are 40 years or older, your chances of a frozen shoulder are higher than others
2. Recovering from a damage or surgery
3. Hormonal imbalance
4. Ladies are more prone to a frozen shoulder
5. Cervical disc infection that influences the nerves around the shoulder
6. Not moving your arm because of other pain or wounds
7. Having a previous medical condition like diabetes or other heart diseases
8. Open-heart surgery or spinal surgeries
9. Poor diet and unhealthy lifestyle

The most widely recognized symptoms of a frozen shoulder include:

1. Stiffness around the shoulder usually happens in one shoulder at a time (not both) and will probably return in the same shoulder. Muscle, joint and bone agony in and around the shoulders or arms may be experienced.
2. Restricted scope of movement
3. Having difficulty moving and using the shoulders or arms ordinarily, (for example, experiencing difficulty in getting dressed, driving, holding objects before you, and gestures.)

Treatment:

1. Stretch the Shoulder: Before beginning shoulder exercises for a frozen shoulder, try to warm up your shoulder by doing a few warm-up exercises. This will improve the blood supply in the affected area and avoid future injuries by making your body more comfortable with the motion. The best approach is to extend and warm up the shoulder by applying heat for 10 to 15 minutes, scrubbing down or showering with Epsom salt.
2. Non-intrusive treatment: While these activities mentioned above can be easily performed at home if pain continues and makes it difficult to move around or work ordinarily, see a physiotherapist who can appoint particular activities and can enhance your scope of movement, flexibility and strength.
3. Acupuncture: Acupuncture is considered one of the best treatment choices for any joint and nerve-related problem. The treatment is based on focusing on the trigger points of the pain and putting pressure on them via needles. The treatment is not painful and is known to produce good results in the long run.
4. Dietary supplements: Various supplements can be taken with the recommendation of a doctor, in order to improve recovery. Alfalfa (horse feed) and turmeric are two of the most regularly recommended elements that relieve swelling and repair the tissue in the shoulder. If you wish to discuss any specific problem, you can consult an orthopedist.

Are Knee Injuries in CrossFit Common?

As CrossFit becomes more popular, we are finding a larger number of patients that present to us with injuries that they sustained while doing CrossFit activities. This is particularly true in the young and middle-aged adult population, whereby a lot of stress in the knee can cause cartilage damage, which is effectively a localized area of arthritis, a meniscus tear, or an ACL tear. Therefore, it is important that one be careful about their activities when they do participate in CrossFit and ensure that they do not injure their knee and endure a lifelong problem that limits their activities going forward.

What can be the Most Common Knee Injury in CrossFit?

One of the most common CrossFit knee injuries that we see is a meniscus tear. In these circumstances, often the athletes will injure themselves when their knee is in deep flexion, either with squatting, using kettlebells or with very deep leg presses or with other activities. In this circumstance, the back of the knee will push against the meniscus and it can tear either at the joint lining attachment or it can tear at its attachment to bone. The ones that tear that attach to the bone is particularly worrisome because if one does not have these fixed in a timely fashion, there is a very high risk for the rather rapid development of osteoarthritis.

Therefore, if one feels a pop at the back of their knee when they are doing CrossFit activities, such as squatting or deep kneeling, they should be seen relatively quickly by a specialist to ensure that they do not have a meniscus root tear. Meniscus root tears particularly hurt when one squats down and the meniscus will actually start to slip or extrude out of the knee. Studies have shown that when one does have a meniscus root tear, that it is equivalent to having no meniscus and some patients will develop arthritis within weeks and certainly months, so early diagnosis and treatment is essential to ensure that one does not have a lot of arthritis before the problem is recognized.

Other meniscus tears can include tears at the joint lining, where the meniscus is squished forward with deep flexion and it tears away from the joint lining. These are definitely repairable-type meniscus tears and one should certainly see a knee specialist ensure that they have a proper diagnosis and then have the meniscus tear treated before it goes on to be a bigger problem. Other meniscus tears, such as degenerative tears or radial tears, may or may not be repairable, but it is certain that the earlier one presents for an examination and evaluation, the better chance that some of the more complex meniscus tears may be able to be repaired instead of taken out.

Why Do ACL Tears Occur in CrossFit?

Another CrossFit injury that may occur is an ACL tear. This can occur when one is doing box jumps, either up or down, or when they are carrying heavy weights on their shoulders and they twist, turn or pivot. An ACL tear is a very problematic injury because it will make one’s knee unstable, and if the knee stays unstable for a period of time, one will develop arthritis and often will have meniscus tears.

If one injures their knee and feels a pop, injures their knee and has it swell up within a few hours, or injures their knee and it feels unstable when they twist or turn, prior to the onset of pain with injury, one has to be particularly concerned that they have a tear of their ACL. Many ACL tears are associated with meniscus tears, so it important to obtain a proper diagnosis so that one does not ignore the tear and then have the meniscus tear become non-repairable over time. This will certainly doom the health of your knee over the long term and is not advised.

Do Squats and Lunges Cause Knee Injuries?

Other common CrossFit activities include those that put a lot of stress on the front of the knee, such as lunges, squats, or knee extension exercises with heavy weights. When one does leg presses, the force is distributed through the whole knee. As soon as they lift their knee up with a knee extension exercise, the fulcrum of all the force becomes the kneecap joint and this extra force can cause the cartilage to wear down. Lunges and squats also put up to 9 times one’s body weight across their knee, so repeated lunges and squats can also damage the cartilage at the kneecap joint.

If one has difficulty with lunges and squats, feels some crunching when they do it, or develops swelling after these activities, they have to be worried that they have some underlying kneecap arthritis and should be seen by a specialist to determine what type of activity modification they should do, if treatment is necessary, and to figure out what type of activities to avoid going forward in the future so they do not further progress the amount of arthritis that they have in their knee.

Outlook

CrossFit activities can be inconvenient and may contribute to knee injuries. Therefore, it is important that one use common sense when they do activities, not overly stress their knees when they are not prepared for it, and to back off if their knee starts to have some swelling or pain. Trying to work through pain or swelling with these types of activities may cause a much bigger problem over the long term and ultimately result in you losing good health of your knee joint and requiring to cut back on your activities permanently.

Your Vitamins and Bones have a major role in protecting your vital organs and structure for the muscles. So, when it comes to self-care, maintaining the strength of your bones should be a top priority for you. Although the growth of our bones happens mainly during childhood and adolescence, taking good care of your bone health and joint is vital at all stages of life.

Bones are the base of your physical structure. Therefore, treating your bones with care will boost your physical capabilities and also reduce your risk for osteoarthritis (degeneration of joint cartilage and underlying bone), osteoporosis (a condition where bones become fragile and brittle) and other bone and joint-related conditions.

Including vitamins rich diet contribute to stronger bones and help maintain an overall healthier lifestyle. The following tips can help.

Vitamin D:

It is one of the most important vitamins for bones and joints. Our body stores vitamin D in the fatty tissues. This means you do not have to replenish the nutrient on a daily basis. According to the National Institute of Health, Vitamin D helps your body absorb calcium. Lack of this nutrient can cause osteoarthritis. Vitamin D is generally available in supplement form, either by itself or as part of a multivitamin. Exposure to minimal amounts of the sun will stimulate the production of vitamin D in your body. Eating foods rich in the nutrient offers another option. Our body requires 600 IU of vitamin D every day, but, avoid consuming more than 4,000 IU each day, due to the risk of toxicities.

Dietary sources of Vitamin D: fish, oysters, margarine and fortified foods like cereals and milk. Dairy foods such as cheese, butter, and cream.

Vitamin A:

Vitamins for bone health, Vitamin A plays an important role. Vitamin A positively impacts both osteoclasts (bone breaking down cells) and osteoblasts (bone-building cells). However, in spite of its good effects, much clinical research links higher vitamin A levels with fractures and lower bone density.

One source of vitamin A is retinol, found in meat and fish, fortified breakfast cereals, and vitamin supplements. Vitamin A is fat-soluble and stored in our livers. Therefore, the liver of animals and fish are particularly rich in vitamin A.

Another source of vitamin A is beta-carotene, found in dark green and orange fruits and vegetables. Beta-carotene is generally considered safe.

But, too much vitamin A, meaning more than 3,000 mcg or 10,000 IU per day, may give you a headache and is also linked to bone loss. Hence, you have to pay particular attention to this risk if you take supplements or eat liver.

Sources of Vitamin A: Muskmelon, spinach, carrots, mangoes, eggs, sweet potatoes, fat-free milk, fatty fish, liver and cheese pizza,

Vitamin B12:

Vitamin B12 shows to have an impact on bone-building cells. Low levels of vitamin B12 are linked to a higher risk of osteoporosis in both men and women. Vitamin B12 is generally found in meat and fish.

Vitamin B12 cannot be absorbed by people with gastrointestinal ailments that lead to poor absorption of fat and also those who have undergone a gastric bypass.  Elderly people in their 80s and 90s may develop changes in the linings of the stomach that prevents them from absorbing iron and B12. In such cases where absorption becomes an issue, doctors may administer injections of B12, bypassing the digestive tract, so patients may get B12 benefits. 

Sources of Vitamin B12: Fortified breakfast cereal, dairy products, fish, milk, eggs, meat, shellfish, poultry, and other supplements

Vitamin C:

Vitamin C is important for healthy bones as well as healthy gums. It is vital to the formation of collagen, the foundation on which bone mineralization is built. Studies have linked increased vitamin C levels with superior bone density.

Vitamin C is water-soluble and the most common reason for low levels is poor intake. Some people with poor absorption will have lower levels of vitamin C. While the elderly at nursing homes tend to have low levels of vitamin C, smokers also tend to show lower blood levels of vitamin C as their intestines do not absorb the vitamin C normally.

Sources of Vitamin C: Broccoli, cauliflower, bell pepper, kale, oranges, papaya, lemons, strawberries

Vitamin K:

Vitamin K is essential for normal bone growth and development. It is also known as calcium vitamins.Vitamin K helps attract calcium to the bone. Low blood levels of vitamin K are linked to low bone density and potentially increased risk of fracture. But, clinical trials did not show vitamin K supplementation to be of help in improving the bone density.

Deficiency of Vitamin K is not common in healthy adults probably because it is found in many of the foods that we eat every day. Individuals on blood thinning medications should not take vitamin K.

Sources of Vitamin K: Broccoli (cooked), Brussels sprouts, cabbage, Canola oil, kale, olive oil, parsley (raw) and spinach.