Dear Readers,

A.D., 26, an athlete, writes Lifeline from Harbour View, Kingston. He likes bicycle riding, running and lifting weights. His doctor recently told him that the chest pain he was experiencing was due to a muscle strain in the chest wall. Checks for heart disease were negative.

A.D. asks Lifeline what is the difference between a muscle strain and a muscle sprain. He has experienced more than one sprained ankle in the past and is used to being told to rest, ice and elevate the injured area. However, the chest pain keeps recurring, especially with weight training.

A muscle strain tends to occur when muscle fibres are physically stretched for too long or muscles are required to hold, carry or push too much weight for too long. Making sudden jerky movements that involve a group of muscles can also result in muscle strain. A muscle strain is similar to a 'pulled' muscle. Strains most commonly occur in athletes during exercise. Muscle strain results in aches and pains to the affected area and some stiffness and diminished range of movement. A strained muscle may also spasm and contract resulting in severe pain. A.D. needs to stop upper-body weight training for a few weeks and rest the chest wall muscles. When he does start again, it should be with lower weights and fewer repetitions.

Outside ligaments

A sprain does not refer to a muscle at all, but is an injury to the ligaments which surround a joint. Tendons and ligaments are fibrous tissues that connect muscle to bone and bone to bone. Ligaments and tendons help to stabilise over joints and to keep them in working order. A sprain occurring to a joint results in a painful swelling around the joint and usually, increased pain is experienced with moving the joint. The most commonly sprained joint is the ankle, but knees and wrists are also often involved in sprains. Ankle sprains usually occur secondary to twisting the ankle, and are, in most cases, inversion sprains where the foot is twisted inwards and the outside ligaments are stretched or torn.

The treatment for strains and sprains is similar. The affected area should be rested for days to sometimes weeks with a bad ankle sprain. If possible, the injured body part should be elevated and cold compresses (or ice packs) should be applied at intervals. The area should be iced for 15 to 30 minutes several times daily during the first three days after an injury. This reduces any swelling and also helps to relieve pain. After several days, heat can be applied instead as it loosen up sore, stiff muscles and joints and increases blood flow to the area.

Restriction of movement

Anti-flammatory pain killers, such as cataflam, voltaren and many others, are useful to provide pain relief and a quicker return of function. The selective cox 2 inhibitors (e.g. celebrex, viox and prexige) and muscle relaxants (e.g. mydacalm, seutamilc, norgesic) are also very useful for pain relief and more rapid return of function. When injury is severe, rest in bed or other restriction of movement and use of the affected area is required. Severely torn tendons or ligaments may also need surgical repair so any sprain or strain associated with significant pain and swelling and loss of function (use) should be examined by a doctor and perhaps, X-rayed to make sure more serious injury is not missed (such as a bone fracture).

In order to prevent strains and sprains, new athletes must slowly increase the levels of exercise participated in and not attempt excessive levels of exercise too quickly. Muscles and joints should be stretched and warmed prior to exercise.

To build muscles and repair muscles, protein must form a part of the diet which should include fish, tuna, sardines, chicken, whole grains and legumes.

Vitamin supplements such as calcium, magnesium, vitamin C and zinc help with repair of connective tissue and prevents inflammation. These can be taken daily.

Write Lifeline

P.O. Box 1731

Kingston 8

A.J.M.