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What is a sprain?

A sprain is the over-stretching of a ligament. A ligament is a type of body tissue that connects bone-to-bone. For example, when someone suffers an ankle sprain, that means they have over-stretched the ligaments that support the ankle joint.

What is a strain?

A strain is the over-stretching of a muscle or tendon. A tendon is a type of body tissue that connects muscle to bone. Strains may also be called “pulls” or any variation of that. For example, when someone pulls their hamstring, that means they have a hamstring strain and have over-stretched the natural limits of that muscle(s).

How do I know if I have a sprain or strain?

No matter if the injury is a sprain or strain, it should be diagnosed by an appropriate health care professional (i.e. Athletic Trainer, Orthopedic Physician, etc…). However, if that is not readily available and you would like to know then, the best way to tell the difference is the location of the pain and/or swelling. If the pain/swelling is near or where two bones meet, chances are it is a sprain. If the pain/swelling is on or near a muscle, chances are it is a strain. Signs and symptoms of sprains and strains present in a similar fashion:

- Pain with movement of injured area

- Pain-to-touch of injured area

- Swelling and/or inflammation

How do I treat a sprain or strain?

It is important to first have the injury diagnosed by the proper health care professional, who can then give appropriate treatment instructions. Typical treatment may consist of but is not limited R.I.C.E. (rest, ice, compression and elevation).

Tips from the Athletic Trainer

One way to decrease the incidence of a strain is to increase flexibility. Engaging in a daily stretching routine can increase your muscle’s elasticity in a much quicker time frame than it would take to gain muscle or lose weight. In addition, performing a proper warm-up and THEN stretch before physical activity can decrease the chance of a strain.

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One of the most common questions to sports medicine and rehabilitation professions is, “how can I prevent injuries in the future?” There are many causes of injury, including muscle weakness or imbalances, decreased flexibility, overtraining, decreased balance, and arthritis or other degenerative conditions. Including the following into your exercise routine will significantly decrease the chance of injury.

Core Strengthening: Every training or exercise program should include core strengthening. This includes specific exercises for the upper back, deep abdominals, and hips. Most chronic injuries (including lower back pain, shoulder pain, and knee pain) are due to weakness in one or more of these muscle groups.

Warm Up: A warm up should be completed prior to starting any exercise. This can range from riding a recumbent bicycle, to a brisk walk, or a light jog – depending on your fitness and activity level. A warm up should be light to moderate in intensity. All athletes preparing for practice or competition should participate in a dynamic warm up routine.

Soft Tissue Mobilization: Stretching should be performed after completing exercise routine. A common training error is to perform long hold stretches before exercising. Research has consistently shown that stretching before exercise reduces the power of muscles and increases the risk of injury. Stretching after exercise, however, helps maintain flexibility and reduce injury. Foam rolling muscles will reduce tightness and spasms and improve recovery between exercise sessions.

In the event that an injury is sustained, a sports medicine or orthopedic specialist should be consulted. Injuries that initially seem minor can progress in severity or cause other body parts to become injured – leading to a much longer course of treatment.

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The preparticipation history and physical exam (PPE) represents the current foundation for the determination of medical eligibility in competitive athletics.  The purpose of which is to identify or raise the suspicion of clinically relevant preexisting conditions that could put the athlete at risk.  Within a structured PPE is a section devoted to screening for cardiovascular abnormalities.  Raising the suspicion of a cardiac abnormality or risk on the PPE is only the first tier of recognition after which a referral to a specialist familiar with cardiac adaptations to exercise and risks in athletes may be warranted.

The American Heart Association (AHA) has developed specific recommendation and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes.  There are 12 key elements to this evaluation that include aspects of a physical exam, personal history and family history.  All 12 elements are important, but often the personal and family history portions are under utilized or overlooked.  It’s vitally important for parents and/or guardians to be involved with this aspect of the PPE, as many athletes may be unaware of their family history.  Additionally, it’s not unusual for a lot of athletes to downplay symptoms that may in fact be important for the person performing the PPE to consider.

Key elements of the personal history to consider:

• Have you ever passed out or nearly passed out DURING or AFTER exercise?
• Have you ever had discomfort, pain, tightness, or pressure in your chest during exercise?
• Does your heart ever race or skip beats (irregular beats) during exercise?
• Has a doctor ever told you that you have any heart problems?
  • High blood pressure
  • A heart murmur
  • High cholesterol
  • A heart infection
  • Kawasaki disease
  • Other
  • Has a doctor ever ordered a test for your heart? (For example, ECG/EKG, echocardiogram)
  • Do you get lightheaded or feel more short of breath than expected during exercise?
  • Have you ever had an unexplained seizure?
  • Do you get more tired or short of breath more quickly than your friends during exercise?

Important aspects of the family history to note:

• Has any family member or relative died of heart problems or had an unexpected or unexplained sudden death before age 50 (including drowning, unexplained car accident, or sudden infant death syndrome)?
• Does anyone in your family have hypertrophic cardiomyopathy, Marfan syndrome, arrhythmogenic right ventricular cardiomyopathy, long QT syndrome, short QT syndrome, Brugada syndrome, or catecholaminergic polymorphic ventricular tachycardia?
• Does anyone in your family have a heart problem, pacemaker, or implanted defibrillator?
• Has anyone in your family had unexplained fainting, unexplained seizures, or near drowning?

Some of the questions may seem unrelated to sports or even cardiac conditions and in many cases they may not be.  However, rarely, they may in fact herald an underlying abnormality that could put the athlete at risk.  It is important that the person performing your PPE know this information, as further testing may be required.

Things that you can do to improve the PPE process and outcome:

1. Be actively involved in the screening and care of your athlete.  Ideally, the pre-participation evaluation and related management decisions should always be undertaken by the athlete in conjunction with their parent(s) and/or guardians and the team physician. The exclusion of parents from the care of student athlete is detrimental to the student’s health and well-being.
2. Fill out the forms completely and honestly.  If the questions are confusing then ask for clarification.
3. Make sure that whomever is performing the PPE for your athlete is using approved and complete forms such as the American Academy of Pediatrics 4^th Edition PPE Monograph history and physical form which is inclusive of the 12-Element American Heart Association Recommendations for the Preparticipation Cardiovascular Screening of Competitive Athletes:

http://www2.aap.org/sections/sportsmedicine/PPEAbout.cfm

The Sports Cardiology Program at Greenville Health System is a valuable resource that can assist you, the athlete and/or your physician to clarify eligibility issues that may have been discovered as part of the PPE or to help evaluate symptoms that may be cardiac related in athletes.

For more information call: 864-455-6977 or visit www.ghssportscardiology.org

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Ther Tee Vang from South Carolina School for the Deaf and the Blind (SCSDB) is being honored as a heart survivor by the American Heart Association. He was chosen one of 24 nationwide of over 400 entries to have his story shared.  The photo above (from left to right) is  Meghan Azhar, American Heart Association Jump Rope for Heart Coordinator, Ther Tee, and Steadman Hawkins Sports Medicine Certified Athletic Trainer Joni Canter.

SCSDB is the only school nationally where every student has a disability and participates. SC raised over $1 million and $2.3 million came back to SC for research at USC, Clemson, MUSC, Spartanburg Regional, Mary Black and Greenville Memorial where Ther Tee was flown to for treatment.

Here is his story…

My name is Ther Tee Vang.  I am 17 years old and a sophomore at the South Carolina School for the Deaf and the Blind in Spartanburg, South Carolina. I was the kicker and wide receiver for the varsity football team this past season. My life has changed and gone in another direction. I was practicing with the football team at SCSDB when the lights went out.

I remembered getting tackled. I felt dizzy. I hurt a little bit and then I woke up at Greenville Memorial Hospital. Later, they told me I had collapsed on the field and that it was an emergency. Joni Canter, SCSDB’s athletic trainer, used CPR and an AED (Automatic External Defibrillator) to get my heart beating again. Our school resource officer, Jamie Elam, called 911. The ambulance transported me to Spartanburg Regional Hospital where I was met by another team and airlifted by helicopter to Greenville Memorial Hospital.

They helped save my life. It took me two days before I knew what had happened. My family was with me the whole time at the hospital. The doctors explained to my family, and to me, that they think my heart just stopped.

I was born with a heart defect, which was repaired when I was a baby. My doctor continued to monitor me and released me when I was 12 years old. I hadn’t  had any problems for years and years. This time it was different. I needed surgery and a heart defibrillator was implanted to help my heart to work.

They told me I could not play football anymore. They told me I could not play any contact sports. I was scared, upset, and sad about not being able to play these sports. I was a good athlete. I enjoyed playing volleyball, basketball, baseball, soccer, kickball, and football. My favorite class is physical education. I started to worry about not playing sports with my friends. The doctors, nurses, and my family assured me that there will be other things to do and to enjoy.

The operation was successful and after several weeks recuperating at home, I was able to return to school. I was so happy to be back with my friends and teachers. I became the football team manager and everyone treated me like I was the school mascot. Go Hornets! They were right!

I am also a member of the school color guard. I am very patriotic and I have bought two American flags and two South Carolina state flags with money that I have saved from working.  I joined the dance group at school. The “Wobble” is my favorite dance. I am part of the Special Olympics swim and bowling teams. I love to exercise and play badminton. I enjoy Wii games at school and at home, too!

This year, as in years past, I was able to participate in Jump Rope for Heart. I helped raise $70.00 for the American Heart Association. I felt good about this because I have had many people help me through my heart health problem. I want to be able to help others.

I always try to eat right, especially to eat all my vegetables, drink lots water, exercise, and to get a good night’s  sleep. I encourage everyone to do the same and to get regular check-ups.

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The Powdersville Medical Center opens Jan. 29 on 34 acres at the corner of Highway 81 and McNeely Road.

A collaboration of Baptist Easley and Greenville Health System University Medical Center, the facility is anchored by an MD360 urgent-care center. The 32,500-square-foot facility also houses The Steadman Hawkins Clinic of the Carolinas, Proaxis Therapy and specialty surgeons from GHS.

“For 10 years we have had plans to expand our health care services in Powdersville,” said Baptist Easley CEO Roddey E. Gettys III in a news release. “The area has long been under-served for medical services. Now community residents will be able to get a full array of services close to home.”

Baptist Easley is a 50-50 joint venture between GHS and Palmetto Health of Columbia.

Powdersville Medical Center will employ 40 people.

The MD360 Convenient Care will provide walk-in and urgent-care services seven days a week. Additionally, Steadman Hawkins Clinic of the Carolinas and Proaxis Therapy provide orthopaedic and physical therapy services. Surgical specialists of GHS University Medical Group Department of Surgery staff an 11-room suite. Diagnostic X-ray and laboratory services are on site, as well as a 16-slice CT scanner operated by Baptist Easley Hospital. The Baptist Easley’s Sleep Lab also relocated to the new center and doubled in size. Additionally, the center offers a community room for health education events and space for use by others in the Powdersville community.

JMD Architects Inc., in collaboration with Batson Architects Inc., both of Greenville, designed the center. Triangle Construction, also of Greenville, was the general contractor.

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It is that time of year again, where respiratory illnesses are spread from person to person.  Whether the common cold or influenza (“the flu”); both are spread by several factors including coughing, sneezing, and unclean hands or surfaces.

To help reduce the spread of germs that cause respiratory illnesses, one can:

• Cover mouth and nose with a tissue when you cough and/or sneeze.
• If you do not have a tissue, use your shirt sleeve or upper arm rather than your hand.
• Clean hands frequently with soap and water or an alcohol based sanitizer, especially after coughing or sneezing
• Throw used tissues in waste basket
• Do not share water bottles and/or utensils
• If you have signs or symptoms, stay at home to rest and recover

Symptoms of the Flu include:

• Fever, often higher than 102 F
• Chills
• Headache
• Body aches and pains
• Cough

Although, both colds and the flu are caused by viral infections, colds usually involve a scratchy or sore throat, stuffy or runny nose and sometimes a fever.  As compared to the flu, cold symptoms are usually less intense and resolve faster.

Flu Prevention

The best prevention methods are described above in how to help reduce the spread of germs and to get a flu shot each year.  In years when the flu shot is not limited it is recommended that all individuals who do not have contraindications get one.  In years when there is a limited supply, priority will be given to individuals that have higher risk factors.  These include but are not limited to the elderly, individuals with center health conditions, individuals that are pregnant, health care workers, and all individuals that have close contact with sick or elderly individuals.

Seeking a Medical Provider

Cold symptoms usually last from 1-2 weeks, but may last longer.  Consider seeing a medical provider if there is no improvement in symptoms after 1-2 weeks, you develop a fever greater than 102 F, difficulty breathing and/or swallowing, severe headache, severe fatigue, or have cold symptoms along with a rash.

Antibiotics

Colds are most commonly caused by viral infections.  Antibiotics treat bacterial infections but not viral infections.  Antibiotic overuse to treat viral infections can cause an increased resistance to antibiotics by many bacteria.

Cold Treatment

The best treatment for a cold is getting plenty of rest and keeping well hydrated and warm.  Medications that can be purchased over the counter can help control symptoms of a cold until it resolves.

More information

If you are interested in finding out more information about colds and the flu, you can visit the Centers for Disease Control and the American Lung Association; both have more information on their websites.

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