Sunday, May 26, 2013


If you have fibromyalgia with painful tender points, deep muscle pain, and fatigue, exercise is probably the last thing on your mind. Yet did you know that exercise may be just what the doctor ordered? Whether it's daily walks, stretching, swimming, yoga, tai chi, or Pilates, low-impact exercise programs can keep you fit in spite of your fibromyalgia and may help reduce pain as well.

Why Is Exercise Important for Fibromyalgia?

Experts believe that exercise is essential for keeping muscles strong and flexible, controlling weight, and helping you stay active in other areas of life. In fact, exercise and activity allow patients to have some control over fibromyalgia and the amount of pain they feel.
It used to be that doctors thought that exercise might worsen fibromyalgia symptoms or accelerate the disease. So doctors encouraged patients to seek rest, not activity. But recent scientific studies have shown that, for most patients, range of motion, strengthening, and aerobic conditioning exercises are safe and necessary.

Does Exercise Boost Endorphins in Those With Fibromyalgia?

Studies show that exercise helps restore the body's neurochemical balance and triggers a positive emotional state. Not only does regular exercise slow down the heart-racing adrenaline associated with stress, but it also boosts levels of natural endorphins -- pain-fighting molecules that may be responsible for the well-known "runner's high." Endorphins help to reduce anxiety, stress, and depression.

Does Exercise Boost Serotonin in People With Fibromyalgia?

Serotonin is a neurotransmitter in the brain that scientists have found to be related to fibromyalgia. Neurotransmitters are brain chemicals that send specific messages from one brain cell to another. While only a small percentage of all serotonin -- 1% to 2% -- is located in the brain, this neurotransmitter is believed to play a vital role in mediating moods.
Studies have found that too much stress can lead to permanently low levels of serotonin. That, in turn, can create aggression. An increased level of serotonin in the brain is associated with a calming, anxiety-reducing effect. In some cases it's also associated with drowsiness. A stable serotonin level in the brain is associated with a positive mood state or feeling good over a period of time. Lack of exercise and inactivity can aggravate low serotonin levels.

How Is Serotonin Related to Women and Fibromyalgia?

It appears that women may have a greater sensitivity to changes in this brain chemical. Mood swings during the menstrual cycle, menopause, or following the birth of a child may be hormonally induced through the action of the hormones on neurotransmitters.

Various factors -- such as sunlight, certain carbohydrate foods, some hormones, and exercise -- can have a positive effect on serotonin. Exercise acts as nature's tranquilizer by helping to boost serotonin in the brain. Studies have also shown that exercise triggers the release of epinephrine and norepinephrine, hormones that are known to boost alertness. For those who feel "stressed out" frequently, exercise will help to desensitize your body to stress.

What Are Other Benefits of Exercise for Those With Fibromyalgia?
Regular exercise benefits people with fibromyalgia by doing the following:

  • burning calories and making weight control easier
  • giving range-of-motion to painful muscles and joints
  • improving a person's outlook on life
  • improving quality of sleep
  • improving one's sense of well-being
  • increasing aerobic capacity
  • improving cardiovascular health
  • increasing energy
  • placing the responsibility of healing in the hands of the patient
  • reducing anxiety levels and depression
  • relieving stress associated with a chronic disease
  • stimulating growth hormone secretion
  • stimulating the secretion of endorphins or "happy hormones"
  • strengthening bones
  • strengthening muscles
  • relieving pain

What Types of Exercises Work Best for Fibromyalgia Symptoms?

Some new findings suggest that exercises such as walking, strength training, and stretching activities are effective at improving physical, emotional, and social function. They also are effective in addressing key symptoms and self-efficacy in women with fibromyalgia who are also being treated with medication. Other studies point to long-term aquatic exercise programs -- such as water aerobics -- as being effective in reducing symptoms and improving the health-related quality of life of the participants.
As you begin your exercise program, focus on three different types of exercise:

  • Range-of-motion or stretching exercises:
These exercises involve moving a joint as far as it will go (without pain) or through its full range of motion. Range-of-motion exercises or stretching will help you maintain flexibility in your muscle groups. Talk to your doctor or physical therapist about range-of-motion exercises. They can explain how to do these exercises properly and give you some guidance if you have difficulty performing the stretch.
  • Endurance or conditioning exercises:
When you increase your endurance threshold with cardiovascular forms of exercise such as walking, biking, or swimming, you do more than simply strengthen your muscles. You also condition your body, tone your muscles, and build coordination and endurance. In addition, endurance exercises help with weight loss.
  • Strengthening exercises:
These exercises help to build strong muscles and tendons needed to support your joints. Some studies show that strengthening exercises may improve fibromyalgia symptoms. Be cautious not to hurt yourself when doing strengthening exercises. A personal trainer or fitness expert can explain how to use resistance, starting slowly and increasing as you build your strength.

Can Low-Impact Exercises Help Flexibility and Stress in Fibromyalgia?

Low-impact aerobic exercises have been shown to improve symptoms and restore muscle strength in people with fibromyalgia. Some helpful exercises include:

  • Yoga: an ancient form of exercise that can reduce stress and relieve muscular tension or pain by improving range of motion and strength. Practicing yoga for fibromyalgia when you are feeling tense or anxious may help you reduce stress and the risk of injury when you are on the job or at home.
  • Tai chi: a series of flowing, graceful movements that can give you a good workout and stretching regimen. Studies show that tai chi participants also increase their sense of balance, can bend easier, and are better able to do household tasks. With fibromyalgia, tai chi can keep your back flexible and strong.
  • Pilates: a form of exercise that focuses on breathing and strengthening the torso muscles. With Pilates, an instructor will help you work on postural muscles that are essential to supporting the spine.

Can Water Therapy Help People With Fibromyalgia?

Yes. If you have fibromyalgia, water therapy can give you good results. Water therapy strengthens and conditions as you move your body against the water. Water supports your weight during movement, which helps alleviate any impact on muscles and joints.
The water alleviates the force of gravity and provides buoyancy as well as mild resistance. Whether stretching in the water, using a kickboard as a floatation device as you push and kick, or swimming using slow, gentle strokes, water therapy can provide a gentle form of conditioning. That makes it quite beneficial for people with fibromyalgia.

How Can I Get Started Exercising With Fibromyalgia?

If you have fibromyalgia and want to start exercising, it's important to start slowly. Begin with stretching exercises and gentle, low-impact activity, such as walking, swimming, or bicycling. Muscle soreness is normal when you are just starting an exercise regimen. But if you have sharp pain, stop and call your doctor. You may have overworked or injured your muscles.

Are There Exercises to Avoid With Fibromyalgia?

There are no particular exercises to avoid if you have fibromyalgia. Aerobic exercise (running, jogging), weight training, water exercise, and flexibility exercises can all help. Golf, tennis, hiking, and other recreational activities are also healthful. 

If you have other medical problems or if you're planning more than a moderate-intensity exercise program, discuss your plan with your doctor before you start.


Fibromyalgia is a disease that strikes more women than men. Typical treatment involves medications that control pain and ease depression. In a new study, researchers find that yoga has benefits for treating serious symptoms associated with the disease, including reduction of pain, fatigue, depression and sleep disturbance.
Yoga that includes gentle stretches and meditation may help alleviate the symptoms of fibromyalgia, a small study finds.

Twenty-five women diagnosed with fibromyalgia, a chronic pain syndrome, were enrolled in a two-hour yoga class that met once a week for eight weeks. Another group of 28 women diagnosed with the condition were put on a waiting list and told to continue their normal routine for dealing with fibromyalgia.

After eight weeks, the yoga group reported improvements in both physical and psychological aspects of fibromyalgia, including decreased pain, fatigue, tenderness, anxiety and better sleep and mood.

"The women were somewhat apprehensive when we started, but once they got into the rhythm of it they found it to be very helpful," said lead study author James Carson, a clinical psychologist and pain specialist at Oregon Health & Science University in Portland. "They came back after the first week reporting less pain, better sleep and feeling encouraged for the first time in years. 
That type of change continued to build over the course of the program." At the end of the study, about 4.5% in the yoga group reported being "very much better," 9.1% said they were "much better," 77% were "a little better" while 4.5% reported no change. In comparison, no one in the the control group reported that they were "very much better" or "much better," 19.2% reported being "a little better," and 38.5% reported "no change."
Average pain scores dropped from a 5 to a 4 on a 10-point scale, although there was no improvement in the overall "tender point" score.

The study was limited by its small sample, absence of follow-up and over-reliance on self-reported data, the researchers noted.

The study is in the November print issue of the journal Pain.

No cure exists for fibromyalgia, which is characterized by multiple tender points, fatigue, insomnia, anxiety, depression, and memory and concentration problems. Some 11 million to 15 million Americans have the debilitating condition, about 80% to 90% of them women, according to background information in the article.

Fibromyalgia can be very difficult to treat, with many patients reporting little relief from medications, said Dr. Bruce Solitar, a clinical associate professor of medicine in the division or rheumatology at NYU Langone Medical Center in New York City.

Yoga is probably worth trying, Solitar said. But he noted that patients in the study were in a yoga class specially tailored to their needs and said the class at a local yoga studio might be too intense.

The yoga sessions evaluated in the study included 40 minutes of gentle stretching and poses, 25 minutes of meditation, 10 minutes of breathing techniques, a 20-minute lesson on applying yoga principals to daily life and coping with fibromyalgia and 25 minutes of group discussion. 

Though it's unknown how much of the positive effect shown in the study is the "placebo" effect of doing something that feels empowering vs. something special about the yoga and meditation itself, that may be beside the point if people feel better, Solitar said.

"Many patients report that not much helps them, so anything that's positive is a very good thing," Solitar said.

In the study, women practiced Yoga of Awareness, a type of yoga developed by Carson, a yoga and meditation instructor, and his wife, study co-author Kimberly Carson. Carson taught the class. (Carson reported no financial considerations that would cause a conflict of interest.)

Yoga of Awareness draws from the Kripalu school of yoga, Carson said, which emphasizes the "inner dimensions" of yoga, such as accepting pain and being willing to learn from pain and stressful circumstances, being mentally "present in the moment" and learning to distinguish between actual events and the mind's tendency to "catastrophize" pain — that is, thinking it's the worst pain ever when really it's manageable, he said.

Previous research showed Yoga of Awareness improved pain, fatigue, sleep and mood in women with breast cancer, Carson said. It's unknown what aspects of Yoga of Awareness are the most beneficial, but Carson said he believes the exercise, meditation and the social aspects all contribute. "It's the combination that has a synergistic effect," Carson said. "Our mind and body are very connected, but we are often not aware of that fact. 
Techniques like yoga really reinforce that connection and make us much more conscious of the fact that our thoughts and our feelings are affecting our body, and our body is affecting how we think and feel."
If you have fibromyalgia and are looking for a yoga class, Carson recommended seeking out a class advertised as "gentle" and making sure the instructor knows you have physical challenges so that poses can be modified.

Since many yoga classes don't incorporate much meditation, Carson also recommends seeking out a meditation class, which teaches breathing exercises to reduce stress and cope with pain.

A study published in August in the New England Journal of Medicine found tai chi may also help give fibromyalgia sufferers some relief. Like yoga, tai chi is a mind-body exercise that emphasizes slow, gentle movements to build strength and flexibility, as well as deep breathing and relaxation, to move qi, or vital energy, throughout the body.



For the 40-dollar a month special discount price of one class at Hot Yoga Studio, one would hope you get at least some of the benefits claimed of hot yoga practice, like increased flexibility, strength, lung capacity and blood circulation.....But it turns out that you may also be paying for a practice that actually impairs your health in some ways. 

According to its founder, Bikram Choudhury, this style of yoga increases mental and physical health by pushing both beyond their everyday limits. While we can all probably agree that some challenge is healthy, some people condemn the practice for pushing yogis beyond a reasonable, gainful strain to a realm that is taxing, stressful and contrary to the fundamental yogic principles.

A lot of critics believe that the extreme temperatures and dampness of Bikram yoga rooms poses a high risk of causing overheating or dehydration. Since classes are usually an hour and a half long, the likelihood of these is high; so high, in fact, that next to Choudhury’s San Diego training center, medical professionals have set up a tent for those who experience these symptoms, suffer seizures or even pass out.

A more severe concern of these symptoms is heat stroke — when the body rises over 105 degrees Fahrenheit, people become confused, dizzy and nauseous, and the person’s pulse and sweating rates slow down dramatically. 

Drinking water, which many teachers discourage during the hour and a half long classes, doesn’t rectify these problems because sweating causes a loss of salts in addition to the liquid. In fact, drinking only water without the accompanying salts like potassium or sodium can lead to a condition known as hyponatremia, which can cause sudden death from a heart attack. And this isn’t the only threat to your heart.

Choudhury argues that Bikram yoga helps blood circulate through the body by the acts of extension and compression associated with holding and releasing muscles in the exercises. Modern medicine has seen little proof of the positive effect of oxygenated blood rushing after it was cut off from a local region of the body. In fact, many physicians in India advise patients with blood disorders such as high blood pressure, hypertension and heart disease to avoid yoga asanas (postures) like headstands and handstands that cause a rush of blood to the torso and cut off circulation from the limbs. Even some seated postures can cause blood flow complications; the rapid exhaling of “kabalabhati breath” performed at the end of a Bikram session can cause internal bleeding for patients with ulcers.

Athletes seeking muscular cross-training with Bikram yoga should beware too: Doctors are seeing a surge of patients whose misapplied yoga practice has caused injuries in both muscle and bone. Bikram followers believe they can obtain deeper stretching because the extreme heat facilitates elasticity in the muscle tissue. But this deep stretching can easily cause tears because muscles that are stretched beyond 20 to 25 percent of their resting length begin to be damaged, according to Dr. Robert Gotlin, director of orthopedic and sports rehabilitation at the Beth Israel Medical Center in Manhattan. The contortions associated with Bikram’s 26 poses, particularly the Hero and Camel poses, are especially likely to cause damage to lower back, groin, knees and ankles. The 12th pose in the Bikram sequence, “toe stand pose,” has been the cause of knee cartilage and cruciate ligament tears.

You might wonder how this dichotomy is possible: How can so many people praise a practice with myriad potential harms? The answer may lie in a misunderstanding: not of the yoga postures, but of the human body performing them.

Many Hot yoga teachers do not take appropriate precautions to protect their students, sometimes because they are trained inadequately or incorrectly. One of hot Yoga teacher say claims “if it hurts, do it more” to cure ailments. While these words may be alluring to those suffering from excruciating herniated discs or arthritis, they have the potential to lend false hope. In fact, many people take up Bikram hot yoga to heal herniated discs, but the Mayo Clinic recommends a conservative treatment of “avoiding painful positions.” Blame for yoga injuries is also on the patient’s shoulders: disillusioned by celebrity hype and a desperate hope to heal, the injured student should not decide to engage in exercise that involves conditions they are advised to avoid.

On a more spiritual level, a lot of the problems associated with Hot yoga seem contrary to traditional yoga themes of peace, meditation and oneness. One of the most controversial aspects of Bikram yoga is its support of competition. But wait … isn’t yoga supposed to decrease or moderate competition and stress associated with our day-to-day lives? 

Choudhury doesn’t think so. In a recent interview, he said: “Competition is the foundation for all democratic societies. For without ‘competition,’ there is no democracy.” 

Choudhury’s yogic style certainly caters to American values in other ways as well; he’s working on a reality show, merchandise line and Bikram radio channel. His style is promoted by famous people like Lady Gaga and Richard Nixon, and Bikram himself is a celebrity; he charges for book signings, owns over 40 Rolls Royces and Bentleys, has a watch collection worth millions of dollars — and he shamelessly flaunts it all.

But Choudhury’s personal behavior shouldn’t deter you from pursuing Bikram yoga; as Charles Lamb once said, “He who hath not a dram of folly in his mixture hath pounds of much worse matter in his composition.” Rather, you should enter Bikram’s practice with a knowledge of these concerns and understanding of your own goals — oh, and don’t forget your 40 dollars.

Sunday, May 19, 2013


Lower backache can have negative effects on a person’s overall quality of life.  

Back pain can be debilitating, and a person who suffers from lower backaches can feel they are missing out on life and are susceptible to depression and anxiety.  

People who suffer from lower back pain often mistakenly believe that rest is the best treatment.  Actually, strengthening the lower back is the best way to get rid of and prevent back ache.  

Yoga for lower backache is one of the best ways to strengthen your lower back and prevent future pain and injury. 

Most lower back aches are caused by stress and tension in the lower back, which is compounded by poor posture and weak muscles.  The proper sequence of yoga postures can strengthen muscles, increase flexibility, relieve stress, and alleviate pain.  

Yoga also helps a person become more aware of their body, and yoga practitioners often unconsciously begin to maintain excellent posture.  Poor posture takes an incredible toll on the lower back, adding unnecessary weight and stress on the spinal cord.

Lower back  problems can also be caused by life’s daily stresses and tensions.  Yoga naturally helps a person rid themself of anxiety, relieving physical strain caused by excess worry.  In turn, yoga practitioners find themselves with decreased pain caused by stress, wherever they accumulate tension, whether in headaches, backaches, or neck aches.
If the back aches as a result of injury, a person should see a physician to diagnose the injury and to get approval before embarking on any exercise routine.  Certain yoga postures can actually exacerbate lower back ache.  A trained yoga teacher can help you make sure you are practicing yoga for backache.  The wrong yoga postures can actually hurt rather than help.

After the recommended amount of rest has been taken, starting a regular yoga practice is the best way to reduce the chances of further injury to your lower back.  Most back injuries occur when a person strains their back, causing discs in their vertebrae to come out of place or ligaments to tear.  

Yoga for lower back ache will strengthen those ligaments so injury caused by lifting heavy objects is less likely.  Yoga also teaches a person to be intrinsically aware of what their body is capable of.

Simply shifting the chore of lifting from the lower back to your stronger legs will reduce injury.   Poses that aid in relieving lower back pain strengthen the core of the body, lower back and abdominal regions.  When you are continuously stretching and taking proper care of your core, you will be keenly aware of when you begin mistreating it.

Here are some postures that are proven to aid and prevent back ache:

Saturday, May 18, 2013

Antisocial Personality Disorder

Antisocial personality disorder is characterized by a long-standing pattern of a disregard for other people's rights, often crossing the line and violating those rights. It usually begins in childhood or as a teen and continues into their adult lives. 

Antisocial personality disorder is often referred to as psychopathy or sociopathy in popular culture. 

Individuals with Antisocial Personality Disorder frequently lack empathy and tend to be callous, cynical, and contemptuous of the feelings, rights, and sufferings of others. 

They may have an inflated and arrogant self-appraisal (e.g., feel that ordinary work is beneath them or lack a realistic concern about their current problems or their future) and may be excessively opinionated, self-assured, or cocky. 

They may display a glib, superficial charm and can be quite voluble and verbally facile (e.g., using technical terms or jargon that might impress someone who is unfamiliar with the topic). Lack of empathy, inflated self-appraisal, and superficial charm are features that have been commonly included in traditional conceptions of psychopathy and may be particularly distinguishing of Antisocial Personality Disorder in prison or forensic settings where criminal, delinquent, or aggressive acts are likely to be nonspecific. These individuals may also be irresponsible and exploitative in their sexual relationships. 

Symptoms of Antisocial Personality Disorder

Antisocial personality disorder is diagnosed when a person's pattern of antisocial behavior has occurred since age 15 (although only adults 18 years or older can be diagnosed with this disorder) and consists of the majority of these symptoms:

  • Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
  • Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
  • Impulsivity or failure to plan ahead
  • Irritability and aggressiveness, as indicated by repeated physical fights or assaults
  • Reckless disregard for safety of self or others
  • Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
  • Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another 
As with all personality disorders, the person must be at least 18 years old before they can be diagnosed with it. There should also be evidence of Conduct Disorder in the individual as a child, whether or not it was ever formally diagnosed by a professional.
Antisocial personality disorder is more prevalent in males (3 percent) versus females (1 percent) in the general population. 

Like most personality disorders, antisocial personality disorder typically will decrease in intensity with age, with many people experiencing few of the most extreme symptoms by the time they are in the 40s or 50s. 
How is Antisocial Personality Disorder Diagnosed?
Personality disorders such as antisocial personality disorder are typically diagnosed by a trained mental health professional, such as a psychologist or psychiatrist. Family physicians and general practitioners are generally not trained or well-equipped to make this type of psychological diagnosis. So while you can initially consult a family physician about this problem, they should refer you to a mental health professional for diagnosis and treatment. 
There are no laboratory, blood or genetic tests that are used to diagnose antisocial personality disorder. 

Many people with antisocial personality disorder don't seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person's life. This most often happens when a person's coping resources are stretched too thin to deal with stress or other life events. 

A diagnosis for antisocial personality disorder is made by a mental health professional comparing your symptoms and life history with those listed here. They will make a determination whether your symptoms meet the criteria necessary for a personality disorder diagnosis.

Causes of Antisocial Personality Disorder

Researchers today don't know what causes antisocial personality disorder. There are many theories, however, about the possible causes of antisocial personality disorder. Most professionals subscribe to a biopsychosocial model of causation -- that is, the causes of are likely due to biological and genetic factors, social factors (such as how a person interacts in their early development with their family and friends and other children), and psychological factors (the individual's personality and temperament, shaped by their environment and learned coping skills to deal with stress). 

This suggests that no single factor is responsible -- rather, it is the complex and likely intertwined nature of all three factors that are important. If a person has this personality disorder, research suggests that there is a slightly increased risk for this disorder to be "passed down" to their children.

Treatment of Antisocial Personality Disorder
Treatment of antisocial personality disorder typically involves long-term psychotherapy with a therapist that has experience in treating this kind of personality disorder. Medications may also be prescribed to help with specific troubling and debilitating symptoms. 

Saturday, May 11, 2013

muscle cramp symptoms and treatment

Have you ever experienced a "charley horse"? If yes, you probably still remember the sudden, tight and intense pain caused by a muscle locked in spasm. 

A cramp is an involuntary and forcibly contracted muscle that does not relax. Cramps can affect any muscle under your voluntary control (skeletal muscle). Muscles that span two joints are most prone to cramping. Cramps can involve part or all of a muscle, or several muscles in a group. 

The most commonly affected muscle groups are: 
  • Back of lower leg/calf (gastrocnemius)
  • Back of thigh (hamstrings)
  • Front of thigh (quadriceps)
Cramps in the feet, hands, arms, abdomen, and along the rib cage are also very common. 

Who Gets Cramps
Just about everyone will experience a muscle cramp sometime in life. It can happen while you play tennis or golf, bowl, swim, or do any exercise. It can also happen while you sit, walk, or even just sleep. Sometimes the slightest movement that shortens a muscle can trigger a cramp.
Some people are predisposed to muscle cramps and get them regularly with any physical exertion. 

Those at greatest risk for cramps and other ailments related to excess heat include infants and young children, people over age 65, and those who are ill, overweight, overexert during work or exercise, or take drugs or certain medications.
Muscle cramps are very common among endurance athletes (i.e., marathon runners and triathletes) and older people who perform strenuous physical activities. 

Athletes are more likely to get cramps in the preseason when the body is not conditioned and therefore more subject to fatigue. Cramps often develop near the end of intense or prolonged exercise, or 4-6 hours later. 
Older people are more susceptible to muscle cramps due to normal muscle loss (atrophy) that begins in the mid-40s and accelerates with inactivity. As you age, your muscles cannot work as hard or as quickly as they used to. The body also loses some of its sense of thirst and its ability to sense and respond to changes in temperature. 


Although the exact cause of muscle cramps is unknown (idiopathic), some researchers believe inadequate stretching and muscle fatigue leads to abnormalities in mechanisms that control muscle contraction. Other factors may also be involved, including poor conditioning, exercising or working in intense heat, dehydration and depletion of salt and minerals (electrolytes). 

Stretching and Muscle Fatigue 

Muscles are bundles of fibers that contract and expand to produce movement. A regular program of stretching lengthens muscle fibers so they can contract and tighten more vigorously when you exercise. When your body is poorly conditioned, you are more likely to experience muscle fatigue, which can alter spinal neural reflex activity. Overexertion depletes a muscle's oxygen supply, leading to build up of waste product and spasm. When a cramp begins, the spinal cord stimulates the muscle to keep contracting.

Heat, Dehydration, and Electrolyte Depletion 
Muscle cramps are more likely when you exercise in hot weather because sweat drains your body's fluids, salt and minerals (i.e., potassium, magnesium and calcium). Loss of these nutrients may also cause a muscle to spasm. Although most muscle cramps are benign, sometimes they can indicate a serious medical condition. 

See your doctor if cramps are severe, happen frequently, respond poorly to simple treatments, or are not related to obvious causes like strenuous exercise. You could have problems with circulation, nerves, metabolism, hormones, medications, or nutrition. 

Muscle cramps may be a part of many conditions that range from minor to severe, such as Lou Gehrig's disease (amyotrophic lateral sclerosis), spinal nerve irritation or compression (radiculopathy), hardening of the arteries, narrowing of the spinal canal (stenosis), thyroid disease, chronic infections, and cirrhosis of the liver. 

Muscle cramps range in intensity from a slight tic to agonizing pain. A cramping muscle may feel hard to the touch and/or appear visibly distorted or twitch beneath the skin. A cramp can last a few seconds to 15 minutes or longer. It might recur multiple times before it goes away. 

Doctor Examination

During your appointment, tell your doctor about your medical history including details about allergies, illnesses, injuries, surgeries, and medications. 

Your doctor may ask you several questions:
**How long have you experienced cramps? 
**Is there a family history of the problem? 
**Do your cramps occur only after exercise, or do they 
   happen while at rest? 
**Does stretching relieve the cramps? 
**Do you have muscle weakness or other symptoms? 

Your doctor may want to take a routine blood test to rule out diseases. 

Cramps usually go away on their own without seeing a doctor.
  • Stop doing whatever activity triggered the cramp.
  • Gently stretch and massage the cramping muscle, holding it in stretched position until the cramp stops.
  • Apply heat to tense/tight muscles, or cold to sore/tender muscles. 
To avoid future cramps, work toward better overall fitness. Do regular flexibility exercises before and after you work out to stretch muscle groups most prone to cramping. 

Warm up Exercise
Always warm up before stretching. Good examples of warm-up activities are slowly running in place or walking briskly for a few minutes.

Calf Muscle Stretch

You should feel this stretch in your calf and down toward your heel.

Lean forward against a wall with one leg in front of the other. Straighten your back leg and press your heel into the floor. Your front knee is bent. Hold for 15 to 30 seconds.

Do: Keep both heels flat on the floor. Point the toes of your back foot toward the heel of your front foot.

Hamstring Muscle Stretch


You should feel this stretch at the back of your thighs and behind your knees.

Sit up tall with both legs extended straight in front of you. Your feet are neutral — not pointed or flexed. Place your palms on the floor and slide your hands toward your ankles. Hold for 30 seconds.

Do: Keep your chest open and back long. Reach from your hips. Stop sliding your palms forward when you feel the stretch.
Do not: Round your back or try to bring your nose to your 
knees. Do not lock your knees.

Quadriceps Muscle Stretch

You should feel this stretch in the front of your thigh.

Hold on to a wall or the back of a chair for balance. Lift one foot and bring your heel up toward your buttocks. Grasp your ankle with your hand and pull your heel closer to your body. Hold the stretch for 30 seconds.

Do: Keep your knees close together. Stop bringing your heel closer when you feel the stretch.
Do not: Arch or twist your back.
Hold each stretch briefly, then release. Never stretch to the point of pain.

Thursday, May 9, 2013

Compartment Syndrome

Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. 

This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.Compartment syndrome can be either acute or chronic. 

Acute compartment syndrome is a medical emergency. It is usually caused by a severe injury. Without treatment, it can lead to permanent muscle damage.

Chronic compartment syndrome, also known as exertional compartment syndrome, is usually not a medical emergency. It is most often caused by athletic exertion.


The area between the knee and ankle has four major muscle compartments: anterior, lateral, superficial posterior, deep posterior.
Compartments are groupings of muscles, nerves, and blood vessels in your arms and legs. Covering these tissues is a tough membrane called a fascia. The role of the fascia is to keep the tissues in place, and, therefore, the fascia does not stretch or expand easily.

Compartment syndrome develops when swelling or bleeding occurs within a compartment. Because the fascia does not stretch, this can cause increased pressure on the capillaries, nerves, and muscles in the compartment. Blood flow to muscle and nerve cells is disrupted. Without a steady supply of oxygen and nutrients, nerve and muscle cells can be damaged.

In acute compartment syndrome, unless the pressure is relieved quickly, permanent disability and tissue death may result. This does not usually happen in chronic (exertional) compartment syndrome.

Compartment syndrome most often occurs in the anterior (front) compartment of the lower leg (calf). It can also occur in other compartments in the leg, as well as in the arms, hands, feet, and buttocks. 

Acute Compartment Syndrome:
Acute compartment syndrome usually develops after a severe injury, such as a car accident or a broken bone. Rarely, it develops after a relatively minor injury. 

Conditions that may bring on acute compartment syndrome include: 

A fracture.  
A badly bruised muscle: 
This type of injury can occur when a motorcycle falls on the leg of the rider, or a football player is hit in the leg with another player's helmet. 

Reestablished blood flow after blocked circulation:
This may occur after a surgeon repairs a damaged blood vessel that has been blocked for several hours.

A blood vessel can also be blocked during sleep. Lying for too long in a position that blocks a blood vessel, then moving or waking up can cause this condition. Most healthy people will naturally move when blood flow to a limb is blocked during sleep. 

The development of compartment syndrome in this manner usually occurs in people who are neurologically compromised. This can happen after severe intoxication with alcohol or other drugs. 

Crush injuries  
Anabolic steroid use:
Taking steroids is a possible factor in compartment syndrome. 

Constricting bandages:
Casts and tight bandages may lead to compartment syndrome. If symptoms of compartment syndrome develop, remove or loosen any constricting bandages. If you have a cast, contact your doctor immediately.

Chronic (Exertional) Compartment Syndrome 
The pain and swelling of chronic compartment syndrome is caused by exercise. Athletes who participate in activities with repetitive motions, such as running, biking, or swimming, are more likely to develop chronic compartment syndrome. This is usually relieved by discontinuing the exercise, and is usually not dangerous.

Doctor Examination
Acute Compartment Syndrome
Go to an emergency room immediately if there is concern about acute compartment syndrome. This is a medical emergency. Your doctor will measure the compartment pressure to determine whether you have acute compartment syndrome. 

Chronic (Exertional) Compartment Syndrome 
To diagnose chronic compartment syndrome, your doctor must rule out other conditions that could also cause pain in the lower leg. For example, your doctor may press on your tendons to make sure you do not have tendonitis. He or she may order an X-ray to make sure your shinbone (tibia) does not have a stress fracture.

To confirm chronic compartment syndrome, your doctor will measure the pressures in your compartment before and after exercise. If pressures remain high after exercise, you have chronic compartment syndrome. 

 Acute Compartment Syndrome 
Acute compartment syndrome is a surgical emergency. There is no effective nonsurgical treatment.Your doctor will make an incision and cut open the skin and fascia covering the affected compartment. This procedure is called a fasciotomy.

Sometimes, the swelling can be severe enough that the skin incision cannot be closed immediately. The incision is surgically repaired when swelling subsides. Sometimes a skin graft is used.

Chronic (Exertional) Compartment Syndrome 

Nonsurgical treatment:
Physical therapy, orthotics (inserts for shoes), and anti-inflammatory medicines are sometimes suggested. 

They have had questionable results for relieving symptoms.
Your symptoms may subside if you avoid the activity that caused the condition. Cross-training with low-impact activities may be an option. 

Some athletes have symptoms that are worse on certain surfaces (concrete vs. running track, or artficial turf vs. grass). Symptoms may be relieved by switching surfaces. 
Surgical treatment:
If conservative measures fail, surgery may be an option. Similar to the surgery for acute compartment syndrome, the operation is designed to open the fascia so that there is more room for the muscles to swell.

Usually, the skin incision for chronic compartment syndrome is shorter than the incision for acut compartment syndrome. Also, this surgery is typically an elective procedure -- not an emergency.