August 1997 Table of ContentsTHE PHYSICIAN AND SPORTSMEDICINE - VOL 25 - NO. 8 - AUGUST 97
Exercise Is Medicine
Evidence for the efficacy of exercise in treating low-back pain is not completely consistent, but most studies and clinical experience suggest that exercise to improve aerobic fitness and build lumbar strength and flexibility in back-pain patients will improve patients' symptoms.
Brian J. Shiple, DO
Brian J. Shiple, DO
The arm or hand of a healthy athlete is not the likeliest place to find a stress fracture, but such fractures do occur, particularly in baseball players, gymnasts, and racket sports players. These lesions tend to develop in the growth plates in young patients and at muscle insertion sites in adults.
Thomas D. Cervoni, MD; Joseph R. Martire, MD; Leigh Ann Curl, MD; Edward G. McFarland, MD
An 18-year-old man suffered low-back pain after he started a rigorous training program with his amateur rugby team. Plain x-rays were normal, but further imaging studies revealed an unusual injury: a facet fracture in his lower back.
Conor P. O'Brien, MB, MSc, PhD; Charles Williams, MB; George Duffy, MD
Three case reports show that active older people can have a serious illness such as coronary artery disease or bacterial pneumonia with few or none of the usual signs and symptoms. Factors that can distort the presentation include chronic medication use, altered pain perception, and the physician's decreased index of suspicion when the patient has been healthy and active.
Carlos E. Jiménez, MD; Joseph Caravalho, Jr, MD; Inku Hwang, MD
A quick twisting or throwing motion or a fall will sometimes lead to rupture of the pectoralis major muscle, as described in three case reports. The history and physical exam will usually make the diagnosis, but swelling can complicate matters by obscuring the defect.
Geoffrey P. Griffiths, MD; F. Harlan Selesnick, MD
Managing Allergies in Active People
One of the standard facetious excuses for not exercising is "I'm allergic to it." But some people really do have allergic reactions related to exercise, usually because working out increases their exposure to common allergens. Here is a guide to helping patients minimize such stumbling blocks to healthy activity.
Malcolm N. Blumenthal, MD, with Carl Sherman
A 35-year-old Army paratrooper in good physical condition noticed a gradual decrease in his endurance over several years. See if you can make a diagnosis from his history, electrocardiogram, and chest x-ray.
Janus D. Butcher, MD
CME Self Test
Index to Advertisers
In an effort to provide information that is scientifically accurate and consistent with accepted standards of medical practice, the editors and publisher of The Physician and Sportsmedicine routinely consult sources believed to be reliable. However, readers are encouraged to confirm this information with other sources. For example and in particular, physicians are advised to consult the prescribing information in the manufacturer's package insert before prescribing any drug mentioned.
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