3-72
Medications: Pain medicines cause sedation; non-steroidal anti-inflammatories may cause fatal stomach or
duodenal ulcer bleeds, kidney, or liver damage. All medications can produce allergic reactions.
Prevention and Hygiene: Avoid offending activities for overuse injuries; perform an appropriate rehabilitation
program (strengthening).
Wound Care: Grossly contaminated wounds should have the material removed and a sterile dressing placed
over them until definitive care is available.
Follow-up Actions
Return evaluation: For overuse injuries, follow-up in 2-3 weeks if no resolution is appropriate. For acute
injuries, most fractures heal in 4-6 weeks. Anterior shoulder dislocations should be in a sling for two weeks,
then gradual range of motion and strengthening exercises instituted.
Consultation Criteria: Fractures, rotator cuff tears, and suspected septic joints should be referred ASAP for
surgical evaluation and treatment in an operating room.
NOTES:
Rehabilitation Guide for overuse*:
Shoulder Rehabilitation Exercises for Strengthening Use light weights and someone to help “spot” as a
safety.
Dumbbell Shoulder Flies stop immediately if pain is felt with any exercise
- Hold the dumbbells down at the waist with thumbs pointing down
- Raise the dumbbells up at 10 o’clock and two o’clock to shoulder height.
- Perform three sets of 10 every other day.
- As strength improves, increase the weight, and keep repetition number the same.
Dumbbell Shoulder lateral Flies
- Hold a dumbbell in the hands at waist level, thumb pointing forward.
- Slowly raise the dumbbell to shoulder height.
- Perform three sets of 10 every other day.
- As strength improves, increase the weight, not the number of repetitions.
Bench press
- Lie on the back with weights in a rack.
- Lift the barbell off the rack with hands shoulder width.
- Slowly lower the weight to the mid chest and then push it up again slowly during exhalation.
- Perform three sets of 10, every other day.
- As strength improves, increase the weight.
*After the initial injury has healed, a strengthening program is essential to prevent additional injury.
Symptom: Joint Pain: Hip Pain
CDR Scott Flinn, MC, USNIntroduction: Hip and pelvic injuries may occur as a result of overuse or trauma. Knowing the mechanism of
injury and evaluating the degree of functional impairment provides the basis for appropriate treatment. Sudden
onset of pain with an inability to bear weight is an obviously worrisome presentation. Acute pain may result
from trauma, change in degenerative disease or infection. Chronic pain may be due to osteoarthritis, bursitis,
referred pain or aseptic necrosis of the femoral head. The need for more advanced diagnostic tests requiring
removal from the operational environment is based on the history and exam. Risk Factors: Recent increases
in activity/training, biomechanical or anatomic variations, and females with the “female athlete triad” (amenor-
rhea, eating disorder, and osteoporosis) are predisposing factors that contribute to overuse injuries including
stress fractures.