Mus­cle tears re­cover, but slowly

The Weekend Australian - Travel - - Health - LINDA CAL­ABRESI

Linda Cal­abresi is a GP and ed­i­tor of Med­i­calOb­server. Send your queries to linda.cal­abresi@medobs.com.au I ama 62-year-old ten­nis player who does some lim­ited jog­ging and golf. Re­cently I jumped off a swim­ming dock and tore my calf mus­cle. Ac­cord­ing to my doc­tor, no surgery is re­quired or rec­om­mended. What can I do to speed up my re­cov­ery and get back on court? THE symp­toms you de­scribe are most likely the re­sult of a tear in the one of the two heads of the main calf mus­cle — the gas­troc­ne­mius. This is also known as a ‘‘ torn mon­key mus­cle’’ in­jury, for rea­sons I don’t quite un­der­stand. It is caused by over­stretch­ing of that par­tic­u­lar mus­cle. While it is not se­ri­ous, it can be de­bil­i­tat­ing in the short term. To help with re­cov­ery you need to (in the first 48 hours) ad­here ini­tially to the RICE ther­apy — rest, ice, com­pres­sion and el­e­va­tion. Wear­ing an elas­tic com­pres­sion stock­ing can help re­duce the swelling as­so­ci­ated with the in­jury. While some peo­ple might need crutches for a few days, most peo­ple with a torn calf mus­cle are ad­vised to start gen­tle ex­er­cise, such as walk­ing, within 48 hours of the in­jury and to in­crease ac­tiv­ity as much as the pain will al­low. Us­ing a heel pad to raise the heel will help re­duce the pres­sure on the calf mus­cle. Gen­tle stretch­ing ex­er­cises will also fa­cil­i­tate re­cov­ery, and th­ese are of­ten best di­rected by a phys­io­ther­a­pist. It is ad­vis­able not to re­turn to full ac­tive sport un­til the pain has com­pletely gone, al­though wear­ing a heel raise can shorten the du­ra­tion of this re­stric­tion. I ama 43-year-old wo­man and have been di­ag­nosed with three gall­stones. My doc­tor ad­vises that I need to have the gall blad­der re­moved. I would like to know if the gall­stones them­selves can be re­moved, as an al­ter­na­tive to re­mov­ing the whole gall blad­der? Can diet stop stones re­cur­ring? GALL­STONES are very com­mon, oc­cur­ring in 10-20 per cent of the pop­u­la­tion. Gen­er­ally speak­ing they should only be re­moved if they are caus­ing a prob­lem. If this is the case, there are some al­ter­na­tives to re­mov­ing the en­tire gall blad­der. Th­ese in­clude tar­get­ing the stone with shock waves and de­stroy­ing it, al­though there is then the prob­lem of stone frag­ments which have to be ei­ther passed or dis­solved. This pro­ce­dure is not rec­om­mended for peo­ple with large or mul­ti­ple gall­stones. There are also drugs avail­able to dis­solve gall­stones, but th­ese have lim­ited ef­fec­tive­ness. Ba­si­cally the gall blad­der is con­sid­ered an un­nec­es­sary or­gan — its role be­ing to sim­ply con­cen­trate the bile which is man­u­fac­tured in the liver. It is this con­cen­trat­ing ef­fect which con­trib­utes to the gall­stone de­vel­op­ment, so if you have symp­to­matic gall­stones it is rec­om­mended you have the en­tire gall­blad­der re­moved. On bal­ance, you will not miss it and its re­moval will en­sure fur­ther gall­stones do not de­velop. A low-fat diet will help re­duce the risk of the stones caus­ing symp­toms, and it will help pre­vent new stones, but it will not cause the stones to dis­ap­pear. Is my breast-fed baby safe if I have a few drinks? WHILE al­co­hol is rapidly ab­sorbed into the blood­stream, its ab­sorp­tion into breast milk is far less. Re­search into the ef­fect of this al­co­hol on the breast-fed baby is lack­ing. The re­al­ity is that we just don’t know. How­ever, what is known is that high doses of al­co­hol can pro­duce symp­toms of ‘‘ drunk­en­ness’’ in in­fants. Also, chronic al­co­hol in­take can af­fect mo­tor de­vel­op­ment in in­fants, but how much al­co­hol is needed to cause this is yet be de­ter­mined. In gen­eral, it is thought that the oc­ca­sional drink by the mother is un­likely to cause any prob­lem to a breast-fed child, but more than this amount is best avoided.

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