Pulled Back Muscle and Lower-Back Strain
This type of hockey injury is especially bothersome. The majority of episodes of acute lower back pain are caused by damage to the muscles and/or ligaments in the lower back. While a muscle strain doesn’t sound like a serious hockey injury, the resulting lower back pain can be surprisingly severe and is the cause of many emergency room visits each year.
There are two common types of lower back strain:
- A muscle strain happens when the muscle is over-stretched or torn, resulting in damage to the muscle fibers (also called a pulled muscle)
- A lumbar sprain occurs when ligaments are stretched too far or torn. Ligaments are very tough, fibrous tissues that connect bones together
For practical purposes, it doesn’t matter if it is a muscle strain or a ligament sprain that is causing the pain, since the treatment and prognosis for both are the same. When the muscles or ligaments in the lower back are strained or torn, the area around the muscles will usually become inflamed. The inflammation leads to back spasm, and it is the back spasm that can cause both severe lower back pain and difficulty moving.
Common Causes of a Pulled Back Muscle
Lower-back pain from muscle strain usually is caused by any type of movement that puts undue stress on the lower back. Frequent causes include lifting a heavy object, lifting while twisting, or a sudden movement or fall.
Sports injuries are also a frequent cause of a pulled back muscle, especially those that involve twisting (such as golf), or any types of sudden impact or jarring motions. Symptoms may range from a mild ache to sudden debilitating pain.
Typical symptoms of a lower-back pulled muscle include some combination of the following:
- The pain is usually localized in the lower back, meaning that it doesn’t radiate into the leg (as in sciatica)
- The lower back may be sore upon touch
- Pain usually comes on suddenly
- There may be accompanying muscle spasms
- The patient usually feels better when resting, and may find standing or walking difficult
Severe back pain may resolve quickly, but a lower level of pain, or intermittent flare-ups of pain, may continue for a few weeks or months. Fortunately, back-muscle strains usually heal with time, with most healing within a few days and almost all resolving within 3 to 4 weeks. The large muscles in the lower back have a good blood supply, which bring the necessary nutrients and proteins for healing to occur.
If the lower back muscle pain is severe, the patient may be advised to rest, but for no more than one or two days.
Typical first line treatments include some combination of:
- Pain medication (such as acetaminophen), to interrupt transmission of pain signals to the brain
- Anti-inflammatory medication (such as ibuprofen, or possibly oral steroids), to reduce the local inflammation that is a cause of the pain
- Muscle relaxants, which may be prescribed on a short-term basis to relieve severe lower-back pain associated with muscle spasms.
- Massage, which can help promote blood flow in the lower back (to help with healing), loosen tight lower back muscles, and release endorphins, the body’s natural painkillers
- Chiropractic Gentle manual manipulation is an option to help loosen tight back muscles and promote healing in the lower back
- Ice or cold packs Application of some type of cold pack can help reduce inflammation, which is helpful immediately following the injury
- Heat therapy. Application of heat to the lower back is helpful longer term to stimulate blood flow and healing to the injured area
If an episode of lower back pain lasts for more than two weeks, the muscles may start to weaken. Because using the lower-back muscles is painful, the natural tendency for most patients is to avoid using them. However, lack of activity leads to disuse atrophy (muscle wasting) and subsequent weakening, which in turn causes more lower back pain because the muscles are less able to help hold up the spine.
Separated or Dislocated Shoulder
A shoulder separation is a fairly common hockey injury and occurs after a fall or a sharp blow to the top of the shoulder. This injury is usually sports related or due to car accidents or falls. This is not the same as a shoulder dislocation, which occurs at the large joint where the arm attaches to the shoulder, although the two may appear to be the same. Continued
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