Im having pain Do I have a stress fracture

How do I get a stress fracture?
This can occur when there is a sudden increase in activity level by increasing the distance or intensity of training. A stress fracture occurs when a bone breaks from repetitive tensile or compressive loads, making it a common overuse injury in long distance runners.

Stress Fracture

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Who is affected?

The incidents of stress fractures are less than 1 percent in the general population, but among runners it is 13% to 52%. Running places more stress on the weight bearing bones in our lower legs. The tibia shin bone fractures account for 49% of all stress fractures seen in athletes, followed by metatarsal foot bone fractures.

What are Risk Factors?

  • History of prior stress fracture
  • Low physical fitness level
  • Increasing volume and intensity too rapidly
  • Female gender and menstrual irregularity
  • Diet poor in calcium and vitamin D
  • Poor bone health
  • Poor biomechanics, like flat feet

What are the Initial signs?
The pain gradually begins in a specific location on the bone and initially gets worse with increased activity. Eventually, the pain is present during less strenuous activity and ultimately during rest. The affected bone will be tender to touch and is often associated with redness and swelling.

What is the difference between shin splints and a stress fracture?
Medial tibial stress syndrome shin splints often precedes the development of a stress fracture on the inside edge of the tibia shin bone. Shin splints are an inflammatory response of connective tissue to repetitive loading and like stress fractures, develop in people who suddenly increase their activity level, intensity, or frequency. The main difference is that shin splint pain is typically located diffusely along the bone on the middle to lower leg, not a specific spot. If the overuse activity continues, shin splints may progress to a stress fracture.

Don’t push through the pain…early diagnosis and intervention is important!
It can help avoid complications, reduce pain, promote healing, prevent further bone damage, and return to running.

Suspect a stress fracture?
It is highly recommended to seek care of a medical professional immediately. An x-ray will often detect if a stress fracture is present.

How to manage pain and symptoms?

  • Ice for 15-20 minutes every three hours as needed.
  • Take pain medication as prescribed by your physician.
  • Modify current activity levels in order to place less stress on the affected bone and remain pain-free.
  • If painful with walking, decreased weight bearing or splinting may be recommended to protect the fracture site.
  • Try alternative activities like walking briskly, using an elliptical machine, deep water running, cycling, or swimming.

Healing time can vary on average from 10-18 weeks depending on how soon it was detected and treatment started. Remember, the key to prevention is increasing training in small, incremental steps, especially for beginner runners.

Learn more about Rehabilitation Services at Divine Savior Healthcare.


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Experiencing a dull pain in the pit of your stomach

Stomach PainGastroesophageal reflux disease, or GERD, and gallbladder disease are two very common disorders. Knowing which one you have may be trickier than you think. Symptoms may be vague, such as a “dull pain in the pit of your stomach”, making it hard for you to explain to your doctor what’s exactly going on.

At Divine Savior Healthcare, General Surgeons, Dr. Eric Anderson and Dr. Joshua Pogorelec, have seen many patients with these symptoms and after further examination are able to help  diagnose and treat both diseases.

What is GERD?
Gastroesophageal reflux disease GERD refers to stomach contents moving into the esophagus causing a burning sensation commonly referred to as heartburn. Other symptoms may occur as well, such as pain in the upper abdomen, bloating, nausea and an acid taste in your mouth.  If this continue, prolonged exposure of the esophagus to stomach contents can result in damage to the lining of the esophagus.  This in turn can result in difficulty swallowing, pain with swallowing or permanent damage to the esophagus.

Although not all reflux results in symptoms or damage to the esophagus, common symptoms include:
• Heartburn
• Acid regurgitation
• Belching
• Difficulty or pain when swallowing
• Waterbrash sudden excess of saliva
• Dysphagia the sensation of food sticking in the esophagus
• Chronic sore throat
• Laryngitis
• Inflammation of the gums
• Erosion of the enamel of the teeth
• Chronic irritation in the throat
• Hoarseness in the morning
• A sour taste
• Bad breath
• Coughing at night

What is gallbladder disease?
The gallbladder is located below the liver on the upper right side of the abdomen. The main function of the gallbladder is to store bile, which is made in the liver and allows fat-soluble vitamins and nutrients to be easily absorbed into the bloodstream. Any condition that affects the gallbladder is considered a disease, and there are many different scenarios that fall under gallbladder disease:
• Inflammation
• Gallstones
• Common bile duct stones
• Biliary Dyskinesia
• Infection
• Perforated gallbladder
• Gallbladder polyps
• Porcelain gallbladders
• Gallbladder cancer

Dr. Anderson and Dr. Pogorelec share "the most common disease of the gallbladder is gallstones. Most people with gallstones do not even know they have them.  Once they cause problems, the gallbladder may need to be removed. Symptoms include pain below the right rib cage or in the “pit” of the stomach. This pain may radiate to the right upper back, chest, or shoulder. Other symptoms may include, bloating, nausea or vomiting, fever or chills, chronic diarrhea, jaundice yellow-tinted skin, or unusual lighter-colored stools or dark urine.”

After taking a closer look at GERD and gallbladder disease, Dr. Anderson and Dr. Pogorelec are able to provide helpful insight on common distinguishing factors between the two diseases.

Common distinguishing factors:
• Location: Although both may feel like a “pit in your stomach”, if you experience symptoms located closer to your throat or in your chest it is more likely to be GERD related. Symptoms located near your right lower rib radiating into your right upper back, chest and shoulder are more likely to be associated to your gallbladder.
• Pain: Unlike GERD, gallbladder pain usually begins suddenly, and changing positions, belching, passing gas or taking medications rarely helps pain symptoms go away.
• Timing: With heartburn being the most common symptom of GERD, symptoms of reflux are likely to occur shortly after eating, where symptoms of gallbladder disease usually occurs several hours after eating and have more consistent patterns of reoccurrence the same time each day.

What does treatment look like?
The symptoms of GERD are commonly and effectively treated with over-the-counter medications such as anti-acids and proton pump inhibitors. However, if relief does not go away from these medications your provider may recommend you be evaluated by one of our surgeons at Divine Savior.

After a thorough history and physical, our surgeons may recommend further evaluation of the esophagus and stomach with endoscopy.  Similar to colonoscopy, but without the need for prep, upper endoscopy allows the surgeon to visualize the esophagus, stomach and intestine to evaluate for damage to the esophagus, infection and a hiatal hernia.  Depending on the findings, further testing may be indicated to evaluate the function of the esophagus. 

Patients with severe GERD benefit from surgery to prevent reflux from occurring.  This procedure is commonly performed by both Dr. Anderson and Dr. Pogorelec, is minimally invasive, and very effective at treating GERD.  In fact, most patients no longer require any antacid medications after the procedure.

If you are found to have stones in the gallbladder causing symptoms, the best course of action is to have the gallbladder removed.  Leaving the stones in place will continue to cause pain and may result in serious infection of the gallbladder and bile ducts, jaundice or pancreatitis. 

Both Dr. Anderson and Dr. Pogorelec routinely perform minimally invasive removal of the gallbladder.  This is most often an outpatient procedure and very successful.  After a short recovery, most patients will find their symptoms are gone and they are able to live a normal life. 

If you experience symptoms related to GERD or gallbladder disease, or have concerns about either, it is best to consult your provider for further examination. Treatment for either disease varies person to person, but taking action immediately and being properly treated can help you prevent problems from worsening.

To schedule an appointment with Divine Savior Healthcare General Surgeons, Dr. Anderson or Dr. Pogorelec, call 608-745-5176.

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