DEAR DR. DONOHUE: Last week, during a football game, I made a tackle that caused a terrific burning pain in my right arm. It lasted a couple of minutes, and I have been OK since. I continued to play. I made the mistake of telling my mom, and she insists I see a doctor and get an X-ray. Is that necessary? – J.O.
ANSWER: You had a common football injury – a burner, or stinger. It comes from stretching the brachial plexus, an intertwining bundle of nerves that comes from spinal cord segments in the neck. The bundle extends from the neck to the shoulder.
Tackling forces the impacting shoulder downward (your right shoulder) and pushes the neck toward the opposite side. That action elongates the nerves and sends a jolt of burning pain down the arm. The pain usually lasts only a few minutes.
It’s not dangerous to return to play if the pain has gone away, if the player can move the arm, and if there is no weakness of the shoulder, arm or hand. Be aware of the fact that weakness can develop hours to days after the injury occurred.
You’d need to see a doctor only if you have any lingering symptoms.
To prevent a recurrence, wear a neck roll. I see many college and professional players using one. You should also go on a neck-strengthening program, but I have to leave that to your coach.
DEAR DR. DONOHUE: I think I have shin splints. I am in training for a 10-k race. I have developed pain on my right shin. It hurts most when I start running, and then it eases off. I had something like this in high school, and the team doctor called it shin splints. Could what I have now be a repeat of that old injury? – R.M.
ANSWER: If you mean did your high-school injury cause the current trouble, I would have to say it would be most unlikely.
Shin splints is a diagnosis that has fallen out of favor because it encompasses too many different problems.
One of those problems is stress fractures of the tibia, the larger of the two lower leg bones. Overtraining without allowing enough rest can produce tiny cracks in the bone. They are fractures – not as dramatic as the complete break of a bone, but fractures nonetheless. It takes up to six weeks for stress fractures to heal. You need to rest until all pain is gone. You can take anti-inflammatory medicines, such as Aleve, for pain. Don’t run until the pain has gone. You can maintain your fitness by stationary biking or swimming. If pain persists, you will need to see a doctor. Stress fractures, incidentally, often are not seen on ordinary X-rays. They can be seen on bone scans.
Another common cause of the pain that used to be called shin splints is periostitis. It’s an inflammation of the bone’s covering, the periosteum. It’s another overuse injury, and rest is its treatment. Periostitis often happens to people with flat feet.
A third leg injury dismissed as shin splints is compartment syndrome. The muscles, nerves and blood vessels of the lower leg are wrapped into compartments that look a lot like sausages. Hard exercise causes inflammation of the muscles and blood vessels. Fluid pours into the compartment. Because all these structures are encased in an unyielding wrapper, the additional fluid compresses them. That leads to pain. If the skin becomes hot and red, then compartment syndrome is an emergency, and the increased pressure must be relieved quickly by a doctor. If the skin has not reddened, then rest can generally take care of the syndrome.
If leg pain doesn’t go away within a week of rest, a person needs a medical opinion.
DEAR DR. DONOHUE: Is it possible for an overweight person to be fit and not to run the risk of a heart attack? – K.L.
ANSWER: It’s possible for a physically fit overweight person to be at less of a risk for a heart attack than a sedentary overweight person. An overweight person, all the same, has a greater risk of having a heart attack than does a slim person.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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