Podiatry Question #1

I created this blog to teach. I wanted to teach my patients first of all to be smarter in the rehab course, and perhaps to prevent injuries in the future. But, I also created this blog for podiatrists, podiatry students, and all in health care with an interest in feet and biomechanics and overall health. I am in my 6th year of teaching the podiatry students at Samuel Merritt University’s California School of Podiatric Medicine. They are wonderful, and I am blessed. I am starting this series of questions with the hope they will all know the answers by the time they graduate, or even as they begin their practices. Many of these questions will be for lay folks, sports store personnel, coaches, or just students of good health. I will ask the question, followed by a photo to gap the answer by some space, and then the answer. Shall we begin?

#1   When treating tendinitis in any form, what mnemonic is commonly used to think through the possible treatments?

Answer: The mnemonic B.R.I.S.S.  Biomechanics  Rest.  Ice.  Stretching.  Strengthening. These are the 5 key components to treating all types of tendinitis. Of course, there are so many other treatments of tendinitis out there that have helped, but BRISS gets the process started. The Biomechanics are concerned with the forces that caused the injury, and the forces that can be changed to help the injury. Rest is a four lettered word for everyone, especially top level athletes in competition, so we tend to shift the attention to Activity Modification. We need to rest the area, but we need to cross train. Ice is universal for Anti-inflammatory measures, but we are getting better at knowing when to ice, and when to heat, when to use contrast bathing. This also applies to anything that decreases the inflammation including oral medicines, injectables, topical, prescription or OTC, physical therapy, or acupuncture. Stretching is key to relaxing the tissue, and many tendinitis cases do not get better until you can find the way to stretch that makes the area feel better. And finally, Strengthening, is so crucial. We must assume that any tendinitis is caused by weakness of the tissue, or surrounding tissue. Start strengthening to some degree the day you hurt yourself.