Primary Care of Musculoskeletal Problems in the Outpatient Setting

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Edward J. Shahady, MD

Tallahassee, FL, USA Editor

Primary Care of Musculoskeletal Problems in the

Outpatient Setting

With 207 Illustrations

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Edward J. Shahady 3085 Obrien Drive Tallahassee, FL 32309 USA

Library of Congress Control Number: 2006920784 ISBN-10: 0-387-30646-3

ISBN-13: 978-0387-30646-9 Printed on acid-free paper.

All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden.

The use in this publication of trade names, trademarks, service marks and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights.

While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.

Printed in the United State of America. (SPI/MV)

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This book is dedicated to my lovely wife Sandra, our six beautiful and gifted children, their wonderful spouses and our ten lovely and talented grandchildren.

Through them I have learned the real joy and meaning of life.

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Contents

Contributors . . . . ix

PART I. GENERAL TOPICS

1 Key Principles of Outpatient Musculoskeletal Medicine . . . . 3 Edward J. Shahady

2 Exercise as Medication . . . . 13 Edward J. Shahady

3 Nutrition for Active People . . . . 28 Eugene Trowers

4 Altitude, Heat, and Cold Problems . . . . 35 Edward J. Shahady

PART II. UPPER EXTREMITY

5 Shoulder Problems . . . . 51 Edward J. Shahady, Jason Buseman, and Aaron Nordgren

6 Elbow Problems . . . . 93 Edward J. Shahady

7 Wrist Problems . . . . 118 Edward J. Shahady

8 Hand Problems . . . . 136 Edward J. Shahady

PART III. SPINE

9 Neck Problems . . . . 159 Edward J. Shahady

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10 Back Problems . . . . 178 Edward J. Shahady

PART IV. LOWER EXTREMITY

11 Hip and Thigh Problems . . . . 203 Edward J. Shahady

12 Knee Problems . . . . 228 Jocelyn R. Gravlee and Edward J. Shahady

13 Lower Leg Problems . . . . 268 Edward J. Shahady

14 Ankle Problems . . . . 289 Edward J. Shahady

15 Foot Problems . . . . 310 Mike Petrizzi and Edward J. Shahady

Index . . . . 343 viii Contents

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ix

Contributors

Jason Buseman, MS, BS

Senior Medical Student, Florida State University College of Medicine, Tallahassee, FL, USA.

Jocelyn R. Gravlee, MD

Assistant Professor, Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee, FL, USA.

Aaron Nordgren, BS

Fourth Year Medical Student, Florida State University College of Medicine, Tallahassee, FL, USA.

Mike Petrizzi, MD

Associate Clinical Professor, Department of Family Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.

Edward Shahady, MD

Clinical Professor, Department of Family Medicine and Community Health, University of Miami; Adjunct Professor, Department of Family Medicine, University of North Carolina; Associate Faculty Family Practice Residency Tallahassee Memorial Hospital, Tallahassee, FL, USA.

Eugene Trowers MD, MPH, FACP

Assistant Dean, Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, FL, USA.