Muscle wear and tearA strain is an injury to a muscle caused by over-stretching. Also called a "pulled muscle," the elastic fibers that make up the muscle are overextended and may tear, bleed and contract.A sprain is an injury to a ligament and other soft tissue around a joint. Ligaments are bands of fiber that connect the bones at a joint. They can be stretched or torn when a joint is twisted, "jammed" or overextended. With a sprain, slight bleeding may produce skin discoloration which resolves slowly.What you can do         The basic treatment for strains and sprains is a two-part process: RICE (rest, ice, compression, elevation) to treat the immediate injury and MSA (movement, strength, alternate activity) to help the injury heal and prevent further problems.Begin the RICE process immediately following the injury:Rest. Do not put weight on injured joint or muscle, and limit movement in the area of the injury. Use crutches, splints or a sling as needed.Ice. Apply ice pack for 10 to 15 minutes every hour for two hours, then leave ice off for two hours. Repeat this cycle for 48 hours or until swelling is gone. For protection, place a washcloth between bare skin and ice. Do not use heat as long as there is swelling.Compress. Wrap injured area in an elastic bandage for support and protection.Elevate. Place injured part on pillows while you apply ice and anytime you are seated or lying down. Raise injured area above the level of your heart whenever possible.Aspirin and ibuprofen may ease pain and inflammation. Acetaminophen (Tylenol) eases discomfort but does not decrease inflammation. Do not use other drugs to mask pain in order to continue using the injured part. NEVER give aspirin to children/teenagers. It can cause Reye's syndrome, a rare but often fatal condition.The MSA process can be started only if the initial swelling is gone:Movement. Begin gently moving the joint to resume full range of motion.Strength. After the swelling is gone and a full range of motion is reached, gradually begin to strengthen the injured part. Slow, gentle stretching during the healing process will make scar tissue flexible and prevent limited movement later.Alternate activities. Resume regular exercise through activities and sports that do not place a strain on the injured area. Go slowly and stop any activity that causes discomfort.Any increase in pain or return of swelling is a sign to stop MSA and resume RICE.PreventionUse correct form in all work and play activities.Adjust equipment and furniture to fit your needs.Go slowly when starting a new activity or sport.Use warm-up and cool-down exercises to help your body prepare and recover safely.Take frequent breaks when performing any continuous activity.Do not push beyond your strength or ability; advance your skill level gradually.*19\303\2*

in its simplest form Dr. Cloninger's model suggests that most of the important differences between our personalities may be accounted for by three key qualities or dimensions: harm avoidance, novelty seeking, and reward dependence.
"Harm avoidance" refers to the urge to escape from unpleasant experiences. People low in harm avoidance tend to be carefree, confident, relaxed, optimistic, uninhibited, outgoing, and energetic. Those who are high in harm avoidance, on the other hand, tend to be timid, inhibited, apprehensive, tense, shy, easily fatigued, and pessimistic about the future.
"Novelty seeking" describes a capacity to be exhilarated by new experiences. Everyone likes excitement now and then, but people who score high in this dimension live for it. They are impulsive, fickle, quick-tempered, extravagant, and disorderly risk-takers. Daredevils fit here. Those who are low in novelty seeking are reflective, loyal, stoic, slow-tempered, and orderly. They're good scouts.
"Reward dependence" refers to the need to be reinforced by approval from others. Those on the low end of this personality dimension tend to be detached, emotionally cool, practical, and tough-minded. People high in reward dependence are sympathetic, eager to help, and sentimental. They're people-pleasers.
Consider some of the combinations. A person who is low in harm avoidance, high in novelty seeking, and low in reward dependence is fearless, impulsive, explorative, and doesn't care what people think. In the extreme this is the criminal personality type. Think Charles Manson. If reward dependence is changed from low to high while the other two factors stay the same, then a person is impulsive and explorative but also emotionally vulnerable. He or she craves activity and excitement but needs positive feedback. This is the attention-seeking, dramatic, gullible individual; perhaps an example would be Marilyn Monroe. Each of the combinations of Cloninger's traits corresponds to a recognizable character.
OCD sufferers, according to Dr. Cloninger's theory, are high in harm avoidance, low in novelty seeking, and high in reward dependence. Recent studies from the universities of Iowa and Toronto have confirmed the strong correlation of OCD to high harm avoidance and low novelty seeking. There is suggestive evidence tying OCD to high reward dependence. OCD sufferers are timid, sentimental, good scouts, people-pleasers. That description fits a surprisingly large number of my OCD patients.
The term harm avoidant fits me to a T. Novelty seeking? When I was a child, my family visited New York City. My brother wanted to see Broadway; I wanted to stay in the hotel room and play cards. My brother is now in the foreign service; I'm living in my hometown. And reward dependence? I can't remember even once making my parents mad at me. This is simply the typical personality pattern of the person who develops OCD.
Of considerable value in Cloninger's personality classification scheme is the fact that, for the first time, personality types have been connected to brain chemistry. Correlations are introduced between, for instance, harm avoidance and the level of the neurotransmitter serotonin; between novelty seeking and the neurotransmitter dopamine. This link allows patients to gain an appreciation of the interrelation between OCD's psychological roots and the biochemical causes of the disorder.
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