Tag Archives: Repetitive Strain Injury

dry needling physical therapist

What is Trigger Point Dry Needling?

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TRIGGER POINT DRY NEEDLING uses small, thin needles to stimulate underlying myofascial trigger points, muscular and connective tissues for the management of many orthopedic conditions, both acute and chronic. Physical therapists use dry needling as a safe, effective, and efficient treatment technique to release painful hyper-irritable spots within a band of skeletal muscle. By inserting a needle into the dysfunctional tissue, it often leads to a contraction of the muscle which then stimulates a release. This leads to a reduction of pain, improvements in flexibility and a restoration of normalized movement when combined with corrective exercises.

WHAT IS A MYOFASCIAL TRIGGER POINT?
A myofascial trigger point is a hyperirritable spot within a taut band of skeletal muscle that produces local or referred pain. The trigger point can lead to increased pain, decreased flexibility and decreased muscle function if not treated. Trigger point dry needling is a safe, effective and efficient treatment technique to release these painful spots.

WHAT TYPE OF PROBLEMS CAN BE TREATED?

Muscle dysfunction can be the primary or secondary contributing factor to many neuromusculoskeletal conditions, which can include:

•  Repetitive Stress Injuries
•  Tendonitis or Tendinopathy
•  Muscle Strains
•  IT Band Syndrome
•  Patellofemoral Dysfunction
•  Plantar Fasciitis
•  Neck Pain or Headaches
•  Rotator Cuff Impingement
•  Carpal Tunnel Syndrome
•  SI Joint Dysfunction
•  Sciatica

Dry needling

This treatment is NOT acupuncture. Modern dry needling is based on Western neuroanatomy and modern scientifi c study of the muscles and nervous system. This modality can only be done by trained clinicians.

If you are interested in Trigger Point Dry Needling, find a physical therapist near you and ask for more information.

causes of carpal tunnel

Common Causes of Carpal Tunnel Syndrome

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Carpal Tunnel happens when the tendons become swollen (tenosynovitis) or if the tunnel size itself decreases because of injury – causing compression to the median nerve.  When compression occurs, a person can experience numbness, tingling, or a dull sensation of the thumb, index, middle and ring fingers. Symptoms may include pain during pinching and gripping, or a feeling of clumsiness and the inability to hold things. The best way to avoid carpal wrist pain, is to understand the main causes of carpal tunnel and use that information at work and at home.

WHAT IS THE CARPAL TUNNEL?
The carpal tunnel is a small space at the wrist in which the median nerve and nine tendons pass through. The median nerve travels on top of the tendons through the tunnel. The tunnel itself is made up of your wrist bones and along the top of the tunnel is a thick fibrous ligament called the transverse carpal ligament.

COMMON CAUSES OF CARPAL TUNNEL
Carpal Tunnel is typically not related to a specific injury. Some common causes of carpal tunnel syndrome include:

Genetic Preposition – Many cases can be a result of physical characteristics of carpal tunnel or medical conditions associated with CTS, which also run in the family.

Repetitive Movements – Certain types of work, leisure and sports activities require use of the hand and wrist repetitively. Occupations such as manufacturing/assembly line workers, grocery checkers, musicians, carpenters and many others require the same movements. Common hobbies such as golfing, knitting and gardening also require repeated movements that cause carpal tunnel syndrome.

Injury or Trauma – Sprain or fracture of the wrist can cause swelling and pressure to the median nerve.

Pregnancy & Menopause – Hormonal fluctuation in women play a role in CTS. Such fluctuation may cause fluid retention and other changes that cause swelling in the body. Fluid retention frequently occurs during the last trimester of a pregnancy and is the reason for CTS.

Medical Conditions – Diabetes, hypothyroidism, lupus, obesity, and rheumatoid arthritis.

ACTIVITIES TO AVOID TO MINIMIZE SYMPTOMS

  • Avoid keeping your wrists bent in either direction. The best position for the wrist is neutral (straight)
  • Avoid rapid repetitive forceful or prolonged hand or arm use such as seen with factory work or data entry.
  • Avoid tight gripping and pinching
  • Avoid pressure to the palm or wrist
  • Avoid extreme cold or vibration.
repetitive strain injury

Repetitive Strain Injury (RSI): Prevention Tips for Strain and Injury in the Workplace

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The Following are Seen as Causes of Repetitive Strain Injury:

  • The overuse of muscles in our hands, wrists, arms, shoulders, neck and back
  • The area is affected by repeated actions, which are usually performed on a daily basis over a long period
  • The repetitive actions are done in a cold place
  • Forceful movements are involved
  • Workstations are poorly organized
  • Equipment is badly designed
  • The individual commonly adopts an awkward posture
  • There are not enough rest breaks

RSI

Prevention 101: Nine Easy Ways to Reduce Your Risk of Developing Repetitive Strain Injury:

  • TAKE BREAKS when using your computer. Every hour or so, get up and walk around, get a drink of water, stretch whatever muscles are tight, and look out the window at a far off object (to rest your eyes).
  • Use good posture. If you can’t hold good posture, it probably means it’s time for you to take a break from typing. If you are perpetually struggling to maintain good posture, you probably need to adjust your workstation or chair, or develop some of the support muscles necessary for good posture.
  • Use an ergonomically-optimized workstation to reduce strain on your body.
  • Exercise regularly. Include strengthening, stretching, and aerobic exercises. Yoga and pilates may also be helpful.
  • Only use the computer as much as you have to. Don’t email people when you could walk down the hall or pick up the phone and talk to them. It’s not only better for your hands – it’s friendlier. Think before you type to avoid unnecessary editing.
  • Don’t stretch for the hard-to-reach keys, e.g. BACKSPACE, ENTER, SHIFT, and CONTROL… basically everything but the letters. Instead, move your entire hand so that you may press the desired key with ease. This is crucial when you are programming or typing something where non-letter keys are used extensively.
  • Let your hands float above the keyboard when you type, and move your entire arm when moving your mouse or typing hard-to-reach keys, keeping the wrist joint straight at all times. This lets the big muscles in your arm, shoulder, and back do most of the work, instead of the smaller, weaker, and more vulnerable muscles in your hand and wrist. If you find it difficult to do this, then your shoulder and back muscles are probably too weak. It is OK, and in fact a good idea, to rest your elbows/wrists when you are not typing.
  • Use two hands to type combination key strokes, such as those involving the SHIFT and CONTROL keys.
  • When writing, avoid gripping the writing utensil tightly. Someone should be able to easily pull the writing utensil out of your hand when you are writing. If your pen or pencil requires you to press too hard, get a new one (my favorite is Dr. Grip Gel Ink).

Article provided by Fit2WRK. The information noted above is a summary of one of the components of Fit2WRK.

soccer injury

Returning from a Soccer Injury

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Soccer is the most played sport in the world and is the number one sport in many countries. It is a great cardiovascular workout that combines aerobic and anaerobic movements. However, due to the sudden changes in pace and the speed at which the game is played there is a high chance of a soccer injury.

Sports injury expert Dr. David Geier reveals that that the six most common soccer injuries are ankle sprains, joint fractures, anterior cruciate ligament (ACL) tear, meniscus tear, adductor strain, and hamstring strains. These injuries are due to the amount of stress a soccer player will put on their leg joints. The good news is that through physical therapy these injuries can be recovered from.

Ankle Sprains
The ankle sprain is the most common and least serious soccer injury. The most common recovery method is to put ice on the ankle to stop the swelling, strap it, and lightly exercise it through physical therapy. One effective motion exercise is to sit on a chair with the foot flat on the floor and gently move the knee from side-to-side to stop it becoming stiff. A player should be out for a maximum of six weeks.

ACL
An ACL soccer injury can leave a player out of the game for much longer. For example, an ACL tear may require surgery (making a new ligament) in order to return to the pitch. While surgery may be required, physical therapy is definitely needed to help rebuild knee strength. The exercises will include mobility and strength exercises such as knee flexion and extension, heel slides, and isometric quadriceps exercises. As the knee joint gets stronger, plyometric drills will be introduced to the therapy to see whether the knee is strong enough to play competitive sport. These exercises may include resistance band jumps, hopping exercises and box jumps.

soccer_injury

Hamstring Strains
After knee and ankle injuries the next most common injury are hamstring strains. These are often caused through a combination of sudden explosive moments and overuse. We have all seen a soccer, football, or basketball player burst forward only to suddenly stop and crumple to the ground. That is nearly always a hamstring injury. Depending on which grade of hamstring injury the player has will change the therapy needed. If it is a grade one injury then as the muscle slowly heals the player will use ice alongside resting. Function training will also be required to regain strength and flexibility. A grade two or three injury may require surgery.

Career Threatening Injuries
A career threatening injury is the biggest risk of playing soccer. However, there is hope for injured and senior soccer players. Walking Soccer, which was developed in 2011 in England, according to British newspaper The Telegraph, allows those with mobility injuries to keep playing. As the name suggests running is outlawed, which in turns takes much of the risk and pressure off of the leg joints that can be easily injured.

The new game has been endorsed by English soccer legends such as Alan Shearer, who according to journalist Dan Fitch who works for news site Betfair Soccer who preview the Champions League fixtures in Europe, is the third fastest player to score 50 goals in the English Premier League. Shearer himself is retired and told The Telegraph that after retiring he couldn’t play the sport he made his name in due to persistent injuries. Walking Soccer has allowed Shearer and other ex-pros to play without the worry of injuries or heavy contact from other players. For amateurs and professionals alike walking soccer is a godsend.

Soccer injuries can be serious and more often that not require physical therapy to recover from. Even if you have suffered a serious injury there is still hope through new sports such as Walking Soccer.

Occupational Therapy Month

April is Occupational Therapy Month!

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Occupational Therapy Month is when we celebrate and recognize all of the work our OT’s do. Occupational therapists (OT) help people of all ages participate in the things they want and need to do in their homes, at work, in school and throughout the community. From a patients initial evaluation to the development and follow through of their rehabilitation plans, an OT works hard to make sure that their patient is able to return to the activities they enjoy and need to live a full and healthy life.

In an outpatient setting, some of the responsibilities of our occupational therapists may include:

  • Hand and upper extremity movement and rehabilitation
  • Teaching patients to use assistive devices to complete activities of daily living (ADL’s)
  • Rehabilitating patients recovering from stroke to regain strength, movement, and learn to accomplish ADL’s in modified ways.
  • Working with employers to create programs designed to reduce risk and injury in the workplace.
  • Helping children struggling to achieve developmental goals progress to their highest possible levels
  • Working with patients suffering from neurological conditions such as Parkinson’s to remain active.

This Occupational Therapy Month the AOTA is celebrating 100 years of helping people live their lives to the fullest.
For more info go to: www.aota.org

Throwing Injuries

Guidelines to Prevent Throwing Injuries

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In this monthly series, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


PUSH UPS
Start on your stomach with your hands below your shoulders. Maintain a straight line from your ankles, through your hips, to the shoulders. Extend your elbows pushing your stomach away from the floor.


BICEP CURL
Begin seated with your elbow extended and palm facing forward. Bend the elbow as far up as you can without flexing your shoulder or rotating your wrist.


TRICEP DIP
Find two even surfaces to support your upper body with your elbows bent (a chair with arm rests works well). Extend your elbows pushing your body up toward the ceiling. Lower slowly.


OVERHEAD TRICEP EXTENSION
With your shoulder in full flexion overhead, hold a weight in your hand with your elbow bent behind your head. Straighten your elbow toward the ceiling without changing the angle of your shoulder.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

throwing injuries PTandMe

Increased Risk Zones

Work Related Stress & Increased Risk Zones: Part 1 of 2

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INCREASED RISK ZONES
All Risks Increase with Duration, Frequency and Magnitude.

• Excessive Force

• Repetition of Activity (Can irritate tendons and increase pressure on nerves)

• Awkward Posture (Can compress nerves and irritate tendons)

• Sustained Static Posture (Can restrict blood flow and damage muscles)

• Unsupported Positions

• Motion (Increased speed or acceleration when bending / twisting, can increase the amount of force exerted on the body)

• Compression (Grasping sharp edges like tool handles, can concentrate force on small areas of the body, reducing blood flow and nerve transmission, and damaging tendons and tendon sheaths)

• Inadequate Recovery Time (Overtime, lack of breaks, & failure to vary tasks)

• Vibration of Tools (From vibrating tools, can decrease blood flow, damage nerves, and contribute to muscle fatigue)

• Whole Body Vibration (From driving trucks or operating subways, can affect skeletal muscles and cause low-back pain)

• Effects of Temperature (Cold temperatures can adversely affect a worker’s coordination and manual dexterity while Heat stroke can be very serious as when the body becomes unable to control its temperature, it rises rapidly, the sweating mechanism fails, and the body is unable to cool down.)

• Environment (Slip/Fall hazard-Uneven Floor Surfaces)

• Material Handling Guidelines:
Weight Loading over 50lbs
Lift Speed greater than 5/minute
Vertical Lift Exceeds 3ft
Carry over 1 minute
Sustained Push/Pull over 30 seconds
Static reach holding tasks over 1 minute

Part two of our Work Related Stress & Increased Risk Zones can be found here

work related stress

Sources:
1) Ergonomics: The Study of Work, U.S. Department of Labor, Occupational Safety and Health Administration, OSHA 3125, 2000 (Revised)
2) T. R. Waters, “Manual Materials Handling”, in: Physical and Biological Hazards of the Workplace 2nd. Edited by P. Wald and G. Stave. New York: John Wiley and Sons, 2002.
3) Ergonomics and Musculoskeletal Disorders, Centers for Disease Control and Prevention/ National Institute for Occupational Safety and Health (NIOSH) © Fit2WRK 2015 R.Gagne

lifting safety PTandMe holidays

When Lifting During the Holidays…

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During the holidays back injuries become more prevalent as patient maneuver themselves up and down ladders and stairways while carrying or lifting heavy objects. A little bit of lifting safety can go a long way to keeping the holidays merry. When Lifting large or heavy objects make sure you:

1. SIZE UP THE LOAD
Check to ensure the load is stable and balanced.

2. PLAN THE JOB
Consider all possibilities. Is the path clear? What is the weight of the load? How much stress will be placed on your back? Is there traffic, a tripping hazard, a doorway to go through, or a stairway to go up or down? Avoid carrying an object that requires two hands to hold, either up or especially down, a flight of stairs.

3. ESTABLISH A BASE OF SUPPORT
Use a wide, balanced stance with one foot in front of the other. Make sure you have firm footing and that your feet are a shoulders-width apart. This staggered stance gives you the stability of not falling over and being able to secure the load.

4. BEND YOUR KNEES, KEEP YOUR HEELS OFF OF THE FLOOR AND GET AS CLOSE TO THE OBJECT AS POSSIBLE.
Always lift with your legs and not your back.

santa

5. BE CERTAIN YOU WILL BE ABLE TO MAINTAIN A HOLD ON THE OBJECT WITHOUT HAVING TO ADJUST YOUR GRIP LATER.
You can use gloves to help maintain an adequate grip, but don’t rely on gloves because they can de-sensitize the fingers making you unable to feel the object.

6. LIFT GRADUALLY with your legs without using jerky motions.

7. KEEP THE LOAD CLOSE TO PREVENT ARCHING YOUR LOWER BACK.
As you begin the lift, tighten your stomach muscles and keep your head and shoulders up. The closer the load is to your spine, the less force will be placed on your back.

8. PIVOT
Don’t twist. Move your feet in the direction of the lift. This will eliminate the need to twist at the waist.

Information can be found at: http://www.tdi.state.tx.us/pubs/videoresource/stpbkinj.pdf

Medial epicondylitis golfer's elbow

Golfer’s Elbow (Medial Epicondylitis)

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Medial epicondylitis is most commonly referred to as Golfer’s Elbow and is a painful condition where the tendons that attach to the inside of the elbow become inflamed due to repetitive use of the hand, wrist, forearm and elbow. It often occurs with repetitive activities such as, swinging a golf club or tennis racket, work or leisure activities requiring twisting and gripping such as shoveling, gardening and swinging a hammer. It can also appear in other sports-related activities such as throwing and swimming. Medial epicondylitis is most commonly seen in men over the age of 35, but can be seen in any population.

Medial epicondylitis affects the group of muscles that are responsible for bending the wrist, fingers and thumb and that rotate the wrist and forearm. The tendons that connect those muscles to the medial epicondyle (bump on inside of elbow). Tendons are made up of collagen fibers that are lined up next to each other. The repetitive forces pull on those tendons creating pain and tenderness. Without treatment those tendons can eventually pull away from the bone. Acute injuries to your elbow can create an inflammatory response which can cause redness, warmth and stiffness in your elbow.

Medial epicondylitis is most often caused by an abnormal arrangement of collagen fibers. This condition is called tendinosis. During tendinosis the body doesn’t create inflammatory cells as it does during an acute injury. Instead, fibroblasts are created which help make up scar tissue to fill in the spaces between the collagen fibers. This increase in scar tissue can lead to increased pain and weakness in the tissues. Physical therapy is the most common non surgical treatment for medial epicondylitis. Your therapist will perform an evaluation where he/she will ask you several questions about your condition, pain level and other symptoms you may be experiencing. He/she will perform motion and strength testingon your entire upper extremity. Your physical therapist will also palpate your arm to determine which tendon(s) may be inflamed. He/she will use special tests designed to differentially diagnose your condition from others that may have similar presentations, such as Cubital Tunnel Syndrome.

golf ball on tee

After you have been evaluated by your physical therapist, he/she will formulate an individualized treatment plan that can include any of the following:

1. Pain Management: this can include Mechanical Diagnosis & Therapy, ice, ice massage, moist heat, electrical stimulation and ultrasound.
2. Range-of-Motion Exercises: stretches and mobility exercises to help maintain proper movement in your elbow, forearm, wrist and hand.
3. Strengthening Exercises: progressive resistive exercises to help build strength in your arm, elbow, forearm, wrist and hand. These can include weights, medicine balls and/or resistance bands. This will also include your Home Exercise Program.
4. Manual Therapy: used to ensure full, pain-free movement is achieved and can include joint mobilizations, manual muscle stretches and soft tissue massage.
5. Neuromuscular Re-education (Functional Training): used to help you return to your prior level of function for both home and work activities. Will include retraining proper movement patterns with necessary modifications based on current level of function and patient limitations.
6. Patient Education: used to help retrain patient on proper postural control during everyday activities including dressing, self-care, work and sports activities. This can include helping return a patient to their specific sport, such as making adjustments to their golf swing or throwing technique.

Once you’ve completed your care under the direct supervision of a physical therapist you’ll want to do everything you can to prevent this from reoccurring. This can occur by maintaining proper awareness of your risk for injury during your daily movements. Key things to keep in mind:

1. Maintain proper form during all repetitive movements both at work and home.
2. Continue your Home Exercise Program in order to maintain proper strength in your shoulder, elbow, forearm, wrist and hand.
3. Use proper posture and body mechanics with lifting or carrying to avoid any undue stress on your joints and tendons.

This information was written by Plymouth Physical Therapy Specialists, an outpatient physical therapy group with fourteen locations in the surrounding Plymouth, Michigan area. At Plymouth Physical Therapy Specialists, they are committed to using evidence-based treatments in their practice. This means that their therapists utilize the most current and clinically relevant treatments in their approach to rehabilitation. For more information click here.

Protect, Stretch & Rest: General Tips

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These are some general healthy tips to remember during your day-to-day activities.

• If you are doing strenuous, household or outdoor work protect your hands with gloves in order to prevent injury and/or loss of moisture.
• Take frequent breaks or switch to a new activity. Overuse of repetitive motions, such as pressing buttons, can cause tendonitis of the elbow or lead to Carpal Tunnel Syndrome.
• If you find yourself sitting at your computer for hours each day, stop each hour and stretch your fingers, arms and the rest of your body to help prevent injury to your bones, joints and muscles.
• If you have pain during your activity, stop. Pain is one of the ways your body is letting you know that you are overextending a particular muscle group.