Odd things happen to our joints and our appendages as we get older. Sometimes these quirks can be ignored, and they work themselves out. But other times, it is best to take heed of what the body is trying to tell us.
Trigger finger is one such condition. Initially it may begin with stiffness of the finger in the morning. Typically it occurs in your dominant hand, with one finger involved, but sometimes multiple fingers or the thumb are affected.
Later, you will begin to notice a clicking or popping sensation when you move your finger. You may notice tenderness or a bump at the base of your palm.
As the condition progresses, the finger will pop back from a bent position, much like a trigger releasing. When the condition is at its worst, you may not be able to straighten the finger at all.
Why is this happening?
Tendons allow the fingers to move, and attach the muscles of the hand to the bones in the hand. These tendons are covered by a protective sheath. When this sheath become irritated or inflamed, the normal gliding motion of the muscles is impeded. Sometimes a nodule or bump can form, and this protrusion can get caught on the edge of the tendon sheath. When it breaks free, the result is the popping or clicking of trigger finger as the finger straightens.
Who is at risk?
Women aged 40 to 60 are more at risk of developing this condition than men. People whose occupations or hobbies require repeated gripping are more likely to be affected, and individuals with diabetes or rheumatoid arthritis are more likely to develop trigger finger.
The good news
Most treatment for trigger finger involves conservative methods such as resting the hands, applying cold packs and taking non-steroidal anti-inflammatory medications. For more advanced problems, a corticosteroid injection may be performed, and specific occupational therapy exercises prescribed for remediation. Sometimes splinting of the finger is used, to keep the finger in the extended position at night for up to six weeks.
If the condition is severe, surgery could be required. This is typically performed in an outpatient operating room, and patients go home the same day. The surgeon makes a small incision in the palm of the hand, to cut the tendon sheath to allow the nodule to move freely. Most people can move their fingers freely following surgery, but soreness will be noticeable in the palm. Most of the recovery is complete within a few weeks, but physical therapy and exercises may be required to return the hand to full function over a period of several months.
How can I know for sure?
If you or someone you know is experiencing any of the symptoms of trigger finger, reach out to a qualified orthopedic doctor, such as Dr. Rehman, for a full and complete evaluation. The hands and fingers are delicate appendages, and it is best to consult with a doctor who specializes in this area of the body. Dr. Rehman and her team of hand therapists are the best qualified to diagnose and prescribe treatment to return your hand to full range of motion and strength. And as always, early intervention is most likely to generate the most favorable outcome. Contact Dr. Rehman for more information or with questions. 586-532-0803
The New Year is upon us, and many kids may have gotten new sporting equipment over the holidays. This time of year brings new hopes, and your children may have their dreams set on becoming a star player in their sport of choice.
But with children playing competitive sports at younger and younger ages, parents need to be informed consumers and safeguard their child from injury or over-training. Competition is a cultural value in the US, and those who “play through the pain” are lauded as warriors and champions. But the standards that apply to professional sports should not be applied to youth sports. Children are still growing, and because of this, they are more prone to injuries that can become lifetime limitations if they are not handled promptly and properly.
If your child is in a sport, how can you be sure he or she is not over-training or being played too much? An organization called Safe Kids reports that, of 752 coaches surveyed nationwide, over half the coaches reported being pressured, usually by parents, but sometimes by the child, to play a child who was injured. Children sometimes hide their pain, or minimize it, so that they can play. The expectations of parents and teammates can be overwhelming for a youth athlete. The watchful parent will be aware and be sure their injured child receives proper medical attention and time to rest and heal, before being allowed to play their sport.
Youth sports foster confidence, discipline, teamwork and sportsmanship. If your child is in a sport where “winning at all costs” is the attitude, either by other parents or the coach, this is not the team for your child. Children need to learn how to cope with success and defeat, in order to put the game in a proper perspective. This in turn helps them cope with other successes and failures in their lives.
Rotating sports throughout the year will help the youth athlete maintain a balance, and work different sets of muscles, to reduce the chance of over-use injuries.
Here are a few more tips to keep your youth athletes safe:
Be sure your child receives a pre-participation sports physical examination, to spot any potential problems ahead of time.
Be sure your child is wearing the proper protective gear, and that it fits him or her correctly. Research the best quality and have the coach check the fit to make sure it is right.
You child should know how to correctly use the athletic equipment, such as bindings on snow skis, etc. Here again, instruction by a professional trainer or coach is required.
Even children need to warm up their muscles before playing. At least ten minutes of stretching and warm-ups are required.
Kids need to stay hydrated. For proper hydration, kids should drink half their weight in ounces of water each day. So if your child weighs 120 pounds, he or she should drink 60 ounces of water daily. Beware of caffeine –loaded drinks, as they are diuretics.
And never let your child play or train if he or she is in pain.
If you or one of your family members notice pain, stiffness, numbness or tingling in their hands, wrist, elbow or shoulder, contact Dr. Rehman for a thorough evaluation. She is a trained orthopedic doctor who specializes in the treatment of injuries and conditions of the upper body. Her team of rehabilitation specialists will implement a program of recovery so that your young athlete can get back to his or her sport with full range of motion and ability to bear weight pain-free.
Call today to schedule an appointment or to learn more: 586-532-0803
The big holiday is just around the corner, and you’ll love watching their faces light up when they unwrap the new skates, skis or snowboard on their wish list. But beginning athletes in these sports are more likely than experienced ones to receive an injury. So along with that great equipment, be sure to book some lessons from a professional trainer, to make sure the equipment fits them properly and they learn some basics of how to fall correctly.
In the U.S., snowboarding accidents are on the rise, and most of these injuries involve the wrist or the hand. Since a snowboarder’s feet are locked into place, they are not as likely to twist when falling. Usually the hand and wrist take the brunt of the fall. It’s estimated that about 25% of snowboarding injuries are to the wrist. Most are fractures of the forearm bone, just above the wrist joint; another susceptible area is a small wrist bone called the scaphoid. The best defense is to wear wrist guards and to be taught how to fall correctly before even hitting the slopes. Wrist guard technology has advanced dramatically in recent years, and gloves are even available with built-in wrist guards. If your child or teen is experiencing pain after a snowboard fall, get it checked out by a specialized hand surgeon.
The most common upper body injury in downhill skiing is an injury to the thumb. This condition, often called “skier’s thumb” occurs when the skier falls and fails to release his or her poles. The pole acts as a lever upon impact with the ground, and bends the center of the thumb, tearing the ulnar collateral ligament (UCL). Accounting for 8 to 10% of skiing injuries, this type of injury may need splinting or even surgery, depending on the severity of the tear.
Young Olympian hopefuls may be inspired by the complex ice skating routines they see on TV. But as usual, it’s harder than it looks. Most upper body injuries in this sport involve a fracture of the wrist, and if your child is experiencing pain here, it is best to get it checked out by an orthopedic hand surgeon. Training from a professional on how to fall can minimize the chance of this type of injury, and be sure to warm up for 5 to 10 minutes before hitting the ice.
The hand and wrists are delicate and contain an abundance of bones, ligaments and tendons. They can be easily damaged in a sporting accident, and if not treated properly and early, can become lifelong problems. If your young athlete sustains an upper body injury this winter, seek a full and complete evaluation by a specialized hand surgeon such as Dr. Rehman. She and her team of hand therapists will use the least-invasive treatment that will return full range of motion and strength to the injured area.
A few more tips for those Olympian hopefuls in your family:
Be sure they’ve got the right gear and that it fits them properly; helmets and wrist guards for snowboarders and poles without platforms or saber handles for skiers
Teach them to inspect their gear or skates each time before they go
Keep blades on skates sharpened; watch for chips or gouges in the ice
Warm up for 5 to 10 minutes before hitting the slopes or the ice rink
Know how to fall: Snowboarders should practice falling onto the forearms, as this will protect the hands and wrists and disperse the energy of the impact. Snowboarders should also try to land bottom first when falling backward, as this protects the head and tailbone. Skiers should practice releasing their poles when they fall.
Skaters should limit the number of repetitions of jumps per session, and practice new jumps off the ice first, using a harness
And never allow your youngster to skate or ski if it is painful
Winter time sports can be a fun, lifelong pursuit. Start them off on the right foot with the proper gear and training this winter, and then enjoy!
Carpal Tunnel syndrome is an insidious condition, and symptoms of it can range from a mild tingling or numbness in the hands and wrist, to full-blown pain and inability to use the hand. If left untreated for too long, the damage can become permanent.
But to diagnose and treat it correctly, you need the right doctor.
Orthopedic doctors are specialists in treating injuries and conditions of the muscles and skeleton of the body, but within this category there are specialists. The hand and the upper extremities are very complex and interrelated; doctors who specialize in these areas are known as “hand surgeons.”
But that term can be misleading, as not all Carpal Tunnel issues involve surgery. A comprehensive program can often be designed to minimize the aggravating activity and help the area heal. This is where the specialist and her team of hand therapists come in. Depending on the situation, a variety of techniques may be used. Splinting to immobilize the wrist and hand may be required, plus medication and special exercises to strengthen the area. Sometimes an injection of Corticosteroid may be given, to help reduce swelling and inflammation. Each case is different, and individualized plans are designed for each patient. Follow-through on the exercises and the doctor’s orders will determine how quickly the condition heals and how soon you can return to your regular activities.
With today’s rapidly-developing technology, specialization in medicine is not just good but necessary. If you feel you are suffering from any of the effects of Carpal Tunnel Syndrome, reach out to Dr. Rehman and her team of specialized Occupational Therapists for a full evaluation and a comprehensive treatment program. With proper help, Carpal Tunnel does not have to be a lifelong condition.
The season of festivities is rapidly approaching, and everyone wants to look their best. Haircuts, make-overs and mani-pedis will be booked as the holidays ramp up. But if you have unsightly, cracked or discolored nails, no amount of polish will fix that.
First to know: problems with your nails can often indicate other health issues. A specially trained doctor is the best person to diagnose and treat nail conditions. Many people try over-the-counter remedies, thinking nail problems are just a minor annoyance. Unfortunately, most of these products provide only temporary relief, and may not really get to the root of the problem. If the treatment doesn’t work, the condition can worsen and spread, and become not just annoying but quite painful!
Your nails should be a healthy pink color, and when you notice changes in the color, indentations in the nails, or other malformations, it’s time to get it checked out.
Some common nail conditions include:
Fungal Infections
Probably the most common cause of nail problems, fungal infections can occur from hot and sweaty conditions, genetic tendencies, or a suppressed immune system. Fungus is present in all humans, but when the system gets out of balance, the fungus can grow and spread. It causes nail discoloration, and a thickening of the nail. It can spread from toenails to fingernails, and across the feet and hands. Prescription-strength anti-fungal medication is typically required to defeat a fungal nail infection, so don’t wait to see the doctor about this condition.
Terry’s Nails
In this condition, the nail bed turns an unusual white color. Again, it can be related to a fungal condition, or your nails may have begun to detach from the nail bed, causing the change in color. People on chemotherapy can sometimes experience this condition, and it can also be related to anemia and low iron.
Brittle Nails
Characterized by thin, frail, crumbling nails, this common nail problem often indicates a deficiency in vitamins, with Vitamin B7 often being implicated. Supplementing with over-the-counter vitamins can help, but brittle nails can also be indicative of nail psoriasis, a thyroid disorder, or that pesky fungal infection.
A doctor who specializes in diseases and conditions of the hand is the best person to properly diagnose your condition. Dr. Rehman will do a thorough evaluation of all possible underlying conditions, and prescribe a treatment program that will relieve your symptoms and resolve the root problem as well. If you or anyone in your family is suffering with nail problems, or other conditions like tingling, pain or numbness in the hands, fingers, wrist or shoulder, contact Dr. Rehman’s office today at 586-532-0803.
What is it?
De Quervain’s tenosynovitis (also called De Quervain’s tendonitis) is a painful condition affecting the tendons on the thumb side of the wrist. Tendons are the strong bands of tissue that attach the muscles to the bones. The tendons going to your thumb are covered by a special sheath, and it is the inflammation of this sheath that causes the condition. Women seem to be more affected by this condition than men.
What causes it?
This condition is often caused by repetitive activities and overuse of the thumb or your wrist, especially in activities that repeatedly move your thumb away from your wrist, such as skiing or hammering. It also can occur shortly after pregnancy, possibly due to fluctuating hormones and the need to hold the newborn frequently for breast feeding.
What are the symptoms?
The pain may develop over time or it may come on suddenly. It can travel from the thumb up to the forearm. Pain when moving your wrist, difficulty making a fist or holding objects may be indicative of this condition. Swelling and tenderness may be present on the thumb side of your wrist, and you may feel or hear a creaking sound as the tendon slides through the sheath.
How is it diagnosed?
A doctor who specializes in the hands, wrists and shoulders is the best person to diagnose this condition. He or she will conduct a physical exam of your hand and arm, and will locate the areas that are tender and painful to move. An X-ray may be taken to insure you do not have a broken bone, if the pain is the result of an injury.
What is the treatment?
A splint that stabilizes your wrist and thumb may be prescribed, to be worn 24 hours a day for up to 4 to 6 weeks. The thumb and wrist must be protected from activities that could worsen the condition.
Ice packs can be applied to the thumb and wrist for 20 to 30 minutes every 3 to 4 hours until the pain has abated. Ice can also be used in a massaging method by filling a styrofoam or paper cup with water and freezing it. The top of the cup can be torn away, and the bottom held to massage the ice over the affected area.
Oral anti-inflammatory medications may be prescribed, and an injection of a medication such as cortisone may be given.
Rehabilitation exercises will also be defined for you to perform to help heal the area.
If these minimally invasive methods fail, surgery could be required, to release the tendon’s tight covering to allow it to move more smoothly. This is typically an outpatient procedure, and the patient can go home the same day.
When can I return to my activity or my sport?
In general, the longer you have symptoms before you begin rehabilitation, the longer the time period of recovery. Returning to your sport or activity will be determined by your rate of healing, rather than a set number of days or weeks. Continuing to perform the activity while the wrist is injured could cause permanent damage. Dedication to executing the exercises, and performing them with the correct form, will also positively influence the rate of healing. The goal of rehabilitation is to get you back to full function as soon as it is safe for you to do so.
When you can move your thumb and wrist without experiencing any pain, it is safe for you to take up the activity again. You may need to continue to wear the supportive splint until you no longer have symptoms.
How can it be prevented?
Try to avoid activities that overuse your thumb or wrist, to prevent the occurrence of De Quervain’s tenosynovitis. If you do perform such activities, take frequent breaks and shake out the hands, hold the wrist tightly and flex the fingers, and rub your hands together like you are washing them. Stimulating the blood flow and allowing the tendons and sheath to rest between activities may help prevent this condition.
If you or someone in your family is experiencing pain, swelling, tingling or tenderness in the hands, wrist, arm or shoulder, reach out to Dr. Rehman today at 586-534-0803. She is a specialist in these areas of the body, and will conduct a thorough evaluation of your condition. Making sure you get the correct diagnosis is important tyo a good treatment outcome. Her team of Hand Therapists will follow through to help you return to recovery with full range of motion and strength.
After one of the hottest summers on record, the cooler weather of fall is a welcome relief. Breezes blow, days are sunny, and homeowners’ thoughts turn to getting their castle ready for the blasts of winter. Gardens need to be put to bed, siding needs cleaning, windows need caulking and the leaves and abundant acorn crop need raking.
But injuries caused by strains or too many repetitive tasks in a short time span can occur.
The first step is to pace yourself. You can’t get it all done in one day, or even one week. Work for two or three hours, and then rest until the next day. Pay attention; if your hands or wrists start to feel numb or are tingling, you should stop the activity and come back to it later or the next day. Try to get leaf rakes that are the proper size for you, and that have ergonomically designed handles.
Do some warm-up stretches before you start, especially if you are not an active person. Lifting the arms overhead, bending side to side, toe touches or forward bends can help loosen up arms, back and legs for the demands of fall clean-up. A five to ten minute warm-up period will help to generate heat in your body. This in turn helps to make the tendons, ligaments and other connective tissue more pliable and less prone to injury.
Even when walking about your neighborhood, beware of fallen leaves. They can disguise holes or uneven pavement, and they are very slippery when wet. In the earlier hours of the day, patchy frost may form in shaded areas, making dangerous slippery spots. Falls onto an outstretched hand can damage the bones, ligaments and tendons in the hand and the wrist. The hand is comprised of 27 bones, and even a slight injury to one of these can be painful and require proper medical attention.
If you or your family are dealing with pain, stiffness, lack of mobility or numbness /tingling in the hands, wrist, arm or shoulder, reach out to Dr. Rehman today. Upper body injuries that are incorrectly diagnosed or left untreated can cause permanent damage. Seek a thorough examination and comprehensive treatment program by a Board Certified Osteopathic doctor with a team of rehabilitation experts. Call Dr. Rehman’s office today at 586-532-0803 to learn how she and her team can help.
How could anyone help but be inspired by Simone Biles, the four-foot-nine powerhouse that swept the Olympic medals in Brazil just last month? Perhaps you have an aspiring gymnast in your family, and with school beginning again, now is a great time for him or her to join a gymnastics group. Gymnastics builds muscle, flexibility, balance and more. It is an amazing core and strength workout, with no barbells required. Physical skills and confidence are built through regular practice, workouts and competitions. And this sport helps to build a strong work ethic; persistence, patience and practice all pay off here.
But injuries can and do occur.
Leg, knee and ankle injuries can be a problem, but here we will focus on upper body injuries common in gymnastics. Overuse injuries to the upper body can include:
Osteochondritis Dissecans of the Capitellum
This is an injury to the outside of the elbow that occurs from repeated weight-bearing activities on the arm and elbow. The repetitive compression of the elbow creates abnormalities of a small part of the humerus at the elbow. The fragment of bone and cartilage can actually break off and cause the elbow to lock. If this happens, surgery may be required. If the injury is caught earlier, stopping gymnastics and allowing the area to heal may be enough to resolve the pain.
Distal Radius Epiphysitis
An overuse injury to the wrist, this condition can develop from a gymnast’s training in vaulting and tumbling. Pain will be noticeable on the radial side of the wrist; the side closest to the thumb. X-rays may be used to diagnose this condition, and a widening of the growth plate may be noticeable. Rest and avoiding stress on the wrist may be required, and to assist in healing the injured arm may be put in a cast or brace.
As a parent, you want your child to benefit from physical activities, not be hindered by them. So make sure that you talk to your kids, and check out whether they are feeling any pain or soreness. There’s a lot of pressure on young athletes today to score well and support the team; they may not tell you if they are hurting. Be sure your child’s workout routines are varied, and that the same activities are not performed week after week, month after month. Varying the muscles used reduces the likelihood of injury. Kids should always have days off from training. They don’t have the strength or stamina that high school or college-age gymnasts have, so they shouldn’t train like them.
If you have anyone in your family who suffers from pain, stiffness, swelling or lack of mobility in their shoulder, arm, hand or wrist, contact Dr. Rehman today. She will conduct a thorough examination to pinpoint the cause, and she and her team of therapists will design a comprehensive program to heal the condition and help return the patient to full strength and range of motion. Untreated injuries can result in lifelong impairments, and in children, this can be particularly damaging. So don’t self-diagnose or treat. Call Dr. Rehman today at 586-532-0803 to learn more.
The triangular fibrocartilage complex (TFCC) is a small piece of tissue composed of cartilage and ligaments on the little finger side of the wrist, situated just past the end of the forearm bone called the ulna. Cartilage is a tough, rubbery tissue that acts as a cushion for joints. Ligaments are connective tissue that attach the cartilage to the bones , in this case in the wrist.
Usually an injury of some sort causes this condition; either an accident or a sports-related injury. A fall onto an outstretched hand or a direct blow to the little finger side of the wrist can generate the problem. Sometimes swinging a bat or racquet can cause it, or a violent twist to the wrist at work or in a sport can also result in damage to the TFCC.
Pain on the little finger side of the wrist is indicative of the condition, often accompanied by clicking or catching when moving the wrist. A doctor who specializes in the hands, wrists and shoulders is the best person to diagnose this condition. A physical exam will be conducted, and your doctor may order an X-Ray, an MRI or an arthrogram—an X-ray that is taken after a special contrast dye is injected into the wrist, to better show the area of injury. Arthroscopy may be necessary to diagnose the tear.
The early treatment of TFCC injuries includes:
Wearing a protective support, such as a splint or a cast
The application of ice for 20 to 30 minutes 3 to 4 times each day
Oral anti-inflammatory medications, such as ibuprofen or other s
Rehabilitation exercises designed specifically for the wrist
An injection of a cortisone-like medication
A complete tear in this area may require surgery. However, many tears do become painless with rest and time, even if they don’t actually heal.
Patience with wearing the splint or cast, and dedication to performing the prescribed exercises to regain full range of motion and strength once the TFCC is healed will result in the best outcome. The goal is to have your injured wrist be as strong as the uninjured one, with no pain present when performing your activity such as golf, gymnastics or work. Returning to your activity too soon could cause permanent damage to the area.
Prevention is always a good idea, but typically these injuries are a result of an accidental mishap. Using proper equipment that fits you correctly, stretching before working out, and taking frequent breaks can help prevent over-use or injuries cause by fatigue.
If you or someone you love is experiencing pain, stiffness, tenderness or numbness in the fingers, hand, wrist, arm or shoulder, contact Dr. Rehman for a thorough evaluation and comprehensive treatment plan. Her team of specially-trained therapists will help you recover more quickly and with confidence, with the best chance of regaining full use of your affected limb. Call her office today at 586-532-0803.
Sports injuries and on-the-job injuries are unpredictable and sometimes unavoidable. Volleyball, football, baseball, basketball, gymnastics; most sports involve some degree of risk. A sharp blow to the finger, whether from a pop fly, a hurtling volleyball, a hammer, or landing on the hand incorrectly can cause a fracture.
The hand is comprised of many bones, and each finger in the hand is made up of three small bones called phalanges. Damage can occur to any one of these bones. Typical symptoms of a broken finger are immediate pain with swelling and bruising. It will be difficult to move the finger, and the finger may appear deformed if the joint is dislocated or the bone is displaced. Numbness and tingling may be present if nerve damage has occurred. Needless to say, if the injury is severe and the bone is visible through the skin, a trip to the Emergency Room is required immediately. Serious problems with infections or bones that heal out of alignment can occur with any finger break.
Especially in children, these types of injuries can be difficult for the lay person to differentiate from a serious sprain or strain. An X-Ray is the definitive diagnostic tool to determine whether a break has occurred, and your doctor or a special hand surgeon will perform this procedure. Once diagnosed, treatment usually consists of realigning the bones and splinting or casting to immobilize the area for several weeks for the bones to knit back together. Initially the doctor may also recommend keeping the hand elevated above the heart to reduce swelling and pooling of blood, and to ice the affected area for 20 minutes 3 to 4 times a day until the pain is gone. Depending on the age of the individual, over the counter or prescription anti-inflammatory medications may also be prescribed to reduce swelling and pain.
Once the cast or splint is removed and the phalange has healed, stiffness and immobility may be present. Specially-trained Occupational Therapists, known as Hand Therapists, will create a treatment program including exercises, stretching and other modalities to assist in regaining full range of motion and strength in the hand. Faithful performance of the exercises, using the proper alignment, will result in the most favorable outcome.
We rely on our hands for everything we do! Injuries to the hand that aren’t treated properly can have long-term effects, including disfigurement and immobility. Most broken fingers heal well with the above-described measures, but if the break is in multiple locations, or very severe, surgery may be required. In this case you especially need a hand specialist, who understands the complexities involved in repairing damage to the hand. Reach out to Dr. Rehman and her team of professionals today if you are experiencing hand, arm, wrist or shoulder pain. Click here to contact her office, or call 586-532-0803 for more information.
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