The initial symptoms may be innocuous and fleeting; an ache in the wrist which may then extend into the forearm or into the hand. Later, as the condition develops, you may notice numbness or tingling in the hands or fingers, or pain that begins radiating through the entire arm. Sometimes weakness is present in the arms or the hand, and grasping objects can be difficult. Oftentimes the symptoms will be most severe upon waking up in the morning, or when using your hands.
Here are some ways to minimize the stress on your hands:
When doing tasks, reduce your force and relax your grip. Try putting foam padding around gardening or other tools to cushion your grip. Most people use more force than is required when gripping an object.
Watch how you hold your wrists. Repetitive motions performed by cashiers, hairdressers, sewers and workers using a keyboard can contribute to Carpal Tunnel syndrome. Ideally, you should keep your wrists straight or very slightly bent.
Take frequent breaks; set a timer for every hour or two to remind you to take a break. Stretch, bend and massage your wrists and hands to promote circulation and blood flow
Be sure your form is correct when performing repetitive tasks on the computer, with tools, or in sports. Be sure your equipment fits you properly and consult a coach to make sure your posture and form are correct. When working on a keyboard, make sure your posture is correct. Incorrect posture can cause your shoulders to roll forward, and shorten the muscles in the neck and shoulders, causing the nerves in your neck to be compressed. This in turn can affect your wrist, fingers and hands.
Ice can be helpful to reduce pain and inflammation, and non-steroidal anti-inflammatory drugs can often help.
Wearing a wrist splint may also help, especially to keep the wrist straight at night, when many people have a tendency to curl the wrists. Bracing the wrist at night will help you keep it straight, reducing the discomfort of carpal tunnel syndrome in the morning.
If you or someone you know is experiencing pain, tingling, numbness or pain in the wrist and hand, contact Dr. Rehman’s office today. She will do a complete evaluation, and her experienced team of hand therapists will use a variety of modalities to help you get relief and to return the wrist and hand to full functioning. And, if surgery should be required, Dr. Rehman is a hand specialist, and has performed many successful Carpal Tunnel release procedures. Contact Dr. Rehman today to get relief from the pain and back on the road to full strength and mobility.
Some of us are chained to it, as we spend 8 or more hours a day peering at the screen and typing cogent replies to superiors, customers and team members. Sitting at a computer typing for hours on end is not a “natural” thing for humans, so take precautions to avoid repetitive motion injuries that can stem from this activity.
Repetitive motion injuries occur from too many uninterrupted repetitions of an activity or a motion. They can also be caused by repetitive awkward motions such as twisting the arm or wrist, overexertion or incorrect posture. They frequently occur in the hands, wrists, elbows or shoulders, and can result in numbness, tingling or pain.
A few simple steps can help you lessen the chance of developing a repetitive motion condition from working at your computer:
Take Frequent Breaks
This is the Golden Rule for preventing most repetitive motion injuries. For every ten minutes you work on the computer, try to schedule in mini-breaks for 30 to 60 seconds. Take a few moments to rest your eyes: let your gaze fall across the room in an unfocused way for a count of ten. Rest your hands and wrists by bending the hands down gently, and by using a hand washing motion to rub the hands and wrists. This helps bring fresh blood to these areas so tissue that is damaged can begin to repair. Rest your back by flexing your spine forward and backward gently. This also brings fresh blood to this critical area. Do shoulder rolls by rolling the shoulders up and around, in both directions, to release tension in the upper back and neck.
Type in a Neutral Position
Also called touch typing, this approach helps you keep your wrists straight, thus putting less stress on them. Keep your wrists elevated and off the surface of the desk or keyboard. The keyboard should lay flat on the desk; don’t angle it up. The tips of your fingers should be the only part of your hand touching the keyboard.
Sit Up Straight
Your mother was right. Proper alignment of the spine helps reduce problems with the neck, shoulders and lower back. Roll your shoulders back, and allow for a slight arch in your lower back. Keep your elbows and knees bent at near-right angles to support the position.
Evaluate Your Monitor Placement
Your screen should be between 20 to 40 inches from your eyes and should be directly in front of you. The top of the monitor should be at eye level, or slightly below. Don’t tilt the screen more than 10 to 20 degrees, for the best viewing and least eye strain.
Adjust Your Mouse Placement
Your mouse should be right next to the keyboard; you should not have to reach or stretch to use it. Invest in a mouse wrist rest so that your wrist can remain straight. Consider replacing your mouse with a trackball. These devices are better designed to fit the hand, and don’t require you to bend your wrist or to grip.
Tingling, numbness or pain in the hand, wrist, elbow or shoulder should be evaluated by a specialist in orthopedic medicine. Schedule an appointment today with Dr. Rehman for a comprehensive evaluation and an individualized treatment program to get you on the road to recovery. Many repetitive motion injuries can be treated with minimally-invasive procedures. Dr. Rehman’s team of hand rehabilitation therapists can help you reduce pain and regain mobility, so your work is enjoyable and you are pain-free for the fun activities of life.
The ice and cold weather of the winter are behind us. It’s that time of the year when thoughts turn to spring cleaning, fresh air and outdoor activities. Our vigilance for accidental trips and falls may be lowered, since sidewalks and parking lots aren’t icy or slick. But it’s just that element of surprise that can cause an accidental slip or fall, even in warm weather. Younger people are at risk for falls, too.
Outdoor hazards include:
Potholes in parking lots: The harsh Michigan winter takes a toll on parking lots, and not every business owner has the money or resources to fix problematic holes or cracks. Be vigilant and look ahead as you cross these areas, especially if you are pushing a shopping cart, which could camouflage holes.
Uneven sidewalks: Even a difference of a mere inch is enough to trip up a walker or runner out on a sunny afternoon. If you’re not nimble enough to get your feet back under you in time, you could wind up with a serious injury to a wrist or hand. Joggers are even more at risk; due to their forward momentum, they have less time to recover their balance.
Boating, skiing or tubing accidents: Weird things can happen with ropes and boats and water. Injuries to fingers can occur, and passengers getting into or out of boats should be especially careful of slippery conditions.
Indoor hazards include:
Carpeting or rugs: All of the edges of carpeting and rugs should be tacked down.
Lighting should be adjusted: Dim lighting can be a culprit, but so can lights that are too bright.
Secure the bathroom: Be sure non-slip bath mats are in place, and grab bars and even shower chairs are on hand for older family members or those with mobility limitations.
Safe Stairways: All stairways must have sturdy handrails. And be sure to use them each and every time you go up and down the stairs.
User-friendly kitchens: Keep frequently-used items at waist height, so reaching, bending and stooping are not repeatedly required. People are more likely to lose their balance if they are not standing upright, evenly balanced on both feet.
Even with diligence, accidents can’t always be prevented. Dr. Rehman and her team of experts are here to assist in the repair and recovery from injuries to the hands, wrist or upper extremities. From the initial evaluation, to the proper diagnosis and design of a comprehensive program utilizing the latest modalities and techniques, Dr. Rehman and her team of hand therapists will guide your recovery. Reach out to Dr. Rehman’s office today to learn more or to schedule an appointment.
Each evening the news channels report the top five conditions local hospitals are treating. Without fail, at this time of year, along with viral and bacterial infections, slip and fall accidents are on the list. With the changeable weather of winter, ice can form quickly and unobtrusively, presenting unknown dangerous conditions. Skiing and skating accidents are also common causes of injuries. But if you fall onto your hand or wrist, how can you tell if it is just sprained, or if it is broken?
If the wrist is obviously out of alignment, severely swollen, or you are unable to move it, an X-ray is warranted, as there is most probably a broken bone. Fractures require immediate intervention, to insure the bone is set correctly so healing can proceed properly. Failure to follow through could result in a longer recovery time, and further problems in the future.
But what if it is just sore and hurts? Usually our bodies will tell us if things are getting better or getting worse. If you think the wrist may just be sprained, initial treatment can consist of resting it in an elevated position, icing it for 20 minutes on and 20 minutes off, and taking non-steroidal anti-inflammatories such as Ibuprofen, Alleve or aspirin. After one to two days, if the swelling and pain has not reduced, further evaluation should be sought.
The most common fractures from falls are breaks to the distal radius. The radius is the large bone in the arm that connects the hand to the elbow. The break typically occurs on the thumb side of the radius, an inch or so above where your wrist bends.
Treatment for this type of injury usually involves casting or splinting the wrist to keep it stable and in a resting position. Non-steroidal anti-inflammatories may be prescribed, and reduced activity during the healing period, which is typically about six weeks. Most urgent care or emergency room doctors are qualified to initially diagnose and treat simple distal radius fractures. But follow up with an orthopedic specialist, a hand doctor, is the best next step. In some severe cases, or if other, smaller bones are also broken in the wrist, surgery may be required. Temporary or permanent pins or wires may be required to hold the bones in place while healing takes place. For this procedure you definitely want a specialist trained specifically in hand surgery.
In either case, as part of the healing program, your hand specialist will likely prescribe gentle exercises to keep the wrist flexible and to re-build strength. As healing progresses, the exercises will increase in duration and frequency, and may include weight bearing in the later stages of healing.
The hands and wrist are comprised of many delicate bones, tendons and ligaments, and can perform incredibly minute movements. A specialist trained specifically in this area, such as Dr. Rehman, will be able to provide the long-term treatment program and other modalities needed to regain full strength and range of motion. Her team of hand therapists will guide your recovery until it is complete.
To learn more about the services offered by Dr. Rehman, call 586-532-0803 today. Or reach out through this website here.
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!
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.
With the changes in schedule summer brings, sometimes it’s difficult to keep up the exercise routines we’ve committed to. With a little bit of creativity, you can stay in shape and entertain your kids at the same time. A bonus: the more flexible and strong each family member is, the less likely they are to be injured in a sporting event.
Morning Family Stretch
Set aside five to ten minutes each morning for the whole family to do some stretching exercises. Stretching helps to get the blood flowing and warms up the muscles for the activities of the day. Make this a daily routine for your family; it is healthful and a quiet bonding experience to help balance the hectic life most kids have.
Kids Make Great Dumbells (and their giggling will keep you going)
Try this Russian Twist: While seated on the floor with your knees bent, hold your child in front of you, engage your core and twist from side to side. Repeat 10 to 20 times. This is a great one for arms and abs.
Squat Press: Stand while holding your child in front of you with your feet hip distance apart, arms extended, but elbows not locked. Slowly lower into a squat like you are sitting in a chair and then slowly stand back up straight. Be sure to keep your knees in line with your ankles. Repeat this 10 to 15 times. Great for the arms and lower body.
Throw a Dance Party
Push the furniture out of the way, round up your family’s favorite tunes, and crank up the speakers for a blast of exercise that will get everyone involved. Dancing is super fun and a great cardio workout. Make one afternoon or evening a week your “Dance Party Night” from now till the kids go back to school.
Family Competition
We’re all about competition in our culture, and most kids are involved in at least one organized sport by the time they are a few years old. Motivate your family by setting weekly goals, and create a chart and point system that helps your family track their activity or eating habits throughout the day. See who can be the healthiest!
All these suggestions should help, but if you or your child are injured in one of your organized sports—or at the company baseball game—be sure to reach out to Dr. Rehman and her team of rehabilitation professionals. Specialists in hand, arm and shoulder rehabilitation, they can help resolve tendonitis, golfer’s or tennis elbow, hand and wrist pain, and many other conditions. To learn more, contact Dr. Rehman’s office at 586-532-0803 today!
With warmer weather, everyone is more active and outdoors more frequently. That can up the odds of having an accident, either slipping and falling, or an injury in a ball game or other sport. A fall onto your wrist or hand, or a strike from an object, or a forced twisting of the wrist can all cause a wrist sprain.
A sprain of any type is an injury that causes a stretch or tear to a ligament. Ligaments are the strong bands of tissue that connect one bone to another in your body. Your wrist is comprised of eight bones that attach to your hand and to your forearm. The wrist joint itself is covered by a joint capsule and the bones are connected to each other by ligaments. When an accident occurs and the wrist is sprained, the ligaments that connect the bones are damaged. Pain, swelling and tenderness in the wrist typically accompany such an injury.
Diagnosis and Treatment of Wrist Sprains
An orthopedic doctor, such as Dr. Rehman, who specializes in the hands, wrists and shoulders, is the best person to diagnose this condition. She will review your symptoms and do a physical exam of the wrist. An X-ray may be needed to insure no bones have been broken.
Treatment may include:
Ice packs on the wrist for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days, or until the pain is gone
Elevating your wrist on the back of a chair or couch while sitting, or on a pillow when lying down
Oral anti-inflammatory or other pain medication may be prescribed
A splint or a cast may be needed to support and stabilize the wrist, and prevent further injury
Specific exercises to strengthen and stretch the wrist may be prescribed by your physician
While recovering from an injury, if you are involved in a sport or activity that uses the wrist, you may have to change to a different type of activity until the wrist is fully healed.
With the short summers in Michigan, people are often anxious to get back to their 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. Resting the injured area, icing as noted above, and dedication to executing the exercises with the correct form will also positively influence your 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 the injured wrist has full range of motion and no pain, you may return to your activity. Prior to this, the doctor may allow you to perform the activity with your wrist in a brace. Ultimately, your injured wrist, hand and forearm need to have the same strength as the uninjured side. You must not have any pain when doing activities such as swinging a bat or a racquet or performing tumbling in gymnastics.
If you are having pain in your wrist, hand, shoulder or arm, contact Dr. Rehman today at 586-582-0803. Getting a complete and thorough evaluation and a comprehensive treatment program will get you on the road to recovery. The sooner you begin the healing process, the sooner you can get back to your activity.
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