Posted on

Tennis Elbow more common in those who do not play racquet sports…Downtown Winnipeg computer users get Laser or ShockWave therapy today!

Q: My doctor says my elbow pain is due to tennis elbow. But I don’t play tennis. Could you explain how this has come about and what I can do about it?

A: “Tennis elbow” is a common term for a condition doctors call lateral epicondylitis. It’s caused by inflammation of the tendon that connects the extensor muscles of the wrist to the outside of the elbow.

Probably fewer than 10 percent of people get this by playing tennis. The usual causes are recreational activities such as gardening, job-related lifting, using a screwdriver or wrist overuse.

The medial epicondyle can also get inflamed. In this condition, called medial epicondylitis, the affected tendons connect the flexor muscles of the wrist to the inside of the elbow. It’s commonly called “golfer’s elbow” or “pitchers elbow.” Tightening and twisting the wrist from activities such as golfing or throwing a baseball can cause it.

Most people with medial or lateral epicondylitis feel pain when their doctor applies direct pressure to the inflamed area. He or she might ask you to push your wrist against resistance, which could also cause pain. You might also feel pain with handshaking, lifting a briefcase or heavy pot or similar activities.

The treatment is similar for both conditions.

LLLT Low Level Laser Therapy is widely used for any inflammatory condition. Given the minimal depth to the affected bone-tendon area, there is little to impede the efficacy of laser treatment.

trigg-back

rSWT Radial ShockWave Therapy was developed little over 10 years ago by the Swiss company that treats kidney and gallstones. It is the latest treatment for those myofascial trigger points; those areas of chronic, nagging pain, whether it be from overuse or poor postural habits, we all have them.

rSWT neck

You could wear a wrist splint or forearm brace to prevent overuse of the muscles of the forearm.

You can also try a non-steroidal anti-inflammatory drug (NSAID such as ibuprofen or aspirin) and ice packs to help relieve symptoms. Your doctor may recommend physical therapy, especially if you need to return to a job or activity that caused the problem.

Sometimes doctors recommend one or two steroid shots over the affected epicondyle. But there is some risk of tissue loss around the elbow with repeated shots.

The symptoms of “tennis” or “golfer’s” elbow normally get better within a few months with conservative therapy. Once the symptoms disappear, you should begin gradual stretching and strengthening of the tendon and muscle attachments. We will develop an exercise program for you specific to your chosen activity or sport mechanics.

We will also look at your biomechanics. How you move, and perform your work is called ergonomics. Even the simplest changes can have great affects on chronic pain.

Call or email today, I can probably assess your elbow the next business day.

204-9438411 or yrphysio@gmail.com

 

Posted on

Whether you sit at a computer, shovel snow, lift sandbags or play hockey in Winnipeg, your back pain is probably the result of tight hip flexors

yourPhysio anatomy lesson first; your hip flexors are the dominant muscle in the ‘knee to chest’ action. Anatomically known as your; Iliacus, Psoas Major and Minor, and your Quadratus Lumborum, these muscles are attached to your hip, to your lower back and your pelvis. Consequently, when overused or tight they can reconfigure your lumbar spine, throw out your hip and back, affect your sacro-iliac joint, and change your biomechanics thoroughly.

Even though stretching is essential for all muscle work, it can actually be damaging if not done properly. When you stretch without warming up your muscles, it increases your likelihood of injury, as you are trying to stretch a cold muscle. So before you stretch, make sure you warm up; walk in place, cross-train, and increase the blood flow into your muscles so you can prevent an injury. As a physiotherapist, I do commonly advise patients to hold a stretch for 20-30 seconds, but why? The reason is because our muscles have a protective reflex to avoid over extension or contraction. When you are stretching your muscle, the muscle spindles, which are the components that produce contraction, activate a reflexive pathway which causes them to shorten in order to compensate for the stretch (called the myotatic reflex). This is what causes your leg to kick out when you tap your knee.

Knee Reflex

There are two main types of stretching: dynamic and static. Static stretching is what we just talked about, which is a stretching routine that includes holding 30 second stretches for specific muscles. When using static stretching before a sport that requires you to use specific muscles to initiate specific movements, it is hard to relate static stretches to dynamic activity. This is where dynamic stretching comes in. Dynamic stretching is designed to mimic the actions and movements you are expected to perform during a specific sport. For example, this would include kicking around a soccer ball in warm-up before a soccer game, so your body can get accustomed to activating the required muscles. That way, your muscles can make the necessary preparations to prevent injury, as playing a sport requires many specific dynamic and explosive movements.

Starting blocks

For your hip flexors, I teach a ‘dynamic lunge’; such that your hip flexors, quadriceps and pelvic muscles are used within the stretch. If you add Kegel exercises to this movement, the pelvic floor muscles are activated more and a greater effort can be applied to this core stretch. Remember those pre-natal classes guys? A patient was recently surprised to know that guys can do Kegels too! Guys are equipped with those same pelvic floor muscles and ladies should appreciate these efforts, as do the men!
Overall, stretching is very beneficial for movements involved in a regular day, and those involved in heavy labor, repetitive activity and sports. Therefore, it should be a priority for everyone to incorporate some sort of stretching into their daily routine (after warming up of course!), in order to maintain optimal functionality.  Flexibility is a highly underappreciated component of muscular strength and function, but key to good performance at work, home and recreation.

Posted on

Snow, garbage, warm winds and bags of leaves in Winnipeg, need Physiotherapy?

Our first snow fall has come and gone in Winnipeg, unfortunately for those who lost their hydro in the first blizzard of this winter season in Manitoba, it dragged on for 4-6 days. Sounds like our garbage collection woes this October, as Winnipeg introduces the automated, curbside, private company collection, not to mention a shortage of paper bags to dispose of the fall leaves. Snow, garbage, raking leaves, the dreaded fall cleanup can all lead to acute, or even chronic back injuries.

My ergonomic tip for you this fall season; switch the way you do things, especially those repetitive tasks, the raking, the shovelling, switch direction, go from right to left and vice versa. Avoid the pitfalls of the weekend warm winds, get it done, but pace your work and enjoy the time outdoors, stretch occasionally; hands on your hips, bend backwards comfortably and repeat.

Next, we’ll talk about whiplash injuries; what to expect from MPI and driving ergonomics for the ice n snow of winter.

Posted on

Sitting in Winnipeg; an Ergonomic approach to your Physiotherapy needs

Many people ask; ‘what do you treat most often Downtown?’, to that I reply; “mostly neck and back injuries, just from sitting all day at a workstation”.

Here’s where my 27 years of experience as a physiotherapist, who provides specific assessment, feedback, education and instruction in Occupational Ergonomics, or how we interact with our ‘work tasks’, benefits my patients of the grain, finance and legal hub of Winnipeg.

As a physiotherapist, I must assess your workstation and task challenges in order to understand your biomechanics that caused an injury or pain. I only use evidence based guidelines published, and reviewed annually (CSA link http://t.co/Su0MxsFy). Beware of those ‘weekend course’ assessors, quite frankly you will get what you pay for.

You, and your company can reduce repetitive strain complaints in your workplace with an ergonomic assessment at your specific, work site. I will assess problem areas and make recommendations for change to workstations, task organization and management, and your specific, body mechanics with a focus on employee participation, responsibility and behaviour change.

A worksite visit to understand your business and jobs will only provide a baseline for understanding the demands on workers. It will provide us with an ability to recommend modifications for ergonomic improvements and safe body mechanics training.

By providing immediate feedback; employees are able to participate and install immediate, habitual changes at work, home and play, that assist in improving compliance with safe work procedures, and biomechanics that prevent injury.

The main risk factors for musculoskeletal injury can be categorized under one of the following four broad headings: force, posture, repetition and duration of task. In the office or call centre environment these risk factors could be interpreted as;

  • force – is an exertion performed to overcome the weight, resistance, or inertia of the body or a work object (i.e. forceful hand movements while keying or mousing),
  • posture – awkward postures deviate from neutral or comfortable positions. (i.e. twisted neck, raised shoulder, extended wrist, etc..),
  • repetition – refers to tasks or series of motions that are performed over and again by the same muscle groups with little variation (i.e. continuous mousing or keying)
  • duration – the time which something continues (i.e. sustained neck extension to view monitor or abducted shoulder while mousing)

check back again for more on this continuing series regarding your ‘sitting in Winnipeg’…