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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

 

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Even science can provide ‘stats’ on sitting in Winnipeg to prevent neck and back pain, especially those Downtown, Physiotherapy Winnipeg can educate you

No one will stand all day when they have the opportunity to sit. This is because the body works harder when standing than when sitting. However, when we at yourPhysio.com in Winnipeg review work production studies indicate that workers are more efficient when they stand to work. So how do you decide between the two? Consider these general guidelines Winnipeg!

When Standing is preferred:

the task cannot be performed with arms kept comfortably by your sides.

assembling, testing, or repairing larger products (i.e., greater than 6 inches high)

the work area is too large to be comfortably reached when seated. Stand when you must reach more than 15” past the front edge of the workstation. The maximum reach envelope when standing is significantly larger than the corresponding reach envelope when sitting for both men and women (Sengupta & Das, 2000).

you work in more than one workspace to perform job duties and must move around frequently.
the work task lasts less than 5 minutes.

dealing with heavy objects weighting more than 10 pounds. In general, more strength can be exerted while standing (Mital & Faard, 1990) Stand when you need to maximize grip forces (Catovic, Catovic, Kraljevic & Muftic, 1991) or complete static or dynamic lifts (Yates, & Karwowksi, 1992).the work surface does not allow the worker to comfortably position legs under the surface because of an obstruction (i.e. working on a conveyor or a progressive assembly line, working in a kitchen, using a workstation with a drawer located underneath the work surface or a wide front beam, working at a retail counter, or using specialized equipment)

tasks require frequent application of downward pressures (loading bags, inserting screws)

Jobs that are most appropriately done standing include construction workers, highway flaggers, medical personnel, painters, electricians, plumbers, loggers, firefighters, plant inspectors, and maintenance personnel.

When Sitting is preferred:

Better when visually intensive or precise work is required, the activity is of a repetitive nature; longer tasks are completed (greater than 5 minutes), and when everything can be placed within easy reach. Sitting is not appropriate when heavy objects must be handled or long reaches are required.

However, prolonged sitting has been associated with a high incidence of back complaints (Mandal, 1981), increased spinal muscular activity and intradiscal pressure (Grandjean and Hunting, 1977; Lindh, 1989). Other problems reported include discomfort in the lower extremities (Westgaard and Winkel, 1996) and increased muscle loading of the neck and shoulder muscles when sitting with the forearms unsupported as compared to standing with the forearms unsupported (Aaras et al., 1997; Lannersten and Harms-Ringdahl, 1990).

To summarize the literature, neither static standing nor sitting is recommended. Take note of ‘static’ versus ‘dynamic’ Winnipeg, learn to balance each through your day.

Each position has its advantages and disadvantages. Research indicates that constrained sitting or constrained standing are risk factors and that alternating work postures may be preferable. Alternation between two postures allows for increased rest intervals of specific body parts, and reduced potential for risk factors commonly associated with MSD development.

Ideally, provide workers with a workstation and job tasks that allow frequent changes of working posture, including sitting, standing, and walking. If either sitting or standing is feasible but only one possible, sitting in a properly designed chair is preferable.

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Steroid injections for back pain can lead to bone loss, beware those with elbow pain, chronic pain, use Physiotherapy Winnipeg

Lately, many patients with chronic pain, including those with back pain, shoulder rotator cuff pain, elbow tendinitis pain or other chronic pain, have been asked by their family doctors ‘if they would prefer corticosteroid injections to physiotherapy?’

A Henry Ford Hospital, in Washington, D.C., study ( http://t.co/W3gj4dJt ) has found that postmenopausal women suffered significant bone density loss in their hip after they were treated with an epidural steroid injection for back pain relief.

Bone density loss after six months was six times greater when compared to the typical bone density loss seen in a year in a postmenopausal woman who doesn’t receive steroid injection, researchers said.

Shlomo Mandel, M.D., an orthopedic physician and the study’s lead author, said physicians should exercise caution prescribing an epidural steroid for select patients, suggesting that multiple injections may compromise bone strength.

“The findings of our study suggest that epidural steroid injections for back pain relief should be approached cautiously in patients at risk for bone fragility,” Dr. Mandel said.

“Physicians who do prescribe them should consider measures that optimize bone health such as calcium and vitamin D supplements and exercise as part of their patient’s treatment plan,” he added.

Back pain is one of the most common medical conditions in the United States, affecting 8 out of 10 people at some point during their lives. As people age, their spine ages with them, causing degenerative changes in the spine.

Patients are typically treated with anti-inflammatory drugs and physical therapy. If symptoms persist, an epidural steroid is often prescribed to alleviate pain and improve function. However, steroid use has been linked to diminished bone quality.

There has always been the link, and the questions concerning steroid injection and tendon or bone deterioration. One of the more famous cases was that of Joe Montana, Hall of Fame NFL quarterback and his elbow tendon rupture following multiple injections. Now there are not many of us that perform at this level, but chronic pain of any type can be debilitating and life altering. Please know your options and be aware of all the side effects associated with longterm medications; the list of side effects may outweigh any medical advantage.

If you are considering steroid injection as a form of treatment; ask your doctor about his/her experience in delivering such a treatment option. An orthopedic surgeon or experienced sportsmedicine doctor would be a wise choice.

Your Physiotherapist should be able to address your concerns about such a treatment option, and he/she should be able to provide treatment relevant to your pain trigger points and the appropriate exercise to assist in your longterm rehab.

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Is your Winnipeg summer, play time limited by a joint sprain ; tennis? golf? walking?

According to the Orthpedic Society for North America; knee sprains, especially those of the anterior cruciate ligament (or ACL) have risen 400% over the last decade.

We are trying to stay more active; at work, at home and during our ‘play time’. All sport participation rates are up, just try and book something in the Winnipeg Leisure Guide, or a camping spot in one of our Manitoba Provincial Parks. Congrats!

Remember to prep for activities; some form of ‘dynamic warmup’, imitate a biomechanical piece of the movement that you shall be attempting, and repeating. At the gym, prep those muscle groups, learn the correct exercises that will benefit your performance.

Sore afterwards? Don’t put all the ice in that glass, use some cold therapy to cool down those worked areas…Rest, Ice, Compression, Elevation

We do have a Golf 911 service for those that need to get back quickly, and avoid loosing that ultimate tee time. Enjoy!

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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’…

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Concourse Physio in the Winnipeg Exchange District

Concourse Physio in the Winnipeg Exchange District

Since 1993, physiotherapy services upon immediate access, downtown convenience and with direct billing if possible…enjoy the Winnipeg Fringe Festival!