Archive for March, 2013

There’s a mouse in my office!

WHY SHOULDER AND NECK PAIN MAY BE A RESULT OF THOSE PESKY CREATURES

They’re everywhere you look these days – rampant in office cubicles, even invading our homes!  While the majority sit quietly on our keyboard tray, some like to hang out on our desk or other nearby locations.  Seemingly harmless, these pesky little creatures can often cause unnecessary pain and tension in the shoulders, neck and upper back.

A growing number of computer users are suffering from neck and/or shoulder conditions directly related to incorrect working postures and chronic repetitive strain.  This strain can lead to chronic muscle tightness and spasm in the shoulders and neck.

This may eventually lead to arm pain and even weakness in your hands.  Be sure to seek help from a Physiotherapist if you pain is persisting or worsening.

WHAT CAN YOU DO TO AVOID THIS…

Be sure your workstation is set up for YOU!  Follow the 90 degree rule at your desk to avoid unnecessary upper body strain and tension.

Knees, hips, and elbows should all be at 90°, when sitting up straight in your chair.

If you need to raise your chair to accommodate your elbows, try placing old telephone books under your feet so you can reach the floor comfortably.  Placing your mouse directly beside your keyboard will help avoid any unnecessary movements between the two and will keep your elbow at 90° when using the mouse.

The ankle is the most commonly injured joint in the body.  A sprain occurs when the ankle is twisted in a sideways motion resulting in injury to the ligaments and soft tissues that restrain the joint.

How Do Ankles Sprain?

The most common type of ankle sprain is when the foot and ankle are rolled inward stressing all the ligaments on the outside of the ankle.  90% of ankle sprains occur in this way.

Landing and jumping sports like netball and basketball have a high incidence of ankle sprain.  High heel shoes also increase the risk of sprain.

Symptoms

The degree of symptoms tends to correlate with the degree of injury.

Ankle sprains are classified into 3 grades.

Grade 1 sprains involve a mild stretch of the ligament which usually resolves within 2-7 days.

Grade 2 sprains are moderate injuries involving a partial tear of the ligament.  The ankle is moderately swollen and very painful.

Grade 3 sprains are severe and involve a complete rupture of the ligament.  They are significantly swollen but may not be that painful.  The ankle will often feel unstable.

First Aid Measures

RICE – Rest, Ice, Compression and Elevation is still the treatment of choice in the early stages of any acute ankle sprain.

RICE controls the swelling, eases the pain and prevents further tissue damage.

Should I Seek Treatment?

If the ankle swells considerably and it is difficult to walk it would be advisable to seek assessment from your GP or Physiotherapist.

It is important to ascertain the grade of injury to determine the management required.  They will carry out a physical examination to assess this structural damage.  An important part of this examination is testing the integrity of 2 main stability ligaments.

Management of a grade 3 ankle sprain is critical.  The damaged ligament must be immobilized to some extent (ankle stability brace) to allow the healing process to repair the ligament.

Poorly managed grade 3 sprains often result in a lifetime of instability.

Rehabilitation of grade 2 & 3 ankle sprains involves restoration of proprioception (balance reactions), muscle strength and normal ankle range.

Do I Need a Brace or Strapping?

Elastic braces may be beneficial for controlling swelling and giving balance feedback.  This type of brace does not restrict ankle motion and will not prevent a sprain.

Ankle strapping restricts joint motion and is used in the acute stage to protect healing ligaments as well as in the early stages of returning to sport.
Rigid braces generally stop the ankle from twisting sideways and are used for unstable ankles in the acute stage to promote healing and in chronic unstable ankles to prevent injury while playing sport or walking on rough ground.

Mike Stewart is a Manipulative Physiotherapist at the Oamaru Physiotherapy Clinic.  He has post graduate qualifications in Manipulative Therapy and Sports Medicine and is a Registered Physiotherapy Acupuncturist.

He has toured as a Physiotherapist with the Maori All Blacks from 1996 to 2008.

Source:  Oamaru Physiotherapy Clinic written by Mike Stewart and Michelle Sintmaartensdyk

Balance – the ability of our body to maintain equilibrium when we stand, walk or perform our daily activities.   As ‘toddlers’ we toddled as our growing bodies developed the pathways that today enable us to balance.  We unconsciously do it all of the time but at some stages of our lives it is harder to achieve and maintain balance.

Athletes and sports people spend many hours perfecting specific skills for their sports which all involve honing their balance. Imagine Daniel Carter kicking goals, or Irene Van Dyk shooting hoops if unable to balance. Even lesser athletes amongst us can improve our performance with enhanced balance skills.

Certain illnesses or damage to the brain can impair our ability to maintain balance.  As we age our balance deteriorates and requires training to maintain the skills we have mostly taken for granted all our lives.

To understand our changing ability to balance it helps to understand some of the anatomy or the ‘nuts and bolts’ that make it work.  Our balance control centre is in the brain in particular, the cerebellum. This area receives and processes information from three types of sensors in other parts of the body and then co ordinates our muscles to respond to maintain balance.

The eyes send visual cues to the brain. An  example of how this visual feed-back helps is when we walk straight down a passageway in day light, but at night with the light off it is hard to  keep straight and off the walls.

The inner ear or labyrinth contains a series of fluid filled canals.  As our body and head position changes the fluid moves, generating feedback to the brain rather like a 3D spirit level.

The third set of sensors are the proprioceptors; nerve endings found in muscles, tendons, joints and skin. These are sensitive to stretch and pressure.  A simple test of their sensitivity is to bend your finger right backwards- it is the proprioreceptors that tell you to stop! And in weight bearing joints that message contributes to your ability to balance.

At different times our ability to balance can be compromised, either by our brain’s inability to receive and process the sensor’s feedback (e.g.; head injury), the sensors feeding inadequate information to the brain (e.g.; inner ear infection or  reduced proprioception in an ankle joint after an ankle sprain), or by our body’s inability to react to the brain’s instructions (e.g.; muscles not strong enough or  joints too stiff to perform the balance correction)

Test Your Balance – Find a safe space where there is something solid to support yourself if you do lose balance. As you attempt these exercises assume the position and try to hold it for 10 seconds. When you can achieve this, attempt the same position with your eyes closed, again aiming to be able to hold for  10 seconds before progressing to the next level of exercise.

i) Stand with both feet together

ii) Stand with one foot in front of the other-heel to toe

iii)Stand on one leg

iv) Stand on one leg  on a soft surface (folded towel)

If you are of advanced years and your balance is not as stable as you would like, discuss your problem with your GP or Physiotherapist who is able to help identify why your balance is impaired and may recommend a balance strengthening exercise programme.

If you are younger, (especially if you are an active sportsperson) and are  unable to maintain balance while standing  on one foot with your eyes closed for at least 10 seconds you also would benefit from a specific balance exercise  programme.

A balance exercise programme will include exercises to sharpen up your balance sensors, strengthening exercises for your trunk (core muscles), hip extensor (butt) muscles, quadriceps (thigh) muscles and calf muscles, as well as stretches.

Balance is an integral part of general fitness and is essential in prevention of falls.  Subtle changes in balance are an indication that it may be time to seek some assistance from your Physiotherapist.

Jeannie Brown is a Physiotherapist at the Oamaru Physiotherapy Clinic.  She has a wealth of physiotherapy experience in the management of orthopaedic and musculoskeletal conditions.

Source:  Oamaru Physiotherapy Clinic written by Mike Stewart and Michelle Sintmaartensdyk

For all appointments call 04 499 3504.