Carpal Tunnel Syndrome

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Overview

Carpal Tunnel Syndrome (CTS) is a form of repetitive strain injury (RSI) which occurs as a result of damage to soft tissue structures (such as tendons) and in some cases bones of the wrist. Women are three times more likely to develop CTS than men, with approximately 3 to 6 percent of adults in the general population being affected. The condition is particularly common in people who use their hands repetitively, for example individuals working on computers or assembly lines. It is quite common to develop CTS in both hands, however symptoms tend to be worse in the side of the dominant hand.

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Anatomy

The Carpal Tunnel is a narrow passage made up of ligaments and bones at the base of the hand. The Median Nerve and tendons responsible for bending your fingers passes through this passage. The median nerve is the receptor (provides feeling and feedback) for the palm side of your thumb, index, middle and part of your ring fingers.

CTS develops when swelling or damage to the structures of your wrist creates pressure on the median nerve. In addition to swelling due to soft tissue injury inflammation any swelling can develop as a result of medical conditions such as diabetes and arthritis. It can develop during pregnancy, in this case it will probably disappear after delivery.[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_2″ type=”1_2″ spacing=”” center_content=”yes” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”false” last=”true” padding_bottom=”0px” margin_bottom=”0px” padding_left=”0px” element_content=””][fusion_imageframe image_id=”4671|full” max_width=”400PX” style_type=”” blur=”” stylecolor=”” hover_type=”none” bordersize=”” bordercolor=”” borderradius=”” align=”center” lightbox=”no” gallery_id=”” lightbox_image=”” lightbox_image_id=”” alt=”” link=”” linktarget=”_self” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″]https://store.livewellhealth.co.uk/wp-content/uploads/2021/01/carpal-tunnel-877×1024-1-e1611597571302.jpg[/fusion_imageframe][/fusion_builder_column][fusion_builder_column type=”1_1″ type=”1_1″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”true” last=”true” element_content=”” padding_top=”1%” padding_right=”2″ padding_bottom=”” padding_left=””][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

Symptoms

Symptoms tend to develop gradually over time, beginning with slight discomfort and deteriorating progressively if left untreated. Initially symptoms usually appear in one or both hands during the night. As symptoms get worse, tingling may be felt during the day, especially with repetitive activities such as typing or using a mouse.

Common signs and symptoms of CTS include:

  • Pain, tingling and numbness in your hand, wrist and also your thumb and fingers.
  • Fingers may feel and/or appear swollen.
  • Hand weakness and difficulty gripping.
  • Partial loss of sensation in the affected thumb and fingers.
  • In severe cases, where left untreated, muscle wastage of the muscles at the base of the thumb can occur

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Causes

CTS is often a combination of many factors which increase pressure on the median nerve rather than a problem with the nerve itself.

Recent studies indicate that CTS can be idiopathic (no identifiable direct cause) and that there may be a genetic component which increases the possibility that an individual develops CTS.

Activities considered high risk for CTS include any which involve repetitive and/or forceful use of one or both hands. In terms of sports this can include gymnastics, weightlifting (Olympic style in particular), racquet sports, cycling, rowing, baseball and golf. CTS also has a high incidence in individuals who regularly use vibrating hand tools (e.g. hammer drill).

Research has shown that certain conditions can increase the risk of developing CTS by causing fluid obstruction in the carpal tunnel. These include:

  • Pregnancy
  • Menopause
  • Obesity
  • Renal failure/haemodialysis
  • Hypothyroidism
  • Use of oral contraceptives
  • Congestive heart failure
  • Tumours
  • Autoimmune disease (eg, rheumatoid arthritis)
  • Wrist fracture/dislocation/deformity
  • Age – The majority of those affected are in range 40 to 60 years old, CTS usually only occurs in adults.

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Diagnosis

To determine the cause of your CTS your doctor may conduct a physical examination of hands, arms, shoulders and neck. This can help them to decide if the condition is being caused by daily activities, an underlying disorder, or if it is a condition which presents similar symptoms to CTS. They will look for abnormalities in wrist tenderness, swelling, warmth and colour. Your doctor will probably conduct nerve testing to establish sensation in each thumb and finger any check for muscle atrophy (wasting).

You should inform your doctor of any history of fractures, arthritis or diabetes. It will also be helpful if you can provide them with an insight in to your daily activities and hobbies. They will discuss when your symptoms occur, improve or get worse.

They may ask you to have and X-Ray (to check for fractures or arthritis), an ultrasound (which can show if the median nerve is an abnormal size) or an MRI (to check the wrist anatomy).

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Treatment

It is important not to ignore the symptoms of CTS. You can often treat it yourself, but it can take months to get better. Leaving the condition untreated can lengthen recovery time considerably.

REST – Where possible stop any activities which make your symptoms worse. Ask an occupational health advisor how you can modify your work station and/ or the activities that cause the pain.

ICE – Applying an ice pack for 5-10 minutes every 1-2 hours in the early stages of the pain/numbness may help reduce swelling and the pressure on the nerve.

SUPPORT – A wrist splint will help limit movement of your wrist which may help reduce the pain and risk of further swelling.

ELEVATION – Try and keep your wrist elevated to reduce the potential for swelling in your wrist. When you lie down this may mean resting your hand on pillows.

MASSAGE – A Sports Massage Therapist can help to relive the pressure in your carpal tunnel by encouraging the proper flow and drainage of fluids to and from your wrist. They may use Soft Tissue Release (STR) to lengthen and normalize the muscles from your wrist in some cases up to your neck. These muscles often become very tight when performing repetitive tasks, this tension can exacerbated the symptoms of CTS. If your therapist is trained in the use of Kinesiology taping they can also use this to create space in the carpal tunnel and support the soft tissue structures of your wrist. Because the problem may be caused, or made worse, by structures as far up as the neck, your therapist will be keen to address these problems as well as the ones at your wrist. Treating the cause of a problem is always more effective than treating the symptoms alone if the condition is to be resolved.

PHYSIOTHERAPY – Consider seeing a Physiotherapist if other treatment have not improved the symptoms.

CTS can be resolved without invasive procedures, following treatments such as those outlined above has been shown to reduce symptoms effectively if properly followed. It is important to be consistent with treatments for CTS as it may take a number of moths for the issue to resolve.

STEROID INJECTION – A medical professional may suggest a treatment involving a steroid injection to reduce inflammation.

SURGERY – In some cases surgery may be necessary but only after all non-surgical methods have been tried.

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Exercises

The exercises shown in the video are designed to improve the flexibility and strength of your wrist and also stretch other muscles which may be putting pressure on the median nerve supplying your wrist. Make sure you are pain-free at all times and take care not to progress too quickly. Where possible stop any activities which make your symptoms worse. We have given suggested sets and repetitions, but everyone is different so your practitioner may give guidance that is more specific to you. It is important to perform the exercises correctly and at the frequency prescribed in order to reach a successful outcome.

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Prevention

As CTS can be idiopathic it is not easy to prevent its occurrence. If possible avoid repetitive activities, when unavoidable take time to perform stretches and take regular breaks. Be aware of the first signs of symptoms developing, the earlier you start treatments the quicker it can be resolved.
The video above is not just to help rehabilitate the area it will also help in strengthening the area and again you should seek professional advice for this.

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Is It Tendonitis or Tendinopathy…

Tendonitis or Tendinopathy?

The Overview

Tendonitis and Tendinopathy are often used interchangeably as they both present very similar symptoms however the conditions are very different.

Tendonitis: Tendonitis is when a tendon (attachment point of muscles) becomes swollen / inflamed. This can be because of a number of issues such as overuse or a specific injury / movement. The inflamed tendon can become stiff and can cause joint pain as it will be affected in the way it functions. Usually, but not always tendonitis is presented once you finish an exercise or immediately after you have rested it for a period of time and can go away during exercise or use. However it can also present as a dull ache more frequently.

Tendinopathy: Tendinopathy, also referred to as tendinosis, is the breakdown / de-generation of collagen in the tendon. This causes burning pain as well as reduced functionality of the tendon, flexibility and range of movement. While tendinopathy can of course affect any tendon, it’s more common in the Achilles tendon, rotator cuff tendons, patellar tendon and hamstring tendons.

Some suggest that tendinitis precedes tendinopathy (tendinosis) however the fact that a healthy tendon can be up to twice as strong as the muscle is true. This would in turn make the body of the tendon unlikely to tear, unless the tendon is already weakened by degenerative change.

So the very idea that tendinitis is the initial stage of tendinopathy as it will presume micro-tears and inflammation precedes collagen degeneration is wrong. Recent research shows that torn fibres, scar tissue, and calcification are only found in conjunction with tendinosis some of the time, and inflammation are rarely found in tendinosis, which would support the idea that tendinitis occurs secondarily to tendinosis

Symptoms

The symptoms of tendonitis and tendinopathy are very much similar at will present itself at the insertion point where the tendon meets the muscle. The symptoms typically include:

  • Pain often described as a dull ache, especially when moving the affected limb or joint
  • Tenderness to touch
  • Swelling
  • Pain or Stiffness in the morning
  • Pain or stiffness after long periods of rest

Causes

Although tendinitis / tendinopathy can happen through a sudden injury or event the condition is much more likely to appear over a long period of time due to overuse or repetitive movements.

Treatment

Tendonitis and Tendinopathy can both be treated in the same way. In more cases Tendonitis will be more effectively treated through conservative methods of rehabilitation as well as rest. The initial advice would be to rest of area that is causing pain, so for example if you are running and that is causing pain to the Achilles tendon then we would advise you to stop that activity an rest usually for around 3-6 weeks depending on the severity. Through this rest period there will be exercises to do in order to strengthen the tendon in question but also by offering stretching techniques and massage to the affected area / muscle attachment.

Tendinopathy can be treated as above however in some more severe cases surgery can be recommended and can also be very effective in providing around 90-95% range of movement and great results.

Golfers Elbow

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Overview

Golfers elbow, clinically known as medial epicondylitis, is a condition that causes pain around the inside of the elbow joint. Often occurring after repetitive overuse of the forearm muscles and tendons used for moving the wrist and hand. Due to the constant strain of the wrist flexors on the insertion (attachment) point, inflammation or micro tears can occur.

Golfers elbow is a musculoskeletal condition usually seen in people aged 40 – 60, whose daily activities include repetitive wrist flexion. Despite generally being diagnosed in golfer’s, the injury can occur in several other professions or sporting activities.

The level of pain associated with the pathology can vary from a mild niggle to a severe ache. Fortunately there are many different treatments available to help, with more than 80% of people recovering with basic treatment.

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Anatomy

Your elbow joint is a joint consisting of 3 bones. The first is in your upper arm and known as the Humerus. The other 2 bones are in your forearm and known as the Radius and Ulna bones. At the bottom of the humerus there are small bony prominences called epicondyles, where muscles within the forearm attach. The bony prominence located on the inside side of the elbow is called the medial epicondyle.

Muscles, ligaments, and tendons play a huge role in holding the elbow joint in position with strength but also flexibility to move.

Medial epicondylitis, or Golfer’s elbow, is a condition that affects the muscles and tendons of your forearm which attach onto the medial epicondyle. Research suggests that the flexor carpi radialis (FCR) and the pronator teres are the muscles most commonly affected.

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Symptoms

The symptoms of golfer’s elbow usually develop over a long period of time. In the vast majority of cases the pain can be minor and more of a side note but can worsen over time. In most cases there is no specific mechanism of injury associated with the condition, it is usually due to repetitive overuse.

Common signs and symptoms of tennis elbow include:

  • Pain or burning on the inner part of your elbow
  • Weakness or pain when gripping, lifting or twisting objects
  • Pain when straightening the arm
  • Sometimes, pain at night

The symptoms are often worse when the forearm is being used in activities that can be as simple as pouring water into a cup, using a screw driver even shaking hands.

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Causes

Overuse – As mentioned previously the underlying cause of Golfer’s elbow is overuse, causing the tendons of the muscles to become inflamed. Overtime this inflammation can lead to small tears within the tendon or muscle. Recent studies have shown that particular muscles when damaged can play a large part in the cause of Golfer’s Elbow. These muscles are located in the forearm, known as the flexor carpi radialis (FCR) and the pronator teres. When these muscles become injured or weak from overuse they can get very tight causing the muscles to shorten and pull on the tendons at the insertion point. This constant pull on the tendons is what then causes the inflammation and micro tears, resulting in pain.

Activities – Activities play a large part in the cause of Golfer’s Elbow (Medial epicondylitis). As you would expect Golf and other sports are a factor in the case of Golfer’s Elbow (hence the name) however, anyone can get it and it could even be down to work related overuse. Professionals such as Plumbers, Electricians, Carpenters, Factory Workers and Office Workers can get this condition, any work where grip and wrist strength is important.

Age – Anyone can get Golfer’s Elbow at any stage in their life depending on the activities they are doing and how they are using their arm. That said, the majority of cases we see can range between the ages of 40 and 60.

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Diagnosis

When discussing this issue with your doctor, they will take into consideration a number if factors before making a diagnosis. These will include how your symptoms developed, your work and your hobbies etc.

The Doctor will discuss how and when the symptoms occur and are more severe and where on the arm the pain / symptoms are materialising. You will need to make sure you inform your doctor of any underlying health issues such as Arthritis (RA or Osteo), you you have injured your elbow in the past or any other medical issues that has a baring on your elbow.

There are a number of tests the doctors can and should perform during your examination such as asking you to try straighten your wrist and fingers with the doctor providing resistance with your arm straight.

Your doctor may recommend additional tests such as X-rays, Magnetic resonance imaging (MRI) scan or an Electromyography (EMG) – this will be to rule out nerve compression.

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Treatment

Golfer’s elbow is a condition that will eventually get better over time, the length of time will be determined by how much you are using the arm in the way in which it was damaged in the first place. This may mean you will need to stay off certain activities indefinitely for a period of around 6-8 weeks. This could be shorter or longer depending on what state the injury is in.

However, there are treatments that can be used to speed up your recovery and ultimately help alleviate symptoms while you recover.

The first stage in any recover is

REST. It is important you rest your injured arm and stop doing the activity that’s caused the problem in the first instance.

ICE – Apply a cold compress to the injured arm, such as a bag of frozen peas or a sports ice pack / gel pack for a few minutes several times a day, this will reduce inflammation and ease the pain. Some people have great success with contrast bathing the area so for example, icing the joint itself (the bony / tendonous areas) and using heat on the muscular areas such as Forearm to relax the muscles and speed up recover.

PAINKILLERS – Taking Paracetamol to ease the pain and Non-Steroidal Anti-Inflammatory’s such as Ibuprofen to reduce the inflammation can help greatly whilst in recovery.

MASSAGE – Asking your personal Sports Therapist / Massage Therapist to perform massage on the arm offering STR (Soft Tissue Release) as well as general massage to relax the area and stimulate blood flow can really help to speed up recovery and make you feel better.

PHYSIOTHERAPY – Physiotherapy should be considered with other conservative treatment options especially for more severe and persistent cases.

A good rehabilitation plan with those elements mentioned above has seen great results and improved recovery time as well as reduced inflammation, reduced pain and improvement to the range of movement in your arm.

SURGERY – may be an option if the issue persists and you have gone through a considered and tailored physiotherapy and massage program as a last resort to remove the damaged part of the tendon.

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Exercises

There are a number of exercises you can perform to help in the Recovery of Golfers Elbow but also to help strengthen the area to help in the prevention moving forward. We have put together a video of some of the popular and most effective exercises / rehabilitation programs for this condition.

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Prevention

It’s not easy to avoid getting golfers elbow as it can be very minor issues that cause it. However a dynamic and considered training program with a qualified strength and conditioning coach can really help. Further to this if your injury was caused through overuse then looking at reducing that particular activity until you have strengthen the area or looking at other ways to do the task in question will help.

The video above is not just to help rehabilitate the area it will also help in strengthening the area and again you should seek professional advice for this.

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Tennis Elbow

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Overview

Tennis elbow is a condition that causes pain around the outside of the elbow joint, the clinical name for this condition is known as lateral epicondylitis. It usually occurs after strenuous overuse of the muscles and tendons of the forearm. It is a very common musculoskeletal condition with an estimated 1 in 3 people having Tennis Elbow at any one time. The condition is more common in adults and across the age demographic of 30-50 years of age. Both Men and women are equally affected by this condition. Not surprisingly, and as the name suggests, playing tennis or other racquet sports can and is a big factor in the cause of this condition. However, several other sporting activities and non sporting activities can also put you at risk. Tennis elbow can be because of inflammation or, in some cases, small tears of the tendons that join the forearm muscles to the bone (epicondyle of the humerus) on the outside of the elbow.

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Anatomy

Your elbow joint is a joint consisting of 3 bones. The first is in your upper arm and known as the Humerus. The other 2 bones are in your forearm and known as the Radius and Ulna bones. At the bottom of the humerus there are small bony prominences called epicondyles, where muscles within the forearm attach. The bony prominence located on the later side of the elbow (outside) is called the lateral epicondyle.

Muscles, ligaments, and tendons play a huge role in holding the elbow joint in position with strength but also flexibility to move.

Lateral epicondylitis, or tennis elbow, is a condition that affects the muscles and tendons of your forearm however extensive research has shown one particular muscle can play a large part in Tennis Elbow which is the Extensor Carpi Radialis Brevis (ECRB) muscle. The muscles associated with Tennis Elbow are responsible for the extension of your wrist and fingers.

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Symptoms

The symptoms of tennis elbow usually develop over a long period of time. In the vast majority of tennis elbow cases the pain can just be minor and more of a side note but can worsen over time. In most cases there is no specific injury associated with the condition, it is usually a repetitive overuse injury but not in all cases.

Common signs and symptoms of tennis elbow include:

  • Pain or burning on the outer part of your elbow
  • Pain when lifting, twisting or bending your arm (with or without objects)
  • Weak grip strength
  • Sometimes, pain at night
  • on the outside of your upper forearm, just below the elbow
  • You may also find it difficult to fully extend your arm.

The symptoms are often worse when the forearm is being used in activities that can be as simple as pouring water into a cup, using a screw driver even shaking hands.

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Causes

Overuse – Recent studies have show that a particular muscle, when damaged can play a large part in the cause of Tennis Elbow. This muscle, located in the forearm, is known as the extensor carpi radialis brevis (ECRB). It is a muscle that helps in stabilizing the wrist when the elbow is straight.

When the ECRB is injured / weakened from overuse or a specific incident, small tears appear in the tendon where it attaches to the lateral epicondyle (bony prominence). This of course then leads to inflammation and the resulting pain.

Studies also show, the ECRB could be at a greater risk of damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.

Activities – Activities play a large part in the cause of Tennis Elbow (Lateral epicondylitis). As you would expect Tennis and other racket sports are a factor in the case of Tennis Elbow (hence the name) however anyone can get it and it could even be down to work related overuse. Professionals such as Plumbers, Electricians, Carpenters, Factory Workers, Cooks and Butchers can get this condition based on how they are using their arm such as the use of screw drivers with the twisting actions etc

Age – Anyone can get Tennis Elbow at any stage in their life depending on the activities they are doing and how they are using their arm. That said, the majority of cases we see can range between the ages of 30 and 50.

Unknown – Tennis Elbow (Lateral epicondylitis) has been known to occur even without any particular reason such as repetitive over use etc. If this happens, it is called “idiopathic” or in layman’s terms, of an unknown cause.

Pain that occurs on the inner side of the elbow is often known as golfer’s elbow

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Diagnosis

When discussing this issue with your doctor, they will take into consideration a number if factors before making a diagnosis. These will include how your symptoms developed, your work and your hobbies etc.

The Doctor will discuss how and when the symptoms occur and are more severe and where on the arm the pain / symptoms are materialising. You will need to make sure you inform your doctor of any underlying health issues such as Arthritis (RA or Osteo), you you have injured your elbow in the past or any other medical issues that has a baring on your elbow.

There are a number of tests the doctors can and should perform during your examination such as asking you to try straighten your wrist and fingers with the doctor providing resistance with your arm straight.

Your doctor may recommend additional tests such as X-rays, Magnetic resonance imaging (MRI) scan or an Electromyography (EMG) – this will be to rule out nerve compression.

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Treatment

Tennis elbow is a condition that will eventually get better over time, the length of time will be determined by how much you are using the arm in the way in which it was damaged in the first place. This may mean you will need to stay off certain activities indefinitely for a period of around 6-8 weeks. This could be shorter or longer depending on what state the injury is in.

However, there are treatments that can be used to speed up your recovery and ultimately help alleviate symptoms while you recover.

The first stage in any recover is REST. It is important you rest your injured arm and stop doing the activity that’s caused the problem in the first instance.

ICE – Apply a cold compress to the injured arm, such as a bag of frozen peas or a sports ice pack / gel pack for a few minutes several times a day, this will reduce inflammation and ease the pain. Some people have great success with contrast bathing the area so for example, icing the joint itself (the bony / tendinous areas) and using heat on the muscular areas such as Forearm to relax the muscles and speed up recover.

PAINKILLERS – Taking Paracetamol to ease the pain and Non-Steroidal Anti-Inflammatory’s such as Ibuprofen to reduce the inflammation can help greatly whilst in recovery.

MASSAGE – Asking your personal Sports Therapist / Massage Therapist to perform massage on the arm offering STR (Soft Tissue Release) as well as general massage to relax the area and stimulate blood flow can really help to speed up recovery and make you feel better.

PHYSIOTHERAPY – Physiotherapy should be considered with other conservative treatment options especially for more severe and persistent cases.

A good rehabilitation plan with those elements mentioned above has seen great results and improved recovery time as well as reduced inflammation, reduced pain and improvement to the range of movement in your arm.

SURGERY may be an option if the issue persists and you have gone through a considered and tailored physiotherapy and massage program as a last resort to remove the damaged part of the tendon.

Depending on the severity of your Tennis Elbow, recovery can take anything from a couple of months through to 2 years in the most extreme cases. Getting over such an injury should not be considered quick or with a magic treatment, recovery and repair takes time, getting the rehabilitation right is also a very important thing to consider to stop this reoccurring.

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Exercises

There are a number of exercises you can perform to help in the Recovery of Tennis Elbow but also to help strengthen the area to help in the preventing moving forward. We have put together a video of some of the popular and most effective exercises / rehabilitation programs for this condition.

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Prevention

It’s not easy to avoid getting tennis elbow as it can be very minor issues that cause it. However a dynamic and considered training program with a qualified strength and conditioning coach can really help. Further to this if your injury was caused through overuse then looking at reducing that particular activity until you have strengthen the area or looking at other ways to do the task in question will help.

The video above is not just to help rehabilitate the area it will also help in strengthening the area and again you should seek professional advice for this.

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Sciatica

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Overview

Sciatica is a specific type of pain that radiates down the sciatic nerve. Which extends from your lower back, into the glutes and down the back of the legs, however sciatica generally takes place down one side of your body. The main cause of this happening is when a herniated disk, which is bone spur on the spine, compresses part of the nerve. This can cause numbness and pain in the legs and also inflammation. Generally this is not considered as anything serious and in most cases will goes away after a few weeks. On rare occasions a patient may need surgery but this is only a result if there is a significant weakness in the legs.

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Anatomy

The sciatic nerve is the biggest and longest nerve in the human body, starting at the base of the spine, into the gluteal region and running down the back of the leg into the toes. The sciatic nerve is formed in the lower spine by the combination of motor and sensory fibers from spinal nerves L4 to S3. These spinal nerves belong to a larger group of nerves in the lower spine called the lumbosacral plexus.This long, thick, nerve then divides into the Peroneal and Tibial nerves which innervate different parts of the lower leg, foot and toes.

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Symptoms

Pain that forms and travels through your legs up via your glute and into your back is the biggest and most common sign that you may have sciatica. Discomfort can be felt almost anywhere but this is more apparent through the nerve pathway through the areas stated above. Feelings such as burning pain can be felt through sciatica and this may be mild or severe. This can sometimes feel worse or be more painful when you sneeze or cough, additionally sitting for a long period of time can also aggravate this more. Another main symptom is numbness or tingling, this is commonly known as the phrase pins and needles. Muscles can also tighten and become weak in the leg and foot.

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Causes

Sciatica occurs when an overgrown bone is on your vertebrae/ herniated disk in your spine and results in the sciatic nerve getting pinched. 

Some factors such as age can not prolong sciatica. There is sometimes nothing you can do to stop this. Obesity can also be a factor as this puts stress on your spine and the extra weight can cause spinal changes leading to sciatica. Your job can also play part as a factor, for example if you have a heavy lifting job or a job that requires you sitting down for long periods of times like driving long distances. Diabetes can also enhance sciatica because of the way your body uses blood sugar, and increases your risk of nerve damage. Finally not being active can also trigger sciatica.[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_1″ type=”1_1″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”true” last=”true”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

Diagnosis

Sciatica is commonly diagnosed through the patients history taking and physical screening. By definition patients mentioning the radiating pain in the leg will spark the sciatica diagnosis. They may be asked to report the distribution of the pain and whether it radiates below the knee and drawings may be used to evaluate the distribution. Sciatica is characterised by radiating pain that follows a dermatomal pattern.Physical examination largely depends on neurological testing. The most applied investigation is the straight leg raising test.

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Treatment

As stated before sciatica can go on its own so in most cases you won’t have to do an awful lot however some cases are worse than others and there are various things that you can do to help treat this. Easy things like making sure that you stretch regularly can help massively. This allows you to keep your muscles stretched out and start to stimulate the nervous system. 

Massage can be really beneficial also and this also helps stretch the muscles and really stimulate the nervous system by increasing the blood flow especially in the legs.

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Exercises

Glute Max Stretch

Piriformis Stretch

Hamstring Stretch

Quadricep Stretch

Trigger Point the Piriformis Muscle

Please see some exercises and stretch examples in our video.

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Prevention

As Sciatic can be idiopathic it is not easy to prevent its occurrence. If possible avoid repetitive activities, when unavoidable take time to perform stretches and take regular breaks. Be aware of the first signs of symptoms developing, the earlier you start treatments the quicker it can be resolved.
The video above is not just to help rehabilitate the area it will also help in strengthening the area and again you should seek professional advice for this.

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Iliotibial Band Syndrome

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Overview

Iliotibial Band (ITB) syndrome is a condition that often causes pain in the outside of the knee. The ITB itself is a thick connective tissue that originates at the hip and inserts into the knee; it is composed of the tendinous portions of the Tensor Fascia Latae and Gluteal muscles. The ITB’s purpose is to stabilise the knee joint and assist with movement

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Anatomy

The ITB is a large thick band of fasia lata, that originates at the anterolateral iliac tubercle of the exernal lip of the iliac crest & inserts into the lateral condyle of the tibia at the Gerdy’s tubercle. Meaning it begins at the top part of your pelvis, runs down the lateral side of the thigh & attaches at the top of the shinbone, just under the knee cap. It is composed from the Tensor Fascia Lata & Gluteal muscles, then becomes proportionately thickened before attaching into the knee. This thick fibrous sheath then helps to stabilize the lateral side of the knee during flexion & extension, as well as aiding with hip abduction. When the knee is in a flexed position, the ITB is behind the lateral epicondyle, as you start to straighten the leg the ITB then travels forward across the epicondyle.[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_2″ type=”1_2″ layout=”1_2″ spacing=”” center_content=”yes” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”false” last=”true” padding_bottom=”0px” margin_bottom=”0px” padding_left=”0px” element_content=”” padding_top=”7px”][fusion_imageframe image_id=”4780|full” max_width=”” style_type=”” blur=”” stylecolor=”” hover_type=”none” bordersize=”” bordercolor=”” borderradius=”” align=”center” lightbox=”no” gallery_id=”” lightbox_image=”” lightbox_image_id=”” alt=”” link=”” linktarget=”_self” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″]https://store.livewellhealth.co.uk/wp-content/uploads/2021/02/it-band.jpg[/fusion_imageframe][/fusion_builder_column][fusion_builder_column type=”1_1″ type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”true” last=”true”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

Causes

ITB syndrome is an overuse injury that usually presents as pain in the lateral aspect of the knee due to inflammation of a portion of the band, most commonly near the knee. It is most common in runners due to the repetitive knee flexion and extension (bending and straightening) of the knee required.

When the knee repetitively bends and straightens, the band slides of the lateral femoral condyle of the knee, causing excessive friction and thus inflaming the band, resulting in pain. It has been found that individuals diagnosed with ITB syndrome often have thickening of the band itself, which inflames the space between the ITB and femoral condyle.

A number of training factors have been suggested to be risk factors for ITB syndrome:

  • Excessive running in the same direction on a track
  • Increased running mileage
  • Downhill running
  • Wearing worn out shoes with improper support

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Symptoms

If you are suffering from ITB Syndrome you may notice;

  • Sharp pain, particularly on the outside of the knee
  • Pain when the knee is bent to approximately 30 degrees
  • Tightness and reduced flexibility
  • Tenderness on the outside of the knee
  • Pain when running or cycling.

If you suffer with any of these symptoms and suspect you may have ITB syndrome, contact your GP or local Sports Therapist/ Physiotherapist who can complete a thorough assessment to determine a clear diagnosis.

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Diagnosis

Our therapists at LIVEWELL are highly qualified in assessing and treating musculoskeletal conditions; you may find that you would benefit from soft tissue therapy, particularly of the TFL and hip-flexors to reduce tightness and improve flexibility. We can also assist in determining whether your bio-mechanics need altering and helping with strength programmes to target the desired muscles.  With our areas of knowledge and expertise we can help you overcome ITB syndrome and have you back running pain free.

[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_1″ type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”true” last=”true”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

Treatment

The immediate goal when treating ITB syndrome is to reduce the local inflammation and thus limit the pain. Ice and anti-inflammatory medications may assist in the reduction in the initial pain, however the most important aspect of initial treatment is activity modification. It could simply be that the individual needs to cease downhill running or running in one direction on a track- educating the individual on correct running techniques is very important.

Once the inflammation has subsided, a programme can be introduced to begin strengthening the gluteal muscles and stretching the TFL/ITB complex. When the gluteal muscles do not function correctly, other muscles must compensate and perform work that they are not suited for.

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Exercises

If you believe you have ITB Sydrome, you should firstly rest your leg & apply ice to the lateral side of knee joint. As it is an overuse injury initially reducing the load on the structure can help to relieve pain. When the pain starts to ease, some stretching and strengthening exercises can help improve symptom’s and aid recovery.

Please see some exercise examples in our video.[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_2″ type=”1_2″ layout=”1_2″ spacing=”” center_content=”yes” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”false” last=”true” padding_top=”0px” margin_bottom=”15px” margin_top=”15px”][fusion_youtube id=”https://youtu.be/b2SPz9V8AMU” alignment=”center” autoplay=”false” api_params=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” css_id=”” /][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]

Suffering from pain? Do you sit at a desk all day?

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Suffering from pain? Do you sit at a desk all day?

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In 2015 there were over 31 million work days lost in the UK by employees / staff taking time off due to neck and back related pain.

In today’s world, we spend more and more time sat at our desks working harder and getting stressed. Although this affects you as an individual, when you multiply this over an entire workforce, businesses are losing millions if not billions in lost time every year.

There are some small wins that can be put in place. Not only can employers instigate a benefits scheme that helps their staff with subsidised massage and fitness but they can also look at work stations, chairs, posture and other very simple things. This proactive approach has been shown in the US to reduce these types of sick days by nearly 60%.

So what can we do?

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From the individual’s perspective to reduce pain…

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  • Concentrate on your posture; this is probably the most important thing to do. Sit up straight!
  • Keep moving – little and often, even if it is just some shoulder rolls on the way to the coffee machine.
  • Stress plays havoc with our bodies, especially our upper bodies, so do some light exercise 3 times a week and you will see your stress levels reduce!
  • Food, diet – yes we talk about it all the time. New diets get released daily and everyone is an expert. All we say is eat a healthy balanced diet with a few cheat meals and maybe even a few glasses of wine/beer a week to keep you fighting fit and happy!

[/fusion_text][fusion_title title_type=”text” rotation_effect=”bounceIn” display_time=”1200″ highlight_effect=”circle” loop_animation=”off” highlight_width=”9″ highlight_top_margin=”0″ before_text=”” rotation_text=”” highlight_text=”” after_text=”” content_align_medium=”” content_align_small=”” content_align=”left” size=”1″ font_size=”” animated_font_size=”” line_height=”” letter_spacing=”” text_shadow=”no” text_shadow_blur=”0″ text_shadow_color=”” dimensions_medium=”” dimensions_small=”” text_color=”” animated_text_color=”” highlight_color=”” style_type=”default” sep_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” class=”” id=””]

From a company’s perspective in reducing pain…

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  • Install the correct desks and chairs. Yes, it’s an expense but a few hundred pounds is better as a one-off investment than thousands of days being lost every year for eternity surely?
  • Treat your staff. A happy workforce is a healthy one! Lower their stress levels and help them towards the cost of their health with subsidised massage at home or in the workplace. Why not some personal training sessions or maybe even a workplace nutrition advisor?
  • Put on some lunches, take your staff out for team building days; all of these things help with stress which is also one of the leading reasons for sick days in the UK!

A final thought to you the employer: if you look after your staff and help them to look after their health, you will not only save millions in the long run but you will have a happy work force!

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