Print- Share
Email- A A A
PrintRunners: ITB Syndrome and the “Stiff” Pelvis
Recurrent Hamsting injuries?
Footballers and sprinters- you must be wondering what your doing wrong? What is causing you to have recurrent problems with your hamstring?
Now as with any injury, you should always consult your GP and or physiotherapist before commencing any new exercise…
So a big mistake when rehabilitating the hamstring is the lack of eccentric work… people tend to stretch and concentrically strengthen muscles which does not protect the hamstring when it is under the most strain. Eccentric contraction involves contracting a muscle in a lengthened position- in the case of the hamstring this would be from knee flexion through to knee extension. This differs to concentric muscle activity where muscles are both contracted and shortened at the same time, this would be the equivalent of performing a hamstring curl
Nordic hamstring exercises are found to be quite useful in strengthening the hamstring muscle
Look out on MCR for a detailed hamstring rehabilitation programme in the coming weeks
What is the difference regular injuries and sports injuries?
“I have some shoulder pain and was wondering what is the difference between a regular injury and sports injury? Do I see a regular physiotherapist or a sports physiotherapist?”
- Joel
Hi Joel,
The terminology used by physiotherapists can ben confusing sometimes. Body parts other than the main body trunk such as your spine and hips are referred to a peripherals by physiotherapists. So a shoulder injury such as yours is a peripheral injury.
Regular peripheral and sports injuries over-lap significantly. You can get knee ACL injury from incidents that are not sports related even though ACL injuries are common seen in athletes.
The main difference in approach in treating regular injuries and sports injuries are
- the speed of recovery
- the intensity of the treatment
Speed of Recovery
The pace of sports therapy is generally much quicker and more aggressive. This is due to the demands of the sports. The longer the athlete is down and out from training, the harder and longer it is for them to return to peak performance as their conditioning can deteriorate quite quickly. So treatment sessions tend to closer together and more frequently, several times a day in some cases.
Regular therapy would be spread out over a longer period of time to allow the body to heal more gradually.
Intensity of Treatment
Also, the demands of the sports can place a lots of stress on the injuries body part. As such the treatment such as strength and conditioning are generally more intensive to build up support – stronger muscular balance and finer motor control to prevent re-injury.
Such treatments is generally not called for with regular injuries as high-stress is not expected to the placed on the injured body part.
Another source for shoulder pain: Could it be the AC joint?
Rotator cuff tears, frozen shoulder and impingement are all very common and well known conditions that may produce dysfunction at the shoulder. Less common but still potentially problematic and therefore another important consideration when determining the source of shoulder pain is the Acromion clavicular (Ac) joint.
Anatomy
The clavicle (collar bone) has 2 joints a medial (to sternum) and lateral end (to the acromion of the scapula-shoulder). The Ac joint refers to the lateral articulation with the acromion of the scapula. The joint is stabilised via the acromioclavicular, coracoacromial and coracoclavicular ligaments and the upper and middle fibers of trapezius muscles aswell as well as the deltoids.
Injuries
Ac joint dysfunction is a result of a sprain, dislocation, fracture or osteoarthritis at this joint
Dislocation and sprain
The Ac joint is usually injured by a direct fall onto the top of the shoulder, cycling injuries, or associated with over head throwing (Javelin) athletes. The shoulder blade (scapula) is forced downwards and the clavicle (collarbone) appears prominent. The degree of injury at the joint is classified by the separation of the joint and damage to ligaments supporting it. A sprain suggests ligament injury whereas a dislocation refers to the clavicle moving upwards and backwards out of its normal alignment. The degree of this separation between the clavicle and acromion is graded on a 6 point scale, with grade 3-4 or higher requiring surgery.
The altered position of the clavicle, disrupts the normal rotation action of thr clavicle that is required to achieve end range forward flexion (overhead ROM). Pain will occur as a result of over stretched/ ruptured ligamemts (depending on the severity) and a stretched joint capsule. As a protective mechanism, pain tends to lead to altered postures which may comtribute to neck pain and altered muscles activity of muscles that attach to the clavicle; such as the pecs, trapezius and sternocleidomastoid.
Fracture
The fracture may occur at the distal end of the clavicle following contact sports injuries, bicycle and car accidents.
Arthritis
The incidence of arthritis at this joint has been shown to be about 50% in MRI studies of elderly populations, however these people may be asymptomatic.
Just like any arthritis this refers to degeneration of the cartilage at the ends of the clavicle and acromion. Normal day-to-day activities that require repetitive arm motion can cause cartilage loss (primary osteoarthritis). In addition arthritis may be due to cartilage degeneration after an injury to the joint (post traumatic arthritis). Regardless of the cause, predominately the normally smooth cartilage, as well as the meniscus between the bones breakdown leading to pain, due to increased friction and thus creating an inflammatory response at the joint.
Signs and Symptoms
Arthritis
Pain and stiffness of the joint is a common symptoms as is catching and “clicking” at the shoulder. Usually, these complaints are worst with overhead activity or with positioning the arm across the body. These are both common positions of the arm- from daily activities such as brushing your hair or reaching your back pocket, putting a shirt on, to sports activities such as a golf swing.
Dislocation and sprain
Pain initially may be widespread throughout the shoulder until the acute phase resolves, following this stage the person will demonstrate specific tenderness at the site of the end of the clavicle. Swelling and depending on the the extent of the injury a step-deformity may be visible. This is an obvious lump where the joint has been disrupted (as in the case of a dislocation) and is seen in more severe injuries. Similar to arthhiritis the individual will report pain on moving the shoulder, especially with overhead activities and across your body motion.
Treatment
Acute injuries will respond to ice therapy, anti-inflammatory medications and a sling is often used.
Electrotherapy could be utilised to prevent the formation of scar tissue in the ligament and promote healing and decrease swelling.
Exercise therapy to restore strength and range of motion of both the neck and shoulder is vital. Strengthening exercises include lateral rotator work, as well as shoulder blade pinching exercises.
Taping can be applied to offload and realign the Ac joint.
Mobilisation of the Ac joint (clavicle) at painful ranges is also a common intervention used by physiotherapist to restore normal and pain free alignment.
If your not too sure whats causing your shoulder to hurt- book in to see a therapist for a shoulder assessment and treatment.
Gym Users – Are you OVER-working the PECS?
If your gym workout is giving you neck and shoulder pains, you could be over-training your chest muscles. The key is a balanced training program that focuses on several muscle groups to prevent muscle imbalance developing and the consequent dysfunction
The effects of over developing one muscle group i.e. your chest muscles (pectorals) in the gym, whilst neglecting your back muscles, often affect your posture resulting in neck, back, and shoulder pain
To understand why this occurs, you must be familiar with the notion that most joints in our body have two or more separate and opposing sets of muscles acting on the joint. Take the elbow as an example.
When the biceps contracts and shortens, it bends the elbow joint. As the elbow bends, the opposing triceps, must relax and lengthen to allow this movement to occur. And vice-versa, for the elbow to straighten; the triceps contracts and shortens and the biceps must relax and lengthen.
To gain a well rounded physique you must consider strengthening more than just one, if not all the muscle groups. An over developed muscle (group) will create more tension on one side of the joint. Over developed muscles are also often tighter (shorter) than normal. The balance between muscles at the joint is lost, pulling the joint away from its mid-line and changes the angle of rotation at the joint.
The Shoulder
The shoulder is a more complicated joint, however the same principles apply.
From personal experience as a physiotherapist, one of the most common mistakes in the gym is over-training the chest muscles. This causes an imbalance between the muscles at the front of the body and those at the back. The shoulders with time are pulled forwards as the chest muscles get stronger, bigger and shorter, making the posture more rounded, creating pain and potential pathology.
Lateral postural Picture
Why is a rounded posture problematic?
Rounded postures place the shoulder joint in a unbalanced position away from the ideal centred position. This unbalanced position leads to increased compression at the shoulder, resulting in pain and reduced function:
- Compression of muscles and other structures at the front of the shoulder joint, may cause pain in the neck, and or down the front of the shoulder and side of the arm. Pain is usually worse with overhead activities. If the compression of the tendons continues for long enough, tears of the tendons (rotator cuff) may occur.
- Rounded postures often lead to neck pain. A large number of muscle that attach to the shoulder also attach to the neck at the other end. If these muscles are affected (lengthened and weakened by the pull of the shoulders) the neck often tends to rest into a head forward ‘chin-poke’ position. This increases the pressure on the neck joints and also other pain sensitive structures around the neck that can cause symptoms (Szeto, 2005).
- The shoulder’s range of movement is significantly reduced as a result of having less space for the joint to move. (Bullock et al, 2005)
Additional contributing factors leading to rounded shoulders
Modern Lifestyles
Think about all your daily activities; washing your face and hair, driving, sitting at the computer. People are becoming chair-shaped, and this keeps the shoulder in a rounded position.
Pain Response
Your body’s response to pain is another factor. When you have neck and shoulder pain we often adapt a rounded posture. This initially is good protective mechanism to prevent further damage for the first few days post-injury, however in the long term this posture keeps the shoulder in a poor/compressed position and will hinder healing.
How to correct your rounded posture?
As a guide, when looking from a side view your shoulders should be fairly central compared to the trunk, and the head should be central on the shoulders. A ‘plumb line’ from the centre of the ear should fall through the centre of the shoulder.
To get into this position roll your shoulders all the way forwards, then all the way back (your shoulder blades should touch), then find the mid-point between these two position. When you have this, gently tuck your chin in, so that your head is positioned on top of your shoulders.
Workout program to prevent the over-training
Weight-training:
If you work the chest 2 x weekly, doing 6-9 sets of 12 repetitions, then do the same amount of work, at the same load and intensity for the opposing muscle groups – the upper back muscles. Most chest exercises involve pushing – therefore to balance this and work the upper back you must include pulling type activity. Some ideas are provided below.
- Lat pull down
- 45 degree angle lat-pull down
- Seated row
- Bent over row
- Pull ups
- Shoulder external rotation
Stretching
As well as strengthening (which contracts and thereby shortens muscles), you should ALWAYS stretch all the muscles you have trained (lengthen the shortened muscles ) at the beginning and end of your workout to reduce tightness of these muscles. In this scenario it is therefore strongly recommended to stretch both the pecs and back muscles.
- Hold 30 seconds
- rest 30 seconds
- repeat x 3 (4 x daily)
References:
- Brukner and Khan. Sports Medicine
- Bullock, M., Foster, N., Wright, C., (2005). Shoulder impingement: the effect of sitting posture on shoulder pain and range of motion. Manual Therapy 10, 28–37
- Kwok Tung Lau, Ka Yuen Cheung, kwok Bun Chan, Man Him Chan, King Yuen Lo, Thomas Tai Wing Chiu (2010). Relationships between sagittal postures of thoracic and cervical spine, presence of neck pain, neck pain severity and disability. Manual Therapy 15 . p457-462
- Szeto, G., Straker, L., O’Sullivan, P., (2005). A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work—2: Neck and shoulder kinematics. Manual Therapy. Vol 10. p 281–291
Osteoarthiritis: Hip and Habits
The previous article touched upon hip Oa and muscles which may be weak and strong allowing for more specific rehabilitation.
In addition to muscle imbalance, are there particular postures that a person adopts that aggravates the disease process?
OA can affect all joints and where a lot has been said about arthiritic knees in this domain, there has not been much written regarding OA and the hip.
The purpose of this article aims to briefly discuss Hip Oa and associated postures that may progress the disease process.
The hip joint consists of the articulating surfaces between the symmetrical socket known as the acetabulum (of the pelvis) and the femur (thigh bone). The acetabulum is deepened by a cartilage-covered ring of fibrocartilage known as the labrum to aid in the congruency of the joint. The joint space between the acetabulum and femur are at equal points throughout, to allow adequate lubrication.
The hip joint relies heavily on surrounding capsule, ligaments (transverse, iliofemoral, pubofemoral, and ischiofemoral ligaments) and muscles to maintain it stability.
Hip osteoarthritis
Essentially the disease process affects the cartilage that surrounds the joint and thus exposes the bone reducing the joint space and allowing for bone and bone contact. Hip osteoarthritis is something that affects people more commonly over the age of 50 and is exacerbated by obesity, previous hip fractures, congenital conditions and genetic predispositions.
Symptoms
Arthritic hips can be very varied and transient depending on factors such as a weather. Main symptoms include:
Pain with weight bearing activities
Limited range of motion
Stiffness of the hip
Walking with a limp
Referred pain into the bottom and groin
Postural habits
In a clinical setting a patient will tend to stand in a way they deem is “good posture” for the benefit of the assessing therapist. This is all well and good and provides the therapist an idea of that patient’s perception and awareness of posture; However another important consideration is what posture that patient assumes during prolonged standing, or in relaxed postures in their normal environment.
When looking at the hip joint, one must consider negative postures like “hanging on the hips” where the weight is shifted to one side (e.g the right) and the opposing pelvis (i.e the left) is dropped down into relative adduction. If this hip (left) is in increased adduction (shortened adductors), by default of muscles working in pairs and as opposites, the abductors on the left will be stretched (lengthened).
Also in such stances, the ITB is in tension and muscle activity on the left is reduced. These are postures that are often observed by clinicians when assessing the single leg stance of patient with hip OA.
The problem with adopting such a pose is, it may lead to a phenomenon termed ‘stretch weakness’ occurring in these hip abductor muscles on the left resulting in inner range weakness.
What this suggests is ‘hanging on the hip’ in adduction, where hip abductors are lengthened, overtime may actually lead to physiological changes making the muscle weaker.
Clinically this proposes that testing and strengthening hip abductors ought to be done with the leg in adduction (10 degrees) as well as in neutral to gain the most therapeutic benefit for OA patients.
Interestingly there has been research suggesting that weight bearing with excessive hip adduction will also result in increased joint forces and this had been found in patients with early hip joint pathology during the stance phase of gait. Further highlighting the importance to reduce adduction and increase abduction strength.
In addition to increasing the load through the joint, excessive hip adduction also has the effect of increasing the compressive load of the ITB over the greater trochanter, into which the glut. medius tendon inserts. Therefore prolonged standing in the “hanging on the hips” posture produces a significant amount of compressive loading of the glut. medius tendon and therefore possible dysfunction.
Other negative postures that produce the above effects include sitting cross-legged in hip adduction, and sleeping in sidelying in hip and patients with occupations requiring prolonged standing must be correctly advised and rehabilitated.
Treatment for such clients should not only look at strengthening the abductor muscles at different ranges, as already discussed but also to educate the patient about these postures to avoid lengthening the abductors and compressive loading of the ITB and Glut. medius tendon.
References:
Grimaldi, A (2009)Assessing lateral stability of the hip and pelvis, Physiotec Physiotherapy, Manual Therapy:16 (2011) 26-32
Heal your Achilles Heel
Most cases of achilles pain that we see at our clinics have reached the tendinosis stage. In simple terms this stage is where the cells are degenerated and not repairing properly. This is different to Achilles tendinitis where inflammation is the primary process.
There are many factors to consider for effective healing of an Achilles tendinosis. The purpose of this article is to provide you with some useful pointers to promote recovery.
1. Tight muscles
The calf muscles are generally tight in people with Achilles conditions. Stretching exercises are often very useful, but at the same time, they can aggravate the condition if overstretched. Most commonly the inside of the calf is often tighter and therefore usually leads to pain on the inner side of the achilles tendon or on the insertion attachment on the inside of the heel.
To stretch this muscle effectively, you can turn the foot away from the body slightly to increase the stretch to the medial gastrocnemius. Bending the knee slightly will increase the stretch further down, nearer to the achilles tendon.
2. Weak muscles
Muscles not only function to move a body part, but also absorb energy like a spring. The achilles tendon is an important shock absorber with almost any weight bearing activity we do, like walking, running, jumping etc. When your calf muscles are weak, they will not be able to function efficiently to absorb the shock or move your body in tandem with the demand of your activity. Hence the impact will be instead taken up by the tendon itself leading to dysfunction.
To train the shock absorption function of your calf muscles, stand on the edge of a step (heel off the step) and perform heel raises (go on to your tiptoes) and then the slowly drop the heel down (heel dip) (about 3 seconds) just before you feel the stretch in your calf muscles, push the heel up again. You will feel the obvious weakness of your affected leg especially if you do it only on one leg. You will notice that the heel can’t go up as high and you need significantly more effort compared to your other leg.
3. Foot Arches
A high arched foot has a smaller surface area in contact with the ground. It is also stiffer into pronation which is what your foot should normally do as it bears weight. The combination of poor shock absorption from impaired pronation and a smaller area will increases the amount of force that goes through the high arch foot. A higher arch tends to have the heel rolled outwards and a lower arch tends to have the heel rolled inwards. This means that the achilles tendon will not be lifting the heel up normally. Instead it will be lifting up the heel plus tilting the heel sideways, either inwards or outwards.
4. Foot biomechanics
When your foot and ankle joint are too stiff or too lax, they either have poor shock absorption or your muscles have to exert more force to stabilise. The biomechanics has a lot to do with the foot arches too (see above).
Customising foot orthotics or inserting of heel wedges may help to correct such dysfunction in biomechanics. The physiotherapist may also perform mobilisation techniques to help facilitate movement in the foot and ankle joints.
5. Training intensity
As mentioned above, tendinosis is a degenerative stage where breakdown of cells is faster than your body’s ability to repair, i.e. overuse. Be mindful of how much you are exerting yourself. Some variables that you can take note of are, speed, distance, terrain etc. For example increasing running speed, walking further or running up a slope can aggravate the injury.
Try increasing the intensity by 10% each week, and always listen to your body.
No pain no gain is definitely not the mantra for healing an Achilles tendinosis.
Hip muscles to target in arthiritis
Hip osteoarthritis (OA) is very common amongst an elderly population. There is a lot of research looking at the causes, the process and even potential (conservative, pharmacological and operative) treatment of osteoarthritis, but what is not as clearly understood is how the muscles of the hip are affected.
Why is this important, as clinicians we are involved in the rehabilitation of patients pre- operatively and post- operatively and therefore it is vital for us to understand which muscles are weak, how best to strengthen them and which muscles are overactive and therefore do not require strengthening
When looking at the muscles synergy around the hip we can separate superficial muscles (Gluteal max (GM), tensor fascia lata (TFL) from those in the deep system which include the gluteus medius (G.MED), gluteal minimus (G.MIN), quadratus lumborum and piriformis.
There is research suggesting that increase adduction activity, increases compressive forces through the hip and therefore may make symptoms worse. What this suggests, is that in generic home exercise programmes, exercises to strengthen adduction ought to be avoided.
The notion of considering the gluteus max as acting like 2 separate muscles carrying out two different movements has also come about of late. This due to its attachment and insertion site, the upper portion of the GM muscle (UGM) arises from the posterior iliac crest, while the lower portion of the GM muscle (LGM) arises from the inferior sacrum and upper lateral coccyx. This therefore causes the UGM, to act primarily as a hip abductor, and not play a role in hip extension unlike the LGM which is predominately a hip extensor. Both portions are believed to externally rotate the femur.
When comparing muscle wastage of patients with unilateral hip osteoarthritis, the results showed muscle wastage in the LGM of the affected hip but not the UGM. On the unaffected side the UGM experienced hypertrophy. Hypertrophy can be explained by compensation with offloading the painful side leading to increase weight bearing on the unaffected side. Commonly enough unilateral OA tends to develop into bilateral osteoarthritis.
To explain the development of bilateral OA, the theory that excessive abduction can also lead to bilateral hip OA due to the increase compressive loading has therefore been proposed. Therefore clinically once again routine hip abduction exercise targeting the superficial UGM provided for osteoarthritic patients may not be beneficial.
The emphasis is moving more towards strengthening hip extensors (LGM) and the deep abductors G.MED, G.MIN and piriformis over superficial hip abductors (UGM). The deep muscles of the hip are believed to have a part in absorbing ground reaction forces at heel strike during gait. The inabilty of these muscles to do this effectively may explain the degenerative process and pain of the hip joint.
In contrast to the above, the has also been suggestions that post total hip arthro-plasty in OA patients, GM plays an vital role in preventing surgical implants from loosening and hasten the recovery. When looking at the energy transfer and mitochondria function of a diseased OA hip, GM appeared to show greater deterioration of the intracellular energy transfer processes. The authors of this study concluded that arthroplasty undertaken before development of the grade 3 OA may improve greater post surgically as there would be fewer changes at a cellular level to the muscle.
A following article will demonstrate useful hip strengthening exercises and stretches
References
Grimald, A., Richardson,C.,Durbridge,G. Donnelly, W., Darnell, C., Hides, J (2009) The association between degenerative hip joint pathology and size of the gluteus maximus and tensor fascia lata muscles, Manual therapy
Eimre, M., Puhke, R., Alev, K., Seppet, E., Sikkut, A., Peet, N., Kadaja, L., Lenzner, A., Haviko, T., Seene, T., Saks, V.A., Seppet, E.K., (2006) Altered mitochondrial apparent af?nity for ADP and impaired function of mitochondrial creatine kinase in gluteus medius of patients with hip osteoarthritis, Am J Physiol Regul Integr Comp Physiol 290: R1271–R1275
Shoulder pain in office workers
A shoulder impingement is common amongst athletes involved in overhead sports. Ironically the same condition can happen in someone who leads a more sedentary lifestyle. A common scenario is where someone reaches out for a stack of documents or a heavy object that weighs too much for the shoulder muscles.
A deskbound worker's posture are the main factors that will give rise to such shoulder problem. These factors are similar to those predisposing factors of shoulder pain in overhead activity athletes.
The image below demonstrates a slouched sitting posture with a forward head posture typical of someone who spends long hours at their desk. A few factors to notice in someone with a shoulder pain, is the position of the shoulder blade, rounding of the shoulder, and poking of the chin.
Narrowing of shoulder joint space from a slouched position
Try slouching your upper body and raising up your arm as high as you can, compare this to sitting or standing upright and reaching high up. You will find that it takes more effort in the former scenerio and you may feel a pinch or a block in the shoulder as you go towards the end of range. This is because the shoulder joint space (subacromial joint) is narrower in a slouched position.
Muscle Imbalance
In slouched sitting, the shoulder blade is rested on the rib cage in a forward tilt orientation. Overtime, this develop into a muscle imbalance where the muscles in front (pectoralis minor) are tightened, and the muscles at the bottom of the shoulder blade (lower trapezius) are stretched and thus weakened. As the lower trapezius is one of the vital muscles to stabilise the shoulder blade, weakness will increase instability and poor control of the shoulder joint leading to overuse of the rotator cuff muscles to compensate for the instability.
Long hours in the slouched position also develop stiffness in the joints of the upper back. This means that even if you get away from the desk, the upper back is so stiff that it's "stuck" in this slouched posture, coupled with the muscle imbalance, a person will find it increasingly more difficult to correct their posture even when in an upright standing stance, further increasing the risk of shoulder pain.
Rounded shoulder makes muscles inefficient
In a rounded shoulder, the ball of the shoulder joint will not be able sit well in the socket of the shoulder as there will be a inward rotation of the ball in the socket. Imagine a golf ball balancing on a tee, when the ball joint is not sitting well in the socket, muscles around it will have to work a lot harder to pull the ball into the socket to maintain stability. The excessive efforts from the muscles makes it tires and wears it down faster.
New mums: Pain in the thumb?
Its common knowledge, that pregnant women and new mothers are prone to experience low back pain. Lots have been said to why, and such women have successfully been treated with strengthening exercises to stabilise the pelvis.
However did you know that pregnant women and new born mothers were also prone to wrist and thumb problems?
Carpel tunnel is widely recognised as a problem experienced by women antenatally and postnatally. This condition arises due to an increase in the blood volume circulation and swelling commonly experienced during pregnancy.
The carpel tunnel itself comprises of the bones and ligaments that form a canal at the base of the hand and as the median nerve passes through this, it can be compressed and impinged.
The median nerve gives sensation to the thumb, the index, middle, and half of the ring finger and is responsible for movement of a muscle at the base of the thumb. Pressure on this nerve can therefore cause a loss of either sensation or strength in these areas.
In addition Deqeurvain tendonitis is also seen during the last trimester of pregnancy and in new mothers. In fact some statistics have suggested that 50% of new mothers will experience these symptoms and the older the new mother (40 plus) the more likely. An increase in the incidence of dequervain also relates to the increase in the weight of new born babies over the last 30 years.
This condition involves irritation to 2 muscle tendons that mobilise the thumb causing pain with pinching, grasping, lifting and other movements of the thumb and wrist.
The root cause of this problem in the pregnant clientale is believed to be due to the repetitive and frequent improper lifting and cradling of the child.
Improper lifting and cradling
As a mother bends down to lift her child she often places her thumb under the child’s armpit. In doing so she put a lot of strain on the thumb joint and muscles. This is a movement that is often done repetitively and for a long period and from various heights (floor to standing, cot to standing). As the child continues to grow and gets heavier the strain may potentially worsen, causing inflammation, waekening and scarring to the tendon.
Also whilst cradling the child, some mother will use an L shape index finger and thumb to cradle and support the child’s head. Again overstraining the tendons of the thumb leading to the above problems.
Save your thumbs
New mothers could place their hand around the ribcage of their child and gently squeeze as they lift the child. This will alleviate the pressure exerted on the muscles of the thumb.
Alternatively supporting the child from the bottom and behind the head to lift the child can also reduce the pressure on thumbs.
Have a read of the carpel tunnel and Deqeurvain tendonitis articles for more informarmation about these conditions and physiotherapy treatment options to help your hands.
