The Right Run- Common Injuries


Running is a great way to stay in shape. But it can take a toll on your muscles and joints. To avoid running injuries, it’s important to take precautions before you set out.

Most running injuries happen when you push yourself too hard. Adding distance or speed to your running routine, running up hills, and interval training are just some of the reasons running injuries occur. Body mechanics — the way your body is designed — also play a role. The hips, knees, legs, and feet are the most vulnerable to injury.Untitled.001

Runner’s Knee

Type of Injury: Overuse injury

Causes: Several. But it’s commonly due to the kneecap being out of alignment.

What to Look Out For: Vigorous activity leads to pain around the kneecap, particularly when:

  • going up or down stairs
  • squatting
  • sitting with the knee bent for a long time

Stress Fracture

Causes: This is a small crack in a bone that causes pain and discomfort. It typically affects runners in the shin and feet. Often due to going too hard before your body gets used to a new activity.

What to Look Out For: Pain gets worse with activity and improves with rest. Rest is important, as continued stress on the bone can lead to more serious injury.

Shin splint

Causes: Commonly occur after a change in activity, such as running longer distances or increasing the number of days you run too quickly.

What to Look Out For: A pain that occurs in the front or inside of the lower leg along the shin bone (tibia). People with flat feet are more likely to develop shin splints.

Achilles Tendinitis

Causes: This is inflammation of the Achilles tendon.

What to Look Out For: Achilles tendinitis causes pain and stiffness in the area of the tendon, especially in the morning and with activity. It is usually caused by repetitive stress to the tendon, often due to increasing running distance too quickly. Tight calf muscles may also play a part.

Muscle Pull

Causes: A small tear in your muscle, also called a muscle strain, often caused by overstretching of a muscle.

What to Look Out For: If you suffer a pulled muscle, you may feel a popping sensation when the muscle tears.

Muscle pull commonly affects these muscles:

  • hamstrings
  • quadriceps
  • calf
  • groin

Ankle Sprain

Causes: This is the stretching or tearing of ligaments surrounding the ankle. It often occurs when the foot twists or rolls inward.

What to Look Out For: Pain in & around the ankle.

Untitled.001Plantar Fasciitis

Causes: 

An inflammation of the plantar fascia. That’s the thick band of tissue in the bottom of the foot that extends from the heel to the toes. People with tight calf muscles and a high arch are more prone to plantar fasciitis. Although it may be linked to an increase in activity, plantar fasciitis may occur without any identifiable reason.

What to Look Out For: Pain in the arches in weight bearing activities.

Iliotibial band syndrome (ITBS)

The iliotibial band is a ligament that runs along the outside of the thigh, from the top of the hip to the outside of the knee.

Causes: ITBS occurs when this ligament thickens and rubs the knee bone, causing inflammation. Long-distance runners are more likely to develop ITBS.

What to Look Out For: This syndrome causes pain on the outside of the knee.

Blisters

Causes: These are fluid-filled sacks on the surface of the skin. They are caused by friction between your shoes/socks and skin.

What You Can Do: To help prevent blisters:

  • start using new shoes gradually
  • wear socks with a double layer
  • apply petroleum jelly on areas prone to blisters

Temperature-related Injuries

These include:

  • sunburn
  • heat exhaustion
  • frostbite
  • hypothermia

These can be prevented by dressing appropriately, staying hydrated, and using sunscreen.

Visit Us This Tuesday to Know More on Injury Prevention & Treatment!

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Trigger Finger: What you can DO


Trigger finger, often experienced by the elderly or by people diagnosed with conditions like rheumatoid arthritis, causes the fingers to pop or get stuck when you try to extend them. Diagnosis is often made by a physical examination & manipulation of the finger by your doctor. Exercises & physical therapy treatments for a trigger finger are suggested before more serious treatment options such as surgery are recommended. 

Definition

Trigger finger is a bone & joint condition caused by a contraction of the flexor tendons lining the inside of the finger. The flexor tendons are secured to the ligaments and bones of your fingers with sheaths. If your finger flexor tendons become thickened or develop small nodules due to age, wear or tear, you’re often unable to extend a finger or a thumb. This causes your finger to bend into a fixed position as you try to extend, much the way you’d hold your finger to pull a trigger, hence its name.

As with all disorders of the upper extremity, proximal segments must be screened.  Also, because posture can contribute to distal problems, it should be addressed to provide the patient with optimal outcomes. It is important to commence Physiotherapy soon after diagnosis to prevent the condition from getting worse & to get back to your normal level of functioning.

Physiotherapy treatment will help to reduce swelling, relieve pain and stiffness & regain functional movement of the finger. Physiotherapy treatment may include:

  • Ultrasound: Reduce swelling & accelerate healing
  • Soft tissue massage
  • Joint mobilisation
  • Passive stretching
  • Supervised hand & finger exercise program to regain strength, dexterity & flexibility
  • Splinting or Taping

Patient Education

Since trigger finger is observed as an overuse injury, education is very important. Education should be given on:

  • Rest
  • Modifications of activities
  • Specialized tools
  • Splinting
  • Modalities
  • Posture

Modalities such as heat/ice, ultrasound, electric stimulation, massage, stretching, & joint motion (active & passive) can have some positive effects on trigger finger. Following heat with stretching can provide more extensibility with plastic deformation. Joint movement & mobilizations increase joint & soft tissue mobility via a slow, passive therapeutic traction & translational gliding.

Exercises

Tendon Exercises

  • Perform a series of tendon gliding exercises.
  • Start with your fingers extended outward and your thumb pointing away from and perpendicular to the palm. Flex your fingers toward your thumb, as if you’re making the shape of a duck’s beak. Your finger and thumb should be approximately 1/2 inch apart. From this position, curl your fingers into your palm, placing your thumb along the outside of the index finger. Curl your fingers more and make a fist; this time, curl your thumb over the outside of your knuckles.
  • Slowly open your hand and lift the fingers, knuckles bent, into a upright position, your thumb again extended away from your palm. Repeat the sequence several times.

Soft Tissue Mobilization

  • Massage or soft tissue mobilization may help reduce the severity of your trigger finger or thumb constriction.
  • Massage manipulates muscle, tendon & ligament tissues & floods the affected area with blood & nutrients.
  • Massage also helps relax tightened muscles, which may facilitate other trigger finger exercises for greater efficacy and benefits.
  • One method of massaging a sore trigger finger is friction massage, which a physical therapist can do or you can do yourself. Stroke the affected finger in a downward motion toward the palm or upward toward the tip of the finger. This may help relieve pain and stiffness caused by nodules & lengthen the finger muscles and tendons.

Palm Presses

  • Hand & finger exercises that contract & extend the muscles & tendons of the fingers may provide relief & greater range of motion of the finger & thumb.
  • Pick up small items & place them in your palm, squeezing tightly for several seconds. Release, opening your fingers wide, & then repeat as instructed by your physical therapist.
  • Regular exercise and movement may help lengthen the flexor tendons, relieving symptoms of trigger finger.
  • Avoid activities which involve a sustained grip. Hold off on the use of grip strengthening devices or exercises involving repetitive squeezing – these put stress on the irritated tendon.

If fingers bend & lock during the night and are painful to straighten in the morning, it may be helpful to wear a splint to keep them straight while sleeping.

Splinting
A first step in treatment is to stop doing activities that aggravate the condition. Splinting is one of the best ways to limit motion. There are various ways to splint a patient but, ultimately, it will depend on what provides the patient with the most relief. Splints are usually worn for 6-10 weeks. It should be noted that splinting yields lower success rates in patients with severe triggering or longstanding duration of symptoms.Two major types of splinting most recently studied:

  • Splinting at the DIP joint.  This showed to have resolution in 50% of the patient’s symptoms.
  • Splinting at the MCP joint with 15 degrees of flexion.  This showed to have resolution of the patient’s symptoms at both 65% and 92.9%, which is consistent with current literature.

 

 

 

Taping Technique (Click for video on Taping)

DISCLAIMER: Please consult your medical professional before beginning exercises.

Trigger Finger


Trigger Finger/Stenosing Tenosynovitis/Flexor Tendinitis is a type of tendinitis which develops in the tendons which bend the fingers. Your fingers or your thumb gets stuck in a bent position and then straightens with a snap — like a trigger being pulled and released.

It is a common problem because of the way that the hand is made. There are no muscles in the fingers themselves. We actually move our fingers by remote control. Muscles in the forearm are connected to the finger bones by smooth, flexible strings, called tendons. The muscles pull on the tendons, which then bend the finger joints.

Trigger finger generally results from swelling within a tendon sheath, restricting tendon motion. A bump (nodule) also may form.

Causes:

  • Highly repetitive or forceful use of the finger and thumb
  • Rheumatoid arthritis
  • Gout
  • Diabetes
  • Hypothyroidism
  • Amyloidosis
  • Certain infections, like Tuberculosis

Farmers, industrial workers, and musicians are frequently affected by trigger finger. Even smokers can get trigger thumb from repetitive use of a lighter. Trigger finger is more common in women than men and tends to occur most frequently in people who are between 40 and 60 years of age.

Symptoms:

  • Soreness at the base of the finger or thumb
  • Finger stiffness, particularly in the morning
  • A popping or clicking sensation when attempting to flex or extend the affected finger
  • Tenderness or a bump (nodule) at the base of the affected finger
  • Finger catching or locking in a bent position, which suddenly pops straight
  • Finger locked in a bent position, which you are unable to straighten

Trigger fingers may result in tenderness and swelling in the palm (red areas), and stiffness, pain and clicking in the finger joints (blue areas).

Trigger finger more commonly occurs in your dominant hand, and most often affects your thumb or your middle or ring finger. More than one finger may be affected at a time, and both hands might be involved. Triggering is usually more pronounced in the morning, while firmly grasping an object or when straightening your finger. This catching sensation tends to worsen after periods of inactivity and loosen up with movement.

In some cases, the finger or thumb that is affected locks in a flexed position or in an extended position as the condition becomes more severe, and must be gently straightened with the other hand. Joint contraction or stiffening may eventually occur.

Treatment:

  • ConservativeNSAIDs, Physical Therapy, Splinting, Steroid Injections
  • SurgicalTendon Sheath Release

If trigger finger is severe, your finger may become locked in a bent position.

The time it takes to recover from trigger finger depends on the severity of the condition, which varies from person to person. The choice of treatment also impacts recovery time. For example, splinting may be necessary for six weeks. However, most patients with trigger finger recover within a few weeks by resting and limiting the use of the affected finger and/or using anti-inflammatory drugs.

Note: Trigger finger is not the same as Dupuytren’s contracture — a condition that causes thickening and shortening of the connective tissue in the palm of the hand — though it may occur in conjunction with this disorder.

Exercising in Ankylosing Spondylitis


Treatment for ankylosing spondylitis is what many often enquire about. People ask for treatment that completely cures ankylosing spondylitis disorder. Well, there is no known curative treatment for ankylosing spondylitis. However, there are different techniques & methods that reduce the effects or intensity of ankylosing spondylitis considerably.
Understanding ankylosing spondylitis, is very important so that you can opt for the best suited treatment for it. Ankylosing spondylitis is an inflammatory arthritis that mainly affects spinal cord & sacroiliac joints, causing fusion of the spine- Bamboo Spine. It is of type autoimmune spondyloarthropathy. There may be involvement of other organs such as kidneys, lungs, eyes and heart. Hence, when your diagnosis is ankylosing spondylitis, you should immediately seek the treatment.

Treatment for ankylosing spondylitis includes various options such as medications, exercise & physiotherapy.
Goal of Treatment: Relieve pain, manage symptoms & prevent further progress of the disease.
Physiotherapy:
  • Various types of movements of back & neck
  • Deep breathing for expansion of lungs
  • Stretching exercises for joint mobility
  • Guidelines- Maintaining erect posture is also very important to reduce spinal scoilotic curvature. Slipping on firm surface & avoid use of pillow while sleeping
Yoga:
  • Yoga can provide a relief from pain, stiffness, improve breathing & improve the range of mobility.
  • Yoga also helps to reduce stress and maintain the energy of patients
  • Asanas: (positions in Yoga) such as Vajra Asana, Dhanura Asana, Makara Asana, Bhujanga Asana, Ardha Matsyendrasana & Neti kriya help to remove rigidity, improve flexibility of joints & also correct bad posture. Pranayama is helpful for muscle relaxation as well as to improve the movements of ribs & changes in pressure within abdomen & chest
  • Before practicing Yoga session, a person should perform stretching to prevent sprains, muscle strains or further injuries
Pilates:
  • Build flexibility, increase strength, endurance, & coordination in legs, abdominals, arms & back.
  • Help with maintaining the  natural curves of the body
  • Create a neutral position for each joint that is close to the optimal alignment of the head, shoulders, thorax, spine & pelvis which ensures that all sections of the body are in their ideal place
However, high-impact exercises such as jogging & sports are jarring to your frame and are generally not recommended. Instead, engage in Tai chi, Swimming because it involves all muscles & joints in a low-impact, buoyant environment. Cycling can also help restore lost movement.
Option of surgery is also viable, in case of severe ankylosing spondylitis condition. Joint replacement surgery, especially of hip and knees is opted for reducing further development of ankylosing spondylitis.
Significance
Exercise, even in small five to 10 minute doses, can improve posture & mobility. According to the Spondylitis Association of America, most people say that their condition improves after exercise. However, first consult a rheumatologist or physical therapist before you begin, because movements that may be beneficial under normal conditions may actually harm those with AS.
Time Frame
Convenience and consistency are the most important parts of your routine. If you feel stiff in the morning, then you may try to loosen up early & then exercise in the midday or evening. If necessary, you can split your exercises throughout the day. For example, you can first do exercises while lying down, and then later in the day you can work on neck stretches or deep breathing.
Much relief can be gained in ankylosing spondylitis by following an exercise regime consistently.
DISCLAIMER: Please consult your medical professional before beginning exercises.