Month: October 2024

De Quervain’s Tenosynovitis

Author: Jerry Song

De Quervain’s tenosynovitis, also known as “washerwoman’s sprain” or “gamer’s thumb,” is an inflammatory condition involving the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons. These tendons run along the thumb side of the wrist and are responsible for thumb extension and abduction. Inflammation of the synovial sheath that surrounds these tendons leads to pain, swelling, and restricted movement. As a result, patients often experience difficulty with activities that involve grasping, pinching, or thumb movements.

The hallmark symptom of De Quervain’s tenosynovitis is pain and tenderness over the radial side of the wrist, which can radiate up the forearm or down into the thumb. The Finkelstein test is a common diagnostic manoeuver in which the patient bends their thumb into their palm and wraps their fingers over it, followed by ulnar deviation (moving the wrist toward the pinky side). A positive test, characterised by sharp pain, is indicative of De Quervain’s tenosynovitis.

Causes of De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is primarily caused by overuse or repetitive strain of the tendons involved in thumb movement. Specific causes include:

1. Repetitive Hand and Wrist Movements:Activities that involve repetitive motions of the thumb and wrist, such as lifting, grasping, and pinching, are a leading cause of De Quervain’s tenosynovitis. These activities place strain on the APL and EPB tendons, leading to inflammation and irritation. Common repetitive tasks include typing, texting, gardening, and lifting infants.
2. Direct Trauma or Injury:Acute trauma to the wrist or thumb area, such as a direct blow or excessive strain, can trigger inflammation in the tendons and synovial sheath, leading to De Quervain’s tenosynovitis.
3. Chronic Overload:Repeated overloading of the tendons over time, even without obvious injury, can lead to microtrauma in the tendons, resulting in inflammation, swelling, and thickening of the tendon sheath.
4. Inflammatory Conditions:Systemic inflammatory diseases, such as rheumatoid arthritis, may contribute to the development of De Quervain’s tenosynovitis due to underlying chronic inflammation in the joints and tendons.

Demographics Most Likely to Suffer from De Quervain’s Tenosynovitis

While De Quervain’s tenosynovitis can affect individuals of all ages and backgrounds, certain demographics are at higher risk of developing the condition:

1. Women:De Quervain’s tenosynovitis is more common in women than men, with some studies suggesting a female-to-male ratio of 4:1. This may be due to anatomical differences in tendon and joint structures, as well as the increased likelihood of women engaging in repetitive tasks such as child-rearing, household chores, or manual labor that involves hand and wrist movements.
2. Postpartum Women:New mothers are particularly susceptible to De Quervain’s tenosynovitis due to the repetitive lifting and holding of infants. This condition is often referred to as “mommy’s thumb” because the motion of lifting a baby from a crib, car seat, or carrier places strain on the thumb and wrist tendons.
3. Manual Labourers and Office Workers:Individuals whose occupations involve repetitive wrist and thumb movements, such as typists, assembly line workers, carpenters, and hairdressers, are at a higher risk of developing De Quervain’s tenosynovitis due to repetitive strain and overuse.
4. Smartphone and Video Game Users:The rise of smartphone usage and video gaming has led to an increase in cases of De Quervain’s tenosynovitis, particularly among younger demographics. Prolonged texting, scrolling, and gaming require constant thumb movement, which can lead to inflammation of the thumb tendons over time.

How Manual Therapy Can Help Treat and Manage De Quervain’s Tenosynovitis

Manual therapy is a non-invasive approach to managing musculoskeletal conditions, including De Quervain’s tenosynovitis. It involves various hands-on techniques aimed at reducing pain, improving mobility, and addressing underlying muscular imbalances. Manual therapy has shown promise in reducing symptoms and facilitating recovery in patients with this condition.

1. Soft Tissue Mobilisation and Massage

Soft tissue mobilisation and massage techniques target the muscles, tendons, and fascia surrounding the wrist and thumb. This approach helps reduce tension, improve blood flow, and promote healing in the affected tendons. Soft tissue techniques can alleviate pain and prevent the progression of inflammation by addressing tightness in the muscles around the wrist and hand.

2. Joint Mobilisation

Joint mobilisation techniques can help improve the range of motion in the wrist and thumb joints by gently moving the joints through their natural range. This technique is particularly beneficial for individuals experiencing stiffness or restricted movement due to inflammation and swelling.

3. Dry Needling

Dry needling is a manual therapy technique in which fine needles are inserted into specific trigger points or tight bands of muscle to release tension and reduce pain. In the context of De Quervain’s tenosynovitis, dry needling can be used to target the muscles and tendons involved in thumb and wrist movement, particularly the APL and EPB tendons.

Dry needling works by stimulating blood flow to the area, promoting the release of tight muscle fibers, and reducing local inflammation. This helps alleviate pain and allows the affected tendons to heal more effectively. When combined with other manual therapy techniques, dry needling can help accelerate recovery and improve overall function in patients with De Quervain’s tenosynovitis.

4. Myofascial Cupping

Myofascial cupping is a technique in which suction cups are placed on the skin to create negative pressure, lifting the skin and underlying fascia. This technique improves blood circulation, reduces fascial adhesions, and promotes tissue healing. In cases of De Quervain’s tenosynovitis, myofascial cupping can be applied to the forearm, wrist, and thumb areas to relieve tension and reduce inflammation.

Cupping helps improve tissue mobility by releasing tight fascia and muscles, allowing for better tendon glide and reduced pain. It can also be used in conjunction with stretching and strengthening exercises to improve range of motion and restore function to the affected area.

5. Stretching and Strengthening Exercises

Manual therapy often includes the incorporation of therapeutic exercises designed to stretch tight muscles and strengthen weak ones. Specific exercises for De Quervain’s tenosynovitis may include wrist stretches, thumb abduction and extension exercises, and forearm strengthening movements. These exercises help improve flexibility, restore tendon function, and prevent recurrence of the condition.

Benefits of Manual Therapy in Managing De Quervain’s Tenosynovitis

Manual therapy offers several benefits in the management of De Quervain’s tenosynovitis, including:

1. Pain Relief:Manual therapy techniques, including soft tissue mobilisation, dry needling, and myofascial cupping, help alleviate pain by reducing inflammation and releasing tight muscles.
2. Improved Mobility:By addressing joint stiffness and tendon adhesions, manual therapy helps improve range of motion in the wrist and thumb, allowing patients to perform daily activities with less discomfort.
3. Increased Blood Flow:Techniques such as massage, dry needling, and cupping promote circulation to the affected area, which enhances tissue healing and reduces recovery time.
4. Reduced Inflammation:Manual therapy helps reduce swelling and inflammation in the tendons and surrounding tissues, which is crucial for managing the symptoms of De Quervain’s tenosynovitis.
5. Prevention of Recurrence:By incorporating strengthening exercises and ergonomic advice, manual therapy can help prevent the recurrence of De Quervain’s tenosynovitis by addressing the root causes of tendon overuse and imbalance.

If you or someone you know are dealing with De Quervain’s tenosynovitis, musculoskeletal pain, or even myofascial trigger points, book an appointment to see Jerry now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.  Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.

Hazards and effects of working at a desk

Author: Jerry Song

In today’s digital world, many of us spend countless hours sitting at a desk, working on computers, or scrolling through our phones. While this sedentary lifestyle is a norm for many, the consequences of prolonged sitting and poor posture, particularly slouching, can have lasting effects on our health. One of the most significant issues resulting from poor sitting posture is forward head posture, a common condition that causes both discomfort and long-term anatomical changes. In this blog, we’ll explore how desk work affects your posture, the specific impact of forward head posture, and the long-term consequences of poor sitting habits.

The Immediate Effects of Sitting for Long Hours

Sitting for extended periods without proper ergonomic support can lead to several immediate issues, including:

• Muscular Tension:The muscles in the neck, shoulders, and lower back can become tight and stiff, particularly if you slouch or hunch over.
• Reduced Circulation:Prolonged sitting reduces blood flow, particularly to the lower extremities, leading to numbness and discomfort.
• Pressure on the Spine:Sitting places more pressure on the spine than standing or lying down, particularly when posture is poor. This extra pressure can lead to discomfort and increase the risk of spinal problems.

However, the most concerning impact of prolonged sitting is the long-term effect it has on posture, particularly in the development of forward head posture.

How Slouching and Forward Head Posture Affect Your Body

Slouching occurs when you round your shoulders forward, curve your upper back, and allow your chest to collapse. Over time, this leads to forward head posture (FHP), which occurs when the head juts forward in front of the shoulders rather than being aligned over the spine. This posture has become increasingly common due to the frequent use of computers, smartphones, and other digital devices.

Forward Head Posture (FHP): What Happens to Your Body?

Forward head posture may seem like a minor issue at first, but it causes significant anatomical changes that affect your entire body:

1. Cervical Spine Strain:In a neutral position, the head weighs about 10-12 pounds, and the cervical spine (neck) easily supports this weight. However, for every inch that the head moves forward, the strain on the cervical spine increases dramatically. This added pressure can lead to chronic neck pain and headaches as the muscles and joints are forced to compensate for the additional load.
2. Rounded Shoulders and Upper Back (Kyphosis):As your head moves forward, your shoulders naturally round, and your upper back starts to hunch, leading to a condition known as kyphosis. This further strains the muscles in the chest, shoulders, and upper back, weakening the stabilising muscles in the shoulder blades.
3. Compression of the Thoracic Spine:Forward head posture places stress not only on the neck but also on the mid-back, leading to compression of the thoracic spine. This can limit mobility in the upper back and restrict movement in the chest and rib cage, making breathing more shallow and laboured.
4. Tightening of Chest Muscles:The pectoral (chest) muscles become tight and shortened due to the forward position of the head and shoulders. Over time, this imbalance leads to further postural problems and reduced mobility in the upper body.
5. Weakening of Neck and Upper Back Muscles:The muscles that support the head and upper spine, including the deep neck flexors and upper back muscles, weaken due to prolonged forward head posture. This creates a vicious cycle where weak muscles further exacerbate poor posture, leading to increased strain and discomfort.
6. Jaw and Temporomandibular Joint (TMJ) Issues:Forward head posture can also affect the alignment of the jaw, leading to jaw pain, clicking, or temporomandibular joint dysfunction (TMJ). The forward positioning of the head alters the relationship between the jaw and the skull, placing undue stress on the joint.

Long-Term Effects of Poor Posture and Forward Head Posture

If poor posture and forward head posture are left unaddressed, they can lead to long-term consequences that affect your overall health and quality of life:

1. Chronic Pain:Forward head posture often leads to chronic neck, shoulder, and upper back pain due to the constant strain on muscles, ligaments, and joints. Over time, this pain can become debilitating and affect daily activities.
2. Degenerative Spinal Changes:Prolonged forward head posture increases the risk of degenerative conditions in the spine, such as herniated discs, osteoarthritis, and cervical spondylosis. The additional pressure on the cervical vertebrae accelerates wear and tear on the joints, leading to chronic pain and reduced mobility.
3. Breathing Difficulties:As the rib cage becomes compressed due to slouching and forward head posture, lung expansion becomes restricted. This can lead to shallow breathing, reduced oxygen intake, and even shortness of breath, particularly during physical activity.
4. Nerve Impingement:Poor posture can also lead to nerve impingement, where nerves in the neck and shoulders become compressed due to muscle tightness and spinal misalignment. This can result in tingling, numbness, or shooting pain in the arms and hands, known as cervical radiculopathy.
5. Impact on Mental Health:Chronic pain and discomfort caused by poor posture can take a toll on mental health, leading to increased stress, anxiety, and even depression. Poor posture can also affect confidence and self-esteem, as it often leads to a more closed and withdrawn body position.
6. Poor Postural Alignment:Long-term forward head posture alters your body’s overall postural alignment, making it harder to stand and sit upright. This misalignment can contribute to balance issues, reduced coordination, and an increased risk of falls, particularly in older adults.

How to Correct Forward Head Posture and Improve Overall Posture

Fortunately, with awareness and the right interventions, forward head posture and its long-term consequences can be corrected or significantly improved. Here are some strategies to address poor posture and reverse forward head posture:

1. Ergonomic Adjustments:Adjust your workspace to promote good posture. Ensure your computer screen is at eye level, and use a chair with proper lumbar support to maintain a neutral spine position. Your feet should be flat on the floor, with your knees at a 90-degree angle.
2. Posture Awareness:Regularly check your posture throughout the day. Focus on sitting and standing tall with your shoulders back and your head aligned over your spine. A good way to practice this is to imagine a string pulling you upward from the top of your head.
3. Strengthening Exercises:Incorporate exercises that strengthen the muscles of the upper back and neck, such as rows, chin tucks, and scapular retractions. These exercises target weak muscles and help restore proper postural alignment.
4. Stretching Tight Muscles:Stretch the chest, shoulders, and neck muscles to release tension and improve mobility. Doorway stretches, chest openers, and neck stretches can help counteract the effects of slouching and forward head posture.
5. Foam Rolling and Myofascial Release:Foam rolling can help release tension in the thoracic spine and upper back muscles. This improves flexibility and helps the body return to its natural alignment.
6. Movement Breaks:Take regular breaks from sitting throughout the day. Aim to stand, stretch, or walk for at least 5 minutes every hour. These movement breaks can help alleviate tension and prevent prolonged strain on your posture.

If you or someone you know are dealing with shoulder bursitis, musculoskeletal pain, or even myofascial trigger points, book an appointment to see Jerry now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.  Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.