Holistic Balance

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Phone: (039) 041-3232
Blog | Holistic Balance - Part 2

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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

Shoulder Bursitis

Author: Jerry Song

Shoulder bursitis is characterised by the inflammation of the bursae, small fluid-filled sacs that cushion and reduce friction between tissues in the shoulder joint. The condition commonly affects the subacromial bursa, which lies between the acromion and the rotator cuff tendons. Shoulder bursitis can cause significant discomfort and limit the range of motion, impacting daily activities and quality of life. While conservative treatments are often effective, manual therapy, including dry needling and myofascial cupping, can play a crucial role in symptom management and functional restoration.

Shoulder bursitis can arise from various factors, often classified into two main categories: acute and chronic causes.

  1. Acute Causes:
    • Trauma: Direct impact or injury to the shoulder can cause inflammation of the bursae.
    • Overuse: Repetitive overhead movements or heavy lifting can irritate the bursae, leading to acute inflammation.
    • Infection: In rare cases, bacterial infections can cause septic bursitis, resulting in significant inflammation and pain.
  2. Chronic Causes:
    • Degenerative Changes: Ageing and wear-and-tear can lead to degenerative changes in the shoulder, contributing to chronic bursitis.
    • Postural Imbalances: Poor posture, such as forward head posture or rounded shoulders, can increase the risk of bursitis by altering shoulder mechanics.
    • Systemic Conditions: Conditions such as rheumatoid arthritis and gout can cause recurrent bursitis due to systemic inflammation.

 

Shoulder bursitis affects a wide demographic, with certain groups being more susceptible:

  1. Age: The risk of developing shoulder bursitis increases with age, particularly due to degenerative changes in the shoulder joint.
  2. Occupation and Activities: Individuals engaged in occupations or activities involving repetitive shoulder movements, such as painters, athletes, and manual labourers, are at higher risk.
  3. Gender: While both genders are affected, certain studies suggest a slightly higher prevalence in females, possibly due to differences in shoulder anatomy and biomechanics.
  4. Posture and Biomechanics: Poor posture, muscle imbalances, and improper biomechanics can predispose individuals to shoulder bursitis by increasing stress on the shoulder joint and bursae.

 

Manual therapy offers a range of non-invasive techniques to manage shoulder bursitis, alleviating pain, improving mobility, and promoting healing. Key manual therapy interventions include:

  1. Dry Needling

Dry needling involves the insertion of fine needles into specific trigger points or areas of muscle tightness to promote pain relief and muscle relaxation. Benefits of dry needling for shoulder bursitis include:

  • Reduction of Muscle Tightness: Targeting trigger points in the shoulder and surrounding muscles can alleviate tightness, improving range of motion and reducing stress on the bursae.
  • Pain Relief: By disrupting pain signals and promoting local blood flow, dry needling can effectively reduce pain and inflammation associated with bursitis.
  • Improved Muscle Function: Enhancing muscle function around the shoulder joint can stabilise the area, reducing abnormal movement patterns that exacerbate bursitis.
  1. Myofascial Cupping

Myofascial cupping involves the use of suction cups to create negative pressure on the skin, lifting and separating the underlying tissues. This technique can:

  • Enhance Blood Circulation: Increased blood flow aids in nutrient delivery and waste removal, promoting healing and reducing inflammation.
  • Release Myofascial Restrictions: Loosening tight fascia and muscle adhesions can restore normal tissue mobility, reducing pressure on the bursae and alleviating pain.
  • Reduce Muscle Spasms: The negative pressure from cupping can relax muscle spasms, improving muscle tone and function in the shoulder region.
  1. Soft Tissue Mobilisation

Soft tissue mobilisation includes techniques such as massage and myofascial release to manipulate the soft tissues around the shoulder:

  • Massage Therapy: Techniques like deep tissue massage can reduce muscle tension, improve circulation, and decrease pain, facilitating recovery of muscle function and flexibility.
  • Myofascial Release: Applying sustained pressure to myofascial restrictions can eliminate pain and restore motion, addressing tightness in the shoulder muscles and fascia.
  1. Joint Mobilisation

Joint mobilisation involves applying controlled forces to improve the range of motion and alleviate pain in the shoulder joint:

  • Glenohumeral Joint Mobilisation: Techniques to mobilise the glenohumeral joint can enhance joint mobility, reduce stiffness, and correct abnormal mechanics contributing to bursitis.
  • Scapulothoracic Mobilisation: Addressing scapular movement can improve overall shoulder mechanics, reducing compensatory stresses on the bursae.
  1. Manual Stretching

Manual stretching techniques aim to improve flexibility and reduce tension in the muscles around the shoulder:

  • Pectoral and Rotator Cuff Stretching: Stretching the pectoral and rotator cuff muscles can relieve tension and improve range of motion in the shoulder.
  • Upper Back and Neck Stretching: Addressing tightness in the upper back and neck can reduce stress on the shoulder and improve posture.

Listed below are some details of a client dealing with shoulder bursitis who is seeking treatment here at HBM, which may also serve as a case study:

Age: 50+

Gender: M

Symptoms: Right shoulder pain

Medical history: Non pertinent

Lifestyle: Frequently goes cycling long distances, and seated for work mainly

The client has received fortnightly treatments here at HBM over the period of 3 months to manage his symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating him on the importance of compliance to treatment due to his active schedule has made a big difference on his quality of life, and after educating him on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, he’s been able to get back to his daily activities with much improvements on symptoms.

If you or someone you know are dealing with shoulder bursitis, musculoskeletal pain, or even myofascial trigger points, book in 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.

 

Hallux Valgus Deformity (aka Bunions)

Author: Jerry Song

Hallux valgus is a structural deformity of the foot that involves the angling of the great toe (hallux) towards the second toe, accompanied by a bony prominence known as a bunion on the medial aspect of the first metatarsophalangeal joint (MTPJ). This deformity can lead to pain, discomfort, and functional limitations, significantly affecting an individual’s quality of life. While surgical intervention is often considered for severe cases, conservative treatments, including manual therapy, play a vital role in managing symptoms and slowing the progression of the deformity.

Hallux valgus develops due to a combination of intrinsic and extrinsic factors:

  1. Genetic Predisposition: Family history of hallux valgus suggests a genetic component that affects foot biomechanics and structural alignment.
  2. Footwear: Wearing narrow, high-heeled, or poorly fitting shoes can exacerbate or contribute to the development of hallux valgus by applying abnormal pressure on the toes and altering foot mechanics.
  3. Biomechanical Factors: Abnormal foot mechanics, such as overpronation or excessive supination, can contribute to the development of hallux valgus. Muscle imbalances and weak intrinsic foot muscles may also play a role.
  4. Arthritis: Conditions like rheumatoid arthritis can affect joint alignment and contribute to the development of hallux valgus.
  5. Trauma: Previous injuries to the foot or toe can impact the alignment of the great toe and contribute to the deformity.
  6. Muscle Imbalance: Weakness or imbalance in the muscles supporting the foot can affect the alignment of the toe and exacerbate the deformity.

Hallux valgus develops due to a combination of intrinsic and extrinsic factors:

  1. Age: The condition is more common in older adults, with the prevalence increasing with age due to cumulative biomechanical stress and degenerative changes.
  2. Gender: Women are significantly more likely to develop hallux valgus than men. This disparity is often attributed to footwear choices, such as high heels and narrow-toed shoes, which can exacerbate the deformity.
  3. Family History: Individuals with a family history of hallux valgus are at a higher risk, indicating a genetic predisposition.
  4. Footwear Choices: Wearing tight, narrow, or high-heeled shoes regularly increases the likelihood of developing hallux valgus, especially in women.

Manual therapy can play a supportive role in managing hallux valgus by alleviating symptoms, improving foot function, and addressing contributing factors. Key manual therapy interventions include:

  1. Dry Needling

Dry needling involves the insertion of fine needles into specific trigger points or areas of muscle tightness to promote pain relief and muscle relaxation. Benefits of dry needling for hallux valgus include:

  • Reduction of Muscle Tightness: Targeting trigger points in the foot and lower leg muscles, such as the flexors and extensors, can alleviate tightness and improve muscle balance.
  • Pain Relief: By disrupting pain signals and promoting local blood flow, dry needling can effectively reduce foot pain and discomfort associated with hallux valgus.
  • Improved Muscle Function: Enhancing muscle function around the foot can aid in improving foot mechanics and reducing abnormal stress on the MTPJ.
  1. Myofascial Cupping

Myofascial cupping involves using suction cups to create negative pressure on the skin, lifting and separating the underlying tissues. This technique can:

  • Enhance Blood Circulation: Improved blood flow helps in nutrient delivery and waste removal, promoting tissue healing and reducing inflammation in the affected area.
  • Release Myofascial Restrictions: Loosening tight fascia and muscle adhesions can restore normal tissue mobility and alleviate pain associated with hallux valgus.
  • Reduce Muscle Spasms: The negative pressure can help relax muscle spasms, improving muscle tone and function in the foot.
  1. Soft Tissue Mobilisation

Soft tissue mobilisation techniques include massage and myofascial release to manipulate the soft tissues around the foot and toe:

  • Massage Therapy: Techniques like deep tissue massage can reduce muscle tension, improve circulation, and decrease pain, facilitating recovery and improving foot function.
  • Myofascial Release: Applying sustained pressure to myofascial restrictions can eliminate pain and restore motion, addressing tightness in the foot and lower leg muscles.
  1. Joint Mobilisation

Joint mobilisation involves applying controlled forces to the MTPJ and surrounding joints to improve range of motion and alleviate pain:

  • MTPJ Mobilisation: Techniques to mobilise the MTPJ can enhance joint mobility, reduce stiffness, and correct abnormal mechanics contributing to hallux valgus.
  • Manual Traction: Applying gentle traction to the MTPJ can reduce joint compression, alleviate pain, and improve alignment.
  1. Manual Stretching

Manual stretching techniques aim to improve flexibility and reduce tension in the muscles and tissues around the foot:

  • Toe and Foot Stretching: Stretching the intrinsic and extrinsic muscles of the foot can relieve tension and improve flexibility, aiding in better alignment and function.
  • Calf Stretching: Addressing tightness in the calf muscles can improve overall foot mechanics and reduce stress on the MTPJ.
  1. Proprioceptive Neuromuscular Facilitation (PNF)

PNF stretching combines stretching and contracting targeted muscle groups to enhance flexibility and strength:

  • PNF Techniques: Effective for improving the flexibility and strength of the foot muscles, promoting better mechanics and reducing pain associated with hallux valgus.

If you or someone you know are dealing with bunions, musculoskeletal pain, or even myofascial trigger points, book in 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.

 

 

Headaches

Author: Jerry Song

Headaches are one of the most common neurological complaints encountered in clinical practice, affecting individuals across various demographic groups. They can be broadly categorised into primary and secondary headaches, with each category encompassing multiple subtypes. Understanding the etiology of these headaches and the demographics most likely to suffer from them is crucial for effective diagnosis and management.

 

  1. Primary Headaches

Primary headaches are not caused by an underlying medical condition but are disorders themselves. The main types include migraines, tension-type headaches (TTH), and cluster headaches.

  1. Migraine

Migraine is a recurrent headache disorder characterised by moderate to severe pain, typically unilateral and pulsating in nature. The pain is often accompanied by nausea, vomiting, and sensitivity to light and sound. Migraines can be preceded by aura, which includes visual disturbances or other neurological symptoms.

Etiology: The exact cause of migraines is not fully understood, but it is believed to involve a combination of genetic, environmental, and neurological factors. There is evidence suggesting abnormal brain activity and blood flow changes, as well as dysfunction in the trigeminovascular system.

Demographics: Migraines affect approximately 12% of the global population, with a higher prevalence in women than men (about 3:1 ratio). They are most common in individuals aged 18 to 44, particularly among women of childbearing age due to hormonal fluctuations. There is also a genetic predisposition, as migraines tend to run in families.

  1. Tension-Type Headache (TTH)

Tension-type headaches are the most common type of primary headache. They are characterised by bilateral, mild to moderate pain, often described as a tight band around the head. These headaches can last from 30 minutes to several days.

Etiology: The etiology of TTH is believed to involve muscle tension and stress. Psychological factors such as anxiety and depression are also associated with TTH. The pain is thought to result from peripheral activation or sensitisation of myofascial nociceptors.

Demographics: Tension-type headaches affect up to 80% of the population at some point in their lives. They are slightly more common in women than men and are most frequently reported by individuals in their 30s and 40s. Stressful life situations and poor posture are common triggers.

  1. Cluster Headache

Cluster headaches are characterised by severe, unilateral pain, typically around the eye or temple, often accompanied by autonomic symptoms such as tearing, nasal congestion, or eyelid swelling. These headaches occur in clusters, with multiple attacks over weeks or months, followed by periods of remission.

Etiology: The exact cause of cluster headaches is unknown, but they are thought to involve abnormalities in the hypothalamus, leading to dysregulation of circadian rhythms. Genetic factors may also play a role, though they are less prominent than in migraines.

Demographics: Cluster headaches are rare, affecting about 0.1% of the population. They are more common in men than women (about 4:1 ratio) and typically begin between the ages of 20 and 40. Smoking and alcohol consumption are significant risk factors.

  1. Secondary Headaches

Secondary headaches are symptomatic of an underlying medical condition. The pain is often due to infection, trauma, vascular disorders, or other systemic issues. Common types include:

  1. Medication Overuse Headache (MOH)

Medication overuse headache, also known as rebound headache, occurs as a result of frequent use of headache medications. The headache is usually present upon waking and can resemble a tension-type headache or migraine.

Etiology: MOH is caused by the regular use of analgesics or triptans for headache relief, leading to a cycle of overuse and increased headache frequency.

Demographics: MOH is more prevalent in women, particularly those aged 30 to 50. It is also common among individuals with a history of chronic headaches, such as migraines or tension-type headaches.

  1. Sinus Headache

Sinus headaches are caused by inflammation or infection of the sinuses, leading to pressure and pain in the forehead, cheeks, and eyes. These headaches are often associated with sinusitis and may be accompanied by nasal congestion, fever, and facial swelling.

Etiology: Sinus headaches occur due to inflammation of the sinus cavities, often secondary to infection (viral or bacterial) or allergic reactions. The pain results from increased pressure within the sinuses.

Demographics: Sinus headaches are more common in individuals with a history of allergies or chronic sinusitis. They are equally prevalent among men and women and can affect all age groups, though they are more common in adults.

  1. Cervicogenic Headache

Cervicogenic headache is a secondary headache caused by disorders of the cervical spine and its components, such as intervertebral discs, facet joints, or cervical muscles. The pain is typically unilateral and may radiate from the neck to the front of the head.

Etiology: Cervicogenic headaches result from cervical spine disorders, such as osteoarthritis, herniated discs, or whiplash injuries. The pain is believed to originate from the convergence of nociceptive input from the cervical spine and trigeminal nerve.

Demographics: This type of headache is more common in individuals with neck trauma or chronic neck pain, particularly those aged 30 to 50. It is slightly more prevalent in women than men.

 

If you or someone you know are dealing with headaches, musculoskeletal pain, or even myofascial trigger points, book in 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.

Compartment Syndrome

Compartment Syndrome 

Author: Jerry Song

Compartment syndrome is a condition where elevated pressure within a closed muscle compartment compromises circulation and function of the tissues within that space. It can be acute or chronic, with acute compartment syndrome (ACS) being a medical emergency requiring prompt surgical intervention. Chronic exertional compartment syndrome (CECS) is less urgent but can severely impact an individual’s ability to perform physical activities.

The causes of compartment syndrome vary based on whether it is acute or chronic:

  1. Acute Compartment Syndrome (ACS):
    • Trauma: Fractures, crush injuries, or severe contusions can lead to swelling or bleeding within a compartment.
    • Surgery: Postoperative complications can include bleeding or oedema causing elevated compartment pressures.
    • Vascular Injury: Trauma or surgery involving blood vessels can result in haemorrhage within a compartment.
    • Tight Casts or Dressings: External compression from casts or dressings can increase compartment pressures.
  2. Chronic Exertional Compartment Syndrome (CECS):
    • Repetitive Exercise: Activities involving repetitive muscle contractions, such as running or cycling, can increase compartment pressures over time.
    • Muscle Hypertrophy: Intense physical training leading to muscle hypertrophy can increase compartment size relative to its surrounding fascia, raising internal pressures.
    • Anatomic Abnormalities: Variations in fascial anatomy or muscle size can predispose individuals to CECS.

 

 

 Compartment syndrome affects various populations based on its type:

  1. Acute Compartment Syndrome:
    • Age: Can occur at any age but is more common in younger individuals due to higher incidence of trauma and sports injuries.
    • Gender: Males are more frequently affected, likely due to higher participation in high-risk activities and occupations.
    • Activities: Those involved in contact sports, high-impact activities, or occupations with a risk of severe injury are at increased risk.
  2. Chronic Exertional Compartment Syndrome:
    • Age: Commonly affects young athletes, typically in their late teens to early 30s.
    • Gender: Both genders are affected, but some studies suggest a higher incidence in females due to different biomechanics and muscle structures.
    • Sports and Activities: Athletes involved in repetitive, high-impact activities such as running, soccer, or military training are at greater risk.

Manual therapy plays a supportive role in managing chronic exertional compartment syndrome by alleviating symptoms, improving muscle function, and addressing contributing factors. Key manual therapy interventions include:

  1. Dry Needling

Dry needling involves the insertion of fine needles into specific trigger points or areas of muscle tightness to promote pain relief and muscle relaxation. Benefits of dry needling for compartment syndrome include:

  • Reduction of Muscle Tightness: Targeting trigger points in the affected muscles can alleviate tightness and improve muscle flexibility.
  • Pain Relief: By disrupting pain signals and promoting local blood flow, dry needling can effectively reduce muscle pain and discomfort.
  • Improved Muscle Function: Enhancing muscle function around the affected compartment can aid in reducing abnormal pressures and improving overall muscle performance.
  1. Myofascial Cupping

Myofascial cupping involves the use of suction cups to create negative pressure on the skin, lifting and separating the underlying tissues. This technique can:

  • Enhance Blood Circulation: Improved blood flow aids in nutrient delivery and waste removal, promoting tissue healing and reducing inflammation.
  • Release Myofascial Restrictions: Loosening tight fascia and muscle adhesions can restore normal tissue mobility and reduce pain.
  • Reduce Muscle Spasms: The negative pressure can relax muscle spasms, improving muscle tone and function within the affected compartment.
  1. Soft Tissue Mobilisation

Soft tissue mobilisation includes techniques such as massage and myofascial release to manipulate the soft tissues around the affected compartment:

  • Massage Therapy: Techniques like deep tissue massage can reduce muscle tension, improve circulation, and decrease pain, facilitating recovery of muscle function and flexibility.
  • Myofascial Release: Applying sustained pressure to myofascial restrictions can eliminate pain and restore motion, addressing tightness in the fascia and muscles.
  1. Joint Mobilisation

Joint mobilisation involves applying controlled forces to improve the range of motion and alleviate pain in the joints near the affected compartment:

  • Ankle and Knee Mobilisation: Techniques to mobilise the ankle and knee joints can enhance mobility, reduce stiffness, and correct abnormal mechanics contributing to compartment syndrome.
  1. Manual Stretching

Manual stretching techniques aim to improve flexibility and reduce tension in the muscles around the affected compartment:

  • Calf and Shin Stretching: Stretching the calf and shin muscles can relieve tension and improve muscle balance.
  • Quadriceps and Hamstring Stretching: Addressing tightness in the quadriceps and hamstrings can reduce stress on the affected compartment and improve overall limb function.
  1. Proprioceptive Neuromuscular Facilitation (PNF)

PNF stretching combines stretching and contracting targeted muscle groups to enhance flexibility and strength:

  • PNF Techniques: Effective for improving the flexibility and strength of the muscles within the affected compartment, promoting better mechanics and reducing pain.

If you or someone you know are dealing with Chronic Exertional Compartment Syndrome, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us 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.

 

Femoroacetabular Impingement (FAI) Syndrome

Femoroacetabular Impingement (FAI) Syndrome

Femoroacetabular impingement (FAI) is a mechanical hip disorder resulting from abnormal morphological interactions between the femoral head and the acetabulum. This condition is often associated with hip pain, restricted movement, and the potential for early-onset osteoarthritis. FAI is classified into three types: cam, pincer, and mixed impingement, each defined by specific anatomical abnormalities.

FAI arises due to anatomical variations that cause abnormal contact and friction within the hip joint:

  1. Cam Impingement: Characterised by an aspherical femoral head that creates abnormal contact with the acetabulum during hip movements. This results in cartilage and labral damage.
  2. Pincer Impingement: Occurs when there is excessive coverage of the acetabulum over the femoral head, leading to labral compression and damage.
  3. Mixed Impingement: Combines features of both cam and pincer impingement, resulting in more complex pathomechanics and greater joint damage.

FAI commonly affects young and middle-aged adults, particularly those who are physically active. Specific demographics and risk factors include:

  1. Athletes: Individuals involved in sports requiring repetitive hip flexion, such as soccer, hockey, and dance, are at increased risk due to repetitive stress on the hip joint.
  2. Age and Gender: FAI typically presents in individuals aged 20-40 years. Males are more likely to develop cam impingement, while females are more prone to pincer impingement.
  3. Genetic Predisposition: Family history of hip disorders may increase the likelihood of developing FAI.
  4. Developmental Conditions: Conditions such as Legg-Calvé-Perthes disease or slipped capital femoral epiphysis during adolescence can predispose individuals to FAI.

Manual therapy is a critical component of FAI management, focusing on alleviating pain, improving hip mobility, and addressing muscular imbalances. Key manual therapy interventions include:

  1. Dry Needling

Dry needling involves the insertion of fine needles into specific trigger points or areas of muscle tightness to promote pain relief and muscle relaxation. Benefits of dry needling for FAI include:

  • Reduction of Muscle Tightness: Targeting trigger points in the hip flexors, adductors, and gluteal muscles can alleviate muscle tightness, enhancing hip mobility.
  • Pain Relief: By disrupting pain signals and promoting local blood flow, dry needling can effectively reduce hip pain.
  • Improved Muscle Function: Enhancing muscle function around the hip joint can aid in stabilising the joint and reducing abnormal stress.
  1. Myofascial Cupping

Myofascial cupping involves the use of suction cups to create negative pressure on the skin, lifting and separating the underlying tissues. This technique can:

  • Enhance Blood Circulation: Improved blood flow aids in nutrient delivery and waste removal, promoting tissue healing and reducing inflammation.
  • Release Myofascial Restrictions: Loosening tight fascia and muscle adhesions can restore normal tissue mobility and reduce hip pain.
  • Reduce Muscle Spasms: Cupping can relax muscle spasms, improving muscle tone and hip joint function.
  1. Soft Tissue Mobilisation

Soft tissue mobilisation includes techniques such as massage and myofascial release to manipulate the soft tissues around the hip:

  • Massage Therapy: Techniques like deep tissue massage can reduce muscle tension, improve circulation, and decrease pain, facilitating recovery of muscle function and flexibility.
  • Myofascial Release: Applying sustained pressure to myofascial restrictions can eliminate pain and restore motion, addressing tightness in the hip flexors, adductors, and iliotibial band.
  1. Joint Mobilisation

Joint mobilisation involves applying controlled forces to the hip joint to improve range of motion and alleviate pain:

  • Hip Joint Mobilisation: Techniques to mobilise the hip joint can enhance joint mobility, reduce stiffness, and correct abnormal joint mechanics.
  • Manual Traction: Applying gentle traction to the hip joint can reduce joint compression, alleviate pain, and improve joint space.
  1. Manual Stretching

Manual stretching techniques aim to improve flexibility and reduce tension in the muscles around the hip:

  • Hip Flexor Stretching: Stretching the hip flexors can relieve tension and improve hip extension.
  • Adductor Stretching: Addressing tightness in the adductors can restore balance and reduce stress on the hip joint.
  • Gluteal Stretching: Stretching the gluteal muscles can enhance hip mobility and stability.

Listed below are some details of a client dealing with FAIS who is seeking treatment here at HBM, which may also serve as a case study:

Age: 70+

Gender: F

Symptoms: Right Hip pain

Medical history: Arthritis

Lifestyle: Yoga at least once a week, walks and stands quite a lot while working.

The client has received 6 treatments here at HBM over the period of 6 months to manage her symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating her on the importance of compliance to treatment due to her active schedule has made a big difference on her quality of life, and after educating her on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, she’s been able to get back to her daily activities with much improvements on symptoms.

If you or someone you know are dealing with FAIS, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us 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.

 

Tennis elbow Vs Golfer’s elbow

Tennis elbow and golfer’s elbow are overuse injuries that result from repetitive stress on the tendons and muscles around the elbow joint, leading to microtrauma, inflammation, and tissue degeneration. Despite their distinct anatomical locations, both conditions share common risk factors and clinical manifestations, including pain, tenderness, and functional impairment.

Tennis elbow, or lateral epicondylitis, involves inflammation and degeneration of the tendons attached to the lateral epicondyle of the humerus, primarily affecting the extensor muscles of the forearm responsible for wrist extension and radial deviation. In contrast, golfer’s elbow, or medial epicondylitis, affects the tendons attached to the medial epicondyle of the humerus, involving the flexor muscles of the forearm responsible for wrist flexion and ulnar deviation. While both conditions result from repetitive stress, they differ in their biomechanical mechanisms, anatomical involvement, and specific activities that exacerbate symptoms.

Photo illustration
 

 

 

Individuals engaged in activities requiring repetitive wrist and forearm movements are at increased risk of developing tennis and golfer’s elbow. Specific demographic groups susceptible to these conditions include:

  • Athletes: Tennis players, golfers, baseball players, and other athletes engaging in racquet sports or throwing activities are prone to developing tennis or golfer’s elbow due to the repetitive nature of their sport and high-intensity wrist and forearm movements.
  • Manual Laborers: Workers involved in occupations such as construction, plumbing, carpentry, and painting are at risk of developing tennis or golfer’s elbow due to the repetitive use of hand tools and sustained wrist positions.
  • Office Workers: Individuals performing repetitive typing, mouse clicking, and other computer-related tasks are susceptible to tennis or golfer’s elbow, as prolonged wrist extension or flexion can exacerbate symptoms.
  • Age and Gender: Middle-aged individuals are more commonly affected by tennis and golfer’s elbow, although these conditions can occur in individuals of all ages. Golfer’s elbow tends to be more prevalent in men, while tennis elbow affects both men and women equally.

Elbow Pain

Elbow Pain 2

 

 

 

 

 

Manual therapy interventions play a crucial role in the conservative management of tennis and golfer’s elbow, aiming to reduce pain, improve tissue healing, and restore functional mobility. Common manual therapy techniques employed in the treatment of these conditions include:
• Soft Tissue Mobilisation: Manual manipulation of the muscles, tendons, and fascia surrounding the affected elbow aims to reduce adhesions, improve tissue extensibility, and alleviate pain and inflammation.
• Joint Mobilisation: Gentle mobilisation of the elbow joint and adjacent joints, including the wrist and shoulder, can help restore normal joint mechanics, reduce stiffness, and optimise biomechanical function.
• Stretching and Strengthening Exercises: Specific exercises targeting the muscles of the forearm, wrist, and shoulder aim to improve flexibility, strength, and neuromuscular control, thereby reducing strain on the affected tendons and promoting tissue healing.

Listed below are some details of a client dealing with tennis elbow who is seeking treatment here at HBM, which may also serve as a case study:

Age: 35+
Gender: M
Symptoms: pain in R elbow from tennis 3x/week
Medical history: MRI showing disc herniation in C6-7
Lifestyle: Plays tennis 3x/week 2 hrs each for the past 2 years. Doesn’t stretch much and isn’t very flexible.

The client has received fortnightly treatments here at HBM over 8 months to manage his symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating him on the importance of compliance to treatment due to his active schedule has made a big difference on his quality of life, and after educating him on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, he’s been able to get back to his daily activities with much improvements on symptoms.

If you or someone you know are dealing with tennis or golfer’s elbow, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us 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.

Temporomandibular Joint (TMJ) Syndrome

Temporomandibular Joint (TMJ) Syndrome

Temporomandibular Joint Syndrome (TMJ Syndrome), also known as temporomandibular disorder (TMD), is a condition affecting the temporomandibular joint (TMJ), which connects the jawbone to the skull. TMJ Syndrome is associated with pain, restricted jaw movement, and clicking or popping sounds in the jaw. The multifactorial nature of TMJ Syndrome makes its diagnosis and treatment challenging.

The development of TMJ Syndrome is attributed to various factors, including:

  1. Muscle Dysfunction: Overactivity or imbalance in the masticatory muscles can lead to pain and dysfunction in the TMJ.
  2. Joint Degeneration: Osteoarthritis or other degenerative joint diseases can affect the TMJ, leading to pain and limited movement.
  3. Trauma: Direct injury to the jaw or TMJ can result in acute or chronic TMJ Syndrome.
  4. Bruxism: Teeth grinding or clenching, often related to stress or anxiety, can cause excessive strain on the TMJ and surrounding muscles.
  5. Malocclusion: Misalignment of the teeth or bite can lead to abnormal stress on the TMJ, contributing to dysfunction.
  6. Psychosocial Factors: Stress, anxiety, and other psychological factors can exacerbate TMJ symptoms through increased muscle tension and altered pain perception.

 

TMJ Syndrome can affect individuals of all ages but is most commonly seen in adults aged 20-40 years. Specific demographics and risk factors include:

  1. Gender: Females are more likely to develop TMJ Syndrome than males, possibly due to hormonal influences and greater sensitivity to pain.
  2. Age: Young and middle-aged adults are more commonly affected, potentially due to higher stress levels and more frequent bruxism.
  3. Stress and Anxiety: Individuals experiencing high levels of stress or anxiety are at greater risk of developing TMJ Syndrome due to increased muscle tension and bruxism.
  4. Occupation and Lifestyle: Occupations and lifestyles involving high stress or repetitive jaw movements can predispose individuals to TMJ Syndrome.

 

 

Manual therapy is a critical component of TMJ Syndrome management, focusing on alleviating pain, improving jaw mobility, and addressing muscular imbalances. Key manual therapy interventions include:

  1. Dry Needling

Dry needling involves the insertion of fine needles into specific trigger points or areas of muscle tightness to promote pain relief and muscle relaxation. Benefits of dry needling for TMJ Syndrome include:

  • Reduction of Muscle Tightness: Targeting trigger points in the masticatory muscles, such as the masseter and temporalis, can alleviate muscle tightness and improve jaw function.
  • Pain Relief: By disrupting pain signals and promoting local blood flow, dry needling can effectively reduce jaw pain.
  • Improved Muscle Function: Enhancing muscle function around the TMJ can aid in stabilising the joint and reducing abnormal stress.
  1. Soft Tissue Mobilisation

Soft tissue mobilisation includes techniques such as massage and myofascial release to manipulate the soft tissues around the TMJ:

  • Massage Therapy: Techniques like deep tissue massage or trigger point therapy can reduce muscle tension, improve circulation, and decrease pain, facilitating recovery of muscle function and flexibility.
  • Myofascial Release: Applying sustained pressure to myofascial restrictions can eliminate pain and restore motion, addressing tightness in the jaw and neck muscles.
  1. Joint Mobilisation

Joint mobilisation involves applying controlled forces to the TMJ to improve range of motion and alleviate pain:

  • TMJ Mobilisation: Techniques to mobilise the TMJ can enhance joint mobility, reduce stiffness, and correct abnormal joint mechanics.
  • Manual Traction: Applying gentle traction to the TMJ can reduce joint compression, alleviate pain, and improve joint space.
  1. Manual Stretching

Manual stretching techniques aim to improve flexibility and reduce tension in the muscles around the TMJ:

  • Jaw Stretching: Stretching the jaw muscles can relieve tension and improve range of motion.
  • Neck and Shoulder Stretching: Addressing tightness in the neck and shoulder muscles can reduce referred pain and improve overall posture, benefiting TMJ function.
  1. Proprioceptive Neuromuscular Facilitation (PNF)

PNF stretching combines stretching and contracting targeted muscle groups to enhance flexibility and strength:

  • PNF Techniques: Effective for improving the flexibility and strength of the jaw and neck muscles, promoting better joint mechanics and reducing pain.

Listed below are some details of a client dealing with TMJ syndrome who is seeking treatment here at HBM, which may also serve as a case study:

 

Age: 50+

Gender: F

Symptoms: Left TMJ pain

Medical history: None pertinent

Lifestyle: Seated for work mostly. Does Kieser 3x/week as exercise and does a bit of jogging.

The client has been receiving fortnightly treatments here at HBM over a period of 3 months to manage her symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating her on the importance of compliance to treatment due to her active schedule has made a big difference on her quality of life, and after educating her on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, she’s been able to get back to her daily activities with much improvements on symptoms.

If you or someone you know are dealing with TMJ syndrome, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us 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.

 

 

Repetitive strain injury (RSI)

Repetitive strain injury (RSI)

Repetitive strain injury (RSI) refers to a spectrum of conditions caused by repetitive movements and overuse of particular body parts, often leading to pain, discomfort, and functional impairment. RSIs are common in occupations and activities involving repetitive motions, prolonged exertion, or maintaining awkward positions.

 

 

RSI manifests in several forms, each affecting different anatomical structures:

  1. Carpal Tunnel Syndrome (CTS): Compression of the median nerve within the carpal tunnel of the wrist, leading to numbness tingling, and weakness in the hand.
  2. Tendinitis: Inflammation of tendons, commonly affecting the shoulders, elbows, and wrists. Examples include tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis)
  3. Bursitis: Inflammation of the bursae, small fluid-filled sacs that cushion bones and tendons, typically occurring in the shoulder, elbow and hip.
  4. De Quervain’s Tenosynovitis: Inflammation of the sheath surrounding the thumb tendons, causing pain and swelling at the base of the thumb.
  5. Thoracic Outlet Syndrome (TOS): Compression of nerves or blood vessels between the collarbone and first rib, causing pain in the neck, shoulders, and arms.

 

The primary causes of RSI include:

  • Repetitive Movements: Continuous, repetitive actions such as typing, using a mouse, or assembly line work.
  • Forceful Exertions: Activities requiring significant physical effort, including lifting heavy objects or using tools.
  • Sustained Postures: Maintaining fixed positions for extended periods, such as sitting at a desk or standing without adequate breaks.
  • Poor Ergonomics: Inadequate workstation setup, improper body mechanics, and poor posture.

 

Demographic Analysis:

RSI predominantly affects adults aged 25-50, particularly those in occupations involving repetitive tasks or prolonged static positions. Office workers, assembly line workers, musicians, and athletes are among the most vulnerable groups. The prevalence is higher in women, potentially due to differences in occupational roles and physical structure.

Manual Therapy encompasses a range of hands-on techniques performed by physical therapists or myotherapists to alleviate RSI symptoms. Key techniques include:

  • Massage therapy: Targets soft tissues to reduce muscle tension, improve circulation, and promote relaxation.
  • Joint mobilisations: Gentle, controlled movements of joints to restore range of motion and alleviate pain.
  • Soft tissue mobilisations: Techniques such as myofascial release to break down scar tissue and adhesions in muscles and connective tissues.
  • Trigger point therapy: Applying pressure to specific points to relieve muscle knots and referred pain.
  • Stretching and Strengthening exercises: Personalised exercises to improve flexibility, strength, and posture, reducing risk of future injury.

Listed below are some details of a client dealing with a shoulder RSI who is seeking treatment here at HBM, which may also serve as a case study:

Age: 35+

Gender: M

Symptoms: Shoulder pain after cricket match

Medical history: MRI showing slight oedema in subacromial bursa

Lifestyle: Sitting for work mainly, but workstation is not set up ergonomically; recently started playing cricket again.

The client has received 4 treatments here at HBM over 3 months to manage his symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating him on the importance of compliance to treatment due to his active schedule has made a big difference on his quality of life, and after educating him on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, he’s been able to get back to his daily activities with much improvements on symptoms.

If you or someone you know are dealing with RSI, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us 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.

 

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