Kinetic Rehab TT
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Therapy Found Effective for Carpal Tunnel Syndrome

Diagnosis

Your doctor may ask you questions and conduct one or more of the following tests to determine whether you have carpal tunnel syndrome:

  • History of symptoms. Your doctor will review the pattern of your symptoms. For example, because the median nerve doesn’t provide sensation to your little finger, symptoms in that finger may indicate a problem other than carpal tunnel syndrome.

     

    Carpal tunnel syndrome symptoms usually occur include while holding a phone or a newspaper, gripping a steering wheel, or waking up during the night.

  • Physical examination. Your doctor will conduct a physical examination. He or she will test the feeling in your fingers and the strength of the muscles in your hand.

    Bending the wrist, tapping on the nerve or simply pressing on the nerve can trigger symptoms in many people.

  • X-ray. Some doctors recommend an X-ray of the affected wrist to exclude other causes of wrist pain, such as arthritis or a fracture.
  • Electromyogram. This test measures the tiny electrical discharges produced in muscles. During this test, your doctor inserts a thin-needle electrode into specific muscles to evaluate the electrical activity when muscles contract and rest. This test can identify muscle damage and also may rule out other conditions.
  • Nerve conduction study. In a variation of electromyography, two electrodes are taped to your skin. A small shock is passed through the median nerve to see if electrical impulses are slowed in the carpal tunnel. This test may be used to diagnose your condition and rule out other conditions.

    Surgery

    Surgery may be appropriate if your symptoms are severe or don’t respond to other treatments.

    The goal of carpal tunnel surgery is to relieve pressure by cutting the ligament pressing on the median nerve.

    The surgery may be performed with two different techniques:

    • Endoscopic surgery. Your surgeon uses a telescope-like device with a tiny camera attached to it (endoscope) to see inside your carpal tunnel. Your surgeon cuts the ligament through one or two small incisions in your hand or wrist.

      Endoscopic surgery may result in less pain than does open surgery in the first few days or weeks after surgery.

    • Open surgery. Your surgeon makes an incision in the palm of your hand over the carpal tunnel and cuts through the ligament to free the nerve.

    Discuss the risks and benefits of each technique with your surgeon before surgery. Surgery risks may include:

    • Incomplete release of the ligament
    • Wound infections
    • Scar formation
    • Nerve or vascular injuries

    During the healing process after the surgery, the ligament tissues gradually grow back together while allowing more room for the nerve. This internal healing process typically takes several months, but the skin heals in a few weeks.

Read These Three Tips For Long Car Rides

Remaining in a seated position for extended periods of time can restrict blood flow to your lower extremities, causing flexion, which is a compressive force in the spine. Stopping to stand and stretch is critical for your spine, as it releases the compression, allows for blood to flow to the nerves, and helps maintain flexibility

Long car trips can literally be a pain. But you can remain physically comfortable on long drives with these tips.

Stay alert. Drowsy driving can be fatal. Don’t push yourself to drive late into the night, when you are usually asleep. Switch drivers if you start to fade. If you’re the only driver, get a hotel room.

Pull over every 2 to 3 hours. Sitting too long is hard on the lower back due to that constant flexed position,” says Lynn Millar, Ph.D., chair of the department of physical therapy at Winston-Salem State University in North Carolina. It may compress the discs between your vertebrae, potentially leading to pain, numbness, or tingling in the legs. Your neck and hips could get tight, too. Getting out of the car and walking around a bit can help keep you comfortable on long drives.

Stretch your back. On your driving breaks, stand tall and circle your shoulders back five times. Then reach arms overhead and arch back slightly. Hold for 5 seconds, then lower arms and repeat once or twice.

Uncramp your legs. Try this calf and hip-flexor stretch: Stand with feet staggered in a lunge, left knee bent in front and right leg straight behind so that your heel touches the ground. With hands on hips (or holding on to something for balance), clench the right side of your gluteal muscles. Hold for 30 seconds, then switch legs and repeat.

Relax your shoulders. Keeping your chin parallel to the ground, slowly draw your head back as far as you can. You might feel a stretch along your upper spine and shoulders. Repeat six times.

Flex your feet. Trips longer than 4 hours increase your risk of deep vein thrombosis, a clot that forms, usually in the lower leg or thigh, says Mary Cushman, M.D., a spokesperson for the American Heart Association. Stopping to walk around helps. Passengers in the car should do ankle rolls and alternate flexing and pointing their feet one at a time every half hour or so.

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How Physical Therapy Can Prevent Injuries

Customized physical therapy may be a useful way to ease low back pain, which affects an estimated 31 million Americans a new study says. Researchers from La Trobe University observed that ‘many patients with low-back disorders persisting beyond 6 weeks do not recover.

Yearly PT check-ups?

While most people don’t have “physical therapy” on their list of check-ups each year (such as the doctor, dentist, etc.), many physical therapists see patients regularly – even when they’re not injured. Physical therapist Karen Joubert, DPT stated that, “People come see us [after] surgery or sprained ankles or prehab before surgery, but the more interesting thing is that I have patients who are getting into their 30s and 40s and are realizing, ‘Wow, I want to live longer, maybe have a family. And I don’t want to have to be hunched over or have back surgery. How can I prevent that?'”

The idea of using physical therapy as a regular, preventive measure against aches, pains, and serious injuries down the road is something our team has always advocated, as well. Many of our patients are regular visitors who prefer physical therapy to other forms of pain management like massage, prescription drugs, chiropractic visits, or injections.

The article goes on to explain that “Physical therapists often work with people who are healing from an injury to help them restore proper movement patterns in the body and avoid future injury. They do this by teaching them how to do exercises that will strengthen important muscles, and work on improving mobility and alignment required for optimal physical function.”

For those that hit the gym hard

“Seeing a physical therapist when you feel perfectly fine can be beneficial for some people—especially those who hit the gym hard,” says Marturana. “Most preventive patients are looking for ways to keep their bodies functioning properly and avoid injury.” If you’re at the gym with the intention of changing the way your body looks, it’s common that you’ll encounter minor injuries along the way. Most people won’t even consider them injuries – just little tweaks or strains. Many push right past these warning signs not considering the more permanent damage that can come down the road.

The counterarguments

The article also speaks to the counterarguments about physical therapy as a preventive measure. The two major points brought up are: a) if you’re already cured; and b) if it’s too costly. If you visited a physical therapist in the past for pain in your arm and that pain was completely resolved, the article suggests that there is no need to go back to “tune up” your arm. In many instances, this is right – if an issue is completely resolved, physical therapy for that exact same issue may not help all that much. However, in our experience we find that patients rarely are 100% healthy in every part of their body. Just because your arm pain has been resolved, the point of a regular check-up is to make sure everything else is functioning correctly and address other issues before they lead to another major incident.

As for the cost argument, the article says, “Seeing a physical therapist before training for an Ironman or joining a recreational adult soccer league is a smart idea to avoid injury and learn what your body needs (in terms of alignment and mobility and stability) during training. When it comes to just seeing a physical therapist on the regular to check in, it’s definitely not going to hurt, but it also might not be worth your money. It’s a pretty personal decision, though—if it seems beneficial to you and your health and fitness goals, then it probably is worth it.” It goes on to state that while seeing a physical therapist once a week or month may not be cheap, neither is getting injured. Ultimately, it comes down to how much you value your wellbeing (and how good your insurance is).

What you may not know

What many people don’t know is that nearly every state allows you to visit a physical therapist without a referral from your doctor or approval from your insurance company. To be sure, all you have to do is call a physical therapy clinic and ask them to verify your insurance before you come in. The front desk team will let you know what your co-pay will be (if any) and how many visits you can come in for without any kind of referral or prescription.

We’ll leave you with one last nugget of wisdom from this article: “If something hurts, stop doing it. If you think you injured yourself, see your doctor or a physical therapist to address it before it gets worse. You only get one body, so it’s always worth giving it the TLC it deserves.”

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