Did you know that Melbourne Hand Therapy also employs shoulder physiotherapists to treat our shoulder patients? We don’t just do hands!
We have Physiotherapists specialising in the treatment of shoulder conditions such as frozen shoulder/adhesive capsulitis, rotator cuff injuries and fractures such as those of the humerus and clavicle. Our Physiotherapists can assess your shoulder pain and provide hands on treatment and a home exercise program.
Our therapists also closely liaise with shoulder surgeons if we feel you need a surgical opinion. We work closely with GP’s and Upper Limb Surgeons and will get you back to doing what you love in no time!
Wrist pain particularly over the ulnar aspect is a common problem. Many patients present without a known aetiology or trauma and often with a prolonged history of symptoms. Pain with weight bearing, supinating or pronating the forearm and ulna deviation are frequently reported, as are difficulties with many ADLs.
Thorough assessment of the wrist and imaging can highlight a variety of causes for ulnar wrist pain, including triangular fibrocartilage (TFC) tears. Our November edition of this newsletter highlighted some of the rehabilitation strategies we use to treat this condition.
An important component to this treatment is the use of appropriate splinting. Immobilising the wrist is often unhelpful as it causes stiffness and weakness. An alternative to this is a velcro strap that is worn over the distal radius and ulna, stopping them from spreading, supporting the DRUJ and essentially taking over the role of the TFC. Combined with a neuromuscular rehabilitation program, this can then allow the TFC to heal naturally and without surgery. An example of this strap is shown below.
The Melbourne Hand Therapy team would like to say a huge thank you to the organisers of the AHSS meeting and particularly for the international guest speakers; PC Ho, Max Hearle, Paco del Pinal and Eva-Maria Baur. It was an inspiring meeting with lots of take home messages. Thank you!
Carpal tunnel syndrome (CTS) is the compression of the median nerve at the wrist. It usually presents with numbness or pins and needles of the thumb, index, middle and half of the ring finger, weakness/clumsiness “I keep dropping things” and in more advanced cases, it can also cause pain and cramping in the hand/forearm and thumb muscle wasting.
Causes for CTS can include increases in swelling due to medical conditions (eg. diabetes), increase in fluid in the hands (eg. during pregnancy), inflammation of the flexor tendons going through the carpal tunnel (eg. through repetitive gripping or squeezing). Symptoms are often worse overnight due to the wrist position when sleeping and are commonly brought on by holding a phone or driving.
Conservative treatment for CTS includes wearing a wrist splint overnight, keeping the wrist in a neutral position, activity modification or pacing and soft tissue massage to the forearm.
Indications for carpal tunnel release surgery are having constant symptoms for 3 or more months, no relief from conservative treatment or high levels of pain.
Hand therapy plays an important role in both the conservative and post-operative management of carpal tunnel syndrome or release. Our role is to individually assess your unique presentation and guide you through your treatment process.
We will commence consulting in Hawthorn East in late October.
