News

10 March 2022

Updates & Communications
March 2022

  • What's New This Month:
  • MHT Update with Jen
  • Back to the Uni Classroom
  • Webinars on Wrist and Pain
  • Fast Five with Haley
  • Trauma and Shoulder Instability

WORD FROM JEN

Jennifer Mathias
MHT Director
Senior Clinician

Welcome to Melbourne Hand Therapy’s March update. Can you believe it is March already?!

It has been a hectic start to the year here at MHT. Is it just me or did 2022 just seem to take-off out of nowhere?

At the moment we are busy registering MHT with the NDIS and ensuring all our therapists are up-to-date with their Working with Children Checks.

We have also welcomed fabulous new hand specialist Nikita Kumar to the MHT family. Nikita is working out of our Mt. Waverley, Blackburn and Ringwood consulting suites.

And finally, our team have been busily engaged in workshops and presentations. I spent two fabulous days at Swinburne University lecturing final year Master of Occupational Therapy students while team member Emmeline Fooks and I presented a webinar on wrist anatomy and pain management for Australia’s peak occupational therapy group, Occupational Therapy Australia (OTA). MHT physiotherapist Dane Johnson and I will shortly be presenting another OTA webinar in advanced hand therapy.

Have a great March everyone. Hope to see you at the Melbourne International Flower Show. My favourite time of the year!

LECTURING AT SWINBURNE UNI

MHT’s expertise and reputation were on show in February as senior clinician Jennifer Mathias was invited to lecture final year Masters of Occupational Therapy students at Swinburne University.

Jen spent two days as a guest lecturer helping steer the next generation of occupational therapists through the tricky aspects of hand therapy, scar management and, of course, splinting.

Jen said she couldn't have been more impressed with the commitment and proficiency of the students.

"They are so switched on and skilled," she said. "They will make excellent OTs."

WRIST AND PAIN SEMINAR BY MHT

At the end of February, senior MHT hand therapist Jennifer Mathias and MHT wrist guru Emmeline Fooks presented a webinar on behalf of Occupational Therapy Australia on wrist conditions and associated pain management.

The webinar was well attended with both therapists describing it as a productive and energetic session.

Jennifer Mathias said her and Emmeline thoroughly enjoyed the webinar and particularly liked meeting all the participants.

"The extended chat at the end was definitely the highlight for us both and we were so appreciative of their input and expertise,"she said. "We can't wait for next year."

A recording of the webinar is available for purchase on the Occupational Therapy Australia website.

FAST FIVE WITH HALEY

To get to know the members of our fabulous MHT team, we are introducing “Fast Five”. Blackburn South OT and our very own Olympic and Commonwealth Games marathon runner Haley Field has bravely volunteered to go first. Hayley has worked at MHT for nine years and, not surprisingly, has a particular interest in sports injuries.

1) Which football team do you support and why? Collingwood because I married a one-eyed Collingwood supporter and now we have theree one-eyed Collingwood kids!

2) Favourite television series and why? SAS Australia because I find it inspiring seeing how far people can push themselves and find new personal limits.

3) Why become an OT? I felt like OT was an area that helped people with physical and psychological limitations to improve using functional and holistic approaches. I love that we get to see our patients as a whole person not just a hand!

4) Do you have a pet? Eek, yes. Much to my husbands disgust we have two dogs, two rabbits, a turtle and a lot of fish (one of our fish just had A LOT of babies!)

5) What do you like to do to relax? Run, run and run and maybe a bit of overnight hiking! Anything involving exercise really!

BLACKBURN SOUTH CLINIC NOW OPEN FIVE DAYS

MHT’s Bellbird practice in Blackburn South is now open five days a week. Please ring 9899 8490 for an appointment with one of our expert Bellbird therapists Mel, Nikita, Dane, Emmeline, and Haley.

TRAUMA AND ANTERIOR SHOULDER INSTABILITY (ASI)

Rose Alibazi
MHT Physiotherapist

Interior - or frontal - shoulder instability (ASI) is the most common type of shoulder instability, making up more than 80 per cent of all shoulder instability cases generally.

ASI occurs when the head of the upper arm bone (humerus) slips to the front of the shoulder joint. The severity of the injury depends on the degree of the “slip” of the bone and can be anything from a mild displacement to a true dislocation. It is generally caused by trauma but can also happen with overuse or in those with a congenital softness of the tissue surrounding the shoulder joint. In a vast majority of cases, however, ASI is caused by trauma, such as in a fall on an outstretched arm.

When a trauma happens, patients could suffer an injury to the ligaments which support the front part of the shoulder's "ball and socket" joint. This is known as a Bankart lesion.

In a trauma injury, patients could also fracture the shallow socket in the shoulder that gently cups the head of the upper arm bone. This is known as a Bony Bankart lesion. Any bone loss associated with this can increase the risk of future dislocations and requires a referral to a surgeon.

In more serious cases, ASI can result in a compression fracture of the bone at the head of the upper arm. This is known as a Hill-Sachs' lesion. Generally, this injury also requires a surgical consult.

Trauma to the shoulder could also result in rotator cuff injuries which occur when the tissues connecting muscle to the bone around the shoulder joint tear. Those over 40-years-old are more prone to this injury.

Finally, neurological and vascular weakening or injury, particularly in the main axillary nerve-which runs from the upper spine down the arm-can also be caused by ASI.

Patients with anterior shoulder instability generally present with pain and a heightened sense of fear and apprehension of future displacement.

Management of ASI

Treatment depends on the degree of instability, patient characteristics and severity of symptoms. Obviously, if there is any acute dislocation, the priority is to relocate the shoulder as soon as possible. In this case, the patient must urgently attend the nearest hospital emergency department.

Many conditions associated with ASI require a surgical review. For example, in younger patients (particularly in those less than 20-years-old) there is a higher rate of dislocation of the shoulder.

If there is any structural damage as a result of ASI, for example Bankart lesion or bone fracture, again a surgical opinion is necessary. Common surgeries associated with this kind of damage are known as Bankart repairs or Laterjet procedures.

However, if the patient presents with a milder dislocation, they can be treated conservatively.

This is done by placing the arm in a temporary sling, using pain killers and frequent icing.

After an initial rest and recovery period, the patient can return to gentle gradual movement then resume proper activation and control of the shoulder muscles including the rotator cuff and shoulder girdle muscles.

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