News

8 September 2022

Updates & Communications
September 2022

  • What's New This Month:
  • Word From Jen
  • End of an Era for MHT's Bellbirds
  • How Crippling Pain Made Me A Better Therapist
  • Thumb Arthritis
  • Injury-prone Ski Family Back Again
  • Fast Five with David Ratner

WORD FROM JEN

Jennifer Mathias
MHT Director
Senior Clinician

Welcome to spring. I don’t know about you, but this winter has felt longer and colder than most and I’m glad it’s over. I can’t wait to get stuck into the garden after a winter of neglect. It is now so overgrown, I might be forced to coerce the family in to help. Wish me luck on that count. Getting my family to help that is, not with the weeding.

As usual, it has been a busy month at MHT. The big news is that we are leaving our beloved Blackburn premises at Bellbird Private Hospital following its acquisition by the Andrew’s Government. For our regular patients, don’t panic. A new MHT clinic has opened with all the details further down in this newsletter.

Meanwhile, many members of staff are taking advantage of the extended warm season overseas to visit family and friends. Shoulder guru Rose Alibazi has headed back to Iran to catch up with family and physio Kim McCall has just returned from visiting her parents in Scotland. It wasn’t a long trip, but I swear her Scottish accent has become more pronounced. Seriously, it’s worth making an appointment with her just to have a cup of tea and a chat! Therapist Mel Thomas is about to head off for a month-long holiday in Europe and hand specialist Emmeline Fooks has returned from a getaway in Queensland, appropriately relaxed.

In this edition, I have also written about my recent experience with a debilitating shoulder injury. I wish I could say it was caused by something exotic like heli-skiing or bungee jumping. But, alas, no. It was a plain ol’ tennis injury and it bought me to the brink of despair. In all seriousness, as terrible as the injury was it has changed the way I practice, and I am grateful for it.

Talking about heli-skiing (and, no, it is definitely NOT on my radar), we have a post-script on a post-script on the family of bungling skiers who keep turning up on MHT’s doorstep. Yep, another family member has bit the dust, or snow.

We look at arthritis of the thumb and for Fast Five we find out what makes MHT’s new Head of Finance and Operations David Ratner tick.

End of an Era for MHT's Bellbirds

After 15 years at our rooms in our beloved Bellbird Private Hospital in Blackburn South, MHT is moving.

The acquisition and redevelopment of Bellbird Private Hospital by the Andrew’s State Government have given us the perfect opportunity to move our magnificent therapists out and into upgraded clinical rooms in an easier-to-access location.

MHT’s Bellbird practice has moved to Blackburn Clinic, 195 Whitehorse Rd, Blackburn. It is on the corner of Whitehorse Road and Maple Street (heading out of the city) and there is plenty of easy parking at the back which you can enter through Maple Street. Ours is the “Carson Suite”, or suite 8.

While it’s been exciting finding and moving into the new premises, it has been a bit of an emotional wrench for our long-time Bellbird therapists Emmeline Fooks and Haley Field.

Hand Therapist Emmeline, who has been at Bellbird for over 13 years, said it was a “sad” end to an era and she would miss all the “lovely patients and staff” she had met while working there.

Hand therapist Haley Field (and our superstar former Olympian), who has practiced at Bellbird for 10 years, said she was both shocked and sad when told the pair had to move.

“Bellbird has always had such a lovely, small community feel about it and is a calm and friendly place to work and visit,” she said.

“I was sad to hear we had to move and will miss all the staff and familiarities we have grown to know and love there over the years.

“But with every closing door another bounces open and after meeting with the staff at the Blackburn Clinic and taking a look around the new clinic my fears were eased.

“The staff were warm, welcoming and accommodating and the new and spacious Carson suite just felt right.

“Parking was aplenty (phew!), and I can't wait to start a new and exciting chapter there - same same but different! While change can feel uneasy and challenging, I'm certain we'll make Blackburn Clinic feel like home in no time at all!”

Emmeline and Haley will join Nikita at the new Blackburn Clinic.

To make an appointment with any of the Blackburn crew go to https://www.melbournehandtherapy.com.au or call 9899 8490.

How Crippling Pain Made Me A Better Therapist

For 25 years, I have worked in upper limb rehabilitation as both a hands-on therapist and the owner of Melbourne Hand Therapy. I pretty much thought I’d learned all there was to know about upper limb injuries, conditions and treatments.

I was wrong.

During this time, in which I have also had two children, I have been lucky enough to have suffered only one minor injury. It was during my “taekwondo phase” (cue: family eye-rolling). I went for what I thought was a spectacular block of an opponent’s kick and fractured my fifth metacarpal. It was easily treated with a splint, healed quickly and I was back trying to knock blokes off their feet in no time at all, feeling invincible.

Years later and I faced another injury, this one more substantial and in my right shoulder. This time, it was tennis to blame as I’d moved on from taekwondo. I was in agony. On top of the excruciating pain, my shoulder clicked painfully and when it did there was a horrid grating sound and sensation. It was difficult to move my shoulder movement and when I did it caused pain in my neck. Desperate to fix the problem and return to tennis - my only real outlet - I booked in to see Kim McCall, one of MHT’s senior shoulder physios. She listened to what I was saying and tapped into my frustration and misery. Very calmly, and in her Scottish no-nonsense way, she explained why my “Plan B” of just picking up a tennis racquet and hitting the court injury be-damned greatly exasperated the condition. Kim undertook a full assessment and provided me with exercises to help. It was a realistic plan; it made sense to my pain-soaked mind and I clung to it.

Of course, this plan included an immediate MRI to assess any damage. This then resulted in me needing to consult with one of the amazing shoulder surgeons we are MHT regularly refer patients and he ended up sending me for a cortisone-guided injection into the head of the bicep to try and relieve the pain.

Out of this whole process, a process our patients face daily, the thing that struck me the most was NOT the physical aspects of the injury. It wasn’t the pain, the limitation of movement or the rigmarole of having an injury treated – therapist, GPs, MRI, surgeons, physiotherapy, cortisone injections and repeat etc.

What struck me the most is what it did to me psychologically.

I couldn’t sleep. I couldn’t lie on my shoulder. I couldn’t lie on my other shoulder as that impacted my affected shoulder. As anybody who has had a newborn baby knows, sleep deprivation is torture. The pain was crushing and constant and would heighten depending on the activity I was undertaking, or the way I walked or tilted my head or laughed, or not laughed. I couldn’t dress, reach above shoulder height, or hang the washing on the line. It consumed my life and affected my mood. I was irritable and angry and couldn’t even go to the local tennis club and bash a ball senseless to ease deal with my frustration. And THAT just made me even more irritable and angry.

Like most of us who work in the medical profession, I am an impatient patient. I wanted the injury seen to and fixed and for me to be given a pat on the back and sent on my merry way to an injury-free life - like what happened with the taekwondo injury. I wish.

This whole horrid episode has taught me the importance of seeing - really seeing - the whole of the injury including its psychological impact. To see the anguish and broader suffering that the injury has caused the patient and their family. It has taught me the importance of sleep and pain management in a patient’s life. As clinicians, we must start addressing a patient’s sleep, pain control and overall psychological state as part of treating the physical injury.

And it has taught me the importance of listening, really listening, to your patient as Kim did to me. My constant pain has settled and I am ready to embark on the rehabilitation process.

Part of this rehabilitation process will be to include all I have learned from my dodgy shoulder.

Thumb Arthritis

Osteoarthritis of the thumb is a common condition affecting both males and females, however is more common in the female population. It commonly occurs with age and is caused by a narrowing of the joint space and a breakdown of the padding, called cartilage, that covers the ends of the bones at the base of your thumb, also known as the carpometacarpal joint (CMCJ).

Thumb arthritis is often very painful during both activity and at rest and can cause swelling, decreased range of motion and reduced strength. Simple tasks such as turning on a tight tap, opening a jar or holding your phone can become difficult. 

Causes

Osteoarthritis is the most common form of arthritis in the thumb and is caused by a gradual breakdown of the cartilage at the ends of the bone. This leads to the bones rubbing together, friction and joint damage. It usually occurs as part of the natural aging process and is most common in adults over 50. Previous trauma to the thumb can also cause osteoarthritis.

Other risk factors may include:

  • Overuse, particularly activities or jobs that place high demands on the thumb
  • Genetic predisposition
  • Gender (female)
  • Previous trauma to the joint (e.g. fracture or dislocation)

Signs & Symptoms

Pain is generally the first symptom of thumb arthritis. People can experience pain with gripping pinching, holding an object with pressure on the thumb or even at rest. People can also experience a decreased range of motion of the thumb with a distorted appearance, often appearing large and “boney” at the base of the thumb. 

Other symptoms include:

  • Swelling, stiffness or soreness at the base of the thumb
  • Decreased strength with gripping or pinching objects
  • Sharp pain or aching at the base of the thumb
  • Decreased range of motion

Treatment

Early stages of thumb arthritis are best treated by a combination of non-invasive and non-surgical techniques. Treatment involves exercises, joint protection techniques, splints and medications.

If your thumb arthritis is severe you may require invasive treatments such as steroid injections or surgery.

Therapy

To help alleviate symptoms therapy can:

  • Provide exercises to increase range of motion, keep ligaments and tendons supple and improve stability
  • Provide strengthening exercises to strengthen muscles around the thumb to support posture and strength
  • Assist with oedema control and management
  • Assess your individual thumb biomechanics to help correct thumb posture during movement
  • Provide education on joint protection techniques
  • Provide custom made splints.

Splinting

Your hand therapist can provide you with a splint. Splinting is the mainstay of conservative management of an unstable and painful thumb. The splint may be used during the day for functional tasks, at rest or both to help:

  • Decrease pain
  • Correct thumb posture during functional tasks to take the pressure off the arthritic joint
  • Rest the joint and allow inflammation to settle

Medications

To help relieve pain and/or inflammation your doctor might recommend trying:

  • Topical gels or creams such as voltaren gel which you apply to the skin over the affected area
  • Over the counter oral medications such as panadol osteo.
  • Prescription pain or anti-inflammatory medications.

Injections

If pain is still persisting after trying conservative management techniques your doctor or surgeon may suggest a long acting cortico-steroid injection directly into the joint at the base of your thumb. Like oral medications this can help reduce pain and inflammation.

Surgery

If you haven’t responded to any of the mentioned treatment options and pain and reduced movement are significantly impacting your ability to function your doctor or surgeon may recommend surgery. Surgical options include:

  • Suspension plasty: One of the small  bones at the base of your thumb (the trapezium) is removed and replaced with a tendon to provide cushioning and stability.

How Can I Prevent Thumb Arthritis?

In some instances thumb arthritis is a result of trauma to the joint. There is also a genetic predisposition and other factors that are not always preventable. However, there are a number of ways you can protect your thumb joint against thumb arthritis or reduce the severity of the disease if you are in one of the risk categories or are in the early stages.

  • Reduce unnecessary repetitive actions of the thumb including holding the thumb in positions of load for extended periods e.g. holding a book
  • Maintain a good range of motion of your joints through regular exercise prescribed by a hand therapist
  • Avoid gripping narrow and small objects tightly.

Melbourne Hand Therapy Can Help You

Our experienced therapists can help you manage your symptoms and slow the progress of this condition. We teach you joint protection techniques, prescribe exercises to improve stability and strength and recommend splints to rest and support your painful thumb. All of our clinic locations have modalities such as the paraffin wax bath which may also assist with pain relief.

To learn more, book an appointment below today!

BOOK AN APPOINTMENT NOW

Injury-prone Ski Family Back Again

It might be time for somebody to have a word in the ear of this MHT family of injury-prone skiers and snowboarders and suggest perhaps a new, less dangerous, hobby … like base-jumping or bomb disposal.

Already this year, MHT has had the pleasure of treating 16-year-old Charlie who suffered a painful distal radius injury from a snowboarding incident that occurred only ten minutes into his first run down the mountain.

Younger sister Bonnie, 13, was soon too on our doorstep with an almost identical distal radius injury from, yes, snowboarding. At least she got a couple of days of fresh powder snowboarding in first!

And now Dad who, in refusing to take the advice of his GP (“men of a certain age should not be skiing”), went for the world’s most inelegant stack when he hurtled too fast down a patchy Mt Hotham run while trying to keep up with a group of omnipotent 20-somethings.

It was not pretty and resulted in Dad suffering an avulsion fracture of the shoulder. This kind of fracture occurs during sporting activities that involve quick movements and sudden changes in direction. For example … skiing. A piece of the bone in Dad’s upper arm, which was attached to a ligament, chipped away in the fall. It is a particularly painful injury. Dad was lucky enough to escape any surgical intervention and was able to rely on conventional therapy for recovery but - skiers be warned - this type of injury often involves surgery and a long recovery.

The ski season is wrapping up but for those who are heading up to the slopes for one last taste of the 2022 snow spectacular, remember …. wrist guards, wrist guards, wrist guards and no skiing beyond your ability.

Fast Five with David Ratner

We've finally managed to pin down our busy new Head of Finance and Operations, David Ratner, for the traditional MHT Fast Five grilling. It was tough. Anybody would think he was trying to avoid us!

David started with us in July after working across many industries including Delf Architectural, Ventura Buses and Massage & Myotherapy Australia and with fifteen years of senior management positions under his belt.

He is treasurer, coach and Auskick coordinator for the Caufield Bears Junior Football Club and while on the face of it that sounds quite stressful, he hasn't yet faced the real stress of our Fast Five interrogation.

Take it away, David.

What football team do you support and why?

Essendon, family tradition. When my grandparents migrated to Australia, John Coleman was the superstar of the time so my grandfather chose to jump on the bandwagon.

What are you reading at the moment?

Disruption Leadership Matters by Gary Ryan.

What is your guilty streaming pleasure?

Loved Ozark (despite getting the chills) and looking forward to Ted Lasso's next season.

What do you do to relax?

I'm a news junkie, so I'll either be reading a newspaper or watching TV (sports or news). Have caught the wordle, quordle and octordale bug lately too.

What was your first job?

Indoor cricket umpire.

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