Olympian long-distance cyclists are at risk for this condition, as are professional baseball pitchers, but you could be too. Do you notice numbness, tingling or pain radiating into your arm and hand on the side of the little finger? “Handlebar Palsy” or Ulnar Neuropathy can be caused by the repeated jarring of the wrists and hands when cycling. The result is an inflammation of the ulnar nerve, a major nerve in your arm that runs down your hand. Inflammation of the ulnar nerve can occur in several areas as it travels from your neck to your hand. Resting your elbows on hard surfaces for a long period may cause a slight inflammation, but intense physical activity such as long-distance biking or repeatedly pitching a baseball are more likely to cause the serious cases of this condition.
Watch for numbness, tingling or pain in the forearm or hand on the side of the little finger. Pain and numbness in the elbow may also be present, with decreased hand grip and the inability to pinch together the thumb and the little finger. The ulnar nerve often becomes trapped in the elbow, as the space it has to travel through in this area is limited. This is called “Cubital Tunnel Syndrome.”
Although ice, rest and anti-inflammatory medications may help initially, if the pain and tingling persist, seek the advice of a specialist trained to evaluate and rehabilitate the hands and upper body. This doctor will review your symptoms and ask about your lifestyle and activities. He or she will examine your neck, shoulder, arm and wrist. The doctor may order tests such as a nerve conduction study (NCS) or an electromyogram (EMG). EMG is a procedure where electrodes are placed into the muscles and on the skin to measure the health of muscles and the nerves that control them, to help identify the area of nerve damage and determine the severity of the condition.
The exact cause of the condition must be determined, and behavioral changes must be made to reduce the pressure on the nerve. Wrist splints may be prescribed to reduce discomfort. If the cause is from bicycling, it may help to wear padded gloves and to change your hand position on the handlebars frequently. Oral anti-inflammatory medications and B vitamins may also be prescribed. Typically these minimally invasive measures will alleviate the condition, but if not, surgery may be required. The vast majority of patients respond favorably to some type of surgery to correct this condition.
If the nerve is trapped in the elbow, Cubital Tunnel Release surgery can be effective. This is typically done on an outpatient basis, and individuals can go home the same day. The area known as the cubital tunnel is cut to allow more room for the nerve to pass through. As healing occurs, new tissue is formed and fills in this area. The recovery period for this type of surgery includes wearing a splint for a few weeks and physical rehabilitation therapy to return full range of motion and strength to the arm and hand.
Repetitious motions or constant jarring of the arm cause the inflammation of the ulnar nerve. Try to reduce activities that repeatedly stress this area, and take frequent breaks with arm stretching when you can. If you are a bicyclist, wear padded gloves and move your hand position on the handlebars frequently.
If you are experiencing pain, stiffness or tingling in your hands, arms or shoulder, contact Dr. Rehman for a comprehensive evaluation and treatment plan. Her team of hand therapists will help you return to your activity with full use of your arm or hand. Call 586-532-0803 for more information.
With the changes in schedule summer brings, sometimes it’s difficult to keep up the exercise routines we’ve committed to. With a little bit of creativity, you can stay in shape and entertain your kids at the same time. A bonus: the more flexible and strong each family member is, the less likely they are to be injured in a sporting event.
Morning Family Stretch
Set aside five to ten minutes each morning for the whole family to do some stretching exercises. Stretching helps to get the blood flowing and warms up the muscles for the activities of the day. Make this a daily routine for your family; it is healthful and a quiet bonding experience to help balance the hectic life most kids have.
Kids Make Great Dumbells (and their giggling will keep you going)
Try this Russian Twist: While seated on the floor with your knees bent, hold your child in front of you, engage your core and twist from side to side. Repeat 10 to 20 times. This is a great one for arms and abs.
Squat Press: Stand while holding your child in front of you with your feet hip distance apart, arms extended, but elbows not locked. Slowly lower into a squat like you are sitting in a chair and then slowly stand back up straight. Be sure to keep your knees in line with your ankles. Repeat this 10 to 15 times. Great for the arms and lower body.
Throw a Dance Party
Push the furniture out of the way, round up your family’s favorite tunes, and crank up the speakers for a blast of exercise that will get everyone involved. Dancing is super fun and a great cardio workout. Make one afternoon or evening a week your “Dance Party Night” from now till the kids go back to school.
Family Competition
We’re all about competition in our culture, and most kids are involved in at least one organized sport by the time they are a few years old. Motivate your family by setting weekly goals, and create a chart and point system that helps your family track their activity or eating habits throughout the day. See who can be the healthiest!
All these suggestions should help, but if you or your child are injured in one of your organized sports—or at the company baseball game—be sure to reach out to Dr. Rehman and her team of rehabilitation professionals. Specialists in hand, arm and shoulder rehabilitation, they can help resolve tendonitis, golfer’s or tennis elbow, hand and wrist pain, and many other conditions. To learn more, contact Dr. Rehman’s office at 586-532-0803 today!
Today, children are participating in sports at earlier ages than ever before. And the demands on their bodies continue to increase.Young baseball pitchers are especially at risk for arm and shoulder injuries. But a new program, aimed at injury prevention, could help these young athletes reduce their chances of injury.
At a recent Specialty Day conference, the American Orthopaedic Society for Sports Medicine (AOSSM) revealed the results of a research study designed to analyze the effects of a well-monitored preseason training program for young pitchers. The study involved 143 pitchers, whose median age was 15.7 years. The program was supervised by an athletic trainer and included resistance training with dumbbell weights and elastic tubing, as well as a focused flexibility program. The time commitment from the youth pitchers was approximately 15 minutes, four times per week.
Numerous arm flexibility and strength improvements were noted in the athletes who participated in the program, versus those without the special training. Of particular note was the fact that young pitchers in the special program, who had had a previous injury, were four times less likely to suffer an injury than those in the general arm care program.
The AOSSM is a world leader in sports medicine, education and research. They work closely with sports medicine specialists, orthopedic physicians and rehabilitation professionals to promote the STOP Sports Injuries campaign, to prevent overuse and traumatic injuries to youth athletes.
If your young athlete is having pain, stiffness or weakness in his or her hand, arm, elbow or shoulder, contact Dr. Rehman today at 586-532-0803. Awareness, early intervention and a comprehensive evaluation and treatment plan will get your child back with their teammates, with no risk of long-term damage.
And isn’t safety the most important part of today’s youth sports programs?
When the bony bump on the outer side of the elbow is painful and tender, this typically indicates the condition of Tennis Elbow, or Lateral Epicondylitis. The elbow joint is comprised of the bone in the upper arm (the humerus) and one of the bones in the lower arm (the ulna), joined together by forearm muscles and tendons. The bony bumps at the bottom of the humerus are called epicondyles. The bump on the outer side of the elbow is called the lateral epicondyle. Men and women tend to be affected equally by this condition, often between the ages of 35 and 65. Some studies indicate that up to 50 % of tennis players may suffer from this problem at some point in their career.
What are the symptoms?
Pain or tenderness slowly increasing on the outer side of the elbow
Pain when straightening or raising your wrist and hand
Pain when lifting a heavy object
Pain when you make a fist, shake hands or squeeze an object
Pain may radiate from the elbow down into the forearm or up into the upper arm
What causes it?
This condition is typically the result of overusing the muscles in your forearm that straighten and raise your hand and wrist. Activities that require repetitious motion, especially while gripping something, can create this condition. Tennis players and golfers are at risk, as well as bowlers, gardeners and landscapers, home or office cleaners, and mechanics and assembly-line workers. Through overuse, the tendons are repeatedly tugged at the point of attachment, which is the lateral epicondyle. This tugging and overuse causes the tendons to become inflamed. Tiny tears occur in the tissue, resulting in pain and tenderness. Sometimes, due to the overuse, the tears never heal.
How is it diagnosed?
A doctor who specializes in the hands, wrists and shoulders is the best person to diagnose this condition. He or she will inquire about your daily activities and recreational sports. A physical exam will be conducted to determine where the pain is originating from. X-rays of the elbow may also be ordered. As with many health conditions, early detection, awareness and a comprehensive plan usually results in the most favorable outcome. If you are experiencing hand, wrist, elbow or shoulder pain, contact Doctor Rehman today for a full evaluation and comprehensive treatment plan to get you back in the swing!
(586) 532-0803
The “bursa” are small, fluid-filled sacs that act as cushions between the various moving parts of the body, in particular the joints. “Bursitis” is a condition where these sacs become inflamed, either from an injury, or over-use, or in some cases, an infection.
Areas of the body that are commonly afflicted are the knees and the elbow. Sitting with your elbows on a hard surface for long periods of time, or kneeling for extended periods can cause an inflammation of the bursa. Likewise, doing repetitive movements that involve these joints over a period of time can result in the inflammation of the bursa.
Pain and swelling are the most common indicators of bursitis. An experienced orthopedic doctor will do a thorough evaluation including a physical exam, and may use X-rays or an MRI to understand the root cause of the problem. It is important to rule out the possibility of infection in the bursa, as swelling from an injury or swelling due to an infection (called “septic bursitis”) require different treatment approaches.
If the swelling is caused by an injury or over-use, the treatment may include rest of the affected area, pain medications and ice. If no improvement is noted, an injection into the area around the bursa may improve recovery. If, after 6 to 12 months the problem persists, surgery may be required to alleviate the pressure on the bursa.
If the doctor determines the bursitis is caused by an infection, some of the same steps may be taken, with antibiotics added to insure the reduction of the infection.
If you are experiencing pain in the elbow or the knee joints, seek the help of a Board Certified Orthopedic doctor such as Dr. Rehman for a complete evaluation of your condition. She and her team of therapists have extensive experience in rehabilitating conditions such as bursitis, so you can return to the full and active lifestyle you love.
The tendons in the body are the flexible bands of fibrous tissue that connect the muscles of our body to our bones. Normally the tendons glide smoothly when muscles stretch or contract. But inflammation in the tendons can cause the gliding motion to be impaired, causing pain and discomfort. At Macomb Hand Surgery we specialize in treating the hands and fingers, wrist, elbow and shoulder with a variety of methods. If you are experiencing pain, numbness, weakness, stiffness or tingling in these areas, you may have tendonitis.
Sometimes tendonitis can be caused by overuse of a muscle or limb; golfers or tennis players may experience tendonitis. Warming up the limb before use, stretching the muscles, and taking frequent breaks from the repetitive activity can rest the muscle and reduce the likelihood of tendonitis. Many tendon and nerve issues can be prevented by regular breaks and exercises to strengthen the muscle. Practicing the correct form while performing the activity can also prevent the injury and damage that leads to tendonitis. Maintaining a healthy weight and a regular exercise program is also helpful, as good blood supply to the tendons helps them to stay lubricated and reduces the chance of injury.
A variety of approaches will be used at Midwest Hand Therapy to treat your tendonitis. First, a thorough evaluation by Dr. Rehman, a Board Certified Orthopedic surgeon, will be performed. The treatment team may then implement solutions such as rest or immobilization of the affected area, the application of cold packs, anti-inflammatory medication, corticosteroid injections, hand, wrist or arm exercises and/or occupational therapy.
Most nerve and tendon damage can be treated successfully if intervention is undertaken early. If you are experiencing pain, stiffness or numbness in your upper extremities, contact Dr. Rehman today.
Now that the fine weather is here, we are ready to get out and play! But activity sometimes brings injuries. The condition labeled “Tennis Elbow” can be caused by overuse of the arm and wrist, but it is not strictly caused by playing tennis. Many other activities that repeatedly stress the wrist, hand and arm can cause a burning pain to radiate from the outside of the elbow into the forearm or wrist. You might have trouble shaking hands or lifting a gallon of milk. Sometimes even lifting a coffee cup can hurt!
Occupations often at risk for this overuse and muscle strain injury are carpenters, plumbers, butchers, painters and cooks. Repetitive strain on the muscles of the forearm can cause tiny tears and subsequent inflammation to occur in the tendons that attach the muscles to the bones on the outside of the elbow. Vigorous games of tennis, and especially hitting backhanded with incorrect form, can have the same result. And it’s no surprise that tennis elbow and its associated pain and tenderness is more likely to occur as we age.
Typical remedies such as icing the area, resting the affected arm, and taking anti-inflammatory medications may help the condition. If, however, the pain persists or does not seem to be lessening, if weakness or numbness are still present, an orthopedic consultation may be needed.
An orthopedic surgeon such as Dr. Rehman will conduct a thorough evaluation of your condition, reviewing how and when the condition developed, and any other factors that may be influencing it such as other health conditions, medication you take, sports and work activities. Physical therapy may be prescribed, with exercises that can be done at home included as follow-up. Using a specialized brace over the back of the forearm may help to lessen the pain and promote healing by relaxing the muscles and tendons. Sometimes steroidal injections, such as cortisone, may be administered to help lessen the pain. In very serious cases, surgery to remove the damaged tissue may be required.
In all such cases, be sure to contact a Board Certified doctor such as Dr. Rehman, before the symptoms and pain become a chronic condition. Her entire team of therapists and staff are dedicated to your health and healing.
Although not technically a pain-relieving medication, injectable corticosteroids, commonly called ‘Cortisone”, have been used since the 1950’s to reduce pain following a muscle or tendon injury. Cortisone is naturally produced in the body by the adrenal gland and is released when the body is under stress. Injectable cortisone is synthetically produced and is similar to the body’s own product. By reducing the body’s reaction to the inflammation associated with the injury, the pain is reduced.
The medicine is injected directly into the inflamed area, such as the wrist or elbow, with a high concentration of cortisone administered with minimal side effects. Discomfort usually improves within a few days and can last for several weeks or permanently. However, cortisone injections must be coupled with appropriate rest and rehabilitation to produce the best results. Cortisone injections are contraindicated for athletes immediately before an event, as they may increase the risk of infection or contribute to additional injury.
Repeated injections can have deleterious side effects, with a softening of the cartilage and weakening of the tendons at the injection site, however this usually occurs only in patients who receive shots on a weekly or monthly basis over a period of months or even years. Diabetic patients must have their blood sugar monitored closely for 24 to 48 hours after an injection, since the absorption of cortisone into the blood stream can cause a significant elevation in blood sugar.
Most individuals tolerate the procedure well, and find significant relief from the pain of a muscle or ligament injury. Always seek a Board Certified orthopedic doctor such as Dr. Rehman for any type of hand or arm injury. And don’t wait to seek treatment! A hand or arm injury that is causing pain should be evaluated early on, when the chance for minimally invasive treatment leading to a full recovery is at its highest.
There are many types of corticosteroid injections, but in general, a corticosteroid injection is a formulation of two or more medications to reduce inflammation, relieve pain and improve function and mobility.
Corticosteroids are derived from cortisone, a steroid hormone released by the adrenal gland in response to stress. When combined with other pain-killing and anti-inflammatory medications in a corticosteroid injection, they work more effectively and efficiently to treat discomfort. Depending on the condition that is being treated, injections can providepain relief for several weeks up to several months.
At Midwest Hand Therapy, we sometimes administer corticosteroid injections as part of a comprehensive approach to hand and wrist rehabilitation. Depending upon the condition and the particular patient, a corticosteroid injection may accompany hand exercises, hot and cold modalities, and massage.
Many patients that have never had one of these injections express concern regarding the amount of pain they will experience. These injections are very similar to any other type of injection; the initial needle stick is similar to the pain caused by a quick bee sting. There is temporary discomfort while the medication is being injected, but nearly all corticosteroid injection patients agree that a short moment of discomfort is much better than ongoing pain of the wrist or hand!
Corticosteroid injections should only be administered by a licensed physician, and to ensure the best results, patients should visit a doctor that specializes in the specific area being treated. For example: a hand specialist for the hand, fingers, wrist or forearm, and a podiatrist for the foot, ankle or lower extremities.
For more information on corticosteroid injections, or if you are experiencing hand, wrist or finger pain, please contact us at Midwest Hand Therapy.
Arthritis is the inflammation of one of more joints. This inflammation occurs because of a cartilage breakdown. Healthy cartilage allows our joints to move smoothly and absorb shock when pressure is placed on the joints. When cartilage breaks down, the area where two bones meet is no longer protected – this results in pain, inflammation and stiffness. Ouch!
But why does this breakdown of cartilage occur?
Contrary to common misunderstanding, arthritis is not associated solely with aging. It is, in fact, associated with general wear and tear on joints, but can also be caused by infection, an autoimmune disease, or even a broken bone. There are over 100 different types of arthritis, with osteoarthritis being the most common.
Common symptoms of arthritis include:
Pain around the joints (this pain may be in the fingers, wrists, knees, ankles, heels, neck, shoulders, back, or hips)
Swelling around the joints
Warmth around the joints
Redness around the joints
Reduced movement of the joints
Stiffness (may be worse in the morning than the afternoon)
While the underlying causes of various types of arthritis often cannot be “cured,” professional treatment helps to reduce joint pain and improve function. Treatment can also help to prevent the condition from worsening.
Arthritis as well as many other types of joint conditions can best be treated when diagnosed early, which is why it is so important to receive a professional diagnosis. If you are suffering from any of the above-mentioned symptoms, contact Dr. Rehman at Midwest Hand Therapy for a comprehensive evaluation and consultation.
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