Overuse and Repetitive Strain Injuries

Repeatedly performing certain motions can produce pain and dysfunction over time

Most injuries will fall into one of two categories: acute and overuse. Acute injuries usually result from a single, traumatic event, such as a fall, slip, or collision with another athlete or object. Some common examples of acute injuries include wrist fractures, ankle sprains, shoulder dislocations, and hamstring strains.

Overuse injuries, on the other hand, occur gradually over time rather than on the spot. They are more common than acute injuries but are also more subtle, which makes them more challenging to diagnose and treat. Overuse injuries may result from training too hard and pushing your body past its limits, or simply by moving incorrectly or with bad posture on a repeated basis. Another term used is repetitive strain injuries, which shows how repeating the same movements can result in small trauma—or microtrauma—to tendons, bones and joints. Eventually, the damage gets so bad that symptoms begin to arise, in which cases treatment is usually needed.

Here at our practice, we treat a variety of sprains & strains. Below, we offer a brief overview of the mechanisms responsible for 5 common overuse injuries:

Shoulder Impingement – Consider Physical Therapy for Shoulder Impingement Syndrome in Visalia
Shoulder impingement syndrome (SIS) is a condition that involves the rotator cuff, a group of muscles and tendons that keeps the shoulder stable. In SIS, rotator cuff tendons become compressed—or “impinged”—as they pass through a small bone on top off the shoulder blade called the acromion. Over time, this causes the tendons to become irritated and inflamed, and will lead to bothersome symptoms like swelling and tenderness, loss of strength, restricted movement and pain that occurs at rest, when moving the shoulder overhead and/or when sleeping.

SIS is most common in individuals that regularly perform lots of overhead activities like golfers, swimmers, and baseball and tennis players, as well as painters and construction workers. The condition can also result from an injury that compresses the structures of the shoulder—like a fall—or from frequently sleeping on your side. Sleeping in this position regularly can strain the shoulder and cause impingement over time.

Plantar Fasciitis – We Provide Effective Physical Therapy for Plantar Fasciitis in Visalia
The plantar fascia is a thick, connective band of tissue that runs across the bottom of the foot and connects the heel to the toes. It’s a tough structure designed to absorb the regular stresses that are placed on the foot, but can become damaged when these forces are excessive. When this occurs, the resulting condition is plantar fasciitis.

Plantar fasciitis is a stubborn overuse injury and the most common cause of heel pain.
It occurs most frequently in runners—especially long-distance runners—due to the repetitive strain they place on their feet. People who have flat feet or high arches, are overweight or regularly perform any other weight-bearing activity are also at increased risk. The most common symptom of plantar fasciitis is a stabbing pain near the heel that’s most noticeable upon waking up and after standing for long periods.

Carpal Tunnel Syndrome – Relief for Those Searching for Physical Therapy for Carpal Tunnel Syndrome in Visalia 
The carpal tunnel is a space at the base of the palm that contains several tendons and the median nerve, which provides sensation to the fingers. If these tendons thicken or any other swelling occurs in the area, this tunnel narrows, which puts pressure on the median nerve and leads to a condition called carpal tunnel syndrome.

Carpal tunnel syndrome is extremely common, as it affects about 5% of the population.
The greatest risk factor is any task that requires repetitive hand motion, awkward hand positions, strong gripping, mechanical stress on the palms, or vibration. As a result, individuals who work on an assembly line—like manufacturing and meatpacking industries—are at the highest risk. The risk if also high in office workers. Symptoms usually start with a burning or tingling sensation, but eventually pain, weakness and/or numbness develop in the hand and wrist, and then radiate up the arm.

Golfers Elbow – Choose Physical Therapy for Golfer’s Elbow in Visalia
Golfer’s elbow is a condition that results from the repeated bending of the wrist that is necessary in a golf swing. This damages the muscles and tendons of the medial epicondyle—a piece of bone on the inside of the elbow that allows the forearm, wrist and hand to bend and move in several different ways—and eventually leads to inflammation. It is especially common in golfers because gripping or swinging clubs incorrectly or with too much force can take a toll on the structures within the elbow over time.

Common symptoms include pain, tenderness, swelling, weakened grip strength and a burning sensation on either the inside or outside of the elbow. These symptoms often develop gradually and are worsened by activities that involve the forearm, and if left unchecked, can go on to make many basic activities that require gripping or grasping a major challenge.

Lower Back Pain – Natural Physical Therapy for Back Muscle Strain in Visalia
Back pain is the most common musculoskeletal injury, and a significant number of cases are due to a strain of one or more back muscles. This condition—also known as a pulled muscle—is the result of muscle fibers tearing from being overstretched or overused, which can occur from repeatedly bending your back or using improper posture.

The most common symptom is pain in the lower back that is often most intense during the first few hours of the day. Pain also tends to get exacerbated with certain movements or positions that strain the muscles of the spine, like standing for long periods of time. Tenderness and stiffness of the spine is also likely.

Physical therapy for all types of overuse injuries
In addition to being the product of overuse or repetitive strain, another feature that all of these conditions share in common is responding to physical therapy. Our physical therapists can help by identifying the behaviors or habits that are responsible for your pain, and then recommending adjustments to your movements along with a personalized treatment program to help you move with less pain.

Contact Us for More Information About How We can Help

Wrist Fracture Exercises After the Bones Have Healed

After a fracture has healed, wrist fracture exercises are an important part of the overall recovery process. We’ve seen some patients lose function because they didn’t receive any physical therapy after their Smith or Colles fracture.  Don’t let this happen to you or a loved one.

Here’s more information on wrist fractures:

The wrist is made up of 15 different bones, each of which can get injured if the joint sustains a force that’s significant enough. But some of these bones are more likely to become injured than others, and the term “broken wrist” usually refers to a fracture of the distal part of the radius. These injuries can be serious and possibly even require surgery, but regardless of the treatments used, a course of physical therapy will be essential to ensure a complete recovery.

The radius is located on the thumb side of the wrist and is the larger of the two bones that make up the forearm. Along with the ulna, these bones permit movements of the elbow, hand, and wrist, and the distal radius takes on a great deal of the load that is sent to the wrist. This is one of the main reasons the distal radius are one of the most common injuries in the body. Of all fractures seen in the emergency room, about one-sixth are distal radius fractures.  If you’d like to read more about these fracture types in our medical library, click here.

The vast majority of distal radius fractures occur after someone falls and lands with their hands outstretched, which is often called a “fall on an outstretched hand,” or FOOSH injury. Falls in sports like soccer and basketball, as well as biking, skateboarding or rollerblading accidents can all lead to a distal radius fracture if the person lands with enough force. These injuries are usually categorized depending on how the person lands on the wrist, as either a Colles’ fracture or a Smith’s fracture:

  • Colles’ fracture: these injuries are caused by a fall onto the palm of the hand, which places the wrist in an extended position; the result is a fracture of the distal radius and possibly the ulna
  • Smith’s fracture: also known as the reverse Colles’ fracture, these injuries occur from falls onto the back of the hand with the wrist in a flexed position

After a Colles’ or Smith’s fracture, the initial treatment for most patients is a reduction, in which the broken bone(s) are situated back into the correct position so that healing can occur. A doctor usually performs the reduction manually, but surgery may be needed if a bone is displaced too far out of position. Reduction is typically followed by a period of immobilization in a cast or brace that must be worn for 4-6 weeks. Regardless of whether or not surgery is performed, a course physical therapy is crucial both during and after the immobilization period to ensure a proper recovery.

Expert Suggestions About Wrist Fracture Exercises After the Break has Healed

While the wrist is still in a cast, a physical therapist can prescribe some gentle exercises the keep the shoulder, elbow, and fingers moving so that these joints don’t lose their flexibility. After the cast is removed, the wrist usually feels stiff and the arm feels weak, so your physical therapist will prescribe some post-injury wrist fracture exercises to address these issues and restore the function of your wrist. This usually includes manual (hands-on) therapy, ice and heat therapy, stretching and stretching exercises, and sport-specific exercises when applicable.

The effectiveness of physical therapy for treating patients with wrist fractures can be seen in the findings of a study published in 2017. Patients who experienced a distal radius fracture were randomly assigned to undergo either a home-exercise program or a supervised physical therapy program, and the results were as follows:

A supervised physical therapy program is effective in the short and medium term, showing a clinically and statistically significant increase in function. This treatment also reduces pain and improves wrist range of motion ROM compared with a home-exercise program.

Colles’ and Smith’s fractures are common injuries that should not be taken lightly, as failing to properly rehabilitate them can lead to long-term issues. This is why all patients should see a physical therapist and complete a comprehensive treatment program to guide them back to full strength.

Carpal Tunnel Syndrome Treatment in Visalia

A course of physical therapy can bring about relief carpal tunnel syndrome

From turning door knobs and driving cars, to picking up children and pointing out stars, we all use our wrists on a nearly constant basis. Sometimes this can lead to tingling and numbness. If you are looking for carpal tunnel syndrome treatment in Visalia, keep reading and we will share with you why seeing one of our physical therapists is a great choice.

The wrist is the converging point where the hand meets the forearm, and it consists of 15 unique bones. Often thought of as a single joint, the wrist is actually made up of three primary joints and several other smaller joints where each of these bones connects with one another. Muscles, ligaments, and tendons further reinforce these connections, and communication is accomplished through a series of nerves. But with such a complex arrangement, there are also many things that can go wrong with the wrist and lead to pain.

The 15 bones that make up the wrist are as follows:

  • 5 long bones in the hand (metacarpals) that connect the fingers to the wrist
  • 8 small bones in the center of the wrist, which are arranged in two rows of four
  • The ends of the 2 bones of the forearm (radius and ulna), which make up the largest joints of the wrist

These bones are connected by numerous ligaments and surrounded by cartilage, which allows for movements and cushion the bones from rubbing against each other. Any of the structures of the wrist can be damaged by extreme movements—like twisting, bending, or a direct impact—that force it beyond its normal range of motion. The result of this damage may be a sprain, strain, fracture, or dislocation, all of which are most commonly seen in sports and other physical activities.

If You Have More than Pain (i.e. tingling and numbness), It Could be Carpal Tunnel Syndrome

Another frequently seen wrist condition is called carpal tunnel syndrome (CTS). The carpal tunnel is a space at the base of the palm that contains a number of tendons and the median nerve, which provides sensation to most fingers. If these tendons thicken or any other swelling occurs, this tunnel narrows, which puts pressure on the median nerve and causes CTS. The greatest risk factors for CTS are repetitive hand motions, awkward hand positions, mechanical stress on the palms, and vibration, and symptoms usually start with a burning or tingling sensation, but eventually pain, weakness and/or numbness develop in the hand and wrist, and then radiate up the arm.

Other common wrist-related issues include rheumatoid arthritis and osteoarthritis, tendinitis (inflammation of one or more tendons), De Quervain’s tenosynovitis (tendinitis on the thumb side of the wrist), Dupuytren’s contracture (abnormal thickening of tissue between skin and tendons in the palm), and ulnar tunnel syndrome (similar to CTS). All of these conditions have their own unique characteristics and arise for different reasons, but they do share one thing in common: each can be effectively treated with physical therapy.

Despite What You May Have Been Told, Surgery is NOT Your Only Treatment Option

Physical therapists are movement experts that can work with patients to identify the source of their symptoms, and from there, will design a treatment program that’s customized to each patient and based on their personal abilities and goals. This one-on-one approach to treatment has been proven to work because it identifies the patient’s impairments and targets them with a unique set of active interventions meant to reduce their symptoms. The findings of a recent study highlight the effectiveness of a physical therapy intervention for CTS called manual therapy based on neurodynamic techniques. The conclusion reads:

The use of neurodynamic techniques in conservative treatment of mild to moderate forms of CTS has significant therapeutic benefits in the short term

So if you’re dealing with symptoms that might suggest CTS or any other wrist-related problems that are getting in the way of your daily life, physical therapy may be the very solution you’re seeking.

Contact us for more information at (559) 733-2478

Rehabilitation After A Broken Wrist in Visalia

A wrist fracture can really slow you down.  If you are looking for rehabilitation after a broken wrist in Visalia, Bacci & Glinn PT can help.  Our physical therapy treatment can play is very important in assisting patients with a full recovery after a wrist fracture.

The wrist is a complex joint in which 15 different bones meet, each one with its own specific function. The radius is one of the bones in the forearm that connects the elbow to the wrist, and fractures of this bone are extremely common. When the term “broken wrist” is used, it usually refers to fractures of the distal part of the radius, which is where it meets the wrist. The treatment a wrist fracture depends on how serious it is, but regardless of what is recommended, physical therapy can—and should—be involved.

Wrist fractures account for approximately 1/6 of all broken bones, and they occur in about 15% of women over the age of 50. The vast majority of these injuries result when someone falls and lands with their hands outstretched, which is often called a “fall on an outstretched hand,” or FOOSH. Athletes who participate in fast-paced sports like soccer and basketball are at an increased risk for wrist fractures, but so are older adults who may suffer an accidental slip or fall.

Every year about 1 of every 3 adults over age 65 experiences a fall, and many of these accidents lead to a fracture of the wrist or some other bone. Unfortunately, research has also shown that older adults who suffer a single wrist fracture are more likely to have difficulties with their balance, which places them at an increased risk for additional injuries in the future. On the flip side, poor balance has been identified as the number one factor that leads to the majority of wrist fractures. So it appears that poor balance, wrist fractures and falls are all closely related: poor balance increases the risk for falling and fracturing the wrist, and wrist fractures in turn impair balance as a result.

This highlights the need for an intervention that addresses all of these factors, and physical therapy may very well be the best solution available. A course of physical therapy can be used to conservatively (non-surgically) treat wrist fractures that are not too severe, and it is also strongly recommended for rehabilitating the fractures that do require surgery. In addition, physical therapists can create balance-training programs for older adults who may be at risk for falling, thereby improving their balance and reducing their risk for a fall—and a wrist fracture—in the process.

One recent study investigated the effectiveness of physical therapy in treating a group of 74 patients with distal radius fractures by comparing a supervised physical therapy program with a home-based exercise program. Six months afterwards, they reached the following conclusion:

A supervised physical therapy program is more effective for improving function in the short- and medium-term when compared with a home-exercise program in patients older than 60 years with an extraarticular distal radius fracture without immediate complications

So if you’re concerned with your risk for falling, have recently experienced a wrist fracture, and need rehab after a broken wrist in Visalia, seeing one of our physical therapists may very well be your best bet for a successful recovery and to protect you from injury in the long term.

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