Hand, Wrist, and Elbow EBook - US

Naturally Relieve Your Elbow, Hand & Shoulder Pain

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Table of Contents

02 Why does my hand, wrist or elbow hurt? 04 Step 1: Improve your posture 06 Step 2: Enhance your flexibility 08 Step 3: Improve your joint stability 10 Step 4: Enhance your joint strength 12 Step 5: Protect your joints 14 Why therapy is the right choice

*medical disclaimer

Always consult your occupational therapist before beginning any exercise program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. Consult with your healthcare professional to design an appropriate exercise prescription. If you experience any pain or difficulty with these tips, stop and consult your healthcare provider.

Why doesmy hand, wrist or elbowhurt?

Pain isasymptomof theunderlyingmechanical problem. Thevastmajority of hand, wrist or elbow pain is caused by poor mechanical movement. This occurs from poor posture, alignment, flexibility, coordination, or weakness of muscles. Many people turn to over-the-counter medications, see their doctor for prescription medications, and even have expensive MRI’s, without achieving any long-lasting results. The reason for this is that most of the focus is on the symptom, instead of treating the root cause. As certified hand therapists, we get results, becausewe are themechanics of the upper extremities, treating the root mechanical problems of your hand, wrist or elbow pain. In this book, we are going to teach you what we do to alleviate joint pain, so you can improve the health of your joints, and return to the activities you enjoy. Hand, wrist or elbowpain is amechanical problem, therefore itmust be treated as such. Here are the main categories that most of these problems fall under: If you are careful about lifting, grasping, writing, or moving your arm because it hurts, then this book is for you!

• Poor posture • Lack of flexibility • Poor joint stability • Repetitive tasks causing microinjuries • Lack of muscle coordination • Injuries

Get to the root problem Hand, wrist or elbowpain canbe acuteor chronic. Acute refers toa sudden onset, like after an injury, whereas chronic is long-lasting. Whichever pain experience, your body is telling you that something is wrong and if you don’t fix it, there will be more serious consequences in the future. Many chronic problems, such as arthritis, can be dramatically helped with the right treatment. The sooner you address the problem, the lesser the risk for long-term damage to your joints. Many chronic problems stem from poor posture causing you to overuse certain joints. Even previous injuries, can result in long-term effects that lessen joint movement or muscle strength. This can impact other joints. For example, if you sprained your wrist, and never completely rehabilitated it, even though you may not have lingering wrist pain, the limited movement could cause your elbow joints to overwork. This in turn, would cause elbow pain, because the bones of the forearm are what make up your wrist and elbow joints. Therefore, the root cause of

the problem is really the limitedwrist motion, and if treated, would relieve the extra work demanded on the elbow joint. About therapy Our Occupational Therapists have degrees in medical science and speciality Certified Hand Therapists, licensed by the state. Many years of training go into an evaluation of your joints, muscles, coordination, movement, and balance. This allows us to pinpoint the exact mechanical problems of your hand, wrist, and elbow joints. Our therapists are experts in gentle hands on therapy, and specific exercises that target affected areas, rebuilding flexibility, strength and coordination.

Do you find yourself slouching frequently, especially at work? Do you have to performmany tasks with your hands and arms that are the same over and over? The way you sit, stand, and hold your arms has a lot to do with the strain on your joints. For example, if you sit slouched at a computer, this puts your shoulders, elbows, wrists and hands at very bad angles. With typing for hours a day, this repetitive task in mostly one direction causes muscle imbalance, tightness in joints, and inflammation. Reduce repetitive tasks Think howmany hundreds or thousands of times a day your finger, wrist, and elbow joints move. Imagine the typing, taping, gripping, lifting, and twisting actions all of these joints undertake. Many painful conditions such as tendinitis, carpal tunnel, and arthritis are a result of repetitive rountine daily tasks that cause too much wear and tear on your body. We all have work and daily activities to accomplish, but knowing how tomodify them to reduce the strain on your joints, is what our therapists can teach you. Step 1: Improve your posture

1.When standing or sitting, try tomaintain a tall posture. This brings your spine and center of gravity into a natural position that allows your shoulders and arms to move more freely. Imagine a string gently pulling you upwards through the top of your head. 2.Avoid sitting for longperiods. Get upand move around during the day at work or at home. Try to move out of a seated position at least every 30 minutes and stretch your hands. 3.Be aware of the position of your elbows when you are at a computer or using a device. Ideally you should have a 90 degree angle or less in your elbow bend.


5. Swing your arms when you walk. Surprisingly, many people limit their arm swing with casual walking. When walking for exercise, you can focus on increasing your natural arm swing. This increases the use of the trunk, shoulder, and armmuscles. It also helps improve circulation into your upper extremities.

Recovery after injury Therapy helps your hand, wrist, or elbow injury recovery. Whether it was a sprain, casting, or you needed surgery, an occupational therapist or CHT is vital in helping you regain full range of motion, and strength. After injury, your muscles weaken rapidly, and prolonged immobilzation leads to a stiffening of the connective tissues in the hand, wrist and forearm. With gentle hands-on techniques, your therapist helps to restore natural full movement of the joints. In addition, specific exercises are done to rehabilitate your muscles back to a supportive health. Therapy helps your hands Certified Hand Therapists are the experts in evaluating alignment and movement patterns of the hand, wrist, and elbow. Often the painful area is compensating for poor posture and alignment in other areas. By working on these other problem areas, better finger, hand and wrist movement can occur, distributing normal daily forces across all the joints, and not focused on a few. Carpal Tunnel Carpal tunnel is a very commoncondition that occurs in thewrist, affecting the median nerve, which can cause numbness, tingling, weakness, and pain to the thumb and first two fingers. Poor posture and repetivitive tasks are usually the main reasons carpal tunnel occurs. The carpal ligament crossing the wrist becomes tight, pressing on the nerve underneath it. Many people have excellent results with therapy first, especially if they are seen early in their symptoms.

Step 2: Enhance your flexibility We are creatures of movement. Our body systems rely on movement to function properly. Studies show that even for young people, 2 weeks of physical inactivity leads to 30% loss of muscle mass(2). In turn this also leads to loss of flexibility within the joints of the body. Your hand, wrist, and elbow joints work together to allow you to lift, grip, twist, and move freely. When one of these areas becomes tighter, it can double or triple the load on the other joints.

Did you know...

The majority of the muscles that make your hand and fingers move are located in your foream and many attach to the elbow area. Therefore, what happens at the elbow, affects the hand, and vice versa.

How to improve the flexibility of your joints It is never good to stretch into pain. Stretch your muscles and joints within a comfortable range and gradually ease into deeper stretches. Depending on your age, you should stretch more frequently. The older you get, the longer andmore frequent your stretching routine should be. This is because our tissues become less inelastic as we age.

Start with gentle stretches for the whole arm. Then focus on your specific elbow, wrist or hand area.

Yoga, Tai Chi and Pilates can be great ways to stretch. However, make sure you start at a basic level, listen to the instructors and stay within your limits. Weight-bearing on the arm can be helpful, but avoid painful pressure. Dynamic stretching is a very beneficial way to improve your flexibility and coordination of the joints. The goal is to stretch while going through a series of movements. This re-educates the body on the propermovement patterns to restore proper flexibility. Stay flexibilewith therapy One of the core principles of occupational therapy is restoring correct movement. Our therapists improve the mobility of your joints with advanced, but gentle hands on manual techniques. These gentle techniques specifically improve the flexibility and multiple ways your elbow, wrist, and hand joints spin, rotate and glide. This takesmany years of training and skill tobe able to correctly evaluate and treat. Occupational therapist andCertifiedHand Therapists also focus on teaching you how to prevent your problem fromreturning through specific exercises, designed to retain your flexibility.

Try these exercises to improve your joint flexibility Always consult your physical therapist or physician before starting exercises you are unsure of doing.


Exercises copyright of


Grasp the affected thumb below the last knuckle and gently stretch it into a more straightened position.

Self Hand Massage

Helps With Stiffness and Pain. Use opposite hand to massage across your palm.

Joint instability is a big problem for many people, especially after an injury or surgery. There are many complex joints in the fingers, hand and wrist that need flexbility of movement, while remaining stable. This requires a complicated ballet of precision balance and movement of the muscles in the forearm and hand. With injury, or overuse, the coordination of the muscles surrounding the joints can become unbalanced. This places an enormous amount of pressure on key spots in the joints, increasing inflammation and pain. A large area of instability in the wrist is found on the inside aspect of the joint. This is due to the angles of the hand and forearm bones that form the joints in this area. In some people, this angle is excessive causing a large amount of force to be placed on the delicate nerves, blood vessels, and other structures passing through the wrist. Joint instability can often occur after a sprain to the wrist, as the injury strains the ligaments holding the joint together. The hand, wrist, and elbow joints also depend on the strength and stability of the forearm flexor and extensor muscles. They maintain the correct alignment and stability of the wrist and hand. After injury to theseareas,musclesweakendramatically, and if not properly rehabilitated, may not fully recover their strength. This can cause long- term strain. Seeing a physical therapist after a sports, fall, or other type of injury is essential to long-term health of your joints. Step 3: Improve your joint stability

How to improve your joint stability • If you have pain in movement, you might consider a supportive brace, especially during periods of work, or even sleep to keep the joints aligned. Our therapists can guide you in the right brace and evenmake specialized braces for all kinds of upper extremity needs. • Performexercises that involvemultiple joints at one time. For example, instead of just performing exercises that flex and extend your elbow, do exercises that use your shoulders, elbow, wrist and hands at the same time. • Look at furniture and equipment such as keyboards, mice, chairs, and tools that are ergonomic, keeping proper alignment in your hand, wrist, and elbow while you perform daily tasks.

Try this exercise to improve your joint stability

Alwaysconsult yourphysical therapistorphysicianbeforestartingexercises you are unsure of doing.

Wrist Flexion Concentric

Wrist over edge, support forearm. Curl wrist toward ceiling.

Step 4: Enhance your strength There are approximately 640muscles in your body that help youmove on a daily basis. Your finger and wrist joints rely heavily on muscle support to make them function properly. Weakness in any one area produces a cascade of problems in other areas, even further up the arm.

Tennis and golfer’s elbow are overuse injuries that are often attributed to shoulder weakness.

When you sit for prolonged periods in the day, your muscles atrophy or become weak. In addition, with repetitive strain or injuries, certain muscles around the wrist and elbow can be injured. Injuries weaken all the muscles around the affected area, especially the smaller muscles that control the intricate movements of the wrist and finger joints.

By strengthening specific muscles, your body can restore control and in turn decrease the strain, resulting in long-term pain relief.

Hand Tendon Glides Differential Fist

Preparation: •

Start with open hand

• Keep your wrist straight throughout this exercise

Execution: • Curl finger tips towards hand. Keep your knuckle joints straight to make a ‘Hook’ • Move the knuckle joints and fingertips into a straight position, touching the tips of your fingers to your palm to make a ‘Table Top’

• Bend all finger joints into hand to make a fist

How to improve your strength Strengthcomes fromperformingtherightexerciseswiththerightamountof control. You are far better off doing small, specific strengthening exercises, than trying tomove large weights. It is safer and you will achieve a better result. A lot of strengthening actually involves restoring your brain’s ability to connect with the right muscle groups again. This develops the neural pathways and activates the right muscles at the right time. When you performexercises, suchas squats, do themslowly and focus your thoughts on tightening your gluteal and thighmuscles, controlling themovement. The pelvic and hip muscles are an important part of strengthening your whole lower extremities. Weak hip abductor muscles fail to take the load when walking, change your posture and knee mechanics, resulting in more strain on the knee, hip, and spine. Performing leg lifts out to the side and back help to strengthen the hip musculature. Perform coordinated strengthen exercises. For example, doing mini- squats while keeping your abdomen tight helps to engage the core, pelvic and leg muscles together. How physical therapy helps your joint strength Physical therapists have years of training in kinesiology, which is the study of human movement. Through proper evaluation of what muscles are weak in your legs, we canpinpoint the exact area that needs strengthening. We then teach you specific exercises that target these particular muscle groups. We help you naturally progress from very simple exercises to more complex coordinated exercises as your muscles heal and begin to work together. You are empowered with the knowledge of how to keep your body strong and healthy.

Our goal is to not only quickly relieve your pain, but tomake sure your hips and knees stay healthy for the long run. One of themost important features of healthy joints is the ability to balance and coordinate themuscles. This provides for long-term joint health and the capability to handle strenuous motions. Your lower extremity movement is complex with many muscles that have to move at the right time and right place. As we age and after injury our normal nerve feedback from the ankles and knees is especially affected. This will effect the way you walk, and result in abnormal strain to your joints. Step 5: Lasting results with balance

Most people are not aware of their difficulty with balance until they challenge it. For example, can you stand on one leg comfortablywithout swaying or having to compensate much with your arms? The good news is that, with the right exercisesandtreatment, coordination and balance can be vastly improved. This leads to the ability to be more active, reduce the risk of injury and prevent arthritic wear and tear.

How to improve your balance 1.Work on your whole balance. While holding onto a steady surface, try to balance on one leg at a time. Tighten your abdominal muscles while you do this and don’t let your hip / pelvis sink down.

2.Perform calf raises while holding onto a steady surface. Try this also with your eyes closed to provide extra feedback to your legs.

3.Walk! This simple action makes you use your muscles and nerves, improving your balance. Walk for 20-30 minutes each day and wear proper supportive footwear, such as a good pair of new sneakers.

4.Perform core exercises such as modified planks.

How physical therapy helps your balance A physical therapist can pinpoint your exact problem through the examination of your flexibility, strength and coordination. You are put through specific movement patterns that showwhere your balance ischallenged.Withthis knowledge, a comprehensive plan isdesignedtorestoreyour balance to a natural condition, so you can return to pain free walking and running.

Why Physical Therapy is The Right Choice

When you have to be careful about what you can or cannot do, because of your knee or hip hurting, it’s time to do something about it. Medication masks the pain and does not treat the underlying problem, which is mechanical. Surgery and injections are a last resort and should only be considered when all else has failed. For the vastmajority of knee andhippain, physical therapy is the perfect solution that naturally restores joint health.

With physical therapy, there is no cracking or popping, no injections, no pushing through pain. Physical therapy evaluates how your joints move and function. Our evaluation process easily pinpoints the root cause of your problem. Then, through an individualized plan of specific, gentle hands on techniques and therapeutic exercises, we restore your joint flexibility, strength, posture and coordination. Imagine, your soremuscles soothed, your joints moving freely, walking easily, and feeling strong. Imagine being able to easily bend down, stand or walk comfortably, without fear of your knee or hip hurting. All this can happen with trying physical therapy first.

You should always try physical therapy first with a certified physical therapist, before trying other aggressive medical procedures. Many studies point to the fact that trying physical therapy first, achieves much higher results and costs significantly less than other forms of treatment. In the rare instances that more invasive procedures are required, physical therapy is an important part of your recovery and helps you return to work, play and living a pain-free life. Call us today or schedule a free phone consult with one of our expert physical therapists. Discover simple actions that you can take, to relieve your pain quickly and naturally. Your joints will be glad that you did.

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