Newsletter by NRG Athletes Therapy Fitness Inc.
NEWSLETTER
CAN PHYSIOTHERAPY BE BENEFICIAL FOR CARPAL TUNNEL SYNDROME?
Carpal Tunnel Syndrome (CTS) is a common condition that results in significant time loss at work, and has been reported to account for up to 50% of repetitive work related conditions 1. Prevalence rates have also been reported to range in the area of 6-12 percent of the general population 2 . CTS is an injury to the median nerve at the wrist Although much of the recent evidence has not shown substantial benefits of Physiotherapy for CTS, I feel muchofthatcanbeattributed to poor treatment programs that focus too specifically at the wrist without taking into consideration the whole path of the nerve. I came across an interesting study that examined the effects of Manual Therapy Vs Surgery
INSIDE: Shoulder,Elbow&WristPain PatientSuccessStory
HealthyRecipe StaffSpotlight
on Self-Reported Function, Neck Range of Motion, and Pinch Grip Force in CTS. It was found in the study that when manual treatment was essentially directed along the entire path of the nerve from neck to wrist, those in the manual therapy group experienced superior improvements in self-reported function and pinch grip force compared to surgery at one month, with no differences between the surgery and physiotherapy outcomes at 3,6 and 12 months 6 . So what insights may this study provide? My take away was that although CTS is considered as compressive neuropathy at the wrist, much of the time many areas along the path of the nerve such as the neck and chest may also be contributing to the problem, and when we direct treatment to account to this, we achieve better outcomes. Bibliography 1.Szabo,RobertM."Carpal tunnel syndrome as a repetitivemotiondisorder."Clinicalorthopaedics and related research351 (1998):78-89. 2.Thiese,MatthewS., FredGerr,KurtT.Hegmann,CarisaHarris-Adamson,AnnMarieDale,BradleyEvanoff,EllenA.Eisen et al. "Effects of varying case definition on carpal tunnel syndrome prevalence estimates in a pooled cohort." Archivesofphysicalmedicineand rehabilitation95,no.12 (2014):2320-2326. 3. Marshall, Shawn C., Gaetan Tardif, and Nigel L. Ashworth. "Local corticosteroid injection for carpal tunnel syndrome."TheCochraneLibrary (2007). 4. Page, Matthew J., Nicola Massy‐Westropp, Denise O'Connor, and Veronica Pitt. "Splinting for carpal tunnel syndrome."TheCochraneLibrary (2012). 5. Page, Matthew J., Denise O'Connor, Veronica Pitt, and Nicola Massy‐Westropp. "Exercise and mobilisation interventions forcarpal tunnel syndrome."TheCochraneLibrary (2012). 6.Fernandez-De-Las-Penas,Cesar,JoshuaCleland,MaríaPalacios-Ceña,StellaFuensalida-Novo, Juan A. Pareja, and Cristina Alonso-Blanco. "The Effectiveness of Manual Therapy Versus Surgery on Self-reported Function,CervicalRangeofMotion,andPinchGripForce inCarpalTunnel An insurancedeductible is theamountofmoney thatyoumustpaybefore your insurancecompanypays foryourmedicalservices. Ifyourdeductible ismet,yourphysiotherapymaynotcostyouanything.Patientswith family plans or those who have had major surgeries or have a chronic illness are especially likely to have a $0 balance remaining on their out-of-pocket expenses.This means that the cost of physiotherapy could be minimal or completely covered by the patient’s insurance plan. If you are close to or have met your insurance deductible for the year, then now isthetimetocome inforphysiotherapy!Areyoufeelingaches&pains? Needtoworkonyourcore?Letushelpyougetaheadstartfor2018.Contact us today to schedule your appointment.
crease which generally causes decreased grip strength, pain, numbness or tingling into the thumb and first two digits.Up until recently there has been very little evidence to support the efficacy of Physiotherapy when it comes to conservative management of CTS, which commonly involves splinting, steroid injections, and wrist mobilization 3,4,5.
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“Complete Simple Errands This Season!” SHOULDER, ELBOW & WRIST PAIN
You try to get through the day, but that nagging pain in your shoulder, elbow or wrist just keeps your attention focused on it. It sure is hard to concentrate on work, your family and other activities you need to do! It is common to fixate on the body part that hurts. It is often thought that because it hurts there, the problem is right there. However, this is typically not the case, as the cause of the problem is in another area. The body part that is painful is usually the one that is doing all the work, because other areas are not doing their job. Why it hurts The body is truly amazing and all the parts work together as one whole. However, when an area of your body becomes weak or stiff because of poor posture, stress or injury, other areas strain from the overwork. A common word that is used for this type of repetitive injury strain is called “tendonitis”. This is simply an inflammation of the tendons, which attach muscles to bones. The upper extremity works in 3 parts, the shoulder, elbow and wrist.They rely on each other to make the incredible movements of your arm so you can reach, grasp and do ordinary daily tasks we take for granted. Proper movement relies on your posture to be in good order. When you slouch or sometimes do a repetitive task, like reaching across your desk, certain muscles can become too tight or strong while others become weak. This muscle imbalance leads to that area not working as well as it should. For example, you sit at a desk all day and you slouch your shoulders. Now, your shoulder doesn’t work as well, but you still move your mouse around with your arm, which causes your wrist and forearm muscles to overwork. As this happens over time, you start to notice aches and pains in your wrist and elbow. If this goes on too long, it becomes sevire and you need to seek out medical help.
Solving the problem Typically a brace may be put on the area, but that does not solve the cause of the problem.The real reason can be because your shoulder was stiff and weak from slouching. An expert physical therapist has the right medical training to spot where your posture is not optimum and how you are compensating. With the right evaluation and treatment from the experts at NRG Athletes Therapy Fitness Inc., you can relieve your shoulder, elbow or wrist pain quickly and be back to doing what you like to do. Our home programs make it easy for you to maintain your gains and stay well for the long haul. Call us today to learn more how we can relieve your pain and get you back to enjoying your activities.
Healthy Recipe: Chocolate Hazelnut Biscotti
INGREDIENTS • 1 1/3 cups all-purpose flour • 1/2 teaspoon baking powder • 1/2 teaspoon baking soda • 1/4 teaspoon kosher salt • 1/2 cup butter, sofftened
• 1/2 cup chocolate hazelnut spread • 1/2 cup sugar • 1/2 cup brown sugar • 1 egg • 1 teaspoon vanilla extract • 3/4 cup chopped toasted hazelnuts
DIRECTIONS Preheat the oven to 375 degrees F. In a medium bowl combine the flour, baking powder, baking soda, and salt. Set aside. In another medium bowl combine the butter, chocolate hazelnut spread, sugar, and brown sugar. Using an electric mixer, cream the ingredients together,about4minutes.Add theeggandvanillaand beat until smooth, about 1 minute. Using a wooden
spoon or rubber spatula, stir in the flour mixture until just combined. Add the hazelnuts and stir until just combined.Usinga tablespoonmeasure,spoonout the cookiedoughontoacookiesheet,spacing themounds about 4 inches apart. Use the tines of a fork to flatten thecookiedough.Bakeuntil lightlygoldenaround the edges, about 10 to 12 minutes. Use a metal spatula to transfer the cookies to a wire rack and let cool.
STAFF SPOTLIGHT
TYLER TAN, RA
Tyler is one of our newer staff members here at NRG Athletes. He is a certified Rehabilitation Assistant from theManitoba Institute ofTrades and Technology. Tyler just doesn’t help in the clinic, he is the night time receptionist, and works in the gym training clients. He believes that health and fitness correlates to an overall improvement in a person’s quality of life. Tyler, also has an interest in going to the gym, jogging and participates in outdoor activities.
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Patient Success Story
“My daughter loves NRG and working with Nathan! She is a softball player and asks every day when her next session is. Nathan has developed a strength and conditioning program for her, and we cant wait till the spring to see all her hard work pay off! Thanks Scott for everything!” - Ed K We can’t wait til the spring to see all her hardwork pay off!
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