Aspen Rehab: Elbow, Wrist, and Hand Pain

Ebook About Your Health and Caring for Your Body by Aspen Rehab

HOW TO RELIEVE YOUR ELBOW, WRIST, & HAND PAIN

NATURALLY RELIEVE YOUR ELBOW, WRIST, & HAND PAIN

TABLE OF CONTENTS

Why does my elbow, wrist, or hand hurt?

Step 1: Reduce Pain and Swelling Step 2: Enhance your Mobility Step 3: Improve your Strength and joint stability Step 4: Restore your Function for Lasting Results 14 Why therapy is the right choice

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

Why Does My Elbow, Wrist, or Hand Hurt?

I f you have pain or difficulty lifting, grasping, writing, or even moving your arm, this book is for you! Pain is often a symptom of an underlying mechanical (joint or muscle) problem. This occurs from a fall or repetitive stress leading to joint dysfunction or impairments in muscle function. Most elbow, wrist, or hand pain is caused by some trauma or overuse condition. Rather than turning to over-the-counter medications, seeing the doctor for prescription medications, or unnecessary testing, find a physical therapist for long- lasting results. Instead of focusing on the symptom, a physical therapist will treat the root cause. Physical therapists are focused on getting results. We are the experts at treating musculoskeletal conditions of the upper extremities. In this book, we’ll guide you through the steps you need to take to alleviate joint and muscle pain so you can

improve the health and function of your elbow, wrist, and hand and return to the activities you enjoy. Elbow, wrist, or hand pain is typically a mechanical problem, meaning movements and activities affect the muscles and joints, leading to the issues you are dealing with daily. Here are the main categories that most of these problems fall under: • Injuries/traumas (i.e., falls and accidents) • Lack of mobility • Weakness and poor joint stability • Repetitive tasks cause micro -traumas and injuries

Finding the Root of Your Pain Problem

E lbow, wrist, or hand pain can be acute or chronic. Acute refers to a sudden onset, like after a fall or other type of injury. In contrast, chronic is long-lasting and typically related to an overuse type injury or degeneration/arthritis. No matter how your pain started, your body is telling you that something is wrong, and the sooner you get help, the sooner you get relief! One of the most common reasons for persistent pain is not fully resolving an old injury. For example, suppose you sprained your wrist and never completely rehabilitated it, even though you may not have lingering

wrist pain. In that case, the limited movement could cause compensations at your elbow joints. This, in turn, could cause elbow pain or impairments in the function of the forearm muscles used in both your wrist and elbow. Therefore, the problem’s root cause is the limited wrist motion, even though the symptoms are felt in the elbow. A skilled physical therapist will help you identify the source of your condition, and more importantly, give you the tools to resolve old and new injuries alike!

Why Choose Physical Therapy?

O ur physical therapists have completed extensive training and most have their Doctorates in physical therapy. This allows us to pinpoint the exact source of your elbow, wrist, or hand problems. Our therapists are experts in manual therapy techniques, specific exercises and the use of modalities, bracing, and taping techniques that target affected areas, rebuilding mobility, strength, and restoring function.

STEP 1: Reduce Pain and Swelling

Reduce Repetitive Tasks Many painful conditions such as tendinitis, carpal tunnel, and arthritis result from repetitive daily tasks that cause too much wear and tear on your body. Think how often your finger, wrist, and elbow joints move daily. Imagine the typing, taping, gripping, lifting, and twisting actions, all these joints undertake. We all have work and daily activities to accomplish, but knowing how to modify them to reduce the strain on your joints, is what our therapists can teach you. • When st anding or sitting, try to maintain a tall posture. Imagine a string gently pulling you upwards through the top of your head. This brings your spine and center of gravity into a natural position that allows your shoulders and arms to move more freely. • Avoid sitting for long periods. Get up and move around during the day at work or home. Try to move out of a seated position at least every 30 minutes and stretch your hands.

• Be aware of the position of your elbows when you are at a computer or using a device. Ideally, it would help if you had a 90-degree angle or less in your elbow bend. Are you living with persistent pain and swelling in your hands, wrists, or elbows? Do you notice stiffness and difficulty gripping things? If you struggle to get your hands working in the morning or have achy soreness at night, it’s time to get an assessment with a physical therapist.

Pain is one of the most common reasons people seek help from a medical practitioner. Pain is often accompanied by swelling but this is often overlooked even though it can be related to the cause of your pain. Sometimes, the swelling is noticeable, like after an acute injury, but the swelling due to chronic conditions is often more subtle and may not be as easy to see. The first step to finding relief is to start with pain relief techniques and swelling control. When people attempt to ignore and push through pain and swelling, the result is a delayed recovery or increased pain. Fortunately, physical therapists have strategies like manual therapy techniques and modalities like ultrasound and laser therapy to assist us in alleviating pain and reducing swelling. Prioritizing swelling control and pain management can help your ability to tolerate more activity and speed up the recovery process.

How to Reduce Pain and Swelling On Your Own

Swelling is a major reason people experience pain; too often, it is overlooked and/or ignored. Often people attribute swelling as a byproduct of pain, yet swelling is often the reason for pain, and swelling has also been shown to impair joint motion and strength. One of the most important steps you can take for relief is to address the swelling head-on. Often, especially after an acute injury, swelling is noticeable and too hard to overlook. Most people have been taught to use ice to reduce swelling. It is also common for people to use ice to alleviate pain, but the exact instructions are not always clear.

Ice is a vasoconstrictor, which means it slows blood flow. If you have an acute injury, using ice for the first 36-48 hours may help minimize the extent of your swelling. After 48 hours, there is no evidence that it helps with swelling. Using ice for pain relief is an excellent strategy. Ice is an analgesic, which means it helps reduce pain. Icing for about 20 minutes at a time is an excellent general guideline. Using real ice for extended periods can cause injury/damage to the skin, so be careful. For people with other health concerns, like heart conditions and pregnancy using ice for shorter periods is recommended.

Compression is a very effective means to reduce and prevent swelling. Using compression helps move blood through your system more efficiently. This helps to carry away the waste materials that build up during the healing process, ensuring a speedy recovery. Compression garments, including gloves or an ace bandage type dressing, are effective forms of compression.

Elbow Compression

Wrist & Hand Compression

Hand & Finger Compression

Elevation is another essential strategy for swelling control. Elevating above the heart is better than nothing, but it is not as effective as keeping it higher, like resting on the back part of a couch or using pillows to prop it up as high as you can comfortably tolerate it. The first step to a quick recovery is reducing pain and swelling. Remember, ignoring this vital first step will often lead to a longer, more painful road to recovery! A physical therapist can help you identify the most effective methods that will work best for you and your specific condition.

Physical Therapy Helps Your Hands Physical therapists are the experts in evaluating mobility and function of the elbow, wrist, and hand. Often the painful area compensates for dysfunction or weakness in other areas. Better finger, hand, and wrist movement can occur, distributing regular daily forces across all the joints. A physical therapist will get to the root of the problem and address any other problem areas to ensure you recover fully and restore the function of your hand, wrist, and elbow.

Recovery After Injury

Physical therapy will guide you through the most effective strategies to ensure your recovery after an injury or surgery. Whether it was a sprain/strain, restrictions after coming out of a cast, or limitations from using splints after surgery, a physical therapist is vital in helping you regain full range of motion and strength. After an injury, your muscles weaken rapidly, and prolonged immobilization leads to stiffening of the joints and soft tissues in the elbow, wrist, and hand. With targeted hands-on techniques and exercises, your therapist will help restore your joints' full mobility. In addition, specific exercises are done to rehabilitate your muscles back to pre-injury levels so you can resume your normal range of motion.

STEP 2: Enhance Your Mobility

We are Creatures of Movement

Our body's systems rely on movement to function properly. Rest or avoiding activity may delay your healing. Immobilization often leads to additional impairments that negatively affect your recovery and overall function. Your elbow, wrist, and hand 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. Limitations in joint mobility are associated with persistent pain, dysfunction, and an increased risk of re-injury. Identifying the specific cause of your pain and injury can be challenging to do on your own. Physical therapists are highly skilled at pinpointing the cause of your problems and, more importantly, how to resolve them. Once a therapist identifies the underlying causes of your pain/injury, we will develop a plan to restore your joint mobility.

Did You Know… The majority of the muscles that make your hand and fingers move are located in your forearm and attached to the elbow area. Therefore, what happens at the elbow, affects the hand, and vice versa.

How To Improve the Mobility of Your Joints

It is rarely a good idea to stretch into pain. When trying to restore your elbow, wrist, or hand ranges of motion, stretch into a comfortable range and gradually ease into a deeper stretch every repetition to gain mobility. Forcing the movement or holding the position too long can lead to more pain and limit your willingness (or ability) to do the stretch again. Start with gentle stretches for the whole arm. Then focus on your specific elbow, wrist, or hand area. Joints respond to frequency, meaning the more often we move our joint, the better it feels and the quicker we recover. Beginning with 5-10 second holds allows your body to adjust to the movement and is often more tolerable than attempting to sustain a stretch for a more extended period. Prolonged holds are not always needed or tolerated when working on joint range of motion, especially in the finger joints.

Dynamic stretching is another beneficial way to improve your mobility and coordination of the joints moving with one another. This form of mobility work involves moving a limb through its entire/maximum range of motion to the point where tension/stretch is felt and repeated several times in a given period. This stretch helps reinforce the body on proper movement patterns to restore joint mobility. Enhance Your Mobility with Physical Therapy One of the core principles of physical therapy is to restore your mobility and correct movement patterns. Our therapists improve the mobility of your joints with targeted manual techniques. These gentle techniques improve the multiple ways your elbow, wrist, and hand joints slide, glide, and rotate. Physical therapists also focus on teaching you how to prevent your problem from returning through specific exercises designed to retain your mobility.

Try These Exercises To Improve Your Joint Mobility

Wrist Flexion Stretch • Extend the arm with the affected wrist in front of you and point your fingers toward the floor. • With your other hand, gently bend your wrist farther until you feel a mild to moderate stretch in your forearm. • Hold the stretch for 15 to 30 seconds. • Repeat 3 to 5 times daily.

Wrist Extension Stretch • Extend the arm with the affected wrist in front of you and point your fingers toward the ceiling. • With your other hand, gently bend your wrist farther until you feel a mild to moderate stretch in your forearm. • Hold the stretch for 15 to 30 seconds. • Repeat 3 to 5 times daily.

Hand Mobility Exercises • Hold your hand out in front of you and move it in every direction you can think of. Make a fist, followed by extending your fingers as far as possible. • Use your opposite hand to stretch and move each individual finger

gently. If you notice limitations of any kind, work more on the ones with a limited range of motion.

Self Hand Massage Helps With Stiffness and Pain. • Use the opposite hand to massage across your palm and forearm muscles.

STEP 3: Improve Your Strength and Joint Stability

A Stronger You Means a Healthier You.

Joints can become unstable, especially after an injury or surgery. Several interconnected joints in the fingers, hand, and wrist need mobility while remaining strong and stable. This requires a complicated ballet of precision, coordination, and movement of the muscles and nerves in the forearm and hand. With acute injuries or chronic repetitive overuse injuries, the coordination of the muscles surrounding the joints can become unbalanced and painful. Changes in the normal functioning of the muscles influence the amount of pressure on the joints, increasing the likelihood of inflammation and pain. The elbow and wrist joints depend on the strength of the forearm muscles for correct alignment and stability of the wrist and hand joints. The hand needs the forearm muscles but relies on the intrinsic muscles (muscles in the hand) for strength and stability.

Strengthening plays a significant role in joint stability and overall function. A sprain affecting the elbow, wrist, or hand can impair function and lead to looseness in the joints. Joint instability can also occur from an injury to the ligaments helping to hold the joint together. Physical therapy can help with this instability. A physical therapist can ensure your functioning through an appropriate program, even after an injury to the ligaments. If an injury is not adequately rehabilitated, you may not fully recover your elbow, wrist, or hand's strength, stability, and overall functioning. Seeing a physical therapist after a sports injury, fall, or another type of injury is essential to your joints' long-term health and functioning.

How To Improve Your Strength and Joint Stability

• If you have painful movement, you may benefit from a supportive brace, especially during work or at night, to get proper sleep. Physical therapists can guide you through the appropriate style of brace and even make a customized brace for you and your specific needs. • Perform exercises that involve multiple joints at one time. Our arms play a significant role in everyday activities through coordinated movements; ideally, exercises should include the use of your shoulders, elbow, wrist, and hands simultaneously. • Look at office equipment such as keyboards, your mouse, chair height, and any tools to ensure they are ergonomic. Keep proper elbow, wrist, and hand positioning while performing daily tasks.

Try this Exercise to Improve Your Strength and Joint Stability

Wrist Flexion • Extend the arm with the affected forearm resting on your thigh and point your palm toward the ceiling. • Grip the band at one end while stepping on the band with your foot to stabilize (or hold onto the dumbbell). • Keeping the forearm on the thigh, flex your wrist against the tension from the band. Slowly lower it down to the starting position. • Repeat 10 to 15 times 3 days/ week.

Wrist Extension • Extend the arm with the affected forearm resting on your thigh and point your palm facing the ground. • Grip the band at one end while stepping on the band with your foot to stabilize (or hold onto the dumbbell). • Keeping the forearm on the thigh, extend your wrist against the tension from the band. Slowly lower it down to the starting position. • Repeat 10 to 15 times 3 days/ week.

Enhance Your Strength and Joint Stability

Your finger and wrist joints rely heavily on muscle support to make them function properly. The most intricate movements and forceful gripping actions require muscles in your forearm and hands to work together. Weakness in any area produces a cascade of problems in other areas, even resulting in pain or dysfunction. Injuries weaken all the muscles around the affected area resulting in the inability to use your hands effectively. In addition, repetitive strain can affect the muscles around the elbow and wrist, resulting in pain, inflammation, or injuries. By strengthening specific muscles, your body can restore control and, in turn, decrease the strain, resulting in long-term pain relief.

STEP 4: Restore Your Function for Lasting Results

How to Improve Your Forearm Strength and Avoid/Reduce Repetitive Stress

Strength comes from performing the proper exercises to achieve the specific results you are looking for. For example, you are far better off doing light weights early on and steadily progressing rather than trying to be too aggressive too quickly. It is safer, and you will achieve a better result. Too often, people try to do too much too soon or are afraid to do anything at all. The key to success is a balance between these two extremes. Gradual progression often leads to results faster than trying to push too aggressively. A lot of strengthening involves restoring your brain’s ability to connect with the right muscle groups again. This develops the neural pathways that activate the right muscles at the right time.

Physical therapists have years of training in the science of exercise and strengthening. Physical therapists are experts in treating all types of musculoskeletal disorders and restoring/improving your functional ability. We can pinpoint the area that needs strengthening by properly evaluating what muscles are weak in your elbows, wrists, and/or hands. Physical therapists will help you progress from basic exercises to more complex coordinated movements as your muscles heal and work together. We will teach you specific exercises that target particular muscle groups for the best possible outcomes. Our goal is to ensure you are empowered with the knowledge of keeping your body strong and healthy.

Try this Exercise to Help Your Forearm Muscles

Pronation • Extend the arm with the affected forearm resting on your thigh and point your palm toward the floor. • Grip the band at one end while stepping on the band with your foot to stabilize (or hold onto the dumbbell at one end). • Keeping the forearm on the thigh, turn your forearm against the tension from the band while rotating until your hand is facing upward towards the ceiling. Slowly lower it down to the starting position. • Repeat 10 to 15 times 3 days/ week.

Supination • Extend the arm with the affected forearm resting on your thigh and point your palm facing upward towards the ceiling. • Grip the band at one end while stepping on the band with your foot to stabilize (or hold onto the dumbbell at one end. • Keeping the forearm on the thigh, turn your forearm against the tension from the band while rotating until your hand is facing down towards the floor. Slowly lower it down to the starting position. • Repeat 10 to 15 times 3 days/ week.

How to Improve Your Forearm Strength and Avoid/Reduce Repetitive Stress The most common elbow, wrist, and hand injuries are repetitive, strain-type injuries. These overuse injuries start from the repetition of faulty mechanics or poor positioning. Fortunately, a physical therapist understands the mechanics behind most overuse-type injuries and the weaknesses and restrictions associated with repetitive strain injuries. Understanding the interrelationship of the parts of the body is where a physical therapist excels. In physical therapy, the term"regional interdependence" is a fancy way of saying if one area of the body has impaired function, it can (will) affect another location away from the problem site. Identifying all the factors contributing to your condition can mean the difference between resolution and persistent pain. Too often, people ignore the early signs and symptoms of a problem. In the beginning, most overuse, repetitive strain-type injuries are mild and go away quickly. Unfortunately, when left untreated, they often lead to more serious problems.

The most common types of overuse injuries in the elbow, wrist, and hand include: Carpal Tunnel Syndrome: Carpal tunnel is a widespread condition in the wrist, affecting the median nerve, which can cause numbness, tingling, weakness, and pain to the thumb and first two fingers. For some, the condition will progress, lead to weakness in the hand, and cause people to drop items. Improper positioning and repetitive tasks are usually the main reasons carpal tunnel occurs. Carpal tunnel is often associated with overuse-type injuries, particularly among construction and manufacturing workers that are required to lift, grip, and perform forceful wrist motions. Or certain sports like golfing, tennis/pickleball, and rock climbing. Many people have excellent results with therapy first, especially if they are seen early in their symptoms! Tennis Elbow (Lateral Epicondylitis): Tennis elbow is very common among tennis players; some research suggests that up to 50% of all tennis players will experience it at some point. Tennis elbow does not just affect tennis players. Office workers and manual

labor-type occupations experience lateral epicondylitis and the limitations it causes. Most often, the symptoms result from faulty or poor technique, repetitive movements, improper grip, and or using equipment that is too heavy. Fortunately, most people with tennis elbows can recover fully and recover quickly with proper guidance. As with most tendon-related injuries, understanding the balance of reducing and increasing the amount of load and effort is the key to lasting results. Total rest and avoidance of the issue will likely lead to poor results and frustration. Getting guidance early in the process will result in the best outcomes!

Golfer's Elbow (Medial Epicondylitis): Golfer's elbow is typically caused by an overuse and/or overload injury to the tendons that attach to the elbow's inner (medial) aspect. This overload often leads to degenerative tearing of the tendons, pain, and sometimes inflammation. Typically, this condition results from repeated microtraumas over the course of days to weeks, causing pain. Eventually, these repeated microtraumas lead to structural breakdown of the tissue and dysfunction of the elbow/arm. As the condition progresses, there is often persistent pain in the inner aspect of the elbow, even with basic daily activities. It is also possible for medial epicondylitis to start due to a traumatic event. This can happen when there is a sudden slowing/ stop, resulting in sudden overloading of the tendons at the elbow. Whether you play golf or not, you can resolve your pain and get back to doing what you love with a proactive program. This is especially true with a tendon injury like with golfer's elbow (i.e., medial epicondylitis). Taking care of minor issues sooner than later leads to a faster recovery.

How Physical Therapy Helps You Resolve Overuse-Type Injuries

Our team of physical therapists will identify all the factors contributing to your pain and limitation until you are back on track. We will identify the root cause of your pain/ injuries and help design the most advanced therapeutic strategies to resolve your problems. Are you ready to get back to work or play sports at your highest levels again? The key to success is addressing your condition sooner rather than later!

Our goal is to relieve your pain and ensure your elbow, wrist, and hands stay healthy for the long run. One of the essential features of healthy joints is muscle strength and the ability to coordinate the muscles through various movements and functions. This provides for long-term joint health and the capability to handle strenuous activity. Upper extremity movements require incredibly complex interaction of the muscles, nerves, and joints. Whether the activity is a small intricate movement or a powerful gripping action, the muscles must move at the right time and sequence. Repetitive strain- type injuries and/or acute traumas affect your everyday function and often lead to an abnormal strain on your joints. Most people don’t act to resolve their pain soon enough, causing the problem to worsen. The good news is that you can vastly improve your coordination and function with the right exercises and treatment. This leads to being more active, reducing the risk of injury, and preventing future problems!

Why Physical Therapy is The Right Choice

A physical therapist can pinpoint your problem by examining your mobility, strength, and coordination. You are put through specific movement patterns that show where your function is challenged. With this knowledge, a comprehensive plan is designed to restore your ability to do what you love. When you notice you are favoring or avoiding activities due to pain, restrictions in mobility, or weakness, it’s time to do something about it sooner than later. Surgery and injections are a last resort and should only be considered when all else has failed. Physical therapy is the perfect solution to restore joint health for the vast majority of elbow, wrist, and hand pain.

With physical therapy, there is no forcing, ignoring, or pushing through pain. Physical therapy evaluates how your joints move and function to pinpoint the root cause of your problem. Once we have identified all the factors contributing to your condition, we will design an individualized plan of targeted hands- on techniques and therapeutic exercises to restore joint mobility, strength, coordination, and function. Imagine reaching, grabbing, and lifting comfortably, without fear of your elbow, wrist, or hand hurting. All this can happen by trying physical therapy first. Before trying other aggressive medical procedures, you should always try physical therapy with a certified physical therapist. 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 integral to your recovery and helps you return to work, play, and live a pain-free life.

Call us today to schedule a consultation with one of our expert physical therapists and discover simple actions that you can take to relieve your pain quickly and naturally.

Your joints will be glad that you did!

9900 WEST SAMPLE ROAD, SUITE 102 CORAL SPRINGS, FL. 33065 Phone: (954) 341-7875 Fax: (954) 341-7895

www.aspenrehab.com

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