Sports Therapy

Common Upper Extremity Injuries

On March 7, 2012
By Dr. Nekessa Remy | 1 Comments

CARPAL TUNNEL SYNDROME

Carpal tunnel syndrome is pressure on the median nerve — the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.

Causes, incidence, and risk factors

The median nerve provides feeling and movement to the “thumb side” of the hand (the palm, thumb, index finger, middle finger, and thumb side of the ring finger).
The area in your wrist where the nerve enters the hand is called the carpal tunnel. This tunnel is normally narrow, so any swelling can pinch the nerve and cause pain, numbness, tingling or weakness. This is called carpal tunnel syndrome.

Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cause of carpal tunnel.

Symptoms

 Numbness or tingling in the thumb and next two or three fingers of one or both hands
 Numbness or tingling of the palm of the hand
 Pain extending to the elbow
 Pain in wrist or hand in one or both hands
 Problems with fine finger movements (coordination) in one or both hands
 Wasting away of the muscle under the thumb (in advanced or long-term cases)
 Weak grip or difficulty carrying bags (a common complaint)
 Weakness in one or both hands

Prevention

Avoid or reduce the number of repetitive wrist movements whenever possible. Use tools and equipment that are properly designed to reduce the risk of wrist injury.
Ergonomic aids, such as split keyboards, keyboard trays, typing pads, and wrist braces, may be used to improve wrist posture during typing. Take frequent breaks when typing and always stop if there is tingling or pain.

TENNIS ELBOW

Tennis elbow is inflammation, soreness, or pain on the outside (lateral) side of the upper arm near the elbow. There may be a partial tear of the tendon fibers, which connect muscle to bone. The tear may be at or near where these fibers begin, on the outside of the elbow.

Causes, incidence, and risk factors

The part of the muscle that attaches to a bone is called a tendon. Muscles in your forearm attach to the bone on the outside of your elbow. When you use these muscles over and over again, small tears develop in the tendon. Over time, this leads to irritation and pain where the tendon is attached to the bone.
This injury is common in people who play a lot of tennis or other racquet sports, hence the name “tennis elbow.” However, any activity that involves repetitive twisting of the wrist (like using a screwdriver) can lead to this condition. This condition may also be due to constant computer keyboard and mouse use.

Symptoms

 Elbow pain that gradually worsens
 Pain radiating from the outside of the elbow to the forearm and back of the hand when grasping or twisting
 Weak grasp

Treatment

The first step is to rest your arm and avoid the activity that causes your symptoms. Put ice on the outside of your elbow 2 – 3 times a day.
 Take nonsteroidal anti-inflammatory medications (such as ibuprofen, naproxen, or aspirin).
 If your tennis elbow is due to sports activity, you may want to:

  • Ask about any changes you can make in your technique
  • Check any sports equipment you’re using to see if any changes may help.

If your symptoms are related to working on the computer ensure that your workstation is set up ergonimcally.
You can buy a special brace for tennis elbow at most drug stores. It wraps around the first part of your forearm and takes some of the pressure off the muscles.

ROTATOR CUFF INJURY

The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keeping it stable. Rotator cuff tendinitis refers to irritation of these tendons and inflammation of the bursa (a normally smooth layer) lining these tendons.

Causes, incidence, and risk factors

The shoulder joint is a ball and socket type joint where the top part of the arm bone (humerus) forms a joint with the shoulder blade (scapula). The rotator cuff holds the head of the humerus into the scapula and controls movement of the shoulder joint. The tendons of the rotator cuff pass underneath a bony area on their way to attaching the top part of the arm bone. When these tendons become inflamed, they can become more frayed over this area during shoulder movements. Sometimes, a bone spur may narrow the space even more.

This problem is called rotator cuff tendinitis, or impingement syndrome, and may be due to:
 Keeping the arm in the same position for long periods of time, such as doing computer work or hairstyling
 Sleeping on the same arm each night
 Playing sports requiring the arm to be moved over the head repeatedly as in tennis, baseball (particularly pitching), swimming, and lifting weights over the head.
 Working with the arm overhead for many hours or days (such as painters and carpenters)
 Poor control or coordination of your shoulder and shoulder blade muscles
 Poor posture over many years and the usual fraying of the tendons that occurs with age may also lead to rotator cuff tendinitis.

Symptoms

TENDINITIS OR IMPINGEMENT SYNDROME
 Early on, pain occurs with overhead activities and lifting your arm to the side. Activities include brushing hair, reaching for objects on shelves, or playing an overhead sport.
 Pain is more likely in the front of the shoulder and may radiate to the side of the arm. However, this pain always stops before the elbow. If the pain travels beyond the arm to the elbow and hand, this may indicate a pinched nerve.
 There may also be pain with lowering the shoulder from a raised position.
 At first, this pain may be mild and occur only with certain movements of the arm. Over time, pain may be present at rest or at night, especially when lying on the affected shoulder.
 You may have weakness and loss of motion when raising the arm above your head. Your shoulder can feel stiff with lifting or movement. It may become more difficult to place the arm behind your back.

Treatment

TENDINITIS OR IMPINGEMENT SYNDROME
Treatment involves resting the shoulder and avoiding activities that cause pain. It may involve:
 Ice packs applied 20 minutes at a time, 3 – 4 times a day to the shoulder
 Taking drugs like ibuprofen and naproxen to help reduce swelling and pain
 Avoiding or reducing activities that cause or worsen your symptoms to worsen
 Pendulum exercise – This “Pendulum exercise” is used to maintain mobility in your shoulder. Bend forward from your hips and support the weight of your upper body. Let your shoulder relax and gently swing a small weight back and forth.

1 comments on Common Upper Extremity Injuries
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  • Nov 15 2012
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