Tenosynovitis is the inflammation of the fluid-filled sheath (called the synovium) that surrounds a tendon, typically leading to joint pain, swelling, and stiffness. The sheath of the tendon becomes thinner which is caused by the reduced lubrication between tendon and its sheaths due to the excess rubbing movements. Some secondary factors that increase the risk of tenosynovitis is having improper skill and posture when moving the wrist. The 2 common types of tenosynovitis are De Quervain’s Tenosynovitis and Trigger Finger Tenosynovitis.
De Quervain’s Tenosynovitis:
De Quervain’s Tenosynovitis is a condition that affects the tendons in your wrist. Repeating a particular motion may irritate the sheath around the two tendons, causing thickening and swelling that restricts their movement. This condition affects tendons that abduct and extend the thumb necessary for dexterity and manipulation.
The exact cause of this type of tenosynovitis is unknown. However, any activity that requires repetitive hand or wrist movement can aggravate the condition – such as knitting, racket sports, lifting a baby, and walking a pet. Treatments for De Quervain’s Tenosynovitis include wearing a thumb splint to immobilize the thumb, preventing further abduction of the thumb.
Trigger Finger Tenosynovitis:
Trigger finger tenosynovitis is tenosynovitis of tendons that flex fingers. The cause of this condition occurs from repetitive and forceful flexing of fingers. As a result, one of the fingers gets stuck in the bent position due to the bulbous swelling that restricts finger flexion and may lock them in a fixed position. A bump, also known as a nodule, may occur from the inflammation of the tendon sheath. Trigger finger occurs mostly near metacarpophalangeal joints, middle and ring fingers of the dominant hand.
People whose work or hobbies require repetitive gripping actions are at higher risk of developing trigger finger tenosynovitis. Additionally, those with health problems such as rheumatoid arthritis and diabetes are at higher risk.
Tendons and ligaments are fibrous bands of connective tissue that help stabilize body structures and facilitate body movements. The main difference between tendons and ligaments is that they connect different parts of the anatomy. Tendons connect muscles to bones, while ligaments connect bones to other bones.
Ligaments and tendons are made of 2 types of protein fibers: collagen and elastin. Collagen fibers have a small deformation range and high strength. Since collagen has such a high strength, they require more force to break down. Contrarily, elastin fibers have a large deformation range with low strength, meaning they are very weak and can break more easily. Ligaments such as the neck and wrists have more motion and movement because they consist of more elastin and less collagen.
Ligaments and Tendon Injury:
Repetitive motions with inadequate recovery periods are the cause of occupational ligament and tendon injuries due to the constant loading and unloading of force with no rest. Loading is the process of physical stresses acting on the body or on anatomical structures within the body.
A ligament injury occurs during the chronic process of loading and unloading, the tissue becomes longer and more fragile and eventually a small amount of force can easily fracture. In addition, cumulative loading can result in a decrease in bone density which increases the vulnerability of a ligament or tendon getting injured. An example of constant loading is by having improper posture for long periods of time which eventually leads to lower back injury.
Stages of Ligament Healing:
- Acute inflammatory phase – The first stage consists of the formation of blood clot within the damaged region.
- Proliferative phase – New blood vessels are formed while fibroblasts are recruited from circulation to produce new collagen.
- Tissue remodeling phase – The third stage starts after 3 weeks of the injury occurrence. During the wound healing process, there is a progressive maturation of collagen fibers in response to loads experienced by the ligaments. If force is applied in the wrong direction, there can be permanent damage of the ligaments.
Resistance training, also known as strength training, is a form of exercise that improves muscular strength and endurance. During a resistance training workout, you move your limbs against resistance provided by your body weight, gravity, bands, weighted bars or dumbbells. Resistance training is recommended to be exercised 2 times in a week. Exercises should be individualized depending on the individual’s knowledge on how to do specific exercises. Kinesiologists specialize in designing exercise programs for patients that need help overcoming chronic injuries and pain.
Types of Resistance Training:
- Calisthenics – Consists of a variety of movements that exercise large muscle groups, including push ups, sit ups, and running
- Weights – Strength training tools such as free weights, machines, kettle-bells, cables/pulleys
Benefits of Resistance Training:
Resistance training can increase tensile strength of connective tissues – helping to strengthen tendons, muscle, and ligaments. It allows tissue to generate more tension and which makes them more resistant to injury. Strength exercises can contribute to optimal performance in daily activities, as it improves posture, encourages weight loss and maintenance, and lowers injury risk. Strength training also reduces the need to do more cardiovascular activities because it helps control blood sugar.
This type of training can also be extremely beneficial for older adults because it improves mobility and functional independence. Implementing resistance training in your physical activity can help in the long run by delaying bone diseases such as osteoporosis – a condition where bones lose their mineral content/bone density and become more vulnerable to fracture. Bone density is improved when stress is put on bones by doing resistance exercises.
Guidelines for Resistance Training:
- Do exercises that involve all major muscle groups (chest, shoulders, back, hips, abdomen, arms)
- To improve good posture, select exercises that strengthen the trunk (abdomen)
- Never lift heavy weights alone (have a spotter)
- Warm up prior to high intensity exercises
- Use proper lifting techniques to prevent musculoskeletal injuries
- Exercise larger muscle groups before smaller ones (Ex. exercise legs before arms)
A shockwave is an intense, short energy wave that travels faster than sound. By introducing these high-energy waves into the body, shockwave therapy can speed up the healing process through stimulating the metabolism and enhancing blood circulation. These processes help regenerate damaged tissues at the injured areas. When human body fails to heal itself on its own, shockwave therapy could be a great solution.
Why Shockwave Therapy?
Shockwave therapy is an affordable non-surgical procedure that effectively speeds up the healing process after 1 to 2 treatments. Each treatment is rather short, usually takes 20 to 30 minutes. It is effective on treating many conditions such as calcific rotator cuff tendintis, plantar fasciitis, Achilles tendinopathy, scar tissue treatment, tennis elbow, jumper’s knee, stress fractures and non-healing ulcers.
Chiropractors will precisely locate the area to be treated by palpation. Then, sufficient amount of gel will be applied to the area for efficient and smooth transfer of the sound wave. The shockwave applicator will be slightly pushed against your skin, and the sound waves will be fired.
Here’s a link to a video illustrating the process of the treatment: https://youtu.be/rXj6ugQuYps
MRI is a technique that uses magnetic field and computer-generated sound waves to obtain detailed images of organs and tissues in our body. The magnetic field inside the MRI machine temporarily realigns water molecules in your body. The aligned molecules produce faint signals with radio waves, and create cross-sectional MRI images. 3D images can be produced with MRI by viewing the organ or tissue in various angles.
This noninvasive imaging technique gives high-resolution images of our body tissues which helps identify different health issues. MRI is the most frequently used method to obtain images of the brain and spinal cord. Other common organs and tissues imaged with MRI include heart, blood vessels, internal organs (liver, kidney, pancreas etc.), bones and joints, as well as the breasts.
However, since MRI uses powerful magnets to generate a strong magnetic field, any presence of metal in your body can be attracted to the magnet and can be a safety hazard. Metal can also distort the MRI image. Tattoos or permanent makeup might contain metal and might affect the MRI result. Report to the doctor if you are pregnant or breast-feeding, as the effects of the contrast material that has to be injected are still not well understood.
Patellar tendonitis, also known as jumper’s knee, is the inflammation of the patellar tendon, which connects your knee cap to your shin bone. This condition can weaken the connective tissue and can possibly lead to tears in your tendon. Possible causes of the inflammation of the patellar tendon include practicing repetitive movements, overusing the tendon or adding too much pressure to your tendon repeatedly.
Knee pain is one of the most common symptoms of patellar tendonitis. If you feel pain especially when jumping, running, stretching and bending your leg; tenderness or swelling at the lower part of your knee cap, it is likely that your patellar tendon is inflame. Some symptoms resemble other medical condition, X-ray is one of the best ways to diagnose patellar tendonitis.
Once diagnosed for patellar tendonitis, it is important to stop the activities that caused the problem until fully recovered. Other treatments such as applying ice packs to your knees helps reduce inflammation, and shockwave therapy speeds up the healing process.
Facet joints are sets of synovial joints between two adjacent vertebrae. There is a pair of facet joints on each vertebra. The joint’s main function is to guide and limit movements and motions such as rotation. Lumbar facet joints also have some minor impact on limiting the range of motion of side bending.
Definition and symptoms of facet syndrome:
Facet syndrome is defined as the unilateral or bilateral backpain that originates from the facet joint and/or its capsule. Though it might not be common, the pain could radiate to one or both buttocks, the sides of groin and/or the thigh, and usually stops above the knee; but in most cases, the pain is localized which helps practitioners easily located its source. Patients would experience more pain when they extend their back (bend backwards) than when they flex (bend forward).
Physical examinations and diagnostic facet joint block detect and indicate facet syndrome, but false positive rate for both diagnostic methods are high. Interventional radiology such as MRI is a more accurate way to detect the syndrome.
Chiropractic adjustments are great ways to treat facet syndrome; the syndrome responds to standard chiropractic treatment procedures like heat and modalities really well. Trainings that can improve time of response and proprioception help with the pain as well.
Plantar Fasciitis is one of the most common causes of heel pain. When the plantar fascia, the flat band of tissue connecting your heel bone to your toes, is strained, it gets inflamed and swollen, and causes pain at the bottom of your foot or at your heel.
Most people with Plantar Fasciitis experience pain when they take their first step after sitting for a long time or getting out of bed. The stiffness and pain might reduce after a few steps. Some might also feel painful after climbing stairs and standing for a long time.
To treat Plantar Fasciitis, you have to give your foot a rest. Cut back from exercises and activities that make your foot hurt. You can also try to put ice on the affected area to ease the inflammation. Toe stretches, calf stretches and towels stretches are excellent stretching exercises to do to relief the pain. It’s always a good idea to get yourself a pair of orthotics to adjust how your shoes fit you.
Start your treatment soon! With the right treatment, you will experience much less pain in a few weeks, but it usually takes at least a few months to a year for the pain to go completely.
Excessive texting or mobile device use can cause stress injury to the neck, commonly known as the text neck. Symptoms associated might include pain in the neck, upper back and/or shoulder, forward head posture, rounded shoulders, headache, increased pain when neck flexion and reduced mobility.
A lot of extra pressure is put on your cervical spine when our head is bent. The unnatural posture can lead to stresses on the spine and surrounding supportive soft tissues.
Here are some tips to avoid text neck:
- Raise the phone to eye level to minimize bending of neck
- Take breaks from time to time while using your phone
- Stretching exercises during breaks to release tension in the neck and to ease muscle pain
If neck pain keeps returning or is accompanied by severe headache, one should seek medical attention for the right treatment.
Many people confuse these two words or use them interchangeably, but there is a difference between a sprain and a strain.
To understand the differences you would need to also understand what a tendon and a ligament is. Ligaments are fibrous tissues that connect bones to bones whereas tendons are fibrous tissue that connect muscles to bones.
A sprain is a stretch or tear in a ligament and strains are stretches or tears in a muscle or tendon. The most comment injury is an ankle sprain, for example when you roll your ankle when you stepped on an uneven surface. Strains are most common in contact sports or overworking the muscle. Both are accompanied by swelling, redness and pain. It is important to ice the area and see a doctor if symptoms persist or worsen or you can’t bear weight.