Tag Archives: hand pain

IS MODERN TECHNOLGY CREATING NEW PHYSICAL AILMENTS?

selfie

We are often warned about the dangers of driving and walking while texting. A while ago, we blogged about “Candy Crush Thumb”. These common activities have sent far too many people to their physicians and worse, emergency rooms. What’s next?

The newest ailments are plentiful: Selfie Hand, Text Claw, Selfie Elbow, and Text Thumb. Say what?

It is estimated that over the course of their lifetime, Millennials will have taken a staggering amount of over 25,000 selfies. Yes, you read that correctly … 25,000 per Millennial. That repetitive action develops physical challenges in the hand and wrist and it’s not from what you would think. The weight of the phone is not the issue; it’s the position of the hand, wrist, fingers, and even the elbow that compromise muscles, tendons, and ligaments. More commonly, this is referred to as “repetitive strain”.

Some may say that using a selfie stick avoids inflammation of the hand and wrist, however, this may cause other complications in the elbow, wrist, arm, shoulders, and neck from extending the arm frequently.

selfie-athlete

Most of us cannot imagine limiting our smart phone time or disconnecting so what’s the answer to avoiding a generation of these future ailments? Here are some suggestions however, as with any new activity, check first with your physician:

  • Use voice dictation when sending a text or email from your phone.
  • Do a “prayer stretch” by placing palms together under the chin and pulling hands down toward the waist keeping them close to the chest.
  • Push palms up above the chest and down toward your shoulders several times; using an 8 ounce water bottle or soup can may help strengthen muscles.
  • Icing the inflamed area may relieve discomfort.
  • Shoulder and wrist rolls may help your muscles from fatiguing.

If you do suffer from chronic pain in your hands, wrist, elbow, shoulder, or neck it may be time to see a physician who specializes in hand and wrist ailments. At Sarasota Orthopedic Associates we have highly skilled upper extremity and hand/wrist Orthopedic Physicians, as well as experienced Occupational Therapists and Certified Hand Therapists, to help you alleviate your discomfort. Check out our website at www.SOA.md where you can make an appointment at any of our four locations directly via the home page, or give us a call at 941-951-2663. We offer same day appointments when necessary.

Our commitment is to get our patients back on their feet, back to work, back in the game, and back to life!

WHEN A HAND NEEDS A HAND

498-expert-q-and-a-yoga-and-carpal-tunnel-syndrome

There are 206 bones in the adult body and 27 of them are in the hand and wrist. So it is understandable that most people will suffer a broken bone to the hand or wrist during their lifetime. These injuries can be debilitating since they can inhibit normal functions of the hand, while adversely impacting normal, daily activities. The frequency of hand and wrist use allows for a constant opportunity for injury.

Most disorders of the hand and wrist can be treated non-surgically with splints, injections or physical therapy. However, traumatic injuries to the hand can cause nerve, artery, vein, muscle, tendon, ligament and joint cartilage problems. Sometimes more severe injuries will require joint replacement.

While there are numerous elbow problems and conditions, tennis elbow seems to be the most common and well known. Many elbow conditions can be treated conservatively without surgery. When surgery is needed, minimally invasive arthroscopy permits the orthopedist to treat the problem resulting in small incisions, less pain and an early return to activities.

Utilizing the advancement of medicine and technology, Sarasota Orthopedic Associates’ hand, wrist and elbow specialists can effectively treat the patient’s problems. Our orthopedists’ experience-based knowledge allows them to optimize recovery and maximum function with the best possible outcome.

At Sarasota Orthopedic Associates, our commitment is to get our patients back on their feet, back to work, back in the game, and back to life. With four locations we are able to provide same day appointments when needed. Visit us online at www.SOA.md or call 941-951-2663 to make an appointment. You may also make appointments online at our website.

What’s That Sound? SNAP, CRACKLE, POP

knuckle cracking

It’s a question most orthopedic surgeons get asked on a daily basis: “My joint pops…is that normal?” Like most things in life, if it’s not broke (or hurting), don’t fix it. An acute injury resulting in an audible “pop” is different from a situation such as a hip “popping” for years. Popping, cracking, or crunching of joints is quite common and often nothing to be too concerned with, especially if it is not causing discomfort or affecting one’s activities. Here are some need to know tidbits on joint popping and cracking.

What Causes This?

  • Numerous theories and causes exist including ligament stretching, tendons snapping, nerves subluxing, or bubbles forming within the joint. A recent study investigated the bubble theory using MRI videos to propose the mechanism by which “cracking” your knuckles results in a negative-pressure event which draws synovial fluid into the joint, thus leading to the subsequent pop. Why does it feel good to crack a knuckle? Thoughts are that the pressure phenomenon within/around the joints stimulates certain receptors which allows for muscles to relax. Another theory suggests natural painkillers (endorphins) are released with such activity, which may explain why it can be a difficult habit to break.
  • Other things must also be taken into account when discussing the cause of noise around a joint, such as prior injuries, surgeries, hardware/implants around the joint, and other accompanying symptoms. It is quite common for someone who injures their ACL to feel or hear a “pop” from the ligament rupturing. This must be taken in a different context from the chronic, painless popping that someone may experience around their knee cap from soft-tissue issues.
  • Lastly, arthritis can commonly be accompanied with crunching or cracking sensations and as long as it is not resulting in increasing pain or swelling, it is something that can be observed. Some older style knee/hip implants may result in noises (e.g. squeaking), and if you were experiencing this, it would likely be best to visit with your orthopedic surgeon to check the status of things and make sure the components were not wearing out in an abnormal fashion.

Should I Be Concerned?

In general, if the popping/cracking around a joint is not causing pain or swelling to occur or interfering with your function or activities, there shouldn’t be much concern. Studies have looked at whether or not cracking your knuckles would lead to arthritis, and to date, no such correlation has been shown. That said, it is generally recommended that one not perform such activities too frequently or on purpose as there have been reports of joints/knuckles becoming loose from habitual cracking. In addition, habitual knuckle crackers have been shown to develop hand swelling (not from arthritis) and decreased grip strength which can lead to decreased manual function. Nodules can also form from such activity, and this may cause cosmetic concerns for certain patients.

Common Areas to Experience It

Any joint can develop it, but perhaps the most common areas to experience it are in the hands, knees, spine, and shoulders.

  • As already mentioned, knuckle cracking is a common occurrence.
  • With regards to the knee, the anterior aspect often experiences popping/crunching from the patellofemoral joint (knee cap). This can be from mild softening of the joint, but most of the time it is from soft-tissues in the area (e.g. plica, fat pad) that simply release themselves during motion.
  • Similar to the knuckles in the hand, the facet joints and other muscles/ligaments around the spine are prone to popping.
  • The spine is a complex unit with numerous muscles, joints, discs, and ligaments contributing to its stability. Chiropractors make a living out of therapeutically popping, cracking, and aligning patients’ backs, so why would you get too concerned with your back popping if you’re not having any discomfort with it?
  • Lastly, the AC joint of the shoulder almost always develops arthritis, but rarely causes too much pain or functional limitation. Popping over this portion of the shoulder with no other symptoms is quite common. On the contrary, patients with symptomatic instability or arthritis in the shoulder joint proper will almost always have pain or issues with their function accompanying this, and would thus be treated differently to the above mentioned scenarios.

Summary

Painless popping around joints is an issue that one should hardly ever get too concerned with. If popping occurred from an acute injury or there were other symptoms being experienced in addition to it, then a visit with your orthopedic surgeon would be recommended at that point. Otherwise, keep up what you are doing and don’t let some painless noise around a joint stress you out.

Born-077_R2

Trevor Born, MD is an orthopedic surgeon with a specialty in sports medicine. At Sarasota Orthopedic Associates our commitment is to get our patients back on their feet, back to work, back in the game, and back to life. We have four convenient locations and offer same day appointments when needed. Visit our website at www.SOA.md or call us at 941-951-2663 for an appointment. Appointments may also be made via our website.

 

MAY IS NATIONAL ARTHRITIS MONTH: Getting the Upper Hand on Arthritis

SANYO DIGITAL CAMERA

According to the Arthritis Foundation, 46 million Americans live with arthritis or chronic joint symptoms. Arthritis symptoms limit everyday activities such as dressing, bathing, and cooking for more than 7 million Americans. Half of those Americans with arthritis aren’t aware of options now available to help alleviate their symptoms.

The most common forms of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis is a degenerative joint condition in which the joint cartilage deteriorates resulting in pain and loss of movement when bone begins rubbing against bone. Your hands are constantly on the go. Everyday activities such as preparing a meal, woodworking, carrying grocery bags, or using your computer may damage your joints over time. Fortunately, joint protection techniques may help reduce pain, stress, and inflammation. These techniques may also help prevent further deformities and increase your independence in daily activities. There are many easy and inexpensive ways to protect your hands.

Here are a few tips to keep your hands healthy:

 Give your Hands a Break

  • If you have pain during an activity, stop the activity. Pain is one of the best ways your body has of letting you know you are causing tissue damage, so listen to and respect your pain.
  • If writing is painful, try using a thick, rubber grip pen with a gel tip or roller ball to decrease the amount of pressure.
  • Remember to stretch and take breaks every 15 minutes during repetitive or prolonged activities such as needlework, painting, sewing, knitting and crocheting, hammering, and filing.
  • Use enlarged grips on every day equipment or tools to reduce strain on your joints; e.g. potato peelers, gardening tools, tooth brushes, hair brushes, or build up the handles with foam.
  • Keep scissors and knives sharp to minimize effort.
  • Always use two hands when lifting heavy objects. A gallon of milk weighs about 8 pounds, and lifting it with only your fingertips places excessive stress on your joints.

Don’t Use your Hand as a Tool

  • Don’t tear your mail open – use a letter opener to open mail.
  • Use utility scissors in the kitchen – do not rip open bags.
  • Always use the right tool for the job – use pliers for tight pinching and a small hammer for pounding.
  • Use a staple remover instead of your fingers and thumb.

Use Adaptive Equipment to Decrease Stress on your Joints

  • Use foam to enlarge small diameter objects such as paring knives, cutlery, toothbrushes, paint brushes, pens, and pencils.
  • Purchase lightweight kitchen, gardening, and workshop tools with built-up handles.
  • Perform a search on the Internet for “adaptive equipment” to see what products are available.

When Symptoms Become Severe

If you have already tried these techniques but are still experiencing symptoms, it might be time to consider a consult with an orthopedic specialist.  Gregory Farino, MD, a Board Certified/Fellowship Trained hand and wrist specialist at Sarasota Orthopedic Associates, can help you with providing an accurate diagnosis as well as treatment options.

Farino pic

In the initial stages of arthritis, conservative management provided by a hand therapist may be all you need. Hand therapists can fabricate splints to support and protect the joints, recommend home exercises to improve strength in the small muscles of the hand, and educate you on pain management techniques.

If the arthritic process or your pain and stiffness is more severe, treatments like oral and topical medications or a cortisone shot may help relieve pain and improve mobility and strength. If conservative measures are not successful, surgery may be recommended. Joint replacement or joint fusion surgery has been consistently successful for both osteoarthritis and rheumatoid arthritis.

The hand and wrist team at Sarasota Orthopedic Associates is here to help you manage hand arthritis and stay as active as possible. We have four locations (Sarasota, Lakewood Ranch, Venice, and Bradenton) and offer same day appointments when necessary. Call us at 941-951-2663 for an appointment or visit our website at www.SOA.md for more information.

Note: Article written by Gregory Farino, MD, a Fellowship Trained and Board Certified Orthopedic Surgeon with a specialty in hand and wrist and Sangeetha Bulusu, OT, CHT, CLT (Occupational Therapist, Certified Hand Therapist, Certified Lymphedema Therapist). Both are available to see patients at Sarasota Orthopedic Associates.

Thumbs Up for Dr Gregory Farino

Farino 2015 lab coat half

This interview marks the halfway point in chatting with our physicians at Sarasota Orthopedic Associates. Dr Gregory Farino, a Fellowship Trained and Board Certified orthopedic surgeon, has a specialty in hand and wrist conditions. Take a look at what inspires Dr Farino and what he does in an occasional spare moment:

What inspired you to become a physician?

I wanted to do something in the sciences where I could be useful and helpful to others. Initially during college, I was going to be a teacher but after spending some time with a few different MDs, decided to pursue medicine.

Why orthopedics?

As a medical student, I thought I would pursue primary care but after rotating through, sensed it wasn’t the right fit for me. I decided to try orthopedics in my 4th year of med school. I did a rotation at Einstein hospital in Philadelphia and worked with a great group of guys. They let me do an entire surgery and I was hooked. I decided to apply for an orthopedic residency.

What do you love most about your job?

Obviously the job is challenging in many ways but I enjoy knowing that the things I do and decisions I make translate into another person feeling better and functioning better. It is satisfying to know all of the time and effort I spent in training allows me to do something useful, not just for myself, but for everyone I see.

What is your biggest challenge?

Dealing with imperfection. I don’t handle failure well at all. I expect 100% success with what I do. Logically, I know it’s not possible but I expect it anyway. That creates unhappiness for me when things turn out less than my expectation.

If I weren’t an orthopedic physician I’d be a ____________.

I’m not sure. Maybe a college professor in history.

Your proudest moment?

I have to say my proudest moment was probably the day I matched in orthopedics at Penn State. It was my first choice and the culmination of 8 years of really hard work.

Where is the most interesting place you’ve travelled? Why?

Sicily. It has everything: food, wine, beautiful vistas (the sea, mountains, an active volcano), fascinating history and great people.

Any hobbies? Activities?

I like to read mostly ancient Greek history and early American history. I am teaching myself to play the guitar and ukulele.

What’s your next adventure?

I usually have a trip planned but don’t at this time. I would love to go back to Italy.

Your guilty pleasure food?

It’s a tie: pizza and French fries.

 NOTE:  Dr Farino, MD is one of 13 physicians at Sarasota Orthopedic Associates. He is Fellowship Trained and Board Certified with a hand/wrist specialty. You may read his medical biography and CV by clicking here. SOA offers four locations (Sarasota, Lakewood Ranch, Venice, and Bradenton), and provides same day appointments when needed. Our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.

GETTING TO KNOW YOU –Michael Gordon, MD

2011-11-04 22.30.42

Over the next several weeks we’ll be asking each of our physicians to reveal a more personal side that extends beyond their medical biography. This week, we spoke with Dr Michael Gordon, who is Fellowship Trained and Board Certified in treating hands, wrists, shoulders, and elbows and sees adults and children of all ages.

What inspired you to become a physician?

I wanted to be able to help people in a tangible and meaningful way. I enjoyed creating and tinkering with and fixing things as a child. You could say I was the neighborhood mechanic. I even built a boat with my father as a summer project.

Why orthopedics?

It’s most similar to architecture, mechanics, and carpentry, and, provides gratification of fixing or restoring function to the anatomy. When I considered applying to medical school, I shadowed an orthopedic surgeon and watched him return the ability of walking to people. It was very inspiring.

What do you love most about your job?

Seeing the faces of joy and gratitude when patients have recovered from their injury or condition.

What is your biggest challenge?

Not having enough time.

If I weren’t an orthopedic physician I’d be a ________.

Rock Star

Editorial Note:  Dr Gordon plays guitar and sings in the band “McDreamy and the Anatomy”, a group consisting solely of physicians! The band competed at the “DR IDOL” fundraising event for Boys & Girls Club a few years ago when they rocked the crowd and won the title.

SOA_Idol_0081

Your proudest moment?

Becoming and being a father to two amazing daughters.

Where is the most interesting place you’ve travelled?  Why?

I’m not fond of trying to name the “best”, “favorite”, or “most” because there are so many great places. I would say Thailand, Japan, and Israel were culturally interesting, but Europe is wonderful too. The US has amazing resources that we sometimes forget like the Grand Canyon and Yosemite.

Any hobbies?  Activities?

Music, Music, Music. Exercise has also become a central part of my life.

SOA_Bike_035

What’s your next adventure?

I’d like to make it to the Great Barrier Reef for scuba diving. I haven’t made definite plans, but it’s on my list. Also the Red Sea.

Your guilty pleasure food?

Cheetos.

You can read Dr Gordon’s professional biography by clicking here.  Michael Gordon, MD is one of thirteen physicians at Sarasota Orthopedic Associates.  With three locations and same day appointments, our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.

WHEN A HAND NEEDS A HAND

Hand-Therapy-Northern-Beaches-Sydney

Many people are unaware that there are specialties within physical therapy treatment.  One of those specialties is Hand Therapy which requires an extensive amount of additional training and certification examination. A candidate must have a minimum of five years as an Occupational or Physical Therapist and accumulate at least 4,000 hours of hand and upper extremity experience.

So what, exactly, do Hand Therapists do? Hand Therapists, in coordination with an orthopedic physician, provide therapy for the hand, wrist, arm, elbow, and shoulder. They manage conditions such as tendon injuries, crush injuries, amputations, and nerve compression to name a few.

At Sarasota Orthopedic Associates we are so proud to offer hand therapy at all three of our locations.  Vivian Robinson, OT/CHT is an Occupational Therapist and Certified Hand Therapist with 27 years of experience. Sangeetha Bulusu, OT/CHT/CLT is and Occupational Therapist, Certified Hand Therapist, and Certified Lymphedema Therapist with 22 years of experience. Maggie Hilton, OT is an Occupational Therapist with 17 years of experience. These highly skilled women provide therapy under the direction of our SOA physicians, particularly Dr Michael Gordon, a general and pediatric orthopedic surgeon with a specialty in upper extremities, and, Dr Gregory Farino, a general orthopedic surgeon with a specialty in hand and wrist.

This week is HAND THERAPISTS week and we are so proud to highlight our fine team of skilled therapists and physicians who work in tandem for your optimal results. Check out this link on our web page to learn about hand, wrist, and upper extremity treatment.

CANDY CRUSH INJURIES? Are you addicted?

Candy-Crush-Saga-Screenshot-01

You may have heard the recent story (click here) about a man who suffered a ruptured thumb tendon from playing the video game Candy Crush for hours at a time. Apparently the thrill of the game masked the pain which eventually resulted in his rupture. For others, there have even been reports of severe eye strain from long spans of video gaming.

Keeping your hand in one position for extended periods of time can cause cramping and reduced blow flow. Simple finger/wrist stretching may help prevent pain and injury and breaks every 30 minutes have been recommended to help alleviate eye strain as well as hand pain. Pain free movement will allow you to enjoy the game safely.

Have you ever experienced pain from video gaming overuse, and what you did to overcome that? We’d like to hear from you in the comment section below.