Category Archives: upper limb

Circulation II

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Just as water stagnates when it stops flowing, your blood which is mostly made out of water starts to decompose when it stops flowing. When the circulation in your tissues (flesh and muscle) significantly slows  you have problems because the tissues have a diminished function and are not as good at repairing themselves.

Heart attacks and strokes are about as scary (and common) as circulatory problems get. If you know someone well who has suffered a stroke or a heart attack you may have noticed that even if the incident was relatively minor it really shakes people up and affects their confidence, it can really make people question their own sense of self identity and worth and make them suddenly feel very old.

One can adopt a fatalistic attitude about if your time is up there is nothing you can do about it so you may as well die doing something that you love, the only flaw in this logic is if a heart attack or a stroke does not kill you it may leave you feeling like you wish it had because there is a good chance that you will never be the same again afterwards.

Taking a bigger interest in your health is no guarantee that you won’t meet such a fate, you might be unlucky enough to have poor circulatory DNA but all that any of us can do is to minimise the risks, you wouldn’t knowingly drive on bald tyres now would you?

Heart attack and stroke rate amongst the top four killers of Australians each year, (cancer and medical malpractise make up the other two) but at the other end of circulatory disease spectrum are less life threatening but still concerning problems like how you look for instance.

A persons’ skin usually shows the effect of years of sun baking, smoking and eating fatty food but even if you don’t do any of these things if your circulation isn’t good because you don’t exercise regularly (for instance) you may not have a very good colour or lustre about your skin. The whole cosmetic industry is about how your skin looks and all the cosmetic products under the sun are a poor substitute for good circulation in the blood vessels just under your skin.

Your eye sight is very much subject to your circulatory health too, glaucoma, the number one cause of blindness in this country is most often caused by by capillary damage in your retina. Having diabetes is the number one reason why people get glaucoma, and it is not the only circulatory problem that diabetics get, capillary damage can give you diabetic ulcers on your extremities and can even cause impotence in men.

Even though diabetes is an endocrine disorder it can have big circulatory consequences, with diabetes growing faster than all other diseases more and more people will be forced into taking greater care in their circulation as well as their diet.

Your circulation really is a big deal and effects your whole body, it is yet another reason why we must exercise, eat and hydrate well and pay close attention to our posture.

Dupuytrens Contracture

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Dupuytrens Contractures are a progressive condition that effects the palm of the hand, they usually occur under the ring finger and pinky but can effect other fingers too.

The progressive thickening of the fascia and tendon ( tough fibrous tissues) under the skin makes it more and more difficult over time to straighten the affected fingers out, often it appears that the skin is stuck to the tissue underneath, a bit like a stitch that has been put in the wrong place on a garment, like an adhesion from surgery or a deep cut that healed long ago. Sometimes Dupuytrens Contracture (DC)  is referred to as Trigger Finger.

DC is more common in men than women, usually has a hereditiory link, rarely starts before the age of 40, is more common in people with Nordic ancestry, more common in alcoholics and in diabetics and is thought to be an auto-immune disease. DC starts off painlessly but becomes increasingly debilitating over the years as the affected finger/s bends more and more towards the palm.

Sometimes DC sufferers get tendon shortening on their soles (called Lederhausen Disease) and men may develope a bend in their penis (called Pyronie’s Disease). Medical texts often state that DC has no known cause but DC is much more common in the right hand than the left so you may want to try not over using your “good” hand and see if it makes a difference.

DC is operable but may come back even worse than before because of the high risk of scar tissue formation (which DC resembles). There is also a procedure performed now in some clinics with enzyme  injection therapy performed under a local anaesthetic ( Sunnybrook Hospital in Toronto has a website that shows it in action) that is considered by many to be a superior treatment to surgery.

Surgery and enzyme injection therapy may be what you need in the long term to fix DC but if you are at the stage of the first nodule forming on your palm well before it reduces your dexterity, there are other measures you might like to try.

Hand massage and exercise is good for your hands anyway and is definately worth trying if you have the early signs of DC and if you go to a physio for it you might ask them about ultrasound too. Warming your hands up in warm water before you stretch your fingers and hands will probably make them more pliant too and best of all it is something that you can do for yourself.

If you start to notice some nodular swelling on your palm, particularly if you have seen this in an older family member it might be a good idea to start massaging and stretching them as a daily ritual, your hands are far too important to neglect. If the stretching and Self Massage doesn’t prevent DC it may slow down it’s progression and gives you more time before it really becomes problematic.

Your Wrists and your Keyboard.

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While it is true that no single solution is going to equally suit all people, one thing that did catch my attention recently was an email newsletter that I received last week about ergonomic posturing for computer use.

The advice was quite simple, it invited you to try using your computer keyboard in the “flat” position (NOT propped up at the back on it’s retractable legs) irrespective of what type of keyboard you are using. Included in this advice was discarding any comfortable looking wrist rest that you may normally use.

The rationale for doing this is that it is your best chance of keeping your wrists as straight as you can while using your keyboard, middle finger tip in direct line with your elbow (no sideways bending of wrists) and your hand neither bent forward or backward at the wrist. Over the last 4 weeks I put this to the test.

To my surprise my wrists did feel better using the computer in this way, it did seem counter-intuitive at first to fold the legs of the keyboard up and to do away with the gel wrist rest but because the wrists are used in this flat way there is no  point of pressure exerted on the wrist. The weight of your forearms are more evenly distributed on the desk top too.

Whether you give this way of typing a try or you elect to continue using your computer in the usual way do stretching exercises for your wrists and fingers. Arm out straight infront of your body, fingers bent upwards with your other hand pulling back your finger tips, you should feel the muscles on the palm of your hand and on the under (pale) side of your wrist and forearm stretching.

Alternate this stretch with arm straight out infront of your body again except with your other hand pulling your fingers downward giving you the sensation that the muscles on top of your forearm are stretching now.

If you experience any sharp or restrictive pain doing this you should desist and find out why this is happening, carpal tunnel compression in your wrists (please see the sore and tingling hands blog) is one possible reason why this can happen. Another condition that can make stretching your hands difficult is having a Dupuytrens Contracture which can slowly cripple your hand over a long period of time. If the contracture is serious you may need to see a hand surgeon.

Whatever your method of typing everybody needs to know their limits, a few short walking or stretching breaks each hour will sooth your wrists and hands. If you work on computers all day and then use them for study or recreation when you get home, you are even more likely to experience wrist pain.

It is a great shame that more thought hasn’t gone into ergonomic computer design with. Industrial diseases such as RSI are no longer the exclusive domain of poorly educated, non-English speaking people working on assembly lines, highly qualified professionals get RSI too now because of computer use.

Self Massage

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The main reasons that people do not get massages more often is that they don’t think they can afford the money or time for them. On the other hand not many people who have had a massage from someone who knows what they are doing are unimpressed. How to get the benefits without the costs?

Do a massage course yourself, make some friends there and swap massages with one another, the cost of the course can vary widely depending on the length of the course and where you study but if you don’t mind giving some massage to get some back yourself this can be a satisfactory arrangement.

If you can’t (or won’t) spend time and money on a massage course buying a massage machine may be an option for you. There are massage appliances ranging from basic wooden and plastic hand operated roller style tools that cost a few dollars right up to electric heated massage couches that can cost thousands. They are all good to a point (so long as you buy them from someone reputable) but they have limitations too. Massage machines cannot think for themselves (not yet anyway) you still have to know how to place them. Falling asleep on one can chafe your skin, mechanical massagers with timer switches are safest. .

There are cheaper cash only massage stalls around the place that do not operate under health department regulations, some of which offer adult services (you might not want anyone you know to see you walking out of such a place). Your health fund is unlikely to pay for these appointments and there is no guarantee the masseur/masseuse is even trained.

Even if you think massage is an indulgence rather than a muscle therapy, it is a healthy indulgence. Most other indulgences will put you into an early grave. Massage is good for your general circulation, it can shorten muscle recovery time, it can calm you down when you are stressed and it frees up body stiffness.

Self Massage & +40 Fitness has been written for everybody who likes getting massage. By using simple leverage with your own body weight and posturing yourself correctly using the best angles and tools you can give yourself the benefits of massage for no cost.

Work out your Work Out II

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One of the most frequently exercise-neglected areas of the body is your abdomen. The abdominals help hold your spine straight and your digestive organs in place, they serve a very important function. Young women with good abdominal tone fair much better in the labour ward than their flabby sisters, good abdominal tone helps your digestion and the cosmetic appeal of a flat belly on men or women is so obvious it hardly needs mentioning.

Sit ups and crunches may still be the most commonly used abdominal exercises but they are not best practice and are likely to cause or worsen lower back pain. They do not work the most important abdominal muscles, overwork your hip flexors which are probably already too tight and are bad for your posture. With the weight of your upper body rocking vigorously backwards and forwards over your lop sided hips, the SI (sacro-iliac) joints become even more off-centre and can cause chronic lower back and hip pain.

A lot of people give up on their abdominal tone because the only exercises they were brought up to believe in just give them back pain. One way you can help your abs is to suck your belly in and tense it several times through the day and hold it there for a couple of minutes each time, you can do this even sitting at your desk at work. Doing this will help keep your back straighter too.

Erik Goodman’s Foundation exercises are amongst the best I seen for abdominal core strength, they have the advantage of being mainly executed in the a standing position making them more accessible for older people and exercise multiple muscles simultaneously, you can see some of these demonstrated on Youtube.

Chin ups (Pull ups) are another good example of multiple muscles being strenuously and symmetrically put to work at the same time, your lats, biceps, upper back, wrist flexors and abs are all engaged with this exercise that only requires an overhead bar to support your body weight.

Walking or running up stairs can be a convenient whole body way to fit short burst of exercise into your busy day, you don’t need to be in a gym to exercise.

Swimming is an exercise that works multiple muscles simultaneously though obviously not nearly as conveniently. Cardio unlike stretching and strengthening requires more time dedication but can be easily accommodated by walking or cycling to work and back.

Some stretching exercises work numerous muscles at the same time too, if you want to make exercising more compact and time efficient you will find some good examples in Self Massage & + 40 Fitness.