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   Life is movement, Movement is life

    Arm

 Arm injuries

Minor arm injuries are common. Symptoms often develop from everyday wear and tear, overuse, or an injury. Arm injuries are often caused by:

Sports or hobbies.

Work-related tasks.

Work or projects around the home.

Your child may injure his or her arm during sports or play or from accidental falls. Chances of having an injury is higher in contact sports, such as wrestling, football, or soccer, and high-speed sports, such as biking, in-line skating, skiing, snowboarding, and skateboarding. Forearms, wrists, hands, and fingers are the injured most often. An injury to the end of a long bone near a joint may harm the growth plate and needs to be checked by a doctor.

Older adults have a greater chance for injuries and broken bones because they lose muscle mass and bone strength (osteoporosis) as they age. Older adults also have more problems with vision and balance, which increases their chances of having an accidental injury.

Most minor injuries will heal on their own, and home treatment is usually all that is needed to relieve symptoms and promote healing.

Acute injuries

Acute injuries come on suddenly and may be caused by a direct blow, a penetrating injury, or a fall or from twisting, jerking, jamming, or bending a limb abnormally. Pain may be sudden and severe. Bruising and swelling may develop soon after the injury. Acute injuries usually require prompt medical evaluation and may include:

Bruises (contusions ), which occur when small blood vessels under the skin tear or rupture, often from a twist, bump, or fall. Blood leaks into tissues under the skin and causes a black-and-blue color that often turns purple, red, yellow, and green as the bruise heals.

Injuries to the tough, ropelike fibers (ligaments) that connect bone to bone and help stabilize joints (sprains).

Injuries to the tough, ropelike fibers that connect muscle to bone (tendons).

Pulled muscles (strains).

Muscle ruptures, such as a biceps or triceps rupture.

Broken bones (fractures). A break may occur when a bone is twisted, struck directly, or used to brace against a fall. See a picture of a fractured arm .

Pulling or pushing bones out of their normal relationship to the other bones that make up a joint (dislocations).

Overuse injuries

Overuse injuries occur when stress is placed on a joint or other tissue, often by "overdoing" an activity or repeating the same activity. Overuse injuries include:

Pain and swelling of the sac of fluid that cushions and lubricates the joint area between one bone and another bone, a tendon, or the skin (bursitis).

Pain and swelling of the tough, ropelike fibers that connect muscles to bones (tendinitis).

Pain and swelling from tiny tears (microtears) in the connective tissue in or around the tendon (tendinosis). Other symptoms of this type of tendon injury include loss of strength or movement in the arm.

Hairline cracks in bones of the arm (stress fractures).

Pressure on nerves in the arm, such as carpal tunnel syndrome.

Treatment

Treatment for an arm injury may include first aid measures (such as using a brace, splint, or cast), "setting" a broken bone or returning a dislocated joint to its normal position, physical therapy, medicines, and in some cases surgery. Treatment depends on:

DE QUERVAIN’S TENOSYNOVITIS

Sometimes called simply tenosynovitis, tendinitis or intersection syndrome, it is without doubt the most common arm injury in sea kayaking. It needs to be treated immediately.

WHAT IS IT?

Tenosynovitis is a painful inflammation of tendons in the wrist caused by friction. It almost always occurs in the wrist directly behind the thumb where two tendons intersect. If you hold your right arm out with palm and fingers vertical, thumb on top, the injury site will be on top of your wrist about where your watch strap would go around. Now, using the fingers of your left hand, pinch the top of your right wrist as you clench and unclench your right hand and you’ll feel the tendons working.

Tendons are fibrous tissue which connect muscles to bone. Some tendons run very close to each other (such as in the wrist). In these locations they are protected and separated by their own sheath which secretes a thick fluid called synovia to lubricate the tendon as it passes up and down the sheath. When a tendon is called upon to work hard it swells slightly and puts pressure on the sheath as it moves. If the sheath is unable to secrete enough fluid to lubricate the tendon’s movements, it dries out (so to speak) and heat develops through increased friction. This is definitely a case of ‘oils ain’t oils!’

If the activity causing the problem continues, there is increased blood flow to the site and quite visible swelling. The area also becomes painful and inflamed. In severe cases, a squeaking noise (called crepitus) can be heard quite clearly. It is a disabling condition which can prevent use of the affected hand altogether.

If the activity causing the inflammation continues, scar tissue can develop in the sheath inhibiting further lubrication. The condition may then become chronic and require surgery to slit open the sheath and remove scar tissue.

WHAT CAUSES IT?

Generally, it is caused by rapid repetitious movements of the thumb and wrist and is common in assembly line workers. Interestingly, the occurrence of tenosynovitis in assembly line workers is more common in those workers performing a task for the first time, which leads to the observation that it is also a more common injury for those new to sea kayaking than it is for the old sea dogs (trip leaders should remember this when leading paddles for those new to sea kayaking). The condition can also occur more readily in the old sea dogs who have had a lengthy rest from paddling. It would seem that there is some conditioning factor here and that those returning to paddling after a lay-off should do so gently at first.

TREATMENT

Like many inflammation type injuries, the first and best treatment is rest. That is, rest the limb from the action suspected of causing the injury. A splint that immobilises the thumb and wrist. The splint can be made of anything - clothing, bandages… even sticks and duct tape! Anything that stops the tendons moving will be OK.

The next step, if those aren’t successful, is a visit to the doctor for a corticosteroid injection into the tendon sheath. If the doctor gets it in the right place, the relief is instantaneous and that may even cure the problem… as long as the arm is also rested.

CARPAL TUNNEL SYNDROME

CTS is also known as Repetitive Strain Injury (RSI) and its occurrence being common among keyboard operators, hairdressers and process workers. Awareness of OH&S issues in recent years has seen the introduction of better work practices and maybe it’s not so common these days.

WHAT IS IT?

CTS is pain, numbness and tingling of the fingers (thumb and first three fingers only) caused by compression of the median nerve where it passes under the carpal ligaments. Carpal ligaments run across the heel of your hand (on the palm side) just in front of your wrist. Under the ligament, in the carpal tunnel, run veins, arteries, eight flexor tendons and the median nerve. There’s not much room in there and any swelling of the tendons (doing work, remember) can put pressure on the median nerve causing tingling and numbness.

If the pressure in the carpal tunnel continues, the nerve can become scarred, further tightening in the tunnel and leading to pain (especially at night) and ultimately, loss of hand function.

TREATMENT .

Splinting the hand/s, especially at night is also helpful. Corticosteroid injection into the carpal tunnel is also claimed to be of benefit. In cases where loss of feeling in the hand and fingers is evident, a simple surgical operation to slit the ligament to relieve pressure on the median nerve is performed. :

TENNIS ELBOW

The medical name for this injury is Epicondylitis. It basically means ‘a lump above the lump at the end of a bone!’ There are two types of Tennis Elbow or Epicondylitis.

They are Medial and Lateral Epicondylitis. The latter is by far the most common injury.

WHAT IS IT?

Despite its name, Tennis Elbow is not as common among tennis players as you would think. It is common in golfers, bricklayers, squash players and surprisingly violinists.

Tennis Elbow is a tear or overload injury and occurs at the elbow. Hold your arm with the elbow at right angles. On the outside of your elbow you can feel a bony lump about halfway up your elbow. This is a lateral epicondyle (now you know!). Tendons of extensor muscles in your forearm attach to the bone here.

WHAT CAUSES IT?

Can you remember ever bumping this bone on a doorway as you’ve walked through and mentioned that you’ve bumped your funny bone? You can? Well, that’s often the start of a Tennis Elbow injury. The tear of the tendon attachment point onto the bone often follows a bump which you may or may not remember. It may be something simple such as opening a jar,  wringing wet clothes or feathering a paddle blade which does the final damage.

Once it’s happened though, you’ll know about it! It can be very painful and simple tasks such as picking up a cup of tea or shaking hands become impossible in severe cases.

There is usually no swelling although the site of the tear is very tender. Normal elbow movement is possible but resisted extension of the wrist upward is painful. Holding up a paddle in one hand can be similarly painful. In fact any action requiring gripping with a palm-down attitude will cause pain.

TREATMENT

The good news is that the injury will respond to treatment. The bad news is that a full recovery may take 6 months to 2 years!

Rest is the first line of treatment. This should involve RICE (Rest, Ice, Compression, Elevation) as required. Anti-inflammatory drugs are also used if the injury is acute.

Corticosteroid injections are also used and surgical intervention too in severe cases.

Stretching and strengthening exercises are also prescribed during recovery. 

If you suffer an arm injury, use commonsense: rest the injured limb immediately and then, as the man says, “If pain persists, see your doctor at A+ clinics.”

      
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