Do you ever shake your hands to rid pain or regain sensation in your hands?

• Do you find yourself waking at night with hand pain or numbness?
• Are you frequently shaking your hands due to lack of sensation?
• Do you get shooting pain up the forearm?

If so, you may have Carpal Tunnel Syndrome.

Carpal Tunnel Syndrome is more common than you think and we've been seeing it (to varying extents) in a large proportion of our patients. It can also be a highly debilitating condition impacting many aspects of daily life.

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is damage or irritation to the median nerve as it passes through the carpal tunnel (a ring of bones in the wrist). The result of damage to the nerve is commonly pains, pins & needles or numbness in the hand (typically the palm side of the hand, including the thumb, index and middle fingers). These symptoms can occur at any time, although they are often worse at night with people frequently waking with a dead hand sensation as well as having severely disrupted sleep.

If Carpal Tunnel Syndrome is left untreated, it can result in:

• Persistent pain, tingling and/or numbness in the hand,
• Weakness in the hand, which may lead to functional impairments (including reduced grip strength and hand dexterity).
• Additional nerve damage further up the arm and even in the neck,
• Permanent damage to the median nerve.

Those with Carpal Tunnel Syndrome will tell you that they will do anything to get rid of it. Why wouldn't you want a pain-free, fully functioning hand with normal sensation? Or perhaps an uninterrupted night of sleep, the ability to open jars again or not having to shake your hand to "wake it up"?

Tailored physiotherapy programs can treat the symptoms of Carpal Tunnel Syndrome that you may have. Physiotherapy treatments for Carpal Tunnel Syndrome include:

• Splinting, which involves wearing an appropriate brace to ease the strain and reduce the irritation on the median nerve.
• Nerve gliding exercises, which are specific exercises to get your median nerve moving well through the carpal tunnel as it often get "stuck" when it is irritated.
• Wrist and forearm stretching and strengthening exercises.
• Addressing postural concerns and neck issues which can be associated with Carpal Tunnel Syndrome.

Our physiotherapists are well-versed in identifying and assessing for Carpal Tunnel Syndrome, as well as differentiating this from other similar conditions.

If you are waking in the night with hand pain or think you may be experiencing Carpal Tunnel Syndrome, a consultation with one of our physios will help put a plan together to put an end to it. Phone 02 8850 7770 or click here and we'll help you get on top of it ASAP.

Ouch! My foot hurts after running/walking...What's going on?

Foot pain can be extremely debilitating, not to mention extremely inconvenient given the amount of time we all spend on our feet during the day.

Lately, with the warm weather and people spending plenty of time out and about being active, we’ve seen an increase in foot complaints and in particular, a high number of stress fracture injuries.

A stress fracture is a nasty injury; however, it is important to note that it differs from a regular fracture in many ways.

So here’s the big question:  How do you know when you have a stress fracture or are at risk of developing one?

As professional physiotherapists, we see a lot of nasty foot injuries and have extensive experience in picking the difference between stress fractures and standard fractures (as well as numerous other foot complaints).

A stress fracture is the result of repetitive stress imparted on a particular segment of bone, and is therefore classified as an overuse injury. It is not the result of acute trauma. Typical activities that can result in foot stress fractures include dancing, running and jumping activities. We have even seen foot stress fractures recently from excessive walking!

The single greatest contributing factor to a stress fracture is load – that is the volume of activity that you are doing and therefore the cumulative stress that you are putting on the bones in your feet.

Other factors that contribute to developing foot stress fractures include decreased strength and flexibility (especially in your calf and toe flexor muscles), reduced balance, poor biomechanics (including feet rolling in), foot anatomical variances including having a 2^nd toe longer than the 1^st (known as a Morton’s foot!) and inappropriate footwear. Believe it or not the surface on which you are exercising (too hard) can play a role as can low bone density, poor nutrition and even menstrual irregularities in females.

Combine any number of these risk factors together with a high load of running, walking, dancing or jumping activities and you place yourself at high risk of developing a stress fracture and spending a lengthy period of time away from these activities.

The reality is that stress fractures can occur in any of your bones in your body with repeated stress applied to them and they do! Due to the complicated biomechanics of the foot, and the fact that we spend large portions of the day on our feet transmitting our body weight through these tiny bones, it should come as no surprise to know that stress fractures are particularly common in the feet.

The most important role that we can play as physios is in the prevention of a foot stress fracture. This is achieved through noting the early signs of bone stress which include foot pain after activity (which may not be severe initially) which progressively worsens with activity and focal pain on palpation.

In most cases identifying what needs to be done to avoid a stress fracture of the foot is as simple as having a thorough discussion with the patient to ascertain activity load (and recent changes to this) and conducting an assessment of the lower limb biomechanics. This allows us to identify activity overload or biomechanical issues in the area, as these are the main contributors to injury and their identification is key to prevention.

Once it has been determined that you are at risk, our physios will take a number of steps in order to help you recover and prevent further injury. This will typically include:

• Altering activity load as appropriate,
• Gait/running/jumping analysis and intervening to make appropriate changes as required,
• Assessment and recommendation of appropriate footwear ,
• Personalised stretches, strengthening & stability exercises,
• Potential prescription of supportive orthotics,
• Soft tissue release techniques (e.g. massage, foam roller),
• Taping techniques to de-load the area at risk or to facilitate changes to biomechanics.

If a stress fracture is actually diagnosed in the foot, the aim of treatment is to facilitate optimal healing, reduce pain levels in the early stages and ultimately facilitate return to pre-injury activity, whilst minimising the risk or recurrence. Treatment may include the following (in addition to the things listed above):

• Immobilisation of the foot for a period of time (e.g. moon boot or cast),
• Rest from foot loading activities (e.g. running, jumping, dancing),
• Mobilising with crutches to eliminate/limit stress applied to the foot,
• Use of anti-inflammatory measures (e.g. medications & ice)
• Personalised plan to return to the loading activities that you desire!

Got a foot complaint?

No problem, we’ve got you covered.

Here’s what you need to do:

Simply call us at the practice on 8850 7770 and we will prioritise you as a matter of urgency.

Keep those feet happy!

Fast Physio Facts #3

1. The difference between running and walking is that running involves a period of time whereby neither foot is in contact with the ground. This period of time is know as the flight phase.
2. The cause of pain isn't always in the area where you feel the pain.
3. Breaks and fractures are actually the same thing when referring to bones.
4. When a joint is sprained, it never completely returns to its pre-injury state.
5. Some people can have an extra rib coming of their neck vertebrae!

Fast Physio Facts #2

1. There are 206 bones in the adult body.
2. Children have even more bones than this. These bones fuse to become mature adult bones in time.
3. A third of those who sprain their ankle will re-sprain their ankle within 3 years.
4. Touching a painful area can reduce the amount of pain experienced. This is why you see people grab an injured area when they hurt themselves. Try it next time you hurt yourself!
5. Excessive abdominal muscle strength training can lead to sexual dysfunction in males!

Fast Physio Facts #1

1. The pedestrian crossing signals at traffic lights in Australia require you to be able to walk at a speed greater than 1.2 metres per second (or 4.32 km per hour).
2. If you strap 2 of your fingers together, after 20 minutes your brain will recognise these 2 fingers as only 1 finger.
3. The shoulder joint is the most unstable joint in the body.
4. Some people cannot feel pain at all. This is known as congenital analgesia.
5. Ice can burn your skin if placed in direct contact with your skin, left in contact with your skin for lengthy periods of time or if too cold.