Hunter Hand and Upper Limb Therapy

Frequent Conditions

Impingement:

Impingement occurs when the tendons of the rotator cuff muscles rub underneath a bone on the outer point of the shoulder blade. Pain is usually worse with overhead movements, and is generally felt as a ‘catching’ pain. The treatment of impingement is individualised and depends on the irritability, cause of impingement and contributing factors. In most cases, it is necessary to avoid aggravating activities and to strengthen the muscles of the shoulder that stabilise the humeral head (‘ball’) in the glenoid (‘shoulder socket’).

Rotator cuff tear:

The rotator cuff is a group of four tendons that attach the muscles that function at the shoulder joint to a bone in the arm. These muscles function to lift and rotate the arm at the shoulder joint, but their primary function is to stabilise the humeral head (the ‘ball’ of the shoulder joint) into the glenoid (the ‘socket’ of the shoulder joint). The tendons run underneath a part of the shoulder blade called the acromion, where they are vulnerable to being injured, or slightly torn. This can occur as a result of general ‘wear and tear’ of the rotator cuff in older people, or as a result of a traumatic event (such as a fall). When the tendons or muscles of the rotator cuff tear, there may be significant pain down the side of the arm, and sometimes there is an inability to lift the arm or rotate the shoulder. Tears of the rotator cuff are usually evident on ultrasound or MRI, and can be clinically tested for by a physiotherapist. Treatment involves strengthening exercises for the rotator cuff and in some instances, if the tear is significant, surgery to repair the torn tendons.

Postural dysfunction:

Postural dysfunction develops as a result of prolonged poor positioning of the body as a result of muscle imbalance or weakness. When incorrect postures are sustained for long periods, the soft tissues begin to stretch to the point they begin to ache, and this results in fatigue and pain, particularly in the neck, back and shoulders. This condition can be managed once the poor postures are identified and muscle imbalances are corrected, with the help of a physiotherapist.

Frozen shoulder (adhesive capsulitis):

Frozen shoulder can be a very painful and potentially functionally limiting condition that affects the shoulder. It can come on gradually and is often confused with other problems that affect the shoulder so it is important that it is recognized early so that appropriate treatment can be started. Treatment options include advice about the condition together with appropriate stretching exercises and advice regarding referral for corticosteroid injection if necessary.

Tennis elbow:


Tennis elbow is a painful elbow condition that is usually caused by repetitive movement at the hand or wrist. It can also be caused by a direct blow to the outside of the elbow. Treatment options involve education about the condition which will help you to avoid re-aggravating the elbow as it heals, practical advice on activity modification and/or fitting of a wrist splint if extra support is needed.

Golfers elbow:

Golfers elbow is a condition that presents with pain on the inside of the elbow which can spread down the forearm. It occurs in the same way as tennis elbow either by repetitive activity or a direct blow. The management is similar to that of tennis elbow but focused on the opposite side of the forearm and elbow.

De Quervain’s tenosynovitis:

De Quervain’s tenosynovitis affects two tendons at the base of the thumb, as they travel side by side along the inside edge of the wrist. This may be caused by repetitive use of the wrist. It is common in new mothers due to the handling technique of their new baby. You may feel pain over the thumb side of the wrist, which can then radiate down the thumb or up the forearm. Advice on avoidance of provoking activity, exercises and splintage may help.

Carpal tunnel syndrome:

Carpal tunnel syndrome is a common condition that interferes with the use of the hand. It is caused by too much pressure on the nerve as it runs through the wrist, often as the result of repetitive or sustained gripping activity. You may feel tingling or numbness in the hand, initially just at night, and clumsiness or lack of strength in the hand. Advice on avoidance of provoking activity, exercise and splintage may help.

Thumb joint osteoarthritis:

Osteoarthritis occurs when the smooth cartilage that covers the ends of the bones begins to wear out. The joint at the base of the thumb allows for swivel and pivoting motions and is subject to an unusual amount of stress as your grip things in your hand. To help with this condition, education should be provided on avoidance of loading across the joint and joint protection techniques. Aids may also be utilised to assist with load reduction and bracing, in the form of various splints, to support the joint may also be helpful.

Trigger finger:

Trigger finger is caused by thickening of the tendons (or the tunnel through which it passes) that bend the finger. You may feel a nodule in your palm, with “snapping” of the tendon as you try and make a fist. Advice on avoidance of provoking activity, exercises and splintage may help.

Mallet finger:

A mallet finger injury (drop finger) is a traumatic disturbance to the tendon that straightens the end of the finger. This may be caused from catching your finger in your clothes or hitting the end of your finger during various sports. Without treatment the tip of the finger will remain permanently bent. Treatment includes tendon or fracture protection, via the use of splints, and a graduated exercise program.

Dupuytren’s Contracture:

Dupuytren’s contracture is a disease affecting the fascia (or tissue just under the skin) of the palm and fingers. The fascia becomes abnormal and gradually thickens, causing dimpling of the skin. The condition initially shows up as a thick nodule or a short band in the palm of the hand, thickening and shortening, until the finger cannot be fully straightened. Therapy cannot help in stopping this process. Surgery is often necessary to straighten the finger and therapy is required for a few months afterwards in order to maintain the correction.

General physiotherapy’:

Whilst we focus in the treatment of upper limb conditions we are able to assist you with any condition that may require physiotherapy. We would welcome any enquiry.

Location:

Phone:
(02) 4962 4477

Address:
Broadmeadow Surgical Centre
18 Lambton Rd
Broadmeadow NSW 2292.


View Larger Map