• Dupuytrens contracture

    Posted on 12/15/2020

    Recently while watching a NFL football game, I came across a commercial with former professional football player John Elway. Mr. Elway was talking about a hand issue he was having called Dupuytren’s contracture, and he explained that there is now a non-surgical treatment option for this condition.

    As a certified hand therapist for almost 17 years now, I am very familiar with Dupuytren’s contracture. However, to see this hand issue brought to life via a TV commercial definitely caught my attention as it isn’t often discussed. In the commercial, Mr. Elway talks about having difficulty with common, everyday tasks and shows a picture of the contraction in the palm of his hand.

    So, you may ask, “What is this condition?”

    Imagine having a finger, or fingers, bent into the palm and being unable to open the hand up fully. This would affect your ability to lay your hand flat on a tabletop, place your hand into a glove or shake hands. In the case of Mr. Elway, he could not grip or throw a football correctly, an activity that he had done for 16 years as a football player. It even affected his golf game.

    There is no known cause of how Dupuytren’s develops. It has been thought of as a condition that people who have origins in northern European countries can contract. It is often called “The Viking’s Disease.” It is most commonly found in men of 50-60 years of age, but women can also be impacted. It affects three percent of the U.S. population.

    Dupuytren's symptoms can take a long time to develop. Mr. Elway mentions in the commercial that he was diagnosed 15 year ago. Signs of Dupuytren’s includes:

    • A hard lump in your palm
    • Inability to place your hand flat on a surface such as a tabletop or counter
    • Scar-like bands that form in the palm
    • Fingers bent into the palm with the inability to open/extend your finger fully
    • Hand pain (although this is less common)

    Our hands contain a tough, fibrous layer of tissue called palmar fascia which gives us a protective layer between our skin and tendons. It also gives our palms firmness. In Dupuytren’s, the fascia can thicken and contract. The most common, visible sign of Dupuytren’s are the hard lumps and bands which are known as nodules and cords. The combination of nodules, cords and the contracting palmar fascia can make your fingers bend in toward your palm.

    I often see patients with Dupuytren’s contracture after they have had some sort of procedure or surgery done to their hand. Many have come to me after they have been diagnosed and treated by a hand surgeon. There are two popular techniques to manage Dupuytren’s contracture, as there is no cure:

    • Surgery, where a hand surgeon opens up the skin and removes all the excess tissue. 
    • An injection to the fibrous cords, which will break them down.

    Typically after either surgery or the injection, therapy by a certified hand therapist is indicated. There are many ways that a certified hand therapist can help patients with Dupuytren’s contracture.

    Therapy after surgery or injection would first consist of an extension orthosis, commonly known as a splint. An orthosis is custom-made for each patient using a piece of thermoplastic material and Velcro strapping. This would help the finger or fingers stay straight. A patient can wear this full-time or just at night, depending on what their surgeon indicates.

    Range of motion exercises are given to help regain full mobility of the hand and fingers. A patient’s wound would be addressed if they have had surgery to watch for infection and manage scar tissue. Lastly, a patient’s strength would be addressed. The end goal for our patients is that they will have functional capability of their hands and are able to perform all the activities of daily living that they choose to do in their lives.

    Please contact your local outpatient center to schedule an appointment with a certified hand therapist to discuss the various options for Dupuytren’s contracture and determine if therapy may be beneficial for you.

    By: Kelly Lee O’Connor, M.S., OTR/L, CHT. Kelly is an occupational therapist/certified hand therapist for NovaCare Rehabilitation in Horsham, PA. Images supplied by Linda Lamaute, M.S., OTR/L, CHT.

    NovaCare is part of the Select Medical Outpatient Division family of brands

     


  • nutritious food

    Posted on 12/1/2020

    In today’s “new normal,” day-to-day life, personal health and wellness is at the forefront of all of our minds. We are protecting ourselves, cleaning more often and trying our best to live fit and healthy lives. One of the most important factors in determining our long-term health and wellness is the food that we put into our body. Especially during this time of year, when sweets and rich foods are easily in reach, it’s more important than ever to make sure our diet is full of nourishing foods to fuel our immune system and fight off illness.

    While a healthy, balanced and colorful diet is extremely important, there are a few key vitamins and minerals that help build our immunity more than others. They all act on different parts of our body’s reaction to illness, allowing the body to fight longer and harder against these intruders. These particular vitamins, and some of their function in the immune system, include:

    • Vitamin C – Protects your cells against free radicals, and absorb/store iron
    • Vitamin B6 – Makes antibodies to fight disease
    • Vitamin E  – Defends your cells against free radicals

    Luckily for us, these vitamins are found in many of the foods that we eat on a daily basis. Some common foods that contain these nutrients include:

    • Vitamin C – Oranges, strawberries, bell peppers, spinach, broccoli, and kale.
    • Vitamin B6 – Tuna, salmon, chicken, chickpeas, bananas
    • Vitamin E – Vegetable oil, peanuts, sunflower seeds, almonds, spinach, broccoli

    The above is by no means an all-inclusive, but definitely a good starting point to begin making changes to help strengthen your immune system. Although these vitamins can easily be found in the health and wellness aisle at your local grocery store or pharmacy, it is not the best way for our body to absorb and take in these nutrients. Including foods that contain high amounts of each of these vitamins into our diet is a much easier, and healthier, way to get our body’s fill.

    Another important aspect of strengthening our immune systems that comes in handy during the current times is daily physical activity. This could include walking, running, hiking, yoga and strength training. Any time you are getting your heart rate up and blood pumping, you are stimulating your body to build stronger muscles, flushing out the lungs and heart as well as boosting your immune system. Exercise helps recruit specific cells that find pathogens and wipes them out, as well as increases the amount of these cells that flow through the body on a regular basis.

    If you have questions, a nagging injury that is limiting your ability to perform daily tasks or are unsure about the right path to take for your personal wellness journey, please reach out to your health care provider to discuss the best plan for you.

    By: Erica R. Konopka, P.T., DPT. Erica is a physical therapist and multi-site center manager for Select Physical Therapy in North Carolina. 

    NovaCare is part of the Select Medical Outpatient Division family of brands.


  • Posted on 11/10/2020

    Did you know that exercise is one of the most under-utilized tools for managing many aspects of your health? It is well known that exercise can help with weight loss by boosting your metabolism and burning calories, but there are so many more benefits, especially as we age.

    Individuals naturally lose bone density and muscle mass as they age. Studies show that after the age of 50, bone breakdown occurs more than bone strength. Women particularly see an acceleration in bone loss around menopause, which puts them at a higher risk for osteoporosis. While there are supplements to help with this, regular weight-bearing exercise reduces the risk for osteoporosis.

    At age 30, we naturally begin to lose muscle mass; physically inactive individuals can lose between three-to-five percent muscle mass each decade after 30. These factors lead to an increase in frailty, which in turn increases the likelihood of falls and fractures. The good news is that you can offset these problematic changes by sticking to a regular exercise program.  
    Here are some other great and important benefits of regular exercise:

    • Exercise helps to reduce the risk of chronic disease. According to The National Institute of Health, lack of regular exercise is the primary cause of chronic disease in the United States. Getting into a fitness routine can increase insulin sensitivity, which in decreases blood sugar, blood pressure, fat levels in blood and cholesterol. It also improves cardiovascular health.
    • Do you have a high stress job? Do you easily allow anxiety to interfere with life? Regular exercise can help with that. Exercise triggers your brain to release endorphins in your body which are mood enhancers and natural pain killers. They create a feeling of well-being. Along with being a mood enhancer, exercise also helps to increase energy levels. Exercise has been shown to begin to help elevate moods in as little as 10 minutes into the activity.
    • Improving brain health and memory. Exercise increases your heart rate, blood flow and oxygen to your brain. According to a study by the Proceedings of the National Academy of Sciences of the United States of America, regular aerobic exercise increases the size of the hippocampus, the part of your brain that is involved in verbal memory and learning. Exercise also stimulates the release of growth factors chemicals in the brain that affect brain cell health, the growth of new blood vessels in the brain and even the survival of brain cells. Reduce your risk factors by beginning an exercise program today.

    You don’t need to exercise for hours at a time to see results in your general well-being. By setting aside 30 to 45 minutes most days of the week for moderate physical activity (brisk walking, swimming, strength training), you can reap the rewards of enhanced health and wellness.

    Now that you are aware of all of the great benefits from regular exercise, why not jump in? You don’t have to be a seasoned athlete to exercise. If you are nervous about beginning a program, a physical therapist is a great resource to help design a safe and effective program for you. Physical therapists are movement specialists who are more than qualified to set up an appropriate program to fit your needs.

    In most states, you can choose to see a physical therapist without a referral from a physician. If you do need a referral, most primary care doctors will gladly provide you with a prescription for physical therapy so that you can begin your journey to a better, healthier you.

    Make time for your wellness before you are forced to make time for your illness. Your physical therapist can help.

    By: Colony A. Hopkins, P.T., DPT, COMT, AIB - VR/CON. Colony is a physical therapist with NovaCare Rehabilitation in Uniontown, Pennsylvania.

    NovaCare is part of the Select Medical Outpatient Division family of brands. 


  • Posted on 10/21/2020

    As recently as five years ago, if you had Googled ‘esports athletes,’ you may very well have come across many sarcastic comments about how they aren’t real athletes. In 2020, you will find items about their tremendous hand-eye coordination, work ethic and the degree to which they work to hone their craft.

    You’ll also find the following: esports are growing at a tremendous rate, for both participants and in terms of viewership. Nearly 100 million people watched the League of Legends World Championships in 2018. There are more than 1.2 billion players of esports worldwide. It is expected that there will be $1.1 billion dollars of revenue generated by worldwide esports in 2020.

    Much like their colleagues in traditional sports, esports athletes place a demand on their bodies that can sometimes be detrimental to their physical health. Unlike traditional athletes, these negative effects rarely start with one-time injuries and are not often obvious. I have had the privilege to work as a physical therapist with the Harrisburg University Storm esports program and have seen problems ranging from carpal tunnel syndrome, to tennis elbow (lateral epicondylitis), to nerve entrapments and neck and upper back pain.

    For the gamers at Harrisburg U, we take a comprehensive approach. They often train many hours a day, so things like load management, which is often discussed in regard to the National Basketball Association and National Football League, is a very real thing that our physical therapists advise for gamers. The gamers at Harrisburg U workout with a personal trainer multiple times every week. We help coordinate with their personal trainer what they should be doing with upper extremities during these sessions so they aren’t overloading muscles in the arms and hands.

    As with many problems that physical therapists address, a problem in one area can be rooted elsewhere, such that an unnoticed postural problem an lead to pain in the wrist or hand. Positioning is very important for gamers and maintaining proper posture is key, so targeted exercises for their postural muscles are a must. Sometimes correcting this can be the difference to the pain in their hands. Basic sports medicine principles like stretching, warming up and using ice after practice and competition are also vital.

    Esports is a burgeoning field both as a profession and as an avocation. Much like their counterparts in traditional sports, they place high demand on key muscle groups and face the risk of injury or pain. This is true for professional and collegiate players and weekend warriors. Just as we do with any athletes, physical therapists play an important role in prevention, management and recovery from injury for the esports athlete.

    By: Bryan Hoyt, MSPT, CEAS. Bryan is a physical therapist and regional director of operations for Select Physical Therapy in central Pennsylvania.