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Stepping Stones Rehab. Services

6320 159th St, Oak Forest, Suite F, IL 60452

PH: 708-687-8768, FAX: 708-364-0518

www.handrehabclinic.com

My Blog

Blog

Tommy John Surgery in throwing athlete

Posted on September 12, 2018 at 10:34 AM Comments comments (3204)
Tommy john surgery is the repair of ulnar collateral ligament of elbow. It is named after the pitcher from LA dodgers to get this surgery done in 1974 for the first time. 
This is a very big topic with lot of myths like after surgery you could throw even faster and harder which has been proven completely wrong. 
 
Recently as the need for speed has risen among young athletes these surgeries are becoming more common. 
 
Not only the need for throwing hard but also doing so without proper mechanics, without proper warm up and proper conditioning is also a contributing factor. 
Role of throwing curve balls at an early age before skeletal maturity has been regarded a contributing factor
but certain researches are finding that there might be no correlation.  see reference: 
If you walk around the baseball fields during the baseball season and watch pitchers you could see the variety of pitchers throwing different ways with ultimate main goal of throwing hard. 
Not only the young pitchers are at risk of causing damage to the ulnar collateral ligament (UCL) but the Major league pitchers are also in the news frequently even though they have full squad of sports physicians, trainers etc. 
 
My perception is that there should be focus upon full body conditioning, special focus upon throwing mechanics and proper routine before pitching in the game especially in the cold evenings. 
 
As the biometrics is taking over our sports where teams select bigger kids especially hitters, young pitchers strive to throw harder hurting themselves in the process sometimes. Advancement in equipment like composite bats and other material is also making harder for pitchers so they want to throw harder to get ahead in the game. 
There are some steps taken by certain organizations to change the bat composition to maintain a balance b/w bat and ball. 
 
Eventually the onus is on coaches and parents to talk to their young pitchers if they notice any early signs of discomfort before the serious damage is done. 
As some young pitchers would not complain even if they are hurting. One needs to be a good coach to spot these signs. 
Some signs could be shaking of the pitching arm after every pitch, sudden loss of speed and accuracy, sudden change in throwing mechanics to compensate for the painfully joint etc. 
 
Injury to throwing arm could be minimized by proper warm up before pitching, adequate resting period b/w days of pitching. 
 
There are certain group muscles of shoulder and forearm needs to be strengthened to put less strain at the Ulnar collateral Ligament on the medial inner side of elbow. 
 
Please talk to an Occupational therapist Physical therapist with experience in upper extremity rehab. to evaluate your son/daughter as soon as the pain develops. They can guide you with proper rehab. program to make faster recovery and them back on the field with confidence and help them achieve full potential safely. 
 
Arun Sharma 

Occupational Therapist / Certified Hand Therapist

Trigger Finger/ Locking finger

Posted on February 21, 2012 at 6:13 PM Comments comments (0)
We always get patients in the clinic who c/o finger getting stuck in bent position and when patient pushes hard it snaps into extension as if trigger is released.  In worst cases finger gets stuck in bent position and patient has to use the other hand to extend the finger back. 
Often times it starts without pain and slowly gets very painful. Especially, when patients think that this is due to weakness in hand and they either buy some kind of gadget to improve grip strength which often backfires heavy gripping worsens the symptoms. 
Mostly these patients respond very well to steroid injections at the A-1 pulley region. In long standing cases where finger develops tightness in flexion, patients might benefit from Trigger finger release. 
Hand therapy helps in regaining range of motion in the affected finger or thumb after surgery. Splinting/ heat/ massage/ultrasound therapy/ tendon gliding exs/  activity modification could also help in resolving symptoms without surgery in mild cases. 


Carpal Tunnel Syndrome

Posted on January 15, 2012 at 1:51 PM Comments comments (0)
Carpal tunnel syndrome is caused by pressure on the median nerve, it is the nerve in the wrist that supplies feeling and movement to parts of the hand especially thumb, index , middle and partial ring finger. 
It usually characterized by numbness, tingling, weakness, or muscle damage (long term) in the hand and fingers.
Common Causes:
1. Associated with repetitive work causing compression on the wrist i.e sewing, assembly line, vibratory tools, certain medical instruments etc.
2. certain metabolic disorders or conditions;
 Diabetes, pregnancy, Acromegaly, rheumatoid arthritis, menopause etc.
3. Direct trauma:
fractures of wrist and hand. 
Symptoms:
  • Numbness or Tingling in the thumb and next two or three fingers of one or both hands
  • Numbness or tingling of the palm of the hand
  • Pain extending to the elbow
  • Pain in wrist or hand in one or both hands
  • Problems with fine finger movements (coordination) in one or both hands
  • Wasting away of the muscle under the thumb (in advanced or long-term cases)
  • Weak grip or difficulty carrying bags (a common complaint)
Tests/ diagnostics: 
Certain manual tests are performed by the doctor/ hand therapist to reproduce the symptoms confirming the diagnosis. EMG could be ordered by the physician in order to confirm the diagnoses and extent of nerve damage. 
Treatment:
In early onset cases changing the work environment , using adaptive devices and equipment , use of brace at night to support wrist could help resolve the symptoms.
Medication: Steroid injection, oral steroids, NSAID's to reduce pain and swelling could be tried and helpful in conjunction with hand therapy by a Certified hand therapist, who would perform detailed evaluation of symptoms and design the best treatment plan. 
In long term cases, surgery would be the best option and nerve structure starts to change with long term compression and may result in permanent damage. 
If left untreated, the nerve can be damaged, causing permanent weakness, numbness, and tingling. 
Surgery could be performed by a Plastic surgeon, Hand surgeon, Orthopedic surgeon or Neuro-surgeon.  
Call us at 708-687-8768 or fill out form here to get free evaluation or consultation.