Caroline Girard RMT

10/13/2022

09/30/2022

🔈 CRANIAL NERVES AND THEIR DISTRIBUTIONS

08/24/2022

🔈 POSSIBLE CAUSES OF KNEE PAIN

08/10/2022

CARPAL TUNNEL SYNDROME

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition in which the median nerve, a major nerve in the upper extremity that travels down the arm and enters the hand through a very small gap called carpal tunnel located in the central part of the wrist, gets compressed in the carpal tunnel. This causes irritation of the nerve leading to tingling or pain. Typically, this disease affects the thumb, index, and middle fingers.

Signs and Symptoms of Carpal Tunnel Syndrome

Carpal tunnel syndrome causes numbness, weakness, pain, or tingling in the hand or fingers. Some individuals experience pain in the arm between their elbow and hand.

▪️Symptoms generally may occur in the thumb, index finger, middle finger, and half of the ring finger.
▪️Pain in the other fingers except little finger may be a sign of carpal tunnel syndrome.
▪️Hands and fingers get weak.
▪️Slight pain in forearm and wrist.
▪️Pain will be severe at night.
▪️Feeling of relief just by shaking out the hand.

Treatment for Carpal Tunnel Syndrome

Carpal tunnel syndrome is first treated by conservative method. The general treatment includes complete rest for the wrist by wearing a splint. Cold therapy helps a lot to relieve the swelling and inflammation.

Surgery is performed in severe cases. Carpal tunnel release is a very simple operation in which carpal ligament is cut in order to enlarge the carpal tunnel and relieve the pressure on the median nerve. This is done either by open technique or endoscopic technique.

Physiotherapy for carpal tunnel syndrome is important in speeding up the healing process and to get the optimal results. Physiotherapy also decreases the likelihood of recurrences in the future. Physiotherapy may include:

▪️Soft tissue massage.
▪️Electrotherapy.
▪️Joint mobilization.
▪️Heat and ice treatments.
▪️Bracing or splinting.
▪️Exercises to improve strength and flexibility.
▪️Activity modification and training.
▪️Appropriate plan for return to activity.Soft tissue massage.

Exercises for Carpal Tunnel Syndrome:

Stretching and strengthening exercises are really helpful for the prevention from re-occurrence of symptoms. Pain free exercises are recommended. Aim for a full, pain-free range of motion before moving on to strengthening exercises.

Wrist Flexor Stretch against a chair

Method:

Starting Position:
Stand next to a chair. Lean forward and place your outstretched hand on top of the chair’s sitting surface with the palm facing and in contact with the surface of the chair.

Action:
In a slow and progressive manner push the wrist against the chair’s surface until you feel the resistance of the end of range. At end of range, hold the position for 15 seconds whilst breathing slowly and deeply. Ensure you keep the elbow fully extended throughout the exercise.

08/05/2022

🔈 HEADACHE AT THE BACK OF THE HEAD

There are many different types of headaches. One of the more common headaches is the suboccipital headache.

At the base of the skull there is a group of muscles, the suboccipital muscles, which can cause headache pain for many people. These four pairs of muscles are responsible for subtle movements between the skull and first and second vertebrae in the neck.

When the suboccipital muscles go into spasms they can entrap the nerves that travel through the suboccipital region. By compressing the suboccipital nerves they set off a series of events that lead to either a tension or a migraine like headaches.

CAUSES

The suboccipital muscles commonly become tense and tender due to factors such as

- Eye strain, wearing new eyeglasses.
- Sitting at a computer with our head forward and our head slightly tipped these muscles are doing a significant amount of work. This poor posture eventually causes the muscles to become tired, fatigue, and injured.
- Grinding the teeth, slouching posture, and trauma (such as a whiplash injury).

SYMPTOMS

Common signs and symptoms of a headache stemming from the suboccipitals include

- Pain, stiffness, and a dull ache in the upper neck and base of the skull
- Pain on the back of the head, and pain in the forehead and behind the eyes.
- Sometimes there may be visual disturbances or nausea, but those tend to be more common in migraine type headaches.

TREATMENT

People often feel relief when icing, stretching, or rubbing the suboccipital muscles. In the early stages rubbing the suboccipital region can reduce or eliminate a headache.

When the headaches progress often palpating the suboccipital muscles intensifies the headache. Some people feel a tension band or headache that moves towards the eye. When pushing on the suboccipital muscles, it may increase the intensity of eye pain.

Suboccipital headaches are improved with over-the-counter NSAIDs, ice, stretching, therapy, electric, ultrasound, and cold laser treatments. Goals of treatment are to decrease muscle spasms of the suboccipital muscles and trapezius. The poor posture of slouching forward and tipping the head up causes additional injury and spasms to the trapezius and upper back muscles. Treatment always looks at improving these muscles as well.

Treatment will focus on improving posture when standing and sitting, to relieve stress and strain on the muscles. In addition massage therapy is excellent at decreasing muscle spasms, pain, tenderness, and tension in these muscles. Stretching will be utilized to enhance flexibility. Strengthening exercises will be utilized for the weak muscles of the neck and shoulder complex.

Graston Technique is a very effective tool at decreasing the scar tissue and spasms associated with poor posture, headaches, and suboccipital spasms. Often people with suboccipital headaches have had poor posture for many years, and grass and helps decrease the fascial adhesions and scar tissue from years of poor posture.

08/03/2022

🔈 KNEE BURSITIS EXERCISES

You can stretch your leg right away by doing the first 3 exercises. You may start doing the other exercises when your leg is less painful.

🔎 Hamstring stretch on wall: Lie on your back with your buttocks close to a doorway. Stretch your uninjured leg straight out in front of you on the floor through the doorway. Raise your injured leg and rest it against the wall next to the door frame. Keep your leg as straight as possible. You should feel a stretch in the back of your thigh. Hold this position for 15 to 30 seconds. Repeat 3 times.

🔎 Standing calf stretch: Stand facing a wall with your hands on the wall at about eye level. Keep your injured leg back with your heel on the floor. Keep the other leg forward with the knee bent. Turn your back foot slightly inward (as if you were pigeon-toed). Slowly lean into the wall until you feel a stretch in the back of your calf. Hold the stretch for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Do this exercise several times each day.

🔎 Quadriceps stretch: Stand at an arm's length away from the wall with your injured side farthest from the wall. Facing straight ahead, brace yourself by keeping one hand against the wall. With your other hand, grasp the ankle on your injured side and pull your heel toward your buttocks. Don't arch or twist your back. Keep your knees together. Hold this stretch for 15 to 30 seconds.

🔎 Hip adductor stretch: Lie on your back. Bend your knees and put your feet flat on the floor. Gently spread your knees apart, stretching the muscles on the inside of your thighs. Hold the stretch for 15 to 30 seconds. Repeat 3 times.

🔎 Quad sets: Sit on the floor with your injured leg straight and your other leg bent. Press the back of the knee of your injured leg against the floor by tightening the muscles on the top of your thigh. Hold this position 10 seconds. Relax. Do 2 sets of 15.

🔎 Heel slide: Sit on a firm surface with your legs straight in front of you. Slowly slide the heel of the foot on your injured side toward your buttock by pulling your knee toward your chest as you slide the heel. Return to the starting position. Do 2 sets of 15.

🔎 Straight leg raise: Lie on your back with your legs straight out in front of you. Bend the knee on your uninjured side and place the foot flat on the floor. Tighten the thigh muscle on your injured side and lift your leg about 8 inches off the floor. Keep your leg straight and your thigh muscle tight. Slowly lower your leg back down to the floor. Do 2 sets of 15.

07/19/2022

Probably the most important set of muscles in your shoulder! Find out more about it, plus how to build rotator cuff strength

07/19/2022

🔈THE SIX TYPES OF SYNOVIAL JOINTS

Synovial joints are classified according to the shape of their articulating surfaces and/or the type of movement they permit.

1. Plane joints permit gliding or sliding movements in the plane of the articular surfaces. The opposed surfaces of the bones are flat or almost flat, with movement limited by their tight joint capsules. Plane joints are numerous and are nearly always small. An example is the acromioclavicular joint between the acromion of the scapula and the clavicle.

2. Hinge joints permit flexion and extension only, movements that occur in one plane (sagittal) around a single axis that runs transversely; thus, hinge joints are uniaxial joints. The joint capsule of these joints is thin and lax anteriorly and posteriorly where movement occurs; however, the bones are joined by strong, laterally placed collateral ligaments. The elbow joint is a hinge joint.

3. Saddle joints permit abduction and adduction as well as flexion and extension, movements occurring around two axes at right angles to each other; thus, saddle joints are biaxial joints that allow movement in two planes, sagittal and frontal. The performance of these movements in a circular sequence (circumduction) is also possible. The opposing articular surfaces are shaped like a saddle (i.e., they are reciprocally concave and convex). The carpometacarpal joint at the base of the 1st digit (thumb) is a saddle joint.
4. Condyloid joints permit flexion and extension as well as abduction and adduction; thus, condyloid joints are also biaxial. However, movement in one plane (sagittal) is usually greater (freer) than in the other. Circumduction, more restricted than that of saddle joints, is also possible. The metacarpophalangeal joints (knuckle joints) are condyloid joints.

5. Ball and socket joints allow movement in multiple axes and planes: flexion and extension, abduction and adduction, medial and lateral rotation, and circumduction; thus, ball and socket joints are multiaxial joints. In these highly mobile joints, the spheroidal surface of one bone moves within the socket of another. The hip joint is a ball and socket joint in which the spherical head of the femur rotates within the socket formed by the acetabulum of the hip bone.

6. Pivot joints permit rotation around a central axis; thus, they are uniaxial. In these joints, a rounded process of bone rotates within a sleeve or ring. The median atlanto-axial joint is a pivot joint in which the atlas (C1 vertebra) rotates around a finger-like process, the dens of the axis (C2 vertebra), during rotation of the head.

07/16/2022

🔈 RELATIONSHIP OF SCIATIC NERVE TO PIRIFORMIS

(A) The sciatic nerve usually emerges from the greater sciatic foramen inferior to the piriformis.
(B) In 12.2% of 640 limbs studied by Dr. J. C. B. Grant, the sciatic nerve divided before exiting the greater sciatic foramen; the common fibular division (yellow) passed through the piriformis.
(C) In 0.5% of cases, the common fibular division passed superior to the muscles where it is especially vulnerable to injury during intragluteal injections.

07/12/2022

🔈 VEINS, MUSCULOVENOUS PUMP & VARICOSE VEINS

Although most veins of the trunk occur as large single vessels, veins in the limbs occur as two or more smaller vessels that accompany an artery in a common vascular sheath.

Musculovenous pump. Muscular contractions in the limbs function with the venous valves to move blood toward the heart. The outward expansion of the bellies of contracting muscles is limited by deep fascia and becomes a compressive force, propelling the blood against gravity.

When the walls of veins lose their elasticity, they become weak. A weakened vein dilates under the pressure of supporting a column of blood against gravity. This results in varicose veins - abnormally swollen, twisted veins - most often seen in the legs. Varicose veins have a caliber greater than normal, and their valve cusps do not meet or have been destroyed by inflammation. Varicose veins have incompetent valves; thus, the column of blood ascending toward the heart is unbroken, placing increased pressure on the weakened walls, further exacerbating the varicosity problem. Varicose veins also occur in the presence of degenerated deep fascia. Incompetent fascia is incapable of containing the expansion of contracting muscles; thus, the (musculofascial) musculovenous pump is ineffective.