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ACTIVE P.T. SOLUTION S ...BECAUSE LIFE SHOULD BE ACTIVE APTS Monthly Office Hours: VOLUME VII, ISSUE XII DECEMBER 2017 Monday - 8:00am - 5:30pm Tuesday - Pain or Pain? 8:00am - 7:00pm Wednesday - Carpal tunnel syndrome is one of the and pain or tingling. There are and forward head pos- most common entrapments of some that get temporary relief but the ture. When the shoulders round 8:00am - 5:30pm the upper extremity. It occurs when problem recurs frequently with symp- and the head shifts forward, the Thursday - the is compressed in toms of higher intensity. Other pa- muscles in the neck and shoulders the wrist. However, it is not uncom- tients develop symptoms similar to compress the that course 8:00am - 5:30pm mon for compression of the median carpal tunnel syndrome following neck from the neck to the . The nerve to occur in several different injury. They may not have had a wrist hand requires a stable base at the Friday - sites in the . Over the course injury but still experience pain in the neck and shoulders in order to 8:00am - 4:00pm of time, the general population has hand. function properly. Weakness come to accept that hand and wrist caused by inactivity and poor pos- Location: pain, numbness, or tingling adds up to Since the ture ultimately causes the hand and carpal tunnel syndrome. In fact, hun- body is a 91 Columbus Street forearm muscles to be over- dreds of people each year have wrist complex worked. This results in “double Auburn, NY 13021 decompression surgery in hopes of network of crush syndrome” or nerve com- relieving these symptoms. The prob- joints, pression in the neck and shoulders P: (315) 515-3117 lem with this thought process is that nerves, proximally while also causing com- there are many causes of numbness, ligaments, pression distally in the hand and tingling, and/or pain in the and muscle, forearm. This results in tingling, . and fascia, pain or numbness in the hand, wrist INSIDE THIS it is possible that a symptom from one and arm. ISSUE: Symptoms specific to carpal tunnel area of the body may be caused by a syndrome most often occur in the problem located in a different part of Before you accept a diagnosis of , index , middle finger, the body. This approach to healing is carpal tunnel syndrome, ask your- Wrist Pain or 1 and half of the . If you have more holistic as opposed to the isola- self some simple questions: Did Neck Pain symptoms in your fingers but your tionist approach. Recent research anyone examine my neck? Was I is fine, this may be a sign demonstrates this to be the case in given an explanation why my neck Exercise of the 2 that you have carpal tunnel syn- patients experiencing symptoms of was not a cause of my hand symp- drome. There are two other periph- carpal tunnel syndrome. Some studies Month: Wrist toms? Should I get a second opin- eral nerves that supply the hand. The indicate that it is not uncommon for Stretches ion? Does the diagnosis of carpal ulnar nerve supplies the little finger, symptoms of carpal tunnel syndrome tunnel syndrome make sense? Good Luck, Laura! 2 while the radial nerve supplies the may be caused by muscle stiffness in Were metabolic causes of carpal Welcome, Patty! backside of the thumb, index and the neck and shoulders resulting in tunnel syndrome ruled out, such as middle fingers. Nerve roots from the poor posture, tense muscles, nerve diabetes, thyroid disease, and even neck or cervical spine (C6, C7, C8) compression, and pain traveling down pregnancy? Holiday Health 2 control a different pattern of sensa- the arm and into the hand. Tips tion in the hand with some overlap. Generally speaking, there are many This is what makes the diagnosis of a While we have created a technologi- options for the treatment of pa- cervical spine problem versus true cally advanced society, these advance- Carpal Tunnel 3 tients experiencing carpal tunnel- carpal tunnel syndrome so challeng- ments have accelerated the aging proc- Syndrome like symptoms. Do your homework ing. It is also why it is so important to ess creating chronic postural distor- and work with healthcare providers answer questions about your symp- tions in even our youngest members. that share your goals and expecta- APTS Recipe Box: 3 toms as specifically as possible. The In a given day, it is not uncommon for tions. As the patient, it is your right (Paleo) Gingerbread diagnosis will sway one way or an- the majority of the population to go to choose a physical therapist with Cookies other based on the answers you from a car to a desk and computer, whom you feel most comfortable provide. back to a car, and finally to a La-Z-Boy. discussing all aspects of your care. Nutrition 101: The 4 Power of Peppermint Many people who have undergone This lack of movement creates a dom- Article by Dale Buchberger, surgery for carpal tunnel syndrome ino effect, and most relevant to carpal DC, PT, CSCS continue to experience hand, wrist, tunnel syndrome is the rounding of the P A G E 2 Exercise of the Month: Wrist Stretches

This month’s exercise features “bottom” (palm) side of the may already feel a stretch just by two stretches for the wrist that forearm. Stand with your palm getting into this position. To will help prevent or relieve pain on the table, fingers pointing increase the stretch, keep the in the wrist, , and forearm, behind you, and the elbow fully back of your hand on the table, especially for those people that extended. You may already feel a elbow extended, and wrist down, perform a lot of repetitive mo- stretch in this position. If not, and then lean back slightly to feel tions with their hands. For each keep your palm on the table and more of a stretch in the forearm. of these stretches, you’ll want to your elbow extended and lean Hold each stretch for 30 seconds find a table high enough to rest back slightly to feel a stretch in and perform one stretch three your hand on comfortably with the forearm. different times a day to keep your elbow straight. If you can’t The second stretch is for the your wrist, forearm, and elbow find one high enough, you can “top” side of the forearm. Stand loose and less painful. stack books on a table until you with the back of your hand on Wrist flexor stretch As always, if you experience any reach a comfortable height to the table, fingers once again (top) and wrist extensor perform the exercise. lasting pain or discomfort, seek pointing behind you, and the the advice of a healthcare profes- stretch (bottom) The first stretch is for the elbow fully extended. Again, you sional. Good Luck, Laura! Welcome, Patty!

Active Physical Therapy at BOCES as well as attend- 12:00-7:00 on Tuesdays. Solutions had to say good- ing Cayuga Community Thank you in advance for bye to our part-time front College. She will be missed! your patience as she learns desk staff member, Laura We do, however, have a the ins and outs of how the Fennessey, who worked front desk operates. Please Even Santa Claus does ball new, full-time, front desk here most recently in the staff member! Patty help us make her feel wel- tables in his “work-out-shop” afternoons and Tuesday Schoonmaker started on come—we’re glad to have to get ready for his big day! evenings for the last 2 Monday, November 13, and her help! years. She had to resign to will be working 9:00-close become a full-time student. on Mondays, Wednesdays, She is studying cosmetology Thursdays, and Fridays, and Healthy Holiday Tips

Keep these tips in mind to ensure quicker buzz, which is more to weigh more. Make sure you your holiday is not only a fun one, likely to lead to mindless get your ZZZs, even during the but a healthy one! munching. busy holiday season.  Don’t skip meals. It may  Even if you do not have time  Make plans for January. Some- seem logical to skip lunch to to make it to the gym, stay times people feel a post- save room for a dinner active in other ways. Clean- Christmas let-down, but if you party. But arriving starved ing, walking, and lifting some have something to look for- may result in overeating, light weights at home are all ward to, you’ll be more likely and drinking on an empty ideas. to stay upbeat. will give you a  People who sleep less tend Source: https://tiltonfitness.wordpress.com/ page/9/

APTS MONTHLY VOLUME VII, ISSUE XII P A G E 3 Carpal Tunnel Syndrome

Carpal tunnel during the night, since many people sleep CTS symptoms due to inflammation of the syndrome (CTS) in a fetal position with their and tendon linings and repetitive compression continues to be a fingers flexed. A person with CTS may of the nerve itself. Patients over the age of label commonly wake up needing to "shake out" the hand 40 are more likely to develop CTS symp- given to anyone or wrist. As symptoms worsen, tingling toms from degenerative changes (arthritis) experiencing pain, occurs during the day. Decreased grip of the wrist joints and/or degenerative numbness, and/or strength makes it difficult to form a fist, thickening of the flexor tendons in the There is little tingling in his or grasp small objects, or perform fine move- carpal tunnel. her hands. While ments. In chronic cases, the muscles at the clinical data to carpal tunnel syndrome is one cause of base of the thumb atrophy. Some people The risk of developing CTS is not confined hand symptoms, it is not the only cause. It are unable to differentiate between hot prove that and cold by touch. to people in a single industry or occupa- continues to be the popular cause. tion, but is common in assembly line repetitive Carpal tunnel syndrome is often the result workers - manufacturing, sewing, finishing, Carpal tunnel syndrome occurs when the of a combination of factors that compress cleaning, and meat, poultry, or fish packing. median nerve, which runs from the shoul- the median nerve in the carpal tunnel, In fact, CTS is three-times more common computer work der through the forearm and into the rather than a problem with the nerve among assemblers than among data-entry hand, becomes compressed at the wrist. itself. Contributing factors include trauma personnel. A 2001 study by the Mayo causes CTS. A The median nerve controls sensations to or injury to the wrist that cause swelling, Clinic found heavy computer use (up to 7 the palm side of the thumb, first two such as sprain or fracture; mechanical hours a day) did not increase the risk of 2001 study by fingers and half of the third finger (but not problems in the wrist joint; work stress; developing CTS. the little finger), as well as small muscles in repeated use of vibrating hand tools; fluid the Mayo Clinic the hand. We need to remember that just retention during pregnancy or menopause; because a patient experiences “median The non-surgical treatment of CTS in- or the development of a cyst or tumor in volves manual therapy such as Active found heavy nerve symptoms” doesn’t mean they have the canal. In some cases, no structural CTS. The median nerve can become en- Release Techniques (ART) or Instrument cause can be identified. In these cases, the Assisted Soft Tissue Mobilization (IASTM) computer use trapped at one of six common places from cause is entrapment at another site along the to the wrist. applied along the entire course of the the path of the median nerve. Symptoms median nerve. Splints may be used at night (up to 7 hours a in all five fingers are not usually caused by The carpal tunnel itself is a narrow, rigid for symptom relief allowing for uninter- a problem in the carpal tunnel and are rupted sleep. Once the symptoms reduce, day) did not passageway of ligament and bones at the more commonly associated with shoulder crease of the hand. It houses the median the brace should be abandoned, as long instability or thoracic outlet syndrome. term use of bracing increases the tightness increase the nerve and finger flexor tendons. Some- times, thickening from irritated tendons or that contributed to the problem in the There is little clinical data to prove that first place. Patients over the age of 40 are risk of other swelling narrows the tunnel com- repetitive computer work causes CTS. pressing the median nerve. The result may more likely to require surgical release of Repeated motions performed in the the carpal tunnel to decompress the me- be pain, weakness, or numbness in the course of normal work or other daily developing CTS hand and wrist, radiating into the fingers dian nerve. Patients under the age of 40 activities can result in repetitive motion are more likely to recover with physical or up the arm. disorders such as bursitis and tendonitis. therapy that includes the aforementioned Women are three times more likely than manual therapy techniques. If you are Symptoms usually start gradually, with men to develop CTS, perhaps because the frequent burning, tingling, or itching numb- experiencing CTS symptoms, you may carpal tunnel itself may be smaller in want to discuss manual therapy treatment ness in the palm of the hand and the fin- women than in men. The dominant hand is gers, especially the thumb and the index as an alternative prior to pharmaceutical usually affected first and produces the or surgical treatment. and middle fingers. Some patients state most severe pain. Carpal tunnel syndrome that their fingers feel useless and swollen, usually occurs in adults. Patients under the Article by Dale Buchberger, even though little or no swelling is visible. age of 40 are more likely to experience The symptoms start in one or both hands DC, PT, CSCS APTS Recipe Box: Paleo Gingerbread Cookies Ingredients: 1 cup almond flour; 2 tbsp aside. In a bowl, combine almond flour, 9-10 minutes. Let cookies cool on the bak- blackstrap molasses; 1 tsp ground cinna- spices, baking soda, baking powder, and ing sheet (without touching) for 15 minutes, mon; 3 tbsp extra virgin coconut oil (or salt. In another bowl, mix coconut oil, then with the help of a spatula, place cook- butter), melted; 1 tsp ground ginger; 1/4 blackstrap molasses, and vanilla extract ies onto a rack and let cool completely. tsp ground nutmeg; 1/2 tsp ground until well combined. Add wet ingredients cloves; 1/2 tsp baking soda; 1/2 tsp baking to dry ingredients and mix well until a Source: http://www.theironyou.com/2013/12/ powder; 1 1/2 tsp vanilla extract; 1/4 tsp dough forms. You might want to add a paleo-gingerbread-cookies.html . fine grain sea salt. couple of tablespoons of almond flour if the dough is too wet or some water if it’s Instructions: Preheat oven to 350 de- too dry. Scoop one tablespoon of mixture, grees F and place rack in the middle. Line drop onto the lined baking sheet, and press a baking sheet with parchment paper, set down to form into cookie shapes. Bake for At Active Physical Therapy Solutions, we utilize the most cutting edge treatment and management techniques available. Our goal is to deliver the best possible healthcare in Active P.T. Solutions a friendly, caring, and well-organized 91 Columbus Street environment. Our staff is here to Auburn, NY 13021 provide active solutions to achieving Phone: 315-515-3117 Fax: 315-515-3121 your personal goals! E-mail: [email protected] website: www.activeptsolutions.com ...BECAUSE LIFE SHOULD BE Get Well...Get Active...Be Active ACTIVE! Newsletter Edited by Carolyn B. Collier, PTA Nutrition 101: The Power of Peppermint

As we approach the season of candy canes, it’s a perfect time pain in breastfeeding mothers. resistant herpes simplex virus type 1. to pay homage to the medicinal herb that gives these winter treats their flavor: peppermint.  Inhaled essential oil of peppermint helped to rapidly  Peppermint oil extract has been shown to be superior to regress tuberculosis inflammation, with researchers the mouthwash chemical chlorhexidine in inhibiting the Far from just a flavor for candy, the therapeutic effects of suggesting it may help prevent recurrences and exacer- formation of biofilm formations linked to dental cavities. fresh peppermint and peppermint essential oil have been bation of the disease. Powdered peppermint leaves have also been used histori- know since ancient times. Today, modern research has contin- cally to freshen breath and whiten teeth; you can even ued to prove what these ancient cultures already know, which  Extracts from peppermint leaves may inhibit histamine add a drop or two directly to your toothpaste. is that peppermint is one of nature’s most valuable herbal release, which suggests it may help alleviate hay fever remedies. symptoms.  Peppermint oil acts as an expectorant and decongestant, Why might you want to add peppermint to your natural and may help clear your respiratory tract. Use pepper- medicine chest?  A topical mint essential oil as a cold rub on your chest or inhale it treatment of through a vaporizer to help clear nasal congestion and  Peppermint oil capsules have been described as “the peppermint oil relieve cough and cold symptoms. first drug of choice” in Irritable Bowel Syndrome resulted in near patients, as it safely helps alleviate symptoms and -immediate  Peppermint oil may help relieve tension headache pain. improve quality of life. Research has shown that it is improvement in Try dabbing a few drops on your wrist or a cloth and effective in children and adults alike, enough to reduce shingles- inhale the aroma. You can also massage the oil directly symptoms by 50%. associated pain, onto your temples and . with the results  Peppermint oil is an effective alternative to drugs for lasting for two  Peppermint oil is cooling and energizing. Add a few drops reducing colonic spasms. It may also relax the muscles months of to your bath or dab a few drops directly on your body of your intestines, allowing gas to pass and easing follow-up and get into the tub for near-instant stress relief. You can abdominal pain. Try peppermint oil or leaves added to treatment. also put the oil into a burner for a stress-relieving aroma. tea for gas relief.  The aroma of peppermint has been shown to enhance  Try blending peppermint oil into your massage oil, sham-  In people with functional GI disorders, peppermint may memory and increase alertness. poo, body wash, or body lotion. It has antiseptic and be useful to enhance gastric emptying. antibacterial properties that can help cool your skin and  Peppermint oil effectively reduces chemotherapy- remove dandruff and lice from your !  Supplementing with 90 mg of peppermint oil, along induced nausea, and at a reduced cost compared to with caraway oil, improved symptoms of functional standard drug-based treatments.  Peppermint contains rosmarinic acid (also found in rose- dyspepsia in 67% of people. If you have an upset stom- mary) which may help to reduce inflammation-causing ach, try drinking a small glass of water with a few drops  Peppermint contains menthol, which may inhibit the chemicals in people with asthma. of peppermint oil added. growth of prostate cancer.  Peppermint may help to relieve muscle spasms and pain.  Peppermint is at least as effective as simethicone in the  Peppermint may protect against DNA damage and cell Try massaging its oil onto sore muscles or adding it to treatment of colic in infants. death caused by radiation exposure. your bath water for muscle pain relief.

 Peppermint water helps to prevent nipple cracks and  Peppermint has been shown to help inhibit drug- Article by Carolyn Collier, PTA Source: https://articles.mercola.com/sites/articles/archive/ 2013/10/14/peppermint-health-benefits.aspx