Elbow, hands and wrist injuries - detection and recovery

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Listening stuff about elbow and elbow injuries right now. This stuff is quite complicated, between the ulna, the radius, and all other joints, bones, bursa, cartilages, ligaments, and tendons. Those injuries used to be career-ending before reconstructive surgery, and by them, I mean golf elbow (on the outside of the elbow) and tennis elbow (on the inside of the elbow). They happen mostly when people come back to train and play after a long break. Conditioning and strengthening is the key to preventing them. Common acute injuries - middle age active people, with a little pain, force it and pop up the biceps, you do not lose the main flexing strength, you lose the supinator one (think about opening jars or turning screwdrivers). A partial tear can be present for a long time, and we do not know. Steady, long-term fitness exercises are another way to prevent elbow injuries. Some kind of reconstruction is only meant for elite athletes, to gain that extra 5 miles/hour, after a partial biceps tear, and normal people have basically no visible benefits from it. Ruptures in active people need to be repaired, ruptures in sedentary people make no difference once repaired. Elbow reconstruction is a kind of specialized surgery, meant to be done only for athletes and very active people.

Hand and wrists, as a little bonus, we are really far now, in terms of treatments, long gone are the days of WW2, when some injuries were just leading to amputation. In extreme cases, we can even reconstruct the muscles, using muscles borrowed from legs, in order to give primitive functions, allowing you to go by in your average day, but not well on complicated tasks. Most of these are the result of an acute traumatic event, as opposed to wear and tear, and sometimes arthritis. Fun fact: each finger has 3 nerves, but the thumb has only two. Back to it, the average time to heal a broken bone in your arms is six weeks, the only exception being the scaphoid bone, which will take 12 weeks, as it got a strange shape and only a few blood vessels. The scaphoid fracture cannot be detected in a CT scan, it is only seen clearly on MRI. Delaying going to the doctor complicates things more, but when realizing that you have a scaphoid fracture and successfully diagnose it, the surgery will help you to heal in one week.

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Treating a fracture of your wrist by yourself, using a splinter, without seeing the doctor, and using a wrong posture (overextending or overstretching your hand as opposed to the neutral position), and can even result in acute carpal tunnel syndrome. Another fun fact, some activities like handwriting, stimulate the brain art center, improving your skills, but others, like texting or typing, make no difference (zero brain stimulation). Back to the carpal tunnel, there is a Roman arch of bones wedging in the area, when it goes in reverse, the ligaments create something similar to a tunnel, where the 9 tendon flexors, the medial nerve, and usually one artery pass by. Flexing the hand, there is pressure on all the tendon flexors (with no visible issues), on the medial nerve (resulting in pain, numbness, and tingling, and on the artery (leading to muscle atrophy due to some conditions). If you are pregnant (due to swelling), or if you are a cyclist, jackhammer user, and even some weightlifters doing specific exercises, this will predispose you to carpal tunnel. Typing a lot on a keyboard doesn't result in carpal tunnel, but if you have it, typing will make it worst.

Most common fractures and dislocations are acute, wear and tear (middle age), or degenerative (old age). Radius fracture is present quite often, as it is arched, while the ulna is not moving, and is fixed. Falling (from trees, on ice, and so on) is responsible for it, and sometimes both the ulna and radius can break if something falls on you. The radial head on the elbow can be broken as a parent yank the child's hand to cross the street, quite common also. Having osteoporosis, even at the beginning, make it much easier for these bones to break. Falling on your elbow can also make another kind of fracture, on the top of the ulna or radius, if you fall really hard. Tendinitis, the inflammation of the tendon, can lead to some chronic pain, and ultimately they will wear and tear, and rupture. If you are a heavy-lifter, or violinist, repetitive moves, can wear and tear, but they can get cured by minor surgery, rest, and cortisone shots.

Hand strength, if you think about how good you are, try 4 fingers pull-ups, taking the pinkie finger out. Or three, if you really excel at it. This will get us to grip strength, and the ulna nerve is so important. Fun fact: pinkie and middle fingers matter more to the grip than the other ones. Arthritis is debilitating and physically deforming, while osteoarthritis seems to be milder. Some need surgery, to address the functional limitation, of elbows and hands, as they decrease your ability to be independent. Losing your hands' function makes you dependent on others. 1 out of 4 people presenting symptoms will eventually need surgery. Knee or hip replacement has a 20% failure rate, and thumb and finger surgery have a 70% failure rate.

I hope I did not get you too bored but treating my weak right side, shoulder, and elbow tends to be important for me and my training these days. If you enjoy it, please tell me.


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Kind regards
George



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