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Skier’s Thumb: A common injury amongst winter athletes

Skier’s Thumb: A common injury amongst winter athletes

Apr 16, 2024

Photo by Vidar Nordli-Mathisen on Unsplash

What is Skier’s thumb?

Thumb ligament injuries are common occurrences and occur when the ligaments that support the thumb are stretched beyond their limit and tear, as with a sprain. The injury itself is to the ligaments at the joint located at the base of the thumb, known as the MP joint. When the thumb is forcefully bent sideways, it can result in a tear to the ulnar collateral ligament. Skier’s thumb, in particular, is a condition common amongst winter athletes.

Depending on the severity of the sprain, categorised as three different grades, pain may or may not occur at the time of the injury. However, bruising, tenderness, and swelling around the base of the thumb are to be expected. Moreover, the characteristic symptom of Skier’s thumb is difficulty grasping items between the thumb and index finger.

    • Grade 1 sprain (mild). The ligaments are stretched but do not appear torn.
    • Grade 2 sprain (moderate). The ligaments are partially torn and may result in some loss of function.
    • Grade 3 sprain (severe). The ligaments are completely torn and is described as a significant injury. This type of sprain requires medical or surgical interventions and can result in lasting loss of function. 

    Treatment

    The treatment of a sprained thumb entirely depends on the severity of the injury, the timing, and whether or not there is arthritis present in the joint. At Opus, we also consider your activity levels, your job requirements, and individual preferences. There are two primary routes of treatment; nonoperative and operative.
    1. Non-surgical treatment. This represents the most common route of treatment for patients with Skier’s thumb and often involves splinting and casting. Typically, a sprained thumb takes between four and six weeks for the ligament to heal sufficiently for light use. However, it is important to consider that for more intense activities, such as sports, it may take substantially longer.
    2. Operative interventions. In some instances, where either the ligament does not heal adequately with non-surgical treatments or the severity of the injury is too great, surgery may be considered. In these cases, the treatment will involve repairing the torn ligament back down to the bone using sutures.

    More recently, a third option for treatment has been proposed: regenerative medicine. We have discussed the roles of platelet rich plasma and mesenchymal stem cell therapy in regenerative medicine in previous updates, which you can find here. Introducing stem cells to the site of the thumb injury can speed up the healing process exponentially and has been used to accelerate the recovery of several sporting figures across the globe.

    Sprained thumbs, although not usually a significant injury, still require medical intervention. When diagnosed and treated accordingly, the vast majority of patients will heal without any additional complications. However, if ignored, the thumb may heal incorrectly and cause long-term problems, including chronic instability, weakness, and arthritis. Get in touch with our team at Opus to ensure that the ligament is correctly healed and your recovery journey is as seamless as possible.
    Shin splints versus stress fractures. What’s the difference?

    Shin splints versus stress fractures. What’s the difference?

    Apr 12, 2024

    Photo by Jakob Owens on Unsplash
    Sports medicine emphasises the importance of physical activity in Shin
    splints are characterised by inflammation of the muscles, tendons and bone tissues surrounding the tibia, also known as the shin bone. Stress fractures, on the other hand, are tiny cracks in the bone. However, both conditions are caused by the same problem, overloading.
    Shin splints refer to pain along the shin bone and are common in athletes, especially runners, dancers, and gymnasts. This condition is also known as medial tibial stress syndrome, as it often occurs in athletes who have recently intensified their training routines, putting added stress on their shin bone. In the vast majority of shin splint cases, treatment involves rest, ice, and other self-care measures, as with most inflammatory and strain injuries. To prevent future recurrence of shin splints, it is advised that you wear appropriate footwear and modify your exercise routine accordingly.
    Whilst shin splints are characterised by pain caused by stress to the bone; stress fractures cause actual damage to the bone. They are common amongst athletes, especially long distance runners, due to repeat force and overuse of the limbs. This injury is most common in the weight-bearing bones of the lower leg and foot. Treatment for stress fractures, as with shin splints, is lots of rest. However, you may be asked to wear a walking boot or use crutches to further reduce the weight-bearing load on the limbs.
    It is worth remembering that, although predominately occurring in athletes, stress fractures and shin splints can also develop from the normal use of a bone that is weakened. This arises with conditions such as osteoporosis.

    How to tell these two conditions apart?

    The main determinant between shin splints and stress fractures is pain. With a stress fracture, the pain will get progressively worse as you run and will continue to persist at a localised point once you have finished exercising. With shin splints, on the other hand, the pain tends to present over a broad area and will cause swelling and significant discomfort, but does not stop physical activity. Once you have warmed up, shin splints also tend to dissipate. Moreover, shin splints exclusively occur in the lower leg; whereas stress fractures, although common in the weight-bearing bones of the lower leg and foot, can occur in any bone.

    Treatment with regenerative medicine

    As mentioned, treatment of these injuries tends to focus on rest and exercise modifications; however, you may experience persistent shin splints or stress fractures, which has a significant impact on your daily activities. This is where regenerative medicine, specifically platelet rich plasma (PRP), comes in. You can read more about how this treatment works here.

    Preclinical studies have emphasised the potential value of PRP injections in stress fractures. This technique is capable of shortening the fracture healing time so you can be back on your feet in as short a time as possible. PRP injections have also shown great promise in the treatment and prevention of shin splints.

    At Opus, we are able to thoroughly assess your condition and provide you with evidence-based techniques underpinned by the current research to ensure the greatest chance of success on your journey. Get in touch today to book a consultation with one of our world renowned doctors.

    Plantar fasciitis: A common injury causing global heel pain

    Plantar fasciitis: A common injury causing global heel pain

    Apr 7, 2024

    Photo by Tonnam Vongsamang on Unsplash

    Plantar fasciitis holds the title as one of the most prevalent causes of heel pain across the globe. It is characterised by inflammation and causes severe stabbing pain that usually occurs with your first steps of the day. Movement does, however, result in a decrease in pain throughout the day. Although the underlying causes of this injury are poorly comprehended, it is more common in runners and older adults. Current statistics suggest that the prevalence of plantar heel pain in the UK population is 9.6%, with the population prevalence of disabling plantar heel pain at 7.9%.

    The plantar fascia is a band of tissue that connects the heel bone to the base of the toes, supporting the foot’s arch and absorbing shock with every step we take. However, prolonged tension and stress on this band of tissue can cause small tears. Alone, they do not cause significant injury, but repeated stretching and tearing of the fascia can cause irritation and inflammation, characteristic of plantar fasciitis. 

    Treatment of plantar fasciitis is varied and depends on the severity of pain experienced. There are remedies that can be adopted at home, or more specialist-focused approaches, including stem cell injections.

    • Physical therapy is the most commonly adopted treatment option for plantar fasciitis; however, it does not fix the root cause of the problem, and many people experience recurrence of the pain further down the line. Exercises such as heel raise, floor sitting ankle inversion with resistance, seated toe towel scrunches, and plantar fascia stretches can all assist in easing plantar heel pain.
    • Steroid injections, specifically cortisone injections, offer short-term pain relief of a few months. However, the risks associated with this method, including skin thinning, often deter people from taking this approach.
    • Plantar fasciotomy is a surgical intervention that detaches the fascia from the heel bone in order to relieve tension and provide a long-term pain relief option. Despite this, only about 5% of those with plantar fasciitis choose this approach as it is only suggested if you experience persistent heel pain for greater than six months.
    • Stem cell injections and platelet rich plasma form the regenerative approach to plantar fasciitis treatment. The goal of these interventions is to expedite your recovery journey and provide a therapeutic option with more long-lasting results. You can find more information on how these regenerative approaches work in our previous posts.

    At Opus, we offer both platelet rich plasma therapy and stem cell therapy to combat your plantar heel pain. Get in touch to speak to one of our experts and begin your journey to pain free movement.

    Lower Back Pain and Pelvic Floor Dysfunction

    Lower Back Pain and Pelvic Floor Dysfunction

    Apr 3, 2024

    Lower back pain (LBP) is the most prevalent musculoskeletal injury, as approximately 80% of the population will experience LBP in their lifetime (Arab et. al 2010). Transverse abdominus activation is often prescribed for LBP however pelvic floor muscle (PFM) is not always incorporated into treatment. PFM aids in supporting the abdominopelvic organs and there is an abundance of research on the role of the PFM in urinary and fecal incontinence. Nevertheless, it is important to remember the PFM role in lumbar and pelvic stability and intra-abdominal pressure (Mohseni-Bandepi et. al 2011). Research illustrates that the combination of pelvic floor exercise alongside routine treatment can provide significant pain relief in LBP compared to routine treatment alone (Bi et. al, 2013), demonstrating the importance of PFM exercises.

    The link between LBP and PFM helps to provide insight into the correlation between LBP and pelvic floor dysfunction (PFD). PFD is an umbrella term to describe weakness, poor endurance and hypertonicity of the PFM which can impact incontinence, prolapses and pelvic pain. Dufour et al. found that 95% of women with LBP had PFD, ‘71% of the participants had pelvic floor muscle tenderness, 66% had pelvic floor weakness and 41% were found to have a pelvic organ prolapse’(Dufour et. al 2018), further highlighting the importance of incorporating PFM in treatment. Arab et al. also examined PFD in women with and without LBP. The results show PFD in participants with LBP compared to those without. This is valuable for health care participants when assessment and treating LBP (Arab et. al 2010). It is also important to recognize PFD in pregnancy-related lower back pain (PLBP). Pool-Goudzwaard et. al discovered ‘52% of PLBP, significantly more than in the healthy control group’ (Pool-Goudzwaard et. al,2005) and promote addressing both LBP and PFD during pregnancy.

    There are a variety of methods to help activate, strengthen and relax the pelvic floor in order to aid recovery in PFD.  Kegels or reverse Kegels are often prescribed to promote awareness and strengthen PFM (Torgenu et. Al 2021). Transverse abdominus contraction has also been shown to help activate and strengthen PFM. Sapsford et al. found ‘that abdominals contract in response to a pelvic floor contraction command and that the pelvic floor contracts in response to both a “hollowing” and “bracing” abdominal command’(Mohseni-Bandepi et. al 2011), therefore proving the PFM can be activated by engaging the abdominals. Hypopressive exercises (HE) have also shown to aid recovery from PFD. HEs lowers the intra-abdominal pressure which enables an involuntary contraction of the PFM and transverse abdominus. Navarro-Brazález et. al suggests the combination of HEs and pelvic floor muscle training improves PFM strength and quality of life for patients with PFD (Navarro-Brazález et. al 2020).

    Reference List

     

    • Arab, A.M., Behbahani, R.B., Lorestani, L. and Azari, A. (2010). Assessment of pelvic floor muscle function in women with and without low back pain using transabdominal ultrasound. Manual Therapy, 15(3), pp.235–239. doi:https://doi.org/10.1016/j.math.2009.12.005.

    • Bi, X., Zhao, J., Zhao, L., Liu, Z., Zhang, J., Sun, D., Song, L. and Xia, Y. (2013). Pelvic floor muscle exercise for chronic low back pain. Journal of International Medical Research, 41(1), pp.146–152. doi:https://doi.org/10.1177/0300060513475383.

    • Dufour, S., Vandyken, B., Forget, M.-J. and Vandyken, C. (2018). Association between lumbopelvic pain and pelvic floor dysfunction in women: A cross sectional study. Musculoskeletal Science and Practice, 34, pp.47–53. doi:https://doi.org/10.1016/j.msksp.2017.12.001.

    • Mohseni-Bandpei, M.A., Rahmani, N., Behtash, H. and Karimloo, M. (2011). The effect of pelvic floor muscle exercise on women with chronic non-specific low back pain. Journal of Bodywork and Movement Therapies, 15(1), pp.75–81. doi:https://doi.org/10.1016/j.jbmt.2009.12.001.

    • Navarro-Brazález, B., Prieto-Gómez, V., Prieto-Merino, D., Sánchez-Sánchez, B., McLean, L. and Torres-Lacomba, M. (2020). Effectiveness of Hypopressive Exercises in Women with Pelvic Floor Dysfunction: A Randomised Controlled Trial. Journal of Clinical Medicine, 9(4), p.1149. doi:https://doi.org/10.3390/jcm9041149.

    • Pool-Goudzwaard, A.L., Slieker ten Hove, M.C.P.H., Vierhout, M.E., Mulder, Paul.H., Pool, J.J.M., Snijders, C.J. and Stoeckart, R. (2005). Relations between pregnancy-related low back pain, pelvic floor activity and pelvic floor dysfunction. International Urogynecology Journal, [online] 16(6), pp.468–474. doi:https://doi.org/10.1007/s00192-005-1292-7.

    • Torgbenu, E.L., Aimakhu, C.O. and Morhe, E.K.S. (2020). Effect of Kegel Exercises on Pelvic Floor Muscle Disorders in Prenatal and Postnatal Women – A Literature Review. Current Women’s Health Reviews, 16. doi:https://doi.org/10.2174/1573404816999200930161059.

    Pain down there? Common causes and treatment of groin pain

    Pain down there? Common causes and treatment of groin pain

    Apr 2, 2024

    Photo by Victoire Joncheray on Unsplash

    In the vast majority of cases, groin pain results from a muscle strain or tear and usually resolves on its own. Athletes disproportionately experience groin pain due to their activity levels, with statistics suggesting prevalence rates between 0.5% and 28% amongst football players. But what actually causes groin pain in the first place?

    There are several unique causes of groin pain; however, the most common cause is a muscle strain, also known as a pull groin muscle. This occurs when the hip joint is involved in an acquired movement that causes a stretch or tears to the inner thigh muscles. The pain experienced is usually sharp and sudden, with the source of it often apparent. Inner thigh muscle spasms and leg weakness may also occur.

    Beyond muscle strain, the following are also common causes of groin pain:

    • Inguinal hernia. A condition where the fatty tissue of the intestine protrudes through the abdominal wall.
    • Kidney stone. A small clump of minerals will form inside the kidney, causing waves of pain as it passes down through the urinary tract.
    • Hip osteoarthritis arises when the smooth hip joint is worn down, causing leg movements to become painful and stiff.

    Treating groin pain depends on what started it in the first place. In most instances, you may not need medical intervention; however, if the pain persists and impacts your daily activities, then get in touch.

    When determining the best route of treatment, you will be asked when the pain started, what activities exacerbate the pain, and if you have experienced any accompanying symptoms. A full physical examination will then be performed, with imaging often being used as well.

    There are five treatment approaches that may be taken, depending on the severity of the pain and your lifestyle:

      1. Rest and recuperation. Although it seems repetitive with sports injuries, rest and ice are your best friends. Limiting your activities as much as possible for a short period of time can significantly speed up the healing process.
      2. This approach solely offers short-term pain relief and has no significant impact on the healing process.
      3. Physical therapy. Depending on the cause of the groin pain, you may be referred for physical therapy. For example, if your groin pain results from hip-related causes, such as hip osteoarthritis, then long-term physical therapy may be beneficial in managing flare ups. Moreover, certain exercises can help improve your range of motion and flexibility, further preventing further injuries.
      4. This intervention is not always necessary and is only applicable in some serious conditions, including hip joint infections.
      5. Regenerative medicine. Platelet rich plasma (PRP) is a novel treatment that has had great success in treating arthritic conditions, including hip osteoarthritis. We go into more detail on the process of PRP here. The benefits of PRP on hip function and pain have been shown to be superior to other options given the long-term duration of its effects.

      At Opus, we pride ourselves on offering a range of treatments to our patients to ensure that the most appropriate route of recovery is selected. If you are experiencing persistent groin pain, we can provide you with the traditional routes of treatment but also the regenerative options, including PRP. Get in touch today to discuss the best option to get you back on your feet.