In our clinic this winter we noticed an increased number of women footballers coming in with injured fingers.
Usually these injuries occur from football v tip (sudden hyperextension) or tackling (rotation and hyperextension).
Most common injuries have been volar plate injuries (+/- avulsion fractures). That is, damaging the middle joint (PIPJ) on the palm side of the hand.
A few have arrived late having been buddy taped without success.
Buddy taping a volar plate injury will ususally not allow for quick healing and delay return to play.
Footy code (locally) enables play when plastic splint is fully covered with tape- we will usually have a splint for sport and another for the rest of the time.
We are encouraging early referral so we can get them moving within safe limits immediately. Whilst enabling repair and preventing deformity.
The NDIS (National Disability Insurance Scheme) is rolling out around Australia, and with it brings changes to the way people with a disability access services. The vision is great; fostering inclusion and breaking down the barriers which stigmitise disability in our country.
Although these changes may seem overwhelming at first; they will inevitably bring positive change to individuals, families and the wider community.
People with a disability will have more choice and control about how they live their life. And which services they engage to best help them reach their own goals.
Over time, with increased access, participation and contribution, the barriers faced by people with a disability will decrease. Enabling greater understanding and acceptance from the wider community.
Hand Therapists offer a unique set of skills to those who suffer from a hand or upper limb disability.
They are Occupational Therapists and Physiotherapist who specialise in rehabilitation from injury, condition or disease to the hand & upper limb (finger tips to shoulder). Hand Therapists understand the complex anatomy of the upper limb, and how disease and disability can result in impairment and dysfunction. And have specilaist skills in helping to improve position, coordination, strength and maximise function in the hands and arms. To find the closest Accredited Hand Therapist to you search the web site www.ahta.com.au.
Some Hand Therapists are registered with the NDIS to provide services to all NDIS participants, including Agency Managed Participants.
At Adelaide Hills HAND THERAPY we are currently a fully registered NDIS provider.
As the scheme is rolling out, and Certification is required for health professionals, it is anticipated that many Hand Therapists will opt to not be registered with the NDIS. This is due to the complex and expensive process involved to Certify for ongoing registration. These therapists will continue to be able to work with Plan Managed, Self Managed and combination managed participants, but not those managed by the NDIS.
Services that Hand Therapists will offer to NDIS participants will vary depending upon the individual provider, at Adelaide & Hills HAND THERAPY some of the services that we offer participants include;
At Adelaide & Hills HAND THERAPY we are excited about the possibilities that the NDIS will bring for participants, their families and the community in general. And we look forward to being involved in this positive change. Contact us if you'd like to discuss how we can help you reach your goals! 08 8339 HAND, 08 8339 4263.
The term Accredited Hand Therapist (AHT) is the name given to a practitioner of Hand Therapy who meets specific criterial listed below;
The AHTA is the professional association in Australia which represents Practitioners of Hand Therapy. The association supports it's members by building upon public awareness of the speciality of Hand Therapy through netowrking and representation. And provides professional development oportunities through education and courses and mentorship support.
A Certified Hand Therapist (CHT) has internally recognised specialist hand & upper limb rehabilitation skills. To be titled as a CHT an individual must;
There are almost 6600 CHT's world wide, and over 180 in Australia and New Zealand.
85% of CHT's are Occupational Therapists.
Choosing a CHT means you are chosing a professional who has demonstrated a high level of knowledge about how the hand & upper limb (fingertip to shoulder) usually are, and how injuries and conditions impact upon the upper limb and how it functions.
1 in 3-4 women over 50 years of age will get osteoarthrtitis (OA) at the base of their thumb. The incidence is less for men, however the symtoms & cause are the same.
OA is a degenerative joint condition which commonly results is pain, sometimes swelling and decreased movement at a joint. It can result from previous trauma to the joint, or due to chemical changes in the joint, which change the joint surface and surrounding tissues over time. Painful OA is particularly common at the base of the thumb.
The joint at the base of the thumb (at the thumb side of the wrist) is called the first carpometacarpal joint (CMCJ). This joint is affected by OA as the joint allows for a complex and wide degree of movements. It is the joint responsible for opposition, where by our thumb pulp (fleshy surface) can face and pinch the finger tip pulps. Because it allows for a great degree of movment, the joint relies on the soft tissues around it to give it stability. However when OA is present, the stability of these structures is often compromised.
Throughout our lives the first CMCJ certainly gets a work out! The joint positions the thumb so we can use it in almost all activities involving our hands. And it also absorbes and transfers pressure associated with the forces involved in pinch. These shearing and loading forces are generally well tolerated. This is because the soft tissues (ligaments, tendons, muscles) aroud the joint stabilise it- that is until they are damaged.
OA effects change on the bone as well as soft tissues around the involved joint. With loosening and deterioration of the capsule and ligaments around the joint- the bones can shift out of alignment. And this is the process of the development of joint deformities in thumb osteoarthritis. There are different patterns of joint deformity which result from imbalances in muscle and ligament strength and the way the bones line up during different activities.
How we can help you, is be assessing the pattern of deformity, seeing which structures are loose and which are tight, and how the bone is shifting during use and sitting at rest. Hand Therapy can help to reposition the joint, and bring balance to the structures which destabilise the thumb. Please call us today so we can help you get the most out of your thumb 08 8339 HAND (8339 4263).
Author Jo Marsh
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