Skiers Thumb is not Caused by Hitchiking to the Ski Hill

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A few flakes are falling in the Wasatch, and the powder hounds are lining up at the base of Little Cottonwood Canyon to hitch a ride up to the resorts.  Their thumbs flagging a ride are a sign that they are not suffering skiers thumb.  …yet.

Skiers Thumb is a strain or rupture of the ulnar collateral ligament of the thumb.  It causes pain and swelling in the web of the hand between the base of the thumb and index finger, and it makes it difficult to grip or fully extend the thumb.  The injury usually occurs when a skier falls on an open palm with the ski pole still in the hand.  The pole, on impact, forces the thumb to the dorsum of the hand (non-palm side), overstretching or tearing the ligament.  Most skiers know this discomfort. A mild strain of the ligament is quite common and can plague a skier all winter if left untreated.

In serious cases where after a fall the thumb swells, becomes painful to move, may bruise, and/or becomes more painful over the next few days, it is best to have a sports medicine doctor or orthopedist evaluate the injury.  Typical treatment involves immobilization of the thumb for 4-6 weeks, but you can usually sweet talk your doctor into a cast where a ski pole can fit so you can still ski.  However, surgery is occasionally required to repair the ligament.

In mild cases where the thumb is merely sore and quickly improves, self-care can help heal the injury so it does not hurt all ski season.  For the first few days after any mild strain you should ice the area several times a day, reduce motion with an ace bandage or over the counter splint, and protect it from a repeat blow, meaning that skiing is not a good idea.  After 3-5 days of gently care for your thumb, you can start performing exercises to help heal the ligament.

Exercises

  • Thumb active range of motion: With your palm flat on a smooth surface, move your thumb away from your hand as far you can. Hold this position for 5 seconds and bring it back to the starting position. Next, rest your hand on the table in a handshake position. Move your thumb out to the side away from your palm as far as possible. Hold for 5 seconds. Return to the starting position. Next, bring your thumb across your palm toward your little finger. Hold this position for 5 seconds. Return to the starting position. Three pain free sets of ten are recommended.  Pain is a sign that you are re-tearing tissue!
  • Wrist Range of Motion (do three sets of 10 of each)
    1. Flexion: Gently bend your wrist forward with an open hand then curl the fingers into a fist. Hold for 5 seconds.
    2. Extension: Gently bend your wrist backward, straitening the fingers as you extend the hand. Hold this position 5 seconds.
    3. Side to side: Gently move your wrist from side to side in a beauty queen wave motion. Hold for 5 seconds at each end.

    After a few days of performing these range-of-motion exercises, normal motion should be restored.  If not, see a doctor.  Otherwise, you are ready to start strength training.

  • Thumb strengthening: Pick up small objects such as pennies between your thumb and each of your other fingers. Practice this exercise for about 5 minutes.
  • Finger spring: Place a large rubber band around the outside of your thumb and the fingers. Open your fingers to stretch the rubber band. Do three sets of 10.
  • Grip strengthening: Squeeze a tennis ball and hold for 5 seconds. Do three sets of 10.
  • Wrist flexion: Hold a light weight or soup can in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do three sets of 10. Gradually increase the weight.

If your Skiers Thumb injury is mild and you take care of the injury you should be back to skiing pain-free in about two weeks.  Within this time frame you should also be able to fully extend your thumb and catch a friendly ride up the canyon.  Happy Skiing!

In 2012 I’m Going to Eat More Cookies… For My Health!

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2012 is just around the corner. Although I don’t make resolutions per se, I do use the anticipation of a new calendar to plan out my training and race schedules and to revise repeat plans based on the successes (and failures) of last year. I also can’t help but reflect on the numbers on the scale and fantasize about the rewards of being two pounds lighter, decreasing my body fat by 1%, shaving 5 seconds off my marathon time, completing the Mid-Week Mountain Bike Race Series, and waiting for the boys at the ridge line on a dawn patrol.

As I plan out my 2012 calendar, I also page through the recent edition of my favorite journal, The Physician and Sports Medicine, which has several articles on osteoarthritis (OA). Several research studies note a fact I hate to dwell on: women athletes (especially those with a history of knee injuries) have a higher risk of developing OA than men and their sedentary counterparts. The usual excuses are noted in each article: women have a greater angle of the femur (thigh bone) from the hip to knee due to a wide pelvis; women are small and therefore have small knees unable to absorb as much force as larger ones; and women have lower bone mineral density (BMD), which is currently believed to be the greatest indicator of OA likelihood.

I cannot change my womanly curves, nor can I double the size of my knees, but I can address my BMD. Glazed over and tip-toed around in literature regarding women athletes is a dirty word: anorexia. In the culture of athletes, being too thin is an obsession praised as a mark of perfect training, discipline and sacrifice for sport. But at what cost? Eating disorders are common among women athletes (and becoming more common in men). A malnourished woman will often experience amenorrhea (a pause in her fertility cycle) as the body’s way of conserving nutrients. This pause changes hormone secretion, including a decrease in estrogen levels. This decrease is a major factor in bone density loss; a low BMD means higher risk of OA.

As an aging woman athlete with a history of knee injuries, I am going to be proactive in reducing my risk of OA in my knees; I am going to accept those two extra pounds on my goal weight.  I am going to do this by not changing my eating plan (crafted by a wise nutritionist), but I am going to occasionally splurge and eat that second cookie. And, instead of feeling guilty, I’m going to tap my crumb coated fingers to my knees and say it is for them.  Here’s to a few more cookies in 2012 and healthy knees that will keep me skiing well into my 80’s!

Congratulations Jay!

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This past Saturday, Dec. 17 Jay Aldos broke the 100 mile World Record for Men age 50-54.  At the Desert Solstice Ultra Marathon Invitationals Jay ran 100 miles in 13:52:29 – that is an average pace of 8:19 per mile.  My feet hurt just thinking about that.  Read Jay’s report about the race, his training strategy for this unique event and how reflecting on the support of his friends and family helped him push through physical and mental fatigue.

Need a Fantastic Last Minute Gift?

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We can help!  We have the perfect gift for the athlete in your life… a session at Focus Bodywork.  We can take gift certificate orders over the phone with a credit card and ship it the same day.  The postmaster recommends shipping by Tuesday December 20 for Christmas delivery, or you can pick one up at our office by noon on Thursday December 22 (just call in advance 801-359-5149 so we can have it ready).

We Are Moving (sort-of)!

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Today, Monday November 21, Focus Bodywork is in it’s new swanky location:

150 S. 600 E. Suite 9D

Yes, this is a new suite in the same business plaza, the Ambassador Plaza.

Our new studio is larger and will provide us the opportunity to grow to meet your needs and our dreams.  We are so excited to show you our new space.

What is Tednonitis (by the way)?

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Time and time again I have clients come in to Focus Bodywork for soft tissue work on tendonitis that’s been diagnosed a physician. Although these clients have seen their physician and have been dutifully performing their physical therapy assigned exercises,  somewhere in our discussion it dawns on me that no one has explained (in understandable language) to these clients what tendonitis really is.  I believe that you will make the best choices as to how to heal an injury, how fast to return to training and what warning signs to notice if you understand what exactly your injury is.  Tendonitis (direct translation: inflammation of a tendon) is a common overuse injury that can occur to any tendon in the human body.  Some sports are notorious for specific tendonitises’. Climbing, for example, is associated with bicep tendonitis, and sprinting with Achilles tendonitis. These injuries are so common that most of us will experience one or several tendonitises’ in a lifetime, so let’s make sure we all know what is really going on in our bodies when this happens to us.

Bicep Tendonitis is Common in Climbers

Anatomy: A tendon attaches a muscle to bone.  It is made of fibrous connective tissue.  Although it does not contract the way a muscle does, it has an elastic quality and stretches like a rubber band so it can passively change length.

Injury Pathology: When a muscle is overused it gets micro-tears.  With adequate rest these tears will repair on their own in a day or two, but often not enough time is given for tissue repair.  The muscle becomes sticky and frayed, which makes it unwilling or incapable of lengthening completely.  With the muscle going through a shortened range of motion (ROM), the tendon is put under increased stretch.  If this state exists for a while without the muscle healing, the tendon starts to fray and becomes inflamed.  Tendons do not have a great blood supply like muscle tissue does so the inflammation stays in the tendon and irritates the nerve receptors, which make the area hurt.

Achilles Tendonitis is Common in Sprinters

Signs and Symptoms: The most common presentation of tendonitis is pain at the onset of activity but, as you warm up (about 20 minutes), the pain subsides or disappears.  The pain is usually constant but localized.  You may feel great by the end of your workout, but several hours later the area is painful again.  After periods of rest, such as first thing in the morning, the area usually aches and feels tight.  Often a few days of rest makes the area feel better but, as soon as you try to train again the pain comes right back.

What to do: Ice (at least four times a day, long enough for the area to become numb and with enough time between sessions for the area to completely return to body temperature).  If you suspect you are injured, and a few days of rest and regular icing have not resolved the issue see your sports medicine doctor for a diagnosis.  Your doctor will typically recommend six weeks of physical therapy, which if unsuccessful, will usually be followed with a cortisone injection or other more drastic modalities.

How Focus Bodywork can help: Some athletes are lucky, and well-managed strengthening and lengthening of the injured muscle/tendon complex will heal the injury.  Many are not so lucky, or this is a repeat injury.  Through soft tissue manipulation we release adhered areas of the muscle that are not lengthening adequately and torturing the tendon.  We treat the tendon area through cross-fiber friction to align frayed fibers in the same plane as the healthy fibers and increase blood supply to the injury site, which flushes out inflammation and saturates the area with nutrients.  In some cases, especially when tendonitis is chronic or repeated, there are underlying issues, such as muscle imbalances, fascial binding or adhesions in other muscles altering movement patterns, that lead to the overuse of a tendon.  We will sleuth out these hidden culprits and help you resolve them so that you heal well and once and for all!

Hopefully this explanation will help you make good decisions on what to do if you are suffering with a tendonitis.  Good decisions, such as not pushing through the first 20 minutes of your workout until the pain subsides, and treating not only the painful tendon but the injured muscle as well, will help you recover fully and get back to training as soon as possible.

Spooky and Ghoulish Body Facts

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Every square inch of your body has around 32 million bacteria on it

Blood sucking hookworms inhabit 700 million people worldwide

Three hundred million cells die in your body every minute

A human head remains conscious for about 15 to 20 seconds after it is been decapitated

In late 19th century Egypt where wood and coal were scarce but human mummies were abundant, millions of mummies were used as fuel for locomotives

Humans shed 600,000 particles of skin every hour; 1.5 pounds a year. By age 70, you will have lost 105 pounds of skin

Your heart creates enough pressure to squirt blood 30 feet

When you sneeze, all bodily functions stop, even your heart

In the course of a lifetime you will grow 2 meters of nose hair

You produce 25,000 quarts of spit in a lifetime, enough to fill two swimming pools

You were born with 300 bones, but by adulthood you have only 206

The Neanderthal’s brain was bigger than your

Happy Halloween!

“Running will ruin your knees” – maybe not so…

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Today the Wasatch 100 ultra marathon started and many of the Focus Bodywork community are running or pacing for this event.  Over coffee this morning I overheard some ladies mocking the competitors, stating, “They are ruining their knees, none of [them] will be able to walk when they are in their 70′s.”

Let’s debunk this notion.

When comparing the knees of seniors over a 10-year period (age ranges from 50-80, in 10-year increments) who live a sedentary lifestyle, who run an average of 20 miles a week, and those who live active life styles (elevated heart rate for an hour at least five days a week), it was found that the most degeneration of knee joint tissues were in the sedentary population.  As one would expect, mild changes were seen in the active group, but surprisingly the running population showed increased health of their knees over the 10 year period!  Source: Long Distance Running and Knee Osteoarthritis

When researchers looked at seven marathoners over a 10-year period, they found only one study participant who experienced significant degeneration of his knees, which lead him to quit running during the study.  However, he had a significant preexisting knee pathology prior to the study and quit running mid-way through the 10-year study period.  The other six runners showed no signs of new damage to their knees during the study period.  Source: Knee Joints of Runners

These are just two recent studies, and more data is needed to confirm that running is, in fact, good for your knees, but as a runner myself this gives me and my knees hope.  The message here is that if your knees are healthy, there is no reason to expect they will deteriorate under thoughtful run training over a lifetime.  An active knee is more likely to stay healthy as you age than a sedentary one.  And maybe, just maybe, running will reduce your chances or severity of osteoarthritis as you age.  Of course, if you have significant knee history, running may not be the best choice for you.

So cheer on all the ultra marathoners out there tonight running up and over the Wasatch Mountains who inspire our athletic spirits and may be adding to the well-being of their knees while they do it.

Welcome to the Focus Bodywork Blog

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Emma Maaranen, Owner and Therapist of Focus Bodywork

Focus Bodywork is a therapeutic massage studio meeting the needs of all types of athletes in and around the Wasatch front.  We strive in our clinical sessions to educate our clients on relevant anatomy, physiology, training techniques, current research related to sport pursuits and local events just to name a bit of what accompanies our hands-on work.  We hope to use this blog to share these athletic musings and current anatomy conundrums with the Focus Bodywork community; so stay tuned!