As it's the final episode of this mini-series, we thought it would be useful to write about the injuries affecting those using their fine motor skills and repetitive actions – i.e. Musicians and Artists.
Let’s start with wrist conditions.
Carpal tunnel syndrome. What is it? Located on the palmar surface of the wrist, carpal tunnel syndrome is where there is a compression to the median nerve.
It can be caused by a few things; a direct trauma to the wrist, a tenosynovitis (inflammation of the tendon) to the wrist flexor muscles, a contracture (shortening and hardening of the soft tissue) to the flexor retinaculum (imagine a refresher sweet wrapped around your wrist holding all of the structures in place) or more of a work based issue like frequently using a vibrating tool or typing on a keyboard.
Hence why we tend to see this condition appear in certain types of artists that do lots of fine work or using particular tools that may increase their likelihood of developing carpal tunnel syndrome.
Patients tend to experience a burning sensation through the carpal tunnel, numbness or paranesthesia alongside the length of the median nerve, a decrease in grip strength and movement, night pain and sometimes pain radiating up into the forearm, elbow or shoulder.
Moving onto De Quervain’s Tenosynovitis - an inflammation of the synovium of the abductor pollicis longus and extensor pollicis brevis tendons of the thumb.
The synovium is a jelly like sheath that surrounds the tendons. It is highly vascular and innervated, so acts as a high source of pain when damaged.
For those that spend their days gripping handles and polls (in sport – this is seen more in racquet sport players). It’s common that symptoms appear as localised tenderness, swelling and crepitus (clicking/grinding) to the area.
Now for elbows. Particularly the painters and jewelers out there, this one’s for you.
You’ve probably heard of ‘Tennis elbow’ or how it’s otherwise known, Lateral epicondylitis. The name is certainly deceptive, as it’s not just the tennis players that can develop this condition.
It originates from the extensor tendons which all come from the lateral epicondyle of the humerus (the most common cases being from the Extensors carpi radialis brevis due to its chronic nature).
The common is caused by repetitive wrist extension against a resistance, a sudden increase in wrist extension (like the flick of a paint brush, drumstick or bow on a string instrument).
Patients often present with a visible difference in their carrying angle (where the arms nautrally sit by your sides when standing), possible swelling with occasional redness, a weakness in grip, pain on wrist extension and extension of the middle finger/second finger as well as pain on particular muscle testing.
The condition can actually occur but on the opposite side of the elbow – otherwise known as ‘Golfer’s elbow’ or Medial epicondylitis. This is where there has been an excessive contraction of the wrist and finger flexors leading to a tendinopathy due to overload.
We hope this mini-series was somewhat helpful! We wanted to highlight how varied our clients can be. Every job has it’s pros and cons, but if you do feel like your job is causing you to become injured then do get in touch and see how we can help.
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