Tuesday, February 25, 2014

Flexor Tendon Injuries

A deep cut on the palm side of your fingers, hand, wrist, or forearm can damage your flexor tendons, which are the tissues that help control movement in your hand. A flexor tendon injury can make it impossible to bend your fingers or thumb.

Tendons are tissues that connect muscles to bone. When muscles contract, tendons pull on bones. This causes parts of the body (such as a finger) to move.

The muscles that move the fingers and thumb are located in the forearm. Long tendons extend from these muscles through the wrist and attach to the small bones of the fingers and thumb.
The tendons on the top of the hand straighten the fingers. These are known as extensor tendons. The tendons on the palm side bend the fingers. These are known as the flexor tendons.
When you bend or straighten your finger, the flexor tendons slide through snug tunnels, called tendon sheaths, that keep the tendons in place next to the bones.

A torn or cut tendon in the forearm, at the wrist, in the palm, or along the finger will make it impossible to bend one or more joints in a finger.

Because flexor tendons are very close to the surface of the skin, a deep cut will most likely hit a flexor tendon. In these cases, the tendon is often cut into two pieces. Like a rubber band, tendons are under tension as they connect the muscle to the bone. If a tendon is torn or cut, the ends of the tendon will pull far apart, making it impossible for the tendon to heal on its own.
Because the nerves to the fingers are also very close to the tendons, a cut may damage them, as well. This will result in numbness on one or both sides of the finger. If blood vessels are also cut, the finger may have no blood supply. This requires immediate surgery.Occasionally, flexor tendons may be partially cut or torn. With a partial tendon tear, it may still be possible to bend your finger, but not completely. These types of tears can be difficult to diagnose.

In addition to cuts on the arm, hand, or fingers, certain sports activities can cause flexor tendon injuries. These injuries often occur in football, wrestling, and rugby. "Jersey finger" is one of the most common of these sports injuries. It can happen when one player grabs another's jersey and a finger (usually the ring finger) gets caught and pulled. The tendon is pulled off the bone. In sports that require a lot of arm and hand strength, such as rock climbing, tendons and/or their sheaths can also be stretched or torn.

Certain health conditions (rheumatoid arthritis, for example) weaken the flexor tendons and make them more likely to tear. This can happen without warning or injury — a person may simply notice that his or her finger no longer bends, but cannot recall how it could have happened.

The most common signs of a flexor tendon injury include:
  • An open injury, such as a cut, on the palm side of your hand, often where the skin folds as the finger bends
  • An inability to bend one or more joints of your finger
  • Pain when your finger is bent
  • Tenderness along your finger on the palm side of your hand
  • Numbness in your fingertip
Doctor Examination:
It is important to see a doctor whenever the fingers are injured. This is especially true if your finger is jammed and you cannot bend or straighten your fingertip. 

First Aid:
When you have a serious cut to your hand or fingers, apply ice immediately. Tightly wrap your hand with a clean cloth or bandage to slow down the bleeding. Elevate your hand by keeping it lifted above your heart. See a doctor as soon as possible. 

Your doctor may first clean and treat any wounds that are not deep. You may need a tetanus shot or antibiotics to prevent infection. 

Physical Examination:

These standard examination tests help your doctor determine if a tendon or nerve has been injured. 
During the examination, your doctor will ask you to bend and straighten your fingers. To test your finger strength, your doctor may have you try to bend your injured finger while he or she holds the other fingers down flat. To determine whether any nerves or blood vessels have been injured, your doctor may test your hand for sensation and blood flow to the fingers. 

Additional Tests:
Your doctor may also order an x-ray to see if there is any damage to the bone.

After examining your hand, your doctor may place your hand in a splint for protection.
Tendons cannot heal unless the ends are touching, which does not occur with a complete tear. In most cases, a cut or torn tendon must be repaired by a doctor. This requires surgery.

Surgery is usually performed within 7 to 10 days after an injury. In general, the sooner surgery is performed, the better recovery will be.
If your injury is restricting blood flow to your hand or finger, your doctor will schedule an immediate surgery.

Recovery from Surgery:
It can take up to 2 months before the repair heals and your hand is strong enough to use without protection. It may take another month or so before your hand can be used with any force. 

Soon after surgery, you will begin physical therapy. Specific exercises will help you gradually regain motion and function. Stiffness after surgery is common, but it usually responds to therapy.

Splint wear and proper exercise, exactly as prescribed by your therapist, are as important to recovery as the surgery itself.

How Stress Affects Mental Health

When someone is under chronic stress, it begins to negatively affect his or her physical and mental health. The body’s stress response was not made to be continuously engaged. Many people encounter stress from multiple sources, including work; money, health, and relationship worries; and media overload.
With so many sources of stress, it is difficult to find time to relax and disengage. This is why stress is one of the biggest health problems facing people today.

Chronic Stress

Chronic stress increases the risk of developing health problems including obesity, diabetes, heart disease, cancer, and a weakened immune system. Chronic stress also affects a person’s mental health. Many studies show a correlation between stress and the development of mood disorders such as anxiety disorders and depression.

According to the American Psychological Association’s latest stress survey, 66 percent of people regularly experience physical symptoms of stress, and 63 percent experience psychological symptoms.

Link between Stress & Mental Health

Although many studies have shown a link between stress and mental health problems, the reason behind this connection has remained unclear. Recent research from the University of California, Berkeley, has discovered new insight into why stress can be so detrimental to a person’s psyche.

Previous research has found physical differences in the brains of people with stress disorders, such as post-traumatic stress disorder (PTSD), and those without. One of the main distinctions is that the ratio of the brain’s white matter to gray matter is higher in those with stress-related mental disorders compared to those without.

People who experience chronic stress have more white matter in some areas of the brain. The UC Berkeley study wanted to find out the underlying reason for this alteration in the brain composition.

Gray Matter

Gray matter in the brain is composed mainly of two types of cells: neurons, which process and store information, and glia, cells that support the neurons.
White matter mostly is composed of axons, which form a network of fibers to connect the neurons. It is called white matter because of the white, fatty “sheath” of myelin coating that insulates the nerves and accelerates the transmission of the signals between the cells. 

For this study, the researchers focused on the cells that produce myelin in the brain to see if they could find a connection between stress and the proportion of gray brain matter to white.
Hippocampus The researchers performed a series of experiments on adult rats, focusing on the hippocampus region of the brain (which regulates memory and emotions). During the experiments, they found the neural stem cells behaved differently than expected. Prior to this study, the general belief was that these stem cells would only become neurons or astrocyte cells, a type of glial cell. However, under stress, these cells became another type of glial cells, oligodendrocyte, which are the myelin-producing cells. These cells also help form the synapses, which are the communication tools that allow nerve cells to exchange information. 

Thus, chronic stress causes more myelin-producing cells and fewer neurons. This disrupts the balance in the brain, causing communication in the brain cells to lose its normal timing, which could lead to problems.
Stress Disorders & Brain Connectivity
This might mean that people with stress disorders, such as PTSD, have alterations in their brain connectivity. This might lead to a stronger connection between the hippocampus and the amygdala (the area that processes the fight-or-flight response). It might also cause weaker connectivity between the hippocampus and the prefrontal cortex (the area that moderates the responses).

If the amygdala and hippocampus have a stronger connection, the response to fear is more rapid. If the connection between the prefrontal cortex and the hippocampus is weaker, then the ability to calm down and shut off the stress response is impaired. Therefore, in a stressful situation, a person with this imbalance will have a stronger response with a limited ability to shut down that response.

Oligodencdrocyte Cells

This study shows that the oligodendrocyte cells might play a key role in long-term changes to the brain that could lead to mental health problems. The researchers also believe that the stem cells which, due to chronic stress, are becoming myelin-producing cells rather than neurons, affect cognitive function, because it is the neurons that process and transmit the electrical information necessary for learning and memory skills.

More research is required to verify these findings, including studying humans rather than rats, which the researchers have planned. However, this study provides important insight into why chronic stress affects the brain and mental health, and how early intervention can help prevent the development of certain mental health problems.

Reference by: 

Sunday, February 9, 2014

The most incorrectly gym exercises

Get the most out of your workouts and avoid injury with these tips for the 10 exercises most frequently performed incorrectly.
From lifting too much weight to poor technique, an incorrectly performed exercise can mean you're not getting the benefits you're looking for, and can even cause pain and damage.
According to a poll of 942 fitness professionals by sports retailer Sweatband.com, top of the list is the bicep curl, followed by stomach crunches and the chest press.

Physiotherapist describes the most common exercises done incorrectly and explains how to do them safely and efficiently. 
To maximise the benefits of these exercises, aim to perform them in a slow and controlled manner, going through the full range of motion and lifting within your comfort zone.

Bicep curls
Target: front of the upper arm

The most commonly reported error was people simply trying to lift too much weight, which engages the shoulders and reduces the effort on the biceps. 

If the weight is too heavy, you'll be working the shoulders and not properly targeting your biceps, your shoulders will hunch forward instead of staying back as you lift the weight, which can cause injury.

Leaning backwards when lifting too much weight puts a lot of pressure on the lower back, which can also lead to injury. To maximise the efficiency of the bicep curl, lift within your comfort zone, keep your back still and straight, and focus the effort on the biceps only. If you can't do the exercise with the correct technique, it means the weight may be too heavy.

How to do a bicep curl correctly:
  • Stand tall with your shoulder blades back and down, and contract your abs.
  • Keep your back, elbows and shoulders still.
  • Curl your arms up until they're in front of your shoulders. 

Stomach crunches 

Target: abdominals

Common mistakes that reduce the effectiveness of a stomach crunch are tucking the chin into your chest, jerking up into a crunch, raising yourself too high off the floor, and not keeping your abs contracted throughout the exercise.

All the work should come from the abs, not the neck, If done properly, you should not feel any strain in the neck.While crunches improve posture, stabilise the core muscles and contribute to a healthy back, doing hundreds of them is probably a waste of time. No matter how many crunches you do, you won't get a six-pack if your abs are hidden under layers of fat.
How to do a crunch correctly:
  • Curl up until your shoulders are about three inches off the floor.
  • Don't tuck your neck into your chest as you rise – imagine a tennis ball between your chin and chest.
  • Contract your abs throughout the exercise.
  • Don't jerk your head off the floor. 

Chest press

Target: chest, shoulders and triceps

Failing to keep the shoulders back and down was the most frequently reported mistake with the chest press.To perform a chest press correctly and reduce your risk of shoulder injury, you should keep your shoulders back and down throughout the entire movement. 

The common mistake is to round the shoulders forward and upward as you press, which not only reduces the work on the chest but also puts the shoulders in a vulnerable position. 
There is also a tendency to recruit the legs and buttocks to help with the effort. Don't contort your body in an effort to lift the weight – if you can't maintain proper form, you're lifting too much.
How to do a chest press correctly:
  • Keep your shoulders back and down.
  • Contract your abs throughout the exercise and keep your neck relaxed.
  • Maintain a natural arch in your lower back – don't let it arch too much.
  • Don't lock your elbows when raising the weight.

Squat lift

Target: thighs, buttocks and lower back

Putting too much pressure on the lower back and not enough leg work were the most commonly observed mistakes with the squat lift. Don't round your back, your spine needs to remain in a neutral position throughout the exercise. All the effort should come from the leg muscles. 
To keep your back in the correct position, keep your back straight and contract your core muscles and buttocks. As you lower yourself, imagine sitting back on a chair, and do not let your knees lean over your toes.
Practice correct technique using a weight lifting bar or squat rack without weights in front of a mirror, when you come to using weights, it's advisable to have someone experienced watch you.

How to do a squat lift correctly:
  • Feet should be shoulder-width apart and slightly turned out.
  • Keep your shoulders back and down and your chest pushed out.
  • Shoulders should remain directly above the hips.
  • Lower yourself as if you were sitting back on a chair.
  • Keep your weight on your heels, not the toes, throughout the movement.
  • Don't let your knees lean over your toes as you lower yourself. 

Lat pulldown

Target: back and bicep muscles
Pulling the bar down behind the neck was the most commonly reported issue with the lat pulldown. When people perform the lat pulldown behind the neck, they tend to bend their head forward as they bring down the bar, which puts strain on the neck and shoulders, It's safer to bring the bar down in front of your body.  

To perform the lat pulldown correctly, lean a little bit back from your hips, bring the shoulder blades back and down, and pull the bar down towards your chest. Keep your spine in a neutral position and engage your core muscles throughout the exercise to protect your back, If you find you're arching your back as you pull down, it probably means you're lifting too much.

How to do a lat pulldown correctly:
  • Keep your shoulders back and down.
  • Lean a little bit back from your hips.
  • Pull the bar down towards your chest.
  • Contract your core muscles. 
  • Don't arch your back. 

The plank

Target: Stomach and back muscles
The plank is an effective exercise for developing your core strength around the spine, but bad form can hurt your shoulders and back.  The common mistake here is sagging at the hips or raising the bottom too high, raised buttocks or collapsing back are a sign of a weak core, either way, you are reducing the effectiveness of the exercise. 
A collapsing back also puts an excessive amount of pressure on your lower back, which can lead to back pain. To get the best results, always maintain perfect form, If you lose form during the exercise, it means your muscles are tiring. Stop and have a rest. You can build up how long you do the plank gradually.

How to do the plank correctly:
  • Keep your legs straight and hips raised to create a straight and rigid line from head to toe.
  • Your shoulders should be directly above your elbows.
  • Keep your abs contracted during the exercise.
  • Don't allow your lower back to sink during the exercise.
  • Look down at the floor. 

Bent over row

Target: back muscles and biceps
A hunched back was the most common error reported among people doing bent over rows.
Having a curved spine when doing this exercise puts a lot of pressure on your back and can cause injury, you should maintain a neutral spine throughout the exercise.

To correct this mistake, pull in your core muscles, look ahead of you and keep the chest high. Pull the bar up towards the waist, not the chest. Pinch your shoulder blades together as you pull the bar towards your waist, to get the full benefits from this move, pull the bar all the way up to the waist just above the belly button, keeping elbows tucked in, and lower the bar by straightening the arms completely. 

How to do a bent over row correctly:
  • Bend forward at the waist, keeping your chest high.
  • Bend your knees slightly and keep your back straight.
  • Keep your shoulders back and down.
  • Pull the bar towards your waist, just above the belly button.   

Leg press

Target: thighs and buttocks
Starting with your knees bent right into your chest was the most common mistake with the leg press.
This starting position is often referred to as 'going too deep' and it puts a lot of pressure on your lower back. 

In the starting position, your legs should not be bent more than 90 degrees. When you straighten the legs, push through the heels and not the toes to avoid straining the knees. Don't lock your knees when you straighten the legs. As you straighten your legs, maintain a neutral spine and keep your neck relaxed. Maintain a neutral spine: don't flatten your lower back against your support.

How to do a leg press correctly:
  • Start with your knees bent at no more than 90 degrees.
  • Straighten your legs by pushing through the heels, not the toes.
  • Don't lock your knees at the top of the move.
  • Maintain your lower back's natural curve – don't flatten your lower back against the support.
  • Keep your neck relaxed and your head pressed against the support. 

Leg lifts

Target: abs, hip flexors
The most common mistake observed with leg lifts is allowing the lower back to arch excessively during the lift, which not only strains the back, but makes the move much less effective as an abdominal exercise. 

If you don't keep your back muscles and abs contracted, you're only working your hip flexors, If you're just starting out with this exercise, focus on doing a few while focusing on proper technique, you can increase the number of repetitions gradually. 

To get the most out of this exercise, the physiotherapist advises lowering and lifting the legs slowly while keeping the abs under constant contraction and without letting your heels touch the ground. When you feel your lower back starting to arch, it's time to stop.

How to do leg lifts correctly:
  • Don't flatten your lower back against the surface – maintain the lower back's natural curve.
  • Keep your head and shoulders pressed against the floor.
  • Your neck should be relaxed.
  • Keep your abs contracted throughout the exercise. 


Target: thighs and buttocks
Done properly, lunges are a great exercise to improve your core strength, but all too often people are risking injury because of poor technique.
One of the most commonly reported errors with lunges is stepping into the lunge and allowing the front knee to lean over the toes, this puts a lot of stress on the knee. 

Other common mistakes include leaning the upper body forward or to one side instead of staying upright, and looking down, which can strain the neck,
using improper form not only has less benefit for the thighs and buttocks, but it can result in injury, especially to the knees and back.

How to do a lunge correctly:
  • Step forward with one leg, lowering your hips until both knees are bent at about 90 degrees.
  • Don't let your front knee lean over the toes as you lunge. 
  • Keep your upper body upright at all times and look straight ahead.