The Remarkable Hand

What makes humans so “human”? While there are certainly many factors – spiritual, emotional, physical – that make us human, the human hand is a unique appendage that opened up amazing possibilities in our becoming human.

From our opposable thumbs to the amazing sensory receptiveness of our fingertips, the human hand is ideally sculpted for exploration and manipulation of this incredibly complex world. A study at the KTH Royal Institute of Technology in Stockholm, Sweden in 2013 determined that the human finger can find an irregularity as small as 13 nanometers, which is less than 1/1000th the thickness of a human hair. With sensory tools like that at our disposal, it’s not surprising we humans have done as well as we have!

Let’s spend a minute and look at the basic set-up of the hand.

The eight bones of the wrist are called the carpal bones. The carpal tunnel is the narrow passage through which passes all of the blood and nerve supply for the hand. You’ve probably heard of carpal tunnel syndrome. Carpal tunnel syndrome occurs when, for a variety of reasons, that passageway no longer allows for friction-free passage of the tendons, nerves and blood supply to the hand, causing pain and dysfunction.

The five long bones that stretch from your wrist to the base of your fingers are called metacarpals, and the individual bones of your fingers are called the phalanges (phalanx is singular). The muscles and tendons that move your hands and fingers are incredibly sensitive, allowing us to pick up tiny objects, while they are strong enough to lift frying pans and carry babies!

It’s amazing all that we can do with our hands! However, when we begin having pain or discomfort in our hands, it can be difficult to function in the day-to-day. If you are experiencing pain in your hands or wrists, please contact us to set up an evaluation.

Ouch! What’s going on with my elbow?

You are used to doing everything you want to do. Lately, though, just picking up a gallon of milk with your right hand hurts so much it almost makes you cry. You made an appointment with your primary care provider, who thinks you are developing osteoarthritis in that elbow. She referred you to us, the Missouri Orthopedics & Advanced Sports Medicine Center.

Elbow Pain, Why Do I have elbow pain, Dr. Irvine, Missouri Sports Medicine, Missouri Orthopedic Care, Missouri Doctors

After hearing your story, reading your history and reviewing some plain x-rays your PCP had obtained, one of the tools our board-certified surgeons may use to both diagnose and treat your elbow pain and dysfunction is elbow arthroscopy.

What is Elbow Arthroscopy?

The elbow, like all the joints of the human body, is a truly amazing anatomical structure. Through small spaces between the bones pass all of the nerves and blood supply for your hand. In addition to the pain symptoms you are currently experiencing, problems in the elbow can cause pain, numbness and weakness to everything past the elbow – your forearm and hand. Compromised blood flow from the elbow to the hand can cause even more serious symptoms.

Arthroscopy is ideally suited to examine the elbow. Instead of a large, open surgical procedure, one or more tiny incisions are made in the elbow to pass a small fiber-optic camera and various small instruments into the elbow space to both diagnose and potentially treat your pain.

While the x-rays your PCP ordered rule out obvious fractures, elbow arthroscopy can also treat arthritis, loose bodies in the elbow, stiffness, tennis elbow and many other conditions of the elbow.

Because arthroscopy does not use large incisions, less soft tissue has to heal, leading to less post-operative pain and speedier recovery times.

To set up an appointment, please contact us. There’s no need to put up with the pain and limitations! We look forward to hearing from you soon.

Scoliosis

General Orthopedic Care

Human Spine

At our center we treat patients on a regular basis as a general orthopedic care center but many of our patients are unaware of a chronic spine condition that often needs ongoing support from spine surgery and aids such as back braces. This condition is called scoliosis and it relates to a curvature of the spine that needs to be corrected.

Written below we have detailed the interesting facts, myths and pieces of art related to the condition. If you have scoliosis you may have heard these already. On the other hand if you are learning about scoliosis for the first time these five unique facts might take you by surprise.

A novel about scoliosis

Many teenagers over the past four decades have learned about scoliosis by reading Judy Blume’s novel “Deenie.” In the book, a teenager deals with the transitional period of being diagnosed and treated for scoliosis. Along the way she struggles with the corrective brace that cuts through her new clothes. She also deals with the social aspects of being different than other kids. However in the past 40 years the braces for treating scoliosis have changed significantly. For example, today’s braces do not de-emphasize the chest area, and are considerably less bulky than the type the character Deenie described.

Scoliosis empowerment support group

Did you know that there was a specific support group in place to empower young girls with scoliosis? According to Curvy Girls founder Leah Stoltz when girls are diagnosed with scoliosis, they often grow silent. For this reason Stoltz has actively maintained a website-based support group specifically for scoliosis-diagnosed girls. Stoltz also talks with social workers and guidance counselors about the special needs of girls with scoliosis.

High scoliosis statistics

In America the statistics related to scoliosis are as high as one-in-40. Regardless most are considered mild cases and the causes for scoliosis are generally unknown. Once diagnosed a child will be monitored with X-rays. If the condition becomes severe surgery or braces may be used to correct the curvature of the spine.

Do not forget about kyphosis

In the field of medicine, there are two conditions that affect the way the spine grows. While scoliosis is an S or C-shaped curvature of the spine from one side of the back to the other, there is a similar condition that bends the spine into the front of the abdomen from the back. Called kyphosis, it can occur when there is a failure for the spine to form or a failure of segmentation of the spine.

Silliest scoliosis myth

On a number of scoliosis websites there are doctors writing about a common myth. Evidently many people believe that heavy backpacks cause children to get scoliosis. This is refuted by medical science and is not a proven cause for scoliosis. Nevertheless keep in mind that there are many areas of the back that can suffer duress due to carrying bags or luggage that exceed the weight your back can withstand. For all of these reasons when you need professional orthopedic care know that we are the educated ear you have been looking for. Thank you for choosing Missouri Orthopedics & Advanced Sports Medicine and we look forward to hearing from you.

Total Joint Replacement

Having Total Joint Replacement

Total joint replacement is not a step that is ever taken lightly, but should you need this advanced surgical option, Missouri Orthopedics and Advanced Sports Medicine is committed to making this a winning experience from evaluation to recovery: Missouri Sports Medicine. Before deciding your joint’s condition warrants replacement, several less drastic forms of care may be tried. These can include physical therapy, injections, and arthroscopic surgery. If these ameliorative treatments don’t restore the joint’s normal function, an x-ray, and possibly an MRI, may be ordered to determine any joint and tissue damage.

The Decision for Surgery

Assuming that you are healthy enough for surgery, joint instability, pain that won’t allow you to sleep at night, the inability to perform the normal daily functions of life, and being prevented from doing the things you enjoy are all factors that may lead you to decide that total joint replacement is the best option. After you and your doctor decide that you will go ahead with the surgery, you will be thoroughly briefed on what to expect, and you will also be informed about the preparation that should take place in the home, so your recovery phase will run smoothly. In most cases you will be administered general anesthesia before the procedure begins. Using knee-joint replacement as an example, damaged parts of the joint will be removed in preparation for your new knee, and after the surfaces of the joint have been prepared, the new components of the knee will be anchored in place.

Post-Total Joint Surgery

After coming out of surgery, a great number of post-surgical tasks will be taking place. You will, of course, be having pain medication administered, but steps will also be undertaken to monitor the surgery site for infection. You may also receive blood thinners to prevent blood clots from forming, and as soon as possible, steps will be taken to maximize the joint’s flexibility. Your hospital stay may last from 3-5 days, and, in addition to post-operative care, light physical therapy will begin.

Recovery From Total Joint Surgery

By far, the greatest part of your recovery will take place during the 4 to 6 weeks following surgery. The physical therapy and follow-up doctor visits you keep will have you well on the way to a much-improved quality of life. If you need a consultation about possibly needing this procedure, please contact us.

At-home Exercises For Retired People

At-home exercises for retired people can be an efficient way to bridge the gap between health and comfort. After spending years laboring hard in the work-force, spending time commuting and sitting behind desks or working long hours on the floor it can be a blessing to be able to enjoy the comfort of one’s home. Comfort can at times get in the way of the regular exercise our bodies need in order to stay physically as well as mentally fit.

Dr. David Irvine has extensive experience treating patients who suffer from joint and tendon disease which can sometimes occur due to lack of sufficient resistance exercises. Let’s spend some time and talk about how an active retired person can remain healthy by following a few exercises at home, whether in the comfort of the living room or braving the outdoors.

How does inactivity lead to weaker joints and tendons?

Looking at the human body one might think that the parts make up the whole. However, unlike a car, the body doesn’t have components which can be treated as stand-alone parts. The knee, for example, requires adequate muscle mass in the hamstrings, gluteus muscles as well as the calves in order to protect it during exercise or even when going for a walk.

Strength is not the only factor, tendons are part of the equation as well, requiring adequate elasticity in order to allow proper movement of the knee-joint. Weak tendons can allow for unstable motions of the knee and if in turn these structures are too tight they may cause excess wear and tear of the sensitive joint surfaces.

In medicine we have learned that a sedentary lifestyle inevitably will lead to decreased muscle mass and tighter tendon structures. The main reason for this is nerve stimulation, the lack of which decreases the blood supply to these structures causing them to become less important to the body which in turn causes degeneration – or simply put, if you don’t use it, you might lose it.

Combining daily indoor activities with exercise

You likely have common daily routines at home which may offer some relaxation such as listening to podcasts, reading a magazine or watching entertainment/news on TV. Combining exercise with such activities is the most efficient way to get mental as well as physical stimulation.

  • Stand at the kitchen counter with you feet close together, flex your calves and raise your heels off the floor and lower your weight down to a count of 5 seconds.
  • When seated on that comfy couch raise one leg at a time up to the level of your pelvis and lower it down and repeat with the other leg.
  • When listening to your favorite podcast or news source stand with your feet at arm’s-length away from the wall and gently lower your weight into the wall, performing a standing push-up.
  • Don’t forget that cleaning your home manually is an exercise by itself. A good rubdown of the counters and that circular polishing motion of the interior mirrors will definitely get your heart pumping and provide a wonderful upper body resistance exercise.
  • A couple of inexpensive 10-lb dumbbells should be used to perform biceps curls by standing erect with arms at your sides while flexing the biceps and bringing the weights to your shoulder.
  • A variation of the above exercise is to then go from the flexed biceps position directly into an overhead press by pushing the dumbbells over your head and straightening the arms as if reaching for the stars.

Exercising the body in your outdoor space

  • Gardening is one of the most meditative and laborious activities you can do in your outdoor space. Aerating the lawn, plucking weeds, planting flours and vegetables serve as wonderful exercises.
  • If you have room for potted plants consider adding them to your garden, besides requiring watering such plants need to be regularly re-potted – this is less of a chore and more of an exercise – said the optimistic doctor.
  • Consider waking up early and performing a Tai chi routine before you start your day either out on your patio, in front of some beautiful plants or under the shade of your tree.
  • Don’t let those stairs stop you, if you have stairs leading up to the house then turn on some music and go up and down them daily to provide stronger quads and calves.

Limitations to exercise

At our practice we often encounter patients who have given up exercising either because they are unable to get to a nearby gym or are limited by aches and pains.

The former is easily remedied by performing some simple home exercises as outlined above. Get creative and use common household items to perform resistance exercises.

The latter is a common concern. Patients often associate pain with causing damage. This isn’t always the case but it certainly is worth investigating. If you are trying to be more active but constantly experience pain in a specific part of your body please don’t ignore it. Dr. Irvine’s experience with muscles, ligaments and joint pains allows him to differentiate between benign pains which can be overcome with changes to your exercise routine while identifying more serious disease processes which may require proper intervention such as advanced arthritis, frayed tendons, inflamed joint surfaces etc.

We hope that you gained some useful tips from this article regarding home exercises. If you are experiencing aches or pains while doing them please contact us so that we can guide your exercise better.