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.

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.

Retired? Stay Healthy at Home by Exercising

  • With Americans living longer on average than any time in history, people have questions about how to remain healthy during their retirement. Remaining healthy certainly includes physical activity; in fact, physical activity is essential. According to the Center on Disease Control, if you are 65 or older and are generally fit, and have no limiting health conditions, you should get two hours and thirty minutes of moderately intense aerobic activity each week–or 75 minutes of vigorous aerobic activity, and you should also train muscles twice per week.

Tufts Medical suggests several at-home exercises for retired people to develop stamina and strength. These can be done inside or outside the house!

Mature man working out at home

First two weeks

Walks: walk for five minutes to get warmed up and the blood flowing, outside if the weather suits or around the house. Treadmills are fine, too. The point is to get the heart pumping.

Squats: stand directly in front of a sturdy chair, with your arms stretched forward and parallel to the ground. With feet slightly wider than shoulder width, slowly lower your buttocks to the chair. Then stand again. Make sure you control the squat movement as you repeat 10 times.

Wall Push-ups: standing in front of a clear wall, place your palms on the wall–feet should be shoulder width. Then, bend the elbows as you lean toward the wall. Push back. Without ever locking your elbows, repeat ten times. Rest a minute. Do ten more.

Toe Stands: against something sturdy, such as a chair, counter, or wall, raise your self until you are standing only on the balls of your feet as you count to 4. Hold it at the top for 2-4 seconds. Repeat 10 times. Rest a minute. Repeat another 10 times.

Finger Marching: sitting or standing, imagine a wall in front of you while you walk your fingers up the wall, wiggling them at the top for ten seconds. Walk them back down. Repeat 10 times. Rest a minute. Repeat another 10 times. After, with arms and fingers stretched to the sky, try to touch your back with your hands. Continue the stretch if you can by reaching for the opposite elbow.

Increasing Strength During Weeks Three to Seven

For these additional exercises, you will need dumbbells and ankle weights, which are best purchased to add weight as you progress, beginning with 2 lbs for women and 3 lbs for men:

Bicep curl: sitting or standing, hold the dumbbells with arms down and palms facing thighs. Rotate forearms as you slowly lift the weights until palms are facing shoulders. Pause. Lower the weights to original position. Repeat 10 times. Rest a minute. Repeat another 10 times.

Step-ups: stand facing the base of some stairs with a handrail. Raise your left leg and place it on the stair. Then, place your weight on the left leg as you raise your right. Tap the right foot on the stair and then return. Repeat 10 times. Rest a minute. Repeat another 10 times for each leg.

Overhead Press: standing or sitting with feet should width, raise your hands with your palms and forearms facing forward, until the dumbbells are level with your shoulders and parallel to the floor. Slowly push the dumbbells up, fully extending, without locking the elbows. Pause. Slowly lower, as you count to four. Repeat 10 times. Rest a minute. Repeat another 10 times.

Side hip rise: standing behind a chair, with feet shoulder width, place your hands on the chair back. Slowly lift your left leg to the side, counting to 2 and keeping the leg straight. Remember, do not lock the knee. Then, slowly counting four, lower the leg. Repeat 10 times. Rest a minute. Repeat another 10 times for each leg.

After seven weeks, you should be in great shape, when you can add more strenuous exercises. Contact Missouri Orthopedics & Advanced Sports Medicine for any orthopedic concerns as you develop your fitness. Remember, keep motivated by setting goals, and they will help you maintain a consistent workout.

Hip Arthroscopy Recovery Tips

How to Boost Your Recovery after Hip Arthroscopy

Having hip arthroscopy is scary when you do not know what to expect afterwards. Science has found that psychological stress is detrimental to the body’s healing process and can prolong your recuperation. Learning how to prepare for the typical recovery period before your scheduled surgery will help ease your mind and give you time to make arrangements for the necessary post-procedural support. These are all great questions to explore with Dr. Irvine before you have hip arthroscopy:

  • How long will you experience pain during your recovery? Recovery from joint surgery is different for each person. It is not unusual to experience pain and soreness for 3-6 months after the procedure. Talk with Dr. Irvine about pain control methods that will work best for you. Keeping on top of your pain levels reduces your psychological stress and aids in your healing process.
  • Will you need to use a walker, crutches, or a cane? Crutches are used for the first 2 weeks (possibly up to 6 weeks) after the procedure so that you are not placing weight on the affected side.
  • Will you need to stay at an inpatient rehabilitation facility afterwards? Typically this is not the case, however, inpatient rehabilitation may be required in rare instances and Dr. Irvine can address this with you.
  • When should you expect to start physical therapy? A post-operative appointment is scheduled about a week after the surgery to remove any stitches and check on your progress. During this visit Dr. Irvine will assess if you are ready to begin physical therapy, which often begins the following week.
  • How long does physical therapy usually last? The usual course of physical therapy is 2-6 weeks, though this varies from patient to patient.
  • Who will help you at home and transport you to your appointments? Enlist a friend or family member to stay with you for at least the first few days after the procedure. You will need assistance with activities of daily living, such as preparing food, toileting, and bathing. If you anticipate needing additional help, you may wish to arrange for visits from a home healthcare service.
  • When will you be able to start driving again? You may be able to drive as soon as a week after the surgery if Dr. Irvine clears you to drive at your initial post-operative appointment. Talk with Dr. Irvine to find out what criteria is used to determine when you will be ready to drive again.

At Missouri Orthopedics, we strive to help you achieve your mobility goals so you can get back to the activities you enjoy. Please contact us to find out how we can serve your physical rehabilitation and orthopedic needs in the Greater St. Louis area.