Digital Disabilities, Repetitive Stress & Our Mobile Devices

Too much time on smartphones and tablets can lead to a host of repetitive stress problems known today as “digital disabilities.” These conditions include; cell phone elbow, texter’s thumb, texter’s neck, iPad hand and selfie elbow.digital_device_overload

Cell phone elbow results when the bent hand holding the cell phone to the ear for prolonged periods of time causes compression of the ulnar nerve.  This is also known as cubital tunnel syndrome, which is neuropathy of the ulnar nerve or “funny bone” nerve.

Cell phone elbow may contribute to another injury called smartphone pinky, which is a condition resulting when the bent elbow (while on a cell phone) causes compression of the ulnar nerve, which also gives sensation to the small finger. Over time, the sensation of the small finger diminishes.

The repetitive movements of our thumbs while texting may lead to texter’s thumb.

Texter’s thumb is a painful inflammation of the tendons that control thumb movement and extend to the wrist.  This causes pain at the base of the thumb, which may extend to the lower arm.

The concern is not the thumb pressing down on the keys of a phone but rather the frequent passing of the thumb over the keyboard, as the thumb joint is not meant to move rapidly in this manner.

Texter’s neck comes from too much time spent on electronic devices, subsequently leading to neck and spine injuries.

Texter’s neck has become a catchphrase describing neck pain and damage from looking down at a cell phone, tablet or other wireless device too frequently and for too long.

Another modern day “digital disability,” iPad hand, causes tendonitis in the hand from having the iPad in one position for a prolonged period of time.

Many of these digital disabilities are seen in Millennials, most notably selfie elbow. In fact, according to studies from the Pew Research Center, Millennials are more likely than other generations to have posted a selfie on a social media site (spending an average of five hours a week taking selfies).

The weight of the phone is not the concern.  The repetition combined with the contortion of the elbow, held in unnatural positions while capturing the selfie shot are actually what pose the problem.

Preventing Digital Disabilities, Repetitive Stress Conditions

There are many preventative measures to prevent damage from overuse of handheld devices, such as hands-free modifications, tablet stands and attachable keyboards.

To reduce the risk of cell phone elbow, use an earpiece, a headset or Bluetooth. To avoid texter’s thumb, a keypad is great. And try taking breaks from texting. Use the audio command on your phone to just give your hands a rest.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cowboy Casualties and the Rigors of Rodeo Life

While the Houston Livestock Show and Rodeo has come and gone, the rodeo athletes who kept us captivated as they rode, roped and wrangled their way across the arena for the duration are on to a new city – and not even half way through their rodeo season.

The life of a rodeo athlete, many true cowboys at heart, is one of unyielding dedication and physicality.

Those who have participated since youth in rodeo events have built both strengths and vulnerabilities to the ongoing rigors of rodeo life. Proper mental and physical conditioning are key in avoiding serious injury.Rodeo Quote

While many of the injuries commonly associated with these athletes include concussions and fractures, others are the result of ongoing strain placed on the same limbs, ligaments and joints day in and day out for months at a time.

Many rodeo athletes begin in their teens, tie-down roping calves before progressing to adult wrangler, bull or bare back rider.  The years of hand and upper extremity strain predisposes this athlete to tendonitis in the hand, wrist, elbow and shoulder. Known as a repetitive stress or overuse condition, without proper treatment it can cause chronic inflammation, joint instability and eventually the early onset of arthritis.

Recognizing early signs of tendinopathic injuries and conditions and establishing an effective treatment program is key.

Tendonitis

Tendonitis (also spelled Tendinitis) is the inflammation of the tendons and other soft tissue connecting muscle to bone.  It is most often caused by repetitive movement, placing strain on the tendon and negatively impacting the affected area over time.  It may also occur following a sudden more serious injury such as a fracture or dislocation.

Tendonitis can affect different parts of the body.  Some of the commonly diagnosed upper extremity tendinopathies include Tennis Elbow, Golfer’s Elbow, deQuervain’s Tenosynovitis, Pitcher’s Shoulder and Swimmer’s Shoulder – named after the repetitive motion and sport implicated.  Though, many other activities and types of sports can result in one of these types of tendinopathies as well.

Among rodeo athletes, wrist tendonitis and tendon damage is particularly common, both as a result of the repetitive stress on the wrist and fractures and other trauma this athlearthritis_tendinitis_elbow_strainte sustains.

Symptoms

Symptoms of tendonitis may include;

  • Pain and swelling
  • A feeling of friction as the tendon moves
  • Warmth and redness about the affected area
  • A lump that develops along the tendon
  • Difficulty moving

A tendon rupture may result in a gap felt in the line of the tendon and would manifest with weakness or lack of function of that muscle.

 

Tendinosis

Tendinosis is often referred to as “chronic tendonitis” and is damage to a tendon at a cellular level.  In fact, “osis” represents a pathology of “chronic degeneration” without inflammation.  Key identifiers include disrupted collagen fibers within the tendon, increased cellularity and neovascularization.  This condition is thought to develop from micro tears, repeated injury and increases the risk of tendon rupture. While pain associated with this condition may be addressed similarly to that of tendonitis, emphasis is on stimulating collagen synthesis and breaking the cycle of tendon injury.

Extensor Carpi Ulnaris (ECU) InstabilityWrist Tendonitis

The ECU tendon of the wrist attaches the ECU muscle to the bone and is responsible for straightening and rotating as well as gripping and pulling movement in the wrist and hand. While this tendon normally slides over the forearm (near the little finger), held in place by the retinaculum (ligament-like structure), damage to the area can cause it to slip in and out of place (sublux) or dislocate completely.

Treatment

Treatment for and recovery from a tendinopathic condition will depend on the type and severity.  While minimally invasive corticosteroid injections have proven effective in relieving pain, rest from the repetitive activity contributing to the condition is also indicated.  Stretching and strengthening exercises are also proving effective.

In severe cases, or when the tendon becomes displaced and nonsurgical treatment fails to resolve the problem, surgical intervention may be indicated.  Surgical intervention may include repair of the retinaculum, tendon lining (tendon sheath), or tendon – or to replace the tendon if it is torn.

Prevention

While many injuries in the life of a rodeo athlete cannot be avoided, damage can be reduced by staying fit and strong overall.  Strength and flexibility, combined with periods of rest and other activities involving different muscle groups will help reduce risk of injury and the impact of a tendinopathic condition.

According to long time rodeo professional and bareback rider Cody Goodwin, “every ride is like getting in a car wreck.”

“You have to be in pretty darn good shape, which is why I jog four miles every other day and lift weights every other day – to develop lean muscle mass,” said Goodwin.

“I take good care of my body, so that I can, at my age, continue to compete with 20 and 25-year-old riders,” added the 41-year-old rodeo veteran.

Dr. Korsh Jafarnia is the hand and upper extremity specialist at UT Physicians / Memorial Hermann IRONMAN Sports Medicine Institute (Memorial City and Texas Medical Center locations), 713.486.1700.