Physio Edge podcast

Your knuckles getting crushed in an overenthusiastic handshake by hands the size of watermelons isn't a fun experience. Do these knuckle-crushers know they're squeezing that hard, or do they just regularly snap pencils while taking notes, and wonder why pens and pencils are so fragile nowadays?

How much grip strength do you actually need, even if you're not planning on crushing any knuckles the next time you meet someone? How much grip strength do your patients need when recovering from a hand, wrist or upper limb injury?

Testing and building grip strength is a really important part of helping your hand, wrist, elbow pain and injury patients get back to work and day to day life. Gripping also pre-activates the rotator cuff, so you can use gripping as part of your patients shoulder rehab exercises.

Grip strength tests using handheld dynamometers (HHD)* test your "Power Grip", but this test doesn't assess thumb or pinch grip strength. There are two other grip strength tests that are pretty easy to perform, that are going to be better suited to some of your patients. What are they, and how can you test the different types of grip strength in your patients?

In this podcast with Physiotherapist (English Institute of Sport Boxing Technical Lead Physio) Ian Gatt, we discuss assessing and building grip strength, assessing hand and wrist injuries and more, including:

  • 3 different types of grip strength you need to measure in your hand and wrist patients
  • How grip strength measures help guide your assessment and prognosis
  • What is the "Power grip" and how is it useful?
  • How can you test thumb strength?
  • Low-tech, simple grip strength tests you can use in your clinic
  • The high-tech approach to grip strength testing
  • How strong should wrist flexors and extensors be?
  • How can you assess weight bearing tolerance of the hand and wrist?
  • Why your patient can have a painfree grip and still be painful with weightbearing on the hand
  • What exercises, weights and reps should you use following upper limb injury?
  • How can you accurately measure wrist range of movement?
  • How are the proximal radio-ulnar joint (PRUJ) and radio-humeral joint (RHJ) involved in hand and wrist injuries, and how can you assess these?

Like the tests demonstrated in the Clinical Edge online courses on Assessment & treatment of the elbow

 

CLICK HERE for your spot on a free shoulder assessment webinar with Jo Gibson, available soon.

Resources associated with this episode:

Video - How to wrap a boxer's hands with Ian Gatt

Loosemore et al. 2016. Hand and Wrist Injuries in Elite Boxing: A Longitudinal Prospective Study (2005-2012) of the Great Britain Olympic Boxing Squad.

Other Episodes of Interest:

PE 088 - Combating hand and wrist injuries part 1 with Ian Gatt

PE 043 - Sporting Shoulder with Jo Gibson

PE 027 - Sports Injury Management with Dr Nathan Gibbs


Hand and wrist assessment and treatment can be overwhelming. There are a lot of tendons, ligaments and bones crammed into a small area, you need to worry about ligament and cartilage tears, rehabbing fine and gross motor control, strengthening, and then there are those fancy-looking splints you see. How would you like to get a better grip on hand and wrist injuries?

Physio Edge 088 Combating hand & wrist injuries part 1 with Ian Gatt

In this podcast with Physiotherapist (English Institute of Sport Boxing Technical Lead Physio) Ian Gatt, we discuss hand and wrist injuries in general, and dive into details on contact-related injuries encountered in boxing. If you treat patients that fall onto their hands and wrists, cop a blow to their fingers in ball sports, are boxers or martial artists, or just occasionally get involved in confrontations with walls or other immovable objects, you will enjoy this episode. You will explore:

  • How to take a comprehensive subjective history for hand and wrist pain patients
  • Questions you need to ask your hand and wrist patients
  • Identify likely diagnoses for your patients injuries based on their pattern of symptoms
  • When imaging is useful
  • Figure out if your patient is likely to have a quick or slow recovery
  • What is most important - pathology &structural diagnosis, biomechanics or function?
  • Common boxing or contact-related hand and wrist injuries
  • How to establish the severity of an injury
  • Carpometacarpal (CMC) joint injury management
  • Knuckle (Sagittal band) injuries
  • Bone stress injuries of the hand and wrist
  • Triangular fibrocartilage complex (TFCC) injuries, and why these are not as common now in contact sports

In the next two podcasts with Ian, we will explore how you can assess and treat these injuries

Resources associated with this episode:

Video - How to wrap a boxer's hands with Ian Gatt

Loosemore et al. 2016. Hand and Wrist Injuries in Elite Boxing: A Longitudinal Prospective Study (2005-2012) of the Great Britain Olympic Boxing Squad.

Other Episodes of Interest:

PE 043 - Sporting Shoulder with Jo Gibson

PE 027 - Sports Injury Management with Dr Nathan Gibbs

 

Direct download: Physio_Edge_088_Combating_hand__wrist_injuries_part_1_with_Ian_Gatt.mp3
Category:general -- posted at: 1:16pm AEST

A crunching tackle, flying headfirst off the bike onto your shoulder, or falling onto an elbow will often be enough to injure an acromio-clavicular joint (ACJ). When your patient walks in supporting their arm, or wearing a collar-and-cuff to offload their ACJ, how will you accurately assess and grade their injury? What will you include in your ACJ patient rehab to help them get back to full shoulder function and return to sport?

In Physio Edge podcast episode 87 with Dr Ian Horsley, Physio with English Rugby, English Institute of Sport and Olympic Team GB, we explore ACJ and clavicular injuries, including:

  • ACJ anatomy, and which ligaments are commonly injured
  • How to grade an ACJ injury
  • When to request imaging
  • Clavicular osteolysis
  • How to identify SLAP lesions that occur with ACJ injuries
  • How to assess patients with ACJ injury
  • Objective assessment tests to help your diagnosis
  • The role of the scapula in ACJ rehab
  • Common exercises you can use in rehab
  • Progressing ACJ rehab to prepare for return to sport
  • How to include return to contact in your rehab eg for rugby players
  • How much pain is ok during rehabilitation
  • Return to play timeframes with common
  • What do do when rehab is not progressing to plan
  • Clavicular fractures - conservative or surgical management
  • Ways to stimulate osteoblastic activity post fracture

CLICK HERE to download your free handout on AC Joint injuries

Resources associated with this episode:

Jacob et al. 2017. Classifications in Brief: Rockwood Classification of Acromioclavicular Joint Separations.

Robertson et al. 2016. Return to sport following clavicle factors: a systemic review.

Other Episodes of Interest:

PE 076 - Anterior shoulder pain, long head of biceps tendon pathology and SLAP tears with Jo Gibson

PE 067 - Shoulder special tests and the rotator cuff with Dr Chris Littlewood

PE 043 - Sporting Shoulder with Jo Gibson

PE 040 - Shoulder Simplified With Adam Meakins

PE 021 - Shoulder Pain With Dr Jeremy Lewis

Direct download: Physio_Edge_087_AC_Joint_injuries_with_Dr_Ian_Horsley.mp3
Category:general -- posted at: 5:08pm AEST

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