With September being designated as National Yoga Awareness Month, it is a great opportunity to add variety to your physical fitness program. Yoga has proven to have a wide range of health benefits for the body, mind and spirit including:

• Strengthened bones and joints
• Decreased chronic back pain
• Improved Posture
• Increased flexibility
• Decreased stress
• Weight loss
• Lower blood pressure and cholesterol

• Eliminate all tripping hazards, such as loose rugs in the home.
• Install grab bars or handrails on both sides of the stairway and other safety devices near bathtubs and beds.
• Place a lamp or flashlight near the bed.
• Keep clutter – like pets’ toys or papers – off the bedroom floor.
• Replace satiny bed sheets with products made of non-slippery material; i.e. wool or cotton.
• Arrange furniture to allow a clear pathway between rooms.
• Secure loose rugs with double-faced tape, tacks or slip-resistant backing.
• Keep stairs clear of packages, boxes or other clutter.
• Install light-switches at the top and bottom of the stairs. Or, try motion-detector lights that turn on automatically.
• Put non-slip treads on each bare-wood step.
• Consider adding rails to the bed to prevent the sleeping person from rolling off.
• Keep track of pets, as these creatures are responsible for more than 86,000 fall-related injuries each year.

Dress:

• Wear properly-fitting shoes or slippers with non-skid soles, throughout the home and especially on stairs.
• Replace slippers that have stretched out of shape and are too loose.
• Never walk with socks or stockings on hardwood floors.
• Think about wearing an alarm device that will bring help in case you cannot get up from a fall.

“Surgical treatment” refers to the release of the transverse carpal ligament. The surgery itself is called a “carpal tunnel release.” Structurally, this allows for an expansion in the area of the carpal tunnel, thus decreasing the pressure on the median nerve. It is a relatively short, surgical procedure that is performed by a qualified surgeon. Common symptoms after surgery are pain, swelling, stiffness, and weakness. To manage these symptoms and guide your recovery, the physician will often send you for therapy.

Here at The Orthopaedic Institute, we have a specialized hand therapy center that currently staffs 5 occupational therapists that specialize in rehabilitation of the hand and upper extremity. No matter which course of treatment is chosen by you and your physician, our goal is to assist you through your recovery in a caring and professional manner. It is our mission to help you achieve the best possible outcome and resume your appropriate role in your normal daily activities.

Written by Rodger D. Powell, M.D.

Carpal Tunnel Syndrome represents one of a group of disorders in the body collectively known as compressive neuropathies. It is the most common nerve compression in the upper extremity and one of the most common problems seen today by hand surgeons. Compression neuropathy as its name implies is a pressure applied to a nerve from any of a variety of reasons. According to the Bureau of Labor statistics, approximately 0.1% of the population in the United States has carpal tunnel syndrome in any given year. Even more common is the perception by patients that any hand pain or disorder is carpal tunnel syndrome.

The term carpal tunnel relates to a region in the wrist that is bounded on three sides by the carpal bones or wrist bones. The roof of this semi-circular shaped bone canal is covered by a very thick ligament called the transverse carpal ligament. Through the tunnel formed by this strong ligament and bones courses the tendons that flex the fingers and the thumb, as well as the median nerve that gives sensation to the thumb, index finger, middle finger and half of the ring finger. In addition, the median nerve supplies the nerve that allows the thumb to pull across your palm to the small finger by innervating the abductor pollicis brevis muscle. For a number of reasons, the space in the carpal canal may become filled, either with fluid, a mass such as a ganglion, or a swelling of the flexor tendon sheath. Any of these situations begins to crowd the tendons and the nerve within this canal. Obviously, the bones will not yield to give any increased space nor will the transverse carpal ligament. The result is increased pressure in the carpal canal. As this pressure increases, the tendons, which are solid structures, can usually tolerate the pressure very well. But, the nerve, which has the consistency of spaghetti, reacts to the pressure by flattening and losing the ability to transmit nerve impulses. This leads to tingling in the fingers and in extreme cases, loss of motion in the thumb. It would be the equivalent of parking your car on the garden hose. Obviously, you cannot water the garden until you take the pressure off the hose. And, in most cases you will not regain sensation until the pressure is removed from the nerve.

The signs and symptoms of carpal tunnel can be varied, but the most common and classic findings are complaints of numbness and tingling at night that often wakes you from sleep. Patients also describe getting up and shaking their hands or “shaking them down by the bedside to restore circulation”. Other complaints include parasthesia or numbness while driving, doing your hair, applying makeup, reading, writing, typing or any other repetitive motion. Many times vibratory instruments such as chainsaws, weed eaters or motorcycle riding make it worse. Pain on the back of the hand, thumb or back of the forearm, usually does not come from carpal tunnel syndrome. However, carpal tunnel symptoms can cause pain radiating into the forearm and occasionally all the way to the shoulder, mimicking shoulder problems.

Diagnosis can be made by physical examination and/or neurological studies such as nerve conduction studies. Underlying diseases such as diabetes and thyroid problems need to be excluded as well. Non-surgical treatments include splints, nonsteriodal anti-inflammatory medications such as Advil, carpal tunnel exercises and in some cases Vitamin B6 (although the usefulness of this vitamin is controversial).

If the patient does not respond to non-surgical treatment, it is recommended that a surgical release of the transverse carpal ligament be performed to prevent permanent changes in the nerve. This is done as an outpatient procedure, and the procedure itself usually takes fifteen to twenty minutes. Most patients, through internet information, know of the endoscopic release which is done using a small scope and a blade placed adjacent to the scope through a very small puncture mark in the skin. The more common approach is called a mini open incision which involves making a slightly larger incision in the palm but not crossing the wrist crease. The decision to undergo this procedure, either endoscopically or open, is best made after discussion between the patient and the surgeon. The patient can expect fairly rapid resolution of the symptoms; although, literature has indicated that recovery can occur for up to 14 months following the surgery. It is felt that complete relief of symptoms and return to normal activities can be expected in greater than 90% of the patients.

The Orthopaedic Institute (TOI) is proud to kick off the month-long TOI School Supplies Drive, an initiative benefiting the school districts of Alachua, Marion and Columbia Counties. New and gently used items will be accepted June 25th through July 23rd , 2010.  All items collected will be distributed to public school teachers in an effort to alleviate the financial strain educators face when preparing for the new school year.

A recent study reported that teachers spend an average of $623 of their own money on supplies for their students each year. Kelly Brill, Assistant Principle at Fort Clarke Middle School understands the challenges faced by area educators. Brill states, “Unfortunately there are many families that are on free or reduced lunch and are unable to purchase the necessary school supplies for their children. Without hesitation teachers, guidance counselors, administrators and school staff purchase materials so no student will go without.”

Donations will be accepted through July 23rd in The Orthopaedic Institute’s 4 North Florida locations: Gainesville, Ocala, Lake City, and Alachua. All supplies collected in Gainesville and Alachua will be donated to Tools for Schools, Alachua County’s reusable resource center where public school teachers can shop for learning materials at no cost. Contributions in Ocala will be directed to Tools 4 Teaching and materials collected in Lake City will benefit the Columbia County School District. Traditional supplies are welcome, like paper, crayons and pencils, but gently used business or household items can also make wonderful educational tools.

“The TOI School Supplies Drive is a wonderful initiative that will provide school supplies to all students in need in Gainesville and the surrounding communities. The additional support is greatly appreciated,” adds Brill.

Below is a list of supplies often requested by teachers. Although all new or gently used educational supplies are welcome, donations of these items are always appreciated.

PENS & PENCILS

MARKERS

LINED NOTEBOOK PAPER

BACKPACKS

CONSTRUCTION PAPER

SCISSORS

DRY ERASE MARKERS

COLORED PENCILS

GLUE

TISSUES

INDEX CARDS

COMPUTER PAPER

ERASERS

CREATIVE/ART SUPPLIES

EDUCATIONAL GAMES

STAPLERS

GRAPH PAPER

NOTEBOOKS

CHILDREN’S BOOKS

non-traditional learning tools

production overruns

interestingly shaped trims

obsolete inventory/logo items

factory seconds or rejects

clean, colorful punch outs

packing products