Case Study – Is your wrist hurting due to faulty posture?

May 12, 2018 | By | Reply READ MORE...

– Dr. Sneha Parekh

Mr. X, 48 years old businessman, came to PHYSIOREHAB with complaints of:

  • Pain in the left wrist since few months.
  • Stiffness in the left shoulder.
  • Difficulty in freestyle swimming.

LIFESTYLE:

  • Desk work of 9hours, 5 days a week.
  • Swimming daily since the last 3 years. (Freestyle and breast-stroke)
  • Travelling an hour by car to work

EXAMINATION:

Physical examination findings:

  • Faulty Left shoulder position :  forward tipped and rounded
    cs-wrist-hurt-by-faulty-posture-01
  • Left shoulder blade muscles significantly wasted (decrease in size of the muscle) and poor stabilization of his left shoulder and arm while doing movements or while swimming.
  • Left chest muscle tightness. (pectoral muscles).
    cs-wrist-hurt-by-faulty-posture-02
  • Reduced strength of the left forearm and arm muscles as compared to the right side.
  • Poor left hand grip strength
  • upper thoracic (upper back) spine was stiff thus the optimum range which is required for swimming was less.
  • neck, shoulder and arm ranges were pain free and full, it did not reproduce the pain. Nerve tests were also negative thus ruling out the pain coming from neck
  • He had no other symptoms or history to suggest any red flags

DIAGNOSIS:

Mr. X was diagnosed with scapular dyskinesia (improper rhythm between the shoulder and shoulder blade during arm movement) and postural dysfunction causing overstrain of his shoulder and wrist during daily and swimming activities

He was explained his diagnosis and importance of rehab

TREATMENT:

  • Posture correction – Correction of posture was an important part of treatment. It helped reposition the shoulder and the scapula in the correct position thus enhancing the weak scapular muscles to work efficiently.Posture awareness was emphasized

    At work and home ergonomics was discussed and corrections done

  • Kinesiology tapes – Tapes helped to maintain the correct posture and alignment post which exercises were started.
    cs-wrist-hurt-by-faulty-posture-03
  • Scapula stability exercises – Exercises to correct the shoulder blade position and maintaining the spine in correct position were started.
    cs-wrist-hurt-by-faulty-posture-04
  • Release of tight muscles – Myofascial release for the tight pectorals muscles
  • Increasing upper spine mobility – Manual mobilization by the physiotherapist and Exercises to increase mobility of upper back and stretches were done to get the optimum range required for freestyle swimming.
  • Strengthening of the weak muscles like the hand muscles for grip strength, shoulder blade muscles was started.
  • Strengthening of the shoulder blade muscles helped in maintaining the correct posture. This further improved the co-ordination between shoulder and shoulder blade bones during arm movements, making freestyle swimming comfortable and pain free.
    cs-wrist-hurt-by-faulty-posture-05 cs-wrist-hurt-by-faulty-posture-06
  • Strengthening of the core and buttock muscles was also started as a part of his swimming specific rehabilitation. The left shoulder and right buttock (right shoulder and left buttock) work in synchrony which is called as the sling system. Hence buttock and core strengthening further helped him.
    cs-wrist-hurt-by-faulty-posture-07

After 6 weeks of above treatment, Mr. X reported a significant reduction in his pain and stiffness and no discomfort while swimming. He is currently ongoing fitness and sports specific rehabilitation with us.

We at PHYSIOREHAB believe in supervised specific charted exercise regime for our patients after a detailed evaluation.

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Category: Case Studies

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