Friday, 29 July 2016

How much do you use your thumb? De Quervain's Tenosynovitis

How much do you think you use your thumb? 

Evolutionarily, it's one of the things that's made us humans more advanced than other species. But do you ever think of how much work it does? Maybe not, until it's in pain. Then every time you move your arm, fill the kettle, hold a coffee cup, write with a pen, get dressed or carry a bag -- you realise your thumb is doing a lot of work. 

I've recently had a patient in my clinic with De Quervain's Tenosynovitis -- fancy name for a condition of the tendons running into the thumb. It's not primarily a condition of inflammation, but more of a mechanical change in the tendons and the coverings of those tendons. A tendon is surrounded by a sheath, which helps it glide, move, and reduce friction. 

The cause of this condition is unknown, but it is thought to be linked to overuse of the area (i.e.: texting, mobile phone usage, repetitive use, and occupations that require gripping & twisting with the hand. 

Many believe that this condition is an inflammation of the tendons and their sheaths. However, the pathophysiology is more that of a cellular thickening of those tendons and their sheaths with gradual degenerative changes too.  

This can be a slow condition to completely resolve, but it does respond to osteopathy. It's important to address the biomechanics and altered positioning of the upper limb, any restrictions in the Thoracic and Cervical spines, and myofascial adhesions and trigger points in the forearm muscles. I also use acupuncture (in the Lung Meridian) and RockTape to support the healing. 

As with any condition, using hands-on manual techniques isn't enough. Once the acute pain stage has lessened, it's of utmost importance to to get the patient into a rehabilitative exercise program to prevent the recurrence of the condition. 

If you suffer with pain on the thumb-side of your hand/wrist, have any burning sensations in your hand, muscle spasms, swelling, or difficulty using your hand, have it checked out by your osteopath. 

Monday, 11 January 2016

My love affair with the Instant Pot

instant pot
Now I don't usually do this, but I must talk about my new kitchen toy -- The Instant Pot 7-in-1 pressure cooker.

After spending the autumn watching Masterchef Australia (adore that show!) I became enamoured with the nifty gadget all the contestants were using on the side of their benches. Their pressure cookers. And I wanted one.

Now, I grew up with a pressure cooker in the house. It was predominantly used to make brown rice quickly and was one of those old stove-top versions. There was something very hippie-ish and wholesome about it (well, at least in my memories of it!), but until recently didn't think I needed one in my kitchen.

Then the vision of beauty that is the InstantPot came into my life. It's electric, so I don't have worry about having the stove on for hours; it's streamline and sleek, but most importantly it has 7 different settings/features, so it works as a pressure cooker/slow cooker/rice cooker etc and a YOGURT MAKER**! 

Since I got the InstantPot for Christmas, I've been pretty addicted to it -- looking up recipes, reading the blogs & forums, and imagining meals of ribs & brisket, cooked after work in time for dinner. It doesn't get much better! So every week, my Tesco order now includes a large hunk of meat that will be tenderly pressurised into a gorgeous paleo/low carb meal!

But the best part thing about the Instant Pot? I can make my silky-gelatinuous-nourishing-gut healing bone broth in a FRACTION of the time it would normally take. It's no secret that I love bone broth - heck, I tweet regularly about it, have reviewed mail-order bone broth companies & praise my local butchers for their continuous supply of bones. But honestly, making it is a FAFF. But not any more! Now, with this pressure cooker, I can make bone broth that gels (that's the important part!) in minimum 90 minutes (but I usually go up to 2-3hours), instead of a whopping 18hours in a slow cooker! And because the pot is completely sealed, there's no steam-room effect in my kitchen!

Needless to say, this InstantPot is the BEST thing I have bought (well, been given!) in a long, long time. If you want to make quick, homemade, nutritious food and if you want to utilise cheaper, tougher cuts of meat, do yourself a favour and invest in this product. 

**I've tried the yoghurt setting once...I wasn't overly successful, but I'm excited to try again & perfect it!