Help for Hairdressers!

Hairdressers are known for their ability to create style and panache from behind the chair. But the coordination, skill, and dexterity that we’ve come to expect can take its toll on our beloved stylists. Sore arms, aching backs, and tired feet may be a daily occurrence for your favorite hairdresser. So whether you’re a stylist or have a newfound appreciation for them, please pass these hints along!

Thumb tendonitis, carpal tunnel syndrome, and tennis or golfer’s elbow are common conditions that can affect hairdressers. To keep these painful ailments at bay, try these stretches before work, at lunch, and after work. If you can also fit in a stretch or two between clients, that’s even better. Don’t forget to do these stretches on both arms. Hold for 20-30 seconds.



Thumb Stretch: Start with your hand by your side, elbow bent and thumb facing the ceiling. Bend your thumb into your palm and gently close your fingers around it. Then straighten your elbow in front of your body. Gently bend the wrist down towards the floor until you feel a stretch along the thumb or side of the wrist. Back off if you feel pain. This stretch helps to prevent painful DeQuervain’s tendonitis.




Wrist Stretch: Begin by making a light fist. Straighten your elbow with your arm in front of you and the palm facing down. Now use your other hand to gently bend the wrist down towards the floor until a stretch is felt. You may feel it on the top of your forearm close to your elbow or all the way down to your wrist.



Wrist Stretch 2: To combat symptoms of golfer’s elbow and carpal tunnel syndrome, start with your palm facing up. Straighten the elbow in front of you. Using your opposite hand, gently stretch your wrist and fingers towards the floor. You may feel this stretch from your fingertips up into your elbow.



Chest Expansion Stretch: Since most activities are done directly in front of the body, the chest muscles often get tight. To stretch them, clasp your hands together behind your back. Gently lift your arms, with your elbow straight, away from your body to intensify this stretch.


Shoulder Rolls: Begin by gently hike your shoulders up towards your ears, then roll your shoulders back, bringing your shoulder blades together. Next, gently drop your shoulders down. This exercise can help relieve tension in the shoulders and neck and improve posture. Try doing five to ten repetitions a couple of times a day.

We hope this helps prevent injuries, but if you or your stylist have already been diagnosed with carpal tunnel, thumb arthritis, tennis elbow, or golfer’s elbow, Treat Yourself Therapy offers do-it-yourself treatment programs perfect for busy stylists! Each video has helpful hints to decrease pain and prevent re-occurrence and a series of exercises and stretches. Learn more about each video at www.TreatYourselfTherapy.com.


Treat Yourself Therapy, LLC provides innovative and inexpensive do-it-yourself videos for people unable to attend hand therapy. These videos were developed by Jessica Karge, OTR, CHT and Kathleen Papi-Baker, OTR,CHT, both certified hand therapists who have over 40 years of combined clinical experience. To learn more, visit www.TreatYourselfTherapy.com.

Give Yoga a Try!

If you haven't tried yoga, I'd like to encourage you to give it a try! Yoga has been a part of my life for many years, both as a practitioner and as an instructor. Practicing yoga helps increase flexibility and strength, improves balance, and studies show that it can help decrease blood pressure and increase bone density.

There is a yoga class for most everyone, from first timers to the most experienced yogis. Community centers often offer basic, gentle yoga classes, and are a good place for beginners to start. Senior Sneakers, exercise classes designed specifically for older adults, offers Yoga stretch classes with a series of seated and standing yoga poses. Check out what is available in your community.

If you are apprehensive, I'd like to put you at ease by telling you what to expect in a typical yoga class. First of all, yoga is about being in the present moment. Focusing on breathing during the poses helps you to stay focused and present. Leave your competition and judgment at the door, and respect and accept where you are. Let your instructor know that you are new to yoga, most instructors will ask at the beginning of class. The instructor will also ask if anyone has any healing body parts, which you can point to. It allows the teacher to offer modifications to the poses so everyone can be successful. Most classes last about an hour, with the first 10 minutes or so focusing on centering and meditation. The body of the class will consist of moving through poses, and the last part of the class will focus on stretching by holding poses longer, and finish up with final relaxation.

Poses can be modified if you experience discomfort while in the pose. If you have carpal tunnel syndrome or thumb arthritis, it may be uncomfortable to have weight through the hands, as in a downward dog position. You can modify the pose by holding the hands in a fist position, instead of putting pressure through the extended hand. Also, try doubling your mat, so you have more cushioning. Bending the knees, or having knees on the mat helps to distribute more weight to the legs and off of the hands. If none of these modifications work, just rest in child's pose.

If you have any specific questions about modifications for yoga poses, email me at Questions@TreatYourselfTherapy.com, I'd love to hear from you! As with all exercise programs, start slowly, and most importantly, listen to your body.

Treat Yourself Therapy, LLC provides innovative and inexpensive do-it-yourself videos for people unable to attend hand therapy. These videos were developed by Jessica Karge, OTR, CHT and Kathleen Papi-Baker, OTR,CHT, both certified hand therapists who have over 40 years of combined clinical experience. To learn more, visit www.TreatYourselfTherapy.com.

Hitting the Gym with Tennis Elbow

Resuming your upper body workout after being diagnosed with tennis elbow can be a difficult decision. For most people, it’s reasonable to return when you are pain-free at rest and with light daily activities. Here are some tips to keep in mind when coping with this condition while still getting to the gym a couple of times a week.

1. Wear an elbow strap while working out your upper body. When a muscle contracts, there is strain on the tendon. The strap allows the stress to be distributed over your muscle belly instead of your healing tendon. Keep in mind that counterforce straps are only meant to be worn during activity. They are not designed for wear while sleeping or during sedentary activities, like watching a movie.

2. Stretch your forearm muscles before and after working out. Start with your right arm in front of you, with the shoulder at a 90 degree angle and your palm facing down. Place your left hand on top of your right hand and gently stretch your right wrist down towards the floor. If you don’t feel a stretch in your forearm, try making a light fist. If you still don’t feel a stretch, rotate your arm so that the palm is away from you and bring your arm down across your body (towards your left knee). Do two to three repetitions, holding for 20-30 seconds. Repeat on the left arm. Try two to three repetitions, holding for 20-30 seconds. This stretch is just one of the many exercises and tips that can be found in Treat Yourself Therapy’s Tennis Elbow program!

3. Lighten your grip whenever it is safe to do so. Many people don’t realize that what you do with your wrist and hand greatly affects tennis elbow. This means you may need to modify all of your upper body exercises. Here’s how:

• Wear gloves with a textured palm to improve your grip.
• Use weights that have a thicker diameter on the grip. You can also add pipe insulation or tape to bars, dumbbells, or machine handles to enlarge the grip.
• Utilize wrist wraps to take some of the weight out of your hands to alleviate strain to the tendon at the elbow.
• For those doing light weight, using ankle weights attached at your wrists instead of holding dumbbells is another option.
• Using resistive bands, where the handle can be placed across the palm (like for bicep curls) or on the wrist (like for some shoulder exercises) can also help.

4. Try keeping your wrist straight when doing machines, rather than extending or flexing the wrist.

5. Have good form and keep the elbow in a midrange when doing military presses or shoulder presses. Initially, avoid the extremes of flexion and extension during bicep and tricep exercises. Do lighter weight so you can have more control on the negative.

6. Keep the elbow bent when possible. Shoulder exercises performed with the elbow straight and a weight in your hand put a lot of strain on the elbow. Lateral or forward raises or flies should be performed with the elbow bent to reduce the strain.

7. Start back slowly. This is very important! Decrease the weight and do fewer reps initially. See how you feel over the next three days. If the pain returns, you know it was too much, too soon. If you have no pain, gradually progress to your previous level utilizing the tips above to decrease the risk of recurrence. Good Luck!


Treat Yourself Therapy, LLC provides innovative and inexpensive do-it-yourself videos for people unable to attend hand therapy. These videos were developed by Jessica Karge, OTR, CHT and Kathleen Papi-Baker, OTR,CHT, both certified hand therapists who have over 40 years of combined clinical experience. To learn more, visit www.TreatYourselfTherapy.com.

What To Do When Weightlifting Gives You Tennis Elbow

Working out with weights is a great way to tone and strengthen your muscles. But for some, these activities can bring on the dreaded diagnosis of tennis elbow, or lateral epicondylitis. Whether you are a novice or a diehard, here are a few suggestions that can help prevent the condition from getting worse so you get back to your routine sooner.

1. Recognize the Signs of Tennis Elbow:  Tennis elbow is an injury to the tendon that attaches your wrist muscles to the elbow. Pain occurs on the outside of the elbow, with point tenderness over the small bony protrusion, called the lateral epicondyle. Often, pain radiates down into the forearm muscles. Numbness and tingling do not occur with tennis elbow.
2. Respect the Pain: Because tennis elbow is an overuse injury, you should NOT work through the pain. The condition is caused by small tears in the tendon. Ignoring the pain and continuing your routine can make the condition worse, resulting in longer healing times. It's best to rest your elbow for a few days. You can still head to the gym, just focus on cardio and your lower body.
3. Use Cold Packs: If you notice the signs of tennis elbow during or after your workout, place a gel cold pack in a pillowcase and put it on your elbow for about
   10 minutes. Repeat this several times a day over the next three days and then intermittently as needed to decrease pain.
4. Stretch the Forearm Muscles: Gentle stretching is important in any exercise routine but many people don't think of stretching their forearm muscles. These muscles are active whenever you use your hand, so make sure to incorporate the following stretch into your daily life. Start with your right arm in front of you, with the shoulder at a 90 degree angle and your palm facing down. Place your left hand on top of your right hand and gently stretch your right wrist down towards the floor. If you don't feel a stretch in your forearm, try making a light fist. If you still don't feel a stretch, rotate your arm so that the palm is away from you and bring your arm down across your body (towards your left knee). Do two to three repetitions, holding for 20-30 seconds. Repeat on the left arm. To learn more specific exercises to treat tennis elbow, check out Treat Yourself Therapy for a four-phased program at www.TreatYourselfTherapy.com/tennis-elbow.

If you try these steps as soon as the symptoms start, you should be able to slowly return to your workout within a couple of weeks. You'll know you're ready if you are pain-free at rest and with light activity. Stay tuned for Hitting the Gym with Tennis Elbow, which provides specific tips to decrease the strain on your elbow during your gym workout.

Treat Yourself Therapy, LLC provides innovative and inexpensive do-it-yourself videos for people unable to attend hand therapy. These videos were developed by Jessica Karge, OTR, CHT and Kathleen Papi-Baker, OTR,CHT, both certified hand therapists who have over 40 years of combined clinical experience. To learn more, visit www.TreatYourselfTherapy.com.

What types of arthritis affect the hands?

You may think that “arthritis is arthritis,” and that it all affects the joints in the same way.  The truth is, there are several types of arthritis and how they present themselves in the hand is very different. 

The most common type of arthritis is osteoarthritis.  It results from wearing of the cartilage on the joint surfaces.  It is usually slow in its progression, with the first signs being soreness at the joint.  As it progresses, it can become more painful.  Over time, the cartilage can wear down, eventually leading to a joint with bone rubbing on bone.  The joints in the hand most prone to osteoarthritis are the base of the thumb and the small joints in the fingers.  Nodules at these small joints, called Heberden’s nodes, are the result of osteoarthritis. Treat Yourself Therapy’s video for Thumb Arthritis is a treatment program designed for osteoarthritis of the thumb. It contains specific exercises and education to decrease pain and improve flexibility while saving you time and money.

Rheumatoid arthritis (RA) is another type of arthritis that affects the hands. RA is a systemic condition involving many organs in the body.  It usually affects both hands symmetrically, and the joints most involved are the large knuckles.  An overproduction of the lubricating fluid around the joints, called synovial fluid, is the mechanism that affects the joints.  When the condition is in its active state, the joints feel warm and become swollen, stiff, and painful. 

Gouty arthritis can also affect the hands, although it is more commonly seen in the feet.  Gout is caused by too much uric acid in the blood, which can develop into hard crystals in the joints.  It usually has a sudden onset, resulting in burning pain, swelling, and stiffness.

Ten to thirty percent of people with psoriasis, a skin condition, develop psoriatic arthritis.  It can affect many joints of the body and is characterized by pain, swelling, and morning stiffness. In the hand, the joints most frequently involved are the small end joints of the fingers.

There are treatments and medications for all types of arthritis that help make the condition more comfortable.  Consult your physician if you suffer from arthritis to ensure that you are properly diagnosed and receive the care appropriate for your specific condition.

Treat Yourself Therapy, LLC provides innovative and inexpensive do-it-yourself videos for people unable to attend hand therapy. These videos were developed by Jessica Karge, OTR, CHT and Kathleen Papi-Baker, OTR,CHT, both certified hand therapists who have over 40 years of combined clinical experience. To learn more, visit www.TreatYourselfTherapy.com.

What Tests Help with Diagnosing Carpal Tunnel Syndrome?

If you have pain, pins and needles, numbness, or muscle weakness in your arm, your doctor may refer you to a neurologist. Think of a neurologist as a nerve specialist. These physicians are trained to perform and interpret tests that look at individual nerves for signs of damage. Why are these tests important? With nerve injuries, the location of the symptoms may not be the location of the damage. For instance, the nerves in your arms emerge from your spinal cord at the level of your neck, called the cervical region. So if you experience symptoms in your hand or forearm, the damage could be in your hand or forearm but it also could be coming from your neck. These tests are invaluable in determining where the damage is occurring to make sure you receive the correct diagnosis. This is especially important if surgery is being considered.

Dr. S.M. Zimmerman, a private practice neurologist in the state of Utah, suggests thinking of nerves like electrical wires. The wire is the axon and the outer covering, is the myelin sheath. If only the outer covering is damaged, it can be expected to heal easily. But if the axon itself is damaged, healing can be slower and less certain.
A nerve conduction study helps to determine the pattern of a nerve injury. "The severity of the symptoms a person is experiencing usually correlates with the severity of damage shown on a nerve conduction study and EMG, but not always. Occasionally a person has classic symptoms but normal nerve conduction studies."

A nerve conduction study looks at both the nerves that make your muscles work and the nerves that provide sensation. The test measures how fast the nerve sends a signal from one point to another, called the conduction velocity. This determines if there's damage in the myelin sheath, or outer covering of the nerve. It also measures how big the response is, which tests the axon of the nerve. If the axon is damaged, it can still heal but it won't do as well as if only the sheath was damaged, explains Dr. Zimmerman.

Dr. Zimmerman explains that  during an electromyogram, or EMG, an acupuncture-like needle is placed in a muscle to act like an amplifier. The neurologist is trained to recognize subtle differences in the sound, as well as in the amplitude of the muscle response to determine if the damage is still occurring. If the damage is no longer occurring, the test indicates how recently it had occurred. The muscles are tested at rest and during an active contraction to look at recruitment. This information tells how much damage is going on in the specific muscle that is tested.

If you have numbness and tingling in your hand or forearm, be sure to see your doctor. Early detection of syndromes like carpal tunnel and cubital tunnel is important to prevent progression of symptoms. If your nerve conduction study and EMG suggest moderate to severe damage, you can expect a referral to a surgeon to further discuss your options. If, on the other hand, the injury is mild to moderate, conservative treatments like occupational therapy, splinting, or anti-inflammatory medications may be recommended. Treat Yourself Therapy has a self-treatment video on carpal tunnel syndrome that includes helpful hints to manage symptoms, how to find the right brace or splint, and appropriate exercises to manage the condition. To learn more, visit www.TreatYourselfTherapy.com/carpal-tunnel.

Treat Yourself Therapy, LLC provides innovative and inexpensive do-it-yourself videos for people unable to attend hand therapy. These videos were developed by Jessica Karge, OTR, CHT and Kathleen Papi-Baker, OTR,CHT, both certified hand therapists who have over 40 years of combined clinical experience. To learn more, visit www.TreatYourselfTherapy.com.

Seeing the Doctor for Tennis Elbow

Written by Kathleen Papi-Baker, OTR, CHT and Jessica Karge, OTR, CHT

First of all, you may wonder what kind of doctor you should see? Since tennis elbow is a fairly common condition, your family practice physician should be able to make the diagnosis. They will do a little poking and prodding to rule out a joint or nerve problem, and rule in tennis elbow. They will do some provocative testing, such as asking you to hold your wrist straight, while the doctor tries to flex your wrist. This typically produces pain at the outside of the elbow when you have tennis elbow.
Once the diagnosis is made, a variety of options may be presented to you. The following list is a options your doctor may suggest.
*Physical or hand therapy may be suggested if your symptoms are not chronic. You will learn about tennis elbow, and be taught specific stretches, and exercises. Of course Treat Yourself Therapy's Tennis Elbow video is an option here!
*Cortisone injection around the affected tendon. Cortisone is an anti-inflammatory hormone that relieves pain in the short run, typically yielding relief up to 4 – 6 weeks.
*Dry needling, or percutaneous needle tenotomy, which involves poking the tendon/bone unit with a needle to create an irritation, which creates an environment for healing to occur. This can be done in combination with a cortisone injection.
*Prolotherapy is similar to dry needling, however, in addition an irritant is injected into the tendon to create an inflammatory reaction, with the goal of stimulating a healing response.
The next two options are called biologics. These procedures, as explained by Dr. Joseph Albano, a musculoskeletal specialist in Salt Lake City, involve using the body's own tissues to aid in the healing process, and are appropriate for more chronic conditions. Dr. Albano first uses diagnostic musculoskeletal ultrasound to identify the extent of the damaged tissue. This ultrasound shows more detail in lateral epicondylitis than an MRI, being able to detect the thickening of the tendon, and they are less expensive. It is a dynamic diagnostic tool in that it can show the tendons and muscles while they are moving.
*Platelet Rich Plasma, referred to as PRP, is a procedure that involves spinning the patient's own drawn blood to obtain a higher concentration of platelets. These platelets contain tendon healing growth factors. Using ultrasound as a guide, the platelets are injected into the damaged area to facilitate healing.
*Augologous blood injections involve the patient's drawn blood being injected back into the damaged area without platelet separation.
*Focus aspiration of scar tissue, or FAST, is a procedure that uses ultrasonic energy to break up and remove damaged tissue after the tissue is first identified with diagnostic musculoskeletal ultrasound.
Surgery for lateral epicondylitis may be an option for some who do not respond to conservative treatment, and/or may show a tendon tear after diagnostic testing. In this surgery, the damaged part of the tendon is removed.
There are a lot of options available today for people with tennis elbow. Be an informed consumer, and be familiar with what is available before you make any decision regarding your care. Be sure to see a physician experienced in the procedures you are considering.

Treat Yourself Therapy, LLC provides innovative and inexpensive do-it-yourself videos for people unable to attend hand therapy. These videos were developed by Jessica Karge, OTR, CHT and Kathleen Papi-Baker, OTR,CHT, both certified hand therapists who have over 40 years of combined clinical experience. To learn more, visit www.TreatYourselfTherapy.com.