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Not A Creature Was
Stirring...
By
Victoria L. Magown, CMTPT, LMT and
George S. Pellegrino, LMT, CMTPT
"...not even a mouse", or so the story goes. There was a
time when the word mouse referred to a small furry rodent.
Now, when we use the word mouse, it conjures up a different image
in our mind. Those of us, who spend hours sitting in front
of a computer wondering where our aches and pains come from, have
a different image of the word mouse.
The use of a mouse, keyboard or 10 keypad for hours at a time
can cause an injury no less painful than those sustained by truck
drivers, carpenters, bricklayers, etc. As early as 1951, an
industrial disease called Occupational Myalgia referred to injuries
specific to muscles involved in the use of another modern miracle,
the typewriter. Not much has changed.
Keying on a keyboard or using a mouse requires constant contraction
of the muscles in the hand, forearm, upper arm and shoulder.
To know what this feels like, try holding your arm out in front of
you for as long as you can. After only a few minutes, you'll
notice a burning pain somewhere in your shoulder. This is what
happens when you keep muscles contracted for a long period of time
as when working at the computer.
Rachel, a bookkeeper, came to MyoRehab with tingling and pain
in her right hand and pain in the forearm, upper arm and shoulder.
She had been suffering with this
problem for 2 years with no relief from anti-inflammatory medications
or other types of therapy.
Many practitioners treated the obvious muscles of the hand and
forearm with modest success, but the pain persisted. One possible
reason for this could have been failure to treat the less obvious
muscles, the subscapularis (Illustration A) and the pectoralis minor
(Illustration B).
Notice the pain pattern of the subscapularis. This muscle
attaches to the front surface of the shoulder blade and extends out
to the front of the shoulder. The pain pattern for this muscle
is the back of the shoulder and most notably, the wrist.
The other key muscle, the pectoralis minor, lies under the pectoralis
major. It assists in moving the shoulder forward and also pulls
it down. When Rachel used the mouse or keyboard, the constant
motion of the shoulder kept the pectoralis minor contracted.
The nerves and arteries of the arms and hands pass under the pectoralis
minor as they travel down the arm to the hand. When this muscle
is contracted it can restrict blood flow and press on the nerves
causing tingling and numbness.
After treating these muscles and giving Rachel a specific Home
Exercise Program, her pain was gone. She also reported that
the tingling and numbness in her hand had completely disappeared.
Rachel was delighted that she could now type pain-free.
A key part of the success with Rachel’s treatment was addressing
factors that perpetuated her pain. She learned that using a
mouse would aggravate her shoulder pain. Switching to a track
ball gave her more permanent relief. Additionally, changing
the position of the keyboard such that it was closer to her body
allowed her elbows to be at a more neutral 90° angle. The track
ball was also positioned on the same level as her keyboard.
Another important change was the position of her calculator.
She had been turning her body to the left and reaching behind her
to use the calculator on another desk. Now, she understands
the importance of keeping all her equipment within easy reach so
as not to overstress the muscles. When Rachel made these adjustments,
she no longer had difficulty with recurring pain and aching in her
hands, forearms, upper arms and shoulders.
Is there a mouse in your life causing you pain?
Give us a call at MyoRehab.
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