FEBRUARY NEWSLETTER

(03) 355 9775 office@merivalehandclinic.co.nz www.merivalehandclinic.co.nz

We are excited to announce the opening of our new hand therapy satellite clinic based at the Longhurst Health Medical Centre in Halswell. The partners of Halswell Health Medical Centre have developed a new health facility in response to unprecedented demand for health services in the area. Halswell and surrounding areas including Tai Tapu, Prebbleton and Lincoln have experienced rapid population growth following the 2011 earthquakes. With several new subdivisions being developed in Halswell the population is forecast to double in the next ten years. Recent projections have a further 11,500 sections to be developed in the south west area over the next few years. The facility also hosts a pharmacy and a dentist and a onsite café is due for completion in mid 2015. Longhurst Health encompasses 1800 sqm of space and has 89 onsite carparks to cater for patient parking needs. It is located across from a newly developed small commercial area hosting a number of retail outlets and educational facilities.The Longhurst subdivision is easily accessed from other parts of Christchurch via the new Southern Motorway.In addition to the medical and dental services there will be a range of allied services operating from Longhurst Health including hand therapy, physiotherapy, podiatry, chiropractic and acupuncture. The new Longhurst Hand Clinic is proud to be a part of this new initiative.

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Located at LONGHURST HEALTH53 Caulfield Avenue, Halswell

Fax: (03) 355 3895

Longhurst Hand Therapist

J e n n i e graduated from the Dunedin School of Physiotherapy in 1978.

Jennie initially worked at the Merivale Hand Clinic in its early days from 1987-1993. She then started her own private practice in Christchurch where she utilised both her hand therapy and physiotherapy skills for 10 years. Once her two children had left home, Jennie then worked in the UK for two years.

On her return to New Zealand Jennie worked in a private practice in Christchurch for five years before moving to Australia as a locum for a further two years. Jennie has now come full circle and returned to work at the Merivale Hand Clinic, bringing with her a broad range of skills and experience. Jennie will be based at the new Longhurst Health Hand Clinic in Halswell.

The Longhurst Health Hand Therapy Clinic

53 Caulfield Avenue, Longhurst Subdivision, Halswell, Christchurch

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Did you know?Online referrals via our clinic website

(www.merivalehandclinic.co.nz) are a quick way to refer a person to Hand Therapy. On receipt of the referral we will contact the client and arrange an appointment for them.

Alternatively, Health Providers can use the HealthLink system to refer to directly to our clinic.

Electronic Referral

Golf holds a special place in the life of many New Zealanders. It is the highest participation sport in the country, with 482,000 Kiwis over the age of 18 playing the game. It ranks as the number one sport for men and the second highest sport for women. A total of 125,000 New Zealanders are affiliated to golf clubs around the country and all up around 7 million rounds of golf are played annually.

In general, the majority of golf injuries occur in the lower hand. Therefore, for a right-handed golfer, the left hand and wrist are most commonly affected. Knowing the phase of the golf swing (i.e. backswing, downswing, impact and follow-through) that exacerbates the symptoms can also indicate the type of the injury.

1. Tennis Elbow/Golfer’s Elbow Tennis elbow is soreness or

pain on the outer side of the elbow. Golfer’s elbow is pain or soreness on the inner side of the elbow. Tennis elbow is more common amongst golfers than golfer’s elbow. Pain may be greatest at the top of the backswing and at impact.

up against the hook of the hamate during the swing. This makes it vulnerable to injury when the golfer strikes the ground. Fractures occur almost exclusively in the lead hand and may cause pain and tenderness in the left palm and numbness in the ring and little fingers. Surgery or cast immobilisation may be indicated.

6. De Quervains Tenosynovitis De Quervain’s causes pain in

the wrist near the thumb and is caused by an inflammation in the tendons that control the thumb. Symptoms include pain, swelling and tenderness at the wrist near the base of the thumb. Pain typically occurs in the lower wrist at the top of backswing. Treatment includes activity modification, splinting, ultrasound, massage, strengthening and possible corticosteroid injection. Surgery is rarely indicated.

If you are experiencing any pain or difficulties with your hand, wrist or forearm as a result of playing golf our experienced hand therapists at any of our four clinics would be pleased to see you for an appointment. You can make an appointment at any of our hand therapy clinics by phoning 03 3559775.

Golfing Injuries Among the possible treatments are rest, counterforce bracing, frictions and mobilisation, or injection (corticosteroid or autologous blood injection).

2. Carpal Tunnel Syndrome Carpal tunnel syndrome

typically presents as numbness and tingling of the fingers (particularly at night), hand weakness and clumsiness. This can be treated with night splinting, activity modification, steroid injection or surgery.

3. Extensor Carpi Ulnaris (ECU) Subluxation

ECU tendon subluxation is caused when the sheath holding the wrist tendon begins sliding in and out of its groove. The main symptoms are painful clicking of the wrist and pain on impact. Splinting and casting may be helpful but in some instances surgery to repair the torn tendon sheath may be required.

4. Carpal Impaction Impaction syndromes of the

wrist are caused when the bones of the wrist bump into one another due to repetitive movements, causing pain and tenderness on the top of the wrist, usually at the top of backswing. Most wrists will respond to rest and splinting however a corticosteroid injection may be indicated. Surgery is rarely indicated.

5. Hook of Hamate Fractures The hamate bone is a small

bone in the wrist. The hamate has a small prominence called the hook, which protrudes into the palm. Most golfers grip their clubs in a way that puts the butt-end of the club right

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• Fractures • Tendon Injuries • Nerve Compressions• Arthritis • Tendinitis • Amputations• Nerve Injury • OOS • Hand Surgery Rehabilitation• Joint Sprains • Muscle Strains

Hand Therapists are highly skilled in evaluating:• Wounds & Scars • Pain• Oedema • Range of Motion• Sensation • Strength & Endurance• Activities of daily living & vocational areas

ACC Hand Therapy Services Contract:The Contract Allows DIRECT REFERRAL By:• GP’s • Physiotherapists• Specialists • Occupational Therapists• Hospital Doctors • Case Managers

WE ALSO WELCOME PRIVATE PATIENTS

Common Diagnoses managed by Hand Therapists include:

Fingertip InjuriesInjuries to the fingertips are

common. They can occur when a fingertip is slammed in a car door, is damaged while chopping vegetables or injured when clearing debris from a lawnmower.  In the paediatric population fingertip injuries account for two thirds of all hand injuries with the most common mechanism of injury being a crush between a door and its frame.

Injury can cause damage to skin, soft tissue, bone and/or the nail and nailbed. Fingertips are rich with nerves and are extremely sensitive and without prompt and proper care a fingertip injury can result in permanent deformity and disability.

TreatmentThe goal of treatment is to

have a pain-free fingertip that is covered by healthy skin. The finger and hand should be able to feel, pinch and grip and should be able to perform normal hand functions.

How a doctor will treat a fingertip injury/amputation depends on the angle of the cut and the extent of the injury.

(Left) Wounds made along the green  lines will probably heal on their own. 

(Right) Wounds made along blue lines will often require some level of  surgical intervention to heal adequately.

In many cases, surgery can return a large degree of feeling and function to a fingertip injury. Full recovery from a fingertip injury may take several months. After the injury heals, mild to severe pain and sensitivity to cold may continue for a year or may even be permanent.

Stitches are generally removed after   7-10 days

A self-adhesive, compressive wrap can help to control swelling.

A thermoplastic splint can be custom made to protect the healing fingertip.

Hand therapy will help to improve movement and strength in the hand. Desensitisation, heat, massage, splinting, and special wrappings to control swelling are examples of therapies your hand therapist may suggest to promote healing and function.

I graduated as a physiotherapist in 1995 and spent a year working in a public hospital before moving to the UK and working for a number of years in outpatients and orthopaedics. On my return to New Zealand I was keen to specialise in hand therapy and started work at the Merivale Hand Clinic in 2005. I enjoy working in a clinic with a wealth of knowledge and expertise and a positive learning environment.

I have been based at the Moorhouse Branch of the hand clinic since 2009 and see a wide variety of patient conditions requiring assistance to help patients make an optimum recovery. I also enjoy the challenge of splint-making and depending on the patient’s needs these are often custom-made to assist people in returning to work or sport. I particularly enjoy treating sports injuries and post-surgical patients and the recent influx of tradespeople into the city has seen an increase in demand for both of these services. I enjoy my job and being part of an enthusiastic team of health professionals seeking to help patients on their road to recovery.

Anne Cox208 Papanui Road, Merivale, Christchurch

Fax: (03) 355 3895

Located at PHYSIOSOUTH MOORHOUSE

MOORHOUSE MEDICAL3 Pilgrim Place (off Moorhouse Ave)

Fax: (03) 377-0614

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Located at PHYSIOSOUTH KAIAPOI

Countdown Carpark, Unit 6, 77 Hilton StreetFax: (03) 327-6313

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Located at LONGHURST HEALTH53 Caulfield Avenue, Halswell

Fax: (03) 355 3895

Sue BellI am a Senior

Registered Hand Therapist at the clinic and have specialised in hand therapy since 2003.

Prior to becoming a hand therapist I worked for many years as an Orthopaedic Physiotherapist and previously worked in both hospital and private practice settings in this area.

As a hand therapist I enjoy the varied case load which includes trauma, postsurgical rehabilitation, conservative management of tendinopathies and degenerative disease and the challenges of complex regional pain syndrome. The close work with the specialist Plastic and Orthopaedic Hand and Upper limb Surgeon’s who run joint clinics with us on a regular basis is a privilege. Our hand patients have access to expert care which streamlines their recovery!

Hand therapy is a wonderful area to work in. Yearly conferences have presentations from international specialists and amongst the hand therapy community there is open communication with expert in-house teaching and learning opportunities available.4 February Newsletter 2015

When the hand is kept wet, the skin of the palm wrinkles. Why? The exact mechanism is not known, but it is clearly controlled by nerves. When the nerve which supplies feeling to an area of skin on the palm is cut, that area of skin not only becomes numb, it loses the ability to wrinkle when wet. It also loses the ability to sweat.

Did You Know?

Dee WilliamsI have been

working at The Merivale Clinic as a Receptionist for 7 months after working in general reception/customer services for 20 years. Most recently I have worked as a Medical Receptionist and Personal Assistant.  I relish the fast paced environment and helpful, hardworking staff here.  I have always been interested in all things medical and enjoy helping people. Patients do not need a referral to see a hand therapist. Both ACC and Private Patients can make an appointment directly with the clinic and I can help patients complete any paperwork that may be required at the time of the appointment.