Common Injuries With Gardening & How Osteopathy May Help.
Gardening injuries are much more common than people believe. Like any form of exercise (and yes, gardening does class as exercise) it has its injury risks. This blog will be talking you through the most common of these, how to prevent them, and other things you can do to help yourself.
Due to the activity requirements and the postures being held for a long time whilst gardening, this places low back pain as the primary area of injury.
The lower back
There are lots of structures within the lower back that patient’s present to Osteopaths with; these include facet joint compression, facet capsular strains, ‘pulled’ muscles, and sprains of the ligaments in the lower back and pelvis. However probably the most common seen through gardening is an injury to the intervertebral disc.
What is it: A weakening of the outside layer of the fibrocartilaginous structure between your spine, which results in the jelly like substance within the disc protruding outwards. This weakness may lead to inflammation, a bulge (the disc remains intact) or a protrusion (the material leaks from the disc). As people age the jelly like substance may also lose moisture making it thinner.
Where will I feel the pain: often pain is located centrally in the spine and may refer into the legs with sensations such as pins and needles, numbness, electric or weakness. You may also feel pain only in the legs and no pain within the spine.
How does it relate to gardening: Whilst bending forward
What will make my pain worse: pain is often exacerbated by bending forward, coughing, sneezing, twisting, sitting and may be sudden or come in episodes.
What might an Osteopath do: Place gentle traction to help relieve pressure from the disc, gentle massage to spasmodic muscles, acupuncture, taping, core stability strengthening, activity modification and exercise prescription.
The knee
Whilst gardening, people spend long periods of time lent on their knees. Due to the mechanics of gardening, multiple injuries are prevalent in the knees, these include repetitive quadricep muscle or tendon strains, and inflammation of different bursae (fluid filled sacs that protect soft tissue structures i.e. tendons, skin and muscle from bony structures). However the most common of these is Housemaid’s knee or Gardener’s knee – also known as prepatellar bursitis.
What is it?
The prepatellar bursa is a fluid filled sac in between the kneecap (patella) and your skin. Bursitis of this is an inflammatory reaction of this bursa leading to painful swelling of it.
What will you feel?
The pain is felt at the front of your knee and may feel quite broad. There is very frequently visible swelling around the kneecap that is tender to touch; and the pain becomes worse with activity, walking or kneeling.
How does it relate to gardening?
This injury is common among gardener’s due to it being related to repetitive, or long term kneeling, or falls onto the knee.
What may an Osteopath do?
If the injury is acute (new or very painful) then it will need differentiating from other conditions that may present similarly. The management differs depending on its intensity, frequency and causation factors. However; you may initially be advised rest, ice and gentle effleurage type techniques to help reduce the swelling. As symptoms improve other techniques may be used such as massage, stretching, taping or articulation to help decrease the pain and reduce its risk of re-occurring. The Osteopath may also recommend advise to help reduce this re-occurring such as strengthening exercises, knee pads etc.
What should you watch out for?
Prepatellar bursitis may occasionally be linked to infection, so if you start to experience any fever, tiredness or illness; make sure you visit a healthcare professional to rule out septic bursitis as this requires different management.
The wrist
The repetitive actions and postures related to gardening means that the wrist is at high risk of injury. According to an orthopaedic surgeon specialising in hand surgery, the three most likely diagnosis of a gardener’s wrist pain is either De Quervain’s Tendinitis, Carpal Tunnel Syndrome or osteoarthritis in the base of the thumb.
What is it?
De Quervain’s tendinitis or tenosynovitis is the inflammation of the abductor pollicis longus or the extensor pollicis brevis. The inflammation may be of the tendon, or the sheath that surrounds the tendon.
What will you feel?
Pain is often felt near the thumb of the affected side, however, you may also feel pain refer into the forearm. The sensation of your pain may vary from an aching, to a burning, sharp pain or pull. Your symptoms may be aggravated by actions such as gripping, lifting or twisting your wrist. You may also feel some clicking, catching or crunching with your wrist.
Alongside the pain you may find that you have some reduced grip strength and general movement.
How does it relate to gardening?
This problem is often initiated by repetitive gripping or twisting motions of the wrist. Therefore repetitive use of gardening tools such as secateurs or trowels may lead to this problem starting.
What may an Osteopath do?
Your Osteopath may assess other areas such as your elbow, shoulder, and neck to confirm your diagnosis. Depending on the stage of injury, you may be recommended ice/heat, gentle stretches and recommended adjustments to your gardening routine. Along-side this massage and manipulation can be effective in relieving the symptoms, combined with a strengthening program to help prevent further re-occurrence.
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