#contracture

[toledofrancisco]

-contractura-

[a-husband-for-a-carer]

Decisions, decisions...

It’s been a while. A lot’s been said since I was here last. And there’s a lot to think about. Because MW has significant cognitive issues now, it’s left to me to be the “memory” and, to all intents and purposes, the “decision maker” for all issues. I have to be the “memory” because MW can’t remember what’s said on a day to day basis, never mind when discussing important issues.  I have to take notes and remember what’s been discussed. She was even asleep during one of the consultations. I’m also the “decision maker” because, despite the fact MW has the absolute final say in whatever happens, she relies very heavily on my opinion. She has real difficulty in making decisions, even for something as trivial as deciding what to eat. So I have to “make” a lot of decisions on her behalf, i.e. explain why I think a certain decision is the best one and get her to say yes or no.

We’ve had two important consultations this last month. The first one wasn’t supposed to be that important, it just turned out that way.  This was a conversation with an OT at the splint clinic - for MW’s hand/arm contractures. Finally, someone has given me their opinion re: MW’s care. I get that professionals aren’t supposed to do that because all decisions are supposed to come from the patient. But it wouldn’t be so bad if they’d offer advice. No-one seems to want to do that. So, I’m left with the impression that the level of care MW receives is considered appropriate for her very advanced needs. Even though I’m fairly certain that most professionals we’ve seen wouldn’t draw the same conclusion - if they were of a mind to forward their opinion, that is.

According to the OT’s professional opinion and looking at the situation with a cold eye, residential care would be the preferred option now, for quality of care, etc. Hearing that was a bit of a relief. Not that I have immediate plans to move MW into a home. But I now have some kind of gauge to go off so that keeping her here isn’t detrimental to her health. I have a yardstick to use. Although not expressed directly, MW’s demeanour when we talk about her staying at the short-term respite home tells me that she wouldn’t be keen on residential care. What MW and I must do now is discuss the long-term future and find the balance between ensuring quality of care and quality of life. I’m not medically trained. Everything I know is through experience - some more bitter than others - or through picking up bits and pieces from medical staff. And I’m doing this on my own. I can’t do it forever and still maintain her quality of care.

The other conversation was always going to be more serious. MW’s contractures are pretty serious (I’m having a hard time not singing the word “Contra-ac-tures” in a Debbie Harry voice). This is a shortening of the muscle or joint affecting her hands, arms and neck. Her hands are pretty much shut tight now. So much so that the knuckle joint at the end of some of her fingers bend back on themselves due to the pressure of the contracture. I keep thinking it’s going to break at some point. Her arms are permanently crossed and her neck’s at a permanent 70º angle to the right, which makes feeding harder and has knock on effects with swallowing and breathing.

The consultant talked about surgery - under anaesthetic, they’d attempt to stretch and set hand and arm ligaments. Possibly some neck manipulation. Alternative surgery includes the amputation of the fingers at the first knuckle. Again, for hours under general anaesthetic. None of which is guaranteed to work or not to cause pain. Also, any general anaesthetic will be a challenge. Because of the existing contracture in MW’s neck, she may require awake intubation. This requires a tube being inserted into the nose and down into the throat, then a wider airway tube being threaded over that first tube. All whilst awake.

The anaesthetic is a whole other thing. MW is getting weaker and I don’t know if she’d be able to withstand what will undoubtedly be hours of surgery under general anaesthetic. I know that all anaesthetic comes with risk. That’s compounded by these pre-existing problems.

This is all quite a responsibility to bear for someone else. It’s hard being the “memory” and de facto “decision maker”. I’m going to have to walk a tightrope between wanting to respect her wishes, even though she’s not expressed anything directly on either subject, and doing what’s best for her health. I won’t lie, I’ve been going round in circles on both issues and I don’t have any idea what to do. But, now that I’ve had proper, professional opinion on the state of things as they are, I’m all too aware that time is running out to make a decision. I only hope I can help her make the right one at the right time.

[drchristophedelongsblog]

La contracture douloureuse du trapèze supérieur : une tension qui vous serre le cou

La contracture douloureuse du trapèze supérieur est une affection musculaire assez courante, caractérisée par une tension excessive et prolongée de ce muscle, situé à la base du cou et au sommet des épaules. Cette tension peut entraîner des douleurs, une raideur et une limitation des mouvements dans cette zone.

Qu'est-ce que le muscle trapèze ?

Le muscle trapèze est un grand muscle plat qui recouvre une grande partie du dos et du cou. Il est divisé en trois parties :

Trapèze supérieur: Il s'attache à la base du crâne, au cou et à la clavicule. Il permet d'élever les épaules et d'incliner la tête en arrière.

Trapèze moyen: Il s'attache aux omoplates. Il permet de rapprocher les omoplates du rachis.

Trapèze inférieur: Il s'attache aux vertèbres thoraciques et aux omoplates. Il permet de déployer les omoplates.

Quelles sont les causes d'une contracture du trapèze supérieur ?

Plusieurs facteurs peuvent favoriser l'apparition d'une contracture du trapèze supérieur :

Mauvaises postures: Position assise prolongée devant un écran, travail manuel répétitif, port de charges lourdes...

Stress et anxiété: Les tensions nerveuses peuvent provoquer des contractions musculaires involontaires.

Problèmes posturaux: Scoliose, hyperlordose...

Traumatismes: Chute, coup du lapin...

Activité physique intense: Surtout si elle n'est pas associée à un bon échauffement et des étirements.

Quels sont les symptômes ?

Douleur: Une douleur localisée au niveau du cou, des épaules et parfois même des omoplates. La douleur peut être vive, lancinante ou sourde, et s'intensifier lors des mouvements de la tête ou des épaules.

Raideur: Une sensation de raideur dans le cou et les épaules, limitant les mouvements.

Maux de tête: Les tensions musculaires du trapèze peuvent irradier vers la tête et provoquer des céphalées.

Fatigue: Une sensation de fatigue générale peut être associée à la contracture.

Comment soulager une contracture du trapèze supérieur ?

Plusieurs approches peuvent aider à soulager une contracture du trapèze supérieur :

Repos: Éviter les activités qui aggravent la douleur.

Chaleur: Appliquer une source de chaleur (bouillotte, coussin chauffant) sur la zone douloureuse pour détendre les muscles.

Massage: Un massage thérapeutique peut aider à relâcher les tensions musculaires.

Étirements: Des étirements doux et progressifs du cou et des épaules peuvent améliorer la mobilité et réduire la douleur.

Médicaments: Les anti-inflammatoires non stéroïdiens peuvent être prescrits pour soulager la douleur et réduire l'inflammation.

Kinésithérapie: Un kinésithérapeute peut vous proposer des exercices spécifiques pour renforcer les muscles et améliorer la posture.

Comment prévenir une contracture du trapèze supérieur ?

Adopter une bonne posture: Que ce soit au travail, à la maison ou pendant les activités physiques.

Faire des pauses régulières: Si vous travaillez sur ordinateur, levez-vous régulièrement pour vous étirer.

Pratiquer des activités physiques régulières: La natation, le yoga ou le Pilates sont particulièrement recommandés.

Gérer le stress: Des techniques de relaxation comme la méditation ou la respiration profonde peuvent aider à réduire les tensions musculaires.

Aller plus loin et contacter

[bookpiofficial]

“Syndrome of Contractures and Deformities” According to Prof. Hans Mau as the Primary Cause of Hip, Neck, Shank and Spine Deformities in Babies, Youth and Adults | Chapter  15 | New Horizons in Medicine and Medical Research Vol. 8

The Syndrome of Contractures and Deformities (SofCD) is thought to be the result of abnormalities in the locomotor system in children, as well as inadequacy and pain in adults. Prof. Hans Mau claims that there is a list of symptoms that can be seen in neonates and babies. He refers to this condition as the "Seven Contracture Syndrome" (or "Siebenersyndrom" in German). The authors describe the eighth abnormality, namely the varus deformity of shanks, in this publication from 2006. The Syndrome of Contractures and Deformities, as the primary cause of wry neck (torticollis) and one of the four causes of Blount disease, is thoroughly discussed in this article, as well as its impact on the development of hip dysplasia. In addition, the biomechanical origin of so-called idiopathic scoliosis is explained. Author(S) Details Karski Tomasz Vincent Pol University in Lublin, Poland. Karski Jacek Medical University in Lublin, Poland. Pyrc Jaroslaw Department of Trauma and Orthopedic Surgery, Hospital Radebeul Elblandklinikum Radebeul, Saxony, Germany. View Book:- https://stm.bookpi.org/NHMMR-V8/article/view/6653

[universallyladybear]

Contracture Musculaire Dos Stress

Contracture Musculaire Dos Stress

De la contracture musculaire du dos de plus vous reculez l’apparition de la fatigue intellectuelle et pouvez davantage vous concentrer sur votre travail le soir grâce.

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[hellogirlfashion]

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[er-cryptid]

Contracture

-- severe tightening of a flexor muscle

-- results in bending of a joint

-- foot is a common point of contraction

-- can reveal information about a person’s neurologic status

-- possible affected areas      -- fingers      -- wrists      -- knees      -- foot

[kreolertv]

Thombé - Leucas lavandulifolia