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Sandi Cullinen OTR, CHT       
Occupational Therapist Registered 
Certified Hand Therapist        

Repetitive Strain Injury Group

Meets on the Second Monday of the Month, 6:30 Ė 8:30 pm

New Location: Elim Lutheran Church office, 504 Baker St. Petaluma, 94952.
A Craftsman house beside Church. Cross streets @ Western / Baker, across the park from Petaluma Creamery. Note: 2 steps into building.

FREE and open to all interested in self care.

Meetings feature a health professional speaker, and opportunities to share strategies for preventing and recovering from tendonitis, carpal tunnel and other repetitive strain injuries.

Contact person:
Lyndi Brown
PO Box 1030
Penngrove CA 94951
*NOTE NEW PO BOX* or call
707 792-7745 FAX

June 11- Adaptive Techniques for Injuries
Sandi Cullinen, OTR, CHT is a Registered Occupational Therapist and Certified Hand Therapist. She will discuss and demonstrate self-care and adaptive techniques for hand and arm injuries, including contrast baths, heating pads, splints, stretching and exercise.

Dynamic Splinting Workshop Coming in Fall 2007
7 CEUís. Date not yet finalized. Limited to 8 participants.
Call Sandi for additional information if interested, or to hold a spot.


Summer is again upon us and the rains have almost stopped.   The weeds seem to have grown 2 feet overnight and there is a lot to be done.   If you have not been active over the winter and try to get outside to put the yard in order, or start up running, bicycling, or sport activities without being conditioned you run an increased risk of injury.   If you have had prior soft-tissue injuries, a sudden jump from being sedentary to active (or overactive) can re-aggravate existing conditions especially carpal tunnel syndrome, tennis elbow, or tendonitis.  While it is important to remain active and to engage in the activities that you love (or maybe hate, but have to do) it is equally as important to protect those areas and/or prevent further difficulties.  This issue will give you some tips to be able to do the things you love, while maintaining healthy tissues and joints.

Prevention Makes a Difference
We like to tell our patients that listening to your body’s response to activity or treatment is as important as listening to your doctor! Before you begin a stressful activity such as in weeding or pruning, it would help to heat and stretch first,* or to complete a contrast bath* (see home treatment).  Take a rest break after 20-30 minutes and ice the area, even if it is not sore.  Evaluate how you feel the next day.  If you do not experience an increase in symptoms you can increase the time you worked.  If you did have an increase in symptoms, decrease the time you worked.

Before you begin yard work, take a moment to think about what needs to be done and prioritize.   Scheduling heavier activities in between lighter activities will give you more energy and will give your tissues time to rest and recover.  Breaking up challenging tasks into small steps, with rest breaks, will also help.  For example, if pruning your four rose bushes is sure to cause an increase of discomfort, prune one, change to another task, like raking, and then prune another.  Complete the remaining two the following day, if all is well.  Use ergonomic tools with long handles to prevent overuse of the smaller muscle groups.

Protective Gloves
Anti vibration gloves are important when using equipment that vibrates, such as, lawn mowers (even riding mowers), weed whackers, chain saws, etc..  These gloves have a pad that protects the palm of the hand, reducing trauma to the nerves and tissues that can cause carpal tunnel syndrome.  You can purchase anti vibration gloves at motorcycle shops or sport stores. Gloves with a good grip also reduce the force required for grasping.  And leather or rubberized gloves will help prevent getting punctured when pruning roses

Maintain Equipment
Sharpened blades, tuned up weed whackers, new pruning sheers with ratchet mechanism etc., can greatly reduce the effort our bodies put out. (I bet we have all pulled that lawn mower or weed whacker cord a few too many times before it started!)
Protect Your Joints
Knee pads that strap onto your knees are handy for protecting knee joints.  There is also a gardening bench that serves as a seat and as a knee pad with handles to help you up.  Use larger joints to do the job when at all possible, for example, using a well padded shoulder strap to hold the weed whacker.

Home Treatment
Contrast Baths:  We have found this to be an inexpensive and very effective way to manage pain and swelling.  Fill one sink or basin with warm water (about 96 degrees), enough to fully cover the area you are concerned about.  Fill another basin with cool water (about 66 degrees).  Soak in the cool water for one minute and then transfer to the warm water for two minutes. Go back to the cool water and soak for one minute and then transfer to the warm again for two minutes. Alternate between the cool and the warm water for approximately 16 minutes, always starting and ending with cool water.  Contrast baths help to minimize and reduce inflammation by constricting and dilating the blood vessels.  We often recommend gentle stretching exercises in the warm water, as prescribed by your therapist or doctor.
Heat:  Warm soaks, heating pads, microwavable gel packs, etc., increase blood flow to tissues and prepare them for activity.  Performing prescribed exercises after heating will help to regain loss of motion, making injury less likely.  Cardiovascular activity, such as in brisk walking, also increases blood flow to all of the bodies tissues.
Ice:  Ice is important for reducing inflammation and for reducing pain.  Always place a pillowcase or thin towel between your skin and the ice pack.  Ice your tissues immediately after any activity that may have caused tissue irritation.

What Our Clinic Can Offer You
We hope this information is helpful to you in managing your care.  If your symptoms increase and/or they do not subside, please inform your physician.  He/she may recommend therapy to assist you in pain reduction, to increase your motion and to strengthen. 

At Cullinen Hand Therapy, we offer a personal approach.   Therapy is never rushed.  We can evaluate the mechanics of your activities and will work with you to find ways for you to be successful without re-injury.

Cullinen Hand Therapy is currently celebrating the beginning of our 4th year in business.  Thanks to all the wonderful physicians in this community who have continued to provide referrals, and thanks to all the old patients who have made referrals to us for friends and colleagues.   We have worked hard to provide the best possible care for our patients.   Susan Scott is our new receptionist and aide.  She is responsible for getting authorizations and for helping the clinic to run smoothly behind the scenes. Call her if you have questions regarding insurance benefits and authorization information or to schedule an appointment.

Enjoy Your Summer!









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