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Ergonomic Mice & Input Devices

Contour Design RollerMouse Free2

The RollerMouse Free2 – all of the benefits of the RollerMouse PRO2 but a new slimmer design. Winner of the Attendees Choice Award for Best New Product at the 2010 ErgoExpo, this mouse design provides a unique solution to upper body repetitive stress problems that occur with traditional mice.


Ergonomic Mice &
Input Devices

Health Postures Adjustable Monitor Stands

  • Enjoy a Healthy Sit-Stand Workstyle. The real benefit of using the sit-stand workstyle is the freedom of movement. The height-adjustable Computer TaskMate can decrease the severity of discomfort for most upper-body regions, including the shoulders, neck, arms, and hands.
  • Changing positions between sitting and standing is easy with the one button control that will quickly adjust the Computer TaskMate. Fatigue and discomfort can now be avoided by being able to stand periodically though out the day without any loss of productivity at work. Your body knows when it is time to move or change positions and the Computer TaskMate will allow you to make these posture changes while staying on task.
  • Changing position helps to alleviate back or postural pain.
  • Changing from sitting to standing encourages and produces more stretching.
  • This variation in movement helps reduce the amount of stress put on the back and promotes blood circulation.
  • The sit-stand workstyle help people feel physically comfortable in their work environments. This will then be more likely to generate quality work in a shorter amount of time, and also to have a more positive attitude about their jobs, contributing to better overall workplace morale.


The Thoracic Outlet Syndrome Part Two

Thoracic outlet syndrome cannot be described as one condition but is the agreed name for a variety of symptoms which are explained by being assumed to be due to compression of the blood vessels and nerves as they go through the area called the thoracic outlet. The outlet is made up of a triangle the boundaries of which are the scalene muscles, the first rib and the collar bone or clavicle, through which the nerves and vessels go to get to the axilla and then to the arm. Patient diagnosis is very difficult in this field and little agreement exists about the condition.

The wide variation in signs and symptoms of sufferers with thoracic outlet syndrome and the absence of any test to confirm or deny its presence means that correct diagnoses of patients with thoracic outlet syndrome is difficult. The numbers of people who suffer from this syndrome is as a consequence not clear although it is known that higher numbers of women occur in this group, especially if they have poor muscle tone and posture.

The nerves and blood vessels travel in what is termed a bundle, moving down from the cervical spine and towards the arm, going through three, mostly triangular spaces, on the way. Compression of the bundle can occur in any of the three triangles, which are already small when the arm is by the side, reducing further in size as the arm moves into certain postures. Postures which increase the tightness of the spaces are used as diagnostic tests to figure out which structures are causing the compression and which are being compressed. Doctors and physiotherapists test by placing the limb of the patient in a specific posture known to be stressful and asking them to perform a repeated muscle action such as fist clenching. This heightens the demand on the blood supply or neurological control required.

The repetitive movement of the shoulder towards the ends of its ranges makes the onset of thoracic outlet syndrome more likely, increasingly so if shoulder abduction (moving the arm out to the side) and outward rotation are involved at end ranges. A common occurrence is for swimmers to complain of pain during their stroke and this should raise the suspicion of thoracic outlet problems. Repetitive shoulder movements towards the end of the available movement make this more likely to occur in many sports or activities. Symptoms may present as neurological difficulties or as problems connected with blood supply to the arm.

Thoracic outlet syndrome presents differently due to whether the compressed structures are the blood vessels, the nerves or both together. The level of pain and disability involved can vary from mild to severe, with symptoms continuous or intermittent. The normal presentation groups are one whose symptoms are not clear or specific, the vascular group and the neurological group. Compression of the main vein or artery in the arm does not occur commonly and perhaps most often in young athletes who perform excessive overhead throwing.

If the arterial flow is disrupted the arm can change colour, there can be pain on muscle use due to their not getting enough blood and an overall pain in the hand and the arm. Mild onset is typical as blood can often get round a blockage, but when the block is large patients attend for medical review independently. Thoracic outlet syndrome from neurological compression involves compression of some of the brachial plexus, a nerve crossroads in the neck which supplies the arms. Nerve compression does not usually occur alone but presents with awkwardness holding a ball or a racket and loss of muscle bulk in the small hand muscles.

Neurological compromise may also cause pins and needles or loss of feeling, with some reports of pain but this tends not to be a major issue. Overhead actions with the arm repetitively tend again to be the aggravating factors. The third group is the contentious one, with a large number of patients who complain of pain in the neck, shoulder blade and arm. Often starting after an accident of some type, this kind of pain is not well understood and there is little medical agreement as to whether this is thoracic outlet syndrome or not.

Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about %26lt;a href=’http://www.thephysiotherapysite.co.uk’%26gt;physiotherapy%26lt;/a%26gt;, physiotherapy, %26lt;a href=’http://www.thephysiotherapysite.co.uk/physiotherapy/physiotherapists/uk/london’%26gt;Physiotherapy London%26lt;/a%26gt;, back pain, orthopaedic conditions, neck pain and injury management. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.

Physiotherapy examination starts with the therapist assessing the posture of the patient, often before they have taken any of their clothes off. A rounded or slumped shoulder posture and a poking forward neck and head stretch the neck and shoulder blade muscles and may make this syndrome more likely to occur. Active range of movements of the neck will be examined and any restrictions noted. The neck may be placed in combined positions involving two or more pure movements plus downward pressure in an attempt to bring on symptoms. Range of motion of the shoulders is also assessed.

Examination of the nerves and the blood supply to the arm will normally be performed, with the greatest effects on the nerves and muscles supplied by the lower roots of the brachial plexus. If the veins are being compressed in the vascular type of syndrome then patients turn up with swelling and blueness of the arm. If the arteries are the vessels suffering compression then the arm can be pale, cool and without a pulse or with a very weak one. The blood pressure in the affected arm may be reduced by more than 20mmHg compared to the normal arm.

The neurogenic type of thoracic outlet syndrome presents with wasting and weakness of the hand’s small muscle groups, usually involving the thumb. With a reduction in the feeling of the hand supplied by the ulnar nerve this again points to the involvement of the lower group of brachial plexus nerves. The third described group exhibiting the typical symptoms is the non-specific thoracic outlet group, by far the largest, with a more diffuse described pain and examination findings which can be unreliable and hard to pin down.

Thoracic outlet syndrome can be brought on by a large number of neck and shoulder anatomical structures and this is reflected in the numbers of diagnostic tests which have been developed to investigate this problem. A significant problem with these tests is the occurrence of false positive and false negative tests. False negatives mean that the test shows the problem not to be present when it really is and false positives mean the test indicates the tested problem to be present when in reality it is not.

Physiotherapists can perform Roos stress test, whereby the patient is asked to maintain their arms in a position of ‘hands up’ while they close and open their hands repetitively. The test is positive if it brings on the usual symptoms complained of or if the arms feel tired and heavy. The structures which cause thoracic outlet syndrome can be of bony or soft tissue origin. The compression or obstructive problems can be caused by a bony structure such as a neck rib or a bony growth on the clavicle or ribs. Soft tissue compressive forces can be due to a fibrous band or oversize muscles.

The neck may be more likely to develop thoracic outlet syndrome if it suffers some trauma or mechanical stresses which can combine with any anatomical abnormality such as a cervical rib. If the blood vessels are obstructed then this acute syndrome threatens the health of the arm and surgical release of the compression and blood vessel repair should be urgently considered. The remainder of treatment is conservative including TENS (transcutaneous electrical nerve stimulation), anti-inflammatories and physiotherapy assessment and intervention to the neck and shoulder.

Conservative management is useful in a large group of patients and if the pain does not settle over a considerable period then surgery remains an option. Physiotherapy assessment includes any abnormalities of posture and imbalances in muscles around the shoulder and neck region. The maintenance of static postures for considerable times or repeated return to certain postures may provoke abnormal neck function.

Chronic compression may be caused by the postural abnormality increasing the local compression or tension forces on the nerves. If muscles are kept in shortened positions for lengthy periods they may adopt that new length and when stretched, react with pain. Muscle imbalance can occur with some muscles typically lengthened and thereby weakened and others shortened and thereby strengthened. This leads to an abnormal balance of muscular strength and length, generating abnormal forces in the neck region. Education is a significant matter in the treatment of these patients in an effort to change their posture.

Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about physiotherapy, physiotherapy, Physiotherapists in Bournemouth, back pain, orthopaedic conditions, neck pain and injury management. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.


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