Few people connect gardening with sports injury, but avid gardeners who enjoy clearing, planting and tending their gardens are susceptible to many of the same types of repetitive motion and overuse injuries that afflict tennis and golf enthusiasts jumping into the game after a long winter break.
Athletes are advised to start a new activity slowly, increasing duration and intensity at a gradual pace. The same is true for gardeners anxious to get digging into the fresh spring soil. They shouldn’t attempt to clear all the winter debris in a single day, or plant the flats of annuals brought home from the nursery all at one time. Instead, they should undertake these tasks at moderate intervals and take a few minutes to stretch when they start to feel a little sore or stiff.
Most of us are familiar with the backaches and sore knees that accompany digging, pulling and edging a garden. Those conditions typically resolve within a few hours or a day or two with rest, ice and, possibly, over-the-counter anti-inflammatory medication. However, the hand, wrist and elbow injuries that gardeners can suffer tend to develop over time and don’t usually cause pain at the outset. Typically, the pain of sprains, tendinitis and even arthritis is mild at first and often ignored. However, these ailments can develop into serious conditions if left untreated. Here are a few common gardening-related problems that would require medical attention:
TRIGGER THUMBS OR FINGERS
The repetitive motion of opening and closing shears or other hand tools can lead to a painful triggering or locking of the fingers or thumb. The condition is caused when the “eyelet” that holds the flexor tendons in place along the finger or thumb interferes with the smooth gliding of the tendons through it. Patients may feel a pain in the palm or the finger and, in severe cases, the finger is stuck downward and requires “unlocking” with the help of the other hand.
Gamekeeper’s thumb is a chronic ulnar collateral ligament injury caused by progressive weakening of the ligament on the inside side of the thumb. This occurs from repeated activities that stress the area, such as opening and closing hand tools and clippers. Patients will notice increasing pain and difficulty in opening jars, using scissors and shears and holding large, heavy objects.
Persistent pain in the wrist could develop from repeated motion of the wrist. In De Quervain’s tendinitis, the tendons that attach at the base of the thumb become irritated or constricted, causing painful swelling along the wrist. Heavy raking can cause pain in the forearm about three inches above the wrist, a condition called Intersection Syndrome. It results from the overuse of the wrist extensor tendons, which rub against one another as the wrist repeatedly bends backward. The friction caused by the rubbing tendons leads to irritation, inflammation and painful swelling.
Tennis and golfer’s elbow (elbow epicondylitis) are painful conditions involving the tendons that attach to the humerus bone at the elbow. With tennis elbow, repeated bending of the wrist while gripping something like a tennis racket or a rake weakens tendons attached to the outer, or lateral, side of the elbow. Similarly, weakened tendons attached to the inner, or medial, side of the elbow cause what is commonly called golfer’s elbow.
In most cases the overuse-related conditions described above can be resolved with activity modification, ice and over-the-counter anti-inflammatory medication. If the pain persists more than five days or so, however, it would be wise to consult with a physician who can assess whether bracing, physical therapy or other treatments are needed.
One other gardening-related risk to mention is Sporotrichosis. Also known as Rose Thorn Disease, Sporotrichosis is caused by fungus found in soil, rose thorns, hay, moss and twigs and usually enters the body through a thorn prick. The fungus is more closely related to mold found in stale bread or yeast used to brew beer than to bacteria. Once the mold spores enter the skin, the disease can take days or months to develop. The first symptom is usually a painless bump or lesion that is pink or purple in color. In most cases, the mold spreads to the lymph nodes. Over time, new nodules can develop from your fingers all the way up the arm, becoming open sores or ulcers that are susceptible to infection. The disease is rarely life threatening, but it is important to seek medical attention. Left untreated, the ulcerative lesions can develop into a chronic condition that can persist for several years. All the more reason to wear garden gloves.
David Wei, MD is a hand, wrist and elbow specialist at ONS — Orthopaedic & Neurosurgery Specialists in Greenwich and Stamford. For more information about Wei or other musculoskeletal conditions, visit ONSMD.com.