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, according to hand surgeon, David Wei, MD of Orthopaedic & Neurosurgery Specialists (ONS).
Just as 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.
“You 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,” Dr. Wei said. Instead, undertake these tasks at moderate intervals and take a few minutes to stretch when you 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.
Said Dr. Wei, “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.”
A few common gardening injuries can be caused by the repetitive motion of opening and closing shears or other hand tools. Trigger finger is the painful triggering or locking of the fingers or thumb. The condition occurs 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,” he said.
Another repetitive hand injury is Gamekeeper’s thumb, a chronic ulnar collateral ligament injury caused by progressive weakening of the ligament on the inside side of the thumb. 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.
Gardeners can also develop lateral or medial epicondylitis, also known as Tennis and Golfer’s Elbow. These painful conditions involve the tendons that attach to the humerus bone (upper arm bone) at the elbow. Repeated bending of the wrist while gripping something like a rake can weaken the tendons attached to the outer, or lateral, side of the elbow or those that are attached to the inner, or medial, side of the elbow.
In most cases these types of overuse-related conditions 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 hand, wrist and elbow specialist who can assess whether bracing, physical therapy or other treatments are needed.
ONS has offices in Greenwich and Stamford, CT and Harrison, NY. For information about the fellowship-trained specialists at ONS or the walk-in ONS Urgent Ortho Care hours and locations, visit onsmd.com.