Looking After Your Hands
Our hands are at the forefront of all activities of work, sport and hobbies, and are therefore vulnerable to injury and over use.
Normal wear and tear takes its toll on the hand especially the joint at the base of the thumb, with sustained pinch as in needlework, writing being the most damaging activities because they push the blood out of the articular cartilage and make it more susceptible to degeneration.
The hands are on the end of the line for circulation and so as many of you will know, cold weather or cold working environments make your hands blue, cold, insensitive and painful.
Long term reduction in circulation can result in permanent reduction in sensitivity, and some of you may be well aware of the clumsiness that that causes.
Scleroderma causes thickened skin which results in stiffness and obstructed circulation and reduced sensitivity.
Swelling in the hand for whatever reason, will restrict movement and cause deformities if not treated. The swollen hand rests in a claw position which can lead to tight straight knuckles and bent fingers and loss of the web space of the thumb.
FOR NORMAL FUNCTION YOU NEED …
- Sensation - hot/cold, sharp/blunt, where in space/bent/straight
- Flexibility - joint movement, tendon glide
- Strength - pinch grip, gross grip, wide grip, wrist strength
SO WHAT CAN YOU DO TO PRESERVE YOUR HAND FUNCTION, OR REGAIN AS MUCH AS YOU CAN?
Exercises - Quite a lot can be gained by doing meticulous exercises. If you can't do the movement well to start with … head in the correct direction, think the correct movement … practice makes perfect!
- Finger hooks … for joints, tendons and to pump out swelling. RHEUMATOIDS, PUSH YOUR FINGERS STRAIGHT BEFORE DOING THIS EXERCISE AND TRY TO KEEP THEM CORRECTLY ALIGHNED AS YOU BEND.
- Make an "O" with each finger and your thumb
Press tips together in "O" position gently
- Slide the tip of your thumb up and down each finger
- Slide each finger tip in turn up and down your thumb
- Make your thumb go round in gently circles, making sure that the movement is happening at the base of your thumb … bend the tip of your thumb and circle if you're tending to only move your middle joint
- Hands flat on table … slide your thumb out to the side and in again
- RHEUMATOID ARTHRITIS - Slide your thumb out to the side, then the index, followed by middle and ring and little. Lift your whole hand up, put it down and start again … Practice moving towards the thumb side only, not side to side
- NON RHEUMATOID HANDS … Slide each finger side to side
- Squeeze a foam bath sponge in warm water if your hand is stiff, or alternate hot and cold water if your hand is swollen or iced water if your hand is inflamed (hot). Make sure your fingers are straight and together to start
- With your hand flat on the table and your fingers together and straight, lift your fingers and palm off the table and hold for 10 seconds. Repeat x 10
- "Pray" to stretch gently … first with fingers straight then with fingers bent and the nails together
- "Stop the traffic and pull in to your shoulders" … to work your forearm muscles
- Happy Talk with each finger and thumb
- Alternate "O" position (nail to nail) and happy talk position (pad to pad) on each finger, with your thumb
- Hand flat on table, life hand and curl fingers under, then straighten again
- Help yourself get good movement by using the natural tendency of your fingers to open when your hand is flopped forward, and curl when your hand is pulled back.
WHAT CAN YOU DO FOR YOUR CIRCULATION?
Regular exercises, immersion in warm NOT HOT water, gloves, go to Queensland for the winter!
Lycra gloves help both circulation and swelling, as long as neither is too severe … if your fingers are colder in the glove, it is working against you … really nice support for the Rheumatoid hand.
WHAT IS BEST TO DO WHEN YOUR HANDS ARE ACHING, HOT AND SWOLLEN?
Rest in a splint that prevents deformity … these need to be custom made in most cases and should rest the wrist and fingers while keeping the fingers in good alignment. All Rheumatoid arthritics should have splints to sleep or rest in when their arthritis is active. (Resting splints also offer great relief of pain at night in lots of cases of Osteoarthritis).
Iced water and gentle exercise, or a cold pack. Reducing the temperature in the joints reduces the inflammation and therefore the amount of damage to the joint cartilage. NB: This is not an option for people with Raynaud's Phenomenon.
HOW CAN YOU BEST PROTECT YOUR HANDS FROM THE STRESS OF NORMAL USE?
Working supports for the wrist, and for the knuckles as well in Rheumatoid arthritis will improve comfort and tolerance to use. Gadgets from the Independent Living Centre for taps, keys, cutting, washing, eating, dressing, writing, dealing with food preparation and cleaning will also help reduce deforming strains on your joints. CHEAT WHENEVER YOU CAN!
WILL PHYSIOTHERAPY HELP?
Physiotherapy treatments will help specific problems, such as carpal tunnel syndrome, trigger finger, but making splints and instructing you in the most appropriate exercises for your hands is the most important thing.
WHERE CAN YOU GET HELP?
All the major Public Hospitals have hand clinics and Rheumatology clinics, with Physiotherapists and Occupational Therapists to help you.
This talk was presented by Mrs Janet Dindler at our September 1998 meeting. Many of you have requested a copy of her presentation - this is it! Mrs Dindler is a member of the Australian Hand therapy Association.
Reviewed by Sue Barwick, Registered Nurse, July 2002
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