News and Updates

Hand Therapy

WHAT IS DE QUERVAINS TENOSYNOVITIS AND HOW DOES IT HAPPEN?

De Quervains tenosynovitis is a condition that affects two tendons that run from the back of the thumb down the side of the wrist. De Quervain’s tenosynovitis is the name given to the condition that occurs when these tendons are swollen and irritated. Swelling of the tendons, and the tendon sheath (a tunnel-like structure that the tendons travel through at the wrist), can cause pain and tenderness along the thumb side of the wrist. Risk Factors De Quervain’s tenosynovitis: •...

Distal Radius Fractures and Osteoporosis

Distal Radius Fractures and Osteoporosis Distal radius fractures (lower forearm fractures) are one of the most common injuries treated by hand therapists. These fractures are normally immobilised in a cast for 3-6 weeks to allow bone healing. Sometimes patients will have stiff, weak, or painful wrists when the cast is removed and are referred to hand therapy for rehabilitation. The aim of rehabilitation is to restore lost range of motion, and to regain strength and function. If the patient is older,...

Splinting for Ulnar Claw

The ulnar nerve runs from the shoulder to the little finger and innervates the small muscles of the hand (intrinsic muscles) that allow fine movements of the fingers e.g., typing. Damage to the ulnar nerve anywhere along its length can cause loss of sensation and muscle weakness in the hand. This is known as ulnar nerve palsy or ulnar neuropathy. This condition can affect the ability of the hand to make fine movements and perform many routine tasks. In severe cases,...

CENTRAL SLIP INJURY

The extensor tendon on the back of a finger is a delicate and complex structure. The tendon divides into a central slip and two lateral bands. Working together, normally these would straighten the finger. A Boutonniere deformity arises when there is a rupture of the central slip. This is a relatively uncommon sporting injury – caused by a sudden, forced bending at the PIP joint (e.g., finger hit by ball, or falling onto bent finger), or can be caused if the...
Filed under Hand Therapy \ Injury

RHEUMATOID ARTHRITIS

Rheumatoid arthritis (RA) is a long-term, inflammatory condition that affects approximately 1% of the population worldwide. It occurs twice as often in women as in men, with a peak incidence between 45-65 years of age. While osteoarthritis is associated with joint pain, rheumatoid arthritis can affect more than the joints. About 40% of people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Areas that may be affected include the skin, eyes, lungs, heart and...
Filed under Hand Therapy

Gestational Carpal Tunnel Syndrome

Swelling is one of the most common symptoms of pregnancy. Patients often notice swelling in their ankles and feet, but for some women, swelling occurs inside the wrist, resulting in a condition known as carpal tunnel syndrome (CTS). Approximately 4% of adults in the general population have carpal tunnel syndrome, but almost 30% of women will develop carpal tunnel symptoms in the last trimester of pregnancy. The carpal tunnel is located in the wrist. The floor of the tunnel is made...
Filed under Hand Therapy

Occult Scaphoid Fractures

A fracture is a broken bone. Occult means hidden. An occult fracture is one that is not visible on an X-ray. A possible occult fracture is a suspected fracture that needs to be confirmed with other imaging tests. Occult fractures can occur because of a fall or other type of impact injury. Health professionals are careful to exclude occult fractures of the scaphoid. The scaphoid is one of eight small bones in the wrist, collectively called the ‘carpal’ bones. Scaphoid...

Is My Finger Broken?

Finger fractures are common injuries, and the mechanism of injury (how it happens) varies from balls hitting fingertips, fingers getting caught in dog leads, fingers being crushed in door jams, through to simple trips and falls. The end result is the same… a broken bone. A common myth is that if you can move your finger, it is not broken. While severe fractures or joint dislocations may prevent movement, for most fractures the finger will still move quite well. Generally,...
Filed under Hand Therapy \ Injury

HELP FOR PEOPLE WITH HAND AND ARM SPASTICITY

SPLINTING HANDS WITH INCREASED TONE (NEURO SPLINTING) Spasticity is caused by an imbalance of signals from the central nervous system (brain and spinal cord) to the muscles. This imbalance is most often found in people with cerebral palsy, traumatic brain injury, stroke, multiple sclerosis, and spinal cord injury. Arm and hand spasticity refers to involuntary and abrupt movements known as spasms that frequently occur in the arms or hands. The spasms are often accompanied by stiff arm muscles, discomfort, and difficulty...

Treatment of a Lumbrical Muscle Tear

The lumbricals are four small muscles located between the metacarpal bones of the hand. While only very small, the actions performed by the lumbricals are important for many functions of the hand, such as gripping movements. Lumbrical muscle injuries occur when a finger (middle/ring finger) is forcefully straightened while the other fingers are actively gripping/bent. Rock climbers are at greatest risk for lumbrical muscle tears. Diagnosis Lumbrical muscle tears can be diagnosed by stress testing (see Figure 1) and by an...
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