Author Archives: the American Society of Hand Therapists

Hand Hand Safety Hand Therapy Snowblower Safety

Advice from a Certified Hand Therapist: Preventing Injuries During Snow Removal

The winter months can be a festive and fun time of year; however, they can also bring many hazards that can lead to hand, wrist, elbow or shoulder injuries. Snow shoveling and removal are strenuous and sometimes risky activities that are necessary in these snowy months, and should be addressed with some simple safety measures to protect yourself from potential injury.

Common safety steps to take when addressing snow removal include:

  • Warm up before tackling snow removal – Doing a short amount of light exercise to warm your body prior to shoveling snow can assist in reducing your risk of injury.
  • Wearing gloves with skid resistant material – One simple strategy to combat the snow is to be sure your gloves and/or mittens have a skid resistant material on the palm and fingers. This will allow you to have adequate grip on your shovel to prevent unnecessary slipping of your equipment.
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Cold Hand Disease Hand Therapy Raynaud's Phenomenon

Advice from a Certified Hand Therapist: Cold Weather Tips for Raynaud’s

Cold weather can bring misery to people with Raynaud’s. Frigid temperatures trigger an abnormal response of constriction (or narrowing) of the blood vessels in the fingers, toes, nose and/or ears interrupting blood flow. As a result, fingers turn white and blue when cold, then bright red when warming and are extremely painful.

If you have Raynaud’s, you are at greater risk for frostbite and may develop sores on the tips of your fingers. You can still enjoy winter activities. Most of the symptoms can be managed with prevention and some lifestyle changes. Here are a few suggestions:

Wear gloves and mittens. Mittens tend to keep hands warmer than fingered gloves. Fingerless gloves with mitten caps are a great option and can also be used indoors as well.

Layer your clothing. Keep your body warm with layers. The Raynaud’s response occurs when the body becomes cold, not just your hands and feet. Wristies® and Limbkeepers® are two products that help with layering.

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Dupuytren's Contracture Finger Hand

Advice from a Certified Hand Therapist on Dupuytren’s Contracture

Dupuytren's ContractureDupuytren's ContractureDupuytren's Contracture

Why can’t I straighten my finger?

Dupuytren’s Contracture is a benign disorder of the hand that may result in tightening of the palm and bending of the fingers. When it begins, the palm or finger(s) appear to have bumps and later may develop a rope-y appearance.  It is not usually painful, but in some cases, discomfort is reported. The condition is most common in men (almost 5 to 1 versus women) of Northwestern European descent and onset increases with age (over 40).

The condition usually starts with the first knuckle. If it progresses, the middle knuckle may also bend. The fingers most affected are the ring and small, with possible progression to the long, index and thumb. Early signs of Dupuytren’s Contracture may include the appearance of “pitting/dimpling” in the palm. It may become difficult to place the hand on a flat surface, put on gloves, or put the hand in a pocket.

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Arthritis Hand Hand Therapy Thumb Arthritis

Advice from a Certified Hand Therapist: Surgery for Thumb Arthritis Pain

Thumb arthritis pain can be debilitating, making everyday self-care tasks intolerable. There is a surgical option when other treatments, such as injections and therapy, fail to adequately reduce pain. A carpometacarpal arthroplasty or CMC arthroplasty is a joint replacement procedure for the base of your thumb. It eliminates the grinding and pain felt from the rubbing of bone on bone after the protective cartilage has worn away, usually caused by arthritis.

Below are some commonly asked questions regarding this procedure:

Will I be in a cast?

Yes. You will likely be in a cast for 2-4 weeks. You will also use either a removable orthosis a hand therapist will custom make for you or an off-the-shelf thumb and wrist splint for a month after the cast has been removed. This will help maintain the optimum position of your thumb as you are healing and protect your new thumb joint.

What happens after my thumb has been immobilized?

Any time a joint has been immobilized, it takes time to regain your flexibility. For this surgery, the wrist and thumb are usually quite stiff. Your doctor will likely recommend you see a hand therapist to assist you with regaining the range of motion and strength safely.

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de Quervain's Tenosynovitis Tendonitis Tendons

Advice from a CHT: How to Prevent Tendonitis in New Mothers

De Quervain’s tenosynovitis is a common, painful inflammation of two tendons that move your thumb.  Most people with de Quervain’s will have pain at their wrist (just below the thumb) that will worsen with thumb or wrist movement. It is most often seen in women, especially in those who have recently had a child or those at the end of pregnancy – usually due to a combination of repetitive movement and an increase in swelling, which naturally occurs during pregnancy; however, all caregivers of young children can be susceptible to this overuse condition.

What can I do to prevent de Quervain’s?

The most important advice is to avoid overuse and repetitive motions of your wrist and thumb. Moving your thumb or wrist from side to side repeatedly (thumb side to little finger side) can provoke symptoms.  Changing the way we do things to rely on stronger, more capable muscles to do a job is helpful.

Specifically for new parents and caregivers, some tips include:

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Food Hand Hand Therapy Knife Safety

Advice from a Certified Hand Therapist: Kitchen Knife Safety

Serious hand injuries can occur during daily activities such as preparing food. Many hand injuries can be prevented with simple adjustments to routines. In preparation for the upcoming fall cooking season, please consider some safe, simple adjustments to your own routine in cutting various food items to prevent knife slips, which can cause injuries to the tendons or the nerves in your hand.

Mangoes

This delicious, yet slippery fruit can be a challenge when it comes to cutting and preparing for serving. The danger arises from removing the outside peel of the fruit. Once this is removed, the fruit center is extremely juicy and becomes difficult to hold. The fruit is also oval-shaped, difficult to place on a cutting board and has a large pit in the center.

Here’s a safe method for preparing mangoes:

  1. Keep the peel intact! Instead, stand the mango on a cutting board with stem side down and cut mango into two large pieces from either side of the pit. Be sure to cut toward a cutting board or solid surface and not the palm of your hand.
  2. Taking the two large pieces with peel side on cutting board, you can use a paring knife to cut cubes or slices of the mango, being sure not to cut through the peel. Again, be certain you are cutting toward a hard surface and not your hand.
  3. Once all your cuts are made, you can begin to peel away the skin of the mango by turning the skin inside out OR you can use a spoon (not anything sharp) and scoop the cut pieces away from the skin of the mango.
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Hand Hand Conditions Hand Pain Hand Therapy

Advice from a Certified Hand Therapist: Hand Edema

Hand edema is inflammation, swelling or fluid collection in the hand. Sounds basic by definition; however, edema in the hand can be extremely problematic and complex when there is a hand condition or injury.

Edema is the body’s response to healing itself, but, in the hand, large amounts and/or long-term swelling can cause permanent impairment and affect one’s ability to perform daily activities. It is one of the most common problems associated with hand injuries/conditions. Edema can be a primary focus during hand therapy as it can trigger so many other problems such as pain, lack of motion, scar tissue and decreased function of the hand and arm.

Edema can be acute in nature, which means it occurs in the first 24-48 hours after an injury or condition, or chronic (present 48-72 hours or longer after injury). Signs of acute hand edema are typically:

  • Redness
  • Warmth
  • Throbbing
  • Swelling
  • Decreased mobility and use
  • Tingling
  • Numbness
  • Pain

Chronic hand edema can be hard or soft and, typically is not warm, red or throbbing; however, it can be painful and cause scarring and/or decreased function.

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Hand Hand Therapy Pencil Grip

Advice from a Certified Hand Therapist: Modifications to Pencil Grip for Handwriting

As a pediatric hand therapist, I see clients who hold their pens and pencils a little bit differently than most. Typically, these clients are using a different grip to compensate for weakness or loose joints. An altered grasp is not in itself a bad thing until it creates a problem.

The problem is usually a complaint of pain with handwriting. An individual with loose joints develops an altered grasp pattern in order to increase stability when writing, thus allowing them to write clearly. An example of a modified grip is excessive extension of the tip of the fingers or thumb along with excessive flexion of the second joint of the thumb.

Another example involves holding the pencil tight in the first web space while using all four fingers and thumb to stabilize the pencil.

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