In the blog entitled “What is a Custom Orthosis?” basic information on custom orthoses was provided. But as hand therapists we can do so much more! In this blog, different types of custom orthoses and the reason your doctor and therapist may recommend one or another will be reviewed. In general, an orthosis is a device that is molded to and worn on a specific body part. The device can help to protect and support bones, tendons, ligaments, and nerves, and keep these structures in safe and healthy positions. An orthosis can also be used to help fix deformities or help people with limitations function better. Orthoses can be used to immobilize (keep the body part and tissue still), to mobilize (move the area) or to restrict partial movement in an area.
You’re in the middle of a good video game. Your team needs you to cover the east arena. But, ouch! Your hands are getting pwn’d! Gaming for hours at a time can cause serious hand or wrist pain. Before you give up your gaming dreams, try these suggestions to ease and prevent the pain.
Ice. If your hand feels hot and swollen, rest and apply ice. Wrap a bag of ice in cloth, and place over the painful area for 15-20 minutes. Ice helps dull pain and reduce swelling.
Rest. Don’t underestimate time disconnected. Your fingers perform forceful, repetitive motions when manipulating buttons and analog sticks. Decrease the strain on your tendons and nerves by taking time away from the controller. Take a five minute break every thirty minutes.
After an injury, surgery, or onset of certain conditions, your doctor may ask you to see a hand therapist. Your prescription for therapy might include the need for a custom orthosis, commonly referred to as a brace or splint. A custom orthosis is a device that is molded to and worn on a specific body part. The device can help to protect and support bones, tendons, ligaments, nerves and keep these structures in safe and healthy positions. It can also be used to fix deformities or help people function better. It will be custom made specifically for you by your hand therapist.
Some of the reasons your doctor might prescribe a custom orthosis include:
With an increase in the use of personal electronic devices during our daily lives, we need to be aware of potential negative impacts these devices can have on our bodies. Using electronic devices for extended periods of time, holding a static position, can create stress on our bodies.
Signs and Symptoms of Overuse
- Numbness in the fingers from sustaining wrist and elbow positions while holding the device.
- Cramping of the fingers and thumbs from using smaller devices for extended periods of time. Keep in mind that for every 1 kg of pressure applied to the pad of your thumb, there is 13 times that amount at the base of your thumb!
- Inflammation from repetitive movements causing triggering or catching in the fingers.
- Muscle stiffness in the neck or shoulders due to a prolonged bent posture when using devices.
According to the Outdoor Industry Association, nearly half of the U.S. population participated in some sort of outdoor activity in 2017. Among these activities, hiking and camping were reported to be among the most popular. As we are packing our backpacks and lacing up our hiking boots there are some tips we can remember to protect ourselves from injury.
Take a Hike
- Ensure that you have the proper footwear – hiking trails often consist of several different types of terrain that can cause falls if you are not prepared. It is important that you have hiking shoes or boots that have soles to help maintain your footing in slippery grass, rocks, mud, snow, or while crossing creeks. A fall could cause injuries to your hands and arms, like cuts, sprains, strains, or fractures.
- Take along trekking poles or a hiking stick – use of one of these can also help you maintain your balance, keep your footing, and prevent falls.
- Make sure that you are dressed appropriately for the season – hiking in the winter in particular can present some perils to your fingers. Frostbite is a serious threat when you let your hands become too cold, and can result in injury or even loss of all or part of a finger if severe enough. It is important to wear properly insulated gloves, and to carry a spare pair in case your hands get wet. Pocket hand warmers can also be helpful.
After an injury or surgery, our bodies naturally make scar. Scar tissue can become a problem if it limits function and/or is unpleasant to look at. Scar tissue can be treated. A physical or occupational therapist who specializes in treating upper extremity injuries can help. There are several factors a therapist assesses to determine the best course of action for scar management. These factors may include the following:
- How close the scar is to a tendon or muscle: A scar may become adherent to the surrounding tissue such as tendons and/or muscles. As tissues heal, scar adhesion can make movement more difficult. Therapists prescribe specific and directed movements that can reduce adherent scarring.
- Shape of the scar: If your scar is from a surgery, it is usually a thin line. If scar is from an accident, it may be irregularly shaped and/or vary in depth which could make it unpleasant for you to look at.
- Type of scar: As skin heals, it shrinks slightly and can cause pain and interfere with motion. Hypertrophic scarring can occur causing scar tissue to form outside the normal borders of the wound. Keloid scarring can also occur which causes a large, raised scar.
- Sensitivity of the scar: Skin is used to being touched by different textures during the day such as clothes, jewelry, and resting surfaces. After an injury or surgery, the wound area is covered for a short amount of time to keep it clean and protected. During this time, the skin can become hypersensitive. This can be very painful, cause you to protect your scar during use, and may also affect your sleep.
We all know the health benefits of regular exercise. Many fitness workouts involve putting pressure on your wrists. You may have noticed some discomfort while lifting weights or during yoga poses that require you to put weight on your hands. Here are some tips to make sure you are not straining your wrists while staying active.
- Tip #1: Keep your wrists flexible. Tight wrists put extra strain on surrounding ligaments, muscles, and joints. Make sure your wrists can move comfortably in all the motions you will use during your workout. If an exercise requires the wrist to bend 90 degrees (as in a push-up, see photo above), gently stretch your wrists back so they can move into the position with ease before adding your body weight.
- Tip #2: Maintain your strength. Strong wrists are more stable during weight lifting and weight-bearing activities. A strong grip allows you to hold weights more securely during intense exercises. Stress balls and spring grippers can be used to strengthen your grip. To help prevent wrist injuries and wrist pain, strengthen the muscles in your forearms using light resistance bands or small weights to resist wrist motions.
- Tip #3: Use your wrists in the most stable position. Keep your hand and forearm in a straight alignment during exercises. Improper wrist position puts strain on the small ligaments. If your exercise program requires putting weight through an outstretched hand (as in a plank pose), add stability at the base of your wrist by slightly arching your hand.
The ability to move our elbows is required for using our arms during daily activities. We would not be able to reach our face to eat or our feet to put on shoes without our elbows.
Three bones make up the elbow: the long bone closer to your shoulder is the humerus, and the two forearm bones are the radius and ulna. See the image above to get an idea of the location of these bones.
The radius and ulna are involved in bending and straightening the elbow as well as turning the palm up and down. Radial head fractures affect all of these motions, especially the ability to rotate the forearm and hand.