RECOVER: June 19, 2015 - End of the Chain & Critical to our Function

After several weeks, we've come to the end of the line.  Well, the end of one line.  We started at the crossroads, where the lower body and the upper body meet and then traced our way up and out....through the shoulder, across the elbow and into the forearm.  Last week we squeezed through the wrist and now....we arrive at the hand.

The hand is critical to our ability to function.  It plays a role in just about everything we do and, as some argue, is what makes us unique as humans.  Our ability to manipulate objects and tools with precise timing and force allows us to do things that literally nothing else on earth can do.  Watch any skillful musician and their speed and dexterity is obvious.  Watch any craftsman or hobbyist who masterfully uses tools to create/repair and you can appreciate the many nerve-connections between the brain and the hand as you watch ideas become reality....the original 3D printer.

However, not unlike any of the areas of the body, when a balance between use and recovery isn't maintained, things can go wrong.  The problem is, when things go wrong in the hand, it can have a major impact on our day to day lives.

So what typically goes wrong? Well, the good news is, the hand is pretty resilient.....it was built for a ton of use.....but it's not without limits.  Therefore, it's important to understand that the trade-off for dexterity and the finely tuned sensation we have in the hand is a lack of padding -- there just isn't much muscle bulk -- this means bones, ligaments, tendons, nerves and vessels are all very close to the surface and is one of the reasons the use of gloves can never be understated.  Lacerations, fractures and other acute injuries to the hand are ALWAYS a risk.

Beyond trauma however, we most commonly see signs of wear and tear.  Individuals who overuse the hands often develop thickening and stiffness of certain tissues.  As hands become muscular, a normal adaptation to hard work, they tend to lose dexterity, motion and sometimes even sensation.  One of the most common imbalances we see on a daily basis is a lack of finger extension and subsequent stiffness in the joints of the hand. This lack of motion often is accompanied by reduced circulation and sometimes results in discomfort....and is largely preventable.

QUICK TEST

Here's a simple self test to illustrate the point.  Flatten your hand on a tabletop by pulling your thumb into the "I swear" position (as if you were "placing your hand on the bible" and taking an oath).  Your fingers should be in line with your hand and the entire surface should be on the table.  

The good news is - most everyone can achieve this.  The not as good news is - that's not the test.

Now, without allowing your fingers to bend (and not using the opposite hand to help), try pulling your fingers up off the surface without lifting your hand....so only the fingers come off.  This is called active finger extension as shown on the third set of pics HERE and is something everyone should be able to do.  Over the years we've evaluated many movement patterns including finger movement and there are many many folks who have lost this motion.  Sometimes the loss in motion is accompanied by other signs/symptoms, sometimes it's not. After evaluation, we often recommend simple "tendon gliding exercises" to help restore motion - as simple as they are, they are surprisingly effective when used appropriately.

Of course, decreased movement is not the only thing we see in the hand....sometimes too much motion can be an issue (unstable or repetitive micro-trauma to joints) and overuse of the thumb with over-reliance on mobile devices is a growing threat (google "iPad Hand").

The best news is, like most areas of movement impairment or imbalance, with some effort, hand motion can return, stiffness in the joints or soft-tissues can often be resolved and movement impairment today doesn't have to be limiting forever.

Let us know if we can lend a helping....um....if we can help.

Have a great weekend,

Mike E.