Physiotherapy for Wrist and Hand Injuries

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Physiotherapy for Your Hand physio-treatment-hand-injuries

Wrist, hand and finger injuries are relatively common amongst the general population, and range from simple joint sprains to fractures.  Soft tissue injuries can include acute ligament sprains, overuse

Tendinopathies (very common), muscle tears (rarer), types of tenosynovitis (inflammation of the tendon sheath) and carpel tunnel syndrome.

Physiotherapists commonly see all of these conditions, as well as treating wrists/hands that have been immobilized following a fracture.  Regaining full wrist and hand range of motion is extremely important considering our dexterity as humans relies largely on our ability to move our hands.

Unfortunately this movement usually does not return on its own, with most teenagers through to adults requiring some intervention from a physiotherapist to help restore normal movement.physio-acute-ligament-sprains

Acute ligament sprains are commonly seen in sportspeople, with a common presentation involving a player having a ball land on the end of their thumb or finger, resulting in a sprain to 1 or more ligaments that support the carpometacarpal, metacarpophalangeal or interphalangeal joints.  Immobilization of these injuries is often required, with physiotherapists being able to prescribe an appropriate splint to allow for healing to occur, followed by a program of exercises to restore movement and strength.

Overuse Injuries of the Hand and Wrist

Overuse injuries are common in workers with physical, repetitive jobs involving lifting and gripping activities.  De Quervain’s tenosynovitis is one such condition, which is inflammation of sheath around the tendons that extend and abduct the thumb, caused by repetitive lifting with deviation of the wrist.  This is most commonly caused by lifting small children, from certain gardening activities and increasingly from computer gaming.  Treatment can involve massage, gentle stretching and strengthening ultrasound, splinting if required, and rest from the aggravating activity long with use of medications to reduce pain and inflammation.

Stenosing tenosynovitis, or “trigger finger”, is an inflammation of the sheath around the finger flexor tendons.  The inflammation and trigger-fingerdevelopment of a nodule then prevents the flexor tendons from sliding back and forth as the fingers flex/extend, causing the tendon to get “stuck”.  It often develops after the age of 40, usually with repetitive hand tasks (although occasionally following trauma to the hand), and is associated with painful clicking and “locking” of the finger.  Dupuytren’s contracture is a tightening that most commonly affects the 4th & 5th fingers, resulting in fixed flexion deformity.  It is more common in males than females, as well as diabetics and people with high alcohol intake, and is prevalent in Northern European and Celetic descendants.

Treatment for both of these conditions also involves education, massage, joint mobilization, exercises to maintain motion and strength, as well as monitoring of symptoms so that appropriate referral for further management can be made if required.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition whereby the median nerve is compressed as it travels through the “carpel tunnel”, resulting in pain, ins and needles/numbness in the thumb and first two fingers.

carpel-tunnel

Symptoms can be quite debilitating, and often develop in pregnancy due to fluid retention, in diabetics, people with hypothyroidism, females over the age of 40, and in people with jobs that involve mechanical gripping/vibration (eg: jackhammering) and office workers (specifically computer based positions).  Physiotherapy treatment to mobilise the carpel bones/joints, loosen surrounding soft tissue structures and educating the patient about good wrist positions can often relieve symptoms and result in delaying or avoiding surgical intervention.

The soft tissue injuries mentioned above are quite common, and the treatment varies depending on the individual presentation.  The physiotherapists at Physio Professionals are skilled and experienced at diagnosing and treating all the above hand conditions, and tailoring a treatment program which may incorporate manual therapy, exercises, splinting/taping, ultrasound, activity modification and education.

 

 

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