Premier Physical Therapy

Category: Hand Therapy

Hydration and Healing: Why it matters in Hand Therapy
Water Facts:
1. 60 to 70 percent of our total body weight is water weight.
2. A typical person with an average body weight is required to drink 64 ounces of water daily. This is about eight glasses of water per day.
  a) (Of course, if you are in a hot environment or are doing a strenuous task and thus are sweating a lot, additional water intake is needed.)
  b) NOTE: This rule does not apply to anyone with heart failure or kidney disease; thus, this amount may need to be adjusted.
3. When you have an open wound, more water is needed to help keep the wound hydrated on the inside due to the loss of fluids that can occur through wound drainage.
4. To know if you are drinking enough water every day, take a quick check the next time you use the bathroom. Urine should be relatively clear and odorless if you are staying well hydrated.
Not drinking enough water will essentially slow down your body’s ability to heal after an injury. This includes an injury to a bone such as a: fracture, an injury to the tendon such as tendonitis, injury to a ligament such as a strain or sprain, or injury to the skin as in laceration or a cut. If you have an open wound with drainage, staying hydrated is essential to healing.

Water affects your body’s circulation and, thus, your ability to heal. The higher your blood volume, the better you will heal. Water is one of the main components of a cell, and it is important to the health of a cell. When the cell doesn’t have enough water, new cells cannot develop, and tissue growth is affected.

Water is needed in our body to help transfer oxygen throughout our body, especially to healing areas. Hydration is essential to healing any structure (bone, tendon, ligament, or skin) as it delivers the necessary nutrients to the injured area. Water is needed to help carry away waste from the injured structure as well. Water provides that river of flow to and from the trauma area to assist in healing and to fight infections.

Tricks for staying hydrated:
1. Keep your favorite drink on hand. Flavored water can help those who don’t like drinking just plain water.
2. When watching a movie or television, get into the habit of drinking a couple of sips at each commercial break.
3. Mix it up! Enjoy a variety of cold and hot drinks to make liquids more enjoyable to drink.
  a) REMEMBER: Avoid caffeinated and alcoholic beverages, as these will actually cause dehydration which ultimately requires MORE water intake!
4. Eat smoothies, gelatin, fruit ices, and other foods with high-water content, such as watermelon.
  a) NOTE: Watch out for these items that may be high in sugar.
5. Make drinking fun! Straws, containers with handles, or angled mouthpieces may help.
6. Have a reusable container with you all of the time and fill it often.
7. Have a daily goal and consider dividing that into a morning and afternoon goal. Get a water bottle with marked time goals.
8. Ask a family member to remind you.
9. Try fruit- or herb-infused water for some added flavor.
10. Make herbal tea to sip throughout the day.
11. Drink a glass of water when you first wake up.
12. Track your water intake on an app or fit bit and make it a goal to reach your goal daily. Your health depends on it.
13. NOTE: My way is to plug my nose and just drink it! It’s really not that bad, and it does make me feel better!
Hydration: It’s what heals you! DRINK WATER!
April 1, 2021
de Quervain’s Tenosynovitis
What is de Quervain’s Tenosynovitis:

De Quervain’s Tenosynovitis is a quite painful condition that causes discomfort to the thumb side of the wrist. This happens because the two tendons that move the thumb through a pulley like system at the wrist becomes irritated. The swelling that occurs due to this irritation limits the tendons’ ability to smoothly move back and forth through this pulley, which causes pain. This is one of those conditions that if you use the saying, “No pain, no gain,” you will definitely get worse!

Symptoms:
- Pain when the thumb side of the wrist is touched, rubbed, or pain is noted when wearing a bracelet or watch.
- Pain noted when the thumb and/or wrist is moved.
- Pain when pinching or lifting when gripping, especially if you are moving the wrist down and towards your small finger side.
- Swelling, also called edema, on the thumb side of the wrist.
- Common in pregnant or new mothers.
- More common in middle-aged women between 30 and 50 years old.
Causes:
- Repetitive tasks that involve thumb/wrist motion.
- Awkward positioning of the wrist (especially moving thumb down while moving the wrist towards the small finger side).
- A direct blow to the thumb side of the wrist.
- Repetitive lifting of objects/things (including a baby).
- Hobbies like painting & carpentry, etc.
Conservative treatment (this means treating it without surgery):
- A thumb spica forearm based orthotic is the best way to treat this condition. This orthotic is recommended to be worn 23 hours a day, taking it off only to perform the prescribed treatment and shower. This orthotic MUST immobilize the thumb AND the wrist.
- Avoid tasks that aggravate the condition. Any tasks that require thumb/wrist motion can make this condition worse. Making it hurt will NOT make this diagnosis better.
- Heat/ice depending on the stage of your injury and other modalities. Ask your therapist which is best for your condition.
- Exercises: any exercises MUST be specific to your injury. Ask your therapist.
Surgery:
- Surgery is recommended only after conservative treatment has failed.
For more information, go to https://www.assh.org/handcare/condition/dequervains-tenosynovitis

Call your doctor if you are experiencing any of these symptoms, then tell them you want to go physical therapy at Premier Physical Therapy. Let us help you find relief and avoid surgery.
March 1, 2021
4 Self Help Suggestions for Pain and/or Swelling

When to Use Heat?

Heat can be used for stiffness, arthritis, muscle pain, and back or neck pain. Heat may be preferred for chronic or long-lasting stiffness and acute muscle soreness.

Note: Heat should NOT be used for the first 3-5 days after joint sprains such as with new knee or ankle injuries. Heat is preferred prior to activity but can be used following physical activities as well.

Why? Heat can help relax and loosen up tense muscles and stiff joints allowing for decreased pain and improved overall movement. Heat may also increase blood flow to the area applied.

Tips for Heat: Many heating products are available for purchase. Electric heating pads, hot packs, warm damp towels, or even warm showers/baths may be beneficial. To be most effective, apply heat for 10-20 minutes.

When to Use Cold?

Cold can be used for new or acute injuries such as joint sprains, strains, tendinitis, and when recovering from surgery. Cold may also be beneficial when experiencing swelling and/or bruising along with pain.

Note: Always use a barrier such as a washcloth or light towel between the skin and the cold pack/ice to prevent potential injury to the skin.

Why? Use of cold can help reduce pain by numbing the area and can help reduce swelling by decreasing the amount of blood flow to the injured area. This may help slow the inflammatory response.

Tips for Icing: The quicker cold is applied the better – cold should be used immediately following injury or surgery. Cold should be used for a maximum of 20 minutes per session. Cold packs, cold compress, and homemade ice packs can be used. Frozen vegetables or frozen fruit can be substituted if you do not have an ice pack. Cold is best used when secured to the area being treated.

When to Use Compression?

Compression can be used for acute injuries or conditions such as arthritis or chronic joint pain that have swelling associated with them. Some examples are joint sprains/strains, bruising, following surgery, or joints with persistent swelling with or without pain.

Note: Ensure that the compression is not too tight. Check for numbness, tingling, or swelling below the area that the compression is used.

Why? Use of compression or wrapping to the injured/involved area may help decrease the overall swelling and thus improve movement and decrease pain.

Tips for Compression: Compression wraps or compression sleeves may be used. Various types are available. Compression wraps are preferred for short-term use and compression sleeves are recommended for more long-term use. If wraps are used start distally and work proximally. Comfort is key.

When Should You Elevate?

Elevation should be used to reduce swelling and decrease discomfort associated with swelling. Elevation can be performed with new or acute injuries as well as following surgery. Elevation can also be used to decrease “fluid retention” in chronic situations such as swelling in the legs.

Note: Compression can be used with elevation to maximize the benefit (see precautions associated with the use of compression).

Why? Elevation can help decrease swelling and bruising. Elevation may limit bleeding to the injured area as well as promoting drainage of “inflammation” into the lymphatic system.

Tips for Elevation: Keep the area of swelling elevated above the heart if possible. Pillows, wedges, or rolled-up towels may be helpful to prop up your arm or leg. In instances of chronic swelling in the feet and ankles, both legs may be propped at the same time.

Talk with your healthcare provider if you do not notice an improvement in your pain and/or swelling or if you feel concerned. Physical therapy may be right for you. If so, tell your doctor you want to go to Premier. We’re here to help you. Call us at (573) 335-7868.

February 5, 2021
What is Trigger Finger or Trigger Thumb
Trigger Finger or Trigger Thumb is a condition in your hand that causes pain, and sometimes you can feel a “clicking” when making a fist or even when straightening the hand. The most common finger to get this condition is the ring finger. But it can occur in any finger or even in your thumb.

Trigger finger or thumb is also called stenosing tenosynovitis (stuh-NO-sing ten-o-sin-o-VIE-tis). When inflammation occurs from trauma, the space within the sheath of the tendon enlarges, and thus the tendon no longer slides through the narrow pulley system in the fingers or thumb. (See the link below for a diagram of the pulley system in our hands.)

Our fingers are stronger when we make a fist than when we straighten our fingers; thus, sometimes we have enough strength to pull that inflamed portion of the tendon through the 1st pulley of the finger. This pulley is naturally found at the base of each of the fingers on the palm-side of our hand. If this nodule is large, it may slide when making a fist, but because our fingers are weaker when we are straightening the fingers, we may not be strong enough to pull that enlarged swollen area back through the pulley system.

So that is why sometimes it takes using your other hand to lift up the finger if it’s stuck in a bent position.

Symptoms

Signs and symptoms of trigger finger may progress from mild to severe and include:

Finger stiffness, particularly in the morning

A popping or clicking sensation as you move your finger

Tenderness or a bump (nodule) in the palm at the base of the affected finger

Finger catching or locking in a bent position, which suddenly pops when trying to straighten the finger

Finger locked in a bent position, which you are unable to straighten

Occurrence

Trigger finger can be found in more than one finger at a time, and both hands might be involved.

More common in women than in men.

Most common between the ages of 40 and 60

Underlying diabetes

Underlying hypothyroidism

Underlying rheumatoid arthritis

Underlying tuberculosis

Performing repetitive activities that can strain your hand, such as playing a musical instrument

Performing sustained gripping tasks such a holding a weed trimmer or a power sprayer.

Sometimes noted following a carpal tunnel release

Hand Therapy

Hand Therapy is very instrumental in helping to resolve trigger finger/thumb with conservative treatment if only minimal clicking is noted, and the finger is not locking. If the finger is “locked,” then surgery may be required.

Conservative Hand Therapy

Patient education is paramount here at Premier Physical Therapy. We want you to really understand your condition so that you have the tools needed to treat this condition conservatively. Hand Therapy can include the following. . .

Rest: keep the hand from assuming the flexed or bent position. We can fabricate a day and/or night orthotic, which may be needed to assist with this.

Transverse friction massage over the area of the A1 pulley to help decrease the inflammation.

Gentle range of motion exercises to maintain or improve motion in the finger or thumb joints.

Activity modification to avoid further irritation.

Instruction in the use of modalities, including heat/ice and possibly provide:

Ultrasound

Iontophoresis

No matter what type of hand pain you’re experiencing, it’s important to understand that you CAN feel better. The first step is finding out the CAUSE of the pain. Seeing a hand therapist at Premier Physical Therapy is a great way to understand your hand pain and start your treatment to get better.

It’s time to feel better NOW! Call your doctor NOW to get your script! Then, give us a call TODAY to schedule an appointment at 573-335-7868.

Click on these links for more information on Trigger Finger or Trigger Thumb.https://www.assh.org/handcare/condition/trigger-finger then click on Trigger Finger: Symptoms and Treatment | The Hand Society

https://www.asht.org/sites/default/files/docs/2018/Trigger%20Finger%202018.pdf than click on ASHT
June 16, 2020
Recognizing National Hand Therapy Week and A ‘Hands Down’ Great Employee

Hand Therapy might be more necessary than you realize. We don’t know about you, but we put our hands and wrists through an intense workout every single day. From lifting groceries to pushing baby strollers, opening tight jars, typing on keyboards, and many other regular day-to-day tasks, our hands take a beating whether we realize it or not.

This stress on our hands can take a painful toll. More than 54 million people have arthritis in the U.S. alone, and many of those suffer from arthritis in their hands. But whether it’s arthritis, carpal tunnel or an injury, hand therapy produces tremendous results by combining both occupational therapy and physical therapy.

Did you know there is a National Hand Therapy Week every year? Recognized the first full week of every June, National Hand Therapy Week was established by the American Society of Hand Therapists. Slated this year for June 3rd through 9th, National Hand Therapy Week serves to celebrate hand therapists around the country, raise awareness about hand and wrist injury prevention and educate the public about the benefits of hand therapy.

We’re celebrating this National Hand Therapy Week by thanking our very own Certified Hand Therapist here at Premier Physical Therapy, Donna Goodson, OTR/L, CHT. Thank a hand therapist you know and read on to learn a little more about Donna and how she joined the Premier Physical Therapy family!

Get to Know Donna Goodson, Premier Physical Therapy’s Certified Hand Therapist:

Why do you enjoy providing hand therapy at Premier? I have been a hand therapist for most of my therapy career and it is constantly changing. New treatment techniques, new surgery techniques, new conditions, and new orthotics continue to be discovered. So, that keeps it very interesting and constantly challenging!

I love knowing a lot about one thing so knowing about hand, wrist, and elbow conditions helps me to better understand any diagnosis that is referred to Premier Physical Therapy. I get to see a wide range of diagnosis from conservative treatment to post-surgical conditions from family doctors to surgeons. I like the variety. I love working one on one with my patients and I am able to do that here at Premier.

Lastly, I love working with the team approach here at Premier PT. The owner, Dennis Riney, PT is an awesome role model and doesn’t require any more from us than he does from himself and he is always pushing me! He is constantly encouraging us to do our best. He puts God and family first and that really shows here in this family-oriented environment. I also really enjoy working with the other team members here. Everyone is dedicated to providing the best care for anyone who walks through the door. We really care about helping people. We work together as a team to help out when needed. You can tell everyone enjoys working here. You can see and feel that when you walk in the clinic.

What is your advice for people considering seeking hand therapy? Don’t expect to get better without putting some hard work into your therapy. Make sure you follow the home program of exercises that are recommended! Ask questions! Coming to therapy 2 to 3 times a week doesn’t get done what needs to be done to get full recovery. Take therapy seriously, take ownership of your injury, set goals, talk with your therapist about your goals and make a plan to get where you want to be. You can control more than you think you can, and we are here to help! Having a “can-do” attitude goes a long long way!

What are some common misconceptions about hand therapy? 1. That therapy always hurts! That it’s “no pain, no gain!” 2. That swelling is very bad and you must wait for the swelling to go away before doing any exercises. And why aren’t they correct? 1. To make changes with your body, you must stress it, do more than it is doing, but this doesn’t have to be extremely painful. I tell my patients doing nothing won’t make you better, but doing too much can also keep you from getting better. Find that middle ground, listen to your body, and challenge it little by little. That will make the most gains overall. 2. Swelling, otherwise known as edema, is a sign that your body is trying to make changes. Moving, performing exercises, stretching, and strengthening will help manage this edema. Now, if you have an infection, of course, edema is not good. But generally, working within your tolerance and managing the edema will help with your overall recovery. Talk to your therapist if you have concerns about your swelling.

Who is a perfect fit for hand therapy? Anyone with a finger, thumb, hand, wrist, forearm, or elbow pain, stiffness, or weakness resulting from an injury.

Why is Premier the best place to go for hand therapy? We have top-notch people working here at Premier! Our goal of getting you back to life is our number one priority. Our hands-on, one-on-one approach can’t be matched by any other clinic. Our dedication to keeping up with the latest treatment techniques while providing research-based approaches can’t be beaten! Come check us out!

Are you ready to make pain relief in your wrists and hands a priority?

Give us a call to set up an appointment at any of our three convenient locations today!

Cape Girardeau 573-335-7868 | Jackson 573-204-7868 | Advance 573-722-9999

June 6, 2019