My Internist is sending me to OT for hand strengthening. My three affected fingers, 2 on one hand, one on the other have not started to contract, may never.

Does anyone have any experience with OT at this stage. I do not want to do anything to trigger contracture. After getting DD in April prior to a rolfing session I am a bit leary of anyone working on my hands.

Loonsong

Lori,

Did you try Occupational th. before contracture? I know most people have it afterwards.

I am very wary of anyone working on my hands since the rolfer caused the trauma that trigger the DD. My hands are very weak.
I need a vise grips to open a simple small bottle of water and this has been for some time. The pain when I try and force open lids is very severe. Even those childproof med caps are impossible for me to remove. I have started trying to get other people to open them for me. I order my meds online and they will only ship with that type of lid.

Don't know if there is anything they can do to help with hand strengthening, I thought a PT once said I was strong, maybe she was testing other muscles.

Unless I get a lot of response here telling me otherwise I am going to at least try it and see, I can always stop.

Loonsong

Edited 02/02/11 07:02

Just so happens, I am an OT. I worked several years as a Certified Hand Therpaist, prior to staying home with kids. Now, I find myself with L.D. and D.D.
Most patients I treated, were post-operative. They all had great immediate results (required splinting, scar management, etc), but I have no idea about long term outcomes.
I saw a few patients for conservative management, trying to avaoid contractures/surgery or manage the inflammation. I used massage, ultrasound, phonophoresis and iontophoresis of steroidal agents to decrease inflammation. Massage sometimes did decrease the tethering of cords to the skin. Nothing slowed nodule growth. Unless thoughts have changed, stretching is not good, and can actually worsen the situation.
I really wish I had asked more questions and kept a journal! Never ever expected to be the patient, instead of the therapist.
My diagnosis was by MRI, because I had a different type tumor in my great toe, in September. They were checking a new growth, and it turned out to be L.D. (just last week). MRI showed inflammation and arthritis as well. The following night, I woke with hand pain (drawing sensation) and in the morning, could already see a cord in my left hand. There is visible inflammation and lots of burning/itching.
I asked the MD (orthopedic foot specialist) about iontophoresis, and he thought this was a good plan. Being a therapist, I will procure what I need, and treat myself. I'll try to post how well it works for me.
I hope this information helps answer your questions..

marjorieb:

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Just so happens, I am an OT. I worked several years as a Certified Hand Therpaist, prior to staying home with kids. Now, I find myself with L.D. and D.D.
Most patients I treated, were post-operative. They all had great immediate results (required splinting, scar management, etc), but I have no idea about long term outcomes.
I saw a few patients for conservative management, trying to avaoid contractures/surgery or manage the inflammation. I used massage, ultrasound, phonophoresis and iontophoresis of steroidal agents to decrease inflammation. Massage sometimes did decrease the tethering of cords to the skin. Nothing slowed nodule growth. Unless thoughts have changed, stretching is not good, and can actually worsen the situation.
I really wish I had asked more questions and kept a journal! Never ever expected to be the patient, instead of the therapist.
My diagnosis was by MRI, because I had a different type tumor in my great toe, in September. They were checking a new growth, and it turned out to be L.D. (just last week). MRI showed inflammation and arthritis as well. The following night, I woke with hand pain (drawing sensation) and in the morning, could already see a cord in my left hand. There is visible inflammation and lots of burning/itching.
I asked the MD (orthopedic foot specialist) about iontophoresis, and he thought this was a good plan. Being a therapist, I will procure what I need, and treat myself. I'll try to post how well it works for me.
I hope this information helps answer your questions..

Edited 02/04/11 21:17

marjorieb:

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Hi marjorieb,

Thank you for your share. Again I have NON contracated DD.

I have not heard anything recent (I am fairly new here) about treament with iontophoresis (but did find a link to here when I visited the web back to postings in 2002 I believe it was). I wish you well with your treatments keep us posted.

I had my second and last visit with OT. She had me put small ball of the putty betwen[i] each finger alternately and squeeze and this was very hard to do.

I am wondering if this side stretch of the fingers is also not good for DD inflicted fingers?

I have [i]not done the exercises at home like she suggested until I hear back from the forum. I don't want to make anything worse.

Then also on my right hand I can not bend my fingers all the way down towards my palm (keeping them straight in line with the palm). She said it is just tight muscles and proceeded to manually push them down.

My question being do I want to force a finger toward my palm? This is what happens in contracture I am not sure I should mess with it. She said it was safe to do.......

Maybe I should start a new thread for this?




Loonsong,

Sounds like the therapist is trying to maintain your hand strength. Squeezing the putty between your fingers (I assume you mean you are placing your hand on a table top, putty between each, and bring fingers together) will maintain the strength of the 'intrinsic' hand muscles. Putting a 'ring' of putty around your fingers and spreading them apart is also strengthening. This will not effect the disease process in any way.
What you do not want to do is stretch your fingers into 'dorsal extension', an example would be if you put one palm against the palm side of your opposite fingers, then stretch your fingers away from your palm, toward the back of your hand. This can increase the tightenning of the fascia/cords.
Can you clarify, which joints won't baned toward your palm? Gently stretching the muscles which straighten your fingers (by gently bending them into your hand) will not make things worse.
It's hard to know, from your post, exactly what she is targeting. Did the MD send you because of weakness, since you have no contracture?
Ionto/phonophoresis are for treatment of inflammation/pain, not contracture.

Hope this helps some. If your therapist is a Certified Hand Therapist, she should have knowledge of what is correct therapy. The safest rule is that if it causes you pain, you shouldn't do it, ESPECIALLY stretching.

Feel free to message me, if you would like.

Beth

Edited 02/05/11 00:32