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Is stretching the hand/fingers of any use?
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06/29/07 14:27
Judith_Proctor 
06/29/07 14:27
Judith_Proctor 
Is stretching the hand/fingers of any use?

As my fingers are starting to contact, I'm spending a few minutes each day bending them back as far as I can in order to stretch the tendons.

Will this actually achieve anything useful, or is it just wishful thinking?

06/29/07 18:59
John

not registered

06/29/07 18:59
John

not registered

Re: Is stretching the hand/fingers of any use?

I've had DC in both hands for several years now and as I get older the fingers are increasingly contracting. I plan on having NA by Dr. Pess in Augus. Both hands are still functional but the increasing bending of the fingers makes it hard to clap or pull change out of my pockets.

Anyway, I've had physical therapy on both hands within the last 2 years and I can't truly say it helped. Remember, each person is differnent so it wouldn't help to give it a try. I was covered by insurance so there was no money out of my pocket.

John

06/30/07 10:16
wach 

Administrator

06/30/07 10:16
wach 

Administrator

Re: Is stretching the hand/fingers of any use?

There have been several comments that streching might even be counterproductive. The idea is that the cords develop as a result of a pulling force on the nodule and they develop in the direction of that force. If you strech frequently you pull a lot and cords migth develop faster. But that's just an idea, not proven.

A few patients report that vigorous massaging, i.e. not streching but persistently pressing/massaging the nodule or cord with e.g. a wooden ball, made the nodule softer and in part disappear. It sounds strange that massaging can reduce a tumor but maybe the skin, originally fixed to the nodule, becomes looser and the pulling force on the nodule is reduced. This effect is not at all investigated or proven, just anecdotal evidence for whatever it's worth.

Wolfgang

07/14/07 23:29
leagentilecn 
07/14/07 23:29
leagentilecn 
Re: Is stretching the hand/fingers of any use?

Quote:



As my fingers are starting to contact, I'm spending a few minutes each day bending them back as far as I can in order to stretch the tendons.

Will this actually achieve anything useful, or is it just wishful thinking?


Hi,

I'm new to this forum, live in China, have just had a consultation with Drs. Zidel and Eaton at The Hand Center in Jupiter, FL and found this forum online. In China, two Chinese hand surgeons examined me and indicated that both massage and undue stretching were counter-productive, non-recommended, and to be avoided.

I use two steel exercise balls (traditional Chinese exercise for mind, hand and body health). That kind of exercise is OK, circular movements which flex the fingers in a natural gentle rotation to move the balls around in the hand. Drs. Zidel and Eaton saw no problem with using them. I also do Qigong exercises regularly but will avoid any forceful stretching, which is not a part of Qigong anyway.

I'm also a pianist (classical repertoire, concert artist/teacher) so my hands are also my livelihood. Because the DP is in early stages, I'm waiting and watching before doing any treatment/intervention, but the NA and the new collagenaise (sp?) treatment that is not yet available are my best future prospects so far.

Hope this info is useful.

Godspeed,
Lea Gentile

07/15/07 02:35
jim_h 
07/15/07 02:35
jim_h 
Re: Is stretching the hand/fingers of any use?

I've never accepted the assertion that stretching is counter-productive. Like some other "known facts" about Dupuytren's, I think it's unproven and very possibly wrong.

I've had 2 conventional surgeries within the last 10 years. I now have 2, active, progressing contractures very similar to those for which I had surgery. Feeling I had little to lose, I began fighting those contractures with agressive stretching. I've been doing this for a year now and have stopped further loss of extension. Basically, I have fought them to a draw.

I stretch hard, and long. Many people would not be willing to do this and physicians certainly aren't going to recommend it. I'm not suggesting that others try this. As I said, I felt I had nothing to lose and am determined to avoid more surgery. My contractures are the worst kind - PIP joint involvement and a lot of adhesion.

The contractures I'm holding off now look just like the ones for which I had surgery - except that I haven't allowed them to pull in my fingers.

07/15/07 10:41
newman 
07/15/07 10:41
newman 

Re: Is stretching the hand/fingers of any use?

Hi Australia Calling. I have had l5 or so operations including 4 grafts. Both plastic surgeons recommended that I carry out stretching exercises,but most importantly not to be aggressive as this would be detrimental and could tear tissue.I was told to outstretch my hand on a flat surface ,place pressure on the fingers and lifting the wrist at the same time. The stretch should be slow then hold for 30 seconds and slowly relax,then repeat.I do this even sitting at the table . I still have full use of my hands and full strength. My D.D. is aggressive with raised nodules on the back of my knuckles and some finger joints.I note that you mention collagenase. Have a look at Scotty's note in the "forum.under Australian Experience." He has a link posted 'Auxilium Pipeline " re this product.I was diagnosed at 35yr of age , when I was diagnosed with DD.I carried out the exercises for some l5 yr before I had to be operated on.I believe this has helped.Good Luck .Regards Barry

07/26/07 22:39
kdenkler 
07/26/07 22:39
kdenkler 
Re: Is stretching the hand/fingers of any use?

Hi,
My belief is that if stetching is bad for Dupuytren's, and causes worsening of contractures, then those afflicted with Dupuytren's of the feet would suffer the most, and have horrible contractures.
Instead, those with Dupuytren's of the feet, Ledderhose disease, can develop large, painful lumps in their feet, but rarely have severe, disabling contractures that pull the toenals into the plantar skin. Instead, the constant stretching from every step keeps the toes from significant curling.
I recommend stetching, especially after NA in the first few months, to prevent the raw internal ends from re-connecting, and then a daily maintanence program to fight the curl.

There have been several studies that show beneficial effects from mechanical overstretching

1: J Hand Surg [Br]. 1994 Aug;19(4):528-33.
The palmar fascia after treatment by the continuous extension technique for Dupuytren's contracture.
Brandes G, Messina A, Reale E.

Laboratory for Cell Biology and Electron Microscopy, Medical School of Hannover, Germany.

After complete elongation using the continuous extension technique the palmar fascia of four patients with Dupuytren's contracture was examined by light and electron microscopy and compared with non-elongated samples from 20 patients at the same clinical stage of the disease. Nodules and cords were no longer clinically recognizable after extension. The tissue contained collagen fibrils of uniform diameter (about 50 nm), densely packed in fibres parallel to the stretching force. Fine filaments (presumably proteoglycans) formed a network which was intermingled with and periodically bound to the collagen fibrils. Fibroblasts and myofibroblasts with an high biosynthetic activity and oxytalan-like microfibrils were aligned along the collagen fibres. The results show that in Dupuytren's disease the contracted palmar fascia reacts to external forces with neoformation and reorientation of all tissue components by myofibroblasts.

1: Plast Reconstr Surg. 1993 Jul;92(1):84-90.
The continuous elongation treatment by the TEC device for severe Dupuytren's contracture of the fingers.
Messina A, Messina J.

Hand Surgery Center, Traumatologic and Orthopaedic Hospital, Turin, Italy.

The continuous elongation technique is a preparatory step for excision of the pathologic palmar fascia for severe Dupuytren's contracture of the hands. It consists of a physiologic, painless, and atraumatic elongation that is obtained by means of a device fixed on the fourth and fifth metacarpal bones by two self-drilling pins. This paper presents our experience since 1986 with the TEC device, which we designed and built for severe hand contracture; the device has been applied on 56 hands and 85 fingers seriously flexed by Dupuytren's contracture. This advanced methodology also represents a real alternative to the surgical indication of finger amputation in progressive cases of the fascia retraction, and it avoids necrosis.

11/09/07 22:18
bstenman 
11/09/07 22:18
bstenman 
Re: Is stretching the hand/fingers of any use?

I had my NA procedures done by Dr. Denkler and had heard his comments regarding the benefits of stretching. Personally I have found that what works best for me is to stretch every other day and give my hands an interval to recover so there is not any chance for inflammation to impact the tissues in my hands.

I apply gentle pressure and release to allow the muscles in my hand to relax and then reapply the pressure and increase the amount of deflection. This procedure seems to work the best for me. Doing it every day caused problems with soreness and made it more difficult to fully open my hand (the one with the significant contracture) the next day.

As much as possible I try to avoid repetitive activities or anything that requires a tight grip with my hands for an extended period of time. When I drive I now have a looser grip on the steering wheel and make a point of relaxing my hands and stretching them when I reach my destination.

I think you have to work with your body and find what works best for you. It is a bit of a trial and error process.

11/10/07 14:02
JAnnRunner 
11/10/07 14:02
JAnnRunner 
Re: Is stretching the hand/fingers of any use?

I was diagnosed in 04 with DC in my mid-30's had visible nodules since I was 25 years of age. I was a very active person in what I thought was perfect health! No family history, no hand trauma, not job related, and no other heath issues. I was a avid runner and a track coach . The first info I had read in 04 was not repetitive motion ( my feet were also tight and sore with little mobility in my big toes) In 04 I stopped running much , no weight lifting, I thought that would make it worse. Two failed surgeries in 04 I could not even make a fist after theraphy for a year! I also lost so much strength in my left hand and my elbow started to get tight and my shoulder had lost mobility as well and ached all the time. I could not believe how fast DC progressed in 1 year!! I was depressed and still in shock in 05. Oct of 06 I was tired of waiting for this crazy DC to take one more once of my quality of life! No more anti- inflammitory meds and no more therapy I said at that time. I researched on the net for the best personal trainer in the area I could fine. We started and continued with 2 1 hour sessions a week with strength training , weight- lifting , stretching with weights. I did this until June 07 until I was able to do this on my own. It was the best thing I have ever done for my health! I only have contracture so to speak in the pip joint were I had the 2 surgeries and my ring finger and middle finger are straighter and stronger that they were before I started. My grip is at almost equal strength as my right hand , my shoulder and elbow is better with full mobility. My feet still hurt but have regained mobility in my big toes. ( cords in hand and feet broke during training) And plus I am in the best shape of my life! I am stronger and a faster runner than I was in my late 20's. I am a firm believer in exercise to help maintain DC , when it hits when you are younger you have to what ever you can to stay as active as you can. No more sitting around for me..

08/23/09 22:31
AnneDublin 
08/23/09 22:31
AnneDublin 
Re: Is stretching the hand/fingers of any use?

Thanks for that great info, especially the study!

Best wishes,

Anne

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