Dear Hannah,
Another alternative to use of thumbs besides elbows: With your hand flat,
lift your third (middle) finger, put the tips of fingers 2 and 4 together,
then rest your third finger on top of the other 2. This makes a triangle of
these finger-tips. To put pressure through this tripod, you'll have to bend
your middle finger a bit. This may take some getting used to, but works.
When you can use a broader surface, use the heel of your hand or even the
outer edge of your forearm. If you need a shrp sudden pressure
manipulation), use hypothenar eminence.
I think that every time you are about to use your thumbs, consider what else
you can use. Try to use your thumbs minimally, if at all. You may want to
consider buying one or more of the devices on the market. I only know of the
"Thera-Press" 800 287-0647. Others on the list may know of more. These
devices work. They don't allow the tactile feedback you get with your
thumbs, but you can get good results with them. You need to preserve your
own joints.
Don't forget to give yourself some Rx that you might give your patients. For
a while I was getting finger joint symptoms which were nicely relieved by
self-administered joint mobilizations a few times per day. Pain-free now.
Good luck. Keep us posted if you need more advice, or if you find something
that works. When you share what works, or doesn't, for you, we all learn.
Sarah Fern Striffler, PT
----- Original Message -----
From: Hannah Pearson Abdullah <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, July 27, 2001 10:58 PM
Subject: Re: SV: Mmmm...
> Dear Henry, Sarah and anna
>
> Thaks a lot for the responses - I seem to be out of the swing of the
immediate
> response category here - maybe its that head wind they always talk of that
makes
> flying to UK half an hour longer than coming back to Kuala Lumpur. (I
must say
> when I see the volume of input I have visions of some of you spending all
day
> sitting in poor postures over the computer for 12 hours!)
>
> I have tried to slow down the use of the thumbs but find it very difficult
in
> some cases - and when I changed to elbow for some myofascial releaaaase
> techniques I feel I may simply be storing up problems in another joint...
>
> I tried splints off the shelf a while back but found it sooo difficult to
do any
> functional things in so may revert to Sarah's suggestion of night splints
only.
> Henry, did you find the knee patients who responded to the joint
infiltrations
> had tried oral glucosamine and choindroitin first or after?
>
> Thanks again.
> Hannah
>
>
> Henry Tsao wrote:
>
> > Hannah,
> >
> > Do you use other techniques that do not involve the thumb? I agree with
> > you... the tapping technique is not effective due to the huge
hyperthenar. I
> > personally have not heard of injections in any other joints apart from
the
> > knee, so I am not sure whether they do it for the thumb, but I have 2
> > patients who are big believers in it in the knee joint.
> >
> > My best bet for you is to use a variety of techniques involving other
> > fingers, and reduce the dependence on the thumb.
> >
> > Henry***
> >
> > >From: Hannah Pearson Abdullah <[log in to unmask]>
> > >Reply-To: - for physiotherapists in education and practice
> > ><[log in to unmask]>
> > >To: [log in to unmask]
> > >Subject: Re: SV: Mmmm...
> > >Date: Wed, 25 Jul 2001 09:36:30 +0800
> > >
> > >After 20 years of mainly manual therapy clinical practice I went
through a
> > >phase
> > >of DeQuervens-type soft tissue inflammation and pain on both thumbs
arouond
> > >three years back which used to settle if I rested or strapped them but
this
> > >past
> > >year I have been suffering from CMC joint pain with huge joint signs
> > >-nothing on
> > >XRay and the fact it got musch worse during pregnancy made me think of
> > >ligamentous instability. With the Mulligan idea of correcting the
position
> > >of
> > >the joint I can get instant pain relief but find it absolutely
impossible
> > >to
> > >tape in that position (something to do with the chunkiness of the
> > >hyperthenar
> > >muscles, I'm sure!)
> > >
> > >Has anyone any idea of how to keep the MC into a laterally rotated
position
> > >during life in general, let alone work? Short of stapling something
into
> > >deeper
> > >tissue/bone and yanking it back I'm at a loss but think I have a good
20+
> > >years
> > >left in me for work if only I can get my thumbs to last that long!
> > >
> > >The other thing I was considering was getting those
> > >hylacen/glucosmine/chondroitin infiltrations they do in early OA knees
int
> > >the
> > >joint space. Has anyone had any expereince with any similar
> > >preventative-type
> > >interventions? Or glucose injections into the ligaments to try and
reduce
> > >any
> > >instability.
> > >
> > >Any thoughts? I should really appreciate as I'm out on a limb here in
> > >Malaysia
> > >and havent come across any other physio with this extent of problem.
> > >
> > >Thanks.
> > >
> > >Hannah
> > >
> > >"Neumann Isaac Rutger, Granheim" wrote:
> > >
> > > > Nothing, Sarah, that's the strange thing. The only stressing thing I
do
> > >with
> > > > my thumbs is pinching my patients when don't work hard enough,
hehehe.
> > > > Do you know about any orthoses or stuff like that I can wear?
> > > >
> > > > Isaac
> > > >
> > > > -----Opprinnelig melding-----
> > > > Fra: Sarah Fern Striffler [mailto:[log in to unmask]]
> > > > Sendt: 24. juli 2001 13:40
> > > > Til: [log in to unmask]
> > > > Emne: Re: Mmmm...
> > > >
> > > > Isaac,
> > > >
> > > > What stresses do you put that jopint through, during your daily
life?
> > >For
> > > > example, do you weight-bear on it, say by deep massaging with the
thumb
> > >in
> > > > full extension?
> > > >
> > > > Sarah Fern Striffler, PT
> > > >
> > > > ----- Original Message -----
> > > > From: Neumann Isaac Rutger, Granheim
> > > > <[log in to unmask]>
> > > > To: <[log in to unmask]>
> > > > Sent: Monday, July 23, 2001 2:24 AM
> > > > Subject: Mmmm...
> > > >
> > > > > Hello All,
> > > > >
> > > > > My aunt (retired fysio) told me a funny story about low-back pain.
> > > > >
> > > > > One of her friends (also ex-fysio) had been having backache for
some
> > >time
> > > > > and decide to go to a PT. It didn't help much however. Then she
went
> > >to
> > > > > another and another and a manual therapist and an osteopath etc
etc.
> > > > Nothing
> > > > > seemed to help. Then - by accident - she told her local opticien
(guy
> > >that
> > > > > sells glasses) about her backache. He told her that her new
glasses
> > >might
> > > > be
> > > > > the problem. It appeared that her walking-pattern was slightly,
> > >slightly
> > > > > different when she didn't had her glasses on.
> > > > > She decided to test this theory by wearing her old glasses. Guess
what
> > > > > happened...: abracadabra... the backache releaved.
> > > > > After this she bought another model glasses and now everything is
> > >fine.
> > > > >
> > > > > Isaac
> > > > >
> > > > > PS: My thum hurts like hell in the metacarpo-phalangeal joint. It
> > >seems to
> > > > > overextend a few degrees. What can I do except for being careful,
> > > > > strenghening exercises, etc?
> >
> > _________________________________________________________________
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