An occupational therapist specializing in hand therapy, Cindy Hartman, describes common hand injuries and preventive treatment options.
The eyes may be the windows to the soul, but it has also been said that the hands are the instruments of our intelligence.
But we often take for granted how much we use and abuse our hands daily.
“I hear people all day long say that they didn’t realize how much they use their thumb or hand or wrist until they have problems with them,” says Cindy Hartman, Occupational Therapist specializing in hand therapy for Great Basin Orthopaedics. “They realize that once they lose function in a finger or can’t bend their wrists, for example, they have a hard time working. And that can be devastating.”
She says that with the onset of springtime in Reno, she begins to see a lot of people wanting to get back into performance mode.
“Many people have had symptoms for months,” Hartman says. “Then it’s almost spring, and they want to get to their favorite activities, but something hurts. So they want to address it.”
Repetitive strain injuries
Among the most common things affecting the hands: lateral epicondylitis — more commonly known as tennis elbow, which she says often happens with repetitive use of the wrist while gripping something like a tennis racket. And thumb strain like De Quervain's tendinosis, which is an injury to the tendons on the thumb side of your wrist causing pain when you turn your wrist, grasp anything or make a fist.
“These are both repetitive strain injuries,” she notes. “Especially with something like De Quervain's, it’s fairly common in young mothers who are lifting their children a lot, and can even be caused by texting and using our phones all the time.”
In order to prevent these fairly common hand issues, Hartman recommends varying positions and activities constantly, even how we lift our children (for example, switching the hand used for lifting up a car seat).
Another repetitive strain condition treated at Great Basin Orthopaedics that she sees less commonly on the therapy side: carpal tunnel syndrome.
“These patients usually end up with one of our physicians, who will assess the severity of the symptoms,” she says. “The reason I don’t see as many of these patients is that these days, it’s a simple endoscopic surgery with a tiny incision, meaning recovery is fairly easy. Our doctors can certainly refer to occupational therapy, but if it’s progressed, surgery is probably the best option.”
She says carpal tunnel symptoms often begin in the fingers or wrist, sometimes moving up through the arm or toward the neck.
Because this is another repetitive strain injury, Hartman recommends preventive measures before these conditions become worse.
“Good ergonomics is definitely the no. 1 recommendation,” she says. “If you have an office job, make sure your computer work station is set up correctly – which I say loosely, because really the best thing is to vary your position frequently. If you are sitting some of time, then stand some of the time. And always try to keep hands in neutral position, which means your wrist doesn’t bend while you’re typing or mousing.”
She also recommends frequent breaks if you’re constantly in the same position, performing stretches intermittently of neck, shoulders and arms.
“One of my favorite recommendations for hand health may seem odd, but drink lots of water,” she says. “This way, you have to get up often, because you’ll need to take bathroom breaks. Repetitive motions will eventually take their toll on your body, so do everything you can to interrupt those repetitions.”
And if you have mild symptoms or hand pain, you can even help your hands while you’re sleeping, she adds.
“If you have pain in the hands or wrist, our doctors might recommend sleeping with a brace. People don’t realize how much they move their wrists while sleeping. But if you wear a wrist splint while sleeping, it’s completely at rest for hopefully eight hours minimum, then you can tackle the rest of the day with a well-rested wrist.”
Don’t ‘fall’ for these hand injuries
She says the bulk of her hand therapy has to do with fractures or ruptured tendons – post-injury, post-operative therapies. And these injuries tend to happen during the warmer weather months, when people are outdoors and engaging in sports or activities.
“Most everything I’m treating is some kind of fall,” she says. “So the best preventive advice I can offer: Pay attention and make sure hands are in a good safe position. Be observant and aware of what’s going on around you, but if you do fall, think of a good way to fall before it happens.”
She acknowledges that accidents happen and that how we react during a fall is often reflexive, but for individuals practicing extreme sports, she thinks athletes should drill for falls just like they drill for success.
“If I’m riding a mountain bike, for example, I should tuck and roll — not throw my hands out in front of me,” she explains. “If you think it through beforehand, you may be able to prevent a more serious injury from happening.”
But it’s not just extreme sports that require planning: “Don’t walk with a phone in your hand while going downstairs,” she says. “Texting and walking don’t mix.”
Her other big advice for hand health: If you sustain a hand injury, see a hand specialist.
“The second you hurt yourself, and think, ‘Oh, I just jammed my finger or sprained my wrist’ – the second you ‘just’ did that — go to a hand specialist,” Hartman says. “The hand is so intricate and complicated, and there are so many little ligaments and tendons, that if you don’t do the right treatment right away, there can be long-lasting consequences. A hand specialist can treat it early to prevent those long-term effects.”
Looking for a hand specialist? The physicians at Great Basin Orthopaedics can assess you and provide treatment options, including physical therapy, so you’ll have the knowledge you need to make an informed decision about your care. Contact the team at 775-786-1600.