Hand care, support and exercises

Amanda Johnson and Theresa Vaughan, Working Hands.

After a lovely lunch, our speakers were Amanda Johnson & Theresa Vaughn from Working Hands. They talked about Hand Care/Support & Exercises.

Amanda and Theresa brought a whole bunch of products to show us and also gave us a bag of goodies to take away.

They talked to us about Hand Therapy for Scleroderma and covered a whole range of topics.

Typical Symptoms

  • Painful and Stiffness of the Joints
  • Swelling or puffiness of the hands
  • Sclerodactyly and Joint Contractures
  • Raynaud’s Phenomenon
  • Ulcers/sores on fingertips
  • Calcinosis

They talked about joint protection and the ways to protect the joints.

Joint Protection

  • Respect pain
  • Avoid prolonged static positions, avoid positions of deformity

Ways to Protect the Joints:

  • Avoid tiredness by:
    -Plan ahead and set priorities
  • Maintain muscle strength and joint range of motion
  • Use larger muscle groups
  • Use Adaptive aids
  • Splints

They talked and showed us different splints for hands and how they were used. They sent around the splints so that we could all have a try.

They talked about Adaptive aids and brought out some, which were handed out for members to try.

Examples of Adaptive aids

Spring loaded scissors, so that when you cut down they spring back, similar action as secateurs.

These scissors save on time and are so helpful for sore hands or joints as you don’t have to put in so much effort.

Skin Protection

  • Keep the skin moisturised. Any good cream will do.
  • Avoid Deep Heat and Tiger Balm.
  • Use Gloves to prevent trauma to the skin

Raynaud’s Phenomenon

Amanda showed a slide that had products that could assist keep the hands warm.

  • Wear gloves
  • Heating Hands
  • Use Hand warmers when outside

My favourite was the USB Heated gloves that plug to your computer / laptop, while working.

There are even USB heated gloves that come in a Toast shape!

Cutting Nails

  • Soak nails first
  • Remove dead skin around the nail with exfoliants, files, and pumice stones.
  • Use Adaptive aids (if you have difficulties cutting your nails).

Tips on exercising

  • Warm up hands before exercising them
  • Heat + /- massage
  • Do little and often
  • Symptoms to aim for: –
    • Stretches – moderate pulling feeling
    • Strengthening – slight fatigue
  • Symptoms to avoid: –
    • Never – long lasting pain 
    • Swelling

Exercises for the Hand

The primary goal is to preserve:

  • MCPJ flexion (bending)
  • PIPJ extension (straight knuckles)
  • Webspace
  • Lateral pinch (MPJ flexion of the thumb, in order to hold things and turn e.g. keys)

Monitor Range of Movement

  • Finger Extension
  • Finger bending and straightening
  • Finger /thumb extension and spanning out

Strengthening Exercise

  • High repetition, low loads (endurance vs big muscle bulk)
  • 1-2x/ day (recovery time)

Summary (Hand Therapy Goals)

  • Moderation is key
  • Maintain maximal ROM (Range of Motion) MCPJ flexion, PIPJ extension and thumb abduction.
  • Prevent unnecessary contractures; e.g. wrist/elbow
  • Maintain Lateral Pinch
  • Improve functional ability & reduce hand pain
  • Encourage optimal skin care
  • Promote circulation / blood flow.