Keeping Hands Flexible
by Elaine Sobin, (originally
published in "Scleroderma Voice," 2002 #3)
You simply must fight scleroderma’s
impact on your hands. From my own non-expert experience,
the only alternative is a slow, inexorable progression
to what I saw at a scleroderma meeting: a lovely lady
who had both hands frozen into clenched fists, still
feeling pressure. Fortunately, she had a kind husband
who did everything she couldn’t.
 I’ve
had scleroderma for some 40 years, luckily not too badly.
Except for needing to have my esophagus stretched, my
only problems have been small mouth and curling fingers
on both hands.
When my rheumatologist referred me to a hand surgeon,
my right thumb was under the forefinger, and the skin
on my hand felt so tight over the knuckles it looked
as though the skin would split. Not a vein or bone was
visible. It felt like I was wearing a drying leather
glove, or a giant was crushing my hand.
Paraffin treatments could do nothing for the pain deep
in my palm. The high-powered jets in the Jacuzzi at
my gym penetrated deeply enough, but they may have helped
destroy my CMC joint (below the thumb, at the wrist),
which the surgeon ended up replacing.
Making a Commitment to My Hands
After my joint replacement, I had physical therapy
three times a week for a month. It was minimal, but
my hand liked it.
If I could see improvement with that (I asked myself),
what would happen if I committed myself to all-out warfare?
We owe it to ourselves to see veins and bones in our
hands, a little bending in previously frozen knuckles,
soft and pliable skin, and remission from crushing pain.
Now I exercise my hands one to two times daily. If
I skip a day, the skin starts to harden.
Below I describe my hand routines.
Heat and Massage
I like my heating pad set on high, wrapped around
my hand for 15–20 minutes.
When I was getting therapy at the hand institute,
for massage they used a therapeutic hand lotion. But
my hands love Bag Balm in a green can, bought at a local
feed store. It’s the thickest, gloppiest, most
penetrating cream I’ve tried.
I divide the can into smaller plastic bottles to keep
it as fresh and uncontaminated as possible.
I recommend you massage it into both hands, even if
you think only one hand is “bad.” I was
amazed to find (see below) the pinky of my “good”
hand had less strength than the pinky of my “bad”
one.
Keep massaging and wringing every centimeter of your
hands until you can almost feel it going under your
skin. Take more cream if you need it.
Stretching and Bending Hand Exercises
Perform every motion to the utmost of your capacity,
firmly but gently. If a motion feels useful, repeat
it 10–20 or even 30 times. You say time is money,
and you can’t afford to spend this much time?
Your return on this investment will be more valuable
than money.
Note: Try to alternate stretching and bending
exercises.
- Holding your four fingers with the other hand,
press the fingers away from your thumb. At the same
time, stretch your thumb as far away from the fingers
as possible.
- Try to bend the knuckles on all four fingers at
once, as far as possible, using the other hand to
apply pressure.
- Now try to bend the knuckles on each finger individually,
as far as possible, applying pressure with the thumb
on the other hand.
- Press both hands together, trying to straighten
your fingers at the knuckles. Also try to press each
hand backward at the wrist, as far as possible.
- Keep massaging the flap of skin between thumb and
forefinger.
- Press a couple of fingers of one hand between each
finger of the other hand.
- Stretching your hand from thumb to pinky (as hard
as possible), twirl and stretch each finger with as
much effort as possible in one direction and then
the other.
Exercising with Toys
Note: You can also do your mouth exercises
while you do these.
Balls: I happen to have a pretty stiff foam-rubber
baseball and a beanie-bag-type of squeeze ball, so
I’ll squeeze each ball 60–100 times with
each hand.
Weights: I have the old-fashioned 2-pound
iron dumbells. Bend your arm, holding a weight in
each hand, and curl your wrists only up and down slowly
30 times. Turn your hands facing the other way and
repeat. Then holding the dumbell with two fingers
only, curl the dumbell up and down 30 times; repeat
till all fingers have been used.
Clothespins: Holding a clothespin between
thumb and forefinger, press 30 times. Repeat with
thumb and all fingers. (This is when I discovered
my “good” pinky was actually weaker than
my “bad” one.)
More Ideas for You
Add, subtract and tailor the exercises above to your
own needs.
I try to do some exercises wherever I am. Examples:
- The driver’s wheel in my car is a great place
to press curved knuckles straight; when you are a
passenger you can do the same thing on the elbow rest.
- One of my favorite places is the Jacuzzi because
of the heat and moisture (though I can only stand
it 10 minutes or so). With your palms spread next
to your body, raise yourself by your hands, concentrating
on straightening your fingers. (If this is too hard,
I highly recommend Aquasize or working out with a
“noodle.”) Also, flatten your palms and
try to raise one finger at a time.
If you have the opportunity to work with a good therapist—unfortunately,
I’ve seen and heard a lot of horror stories—you’ll
have a good idea of much pressure you, or someone working
with you, should apply.
I’m still working on refining my routines, and
trying to find what works best for me. For me, as for
all of us, hand therapy is a work in progress. But for
now, I am keeping some flexibility in my hands, and
the crushing pain is gone.
The Scleroderma Foundation recommends that you consult
with your physician before embarking on this or any
other treatment or exercise regimen. |
