Thumb Metacarpophalangeal Joint problems

[Ava is Beastin!]

I had an interesting case present the other day, and was wondering if anyone has experience or recommendations.
Client presented with pain in both hands, and the left mostly. She has been a programmer for 25+ years, and the left thumb is used very frequently. The thumb metacarpophalangeal joint is enlarged and the thumb is adducted with a hypertonic abductor pollicis brevis. The opponens pollicis is almost nonexistent. She has lived with this condition for so long that there is likely permanent joint deformation. (Press down on your space bar with the side of your thumb, to get an idea of how her thumb is at rest.)
I'd like to release some of the tension for her, and recommend some exercise. Any ideas?

Darren

 

[Ayameko]

any other joints with swelling or pain, could be arthritis. If not sounds like overuse and there has been a change in the tendon and surrounding musculature. Massage to and around the area will help as long as it does not cause her pain. Plenty of stretching the fingers, and wrist extension exercises. A good one is to put a rubber band around the tips of the fingers then extend them...good luck

 

[dalehughes3]

We all see many clients with less severe variants of this condition every day, it simply may not have come to this level of dysfunction. I treat a variety of hand (and foot) problems by giving compression style releases to the entire involved area. Somewhat like Upledger's "Direction of Energy" releases, you simply put one of your hands over the area, and one under, cradling the hand. Gently compress your hands together until you can begin to feel the tightness. The client may feel some light discomfort in the area or other areas. Maintain this compression through a number of releases. I will often spend a good deal of time in this phase. After things have quieted, with the client's palm facing upward, gently grasp their hand with one of your hands holding the ulnar side of their palm and the other grasping the thenar eminence. Gently spread the palm apart while simultaneously tractioning the entire arm. Again, spend time with this. Follow the releases and motion three dimensionally.

While arthritis may be present, it is nearly impossible to distinguish between the pain of arthritis and the pain created by a restricted myofascial system unless you take one out of the picture. Very often doing work like I described above will greatly decrease the client's pain and improve their functional abilities, despite the presence of any arthritic degeneration. Take your time, feel inside the hand, and go with what you feel.

 

[MEZA!]

Thanks Walt,

It's reassuring to know I was going in a similar direction.

Darren