- Okay. Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Yes, it's on.
And together, we are the most famous physical therapist
on the internet
- In our opinion, of course, Bob.
- Right, right.
Today, we're gonna talk about Dupuytren's contracture.
D U P U Y T R E N S.
Dupuytren's contracture.
Who's it named after, Brad?
- Baron Guillaume Dupuytren in 1831.
He was a surgeon.
- Right. And so it's been around a long time.
Some notable people that have had it,
You said, Ronald Reagan and Margaret Thatcher.
- Right.
- So, and Bob Schrupp.
And I'm gonna show you in just a minute so you can see
an up close and personal view of Dupuytren's.
- Right.
- So, generally it starts off as
a little nodule or lump on your hand.
And, and you know, some people are concerned about it.
I was concerned.
- When it started.
And, I actually started 25 years ago.
I remember that, you know, at the time, because I was
working with this doctor
and that was 25 years ago and he looked at me,
he goes, "oh, it's nothing to worry about."
And, he told me what it was. And,
but the problem is it just gets worse and worse.
It becomes, it's a nodule.
Then it becomes kind of a cord.
And it starts to affect generally these two fingers,
the ring finger and the little finger.
And it starts to tighten up those cords to the point where
it starts pulling the finger down.
And now I'm gonna reveal it, Brad.
- Yeah.
- So, up to the camera.
So, you can see there it is.
Now, in my case, it really only affected the ring finger.
- Put it at an angle like, no, like this.
- Oh, like this,
- You can see it that way.
- Yeah, that Finger doesn't
I can't straighten it.
- Yeah, I can't go up.
But, now, my little finger does,
that goes all the way up. It's not affected.
It's just the ring finger.
I can't wear a ring on it, by the way,
- Sure.
- which is my wedding ring finger.
But, other interesting things where
it really hasn't affected me that badly.
I have trouble playing basketball.
Because I can't grab the ball.
- Sure.
- with that hand.
I have trouble putting a glove on to some extent.
I can't wash my hair with this hand.
I just do it in one hand.
I can't wash my face with one hand.
Really tough for people who play like the piano
or I think like a flute or something.
- Sure. Right. Oh, yeah.
- In those cases,
they probably really are gonna need to have something done.
What's interesting about this, Brad, is
and we're having this discussion.
My wife and children did not know I had this for 20 years.
And only reason they knew it after the 20 years
is I told them.
- Sure.
- And I don't know that you knew either.
- I'm not sure.
I don't remember, but I noticed it in the videos.
So, I don't know if any of our subscribers
or viewers have noticed it.
What's wrong with that finger there?
- Make a comment below,
but it's also called Viking
- Right.
- Or Celtic hand.
- Right.
- What's interesting is
it often happens in people with Northern European descent,
which I am, German.
Very often male and it is inherited.
- Sure.
- So, okay.
Let's talk about treatment approaches, Brad.
- And as a good teacher, we'll flip up here.
Okay. Here they are. Really, four treatment approaches.
Number one is surgery.
The thing with surgery, it is invasive.
It can be painful.
Two to three months of rehab after surgery.
- Sure.
- Which is a long time.
And you know what?
It can come back. That's it's thing.
And there's no cure for it.
This is basically a disease.
But, generally surgery offers the longest relief
- Sure.
- Of all these four options.
The second approach is called needle aponeurotomy.
I'm sorry, aponeurotomy.
And basically, in that case, all they're doing, Brad,
is taking a needle and going along
it's done in the surgical's office
in a surgeon's office
and they're just breaking up that cord.
- Sure.
- They just kind of work along the surgery
and I watched that. There's a big cut that they make.
- Yeah
- It's a big scar
and this one they're just going to needle
and they're breaking up the cords.
It's a short rehab,
but the one surgeon I watched in the Mayo Clinic,
he said, they don't have studies on it.
But, based upon his experience, about 20 to 30%
or 25 to 30% reoccur within about two years. So,
- Yeah.
- It's not as bad.
- Yeah.
- And, but generally they, it, you know, it does come back.
- Sure.
- The third one, now,
and I just saw an ad for this in the paper, Brad,
a big full page ad.
Collagenase injections.
And the chemical I saw is Xiaflex.
And it's basically this chemical dissolves the cord.
- Okay.
- You know, injection there.
I think it's a one office visit.
You still have recurrence,
but the biggest negative about that is it's very expensive.
- Sure.
- I don't know what each treatment costs
or what, you know, what one procedure costs
but they said a vial costs $3,000. So,
- Don't drop that one.
- Yeah , don't drop that vial. Yeah.
And the fourth approach is the one I've been doing, Brad,
is observation.
In most cases, this Dupuytren's contracture does not hurt.
I saw a few cases where people had itching
or they had some burning pain.
- Sure.
- I've never had any pain.
I can still golf.
That's the most important thing.
If I couldn't golf, I would've went in
and had that procedure
- Oh, yeah.
- Right away.
But I got good grip.
- Yeah.
- And so,
- Like I said, it might be better for gripping.
- Yeah. It might even be better.
I'm already in the gripping position.
So that's kind of where I'm at.
The other thing is,
I'm probably not gonna do anything about it
unless it starts to go to the point where, you know, Brad,
if you look at it now,
if it starts getting down like this.
- Yeah.
- To the point where I can't even
they said it becomes that you can't even clean in there.
- Right. Sure.
- Fungus grows.
- Yeah. That would be fun, Bob.
- Yeah, that would be fun, Brad.
- Your wife will like that.
- Yeah.
Then in that case, maybe I'll have something done, but
- Now with yours, did it, how long did it take
before it contracted to the point it is now?
- I would say probably a good 20 years.
- It just slowly,
- Yeah, it just slowly goes.
I used to try to stretch it,
but they said nothing really stops it.
Sometimes you can do a cortisone shot
and it'll slow it down.
- Yeah.
- You know, it just slows the process down,
but it's been kind of stuck at this level for quite a while.
- Yeah
- So I'm hoping it doesn't get any worse.
- And, it's not painful.
- No, it's not painful.
In the whole scheme of things you can get in life,
I think this is a minor one.
- Right.
- So I'm not gonna worry about it.
- Sure.
- So,
- Now I could be, you know, I could be a packer fan
(Brad laughs)
- So, that would really be a bad thing
- Bring it on, guy. Bring it on.
(Bob laughs)
- All right. If you wanna subscribe,
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- You bet.
(Bob and Brad laugh)
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All right. Thanks