♪ Bob and Brad ♪
♪ the two most famous ♪
♪ physical therapists on the internet. ♪
- Hi, I'm Bob Schrupp, Physical Therapist.
- I'm Brad Heineck, Physical Therapist.
- Together we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- He's on a higher stool than I am
just in case you're wondering.
Okay, today, Brad we're gonna talk about
how to stretch your hand
after you've maybe had a wrist fracture
and it's tightened up on you
and you have a contracture
and now you want to get it back to normal. Right?
- Right. So you've had the the fracture in the wrist
and you've had it casted probably for four to six weeks.
And after you take the cast off,
if you've had this or you're going through this,
you know, it's like, you can't do this. It's stiff.
And sometimes it gets what we call contracture
where things are just tightened up.
And it takes a number of days and weeks sometimes
to get that hand to open up.
- To get back to where it was.
- So if you're in that situation right now
this is the way I treat my patients with this.
And it works quite well
is I'll have them go, finger at a time.
Instead of trying to stretch the whole hand,
one finger at a time.
- For the stretch.
- Right, versus four tendons, you're doing one.
And I just take your good hand and I tell 'em just
work it sometimes just one joint at a time, or
- I'll go from the side.
- Yep. And I'll work it there.
So we're just trying to straighten that finger out.
And sometimes I'll work the end,
and it kind of depends on the person,
or we'll work up into this joint.
And it really depends, it varies person to person,
but it's one finger at a time.
- One thing that you're doing automatically, Brad,
without even thinking about it,
is you're putting your hand on the joint.
- Yeah.
- And then pulling up, see, there's, you know
three joints here.
- Right.
- So you put his hand, pulled up.
- Sure.
- Hand pulled up, hand pulled up.
- Yeah. Yep.
- So.
- And, if you're contracted you won't be able to do that
but as it gets better, that's when that concept,
you get a leverage in, there comes on better.
You may just end up going like this at first.
And as it works and do one finger at a time.
- Yep. One finger at a time.
- Yep.
And all the way to the pinky finger.
And once you get all the fingers starting to loosened up
and one thing that works good for this Bob too,
is I'll say try and wash the dishes, but no knives,
just the warm water just, or put it in warm water.
- Sure. Any movement, and you got warmth.
- Yep. You got the warmth and there a hot pack can work
assuming there's no swelling and redness already.
And then, once the fingers start to open up
then I'll go into this where you take the other hand,
and I call this the spider on the mirror effect.
Because it, you know, if you ever have a spider
on the mirror, you know, there we go. We got the
- Did you come up with that term?
- No, a patient did.
- Oh.
(laughs)
- I'm not (indistinct) the creator
- A great one, that's a great one. That's so cool.
- Yeah. So you finger to finger
and then you try and work and stretch.
- Spider on the mirror.
- Yep, and stretch it like that.
You get a little weight bearing,
so there's a little bit of strength.
Not really, but you know, you can in theory
you could do that for classroom tests.
- I like this technique. That's a great one.
- Or sometimes I'll have them go like this,
and just do this because the wrist will be tight too.
- Sure.
- Once you get to the fingers and the wrist is tight
then that thumb here and stretch up here,
here, and look at my elbows are down.
- You bring it up like this.
- Elbows up works the wrist and the fingers.
The whole goal is to get the hands flat and elbows up
you know, like praying or something like that nature, okay?
- Sure, yep.
- Now, one thing that works nice is to
get some weight bearing through this.
This is an option when it's starting to open up,
put your hand on the table,
and make sure you got a cloth so it slides.
- Are you catching this Lonnie?
Or do you want to get closer?
- I'll do it from this angle right here.
So here we have a little bit of contraction.
The fingers are tight.
I'm gonna take my good hand right over the top.
And I'm just gonna push 'em down.
This may hurt a little bit.
If it's really sharp pain, you're going too hard.
You're not ready for it yet.
- Right.
- But it should be some stretching,
maybe a stretch pain and that's it,
stretch, stretch, hold.
And then I'm gonna lean forward, get my tie out of the way.
And then I'm gonna stretch that wrist out.
- Now, I don't know that I would do this.
If you had a fracture or pins put in the hand,
you know, I mean this is more if you broke the wrist
and the hand got tight as a secondary response.
- Right. The doctor has already mentioned,
and you know, maybe we should mention this right away,
activity as tolerated.
- Right.
- As long as it's not painful, you can go ahead and do it.
- So the doctor has ordered it that way
that you can whatever you can tolerate.
- Right. That's a good point, Bob.
- So yeah, it's good exercise leaning on it like that.
- Great well using your own body weight
with a little gravity, yeah. So what say you, Bob?
- I say thanks for watching
and please subscribe if you haven't already.
- All right, hold on. I want to do this.
- All right, that was funny.
(laughs)