- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapist
on the internet.
Well, in our opinion, of course, Bob.
But what's the topic today?
- Brad, today we're gonna talk about,
I say decar-veins.
- It's really DeQuervain's.
- DeQuervain's. I think he is closer to saying it right.
- Whatever it is, what, what are we talking about?
- Brad, this is a tendonitis or tenosynovitis,
- Ooh.
- That actually occurs right at the base of your thumb
or along the radial side of your forearm.
So along in here.
Quite often this comes from overuse of the thumb,
so texting.
It's also called Blackberry thumb
but nobody uses a Blackberry anymore.
- Yeah, it's outdated.
- So we just call a texting thumb. Sorry, Blackberry fans.
The other thing is like, if you use scissors a lot.
- Yeah.
- Hammer a lot.
- Sure.
- Did you wanna show your wheelchair Brad?
- Yeah.
When people push lot of wheelchairs around
and here we got our patient right here.
How're doing big guy?
But when you push here and you're pushing
especially if you over bumps and stuff
that part of your wrist is really getting stressed.
That tendon, takes a lot of stress.
And that's repetitive stress on the wrist from little things
like texting to something like this pushing.
- Right. I got it, Brad, one time when I was a waiter
when I was in physical therapy school,
and I'd carry plates like this
and I had to learn to carry it this way
because it was stressed out.
- Yeah.
- So that's one thing you can do is obviously
take the stress off the area.
There's splints or braces you can buy
that are at Walmart that kind of go over the whole wrist.
But that's not what we're talking about today, Brad.
We're gonna talk about actual treatments for it.
So you can also ice obviously.
- Right, if it's an acute phase, that's very sore,
you're gonna splint and, and ice probably.
- Yeah. And we just did a, a video on ice massage so,
- Great.
- So let's say we're gonna treat this one.
You're gonna treat this one yourself.
The thing that you want to try is you wanna try to do a
cross-fiber friction massage.
I'm gonna show you this very simple,
big words, but really, really very, quite simple.
Get your hand so that it's in a
slightly flexed, bent position like this.
- Yeah. Here's flex. This is extension.
We want it down.
- Right. Just get supported, you know,
just like I support the Vikings
- It's how it's supposed to be.
- You support me.
Alright. So you're gonna take your, your fingers.
You can go one over the other or two, right, right.
Side by side.
Alright And you're gonna find the, the tender spots
and I'm gonna go right across it like this.
Now you're gonna start off very light.
And if this is just too much,
and if you're doing this and it starts getting
worse and worse and worse and worse,
you still gotta ice then.
- Right.
- Ibuprofen, all these things that can help
calm the inflammation down. It's too soon for it then.
- Right.
- But if you can tolerate it
you go ahead and you start rubbing across the area.
- And how do they know what area?
Where, how can you find it?
- You find the area of tenderness, but quite often
what you're gonna see here is,
I know can you pick that up, Nancy?
That's the anatomical snuff box they call it right there.
They call it snuff because they used to put
powdered tobacco in there and people would sniff it off.
- This is like about a hundred years ago or so.
- Maybe it was in your day, Brad. I don't know.
- Oh no.
- But we got, I don't remember all the muscles,
but extensor pollicis longus, extensor pollicis brevis,
extensor er abductor pollicis brevis, I believe.
- They don't care about that.
But these tendons here and here,
- Right.
- Really, this is the one that's probably gonna be
the one that's the more as far as my understanding
with this particular,
- there's two right there. So,
- Right. Yeah.
- Alright. So again, you're gonna rub right across it.
You can rub a long time. Brad,
if it can tolerate it, you can go,
believe it or not, Cyriax.
actually used to go for 20 minutes.
- Yeah.
- But obviously you probably won't have
that much amount time.
It's a good one to do when you're sitting and you know
idly waiting somewhere and, and you're getting pain in that
that thumb to start rubbing across
and you can go very hard after a while
and you can also go further up here if it's
if it's up in, up in here.
- Sure.
- Alright, let's go into the first exercise.
- I'm only going five minutes myself,
I'm not going 20 minutes.
- Okay. Old, old man, Cyriax, Father of Orthopedic Medicine
used to say 20 minutes.
- Okay.
- Alright. So the other one you're gonna do,
you're actually, again
have some support here and you're gonna put your thumb,
this by the way, is the test.
- Yeah.
- If you, if you want to know if you have...
- DeQuervain's
- DeQuervain's, what you do is you put your thumb
in here and you bend the wrist this way.
And I'll tell you, you will have pain if, if that's
if that's the case, but this section would be the treatment.
What you do is put your thumb in there
and you're gonna bend it
to the point where you feel the pain
and then you're gonna lift the thumb up and go up like this.
- So you, are you gonna go into the pain or just to it?
- Bump up against the pain.
- Just a little bit.
- Bump pain.
Up.
Pain.
Up.
- So we're just stretching those injured tissues.
- Yep. Up.
- A little bit.
- Pain.
Up.
- Pain is the guide. No sharp pain.
- Even rub here a little bit while you you're doing this.
Alright. I would do those for at least, at least 10 times.
And you could do that every hour if you want.
That's just how often you could do that.
- Assuming it should be feeling a little bit better, right
As a result of it?
- Right, exactly.
Alright. Later on, maybe a week later,
it's starting to feel better.
I want to make sure it's not gonna come back again.
Or I wanna strengthen a little bit.
Now you can take a weight.
Now this looks like a big weight
but it really is only, it's three pounds.
- Yeah.
- You take a weight.
I'd rather have you take something rather a little bit thin.
I don't want you to take a soup can
you're grabbing too far out with that.
This kind of keeps the thumb in
and what I want you to do, is you're gonna lower the weight
but the other arm's gonna lift it up for you,
- Right.
- It's eccentric strengthening.
So you're gonna hold it, lower the weight, lift it,
lower the weight, lift it, lower the weight.
I'd say a good 10 to 15 times.
- Sure. People that are into the weight room
and really into weightlifting,
they call these negatives as well.
- Yeah.
This does not seem like much weight
but believe me, this, this'll help.
- Yeah. If you're recovering from
- Right, you're gonna feel it.
- tenosynovitis or tendonitis.
But we want get you back to your texting as soon as you can.
Cause Brad, how would we get by without it huh?
- Oh, Bob, why?
- Haha. Okay, take care.
(fun piano music)