♪ Bob and Brad, ♪
♪ the two most famous ♪
♪ physical therapists ♪
♪ On the Internet. ♪
(clapping a rhythm)
(clapping a response)
- All right there, you got it.
Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together, we're the most famous physical therapists
on the Internet.
- In our opinion, of course Bob.
- After a cast removed from hand and wrist,
these are the best five stretches for success.
- Yeah. - I wish that rhymed somehow,
but it doesn't.
(laughs)
- Well, I'm not a poet Bob.
- By the way, if you're new to our channel,
please take a second to subscribe to us.
We provide videos on how to stay healthy,
fit, pain-free, new upload every day.
Also, you're gonna wanna join us
on our social media channels because yes Brad,
we are always giving something away.
- There ya go.
- If you go to bobandbrad.com,
and go to our giveaway section,
you'll see it there, or if you go to Facebook, Bob and Brad,
it's always pinned to the top of the page.
We're giving away the Pro Slant right now.
This is a foam device that you can use
to stretch your calf and your achilles tendon.
And you get two of 'em actually, and they're nice!
They work out really well.
I've mentioned before in other videos
that my wife has one below her desk
and she's using it to stretch out her calves
while she's working.
- There's gonna be people across the nation,
- Across the nation.
(chuckles)
- Having these under their work station,
stretching out. - That's right.
- It's gonna be the late next fad.
- There we go.
- Anyways, so we're gonna talk about wrist range of motion.
- And finger. - Right.
It's been a couple years since we did a video on this,
and what really got me going on it was I just started
working with a patient the last month or so.
He was 73 years old, out in the woods working his chainsaw
and it got away with him, and the chainsaw buzzing away
at full speed went right across his palm
- Oh, jeez. - and opened it right open.
He was all by himself, I mean, this is a little bit
of a story we're gonna offer you,
- Right. but he wraps it up with a rag,
jumps on his tractor and drives to his farm,
nobody home. - Ohh.
- He jumped in his car, drives
to the clinic, the local clinic.
They say, "We can't do anything with it."
They send him to the hospital 30 miles away.
They say, "We gotta send you to Mayo."
(laughs)
- Oh good Lord.
- So they put him in emergency
(laughs)
- Wow. - in an ambulance
and he drives 70 miles to Mayo.
- Wow. - And anyways,
he was casted, it was just, he brought pictures,
he was kinda proud of it, wide open,
cut through tendons, did not get to the bone.
They sewed him up real nicely and put him
in a cast for eight weeks.
- So this isn't blood, you just have, you're marking--
- Yeah we'll get into that, so--
- Show you what that is later.
- So we had the ultimate contracted hand--
- So he was like this, basically.
- Not quite a claw, he was about like this.
- Okay. - See, the cast kept him
from going like that. - Gotcha.
- But he was tight and there was dead skin
and it was just not a real pretty sight.
- Okay.
And now actually it's about six weeks later,
he's doing much better but he's got a ways to go.
But these are some of the stretches
that worked for him and they're gonna work for anybody
and probably most people are not gonna have
this tight of a hand as this gentleman.
- Yeah, you've got some good ideas here Brad,
kinda as a transition. - So,
the first thing is let's get the fingers first.
- Sure.
- If your fingers are tight and you cannot extend 'em,
so extending is going up and back.
- Straightening. - Yup.
- Basically straightening. - There ya go.
So you wanna work each finger individually
and actually you may work each joint.
So you can see that, I'm not gonna go through every finger
because they all have the same number of joints,
but you try to get each joint and each finger
at least to neutral, which is straight.
- Right. - You know,
and this may take a week or may take even longer than that,
or it may come sooner, but you wanna work
each finger so you can get it straight.
And then the thumb's a little bit different,
it has one less joint, so you work here,
and then you work here, and this is pretty important
for the thumb, this right here.
So, make sure you get that, and then, the wrist.
You're gonna want to get the wrist moving,
- Sure. - and it's nice
to put it on a table. - Go off the edge.
- Yeah, and then don't worry about the fingers
and do the wrist as you can.
- So he's going into flexion,
- This way. - and also
stretching it to extension.
- You're right, yup.
- And the extension is critically important, critically.
- Right, yeah. - I mean,
if you're gonna grip things again,
you need to have full extension.
- Yeah, and it'll work both ways.
Hopefully it all comes, it depends on your injury,
if it was at a wrist, hand.
What I've found is the next step I always used to do
is to put people on a table and then kind of see
if they can flatten out this way.
- Mm-hmm.
- [Brad] Well, if you're too tight
that's too much, too soon, it just didn't work
for this gentleman at all. - Sure.
- [Brad] So we took something soft, you can use a flat ball
that's kind of flat.
- [Bob] Sure.
- [Brad] Put it on there so it kinda naturally
goes right on there.
And then you push right into your middle knuckle
with the other hand and see how that--
- [Bob] Show it from the side, Brad.
- [Brad] Yeah, so you can see it
gradually pushes into extension,
- Right. - as opposed
to how abruptly you are on a hard surface.
- Right. - So,
this is kind of a neat idea, using a soft surface
to help stretch there. - Yeah.
It has give, so you can actually do mobilization.
The one, and two, three-- - Yeah!
I can see how that - And the fingers sink in!
- [Bob] would work out really good!
- [Brad] If you don't have that, you could use a pillow
like this, we've got our Good Day pillow--
- [Bob] Flip it this way so you can see what you're doing.
- [Brad] There we go.
We'll put it on here, and you do the same thing.
The pillow gives it so it's not so aggressive
and it's a little more tolerating.
And you're gonna work that until you can get down
to a firm surface-- - So I could see this
actually, even after someone who's had a stroke.
- Sure. - And they have a spastic hand
and they're going into flexion.
That would be a great way to gradually get into extension
that way too. - Right.
- [Brad] Exactly, so this is not just for casts.
No no it's, - Casts are rough.
- [Brad] Anybody who's really got a tight hand.
I would say.
- [Bob] Sure.
- [Brad] If they're allowed to stretch it,
go ahead and do this.
And of course while you're doing this you're going
to work some active range of motion.
But the next one is something that,
particularly the lay person probably would not
think of.
- [Bob] Be aware of.
- [Brad] Is the joints here, the metacarpal,
phalange joints.
- [Bob] Yeah MC.
- [Brad] The knuckles here that make the fist.
- [Bob] The big knuckle.
- Yep.
Between these bones there should be movement.
Now I'm gonna put this down,
this is why I have the red on my hand.
I'm gonna try and stabilize this knuckle
by putting it right on the edge of this table.
- [Bob] Yeah the table's holding it.
- [Brad] Yep.
And now I'm gonna put a little weight through there.
Now this knuckle I'm gonna grab with
a pincer grip right there and I'm gonna
move it up and down.
Now you should be able to see, hopefully,
that there's movement.
This joint is moving.
This one is stabilized the best I can get it.
- [Bob] Yeah it's moving a little but you can see
the great amount of movement is happening
where you got your thumb.
- [Brad] Right.
- [Bob] Where you're pushing.
- [Brad] So you do that joint,
then you slide over.
- [Bob] Then you get the next joint.
- [Brad] Get the next one.
Over.
And get the last one.
That one I can feel the most movement.
- [Bob] Now you could go to the other side
of the table.
- [Brad] Sure.
Yep we could go over here.
- [Bob] And work it that way too.
- [Brad] Yep.
- [Bob] Oh yeah yeah.
- [Brad] Actually, let's--
- [Bob] That makes a little more sense.
- [Brad] You gotta reach over your body
just a little bit.
But you'll feel the movement there.
And there should be that.
And that helps you with your full total grip.
- [Bob] And that's where the joint tightness occurs,
in the joint itself.
There's a capsule, a tight capsule.
And so that's why you move the individual joints,
you're gonna get better motion over all.
- And of course the thumb, do not forget the thumb.
That's a little easier,
you can grab it here.
And get that movin', the opposing thumb
that's responsible for all your grip and what not.
So don't, make sure you get those joints very,
as much range of motion you can.
And then the last thing,
it's not the complete last thing.
But one thing you wanna get into is functional practice.
- Sure.
- Easy things first.
Fine motor, like playing cards.
- Sure.
- Once you can start gripping and touching here,
you wanna be able to coordinate things.
There may be some numbness and tingling,
scar tissue healing, nerves that are healing up.
Play cards, you can wash dishes, get 'em
in some warm water.
Watch out for the knives.
Get the knives out of there.
- But that's what nice about dishes
because you actually are using the warm water
to heat things up a little bit
so it might stretch a little bit.
I've seen people just take a magazine
- Oh sure. And have to move each page.
- There you go.
- It just adds to, evolves coordination,
tryna move it so...
- Working on a keyboard, shooting baskets.
You can take that ball and you can slap the hand
on it so it splits, spreads it over.
Shooting baskets, making sure you get that
what do you call that?
- That's a jump shot.
- Yeah.
(laughs)
But the wrist motion when you let go of the ball.
- Well you can also just toss a ball back and forth.
- Yep right.
- You're getting wrist flexion and finger extension,
add that too so.
- You know, go out and weed the garden,
all these things are gonna be very helpful.
- My wife's gonna hope that I hurt my hand
so I'll do the dishes
(laughs)
and weed the garden.
Do all the things--
- We can take care of that.
- Yeah we can take care of that so...
- All right well very good.
Good luck with your getting your hand
back to normal motion
and weeding the garden and doing the dishes.
- Say noir.