• Close up of female hand while playing the piano

    Posted on 6/9/2021

    The first week of June has been annually designated by the American Society of Hand Therapists as Hand Therapy Week. It’s a time for raising awareness of hand, wrist, arm, elbow and shoulder injuries and conditions and the therapists who have specialized training to treat them. This week is also a great time to spotlight the individuals who most benefit from hand therapy, individuals like musicians.

    Playing a musical instrument is emotionally, mentally and physically demanding. Musicians, like athletes, are at risk for career-ending injuries in the neck, shoulder, wrist and hand. In a musicians’ lifetime, 63-93% will experience musculoskeletal symptoms related to their instrument play. Even the most conscientious musician can begin with symptoms or injury at various times through their play and performance season.

    The challenges musicians face are practice and rehearsal patterns established by others (an orchestra conductor, for example) in large segments of time, without rest or stretch breaks. There is also fierce competition for work, and musicians may be reluctant to complain of injury or new symptoms for fear of losing out on an opportunity. Additional injury risk factors include inadequate physical conditioning, poor posture, abrupt increase in play time and patterns, poor techniques or a change in the instrument.

    Symptoms, whether intermittent or persistent, are seen most often when learning to play over the age of 50. In professional musicians, symptoms can present when increasing the complexity or time spent playing.

    Common symptoms include:

    • Pain
    • Muscle cramping
    • Tremors/spasms
    • Inability to control motion
    • Headaches
    • Numbness/tingling
    • Stuck, catching or locking joints
    • Inability to straighten fingers

    Hand therapists have the important skills needed to evaluate musicians and identify abnormal sensation, poor posture and other causes of symptoms.

    A therapist identifies risk factors and develops a rehabilitation program specific to the musician’s instrument, goals and play demand. The plan may start with an active rest period, avoiding activities that cause symptoms while mentally rehearsing and initiating new normal movement patterns. During this stage, the therapist modifies the play/practice schedule and explores pain control techniques and strategies including diet, exercise, sleep and posture.

    When the active symptoms quiet down, the hand therapist begins the advanced rehabilitation phase with a goal to return to play. The therapist monitors play and rest cycle and a home program is developed to provide visual feedback using imagery and mirrors. The advanced rehabilitation phase also involves aerobics and fitness, strengthening, postural exercises and increased duration and complexity of play.

    The hand therapist works with the musician to develop a return to normal play schedule that is timed incrementally. The schedule starts with a slow and easy repertoire and passages, increasing to fast and more challenging passages for up to 10 minutes. Activities that help with return to play include warm-up with brisk walking, cycling and stretching.

    The musician will warm-up with their instrument using easy scales, long movements, slow and quiet play. As rehabilitation progresses, 50 minutes is generally the maximum play time before rest is suggested. The therapist also instructs the musician on symptom management techniques during rest and after play. These management techniques include ice, hydration and stretching.

    Hand therapists identify the root cause of injury, provide a whole-body approach to care and work in collaboration with music instructors to ensure continuity with proper technique and posture. Education and early intervention is key, as early treatment leads to better outcomes.

    If you or a loved one are a musician and suffering from pain or discomfort while playing, request an appointment today and experience the power of hand therapy. Our certified hand therapists will help you get back to doing what you love – creating beautiful music!

    By: Rob McClellan, OTR/L, CHT. Rob serves as the hand program coordinator for Physio.

    Physio and Kessler Rehabilitation Center are part of the Select Medical Outpatient Division family of brands. 

     

     


  • woman wearing covid protection mask

    Posted on 5/25/2021

    Have you ever heard the term “mask jaw”? Well, guess what? It’s a thing!

    Mask jaw is the jaw pain and pressure many of us experience as we wear our masks for an extended period of time since the start of the COVID-19 pandemic. Now, while the Centers for Disease Control and Prevention recently put out new masking guidance for vaccinated people, masks will still be part of most of our lives for the foreseeable future. And, all that mask wearing can take a toll!

    If you jut your chin forward or tense your jaw muscles to hold your mask in its proper position over your nose and mouth, you are likely experiencing jaw tightness. Headaches and muscle tension can also be caused by stress, something we’ve all felt more of since March 2020!

    Let’s take a closer look at how your jaw works. Your jaw bone connects to your skull on both sides of your face, and is referred to as the temporomandibular joint, or TMJ. It is a rounded bone, with a disc that provides a cushion to support the joint, much like the discs in your spine and meniscus in your knee.

    When you first open your mouth, your jaw hinges and rotates. As you open further, it glides and translates until you open it fully. This action happens with large muscles from your temples and cheek, to smaller muscles deep within the jaw. At least that’s how it works normally. When there is an issue with the disc, the muscles or the joint itself, it is referred to as temporomandibular joint dysfunction, or TMD.

    TMD includes a wide range of symptoms, such as pain in the jaw or neck, headaches, locking of the jaw in an open or closed position, clicking noises and pain or difficulty with speaking, eating or chewing. TMD symptoms are widely reported by many people, but become troublesome when they start limiting your day-to-day activities.

    Now, let’s dive into how your mask may be the culprit to any lingering jaw pain you may be experiencing.

    1. Maybe you are breathing through your mouth while wearing your mask. Did you know that this places more stress on the jaw from it being constantly open?

      Wearing a mask can feel like you are not getting enough fresh air, but it should not alter how you breathe. Each inhale and exhale should pass in and out of your nose. Your jaw muscles are relaxed in this “resting” position. This means that the tip of your tongue is gently touching the roof of your mouth while your back teeth, the molars, are not quite touching.  

      If you breathe in and out of your mouth, your jaw remains open. To keep your jaw open means your muscles are doing extra work. When you breathe with a mask on, focus on the air passing in and out of your nose.
    2. Maybe the ear loops are too tight. This creates tension and can throw off the alignment of your jaw and, in some cases, cause headache. 

      Masks come in all shapes and sizes, and the fit is important. Whether made of fabric or disposable, it should never feel like it is pulling your ears forward or your chin backward. These compressive forces can easily trigger a headache. Consider a mask extender or “ear savers” to keep the ear loops from tugging and avoid a potential headache altogether.
    3. Are you clenching your teeth more because of stress? This is an easy trigger for TMJ pain and dysfunction. 

      Remember the resting jaw position? This is the most relaxed position for the muscles. When you clench your teeth and hold that bite position for extended periods of time, the jaw muscles can go into spasm. Avoid gum chewing or biting your nails, which can make symptoms worse. Exercise is a key component to overall health and managing stress. Take a walk or jog, meditate or find another way to get moving. Your body and your jaw will thank you.
    4. Chances are, you are moving your jaw in altered positions to adjust how your mask is resting on your face. 

      With a proper fitting mask, you will avoid overusing your jaw. Use a mask that has some moldable wire that can be shaped around your nose. Additionally, avoid masks that are too big and sag on your face, or that are too small and tug on your ears. You should be able to speak and breath through your mouth (wink, wink) comfortably. To avoid jaw pain, make sure your mask is molded to your face and does not slide or move easily.  

      If you are feeling pain or clenching in your jaw, experiencing headaches or are having difficulty with chewing or eating, physical therapy can help. To learn more about our TMD program or to schedule an appointment at one of our centers, please contact us today.

      By: Nicole Romaine, P.T., MPT. Nicole is a physical therapist for Kessler Rehabilitation Center in West Orange, NJ. 

      Kessler is part of the Select Medical Outpatient Division family of brands.
     

     


  • Lake Hopatcong Center Team Photo - Kessler Rehabilitation Center

    Posted on 5/17/2021

    Kessler Rehabilitation Center is pleased to open a new location in Lake Hopatcong, NJ. The facility is located at 5 Bowling Green Parkway, next to the Jefferson Diner.

    The center offers physical therapy and hand/occupational therapy, and specialized services to individuals with sports injuries, orthopedic conditions, balance issues and work-related injuries. The center also provides ReVital Cancer Rehabilitation for patients with cancer and who are in remission, and our unique Recovery and Reconditioning Program for patients recovering from COVID-19 symptoms including deconditioning, weakness and lack of mobility.

    Kessler Rehabilitation Center offers extended hours with evening appointments available. No prescription is necessary* to schedule an appointment.

    “We are excited to be part of the Lake Hopatcong and Jefferson communities and to offer high-quality physical therapy and hand therapy to this growing population,” said Rich Romano, Kessler’s vice president of business development. “All Kessler centers follow strict Centers for Disease Control and Prevention guidelines, including screening protocols, social distancing and masking requirements to keep patients and employees safe during these challenging times.”

    Kessler Rehabilitation Centers accept most insurance plans, offer flexible scheduling and virtual telerehab services for patients unable to visit.

    For more information, or to request an appointment, please call 973.601.5250 or click here today.

    *Restrictions may apply.

     

     


  • Posted on 5/12/2021

    “Am I Injured?”

    This is a question I get asked by many runners.

    “How do I know if I’m injured and not just sore from running/training?”

    Short of a physical examination, this is what I tell them...

    There is good pain and bad pain. Good pain stops when you stop. It is generally mild, diffuses and doesn’t affect quality of movement. Bad pain does not stop when you stop. It can get worse during or after activity. It can be sharp in nature, and significant enough to force you to change your gait whether you realize it or not.

    If you have rested or taken time off from running, and the pain has decreased or gone away only to return when you start running again, there is most likely some underlying issue that needs to be addressed. There could be an issue with muscle imbalances, running form, footwear, training schedule, joint mechanics or any combination of these.

    If you are taking non-steroidal anti-inflammatory drugs (NSAIDs) daily or after every run for pain, you may have an overuse injury. Overuse injuries account for the majority of running injuries. They occur when a tissue is loaded beyond its threshold. In bone, this can result in a stress fracture. In tendon, this usually manifests as tendonitis or tendinosis. Excessive stress to a ligament can result in a sprain.

    Overuse is relative and not always obvious. It can be a result of “too much, too soon” with regard to training or mileage. It can also be due to cumulative stress from non-running activities and/or compensation. When a structure takes on additional stress to unload another, it can break down.

    How can physical therapy help? A thorough evaluation by a physical therapist can help identify the underlying problem so that you’re not just treating symptoms.

    A progressive loading program can assist the injured tissue regain the strength needed to resume running and training. Hands-on therapy can also help restore normal joint mechanics so that muscles are functioning more efficiently and inert structures are not unnecessarily stressed.

    Physical therapy can you build strength, endurance and minimize running injuries, so you can achieve your personal best.

    By: Martine Marino, MPT, COMT. Martine is a physical therapist and the center manager for NovaCare Rehabilitation in Bethel Park, PA.

    NovaCare and Kessler Rehabilitation Center are part of the Select Medical Outpatient Division family of brands. 

     

     


  • pediatric e-learning ergonomics

    Posted on 2/17/2021

    Is your child’s e-learning set-up ergonomically correct? Poor ergonomics can lead to poor posture, resulting in neck pain, low back pain, tightness of muscles and weakening of other muscles. It can also cause headaches, tendonitis in the hands/wrists and carpal tunnel syndrome.

    With COVID-19 presenting new ways in which schools are conducting class, it is important to maintain proper sitting posture to prevent muscle straining and improve attention. Age does not discriminate against poor ergonomics, especially if long periods of time are spent sitting in front of a computer. Our physical and occupational therapists offer five simple tips that can help you ensure that your child is maintaining the proper sitting posture during e-learning.

    Tip 1: Ensure that your child’s feet are planted firmly on the ground. If their feet do not reach the ground, use a text book, plastic container or cardboard box for them to rest their feet on.

    Tip 2: Adjust the height of the chair to ensure that there is a 90 degree bend at the knees and hips while sitting. Changing the depth of the seat can alter the angle at the hips. Consider using a pillow or rolled towel to keep the hips bent.

    Tip 3: Elbows should rest gently at the side with forearms reaching just forward to the computer, allowing your child’s back to remain against the backing of the chair. If the elbows and shoulders are elevated, try lowering the height of the desk or increasing the height of the chair.

    Tip 4: Elevate the screen of the computer so that your child is looking straight forward. Place your device on textbooks, laundry baskets or couch cushions. When it comes time to type, lower the device back to the desk or table. Remember, there should be a 90 degree bend in the elbows to allow the arms to rest close to thigh height while typing.

    Tip 5: Kids are wired to play and move! Have your child get up and move around when given breaks during class. Encouraging these movement breaks will improve your child’s attention, regulation and body awareness to help maintain good posture during learning.

    If you have questions or concerns about your child’s posture or development, please contact our Kids pediatric therapy centers today to request an appointment.

    By: Courtney Engel, M.S., OTR/L, and Meredith Krifka, P.T., DPT, c/NDT. Courtney is an occupational therapist and Meredith is a physical therapist with RUSH Kids Pediatric Therapy in Fullerton, Illinois.

    RUSH and Kessler Rehabilitation Center are part of the Select Medical Outpatient Division family of brands. 


  • concussion - soccer players

    Posted on 1/22/2021

    While sports might continue to look a little differently this year due to the COVID-19 pandemic, the safety for our athletes remains a top priority. Our athletic trainers and physical therapists provide crucial education for the protection of our athletes while they are participating in their long-awaited sports seasons, as well as provide comprehensive therapy to aid in the recovery of any injuries sustained.

    One of the most prominent, but often less understood, sports injuries is the concussion. There are many myths and misconceptions about concussions, but they can occur from any impact to the head, neck or body. A concussion starts with a physical impact and can be a direct hit to the head or an indirect hit, such as the rebound of the head/neck in a football tackle. The obvious hits are the easiest to recognize; however, the less obvious hits are harder to catch and may lead to missed symptoms.

    While not all hits lead to a concussion, it is important that we are on the lookout concussion symptoms. Parents, coaches and teammates should be educated on common symptoms in order to prevent the athlete from playing through injury. Symptoms can include:

    • Headache
    • Dizziness
    • Fatigue
    • Feeling foggy
    • Difficulty thinking
    • Imbalance
    • Sensitivity to light or sound
    • Blurred or double vision

    The presentation of these symptoms may start showing immediately or be delayed up to 24 hours.

    It is also important that a thorough assessment be performed to rule out that an injury has not occurred before returning to play. Playing through a possible concussion or missing concussion symptoms overall is a safety concern and could delay return to sport. Always think, “When in doubt, sit them out.” This assures the athlete rests initially for 24-48 hours to allow the body and brain to rest and heal.

    During this resting period, to the athlete should avoid mental and visual strain as well as excessive activity. This includes anything that increases your symptoms, such as watching television, playing video games and being on the computer and/or phone.

    Most concussions will resolve themselves within 7-10 days, but approximately 15-20% of patients present with lasting symptoms – most notably headaches – which may be the result of delayed healing. Initially, resting the brain helps decrease prolonged symptoms and extended healing times. After the initial resting phase, best practice is to begin an active recovery. Physical therapy intervention can set athletes up with an appropriate exertion program that is safe for the brain.

    Our centers offer a variety of opportunities to work with therapists specializing in concussion rehabilitation who help to establish the underlying cause of prolonged symptoms. Each comprehensive examination focuses on the most common factors that may lead to delayed healing, including physiologic recovery (Is your brain healed enough to tolerate activity) and visual and vestibular involvement (Are your eyes or inner ears playing a role in your symptoms? Is the neck involved?).

    Our evaluation and treatments are backed by evidence that will help patients recover more quickly in order to safely return to symptom-free participation in their respective sports.

    By: Megan Brainerd, P.T., DPT, COMT. Megan is a physical therapist with Select Physical Therapy in Summerville, SC.

    Select Physical Therapy and Kessler Rehabilitation Center are part of the Select Medical Outpatient Division family of brands. 


  • Asian Dad pushes Daughter on Swings

    Posted on 1/20/2021

    Does your child suffer from bowel and bladder issues? If so, did you know that pediatric physical therapists can help to treat conditions including constipation, urinary incontinence, daytime and nighttime wetting, holding bowel movements and refusing to have a bowel movement?

    As a pediatric physical therapist, I believe in a family approach to care and assess muscle strength and muscle imbalances in the body, specifically the pelvic floor. I address body awareness and coordination of muscles so that children can urinate and have a full bowel movement effectively and efficiently. To do this, I use exercise, proper breathing techniques for fun and relaxation, books, videos, play and biofeedback (a way that kids can get “in tune” to their pelvic floor by watching their muscles in a mirror or using a machine) to help children understand their body and take control.

    Let’s talk a little bit about where this journey typically starts for a family – potty training. There is so much information on potty training methods, yet there is a relatively small amount of quality research to support or disprove most of the methods. The most successful method will be the one that both you and your child agree on. It is important that you both feel motivated and confident throughout the process.

    No matter what method you choose:

    • Be consistent.
    • Never scold or humiliate.
    • Never prohibit from toileting.
    • Make sure you know where toilets are when you are outside of the home.
    • Reward attempts and successes.
    • Incentives do not need to be store bought; spending time together is special enough.
    • Make it fun!

    Awareness of bladder sensation and control begins in the first and second year of life. Voluntary voiding control begins at two to three years of age. An adult pattern of urinary control should be developed by four or five years of age. It’s not about starting at a certain age, it’s about starting when your child is ready.

    According to the American Academy of Pediatrics (2006), your child should show the following signs when they are ready to potty train:

    • Is dry at least two hours at a time during the day or is dry after naps
    • Bowel movements become regular and predictable
    • Facial expressions, posture or words reveal that your child is about to urinate or have a bowel movement
    • Can follow simple instructions
    • Can walk to and from the bathroom and help undress
    • Seems uncomfortable with soiled diapers and wants to be changed
    • Asks to use the toilet or potty chair
    • Asks to wear “grown-up” underwear
    • Can sit on a potty, maintaining the physical position and attention, for a short time
    • Is able to communicate bodily sensations such as hunger or thirst
    • Demonstrates interest in watching and imitating others’ bathroom-related actions
    • Communicates the need to go before it happens

    Typically, we see children urinate six-to-eight times per day and have five-to-seven bowel movements per week.

    I, too, have been on the potty training adventure with my son Devin. It is not always an easy road, and having a professional to talk with is helpful. Devin was potty trained before I was trained in dysfunctional voiding, but it would have been useful to know about massaging the belly to promote a bowel movement, deep breathing for relaxation of the pelvic floor muscles, and the plethora of kids’ books about potty training.

    If you have questions or concerns, please contact your local pediatric therapy center to schedule a complimentary 15-minute consultation to assess the needs of your family’s potty training adventure.

    By: Dawn Meller, MPT. Dawn is a pediatric physical therapist and pelvic floor specialist with RUSH Kids Pediatric Therapy in North Aurora, Illinois.

    RUSH Kids and Kessler Rehabilitation Center are part of the Select Medical family of brands. 


  • Kessler Rehabilitation Center Monroe Clinic

    Posted on 1/12/2021

    Kessler is pleased to open a new location in Monroe Township, NJ by welcoming Monroe Physical Therapy to our family of more than 100 centers.  The facility is located at 1600 Perrineville Road in the Concordia Shopping Plaza by Stop n Shop.

    The center offers services to individuals with sports injuries, orthopedic issues, concussion, vestibular or balance deficits, Parkinson’s disease and work-related injuries. In addition, Kessler’s Recovery and Reconditioning program helps patients overcome the complications of COVID-19 by addressing a wide range of issues including deconditioning, weakness and lack of mobility. This location now offers extended hours with evening appointments available. No prescription is necessary* to schedule an appointment.

    “We are excited to be part of Monroe community and building off Monroe PT’s already great reputation,” said center manager Leon Grant, P.T. DPT and a Monroe resident. He is joined at the center by Marie Reyes, P.T., and former owner of Monroe Physical Therapy, who will stay on board at Kessler, and looks forward to providing continuity of care to her many valued patients.

    Rich Romano, Kessler’s vice president of business development added that “all Kessler centers are following strict Centers for Disease Control and Prevention guidelines, including screening protocols, temperature checks, social distancing and masking to keep patients and employees safe during these challenging times.”

    Kessler Rehabilitation Centers accept most insurance plans, offer flexible scheduling and virtual tele-rehab services for patients unable to visit.

    For more information, or to request an appointment, please call (609) 409-8484. No prescription is required (restrictions may apply).*

    Follow Kessler on Twitter, Facebook and Instagram.

     

    *Limitations may apply.


  • top five injuries in basketball

    Posted on 1/6/2021

    Basketball is arguably one of the most popular sports in America, especially among children and young adults. From March Madness to the NBA finals, people love watching and playing basketball. The love for the game does not take away the risk that it carries for injury, though. Whether played recreationally or in an organized league, there are injuries that arise, and some are more common than others.

    Outside of head injuries, the most common basketball injuries typically involve the lower body. Some of the most common ones include:

    1. Ankle sprains – Nearly half of all basketball-related injuries involve the ankle and foot. From “rolling” an ankle, to landing awkwardly, to getting stepped on, playing basketball leaves athletes open to injury. Treatment for ankle injuries, specifically ankle sprains, involve ICE - ice, compression, elevation - and physical therapy, dependent on the seriousness. 

      Most injuries can be treated without a trip to the doctor’s office; however, if there is pain directly on top of the outside bone and you are unable to walk a couple steps, a trip to urgent care could be necessary. Typically, with the right exercise plan, an athlete can be back to their sport in two-to-six weeks.
    2. Thigh bruises – Getting a knee to the thigh can be one of the worst pains for a basketball player. Because of this, more and more athletes are beginning to wear compression garments with thigh padding. If hit hard enough in the thigh by an opposing player, the muscle can tighten up and bruise. 

      Typically, these injuries can be played through; however, some deep tissue massage by a licensed professional is often needed to help loosen up the muscle. Outside of massage, ICE is recommended.
    3. Knee injuries: ACL/Meniscus/Patella tendon – Knee injuries are very common in basketball. The three most common knee injuries include the anterior cruciate ligament (ACL), Meniscus and patella tendon. If you watch or play basketball, you have likely heard of these injuries. 

      An ACL tear is probably the most talked about. The ACL is one of the bands of ligaments that connect the thigh bone to the shin bone at the knee. If an ACL is torn, it generally requires surgery and months of physical therapy to return to play. 

      The meniscus is the little brother of the ACL. Every knee has two, and oftentimes they are injured along with the ACL. The meniscus is the cushioning of the knee joint. Without them, the thigh bone would sit directly on top of the lower leg bones, which would get uncomfortable quickly. Treatment for meniscus injuries can vary from ICE, to surgery and physical therapy, to just physical therapy. 

      Lastly, patella tendonitis, typically known as jumper’s knee, is the most common knee injury. It is a result of inflammation of the patella tendon which connects your kneecap to your shin bone.  Jumper’s knee can usually be healed with a personalized exercise plan from a physical therapist.
    4. Jammed fingers – Jammed fingers are exceptionally common in basketball. They normally occur when the tip of the finger hits the ball “head on” without bending. This motion can lead to swelling in the finger and immediate pain. 

      Although uncomfortable, this injury isn’t usually serious. Jammed fingers typically heal without medical interventions or trips to the emergency room. Buddy taping (taping the finger to the finger next to it) and ice can you heal in as little as a week. However, if pain or swelling persists, a trip to your doctor or a consultant with a physical therapist may be necessary.
    5. Concussion – Concussions make up about 15% of all sport-related injuries, not just basketball. Most of these injuries are typically managed either by an athletic trainer alone, an athletic train and physical therapy or by an athletic trainer in combination with a doctor or other health care professional. A concussion is brain injury that occurs after an impact to the head, neck or body. In basketball, a few examples of when concussions occur is when an athlete hits their head on the hard gym floor or when there is a head-to-head, head-to-elbow, head-to-shoulder, etc., collision. After a concussion is diagnosed, the athlete is unable to return to play for a minimum of five days. Some concussion recoveries can go slowly, with symptoms lingering. When this occurs, concussion and vestibular rehabilitation by a licensed physical therapist is a great option.

    Nearly all of these injuries can be resolved with the help of a licensed physical therapist. If you suspect that you have one of these injuries, please contact a center near you to request an appointment today. With a guided treatment and exercise plan provided by a licensed physical therapist, you can be back on the court in no time.

    References:

    By: Wyneisha Mason, MAT, ATC. ‘Neisha is an athletic trainer with RUSH Physical Therapy in Chicago, Illinois.

    RUSH and Kessler Rehabilitation Center are part of the Select Medical Outpatient Division family of brands. 

     



  • Dupuytrens contracture

    Posted on 12/15/2020

    There's an interesting TV commercial with former professional football player John Elway. Mr. Elway talks about a hand issue he was having called Dupuytren’s contracture. He explained that there is now a non-surgical treatment option for this condition.

    As a certified hand therapist for almost 17 years now, I am very familiar with Dupuytren’s contracture. However, to see this hand issue brought to life via a TV commercial definitely caught my attention as it isn’t often discussed. In the commercial, Mr. Elway talks about having difficulty with common, everyday tasks and shows a picture of the contraction in the palm of his hand.

    So, you may ask, “What is this condition?”

    Imagine having a finger, or fingers, bent into the palm and being unable to open the hand up fully. This would affect your ability to lay your hand flat on a tabletop, place your hand into a glove or shake hands. In the case of Mr. Elway, he could not grip or throw a football correctly, an activity that he had done for 16 years as a football player. It even affected his golf game.

    There is no known cause of how Dupuytren’s develops. It has been thought of as a condition that people who have origins in northern European countries can contract. It is often called “The Viking’s Disease.” It is most commonly found in men of 50-60 years of age, but women can also be impacted. It affects three percent of the U.S. population.

    Dupuytren's symptoms can take a long time to develop. Mr. Elway mentions in the commercial that he was diagnosed 15 year ago. Signs of Dupuytren’s includes:

    • A hard lump in your palm
    • Inability to place your hand flat on a surface such as a tabletop or counter
    • Scar-like bands that form in the palm
    • Fingers bent into the palm with the inability to open/extend your finger fully
    • Hand pain (although this is less common)

    Our hands contain a tough, fibrous layer of tissue called palmar fascia which gives us a protective layer between our skin and tendons. It also gives our palms firmness. In Dupuytren’s, the fascia can thicken and contract. The most common, visible sign of Dupuytren’s are the hard lumps and bands which are known as nodules and cords. The combination of nodules, cords and the contracting palmar fascia can make your fingers bend in toward your palm.

    I often see patients with Dupuytren’s contracture after they have had some sort of procedure or surgery done to their hand. Many have come to me after they have been diagnosed and treated by a hand surgeon. There are two popular techniques to manage Dupuytren’s contracture, as there is no cure:

    • Surgery, where a hand surgeon opens up the skin and removes all the excess tissue. 
    • An injection to the fibrous cords, which will break them down.

    Typically after either surgery or the injection, therapy by a certified hand therapist is indicated. There are many ways that a certified hand therapist can help patients with Dupuytren’s contracture.

    Therapy after surgery or injection would first consist of an extension orthosis, commonly known as a splint. An orthosis is custom-made for each patient using a piece of thermoplastic material and Velcro strapping. This would help the finger or fingers stay straight. A patient can wear this full-time or just at night, depending on what their surgeon indicates.

    Range of motion exercises are given to help regain full mobility of the hand and fingers. A patient’s wound would be addressed if they have had surgery to watch for infection and manage scar tissue. Lastly, a patient’s strength would be addressed. The end goal for our patients is that they will have functional capability of their hands and are able to perform all the activities of daily living that they choose to do in their lives.

    Please contact your local outpatient center to schedule an appointment with a certified hand therapist to discuss the various options for Dupuytren’s contracture and determine if therapy may be beneficial for you.

    By: Kelly Lee O’Connor, M.S., OTR/L, CHT. Kelly is an occupational therapist/certified hand therapist for NovaCare Rehabilitation in Horsham, PA. Images supplied by Linda Lamaute, M.S., OTR/L, CHT.

    NovaCare and Kessler Rehabilitation Center are part of the Select Medical Outpatient Division family of brands