Hand and Forearm
Professional physiotherapist in Southampton, Hampshire, UK.
Hand
The wrist is made up of eight carpal bones, metacarpal bones and fingers. The ligaments strengthen the joint capsule, and the intercarpal ligaments connect the wrist bones. The wrist ligament, together with the metacarpal bones, form the carpal tunnel. The tendons of the flexor muscles, as well as the median nerve and blood vessels, run through the canal.
The most common problems within the wrist joint are:
- Bone fractures (e.g., scaphoid, phalanges) where lymphatic drainage and magnetron are applied, additionally the type of orthopaedic equipment such as orthoses is selected.
- Muscle overloads in the hand and forearm that respond well to the use of Kinesio-taping, dry needling and ultrasound.
- Ganglions – also known as a gelatinous cyst, which results from overloading a joint or a tendon. The process of synovial fluid overproduction accompanies it. It’s a painful lump that restricts movement in a joint. Rehabilitation is through the use of kinesiotherapy, massage, tissue mobilisation, laser.
- Diseases such as rheumatoid arthritis and stroke
- Degeneration where magnetron helps.
- Dupuytren’s Contracture – Palmar fascia contracture leads to shortening of the hand fascia. Mainly contracture of the 4th and 5th finger, they can even touch the hand, which makes it difficult to grip. Most often, surgical treatment is necessary. Rehabilitation to strengthen muscles and prevent contractures.
- Guyon’s canal syndrome – irritation of the ulnar nerve at the wrist level. Impaired dexterity, muscle atrophy, limited mobility, pain and numbness in the thumb, finger 5 and 4. Rehabilitation consists of myofascial relaxation and neuromobilisation.
- Carpal tunnel syndrome – compression of the median nerve in the carpal tunnel. Symptoms include numbness in the hand or fingers, muscle weakness, inability to hold objects in the hand, numbness which intensifies, e.g., during a phone call. If necessary, use of a laser, orthopaedic equipment, taping, manual techniques, fascial relaxation, neuromobilisation and exercises are advised.
Due to several problems and irradiation of pain from other parts of the body, differential diagnosis of the cervical spine should be deepened.
Forearm
The forearm is made up of the radius and ulna, which are connected by the interosseus. They form the proximal and distal radial-elbow joints. The forearm muscles are divided into three groups: the anterior group, innervated by the median and ulnar nerves, the posterior and lateral group, innervated by the radial nerve. The forearm muscles move the hand and fingers and perform the forearm turning and turning motion.
Problems related to forearm structures that affect the elbow and wrist joints:
- Nerve Injury (the so-called “Blessed Hand”) – Electrostimulation and neuro-mobilisation are the most common methods of rehabilitation
- Muscle overloads – manual therapy, dry needling, fascia relaxation, massage and ultrasound give good results
- Injuries (fractures) – lymphatic drainage, magnetron and the selection of orthopaedic equipment are of help
- Damage to the muscles and skin – which is irradiated with the Bioptron lamp.
Should any discomfort be experienced, visiting a therapist must not be postponed. If the disease becomes chronic, rehabilitation takes much longer. The therapist will determine the cause of the problem, and in the case of post-injury conditions, will apply treatment involving anticoagulant, anti-swelling, strengthening and tissue mobilisation exercises.