Ep 40: Loosening Stiff Joints: Reclaiming Movement in Arthritic Hands

Arthritis and stiffness in the hands and fingers can severely limit mobility and function over time, but proper stretching techniques can help restore range of motion and reduce pain. We explore effective methods for stretching fingers and wrists that emphasize gentle, consistent approaches rather than pushing through pain.

• Arthritis (joint inflammation) causes stiffness that compounds when people move less to avoid pain
• Trauma, bone fractures, and healing periods can also contribute to joint stiffness
• Finger stretching should bend the big knuckle to 90 degrees until feeling a pulling sensation, not pain
• "Place and hold" technique: stretch for 10-20 seconds, then actively hold position to retrain muscles
• Wrist contains 15 bones, 24 ligaments, and 24 tendons requiring specific stretching approaches
• Keep fingers open when stretching wrists to prevent tethering tendons and limiting motion
• Stretch in both directions (flexion and extension) for comprehensive mobility
• Rest periods between stretches are equally important as the stretching itself
• Perform stretches every 2-3 hours with proper rest intervals

Always consult with your healthcare provider for stretches tailored to your specific situation as there are unlimited possible conditions requiring individualized approaches.

Chapters

• 0:00 Introduction to Hand Stiffness

Transcript

Speaker 1: 0:00

Welcome back to the Hand to Shoulder Solution. Giving pain the middle finger. I'm your host, carl Petito. I'm an occupational therapist and a board-certified hand therapist. I specialize in the rehabilitation of orthopedic conditions affecting the fingertips through the shoulder. Today I want to talk to you about something that's very common A lot of people are asking about.

Speaker 1: 0:20

You know, over the years you know this, this arthritis my fingers have gotten really stiff. My joints are tight and stiff. It's hard to move. You know, I try to grab small things but I can't get my fingers around them. You know, there's a lot of reasons why the joints and the just overlying soft tissues get really tight, very stiff, and one, of course, is arthritis. Itis means inflammation, arthro means joint. So when the joints get very inflamed and and painful and aggravated, the things start to tighten up and because they tighten up, the people start to move a little bit less, because when you move it hurts and then and and so it goes. You know it's it really snowballs in the in the wrong direction. The stiffness adds up over time. Now there's other reasons stiffness might occur. Maybe some form of trauma. Either a person has a soft tissue bruise or they bruise their bone or broke a bone. So if they have a bone fracture and then it has to heal, while the fracture is healing they're not moving like they normally would.

Speaker 1: 1:22

I want to start talking about the fingers. So with arthritis the fingers you know, you can remember when you were younger or before your arthritis started bothering me a lot you can make a really tight fist and get right in there and then after time you know that maybe your fist looks more like this and then it, then it looks more like this, et cetera the fingers can be stretched. So with arthritis and I recommend you check out some of my previous videos talking about proper self-management of osteoarthritis, even rheumatoid arthritis to reduce inflammation, restore range of motion, get things loosened up a little bit the do's and the don'ts. But now let's talk about actually stretching the fingers. The do's and the don'ts, but now let's talk about actually stretching the fingers. So the big, the big knuckle should bend to 90 degrees.

Speaker 1: 2:14

So if your palm is up like this and you place your finger on the back of that first bone of your finger and then you take your thumb and put it on the tip of your finger, you can actually start pushing that into the, the position of a fist and I always tell people to just go until you feel a pulling sensation or a stretching sensation. When you touch your toes and you feel it pulling in your hamstrings, the back of your legs, that's a stretch, that's a pulling sensation. I don't want anyone to go to the point where they're feeling pain. If your face starts to look like you're in pain, it's way too much. But if you're having, you know, one out of 10 discomfort, maybe two out of 10 discomfort, that's okay and you can hold that light pulling sensation for 10 seconds. And then, after 10 seconds, you hold, activate your muscles and hold that position one and two and three and relax that's called a place and hold exercise. So once it's been placed, after the stretch has been held for 10 to 20 seconds, you hold that. That activates the muscle and that retrains the muscle, because it's not used to going that far. The muscle isn't. So, as you'll actually retrain the muscle to move to the end of your maximum flexibility that you're gaining, because here's, here's what can happen is is sure, eventually you can push yourself into a full fist, but now when you ask your muscle to do it by itself, it won't go all the way. So it accomplishes two goals with one exercise to stretch and then holding it. That retrains the muscle so you can regain your range of motion.

Speaker 1: 3:44

Now let's talk about the wrist. There's 15 bones in the wrist. So you have your carpal bones, these tiny bones here that form the carpal tunnel. You have your end of your radius and you have the end of the ulna, which are in your forearm, and then you have the five metacarpals in the hand. There are 24 ligaments that connect all these bones together. Then there's 24 tendons that connect all of the muscles in the forearm to the bones of the hand and the fingers. So there's a lot going on in the wrist. And to restore range of motion of the wrist, I have people either put their forearm over their leg to stretch over their knee, use their knee as a fulcrum or even the edge of a table. They can bring it down and push on the back of the hand. The fingers should be free. If the fingers are in a fist, it's tethering the tendons and it's stopping the joint motion. So putting these tendons on slack allows more movement of the skeleton. Because we're focusing on the skeleton, we're stretching those ligaments and the wrist tendons which connect to the muscles. Sometimes we also have patients stretch the finger tendons which connect to the finger muscles which live inside the forearm. So there's there's a lot of mechanics going on here, but let's just talk about isolating the wrist fingers open wrist bent.

Speaker 1: 5:12

Sometimes people will have an effective stretch if they just bend their elbow, bring it down and push on the back of the hand. Sometimes people want to put the thumb underneath the hand. That's not a good idea. It's nice to just put everything on top and the key is to use your muscles that pull it in that direction. And then you're going to assist with opposite hand. So you're pulling down and assist.

Speaker 1: 5:33

The natural reaction is to want to resist the stretch. Okay, so if you're resisting the stretch, you're only arm wrestling yourself. So you pull it down in the direction you want it to go, with the muscles of the same side, and then you assist it with the other side. Hold that for 20 seconds, a light stretch. Again, you're not giving yourself pain. You're holding a light stretch, 20 seconds. When you're done, hold it one, two, three and relax.

Speaker 1: 5:59

I have people do two rounds of that and you know nothing should be made a habit. Here's a great analogy. We have to water the plants so we can't water them all day long and when I tell that to patients then they understand. So the the rest period is as important as a stretch. So every every two to three hours and then hold it, now opposite direction, your wrist also has to bend toward the back of your hand. That's, that's extension. So we always go with gravity so you can just flip it over and now it's going the opposite direction. Fingers are open, so it's important to know the fingers are open when it's palm up, we're going toward the back of your hand and fingers are open when it's palm down, going toward the palmer surface of the hand. Fingers open, fingers open here and then after 20 seconds, one, two, three and relax. A couple of rounds of that now there's. Remember how complex the wrist and the hand and the fingers are.

Speaker 1: 6:49

You should always be seen by your healthcare provider. It's you know. These are some, just some basic stretches. I'll use this video. I'll send my patients to some of these videos and say, hey, forget that. If you forget the technique, go watch my video. I also use their cell phone in the office. I take a video of them doing their stretches, which are tailored to them. Very important. You have to have the proper stretch, the proper everything tailored to your situation. There is an unlimited number of possible situations. That's why you have to be seen by your healthcare provider. Thanks for watching, thank you for subscribing and sharing these videos with other people who would benefit from the information. Thank you.