Solving Hand Mystery Pain

Chapters

• 0:00 Welcome And Topic Overview
• 0:16 Why Hand Pain Stays A Mystery
• 0:43 Intrinsic vs Extrinsic Muscles
• 1:48 Where Intrinsic Muscles Live
• 2:25 The Intrinsic Plus Position
• 3:17 Self-Test For Tight Intrinsics
• 4:22 Stretch Setup And Variations
• 5:36 How To Hold And Progress Stretch
• 6:36 Expected Results And Timeline
• 6:55 Thanks, Website, And Coaching Calls
• 7:17 Coaching Details And How To Book

Transcript

SPEAKER_00: 0:02

Welcome back to the hand to shoulder solution, giving pain the middle finger. I'm your host, Carl Petito. I'm a certified hand therapist specializing in rehabilitation of orthopedic conditions affecting the fingertips through the shoulder. Today I want to talk about mystery pain in the hand. And it happens quite often when folks would come in the office and say, you know, I've had this pain, it started on and off a couple of years ago, it got worse a year ago, six months ago, and you know, I went to the doctor, then I went to this other place, and you know, it's just um I got an injection, you know, it's still not better. And something that I always check on the hand is the intrinsic muscles. They're called intrinsic muscles because they live right inside the hand, that's where they exist. I'm going to show you some stretching techniques today, but this the this podcast is designed for information purposes only, so you have an awareness. It really does not replace the benefit of being seen by your healthcare professional in person in the office. So the disclaimer is that this is not treatment or treatment advice, this is information sharing. So the intrinsic muscles, we have intrinsic and extrinsic muscles. The extrinsic muscles are located outside of the hand, but they still control the hand. For example, the muscles here, when they contract, they bend the fingers, they bend the wrist, they turn your hand palm down. The muscles on the back open the hand or extend the fingers, extend the wrist, and they turn the they turn the hand palm up. Intrinsic muscles support the other muscles outside of your hand, and those muscles exist. Starting from the pinky side, there's this big pad of muscles here, is actually this is a group of muscles right here on the side of the palm on the edge of your hand. In the thumb, if you pinch the media part of your thumb, that's another group of muscles which includes the web space right in here in your thumb. Now, to the fingers, these muscles, when you go into this position, that's called the intrinsic plus position, that's when these muscles between these bones are activated and they're putting you in that position. There's other muscles that do this and do this. So the lumbricals do this, and the dorsal interossi do this, and the poly interossi do that. Now, let's talk about the lumbricals, and those muscles, when they're in a shortened position, your fingers are in this position. So the opposite of that would be putting these big knuckles in the opposite position and then bending these. So you can test yourself if you're having stiffness and discomfort, or let's just say you're just having stiffness and tight feeling in your fingers that just doesn't seem to go away, but you can make a full fist. But why does it feel so tight? And you can compare both sides to each other. So if you were to carry a grocery bag or we call this a hook fist, so it's a also called a flat fist. So you see what position my palms and fingers are in. On one side, this might be nice and flat, but on the other side, these might be out a little bit. You might see a space, and that space shows it demonstrates that these muscles between these bones are very tight. Now, another technique is to start with it in a full fist and then bring it up and then see if they if they spread open. And both sides might be tight. So, either way, if it's if you're coming up like this and they're opening a little bit, you have tight intrinsics in the palm. And how do I have people stretch those? So, what I do is I have people go into this into a fist and lay their the palm or surface of the fist on their lap, and then you come out like this, and then you can do one finger at a time where it you kind of just pinch it in like this, and then hyperextend the big knuckles so you lift up the the finger while all the small knuckles are bent. And I usually have people do individual fingers and then do all of them together, and some people also benefit from doing it like this, palm up, and then bringing them out here, because if they're if your fingers are very, very tight and you come out and they start coming out here, already at that position they would be feeling a stretch. So I'd have them start in a fist and go here like this, and to keep those that stays in tight, okay. Then right when you when the patient starts feeling that stretch, that's the position we hold. Now, it is natural to resist the stretch, and there's a very, very easy way to stop patients from resisting the stretch. So the the urge for people is to keep their fist, but if they're keeping their fist, they're not going to go into the stretch. So I tell people you do the motion with the hand, so you're doing this that shuts off the opposite muscles. Okay, so you're doing it, you're bringing it out while you're helping with the other hand. So both hands are working in partnership to bring those big knuckles out straight. So you're pushing it into that position, and it feels I'm gonna pretend my hand is stiff, I'm feeling it pull right there. It's a pulling sensation. I'm gonna hold that for 20 seconds and relax, and again for 20 seconds, and relax a couple of rounds of that every two hours or so, and that is very effective. And usually, it this is really fun because patients are experiencing symptoms for sometimes a year or more, and after a couple of weeks, they start feeling significantly better. Then, after a couple of weeks after that, their pain syndrome is gone. So, the intrinsic muscles should never be forgotten. Well, I hope you enjoyed that, and I and I hope that this information helps a lot of people out there. Thank you very much for subscribing to the channel and liking, and thank you for sharing it with others. Take a look at my website, carlpetito.com. Thank you. I'm excited to announce that coming up this January, I am starting coaching calls for guidance. Uh, we can meet online to discuss any problems that you might be having that might be causing pain from the fingertips through the shoulder. Not treatment or treatment advice, but information. I've been experiencing a lot of patients who have been writing in and contacting me about conditions that have been going on for years. And I occasionally see patients in the office who have been dealing with quote unquote mystery orthopedic problems causing pain over the years. They've been to several different facilities and getting a lot of different answers. And I've been very good over the years at unraveling a lot of the mystery and getting down to what the most likely cause would be. So my goal is to point you in the right direction. Starting in January, you'll be able to go to carlpatito.com, that's Carlpatito.com, to access the calendar, to schedule your meeting with me online. The only fee is a donation and the amount that you feel is appropriate based on the value of our coaching call.