The Hand to Shoulder Solution
Your new resource for hand, shoulder, and elbow pain. Together, we are giving pain the middle finger and gaining knowledge to live a better, pain-free life!
Discover what might be causing pain in your fingers, pain in your hand, pain in your wrist, pain in your arm, pain in your elbow, pain in your shoulder.
Learn about your body, arthritis, tendinitis, tennis elbow, fractures, golfer's elbow, and carpal tunnel syndrome.
Hosted by Carl Petitto, OT, CHT, and Certified Hand Therapist specializing in orthopedic conditions of the hand to shoulder. Also an expert in fabricating custom orthotics.
The Hand to Shoulder Solution
Thumb Tip Won’t Lift
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Hello and welcome to the show, The Hand to Shoulder Solution, with me, Carl Petitto.
If you are experiencing pain in your arms and hands, this is your resource.
Subscribe, listen, and share to help us 'give pain the middle finger for good'!
This is a resource to help you mitigate pain at home and become more educated on what to ask your doctors and therapists. No medical advice will be given, and you should always see your medical professional for any questions.
Thank you, and welcome to the show!
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 specializing in the rehabilitation of orthopedic conditions affecting the fingertips through the shoulder. I want to talk about a problem that a lot of people have, and it's it's it's pretty frequent where folks will notice that all of a sudden they can't pick up their thumb. And some can partially pick up their thumb, but they'll notice that the tip doesn't pick up and the tip stays bent. So let's talk about this briefly, and I want to show you an easy test that you can do at home to see if your tendon is ruptured. Tendons connect muscles to bones, and if the tendon is severed, then the muscle will have no action on the skeleton. So looking at the thumb here, you can see the tendons in blue, and there's one tendon connected to a muscle in the forearm that lifts this joint and it straightens that first knuckle of the thumb. And then the other one, you can see them pop up on me pretty good. This muscle, the tendon goes way over here, and it connects to a muscle up here, and that straightens the last joint or last hinge of the thumb. Now, there's a lot of reasons why that tendon might be severed. Perhaps there is an injury from a knife or a window falling on it or some kind of trauma. Also, what is quite common is arthritic changes in the wrist. This is the back of the wrist. And there's a little bit of a sharp edge here. And arthritis changes can cause this edge to be sharper. It can also cause some bone spurs to form. So you can imagine this cord that's sliding over that just throughout your day while you're using your hand, it starts to wear away. It starts to wear away at that at the tendon, just like a rope would on a sharp surface. And eventually the tendon pops. And most people don't feel that happen. That's called an attritional rupture. The after an attritional rupture, you won't be able to lift the tip of your thumb off the table, and that's a very effective orthopedic test to just see if the patient can lift their thumb off the table. And when I lift my thumb off the table, you can see that tendon, it's called like sensor pollucus longus muscle, and that's the EPL or sensor pollicous longus tendon, goes to the tip of the thumb, is popping up. If you attempt to raise the tip of your thumb off the table, two things. Number one, you won't be able to do it, and number two, you won't be seeing that tendon pop up. And also, which you might not uh normally think of is compare it to the other side and see what that one is doing, and compare it. If you can't pick that up, then you should go into your surgeon. Uh, make sure you're going to see a hand surgeon, a fellowship-trained hand surgeon, orthopedic surgeon. There's a uh very good surgery to take one of the tendons connected to one of the muscles of the index finger, and there's two to the index finger. You don't, there's one of them that you don't need. They just move that over and attach it to the ruptured thumb tendon. And the rehab is very straightforward. It's not very long. Um, I fabricated a protective splint to keep the repaired site on slack so the stone tendons can heal. Wean out of the splint, begin some basic exercises, restore range of motion to get flexible to get flexibility, and then restore the muscle action, and all of the movement comes back 100% normal. Now, a natural question would be: what if I don't have the surgery and it just well I can open my thumb good enough, and yeah, the tip is bent. Things start to change and some deformity starts to form, and then the mechanics of the thumb really get thrown off. It's important to have it fixed. And as soon as you notice that the problem is there, get in and see your doctor. And once again, make sure it's a fellowship trained hand surgeon. Thank you for watching. Check out my website, Carlplatito.com. And thank you very much for subscribing to the channel and thank you for liking.