The hand is a very flexible part of the human body and not only manages to grasp heavy objects with a lot of force, but also to do precise fine work (e.g. sewing). This is important for our everyday skills. For example, the connective tissue fibers of the hand must be elastic and allow perfect movement.
Description of the disease
Dupuytren’s disease is found on the palmar aponeurosis of the palm. Here, the connective tissue hardens and moves towards the flexor tendons of the fingers. The first sign of Dupuytren’s disease is a noticeable hardening of the palm of the hand.
As a consequence, this leads to a kinking of the fingers and a restriction of the stretching movement. In order to avoid treatment completely, Dupuytren’s disease should be prevented. Knowledge of the causes is relevant here.
Description of the physiotherapeutic intervention
It is important to mention beforehand that not only the affected hand must be practiced, but both sides must be considered. Depending on the severity of Dupuytren’s disease, a suitable one can be taken from various exercises. The first goal of the exercises is to promote and maintain finger extension.
By permanently curving the fingers, the finger flexion muscles shorten. Also the connective tissue of the palm, which is already scarred, becomes more and more inelastic and can be pulled less and less. Therefore, these structures must first be stretched.
This happens over a longer period of time and should not be too short. For the first exercise you sit down at a table and place the back of your hand on the table top. All fingers are spread apart and the fingernails touch the table top.
The middle of the palm is lifted a bit towards the ceiling, but the fingertips do not lose contact with the table top. If one finger is too restricted by Dupuytren’s disease to reach the tabletop, press it with the fingers of the other hand in the direction of the tabletop. Depending on how far they get, they stretch the restricted finger.
In the next exercise, stand with your face against the wall and support yourself with the palms of your hands against the wall. Their arms are at shoulder level and the arms are fully extended. Both palms are completely touching the wall and the fingers are spread apart.
Then they put pressure on their palms as if they wanted to push the wall away. Most of the pressure is directed to the fingertips and held. A stretching at the wrist to the forearm is allowed.
To increase this exercise, you can end up standing on your toes, so that the pull on the palm of your hand is increased. After the muscles and palmar aponeurosis have been stretched, we come to the strengthening of the finger extensors. Due to the reduced stretching in Dupuytren’s disease, these muscles of the fingers become insufficient and must therefore be reactivated.
So that the fingers can be steered in the opposite direction. First, sit down at a table and place your entire forearm and palm on the table. All fingers are spread and rest on the table top in any case.
Then each finger is lifted individually and held up briefly. Here it is observed that only the finger is lifted. The rest does not lose contact with the table top.
To increase the exercise, you can lift all fingers at the same time and hold them up. During the next exercise, we use a firm rubber or hair band to help us. The fingers of one hand are touching the finger berries.
Now, when the fingers meet each other, the band is put around the fingers. You should now spread your fingers apart so that the band slides towards your wrist. Even the weakest finger must not slacken and should join in. This spreading of the fingers does not have to be done quickly and the band should be guided slowly.
