It’s Hoang with Hand Therapy Secrets, and I got a question that I want to share with you. This question comes from my free 30-day hand therapy training. If you haven’t done that yet, click the link and you can join at any time. It’s a go-at-your-own-pace type of program. Make sure you read the email from me because it gives you the directions of what you need to do and how the program works.
I’ve got tons of students. I’m really amazed at the number of students that I’ve gotten into that program from all around the world. I got this question and thought, let me go through it with you instead of just her because I think it’s great to share.
Case Study: Distal Radius Fracture
This is a distal radius fracture, and they had an ORIF, I’m assuming. They’ve had about six sessions of occupational therapy. When she apparently extends the whole arm, the IP joint of the thumb goes into flexion that she can’t control. It does the same even when the wrist is in extension. So, the wrist is in extension, and the thumb goes in.
I see this all the time. Definitely, I want to help you think through what that might be and why. Because we know what it could be and why, it makes it easier for us to be able to help somebody with this particular problem.
Hand Therapy Mentorship Program
This is exactly what I do in my hand therapy mentorship program. It’s a month-to-month type of program that gets us face-to-face. It allows me to help you get through some of these challenges that you might have. Also, I’m going to teach you why something is the way it is and then show you what you can do and how you can do it.
Anatomical Explanation
So, what happens in a distal radius? You can imagine the distal radius, and you have an ORIF (Open Reduction and Internal Fixation). Now, consider what structures get cut or bypassed in the area of the distal radius during the procedure. One of the tissues that gets bypassed in this region is the flexor pollicis longus, which is a muscle that helps bend the thumb. The flexor pollicis longus is the muscle that bends the IP of the thumb. Where does that muscle originate and insert? This is not anatomy; you don’t need to know exactly where it is. But you want to know and think through what passes through here and what happens to it.
The Role of the Flexor Pollicis Longus
The flexor pollicis longus starts in the forearm, passes the wrist, passes the MP, and inserts into the IP. That muscle bends the IP. It can also secondarily bend, but it also passes the wrist and pulls into flexion.
If you have someone with a distal radius, and they are able to move their wrist, but their IP gets a little stuck into flexion, it might be because they’re scarring. It might be because it’s tight. A lot of times, if the wrist is in neutral, you’re moving that IP, and it seems fine. But when you think about composite movement, if the wrist goes all the way back, that muscle has to tension.
The muscle is stretched all the way out, passing the MP and the IP. It’s a great way to stretch and make sure that everything is moving and gliding throughout that area. That way, people can move better, have less pain, and fewer adhesions.
I hope that helps you think through a particular problem. You can take that kind of critical thinking and apply it to the problems you might have. And if you want to find out more, watch the full YouTube video:
Conclusion
I hope you enjoyed this blog post. If you are an occupational therapist and looking for some mentorship so that you can learn quicker, I’ve got this huge extensive library. You don’t have to start from video one. You go in there, pick what you need.
- Is it a shoulder problem that you’re struggling with?
- Is it a wrist problem?
- Is it a hand problem?
- Are you struggling with wound care or splinting?
If you’re struggling and have no one to really go to, to make sure you’re on the right track, progressing someone, doing things correctly, then you get to get on a call with me weekly.
Every week we meet on Thursday, and you get to ask your questions. I’ll help you think through the problem so that you can have a full understanding and apply it to each subsequent case.
If you’re not sure it’s for you, just give me a holler. I’m happy to talk to you and make sure this is the right program for you.
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