Special problems after plaster cast or other trauma - exercises

1. Stiff hand and fingers 

After a plaster cast, hand and fingers may be stiff. Finger can stiffen also after a small injury.

The use of finger splits and the stretching of the fingers straight against a table stiffen the hand and fingers; likewise the hand can be rigid or there can be a feeling of tension in the fingers for other reasons.

There are two different exercises which help to remove stiffness:

Bend / extend stretch

Bend the wrist in back position and then bend the fingers into a fist, as tight as possible and hold the stretch for 10 seconds. In case the fingers do not bend correctly, try to bend them more during the 10 seconds.
Then extend the fingers as straight as possible, and try to extend the fingers even more during the 10 seconds.  Repeat 3 to 5 times. Renew the bend/extend stretch several times during the day. 

This stretch is important, if the fingers do not bend correctly, or if the fingers feel stiff when you bend them to fist, e.g. after the use of finger splints. This stretch never causes rigid fingers.

Bending of the fingers is easier, if the wrist is bent behind and not straight.

I had the feeling that the very slow bend/extend stretch also helped to straighten the fingers. 
Do this exercise if:
- The fingers do not bend well

- The fingers do not straighten well

- Stiff hand and fingers

PE Foam disc squeeze

A strong squeeze is an excellent way to increase flexibility in hand and fingers and to eliminate stiffness or the feeling of tightness in the fingers.

Keep the wrist behind and squeeze the disc very slowly as much as you can, then extend your fingers straight.

Repeat 10 times. You may assist slightly with the other hand, but only if necessary, and only in the beginning. 

KNUCKLES STRETCH

If the major knuckles do not bend properly, bend the knuckles and press the hand against a flexible but not too soft support. Move the weight of your hand over the fingers, as far as you can, and hold for 10 seconds. Relax and repeat a few times. 

You can do this stretch with straight or bent fingers, try both.
In the case one of the major knuckles seems to "disappear", this stretch is very important.

Use this stretch in the case of:
- Stiff hand and fingers
- Problems with little finger (pinkie)
- Feeling of tightness or pain when you bend the fingers

KNUCKLES STRETCH WITH AN AID (HipperSmile)

A polyethylene water gym tool (HipperSmile) can be used for an agreeable and efficient knuckles stretch together with a PE foam disc. You just need to get the knuckles in an angle of 90 degrees. 

Stretch at least half an hour at a time, three times a day. 

This is very important, especially in the case one of the knuckles seem to "disappear", because the other option is an operation.

Use this stretch in the case of:

- The fingers do not bend well

- Feeling of tightness or pain when you bend the fingers

2. Pulling sensation, tightness and feelings of cramps or pain in the hand

In case you feel pulling sensation, tightness or pain in the tendons of your palm or fingers when the hand is in cast or wrist support, or after it, it can lead to an inability to extend or bend the fingers well and cause later permanently bent fingers, if nothing is done. 

If you have feelings of cramp in your hand, the result may be the same. 

A pulling sensation can lead to a contracture in the hand or fingers, as it happened in my hand.

You may also have difficulties when you extend your hand, your palm may stay a little bit bent and one of the fingers may be out of align.

In case you have also some callus-like spots in you palm, you may see the first symptoms of Dupuytren's contracture in your hand.

Observation isn't recommended, because during the observation the hand and fingers may stiffen and your palm contract, then the only option is a surgery, one ore more times. 

Instead, start daily stretching exercises as soon as possible, because they help only when your hand and fingers are still flexible.

Pulling sensation in the palm - palm stretch against a wall

Pull the palm against a wall and press your hand against it. Then turn the arm to more upright position so that the angle of the wrist is bigger; hold the stretch for 10 seconds. Repeat three times.

In case you have a warm wall surface, for ex. an internal hot water pipe in your bathroom, use this area for the stretch, it feels better. This is a good stretch in case of the "calluses" in the hand.

The better you get your hand against the wall and the bigger angle you get in your wrist, the better the stretch. If you can’t get your hand tight against the wall, push with the other hand.

You can also lift your wrist a little from the wall and keep this position during 10 sec, the stretch is even more efficient. 
Sometimes you feel a pulling sensation only when you do this stretch, if so, continue to do the exercise as long as you have this feeling. 

If your hand is "normal", you don't feel a pulling sensation.

Pulling sensation in the fingers

In case you feel a pulling sensation in one or more fingers,  lift your wrist a little when you press the fingers against a hard surface with your other hand, and keep this position for at least 10 sec. 
Repeat three times and do the stretch several times per day. 

Stretching help the fingers to straighten and to bend better. 

The bending of the knuckles and the wrist can also be improved by stretching; and the feeling of a cramp can be removed. 

Regular stretching exercises helps to keep your hands and fingers elastic and flexible.

Stretching can be active or passive, performed with stretching exercises or with splints.

3. How to straighten the fingers with stretching

Place the hand on a table and press the palm gently with your other hand, until the entire palm and fingers touch the table. Hold for 10 seconds and relax, repeat three times.
Do the stretch several times per day. 
Any hard and straight surface is suitable. In case of bent PIP-joints, the best pot for the press is the first phalange.

Stretch against a firm surface stiffens the fingers, the counter movement is the bend/extend stretch, but do also other exercises. 

Use this stretch in the case of:
- Bent fingers, if they are still flexible
- Pulling sensation in the hand and fingers

Left hand in August 2010

4. Finger splints help to straighten bent fingers

In addition to stretching, finger splits may be needed for the straightening of the fingers. Sometimes, the best results are obtained by combining the both, at least in the case the fingers have already been bent for some time.

However, finger splints do not straighten stiffened fingers.

Hand in February 2012

Wear the splints at least half an hour at a time three, times a day.

Note: the use of finger splints stiffen the fingers, so that after their use, it is important to do the bend/extend stretch, as well as other hand-and finger exercises.

If the use of a finger splint begins to feel painful, try a different model or take a break and make different hand exercises.

Spring splints and ring splints

Finger splints with a spring 

Splints with Velcro fastening suit even crooked fingers. The correct length of the splint is important, if too long, it does lift the fingertip upward. Small sizes, suitable for little finger, can be difficult to find. The stretch of a spring may be quite strong; they cannot be used for long periods of time. Spring splints are usually not used simultaneously at adjacent fingers.

Ring splints 

If the fingers have enough flexibility, and are only slightly bent, ring splints are a good option. Ring splints exist in small sizes; they can be used in adjacent fingers, and under a glove.

Oval-8 Ring splint are made of plastic and a splint fits two sizes, depending from the side. Stretch the finger a little before putting the splint on; or use a cream to facilitate it. You may start with the bigger size, and after a while you can change the splint the other way. Ring splint can be adjusted with the help of health care professionals and special tools.

5. Stretches & finger splints help even stiffened fingers to bend 

If the deficiency in extension and flexion is the problem, the stretching is the first treatment method, if there is no physical trauma in the fingers.

Finger splints with a spring

Bend to fist

If the fingers do not bend well, they need both stretching straight and bend / extend stretch. 

After a wrist fracture and 7 weeks in plaster cast, my fingers didn't bend well. Finger splints with a spring helped my fingers to bend before the finger operation, however, they didn't  straighten my fingers anymore, because they were stiffened.

Start the stretching as soon as possible, otherwise the fingers may become so stiff, 

that they need an operation.

However, if the fingers are bent and stiffened, finger splints with a spring do not straighten them anymore.