My theory on how to prevent surgery for Dupuytren's
I think I have had an inkling I've wanted to help people's hands for my entire life - let me explain!
My dad tells me a story of how when I was a little girl, we were reading together before bed as we always did, and one night we were cuddled up and in the middle of the story I stopped him and pointed directly at one of his knuckles.
"What's that, Daddy?"
Apparently I had noticed the very beginning of a Dupuytren's 'knuckle pad' - basically, a firm area right overtop (most commonly) the PIP joint, or that knuckle that's in the middle of your fingers.
He shrugged it off, and that was that for 15 years.
Fast forward to my husband Garrett's graduation ceremony from OT school.
(I was a year behind Garrett in school, so I was still in the thick of learning all the things lol)
I remember my dad came up to us, of course congratulated Garrett, and because he knew I was really into hand therapy and had just finished my Level 1 fieldwork in a hand therapy clinic...
...he asked me "Hey I know you love hands and I was wondering if you knew what this thing was. Remember you saw it as a kid? It's gotten a lot worse"
He then proceeded to show me his hand - he literally couldn't open it up.
It was stuck in a bent position.
Not so bent that he couldn't still grab ahold of a coffee mug, pen, shirt, bag, etc...
...but bent enough that he couldn't open up his hand to give anyone a high-five, waving to people looked definitely awkward (I say this with so much love Dad LOL), and getting a glove on was actually really really difficult.
I was shocked. I definitely didn't remember it being like this from my childhood.
I also had not a clue what the heck it was, because at that point I had only had about 40 hours of experience in a hand clinic and was still learning all the things.
I remember looking for my close friend and fieldwork mentor, Sejal, who is truly the Hand Guru (love her to death), and after a brief introduction I grabbed ahold of my dad's hand...
...mind you, at my husband's graduation ceremony...
(LOL yes you know I love helping people's hands so so much)
And asked her "Sejal what the heck is this on my Dad's hand and why can't he open it up all the way?"
She told me it's a hand contracture from Dupuytren's disease, and this was the first of many, many experiences I was about to have with people with Dupuytren's.
I proceeded to learn that Dupuytren's disease is most common in people of Norwegian descent, and often people who have it are tall, large in stature (my dad is 6'4"), with big hands and feet.
There's a gene that turns on and basically causes an overgrowth of connective tissue within the palm of your hand, which can then cause the contracture, or my dad's inability to fully open up his hand.
The thing that frustrates me the most about this disease is that doctors, therapists, the medical community in general tends to write off any amount of preventative measures and we jump straight into a procedure or surgery...
...AND another infuriating thing is that there's currently no cure, AND IT COMES BACK often 5-10 years after surgery...
....resulting in MULTIPLE surgeries, MULTIPLE procedures...
...yet we don't have very clear evidence on how we can prevent the procedure or the surgeries, how we can preserve the hand's range of motion and function to at least TRY to ward off or prevent multiple rounds of procedures that don't even work in the long run 🤯
Call me crazy (and I kind of am lol)...but I teach my people my ideas on how to prevent or prolong having to get surgery.
Now because there's no clinical evidence to back me up, I want you to know these are simply my ideas and my clinical reasoning skills in action.
I get asked all the time by people with Dupuytren's what exercises to do to maintain hand function, so I made this video for you!
3 stretches and 3 exercises for Dupuytren's, but honestly they can help everyone - not just people with Dupuytren's.
