DRAFT: This module has unpublished changes.
19 October 2010
1:30-4:30pm 3 hours
Accumulated Hours: 21
A 13 year old girl came in complaining of pain within her right thumb. She practices her flute about an hour and a half for six days a week and noticed the pain about a week prior to the visit. After doing measurements, Nicole found the lack of movement in the right thumb compared to the left was due to the tendon that runs along the thumb. The patient found pain in straightening her thumb and pushing things up with it (like her locker latch). She seems to have a common case of tendonitis in her thumb, causing pain and weakness. To treat this, the patient would go through exercises to strengthen the tendon, however the girl has a flute try-out in three weeks and starting exercises could cause interference in he practicing and performance. For now her wrist and thumb are put into a splint to disable movement in order to calm down and decrease irritation. She also has been told to ice her thumb and wrist to decrease swelling since she currently is in the acute stage of her injury. After her try-out, he program including exercising and strengthening can begin to get the tendon back to its original condition without injury.
the patient I have been viewing for a while now who had a joint replacement in her thumb followed by a second surgery to clear scar tissue experienced intense swelling last week. Two weeks ago when I saw her last, she did a lot of pinching exercises using clothes pins and putty. A couple of days later she experienced immense pain and a large amount of swelling. After seeing a doctor she discovered the large amount of exercising and movement she did in her precious session of physical therapy caused the break up of scar tissue throughout her thumb, causing swelling that takes about ten days to go away. The doctor said this process is crucial to her healing and may take up to three months to clear out all the scar tissue and put her back to normal. Therapy must be watched as although breaking up scar tissue is healthy, too much exercise can cause a lot of pain and discomfort to the patient.
another patient shattered the bone in the tip of her finger, pulling the tendon out of place and causing the need for surgery. Therapy needs to break up scar tissue while being careful to not pull the screws within the bone and tendon out of place. Until the finger is completely healed, therapy consists of gentle massaging to make sure the finger does not get too stiff to move however without too much bending to push the screws out of place.