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Old 12-01-2011, 10:00 AM   #1
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Basal Joint Surgery effects and P.T.


I had basal joint surgery on 12 Sep 11. After the cast was removed (6 Oct) the surgeon asked me if I wanted to do physical therapy, and I said, "Yes, of course" because I thought that was a given. He wrote orders and part of those orders read, "In two weeks start weight bearing exercises..." I found a certified hand therapist and went there for about 4 weeks when I saw the surgeon again (7 Nov). At that time, he said I still had a lot of swelling and that he thought the physical therapy was aggravating the healing. He told me to stop physical therapy; stop using weights; and to just use my hand as I would "normally." He also said, "This type surgery situation continues to get better for up to a year on its own." My index finger has gotten crooked and is "leaning" toward the middle finger; also has a bent look in the middle joint (didn't use to be there). My hand is "hollowed out" in the center, and you can feel and see the tendons there. Question: Has anyone else experienced this type of advice/treatment and/or results? The physical therapist said if I stopped coming, I might never have any better results, but the doctor says differently. Help!!

 
Old 12-03-2011, 10:51 AM   #2
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Re: Basal Joint Surgery effects and P.T.

Quote:
Originally Posted by Pat Tykota View Post
I had basal joint surgery on 12 Sep 11. After the cast was removed (6 Oct) the surgeon asked me if I wanted to do physical therapy, and I said, "Yes, of course" because I thought that was a given. He wrote orders and part of those orders read, "In two weeks start weight bearing exercises..." I found a certified hand therapist and went there for about 4 weeks when I saw the surgeon again (7 Nov). At that time, he said I still had a lot of swelling and that he thought the physical therapy was aggravating the healing. He told me to stop physical therapy; stop using weights; and to just use my hand as I would "normally." He also said, "This type surgery situation continues to get better for up to a year on its own." My index finger has gotten crooked and is "leaning" toward the middle finger; also has a bent look in the middle joint (didn't use to be there). My hand is "hollowed out" in the center, and you can feel and see the tendons there. Question: Has anyone else experienced this type of advice/treatment and/or results? The physical therapist said if I stopped coming, I might never have any better results, but the doctor says differently. Help!!
Pat hi, I have just seen & read your post & understand your confusion.
I have never heard of doing weight bearing exercises just 2 weeks after the surgery you had on your hand.

I also had basal joint surgery & physical therapy without weight bearing exercises at all. I am fully recovered now, 7 months after surgery.
I find it weird that your doctor asked you if you wanted to have physical therapy which is a must after this kind of surgery.

I cant advise you what to do but I do suggest that you go to the thread,''going through the basil joint surgery process-at least my story'' on this forum where you can read how we all got through this surgery. Posters also write about their experiences with physical therapy.

I would be very interested to hear how your are getting on, so please return here & let us know. Until then I wish you good luck.

Hugs,
Haydena.

 
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Old 12-03-2011, 03:04 PM   #3
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Re: Basal Joint Surgery effects and P.T.

The weight-bearing exercises were two weeks after physical therapy started; not two weeks after surgery. It would have been about 6 weeks after surgery. The physical therapists I went to didn't seem to think it strange. Do you mind my asking what kind of hand/finger exercises (therapy) your therapists had you do?

 
Old 12-04-2011, 02:19 PM   #4
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Re: Basal Joint Surgery effects and P.T.

Quote:
Originally Posted by Pat Tykota View Post
The weight-bearing exercises were two weeks after physical therapy started; not two weeks after surgery. It would have been about 6 weeks after surgery. The physical therapists I went to didn't seem to think it strange. Do you mind my asking what kind of hand/finger exercises (therapy) your therapists had you do?
Good to hear your weight bearing exercises started 6 weeks after your surgery. I made a mistake when I read your post!

My physio got me to squeeze a small rubber ball. At first I could not get my thumb to bend onto the ball. Slowly I squeezed the ball until my thumb managed to touch the ball. That took me about 1 week.

I also got my thumb to touch my 5th finger, then 4th until I reached the index finger. That took me 2 weeks.

I did finger stretching exercises as much as I could & as often as I could.
In the 3rd week she gave me a box of matches, spread the matches onto the table & asked me to pick up each match & place them back into the box.

All the above exercises I did 3-4 times a day until I was picking up pins.

After 2 months I could close the zips on my jeans, tie my shoe laces, wash my face & shower with ease, (using my left hand where I had the surgery )

My physio also gave me a hand massage which I was able to give myself with my right hand.

I am very lucky in that my healing process was fast.

 
Old 12-05-2011, 11:27 AM   #5
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Re: Basal Joint Surgery effects and P.T.

Thank you for your reply. It interested me greatly to read about your p.t. My therapists went much faster and used tougher techniques. They first started me doing finger bending/stretching exercises (10 of them 10 times each 2 to 3 times as day). The next week they gave me a "silly putty" type substance and had me squeezing it with my hand, fingers, and thumb in different positions. The third week they started the weight-bearing as the doctor recommended. This involved holding a hammer half way down the handle with my wrist hanging off the end of a table and bending it first over to the right and then back to the left (hand with thumb pointing to ceiling). I also did biceps, triceps, and forearm exercises with 2#, then 3# weights (the next week). They also had a machine (Fludiotherapy) that had "something" blowing about inside with heat. Then after all the exercises they would put me on some sort of machine with electrical "thingees" on top and ice underneath.

Altogether the p.t. was great, and I was buttoning buttonholes and using my hand just as I had before surgery within a couple of weeks. I still am, but worry about the palm of my hand still being a little too hollowed out, and the big difference in my index finger; i.e., bent look (toward the middle finger) and soreness (rather than pain I guess). I didn't understand the doctor's outlook on the p.t. as I thought it was great.

Anyway, thanks for your reply. Maybe my physical therapists were a little too aggressive?? I just don't know, but I'm doing normal things; just have some concerns about what I mentioned above.

 
Old 12-06-2011, 10:06 AM   #6
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Re: Basal Joint Surgery effects and P.T.

Quote:
Originally Posted by Pat Tykota View Post
Thank you for your reply. It interested me greatly to read about your p.t. My therapists went much faster and used tougher techniques. They first started me doing finger bending/stretching exercises (10 of them 10 times each 2 to 3 times as day). The next week they gave me a "silly putty" type substance and had me squeezing it with my hand, fingers, and thumb in different positions. The third week they started the weight-bearing as the doctor recommended. This involved holding a hammer half way down the handle with my wrist hanging off the end of a table and bending it first over to the right and then back to the left (hand with thumb pointing to ceiling). I also did biceps, triceps, and forearm exercises with 2#, then 3# weights (the next week). They also had a machine (Fludiotherapy) that had "something" blowing about inside with heat. Then after all the exercises they would put me on some sort of machine with electrical "thingees" on top and ice underneath.

Altogether the p.t. was great, and I was buttoning buttonholes and using my hand just as I had before surgery within a couple of weeks. I still am, but worry about the palm of my hand still being a little too hollowed out, and the big difference in my index finger; i.e., bent look (toward the middle finger) and soreness (rather than pain I guess). I didn't understand the doctor's outlook on the p.t. as I thought it was great.

Anyway, thanks for your reply. Maybe my physical therapists were a little too aggressive?? I just don't know, but I'm doing normal things; just have some concerns about what I mentioned above.
The palm of your hand should not be hollowed out, your index finger should not be bent & you should not have any sort of soreness now.
I am amazed to read that you started weight bearing after 3 weeks of having your surgery & yes I do think your pyhsio was much too aggressive.
I suggest you go back to your doctor as soon as possible, show him your hand & tell him about the soreness.
I'd very much like to know his answer.
Good luck.
Haydena.

 
Old 12-06-2011, 11:23 AM   #7
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Re: Basal Joint Surgery effects and P.T.

My original reply was after seeing the surgeon again, so he knows about everything. That's when he said to stop physical therapy; that he thought it was aggravating it, etc. I had arthritis in my fingers to some degree before having the surgery, but not the hollowed out hand or bent finger. I saw my rhumatologist today who said the finger looked like arthritis. I also learned being in a splint/cast for several weeks can cause arthritis to "act up;" hence the bent finger, etc. I see the surgeon again in two weeks and after that plan on doing the p.t. here at home again. I just know I felt better when I was doing it, and my fingers/hands weren't as stiff. As to being able to do whatever I pretty much want after basal joint therapy, I guess I do. The surgery can't correct arthritis everywhere in your hands and, apparently, the splint/cast caused the problems with arthritis in the index finger; not the surgery.

 
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