Understanding Hand Exercise & Grip Strength – (Part 5b) Active Grip Dilemmas at the Elbow

Dr. Terry Zachary

Today’s blog in our ‘Understanding Hand Exercise & Grip Strength’ series is entitled ‘Part 5b – Active Grip Dilemmas at the Elbow.’ It further explores the interesting area of repetitive grip as it relates to the elbow.

Take this one super slow. It is a long one. Again, it will be NEW information to almost everyone, but will expand on our previous blog, ‘Part 5a – Grip Dilemmas at the Elbow,’ which examined grip dilemmas 1-3. Please review if necessary, as they relate directly.

Today’s blog isolates the 4 main categories of ‘ACTIVE’ grip dilemmas at the elbow. In other words, the discussion to follow asks the question” ‘What happens when ‘gripping PLUS stressful actions’ occur simultaneously?’

The examples of active grip dilemmas are everywhere and are directly causing diverse & costly elbow problems (and injury to the entire upper extremity). Elbow stability is especially at high risk in sports, music, hobby and in the workplace. And the result of these active elbow problems are becoming more apparent as an enormous baby boomer generation ages, and as our society becomes more grip, finger and thumb dependent with regard to cell phones, gaming & computers.

The author does not understand how the material to follow can be new material. But it is. And yet it is vital. It should become obvious, especially once a light is shined upon it and we begin to think for ourselves and explore our own grip habits.

Yes, as of today, it’s true… repetitive grip has been mostly overlooked. And rarely mentioned. And people continue to repetitively grip every day without a thought, both in their daily routines and in their fitness training. I’m hopeful that by the end of this blog you will recognize that the elbows are exposed so much to so much force in so many active pursuits. Something must be done to understand and prepare them better. Especially when gripping and action is simultaneously involved.

When an individual has been repetitively gripping in training or simply in performing their given daily activity (or both), the tissues of the elbow (ligament, tendon, muscle & fascia) are already shortened and already have poor blood flow. They are already at high risk for injury. They are already performing well below capacity, even if one is asymptomatic.

Keep in mind that whenever any joint, muscle, tendon, fascia or general body area is prepared poorly for activity and is then exposed to the stressors of real-world performance, the results are predictable: Weakness > Poor performance > Nuisance > Breakdown & Injury.

A simple progression. No one is immune to the laws of Nature.

Think of poor posture, for example. A person with poor posture feels normal, gets weaker, performs at a lower level, feels stiff, gets sore, and then, boom!… is debilitated.

Repetitive gripping is not unlike poor posture (in fact, VERY similar). The elbows are subsequently exposed to injury due to repetitive gripping the same way that the low back is exposed to injury because of poor posture. Both scenarios create primary imbalance and secondary mechanical stress.

There are 4 different and specific types of ‘active elbow stress’ that are notable in sports, music, hobby, gaming, computers and in the workplace. These are all exacerbated greatly by improper ‘squeeze-only’ grip training, or by no training at all (i.e. by constant daily repetitive gripping only).

You may identify one or many types of ‘active elbow stress’ in your own daily pursuit or pursuits. Once understood, the correlation between complete hand muscle training and elbow health and performance potential becomes crystal clear. The 18 hand muscles (9 open, 9 close the hand) are diverse and need to be healthy, balanced and have good blood flow. Otherwise, the rigors of gripping and performance stress will continue to win out in the form of limit, injury and debilitation.

Nature has designed the muscles of grip well. It is up to us to understand the principles well and live by them.

We know now that repetitive gripping leads to shortened finger flexor muscles and tendons AND static finger extensor muscles and tendons, as well as general elbow muscle imbalance.  In other words, repetitive gripping creates health and performance challenges at both the inside and outside of the elbow.

So what happens at the elbow when we add activity to these overworked & oft underprepared areas? What happens when we add the stressors of performance (both physical and mental (yes, general tension)) to the elbow? Let’s look at some common scenarios and realize that balanced grip training and hand muscle health is essential in order to maximize performance and prevent injury.

Active Elbow Dilemma #4 – The Stress of ‘Gripping PLUS Striking’

Golf, tennis (i.e. all racquet sports), and hockey are three prime examples of additional stress being placed on the elbows during a striking motion… but there are many others. Chefs, butchers & drummers also share this activity. For explanation sake, let’s stick to some familiar sports to create easier visual examples in our minds.

elbow stress pain golf

Golf shot creates elbow stress

Tennis serve & forehand expose medial elbow

Think first of contact during a golf shot (i.e. ball & ground) or a hockey slapshot (i.e. puck & ice). The ‘inside’ elbow of the trailing arm (the right arm for right-handers, left arm for left-handers) in both are placed in great stress. The same is true for the ‘inside’ elbow during the serve and forehand stroke in tennis. All place the elbow hugely at stress.

Additionally troubling and fascinating, is that (using surface electromyography (sEMG)) we can illustrate that grip pressure is at its highest during the actual strike in all 3 of these scenarios. The main finger flexor muscles (which cross the ‘inside’ or ‘medial’ joint of the elbow) are most fully engaged in grip AND most fully exposed to the greatest strike force resistance… BOTH at the same time.

Hand exercise - extensor & flexor muscles

Green peak (extensors), Red peak (flexors) during hockey 3 slap shots

golf swing & elbow

Hand Muscle pattern during golf driver shot

This is a serious dilemma to the inside/medial (flexor) side of the elbow exposing it to regular repetitive micro- and macro-stress of the medial flexor tendons, muscles and ligaments. Micro- and macro-tearing that are both unnoticeable and noticeable in occur regularly during ‘gripping PLUS striking’ actions.

Advanced ligament damage can even be the result in more extreme situations (i.e. accidental tree root contact in golf) and more chronic cases (i.e. chronic tendon injury in professional golf, hockey or tennis athlete, etc.) at both the elbow and the wrist.

In all of these cases, the athlete must know to best prepare their hand muscle strength, health, circulation & balance to mitigate their exposure to these core chronic elbow imbalance risks. Repetitive grip training is not a solution. It is a problem.

Let’s also seriously consider the ‘outside’ elbow of the lead arm in golf and hockey (i.e. the left arm of a right-hander, right arm of a left-hander), and the outside elbow of the dominant arm during a backhand stroke in tennis. During the ball/puck strike, the main finger extensor muscles (that cross the ‘outside’ or ‘lateral’ elbow) are most fully engaged in grip AND most fully exposed to the greatest strike force resistance. Again, at the same time! Each strike applies stress to an already contracted and engaged outside elbow.

Hockey slap shot creates stress at trail medial elbow

Just as a guitar string is easier to rip, cut or snap when it is overtightened, muscles & tendons so are more easily torn or injured when chronically tight and shortened.

‘Gripping PLUS striking’ actions on their own place stress at the elbow, but that risk is amplified exponentially when the tendons of the hand muscles that affect the elbow have been chronically shortened, made static, and/or are lacking healthy blood flow in our over five decades of ‘squeeze-only’ dominated hand exercise thinking.

Attention to detail must be made to be the highest priority when training the grip of anyone who regularly and inherently exposes their elbows to regular ‘gripping PLUS striking’ scenarios. The 9 muscles that open the hand and the 9 muscles that close the hand must be strong, healthy and balanced in order to accommodate this regular repetitive stress.

Active Elbow Dilemma #5 – The Stress of ‘Gripping PLUS Stretch’

The remainder of the elbow grip dilemma explanations (#5-7) may be somewhat more easy to comprehend now that ‘gripping PLUS striking’ has been discussed. For example, grip dilemma #6 at the elbow is similar, ‘gripping PLUS stretch.’

The best examples of the ‘gripping PLUS stretch’ type elbow stress are in throwers. We’ve all heard terms like thrower’s elbow, little league elbow and javelin elbow. These are throwing motions that create an inherent conflict between ‘grip’ and ‘separation’, two actions that are opposing.

Let me explain.

Throwing motions create a very dangerous valgus stress (i.e. an angled separation outward) risk for tendon and ligament injuries at the medial elbow.  The elbow is essentially tractioned by stretch, yet the gripping action of the fingers is creating a contraction stress. These actions essentially oppose one another until the release of the ball or javelin in these examples. It’s a tug of war at the elbow before the throw.

baseball thrower's elbow

Valgus stress at baseball thrower’s elbow

This ‘gripping PLUS stretch’ exists in many instances without the release of the gripped item. Two examples are gymnastics (i.e. grips, bars & rings) and football tackling. Each can create stressful elbow moments that bring a great risk of injury to the elbows. The fingers contract across the elbow but the joint is being stretched. Yuck.

Grip & stretch in gymnastics – rings

When hand muscles are trained improperly (i.e. traditional ‘squeeze-only’ training) or are not trained at all (i.e. most athletes in ‘gripping PLUS stretch’ sports regularly train biceps, triceps, shoulders, chest, back, and torso… all requiring grip for resistance) and lead to unopposed hand muscle imbalance, shortened tendons and muscles at the medial elbow.

Traction spurs at the medial elbow can occur with chronic elbow stress as the body’s way of stabilizing this unstable situation.

Best to prepare the elbow properly through balanced hand and arm exercise.

A further stretch dilemma occurs upon full release of a thrown item. The momentum of a baseball thrown by a pitcher or a javelin thrown or a football thrown creates a full follow through (release) at the lateral elbow that can cause stretch stress at the outside elbow.

Baseball pitcher outside elbow stress

Baseball release creates stress at the outside elbow

Throwers face the potential for trouble everywhere… just before the throw… during the throw… after the throw. They MUST be trained properly. They must be in balance. They must have healthy blood flow to their elbow related ligament, tendons and muscles.

Otherwise, the results are predictable.

Active Elbow Dilemma #6 – The Stress of ‘Gripping PLUS Rotation’

Grip dilemma #6 at the elbow is ‘gripping PLUS rotation.’ Let’s again first offer some examples and next examine the problem.

Activities which require active grip plus rotation are mechanics, heavy duty mechanics, autobody mechanics, plumbers, painters, motorcyclists, jet-skiers/motocross, table tennis and tennis (spin hitters), assembly line (if twisting), check out cashiers in grocery stores, etc. These are common activities where gripping and rotating the forearm are combined.

Here we see a unique elbow stress. The individual will seem healthy, even super strong, and then suddenly become quite debilitated with elbow pain usually laterally, but sometimes medially.

The finger muscles and tendons (both extensors and flexors) are chronically engaged in repetitive grip, which we know causes unhealthy shortening and poor blood flow at the inside and outside elbow.  To that, add that the individual is trying to create rotation at an elbow that isn’t (via habitual repetitive gripping) able to move maximally.

Supinator muscles, that attach at the lateral epicondyle of the humerus as well as at the forearm, become shortened when forearm rotational tasks are habitually into external rotation. Pronator teres muscle, that attaches above the medial epicondyle, becomes shortened in habitual forearm internal rotation tasks.

‘Gripping PLUS rotation’ isn’t a strike force dilemma, but a chronic request for forearm rotation in performing an activity while also in grip, though the finger flexors and extensors that cross the elbow stay shortened. Another dilemma.

Additionally, as mentioned, these forearm rotation activities, on their own are rarely in a perfect balance of rotation (i.e. equal supination (external rotation) and equal pronation (internal rotation)). The soft tissue elbow structures in these ‘gripping PLUS rotation’ activities are littered with chronic imbalance.

Repetitive grip elbow injuries common in motocross

For example, the motocross athlete would repetitively grasp, wrist extend AND pronate in order to throttle the bike. The mechanic would grip the wrench and twist often with great pressure to loosen a bolt or screw. The grocery cashier grips and rotates to swipe to reads the bar code.

The bottom line is that there is forceful or chronic repetitive rotation required against an elbow that is more and more immobilized because the finger muscles and tendons contract across the elbow chronically in gripping… but are never trained for balance nor blood flow.

Properly balanced grip training is vital for these individuals – as all other active grip situations – even though they may seem strong for a long time. Once the imbalance is chronic, trouble may be around the corner at any second.

Active Dilemma #7 – The Stress of ‘Gripping PLUS Repetition’

If you are following well so far, awesome! Way to go!

Again, this is new information to most. Sometimes it takes time to create new room in our brain. You should process these concepts yourself and see if it makes sense in your activity or expertise. Read it over a few times if needed. I guarantee it does make sense. We have the sEMG (surface electromyography) studies to prove it.

New ideas such as simple full range of motion hand exercise may have difficult births, even if sensible.

Grip training principles and hand muscle balance must be understood deeply if we intend to create solutions and have strong, stable, healthy elbows.

And now we examine a problem that many identify with. Like ‘gripping PLUS rotation’ this type of active grip dilemma is insidious… until it is obvious. Until then, it is also subtle and disregarded.

The final main elbow dilemma is ‘Gripping PLUS repetition’ and is most probably inherent as a key factor in all other grip dilemmas. ‘Gripping PLUS repetition’ requires attention on its own because of its relation to many commonly heard conditions which (for some reason) have never been described in relation to their underlying cause.

The best examples to offer in an effort to illustrate this problem is musicians, workplace injuries, and weightlifters. For the purpose of illustration, I will specifically use guitar players (as musicians), dental hygienists (as workplace) and a biceps exercise (in weightlifting/fitness).

In my experience, they are three of the most chronically debilitating repetition activities I’ve studied and been involved with. And in each, there is very incomplete knowledge and education available for users to peruse.

Guitar & music stores are still filled with ‘5-decade old’ default hand exercisers… ‘squeeze-only’ grippers, whether spring-loaded or coiled. They are still very popular. Somehow.

The music marketplace (like all markets) cares about what sells, and these ‘squeeze-only’ items sell. They sell because of an archaic customer belief about the mechanics of finger grip & hand strength training.

On the surface, ‘squeeze-only’ devices appear to work well because the user feels (and is) stronger and faster in the short term, the same way a young boy is strong who only strengthens their chest and biceps (to impress the young girls) and forgets about training their back and triceps for strength AND balance.

grip strength guitarist

Grip and Repetition in Guitarist

But eventually, this imbalanced approach will show its weakness. Slowly. Subtly. The body can absorb some imbalance, but eventually, there is a tipping point.

And when problems do start, who would blame a hand exercise that has become a familiar and celebrated for its help?

I’ve worked directly with many musicians including some from very famous and accomplished bands. The guitarist of one Rock and Roll Hall of Famer was riddled with hand arthritis, very common in older guitar players. Another has fingers stuck in a repetitive grip related flexion malposition. One Grand Ole Opry bassist struggled with circulation and resultant cramping, especially during performances.

All examples are very common in musicians, especially as they age and ignore fundamental balance and blood flow principles.

If repetitive gripping worked well, these career musicians would be in great shape. But they are not. And the older they get, the more these imbalances will add up and worsen the symptoms. They then most often turn to pharmaceutical drugs to numb the pain, drugs that have nothing to do with what is causing the situation. And they have supposedly been well advised. It is ludicrous and ignorant. It is the norm. Ask an old musician.

When musicians are young, their body adapts much better and these imbalances, though present, remain asymptomatic. They don’t know how strong, fast and stable they could be because they don’t hurt or hurt enough. It is all under the radar and can only be illustrated by pain point mapping and muscle testing.

The music market is in need of health and fitness education and leadership. Musicians are in need of balance. And the world needs music.

At the elbow, ‘Gripping PLUS repetition’ riddle most musicians with subtle and not so subtle imbalance conditions. Tennis elbow (lateral epicondylitis) is ultra-common and is almost a given (i.e. only depends ‘how bad?’) for all accomplished musicians. Medial epicondylitis is also common because of repetitive wrist and finger flexion.

A lesser known, but common condition among guitarists, occurs at the inside and back of the elbow and is known as cubital tunnel syndrome.

Cubital tunnel syndrome is a prime example of ‘gripping PLUS repetition’ The combination of repetitive shoulder abduction, elbow, wrist, and finger flexion, plus forearm rotation of the fretting hand leads to a habitual decrease in the height of a space called the cubital tunnel.  This change in space interferes with the passage of the ulnar nerve, causing weakness, numbness, and pain. Cubital tunnel syndrome can incapacitate a guitar player.

The wrist flexor muscle on the inside of the elbow can also trap the ulnar nerve. Primary imbalance. Secondary stress. A common theme of ‘gripping PLUS repetition.’

guitar RSI cubital tunnel syndrome

The musician must effort to understand their imbalance and offset the repetitive nature of their pursuit in order to keep the balance of the hand, wrist and forearm muscles well maintained  (as well as the rest of the arms, shoulders, and spine). To do so requires educational leadership and regular, disciplined, balanced training.

Workplaces around the world are also strewn with ‘gripping PLUS repetition’ dilemmas at the elbow, no more so than dental hygienists.

Dental hygienists 1) handle tools that are small in nature (creating increased hand muscle output for grip), 2) tools are often vibrating (increasing grip demand), 3) grip for long periods without a break, and 4) the position of their hands are mostly palm-down (something we will discuss at length in a later blog) creating extra stress to the grip and elbow.

dental hygienist repetitive gripping

Gripping PLUS Repetition – Dental Hygienist

As a result, dental hygienists are subject to chronic ‘gripping PLUS repetition’ elbow imbalance conditions, one of the most invasive grip occupations we have studied thus far.

Ergonomic exercises should be presented to all dental hygienists during their training. None are immune to this dilemma at the elbow.

Let’s next examine the weightlifter/fitness enthusiast, another huge but undetected problem due to lack of attention on grip mechanics. If you are a person who goes to the gym, this is for you,

First, please think of how many free weights, kettle balls or weight machines require gripping to hold a weight or a weight machine handle to create muscle resistance? A lot, right?

fitness handle repetitive gripping

Fitness weight & handle repetitive gripping

And think how often we hold that weight or handle with our hands fully open compared to with hands fully closed…? A facetious thought indeed, but a thought that must be considered. We know from ‘Part 3 – The Kinetic Chain of Grip’ that the muscles that open the hand are as important in gripping as the muscles that close the hand. Still, weightlifters and fitness enthusiasts only train hand squeezing.

The result is what we are calling the appearance of lego-hands, hands that do not hang naturally or neutrally. Hands that have been trained and held into a curled flex. Hands that, in essence, have bad posture.

Thus, finger extensor muscles on every weightlifter and every fitness buff that enters and leaves a gym lack a solution for strengthening the 9 muscles that open the hand. 9 muscles that are vital. 9 muscles that Nature, in all of its wisdom, supplied. Completely ignored. It has been an unpardonable omission in fitness. This must change.

There exists commonly in weightlifting a famous condition called radial tunnel syndrome where the radial nerve gets caught between the supinator muscle heads, especially during heavy repetitive biceps curl exercises with free weight dumbbells (i.e. chronic grip PLUS elbow flexion PLUS supination).

Of course, ‘gripping PLUS repetition’ exists in so many other occupations, sports, musical pursuits, and in gaming, hobbies & computers. Hand muscle training and balance is still a new idea that has vast applications to the health and performance of so many.

In our modern society, elbow dilemmas are nearly everywhere because repetitive gripping is nearly everywhere. Our first step is to understand these elbow dilemmas and take them seriously. Only then can we affect widespread change.

We are hoping now that you will recognize the various active grip dilemmas at the elbow and recognize where ‘gripping PLUS striking,’ ‘gripping PLUS stretch,’ ‘gripping PLUS rotation,’ and ‘gripping PLUS repetition’ is at play, and effort to prepare the body properly for these activities.

Only then can we hope to perform and prevent elbow injury maximally.

In our next blog, we will address why most grip dilemmas at the elbow also occur at the wrist.

Don’t miss it!

Dr. Terry Zachary is an advocate for proper and complete hand exercise & grip strength training in sports, music, the workplace, modern computer, electronics/gaming/esports, therapy/rehab/wellness, and hobby. Dr. Zachary discovered that repetitive gripping imbalances have gone under the radar as a cause of muscle imbalance, weakness, poor blood flow, and poor lymph drainage for over 5 decades. He developed Handmaster Plus to provide the world with fast, easy and complete hand training to create maximum strength, balance, performance, and overall health. The result is healthy, stable fingers, thumbs, wrists, carpal tunnels, forearms, and elbows… and healthier lives.

Dr. Zachary can be reached at terry@doczac.com. For information on Handmaster Plus, visit www.handmasterplus.com

Understanding Hand Exercise & Grip Strength – (Part 5a) Grip Dilemmas at the Elbow

Today’s blog ‘(Part 5a) Grip Dilemmas at the Elbow’ explores an interesting area in our ‘Understanding Hand Exercise & Grip Strength’ series. It may seem confusing to some readers at first glance. What do the grip and the elbow have to do with one another? The truth is… lots! I’m hopeful that by the end of this blog the link between the two will be as clear as day. Too many people suffer – and so many more WILL suffer – if we don’t draw attention to this correlation.

OK. Here we go. Please now… leave all pre-conceived beliefs behind about the elbow, hand exercise, and grip strength training in general. It is an essential time in our interrelated cultures of health and fitness to be open to looking differently at this area of the body. Change is needed.

A quick review. You’ve learned in this series thus far (Parts 1 & 2) that the 9 muscles that open the hand are generally located on the BACK of the fingers, thumb, hand, wrist, carpal tunnel, forearm, and elbow. Similarly, the 9 muscles that close the hand are generally located on the FRONT of the fingers, thumb, hand, wrist, carpal tunnel, forearm and elbow. You’ve learned (in Part 3) that when we grip or grasp something, the finger extensor muscles contract as part of the kinetic chain of grip in order to support the action of the finger flexor muscles. In other words, grip a cooperative co-contraction of both the finger extensor muscles AND the finger flexor muscles. In Part 4 of this series, you learned that two of the main finger extensor muscles contribute towards forming the common extensor tendon which likely becomes unstable in cases of tennis elbow (aka. lateral epicondylitis).

review hand muscles

Review the Hand Muscles

Whew. Seems like a lot, but is really just basic factual information about grip and hand muscles that have traditionally been unknown, or have simply drawn little interest, or little discussion, or all of the above.

Historically, when it comes to gripping in general, there has somehow been a firmly established belief that ‘squeeze-only’ is how grip works. You’ve heard it. I’ve heard it. Everybody I discuss it with has heard it. ‘Grab a squeeze ball or a coiled or spring-loaded grip device or ring and start squeezing.’ In other words, it has been quietly accepted that the hand-closing muscles ONLY are at work (or are important) when it comes to gripping or grip training. It is a belief that needs to dissolve. NOW. I beg of you… Let this idea go.

For the last 5 decades, I believe this ‘squeeze-only’ perception has created many and varied limitations and problem conditions for athletes, musicians, workers, hobbyists, and mankind in general, no more so than its effect at the elbow.

So, what is meant by ‘grip dilemmas at the elbow?’ To introduce this concept properly requires two separate blogs.

In today’s blog (Part 5a), we will examine the first 3 core dilemmas of the 7 grip dilemmas. These first 3 dilemmas expose the elbow to various problems directly due to repetitive gripping itself.

In our next blog (Part 5b), we will examine the final 4 of the 7 grip dilemmas at the elbow. These dilemmas are caused by repetitive gripping combined with stressful motions.

We will then discuss what we can do differently to prepare and protect the elbow as much as possible in activities where gripping combined with stressful motions is inherent.

These two blogs will open your eyes to several very real threats to elbow function and performance.

Let’s get started…

Dilemma #1 – Static Finger Extensor Muscles

It is always worth reviewing the premise within (Part 3) The Kinetic Chain of Grip. Again, what is meant by the ‘kinetic chain of grip’ is that: 1) the finger extensor muscles contract statically (i.e. in one static position) to 2) support the actions of the finger flexor muscles. Grip is indeed a cooperative co-contraction.

As well, when we discussed tennis elbow (lateral epicondylitis) in Part 4, we were quick to observe that the kinetic chain of grip creates chronically shortened, static finger extensor muscles, two of which (i.e. extensor digitorum, extensor digiti minimi) contribute tendons to the common extensor tendon that originates at the lateral epicondyle. Instability at the common extensor tendon creates the breeding ground for injury and swelling at the lateral epicondyle, thus lateral epicondylitis, aka tennis elbow.

Grip Activities Tennis Elbow Cause

Grip Activities Common Cause of Tennis Elbow (Lateral Epicondylitis)

Finger extensor muscles by design serve two functions: 1) they open the hand (extend the fingers), and 2) they support grip (by contracting statically to support finger flexor muscles). The first function allows these extensor muscles to act through their full range of motion (ROM). The second, as noted, is STATIC.

Now ask yourself: How often do I perform the first function and simply open my hands? The answer is – most commonly – rarely. If ever. Ask yourself this: How often do I open my hands against resistance. Likely, never.

Yet how often do you grip something against resistance? Often. Think about sports, music, work, art, gardening, briefcase carrying, coffee cup holding, fitness, dumbbell & kettlebell workout, hand-shaking, cellphone operating, painting, cleaning, repairing, maintaining, grabbing, helping, etc. The list goes on and on. We are all constantly gripping. Constantly shortening our finger flexor muscles. Constantly creating static finger extensor muscles. Constantly.

When our society’s finger extensor muscles are being developed statically, they eventually become a cog or a weakness to our health and our performance. Our repetitive grip society is helping, even encouraging, the development of these problems. And we remain unaware. We continue to repetitively grip in our day to day world.

Then add to the equation that if and when we decide to exercise our hands, it is very commonly accepted that we perform aggressive repetitive gripping motions using squeeze balls, rings, and coiled or spring-loaded grippers.

In essence, we are active and compliant in creating weak, static finger extensor muscles.

What we are also compliant in is creating what is ‘not a fair fight’ between the strength of our hand closing muscles compared to the strength of our hand opening muscles.

Which leads us to our next dilemma…

Dilemma #2 – Imbalanced Finger Flexor vs. Extensor Muscles

It is understood in fitness that when one exercises their chest muscles, they will also equally address the training of their back muscles. The same can be said for all body areas including the biceps and the triceps, the quadriceps and the hamstrings, the stomach and lower back, as well as the left side of the body and the right.

It is only sensible. In order for our bodies to move maximally in 3 dimensions – as well as stay in balance – we must always consider the harmony of the opposites.

Why then has this balance been ignored for 5 decades or more when we speak of the hand muscles? For a person (the author) who has studied hand muscle structure and function specifically for over 20 years, the overlook is truly confusing.

The hands are not a boring area at all. Quite the opposite. They are fascinating. 9 muscles close the hand. 9 muscles open the hand. Some muscles are intrinsic within the hand. Some muscles are extrinsic, largely existing outside of the hand and crossing many joints. Nerves weave in and out and over and through to help you with life’s daily demands. Simple, yet super-intricate. Super-important. Completely fascinating.

And the hands are completely relevant because hand muscle strength and balance directly effect fingers, thumbs, hands, wrists, carpal tunnels, forearms, and elbows.

Yet low and behold our fitness and healthcare markets have historically chosen to separate the body into areas, and somehow the hands have been overlooked. Left for dead apparently.

It is time for us of all to awaken. Everyone with hands, take note and think for yourself; hand muscles affect the function of every joint they cross. And possibly more.

As we learned in Parts 1 and 2, the elbow is the starting point for the main hand opening muscles (outside of the elbow) AND the main hand closing muscles (inside of the elbow). Elbows are silently being abused and imbalanced, yet nobody in science, health nor fitness seems to be concerned. Elbow problems and grip? Go ahead. Seriously. Try to find someone who is concerned about it.

Insert cricket sound.

When we repetitively grip in our daily activities, we create strong but shortened finger flexor muscles. In the short term. The longer we repetitively grip, we are more likely to have our grip strength plateau and then decrease (true for most poor training mechanics). Repetitive grip is a direct burden on the medial epicondyle (medial epicondylitis) due to finger flexor muscle overuse and shortening without an appropriate healthy opposition.

How many tradespeople, body-builders and fitness enthusiasts do you see with chronically flexed/curled fingers? All finger flexion habits. No opposing finger extensor muscle training. I refer to it as ‘Lego-hand’ as the appearance mimics the hands of Lego characters. This is neither healthy nor functional, yet is so commonplace that we don’t question it. It is indicative of a chronic finger flexor muscle dominance imbalance.

Lego hands from repetitive gripping

‘Lego Hands’ on Gymnast

Concurrently, because of the kinetic chain of grip, daily repetitive gripping is also creating chronically static and overworked finger extensor muscles. This becomes a burden at the lateral epicondyle (lateral epicondylitis), as previously discussed. When I see extremes of the ‘Lego-hand’ appearance, individuals are almost always weak when they demo Handmaster Plus finger extension, no matter how strong they appear.

Finger extensor muscle bellies can appear strong when simply ‘looking’ at an individual’s lateral forearm. It can appear toned, even bulky. But static is not strong, stable, nor healthy. Finger extensor muscles must be trained through their full, natural ROM in order to: 1) create healthy tendon attachments at the lateral epicondyle, 2) create healthy grip, AND 3) best create balance with the opposing finger flexor muscles.

Does the future sound bleak for society’s current elbows? Without a new level of learning, open discussion, and proper training, I believe it is.

But it doesn’t have to be. As a whole, we simply have to become familiar with the actual structure and function of the 18 hand muscles, and then create an environment where hand muscles are regularly trained according to their natural balance. Full ROM opening. Full ROM closing. Strength. Balance. Performance. Shangri La.

Handmaster Plus was developed over 15 years ago to give ANY user the easiest path to strength, stability, and balance, especially at the elbow.

When we do train our hands through full, natural opening with resistance and full, natural closing with resistance, we also solve the 3rd core dilemma at the elbow…

Dilemma #3 – Poor Circulation

This dilemma (poor circulation) used to be ‘barely on my radar’ but has now moved to where I believe it likely should be #1. Unfortunately, it takes a bit more explanation and more levity from the reader to consider, so I don’t scare people away. That’s why it’s #3.

When we repetitively grip, we are not truly exercising ANY of the 18 muscles maximally.

Think about it. The finger flexor muscles are generally closed fully when gripping (think golf, tennis, carrying a suitcase, gripping a steering wheel, etc.). They are not fully active. They are not contracting through any active range of motion.

‘Squeeze only’ grip devices are also guilty of not taking the hand through a full closing motion, only a partial motion. The hand is half-closed to begin the exercise in order to hold a ball, ring, or spring-loaded/coiled device).

The finger extensor muscles (as we have discussed ad nauseam) are contracting statically to support the finger flexor action during grip. Again, no functional range of movement. Only static contraction.

Little or no movement means little or no blood flow is being stimulated to and away from the muscles, tendons, and joints of the elbow (and upper extremity in general).

True, the 9 finger closing muscles are contracting in order to grip an item, so there is muscle contraction evoking some blood flow response by the body. But the response is not near as strong when compared to hands actively moving through a full range of natural opening and closing with resistance.

There is an exercise physiology phrase ‘functional exercise hyperemia,’ which sounds confusing but basically means that the body knows to increase blood flow when, where and to what degree an area is commonly exercised.

I often use shoulder motion scenario to illustrate blood flow in relation to exercise.

If I was to move my arm through a small range of motion (such as rocking my arm at waist level), compared to moving move arm through a full ROM windmill motion, which exercise would stimulate more blood flow? The second full ROM exercise, of course. This is an over-simplification, yes, but I do believe it allows most people to come to a common agreement intuitively.

Do you think closing your hand against resistance compared to closing AND opening your hand against resistance would produce any difference in your body’s blood flow or circulation response? Turns out it does.

I have faced this same question (in a roundabout way) during the first ten years of working with Handmaster Plus. We have always had strong positive feedback relating to the specific issues and conditions that our users addressed intentionally, but there were always regularly comments like ‘I also feel better in general.’ This general wellness comment may seem strange in relation to a hand exercise. At least it did to me… Kind of.

At trade shows and presentations, I’ve been pointing out to users for years to sense how much blood flow they feel in their entire arm after demo-ing Handmaster Plus’ most basic exercise. They are inevitably nodding, blown away. So when I hear people say ‘I feel better in general’ after using Handmaster Plus, I always wrote it down as a healthy response to better blood flow. More blood flow means more oxygen and nutrients to the area, and thus better health and stability.

In October of 2017, we compared common ‘squeeze-only’ grip device approaches to the Handmaster Plus exercise, having thermograph pictures taken one minute after each exercise. The Handmaster Plus exercise was clearly superior to the ‘squeeze-only’ devices for stimulating circulation.

Thermography Handmaster Plus hand exercise study

Thermography: Squeeze-Only vs Handmaster Plus

Soon after, I was exposed to the work of Dr. Raymond Perrin who stresses the importance of regaining the proper function of the lymphatic system in regards to healing from chronic fatigue syndrome. He spoke specifically about stimulating the proper flow of lymph to the lymphatic ducts, which permit drainage of waste and toxins back into the venous blood flow for elimination out of the body.

I believe that proper hand exercise may be more important than we ever imagined. Full ROM hand exercise clearly improves circulation. I don’t believe it to be too great of a stretch to say that better upper extremity circulation means better lymphatic drainage and indeed better lymphatic duct efficiency.

This statement is certainly bold and unproven, but if it is true, let’s remember that the lymphatic ducts drain toxins from the head, neck and whole body, including the brain (via the glymphatic system). Could proper, complete hand exercise stimulate better detoxification and maybe contribute to better mental and emotional well being? It’s possible.

While Handmaster Plus and its full-range-of-motion hand exercise may eventually be proven to be the ultimate stress ball, we know for sure now that it improves blood flow and venous drainage to and from the upper extremity when compared to traditional ‘squeeze-only’ exercise.

A main benefit of proper hand exercise to the elbow is a better supply of oxygen and nutrients to the muscles, tendons, and joints and more efficient drainage of waste products away. Better circulation means healthy tissues.

Better circulation means healthy elbows. Period.

This ends the first half of ‘(Part 5) Grip Dilemmas at the Elbow’

In the next blog, we will reveal ‘(Part 5b) Grip Dilemmas at the Elbow’ and examine Dilemmas 4-7 which address what is at stake when the elbow is not only trained poorly but is then asked to perform stressful motions.

Here we see less room for error and more exposure to injury, hence more demand for proper training.

And we will show you how Handmaster Plus addresses proper training of this vital elbow area.

See you again soon.

References:
By Matt Zender Modern Restaurant Management https://www.modernrestaurantmanagement.com/recent-trends-in-restaurant-claims/

Dr. Terry Zachary is an advocate for proper and complete hand exercise & grip strength training in sports, music, the workplace, modern computer, electronics/gaming/esports, therapy/rehab/wellness, and hobby. Dr. Zachary discovered that repetitive gripping imbalances have gone under the radar as a cause of muscle imbalance, weakness, poor blood flow, and poor lymph drainage for over 5 decades. He developed Handmaster Plus to provide the world with fast, easy and complete hand training to create maximum strength, balance, performance, and overall health. The result is healthy, stable fingers, thumbs, wrists, carpal tunnels, forearms, and elbows… and healthier lives.

Dr. Zachary can be reached at terry@doczac.com. For information on Handmaster Plus, visit www.handmasterplus.com

Understanding Hand Exercise & Grip Strength – (Part 4) The Cause of Tennis Elbow Examined

We’ve helped a lot of people with tennis elbow conditions over the years, both in treatment and in preventing reoccurrence. That said, my journey through this condition has been humbling. Studying and treating tennis elbow and carpal tunnel syndrome have been my two greatest single teachers regarding grip strength training mechanics and how to properly approach hand exercise for sports, music, the workplace, computers/digital & hobby. It is a subject that is close to my heart.

I hope you find today’s blog to be eye-opening. Our hands are more at risk now than ever. Which means so are our elbows…

In Parts 1 & Part 2 of ‘Understanding Hand Exercise and Grip Strength’ series, we went over the 18 muscles of the hand. In Part 3, we learned about the Kinetic Chain of Grip. We are building a strong base to truly understand our hands, our grip, proper hand exercise, and general health principles.

Today’s Part 4 The Cause of Tennis Elbow Examined and next week’s Part 5 Grip Dilemmas at the Elbow are two of the most important sections of these entire teachings. They are doozies! They WILL affect hand exercise and grip strength training programs around the world. When we examine the cause of tennis elbow, we relate grip mechanics to elbow mechanics… and open up a whole new can of worms.

Before you begin, please also be super-comfortable with Part 3 The Kinetic Chain of Grip. If you understand Part 3, Part 4 and Part 5 will be much easier to process, possibly even be obvious.

Share this blog with EVERYONE you know who depends on, trains or treats hands and elbows. TE is that prevalent of a problem with nearly everyone. It is an imbalance that develops subtly. If you are not currently suffering, I can nearly guarantee you have some weakness and imbalance at the lateral elbow, unless you are already knowledgeable of proper training.

In other words, everyone could benefit greatly as of TODAY from understanding tennis elbow, especially if you are grip-dependent in your work, sport, musical pursuit, or hobby.

Sound over-hyped? Unless you are already in our inner circle, this will be brand new information to most of you regardless of how advanced or accomplished you are within your healthcare or fitness field.

Unfortunately, tennis elbow (TE) is not historically a very sexy subject and thus has not been dug into deeply. The mainstream health term for tennis elbow is lateral epicondylitis, where ‘-itis’ means inflammation at the lateral epicondyle, the bony protuberance at the outside of your elbow, the far end of the upper arm bone (the humerus). Hmm.  Even less sexy.

I remember seeing TE cases when I first started in private practice. To me, these were nearly nuisance cases. Not the least bit exciting. ‘Your elbow hurts? It’s inflamed? You overdid it? Ice it, rest it, and suck it up‘ was basically my approach. My success rate, not surprisingly, was low. I became more and more interested as I smartened up.

I began to dig deep as I saw the huge prevalence of tennis elbow cases, especially in sports and music (and eventually in the workplace). In honor of those first poor TE patients of mine, I’d like to entice everyone to do the same thing. Dig deep and understand the relationship between grip and tennis elbow. It will affect you. It already has.

Once you dig deeply into tennis elbow, it will be much easier to explore all grip dilemmas at the elbow.

Is Tennis Elbow (TE) Caused By One Muscle?

If you read articles about the ’cause’ of TE, you will see that inflammation of the extensor carpi radialis brevis (ECRB) tendon is often the focus. It’s a fancy name but the ECRB is simply one of the muscles that aids in extending your wrist backward.

Even though grip activities are always cited as high-risk factors for TE, grip itself is never examined closely as a suspected cause. That has always seemed odd to me. It’s as if there is no awareness that the finger extensor muscles attach at the lateral epicondyle. The theme remains the same to this day. Have a Google search if you wish. I’ll wait.

Grip Activities Tennis Elbow Cause

Grip Activities Common Cause of Tennis Elbow (Lateral Epicondylitis)

My hesitation with the ‘one muscle cause of tennis elbow’ theory is two-fold.

Firstly, there are five muscles that attach at the lateral epicondyle, not one. Three of these muscles are indeed wrist extensors (one being the ECRB muscle), but two are finger extensors.  These five muscles attach to the lateral epicondyle via the common extensor tendon. TE occurs when the common extensor tendon is overused, breaks down and becomes unstable.

It is difficult to conceive that the common extensor tendon (made from 5 muscles) itself is perfectly stable except for the ECRB muscle, yet this has been the thinking for at least the last 30 years. The finger extensor muscles are never suspected as causative (of TE). This is because health and fitness experts are not familiar with the key concept of the kinetic chain of grip (covered in Part 3).

Common extensor tendon weakness leads to Tennis Elbow

Common Extensor Tendon Weakness – Core Cause of Tennis Elbow

The second misgiving I have with ‘one muscle causes TE’ is that most therapists and trainers actually DO train the wrist extensor muscles. Wrist muscles are popular and quite easy to train. Therapists and trainers, in general, are aware of the importance of wrist muscle strength and balance. No serious tennis player, hockey player or golfer omits wrist muscle training, yet these athletes DO develop TE.

This over-simplification of the cause, diagnosis, and treatment of TE lead the ‘old me’ to initially ignore TE’s importance and diversity. Years later, after much experimentation, feedback and study, I know that TE is a debilitating cry from the body for balance and understanding, not just an inflammatory inconvenience. Old ideas remain as dogma while TE prevalence continues to rise.

But if the ‘one muscle causes TE’ theory isn’t the real cause, what then is?

In studying grip and upper extremity mechanics specifically for over 25 years, I believe strongly that the prevalence of modern TE or lateral epicondylitis is due to:
a) a ripening of the baby boomer generation who have been repetitively gripping for a lifetime and are now focusing on retirement grip sports, music pursuits, and other grip-related hobbies,
b) the prevalence of our electronic-age daily repetitive finger motions (i.e gaming, computers, cell phones, etc.)
c) continued poor understanding and training of grip and hand muscles.

Repetitive gripping dental

Dental Grip

Smartphone repetitive grip

Smartphone Grip

Repetitive Grip Hobbies

Hobbies Grip

Current grip training ideas focus on ‘squeeze-only’ exercises where finger extensor muscles contract statically to support finger flexor muscles. This ‘squeeze-only’ approach creates static, weak finger extensor tendons that attach at the lateral epicondyle, via the common extensor tendon.

Additionally, when other muscles are trained in fitness (wrists, biceps, triceps, shoulders, back, chest, legs, etc.) a weight is almost always being held via a ‘clenched hand,’ further training these finger extensor muscles statically… further leading to weakness and overuse at the lateral epicondyle… and further leading to TE.

Grip only training common for grip strength

Grip Only

Grip is clenched for fitness

Clenched Grip

Kettlebell requires clenched grip

Clenched Grip Kettlebell

We must stabilize all five muscles of the common extensor tendon that attach at the lateral epicondyle if we expect to see TE go away and stay away. And we must maintain the strength and balance of the 18 hand muscles. Only then will we see elbow performance potential and stability maximized.

The examination of the cause of tennis elbow may seem somewhat complicated at this point. I’ve likely muddied the waters for most, but the solution for general elbow health is simple.

Next, we examine further – likely for the first time – why repetitive gripping, poor understanding and poor grip training have been the root cause of an array of elbow health and performance problems, including TE.

Continue to our next blog, ‘Part 5 – The Grip Dilemmas at the Elbow,’ and the picture will become much more clear. Plus, we’ll show you some simple training that anyone can do (and understand!) to treat and prevent TE and other elbow problems. Thanks for reading!

Link to Next Blog: Understanding Hand Exercise & Grip Strength – (Part 5) The Grip Dilemma at the Elbow

Dr. Terry Zachary is an advocate for proper and complete hand exercise & grip strength training in sports, music, the workplace, modern computer, electronics/gaming/esports, therapy/rehab/wellness, and hobby. Dr. Zachary discovered that repetitive gripping imbalances have gone under the radar as a cause of muscle imbalance, weakness, poor blood flow, and poor lymph drainage for over 5 decades. He developed Handmaster Plus to provide the world with fast, easy and complete hand training to create maximum strength, balance, performance, and overall health. The result is healthy, stable fingers, thumbs, wrists, carpal tunnels, forearms, and elbows… and healthier lives.

Dr. Zachary can be reached at terry@doczac.com. For information on Handmaster Plus, visit www.handmasterplus.com

Understanding Hand Exercise & Grip Strength – (Part 3) The Kinetic Chain of Grip

In Parts 1 & Part 2 of ‘Understanding Hand Exercise and Grip Strength’ educational series, we went over the 18 muscles of the hand. This is such key information as a starting point.

9 muscles open the hand and 9 muscles close at hand. It sounds so simple, but now you ALSO realize that these muscles have great reach, not only within the hand but to the fingers, thumb, wrist, carpal tunnel, forearm, and elbow. The veil is off. Hand strength and grip training is no small subject. It relates to everything that happens to the mid and lower arm… and maybe even further.

Now let’s shed some clear and bright light on another new and vital grip concept that you will likely have little idea of, yet utilize every day. It is referred to as the ‘kinetic chain of grip,’ or in other words,‘the sequence of muscle contractions that occur in order to grip something, grab something, or move the fingers and thumb to perform various actions.’ It is how your hands work. And, once you know it, you will wonder how you as an individual or we as a health- and fitness-conscious world ever trained the hands as we did.

‘The kinetic chain of grip’ refers to the cooperative contraction of distinct muscle groups to produce a final desired action of grip. In order for grip to occur, the body, in its wisdom, must stabilize its base so as to connect ‘the peripheral with the proximal.’ In simpler terms, it would appear to do no good to grip a baseball with the fingers and thumb alone if the wrist were not stabilized. The ball, fingers, and thumb would simply just hang there. That picture makes sense to most people… especially pitchers (lol).

Now the slightly tricky part…

What would happen if the finger and thumb extensor muscles are also not providing stabilization, meaning… not contracting? What would happen to the ball then? Would the player have control of it?

Kinetic Chain of Grip

Baseball Grip Illustrated – Kinetic Chain

Try it. Go grab a ball, or tennis racquet, or pen or keyboard and feel what happens when you grip them or use your fingers. Feel the ‘back of your hand’ where your finger extensor tendons are. Review ‘Part 2 (The 9 Muscles That Open the Hand)’ here. Are they contracting? The answer is a resounding ‘yes.’ They have to be. Otherwise the hand would fall limp.

One might say that this doesn’t make sense because finger extensor muscles and tendons are supposed to open the hand not close it? Right?

Right! The finger extensor muscles DO contract to open the hand… but they ALSO contract ‘in cooperation with the finger flexor muscles‘ in a supportive role when gripping and grasping, as in sports, music, computers, gaming, workplace and hobby. The finger extensor and finger flexor muscles are constantly in a ‘cooperative co-contraction’ when gripping.

This is what is meant by the ‘kinetic chain of grip.’ The finger extensor muscles contract cooperatively to support the finger flexor muscles… i.e. to grip. It is a kinetic chain. And the kinetic chain of grip can be shown clearly on surface electromyography (sEMG). In fact, it is how we discovered the clear consistent evidence of the kinetic chain of grip. To this day, we have done dozens of sEMG pattern tests in doing our grip research. The images are consistent, revealing and super-interesting.

dental hygienist hand muscles

Hand muscle fire pattern of dental hygienist

The above sEMG signal above shows the sEMG pattern of a dental hygienist while doing a teeth cleaning. Did you ever think that a dental hygienists has a tough physical job? Probably not. You were likely thinking other thoughts while having your teeth cleaned – lol! But dentists, dental hygienists and dental assistants do have a difficult physical job, as do many repetitive grip professionals and workers. In fact, dental hygienists have one of the most demanding physical jobs of any profession.

For real!… as my daughter says.

And one of the main reasons is because of the constant presence of the kinetic chain of grip.

Notice the green signal that indicates the contraction of the finger extensor muscles on the sEMG chart above. The red is the finger flexor muscle signal. When the hygienist is cleaning teeth, BOTH the finger extensor AND flexor flexor muscles are contracting… the whole time… otherwise the hygienist would drop their dental cleaning tool.

Notice the intensity of the green finger extensor muscle pattern. This might surprise many people. It is a huge burden on the entire profession, and we will explain why in more detail in later posts in this series. Indeed, much more to cover on workplace injuries to to repetitive gripping later.

The baseball catcher sEMG below shows the detailed pattern of both finger extensor (green) muscle pattern contraction in support of the finger flexor (red) muscle pattern when the catcher provides a target for the baseball pitch (spike on left of the graph) and when the catcher catches the pitch (red and green simultaneous spikes near right of graph).

Catcher muscle pattern

Baseball catcher muscle pattern – target & catch

Again the intensity of the finger EXTENSOR muscle signal (green) might surprise you. Most would expect the finger FLEXOR muscle signal (red) to be strong, because historically athletes think of grip only and use ‘squeeze-only’ training devices to prepare for sports.

Guitar finger strength pattern

Muscle fire pattern – Guitar (fret hand)

There is little difference in the study of the kinetic chain of grip in music. The above sEMG pattern depicts the pattern of the finger extensor muscles (green) versus the finger flexor muscles (red) when viewing a guitar player’s fret hand. Note the intensity once again of the green signal that represents the finger extensor muscles, or ‘support muscles’ in the kinetic chain of grip.

These patterns surprise experts and lay people alike. The finger extensor AND flexor muscles contract together in cooperation in order to grip. Indeed, the finger extensor muscle fire pattern is almost always very intense in grip activities.

In summary, the kinetic chain of grip refers to the fundamental concept that the finger extensor muscles contract to support the finger flexor muscles in any grip, grasp or finger action. And as well, the thumb extensor and abductor muscles contract to support thumb flexion muscle actions (more on the thumb later).

It makes sense that, if the finger extensor muscles are not contracted, the finger flexor muscles would simply fall contracted limply towards the ground. It is a rather simple complex, though not at all well known. I often compare cooperative grip contraction (‘the kinetic chain of grip’) to pairs figure skating. We are watching the female skater eloquently complete all of the thrilling tricks, but the partner skater is working well and hard in support to equally create the outcomes we are dazzled by.

The finger extensor muscles are the vital motor for grip. If one expects advanced strength, stamina, and grip performance, finger extensor muscles must be trained properly through their full range of motion. When an athlete’s, musician’s or worker’s grip fatigues it is a more clear indication of poor finger extensor muscle training than finger flexor muscle training. In other words, it is an indication of a kinetic chain that is broken.

Finger extensor muscles must be trained properly by all who depend on grip.

Now that we understand the kinetic chain of grip, we complicate matters a lot. We are a repetitive grip society. We must start to understand where these mechanical problems of the fingers, thumbs, hand, wrist, carpal tunnel, and elbow come from. We must also be prepared to change our training approaches to correct these very debilitating and costly problems.

One of the most common of those problems is tennis elbow or lateral epicondylitis. It is the eye-opening topic of Part 4. But do we understand tennis elbow? Are we approaching tennis elbow exercises and training properly? Thanks for reading!

Next:
Understanding Hand Exercise & Grip Strength – (Part 4) Discussing Tennis Elbow Cause and Treatment

Dr. Terry Zachary is an advocate for proper and complete hand exercise & grip strength training in sports, music, the workplace, modern computer, electronics/gaming/esports, therapy/rehab/wellness, and hobby. Dr. Zachary discovered that repetitive gripping imbalances have gone under the radar as a cause of muscle imbalance, weakness, poor blood flow, and poor lymph drainage for over 5 decades. He developed Handmaster Plus to provide the world with fast, easy and complete hand training to create maximum strength, balance, performance, and overall health. The result is healthy, stable fingers, thumbs, wrists, carpal tunnels, forearms, and elbows… and healthier lives.

Dr. Zachary can be reached at terry@doczac.com. For information on Handmaster Plus, visit www.handmasterplus.com

Understanding Hand Exercise & Grip Strength – (Part 2) The 9 Muscles That Open The Hand

Hello again. It’s Dr. Terry Zachary here. And I am the developer of Handmaster Plus.

In order to understand the proper process of exercising the hands and strengthening the grip, we must take a closer look at the location, structure, and function of all of the hand muscles. Nowhere else in the body is the function of ‘like’ muscles so misunderstood… and so neglected.

The performance of grip is a basic vital skill throughout many facets of life including sports, music, the workplace, and hobby. It cannot be overlooked.

Later in this series, we will show the reader that proper hand exercise may also be vital even in relation to your entire health and wellness. That may sound absurd now, but please read on… Our dismissive beliefs of hand exercise are deeply ingrained.

For those readers who prefer NOT to get into the details of the layout of the hand muscles, rest assured, they are rather simple:
There are 18.
9 muscles open the hand.
9 muscles close the hand.
The muscles that open the hand are generally on the ‘back’ of the hand, wrist, carpal tunnel, forearm, and elbow.
The muscles that close the hand are generally on the ‘front’ of the hand, wrist, carpal tunnel, forearm, and elbow.
If that’s all you remember, that’s enough. You’ll never train grip or hand muscles wrong again.

In Part 1 of this educational series ‘Understanding Hand Exercise & Grip’, we looked at the ‘9 Muscles That Close the Hand.’

In a similar fashion (and a similar pattern) we will now explore the lesser celebrated ‘9 Muscles That Open the Hand.’ These 9, in essence, have been neglected in most hand training protocols for over 5 decades, a fact that may contribute to more finger, thumb, hand, wrist, carpal tunnel, forearm and elbow problems than any other single underlying ingredient of cause.

The health and fitness effects due to improper (or of poorly delivered) hand training cannot be overstated. Hand muscles attach at the front AND back and therefore affect the: 1) fingers, 2) thumb, 3) hand, 4) wrist, 5) carpal tunnel, 6) forearm & 7) elbow.

In an effort to illustrate the organization and wide reach of the pattern of muscles that control your hands, let me very basically review ‘The 9 Muscles That Open the Hand,’ and compare them to ‘The 9 Muscles That Close the Hand.’ This way the reader can understand for himself or herself the potential ‘effects’ of hand muscle imbalance, especially when hand muscle imbalance becomes chronic.

By nature, the intricacy and organization of hand muscles and their movements are miraculous. When we train them, we must respect what we learn if we expect to be at and perform at our best.

Without further adieu, the ‘9 Muscles That Open the Hand’ (and their attachment points):

finger grip extensor muscles

finger & thumb extensor muscles for grip

1. Dorsal interosseous – Originate at the metacarpals (hand), insert at the base of the proximal phalanges 2,3,4 (fingers).
2. Abductor pollicus longus – Originates at the radius, ulna and interosseous membrane (forearm), inserts at the distal phalanx of the thumb.
3. Extensor pollicus longus – Originates at the ulna and interosseous membrane (forearm), inserts at the distal phalanx of the thumb.
4. Extensor pollicus brevis– Originates at the radius and interosseous membrane (forearm), inserts at the proximal phalanx of the thumb.
5. Extensor digitorum – Originates at the lateral epicondyle of the humerus via the common extensor tendon (elbow), inserts into the middle phalanges of the 4 fingers.
6. Extensor digiti minimi – Originates at the lateral epicondyle of the humerus via the common extensor tendon (elbow), inserts into the extensor expansion of the little finger.
7. Extensor indicis – Originates at the ulna and interosseous membrane (forearm), inserts at the extensor expansion of the index finger.
8. Abductor digiti minimi– Originates at the pisiform bone (wrist/carpal tunnel), inserts at the proximal phalanx of the pinky finger.
9. Abductor pollicis brevis – Originates at the transverse carpal ligament (carpal tunnel), inserts into the proximal phalanx of the thumb.

hand opening muscles

some of the intrinsic muscles that open the hand

Notice again, mirroring the path of the 9 muscles that close the hand, that the 9 muscles that open the hand attach at the fingers, thumb, hand, wrist, carpal tunnel, forearm, and elbow and will, therefore, have some effect on each of these joints or structures.to

How often do you close your hand during your daily work, hobby, music or sports pursuits? How often do you open? Repetitive gripping (or repetitive flexion) is a fact of life. It’s not a fair fight. The muscles that close the hand are at great risk of becoming dominant over the muscles that open the hands.

If you remember only 1 concept from Parts 1 & 2 of this educational series on hand strengthening and grip, let it be this:
‘9 muscles open the hand.
9 muscles close the hand.’

In later posts in this series, we will show how this chronic imbalance of the 18 hand muscles leads to joint and structure instability throughout the entire distal upper extremity, as well as circulation and lymphatic drainage concerns.

For our next post in this series, I’d like to explain something that is not well known to many: The Kinetic Chain of Grip. In other words, we’ll show you what muscles combine to allow you to grip and use your fingers. Once you understand this, the whole games changes.

Dr. Terry Zachary is an advocate for proper and complete hand exercise & grip strength training in sports, music, the workplace, modern computer, electronics/gaming/esports, therapy/rehab/wellness, and hobby. Dr. Zachary discovered that repetitive gripping imbalances have gone under the radar as a cause of muscle imbalance, weakness, poor blood flow, and poor lymph drainage for over 5 decades. He developed Handmaster Plus to provide the world with fast, easy and complete hand training to create maximum strength, balance, performance, and overall health. The result is healthy, stable fingers, thumbs, wrists, carpal tunnels, forearms, and elbows… and healthier lives.

Dr. Zachary can be reached at terry@doczac.com. For information on Handmaster Plus, visit www.handmasterplus.com

Understanding Hand Exercise & Grip Strength – (Part 1) The 9 Muscles That Close The Hand

My name is Dr. Terry Zachary. I’ve been involved specifically in grip and hand muscle training for over 25 years. In applications ranging from sports, music, therapy, the workplace, hobby & modern electronics, I can’t say strongly enough how important I feel properly understood hand exercise is to your health, fitness, and performance.

Over these decades, my opinion of grip and hand strength training has changed substantially. Every year, through research, our group discovers more reasons why proper, complete hand muscle training is vital. The more we test, the more details we find. Learn the hand muscles and their vast reach and you will understand my passion.

In regard to the health & fitness culture, we tend to move onto training the biceps, triceps, shoulders, back, and chest – and so on – as our vital exercise focal points. Exercises in these historically popular areas have been demonstrated over and over for good reason. Yet not much consideration has been given to proper hand exercise and overall grip muscle training.

It serves anyone involved in grip related activities to study or reflect on the detailed and diverse attachment points and effects that the hand muscles have on the various joints and components of the upper extremity. If you are a healthcare or fitness professional, it is a good idea to review grip muscles regularly. If you are like I was, hand muscle anatomy can get away on you easily!

So what is it about the diverse hand muscles that have left them to be so carelessly dismissed from all upper extremity health and training concerns? They are a vital part of the fitness story, a vital part of the kinetic chain of grip and are depended on in the training room when addressing the entire upper body. The ‘hand grip’ is often the link of the user to the training weight or resistance in upper body training. Grip happens as a known kinetic chain.

9 Muscles Close the Hand

9 Muscles Close the Hand

The health effects and Imbalances of improper hand training (or of poorly delivered training) cannot be overstated. Hand muscles attach at (and therefore affect) the 1) fingers, 2) thumb, 3) hand, 4) wrist, 5) carpal tunnel, 6) forearm & 7) elbow.

If you depend on your hands in your daily routine, this is a subject you need to have a grasp on. Grip performance may seem adequate one day and be completely gone the next. Just ask any injured athlete in golf, tennis, hockey, baseball, and gymnastics to name a few. Or ask any musician, gamer or dental hygienist. These imbalances can be debilitating and life-altering.

In an effort to illustrate the diversity of the anatomical area that controls the hand, let us now very basically review ‘The 9 Muscles That Close the Hand’ and mention their general origin and insertion points to illustrate the diverse path of each muscle. This way the reader can see for him- or herself all the potential negative and positive ‘effects’ of hand exercise.

Hand Closing Muscles

1. Palmar interosseous – Originate at the metacarpals (hand), insert at the proximal phalanges (fingers).
2. Adductor pollicus– Originates at metacarpals (hand) and carpals (wrist), inserts at the proximal phalanx of the thumb.
3. Flexor digitorum superficialis – Originates at the medial epicondyle (elbow) of the humerus, and at the ulna and radius (forearm), inserts into middle phalanges of the 4 fingers.
4. Flexor digitorum profundus – Originates at the ulna and interosseous membrane between the ulna and radius (forearm), inserts into the distal phalanges of the 4 fingers.
5. Opponens digiti minimi – Originates on the transverse carpal ligament (the roof of the carpal tunnel), inserts at the metacarpal of the pinky finger.
6. Opponens pollicus – Originates on the transverse carpal ligament (carpal tunnel), inserts at the metacarpal of the thumb.
7. Flexor pollicus brevis – Originates at the transverse carpal ligament (carpal tunnel), trapezium, trapezoid & capitate bones (wrist), inserts at the proximal phalanx of the thumb.
8. Flexor digiti minimi – Originates at the transverse carpal ligament (carpal tunnel), inserts at the proximal phalanx of the pinky finger.
9. Flexor pollicis longus – Originates at the radius and interosseous membrane (forearm), inserts into the distal phalanx of the thumb.

Please note that many may add another muscle to the muscles that close the hand:
Palmaris brevis – Originates at the transverse carpal ligament (carpal tunnel) and palmar aponeurosis, inserts at the skin of the ulnar border of the hand.

As you can see in bold, the hand muscles as a whole have many diverse attachments throughout the upper extremity. They are far from simple. Thus, they will clearly have an effect on the health, stability, and performance of a diverse group of key joints and structures. Notice the diverse hand muscle attachment sites at the fingers, thumb, hand, wrist, carpal tunnel, forearm, and elbow. They have to affect the stability of all of these areas!

If you can picture these muscle paths, try to also imagine how many areas they cross as they ‘shorten’ when in use. More than anytime in history, we are a repetitive grip culture. We must be aware. These 9 muscles are regularly being shortened. Any structure that they connect to is currently becoming shortened and imbalanced …even though you likely don’t feel the problem… yet.

How will you respond?

Hand muscles clearly have diverse attachments and should be taken very seriously. They must be studied better. They must be understood better. And they must be included in all health and training protocols.

A review of the ‘9 Muscles That Open the Hand’ is next to follow in this blog post series. It’s about to get more interesting. And more complicated. And more important.

Thanks for reading!

Dr. Terry Zachary is an advocate for proper and complete hand exercise & grip strength training in sports, music, the workplace, modern computer, electronics/gaming/esports, therapy/rehab/wellness, and hobby. Dr. Zachary discovered that repetitive gripping imbalances have gone under the radar as a cause of muscle imbalance, weakness, poor blood flow, and poor lymph drainage for over 5 decades. He developed Handmaster Plus to provide the world with fast, easy and complete hand training to create maximum strength, balance, performance, and overall health. The result is healthy, stable fingers, thumbs, wrists, carpal tunnels, forearms, and elbows… and healthier lives.

Dr. Zachary can be reached at terry@doczac.com. For information on Handmaster Plus, visit www.handmasterplus.com

The Best Hand Exercise To Strengthen Grip Looks Round, Not Flat – Like Eratosthenes Said of The Earth

When I first started talking about how poorly hand muscles and hand exercise was understood by the masses – both amateurs and professionals… as well as health and fitness professionals – people reacted about the same way as I pictured them reacting when people first heard the earth was round.

The similarities of Handmaster Plus popularity to the ‘World is Round’ story are incredible. Hand exercise for the last 50 years has been flat, in 2 dimensions or one plane, even though the hands move naturally in 3 dimensions through many planes. Hand exercise has been wrong for a long time. I know. I learned it wrong. I didn’t realize my error until I was in college and studied chronic elbow injuries, namely tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis). Then I became sure of it after changing people’s grip training in practice with patients, and later while touring playing professional golf. Weeks after starting people on proper grip training, chronic issues would start to clear. I knew the world of grip strength was truly ’round.’

I can understand how Eratosthenes felt when he was persecuted for saying the world is round. It is such a similar comparison. I came out to the public in 1997 saying strongly that proper exercise must be more ‘round’ (i.e. both full opening, spreading and closing), and ‘grip-only’ training must stop. Nearly everyone (at the time) looked at me like I was crazy.

Eratosthenes had convincing proof of a round world (…to very accurate measurements) just as I did, but the eyes of the world still looked out at the horizon and it ‘looked flat.’ Those coiled and spring loaded hand strengtheners still ‘look and feel good.’ They are shiny and technical looking, and hand motion usually ‘looks’ like the hands just continually ‘close.’ Their users have never noticed any reason to think the exercise wasn’t best in class.

But why is it that hand exercise is generally a non-factor in health & performance today when I continue to preach how Handmaster Plus helps the masses? … because ‘grip-only’ doesn’t work well, and has never worked well. Handmaster Plus will put hand exercise on the healthcare and performance map.

We have tested Handmaster Plus with thermography and KNOW that when you train properly through full ROM (ranges of motion), not only do you balance the hand, wrist, and forearm, you also increase circulation and, in turn, lymphatic drainage. When you affect the lymphatic drainage of the upper extremities, you can’t help but improve the efficiency of both the right and left lymphatic ducts which are responsible for removing large molecule waste and toxins from the body.

Hand exercise is about more than just the fingers and thumbs. It’s about more than just the hands, wrists, carpal tunnels, forearms, and elbows. It’s about health, performance, blood flow and lymphatic drainage.

Hand exercise, done properly, can change a person’s life.

Hand Exercise & Grip Mechanics

Hand exercise Hand Health & Grip Mechanics

Hand exercise & Hand Health is poorly understood

It is important to understand grip mechanics. The health of your fingers, thumb, hand, wrist, carpal tunnel & elbow depends on it!

But the mechanics of grip are largely unknown, even in professional circles. The proof of this statement is shown by the popularity of traditional ‘grip-only’ hand exercisers, even to this day. We all grew up thinking hand exercise was ONLY a closing motion. Yet, grip mechanics can be easily shown on sEMG (surface electromyography), proving that grip is a co-contraction This means that when gripping any object, our hand opening (extensor) muscles AND our hand closing (flexor) muscles CONTRACT TOGETHER. Unfortunately, the finger extensor muscles contract in ONE static position, while the flexor muscles close fully. The extensors are never fully opened during repetitive grip. The result is a chronic muscle imbalance of the hand muscles that affects the fingers, thumb, hand, wrist, carpal tunnel & elbow. Hand opening & spreading muscles have been neglected in hand exercise and MUST be trained.

We designed Handmaster Plus to address the complete health needs of the hand. One easy, convenient hand exercise strengthens the 9 muscles that close the hand, as well as the 9 muscles that open the hand – resulting in strength, stability, circulation and maximum hand health.

Visit www.handmasterplus.com to learn more about complete, convenient hand exercise & where to purchase Handmaster Plus.

Easily care for your finger, thumb, hand, wrist, carpal tunnel & elbow health – NOW!

Basketball Shooting Technique Drill Allows Best Ball Control & Backspin

Basketball shooting mechanics are affected directly by how the athlete uses drills and trains and develops his or her body – to be specific, the grip. Each player is slightly different by Nature, yes, but each player can also strive to understand the proper physical training necessary to support proper basketball shooting mechanics for creating: 1) consistency, 2) backspin, 3) power, and 4) ball control.

When I was first developing the concept of (what turned out to be) Handmaster Plus, it was with sports performance in mind. 4 sports to be specific – that I had deep interest in, as well as many patients involved in. They were golf, hockey, basketball and baseball.

Because I recently received blog questions about the shooting mechanics in basketball, I would like to expand on basketball today.

There are many great instructors and instruction videos (I like shotmechanics.com) about basketball shooting mechanics drills, some even from Michael Jordan himself (my personal favorite player of all-time!). I am a ‘junkie’ for these videos, but they just don’t address, nor understand, the affect of the training of muscle mechanics of the fingers, thumb, hand, wrist, and forearm, in relation to the basketball stroke and specifically, set angle.

The angle at the end of the ‘set’ (the position when the ball is ready to be shot/advanced towards the basket) is completely KEY to the ability of the player to release the ball in control with the least amount of effort, and create the most amount of backspin, a HUGE advantage to shooting consistency. It is an as-of-yet unexplored mechanic in basketball; but once examined, the basketball athlete improves immediately!

Grip mechanics (i.e. hand muscle strength and balance) have a great affect on this ‘set angle’ and thus the potential of the basketball player. So how do most athletes train grip? It is a question I have examined/studied/dealt-with for the past 20 years. The answer is, most athletes (no matter the sport) train grip poorly by addressing ‘grip-only’ mechanics (hand closing muscles), if at all.

The anatomy of the hand muscles is quite simple.

9 muscles close the hand. These muscles are located generally on the front of the fingers, thumb, hand, wrist, forearm and elbow… their strength and length will have an affect on the mechanics of all joints they cross.

Equally, 9 muscles open the hand. These muscles are located generally on the back of the fingers, thumb, hand, wrist, forearm and elbow.. they also have a direct affect on the mechanics of all of the joints they cross.

The problem with traditional hand/grip training is that most athletes either: 1) do not train the hand muscles at all (in which case grip muscles shorten because of daily-life grip repetition), or 2) train only the hand closing muscles using balls or spring loaded or coiled trainers. Both scenarios create hand muscle imbalance, and therefore range of motion (ROM) limitations for the fingers, thumb, hand, wrist, forearm and elbow of the athlete. The joints are ‘stuck’ in flexion. And this very key CORE hand muscle imbalance has been classically either undiscovered or ignored.

All grip sport athletes have suffered technique limitations from repetitive grip imbalance, whether they know it or not. The imbalance leads to performance limitations and eventually, injury.

All 18 hand muscles must be trained in balance in order to allow best-case shooting and ball control grip mechanics. Flexor muscle domination limits the set angle because the flexor muscles cannot ‘stretch’ through a proper wrist and finger extension range of motion (ROM). They are literally too short to allow extension ROM.

These same mechanics (all 18 strong and balanced) are vital in giving the player the ability to easily control the basketball in any gripping situation, thus an advantage for rebounding, ball control, pass receiving and loose ball recovery. Strength trainers, athletic trainers, athletes and coaches must open their minds to proper physical training concepts and keep learning in order to maximize basketball performance potential! We haven’t learned it all yet!

Using the Handmaster Plus hand training technique 1-3x daily (each session until comfortable fatigue only (usually 1-2 minutes)), an athlete will generally see results in their shooting consistency within a few weeks – as soon as the strength, length and balance of their finger and wrist extensors (back of hand, wrist, forearm, elbow) catches up with the strength, length and balance of their finger and wrist flexors (front of hand, wrist, forearm, elbow). Balance and length on both sides (front & back) is the key. The result will be proper range of motion (ROM), creating a maximum angle to ‘set’ the basketball, in turn creating the best position to deliver the stronger, more controlled shot and follow through.

 

Hand Exercise for Grip Strength & Balance – Nature Always Knows

Nature Always Knows.

Grip strength is not super-complicated, but if you are like most (even most health & fitness professionals), grip strength and hand exercise training is not what you think. You see, grip strength and hand exercise training have traditionally been depicted as a grip ball-, coiled grip trainer- or spring loaded gripper-related exercise.

When I was a young aspiring Canadian golf professional, I was told by EVERYONE to strengthen my hands by squeezing a ball. Moe Norman did it, so how could it be inaccurate?

But hand exercise is not a ‘close-only’ exercise. In fact, far from it. Nothing could be further from what our Nature and anatomy (as humans) tells us – in relation to the strength & stability of the fingers, thumb, hand, wrist, carpal tunnel, forearm or elbow. In fact, there is evidence that ‘grip-only’ training of the hands could lead to repetitive grip injury. If we hope to begin to: a) maximize performance, and b) prevent the plethora of modern RSI injuries of the hand, wrist, carpal tunnel & lower arm, we must look seriously at our own Nature – and smarten up! Nature always knows…

Our hand muscles are a collection of approximately 18 muscles, 9 that close the hand (yes, only half) that are generally located on the FRONT of our hand, wrist & elbow… and 9 that open the hand that are generally located on the BACK of our hand, wrist & elbow. ’50/50′ for hand closing vs. hand opening muscles should tell us something… and be our first hint that hand opening muscles are important.

Then add in the study of natural grip mechanics of any grip activity…. and the evidence for grip training reform is overwhelming…

It is super easy study Nature’s mechanical grip design and to illustrate, via sEMG (surface electromyography), that both hand opening muscles and hand closing muscles fire aggressively when the fingers and thumb grab, close, flex or grip. Why do BOTH muscle groups contract at the same time?

Many people believe that ALL ‘opposing’ muscle groups perform in a reciprocal agreement… when one acts, the other relaxes.. and vice versa. But the Nature of hand muscles shows otherwise.

We now know that the so called ‘opposing’ muscles of the hand (the opening and closing muscles) work in a cooperative/supportive contraction. They are in fact A KEY CORE FACTOR of the ‘kinetic chain’ of grip. The finger extensor muscles CONTRACT to support the finger flexor muscles as they CONTRACT.  The problem is, the finger extensor muscles contract in a small static ROM (range of motion) all day, every day, all year round… and are never exercised properly by most.

In sports, music or workplace, when your hands tire/fatigue from duration activity, I can almost guarantee you, it is your hand ‘opening’ muscles that have fatigued first to cause grip fatigue/weakness. Nature’s design has been ignored. Hand opening muscles are key stabilizers for grip, but have been ignored for years.

These key muscles are the reason I developed Handmaster Plus. And it is my goal to change the way of thinking of the WORLD when it comes to hand exercise and grip strength. It is not a big change, but it is a change. Proper hand exercise addresses both hand closing muscles AND hand opening muscles. As Nature has designed it!

Needless injuries (and perform limitations) could be a thing of the past. We need to understand the hints and messages from our own Nature. Look at the anatomy. Study the sEMG patterns of grip activities. LEARN. And always question the status quo.

These weaknesses and imbalances are SUPER-EASY to prevent, but are SUPER-TRICKY to correct, especially when we don’t understand our own Nature, and the CAUSE of these imbalances. Carpal Tunnel Syndrome, Tennis Elbow, Golfer’s Elbow, Cubital Tunnel Syndrome, Dupuytren’s Contracture, DeQuervain’s Tenosynovitis, wrist tendonitis and much more, have a deep underlying hand muscle imbalance as their core cause.

Handmaster Plus brings strength, balance, endurance and circulation to the muscles of the fingers, thumb, hand, wrist, carpal tunnel, forearm and elbow, resulting in stability and maximum performance/productivity in sports, music, workplace and everyday activities.

Dr. Terry Zachary is the developer of Handmaster Plus. His goals are to: 1) change the way the world views hand exercise & grip strength training, and 2) provide a complete, convenient and cost-effective solution that ANYONE can and will actually use and understand.

For more information about Handmaster Plus or how to purchase as a partner or individual, visit www.handmasterplus.com or email us at info@doczac.com

Treatment For Dupuytren’s Contracture

DuPuytren's Contracture showing palmar adhesion

Treatment – DuPuytren’s Contracture

Although the standard causal default suspicion of Dupuytren’s Contracture (DC) is usually ‘genetic,’ I strongly feel this is a historical cop out, or at the very least, merely a thread in the fabric of the condition. The usual treatment for Dupuytren’s Contracture thus is seen as drugs and surgery.

In my opinion – and from my experience – the best treatment for Dupuytren’s Contracture is full ROM (range of motion) hand exercise – with controlled resistance, beginning at the first sign of palmar fascia tightness… or before (in prevention)! I suspect DC may be caused by prolonged unprepared tearing and micro-trama, and thus may be helped by blood flow. This statement is assuming the patient still has full or nearly full ROM at the hand. If any advanced DC or trigger finger situation is present, surgery indeed may be necessary.

Yes, I have personally seen Dupuytren’s Contracture cases do very well using Handmaster Plus. And I believe I know why.

Handmaster Plus provides resistance through FULL, NATURAL ROM’s (closing, opening, spreading), so maximizes BLOOD FLOW AND VENOUS/LYMPHATIC DRAINAGE to the entire hand. Thus, maximum nutrients & oxygen arrive to the palmar surface of the hand … and maximum ridding of toxins and by-products occurs away…. the same way all tissues repair and stay healthy…

Treatment Dupuytren's Contracture - Handmaster Plus, Closing

Treatment Dupuytren’s Contracture – Handmaster Plus, Closing

I have been very critical of repetitive grip environments and ‘grip-only’ exercise/training that overworks/brings imbalance to the palmar musculature and soft tissue (causing repair tissue change and adhesions) and minimizes blood flow & draining (due to ‘grip-only’ small ROM environment, where there is no attention to opening of the hand against resistance).. In summary, like any body

Treatment of Dupuytren's Contracture  using Handmaster Plus through full closing and opening of the hand, resulting in efficient blood flow and repair

Treatment Dupuytren’s Contracture – Handmaster Plus, opening

area, exercise & training must be through full ROM’s for the tissue to stay healthy.

My father-in-law is a auto-body mechanic, had Dupuytren’s Contracture when I met him (though mild), he has done very well… and now loves Handmaster Plus. Treatment of Dupuytren’s Contracture can stop, reverse, or slow the progression, a key advantage my father in law has witnessed. Many other cases exist with similar results. Blood flow, blood flow, blood flow. Full ROM exercise & training is VITAL. Standard hand exercise to this point in time, has been poor… using grip-only devices.

Of course, if the Dupuytren’s Contracture is simply too far along in progression, and especially if there are adhesions restricting tendon slide through a flexor pulley (i.e. trigger finger), surgery will be first, then Handmaster Plus rehab therapy will help re-establish  health, strength, balance & blood flow and minimize risk for a return of the condition.

The best use of Handmaster Plus as a treatment for Dupuytren’s Contracture is as a preventative tool… i.e. identify high force repetitive grip activities, hobbies and professions, then start to train the hand PROPERLY… through FULL ROM’s… both open and closed.

Try Handmaster Plus as part of your protocol with any patient as a rehabilitative exercise treatment for Dupuytren’s contracture that has not progressed chronicallly. Handmaster Plus is one continuous hand exercise that patients will understand and comply with. Simply ‘open and close the hand alternately’ until a comfortable fatigue is experienced. Each session should last between 30 seconds – 2 minutes. Repeat 1-3 times per day, depending upon your advice (i.e. the advice of a health care professional is essential in any treatment protocol requiring exercise).

For more information on Handmaster Plus and Dupuytren’s Contracture, please contact us at info@doczac.com

To try Handmaster Plus, please visit Handmaster Plus Store and use the coupon code TE10 for a 10% purchase discount. Your satisfaction is guaranteed. Our return policy is a ‘No Questions Asked’ full refund within 60 days.