Exercises to Strengthen Hand Muscles & Coordination:
Have you ever hurt your hand and had the realization of how much you use it in your everyday activities? We should, because we take our hands for granted. This past year, I had the unfortunate experience of losing function of my hand after accidentally lacerating it when I fell. I now have a greater appreciation for hand functions. As a manual physical therapist, my hands are a necessity to me, but this experience provided me so much more appreciation for how much we use our hands for every day actions. The journey to regain my strength helped me appreciate how to address the hand, elbow, and shoulder.
There is a saying in the physical therapy world, “proximal stability before distal mobility.” Simply put, stability in the hip and shoulder is needed to move the hand or foot in a smooth, coordinated action. When strength and control is not established in the proximal joints, there is increased stress placed on more distal joints, like the wrist and hand. Hence, when addressing issues of the hand, the elbow and shoulder need to be strengthened or mobilized, and ideal posture and biomechanics achieved. Think of a push up. If the shoulders are elevated, turned in, elbows locked out (hyper extended) then the wrists can be placed at a poor angle and the client can complain of wrist or hand pain and/or tingling.
Even when strength and flexibility are ideal, a client can still experience hand irritation due to repetitive stress and strain. Chronic strain can lead to continued irritation to nerves, tendons, or both. Symptoms include weakness, fatigue in the grip, movements, or nerve sensations such as numbness or tingling. Treatment and prevention include ensuring an optimal wrist and hand alignment with grips and hand activity.
The following outlines how to address shoulder, elbow, wrist, and hand for not only treatment but more importantly for prevention.
Forward head and rounding of the upper back and shoulders places the shoulder muscles to rest at a bio-mechanical disadvantage and the nerves from the neck effecting the upper body for providing optimal strength and stability. Keep the chest open, collar bones wide, and shoulder blades slightly together and down. Exercises can include:
2. Shoulder extension while sitting, kneeling, or lying on your belly
3. Shoulder Horizontal abduction/ Wide Rear Fly extension while sitting, kneeling, or lying on your belly.
4. Pull Ups
5. Stretching: Latissimus stretch kneeling facing tower
When isolating the elbow or wrist, ensure that the joints above or below are not moving to compensate. Since these muscles tend to be smaller in nature, load does not need to be high. If greater stability at the shoulder is needed, perform biceps and triceps in a supported spinal position, such as supine and inverted supine.
3. Wrist Flexion/ Extension (forearm curls)
4. Wrist flexor and extensor stretching
Strengthen Your Hand
There no specific exercises on the Total Gym which address the hand itself but there are some important aspects to note:
1. If the wrist is in a poor alignment, then the muscles of the wrist and hand are strained.
2. Have a good grasp of the handle.
3. If pain is felt about the thumb with the grasp, then align your thumb with your fingers versus around the handle.
4. Use a rubber band to strengthen the wrist extensors, and squeeze a small ball for finger flexors.
5. Stretching the hand can be incorporated with stretching wrists as the hand muscles cross the wrist.
The hand is highly innervated from nerves originating in the neck. Radial, ulnar and median nerves are the primary nerves impacting the hand. The ulnar nerve innervates the pinkie finger and half of the ring finger. The median nerve innervates the half of the ring finger to half of the thumb on the palmar side and then the top three on the knuckles on the dorsal side (back of the hand). The radial nerve innervates the half of the thumb on the palmar side and dorsal side on the thumb and first three fingers to the knuckle. Nerves can also get tight. In the rehabilitation world, stretching, also known as gliding or flossing, is one way to treat and prevent nerve irritation. See video for techniques for nerve gliding, which can be done 8-10 times and 1-3 times a day.