So I’ve been working for nearly three weeks now, it feels like it’s flown by as I’m starting to get used to it. One of the things I experienced in my first two weeks was some first CMC pain. Just a general dull ache, and pain on palpation of the joint. I felt like such a weakling because I’d only been working for a couple of days before it started.
I bought a pair of Thumbsavers a couple of months ago, when I knew I was going to go straight into private practice. Like everyone doing manual labour, I am afraid of overuse and degenerative conditions related to massive amounts of force applied. So I bought them, they arrived, but I never really learnt how to use them properly so that my clients wouldn’t notice I was using them.
After a week of working, I decided to work on my willing sister, willing to be the guinea pig for me to test out some maneouvres for them. They were fantastic! She couldn’t tell the difference, and I was able to push much harder with significantly less effort from my intrinsic hand muscles. But the thought running through my mind was that there was now more force going through other joints – that could have unknown long term effects too.
I asked my boss for some tips regarding manual therapy, as he has been in the private practice industry for 20 years and uses predominantly manual therapy. In Cantonese, he said I have to use literally more ‘inner strength’. In the Western world, I suppose we could describe that as ‘bodyweight’.
So I thought about this an I have changed the way I work a little bit. My hands are less tired and sore but I have a feeling my wrists in general are going to take a fair bit of wear and tear in the years to come. The focal pain in my first CMC is now less noticable, but there is still a bit there when I palpate it. I hope it doesn’t turn into a dull, chronic thing that I just don’t notice because my hands have now just been ‘conditioned’.
At this, I will continue to think about what techniques I am using, and see if I can modify the way I am working to reduce this further. I am going to learn dry needling at the end of March, so hopefully that can give me more, effective passive treatment options (rather than just interferential and ultrasound). I don’t really do spinal moblisations, as I find soft tissue work addresses the cause of stiffness better than mobilisation, apart from for assessment and gentle mobes in older patients who clearly have degenerative joint disease.
The dreaded thumb pain in action.
