Dupuytren's contracture

So, I have just diagnosed myself with an early stage of this disease, which makes me a little worried, since I'm evidently developing it quite early at age 39, meaning that it has plenty of time to progress until the point where my pinky and ring finger eventually becomes a hook or at least restricted in extension. Bummer, since, as everyone else on this forum, I care a great deal about maintaining my mobility as I grow older.

https://en.wikipedia.org/wiki/Dupuytren%27s_contracture

I am 99% sure my diagnosis is correct, as the symptoms are spot on, my father has it too (it's hereditary), and I have some other rheumatological co-indicators. It also appears to be more prevalent in climbers, which I am.

I have of course booked an appointment with my MD to confirm.

On the upside, I guess keeping the hand mobile by doing the H1 wrist prep 2-3 times per week can only be a good thing. Also, the colloquial name of the disease is 'viking hand'. So, I'm officially of viking heritage.

Questions:

Do any of you guys have any experience with this disease?

Apparently, the Danish healthcare system has a policy of only intervening once the disease has progressed to the point where reduced function occurs (a positive tabletop test). However, studies show that radiotherapy can have very good effect if used at early stages of the disease. Is that something I should be insisting about, when consulting my MD?

Hi Ravn, 

I don't have any useful information on treatment, but good luck with managing this and I hope your Foundation journey can side-step this where necessary.

Viking huh? Respect! 

Best wishes,
Kate

I would recommend:

1. Lots of finger extension stretches every 2 hours. I would do these as single and all finger stretches.

2. Self massage

3. Reduce time spent climbing and possiblly stop

4. Speak with the medical doctor

Thanks Mark, I'll do that. Really having trouble deciding about no. 3 though...

I'm most concerned that the disease tends to be more aggressive if it manifests at a young age. We'll see what the MD says, but I think I can already guess the answer.

My grandad had a similar condition and he was recommended to some manual therapy such as playing piano, he never did so I don't know if it helps or not, best of luck with managing your condition

So sorry to hear this Ravn, please keep us up to date and best wishes.

Thanks Cole.

It's not the end of the world, apparently ~40% of Danish men in their seventies have it to some extent. Just feels like I'm growing old very fast these days!

Hey Ravn,

I have seen quite a few cases of Duputryn's contracture in my time. Most people don't do much to manage it or deal with it however, and only seek help when it has advanced enough to cause a loss of function.

If I remember rightly there is a positive correlation with alcohol consumption and an increase prevalence alongside diabetes mellitus. Not sure how either of those relate to you personally but something to think about (reducing sugar/carbohydrate intake may have a positive effect?)

I would agree with Mark about what to do practically. Self massage can be so underrated! I would use castor oil and use quite strong digital pressure working from the wrist to the MCP joints (first knuckle) and from the MCP's toward the wrist, for local hands on and you can do these in conjunction with the stretches. I would also work on the entire forearm musculature also and make sure to keep the axilla (armpits nice and open). Crucial for good lymphatic drainage of the upper extremity as a whole.

If you think about the hand and arm in terms of fascial chains, then it would be a good idea to stretch the whole anterior aspect of the forearm, arm and chest together. Table holds would be good, perhaps you could increase the stretch through the palm of the hand and forearm flexors by placing the fingers on a book, building up to increased thickness.

I personally think diet and nutritional elements will have a big impact on how much it progresses, even though there may be a genetic predispositon, i'm sure the diet of those 40% is fairly uniform.  

Keep us posted :-)

Thanks so much guys, this forum is invaluable in its support and knowledge sharing.

I hardly ever drink alcohol, maybe once a month, and then it just a glass or two of wine, or a beer. I'm also not a soda drinker, although I do eat a bit of candy on Friday nights, and sometimes some sweetened types of yoghurt and/or white bread, mostly post workout, when I figure that I need some carbs.

Interesting perspective about the diet, although it is going to be extremely difficult to establish any sort of causal effect on the progression of the condition in relation to dieting.

I'll get to work on the stretching and self massage.

Wes, could you perhaps illustrate what you mean by stretching the anterior forearm and chest at the same time? I imagine something like resting the fingertips against a doorway, then turning the torso away until chest, biceps and hand flexors are stretched?

I get what you mean about using books, seems like a good idea.

Hi Ravn,  

I first noticed something different in my left hand around 30.  At 32, I was at the doctors for something else and he informed me that I had dupuytrens.  I'm turning 39 today.  All I've done is the wrist work in the GB handstand course since it came out, and not as consistent I should.   At first I didn't think about it much and could feel it getting a little tighter.  I was able to lose the tighteness and my wrist and hands are as flexible as they've ever been.  I still have a lot work to do, but I had that before the dupuytrens showed up.  The wrist work has been a blessing. Thanks once again to Coach and the GB team.  I have two uncles and an aunt with dupuytrens and they were not very proactive in meeting the condition.  Not sure what advice they were given, if any.  Fight the good fight my friend. 

To Mark and Wes, 

Thanks for your advice guys.

This post was a nice reminder to not get lazy .  Thanks

Jacob, good to know. Thanks for sharing your story, I'll definitely keep doing the wrist work indefinitely.

Does the finger lock?

I have this in both little fingers, and when they lock, the least painful way to unlock them is to bend the elbow and the wrist as much as possible (to put the flexor tendons on slack), then manually unlock the finger(s).

The H1 wrist work has helped, definitely. I'm a massage therapist and so self-massage helps a lot as well.

NickM said:

Does the finger lock?

 

I have this in both little fingers, and when they lock, the least painful way to unlock them is to bend the elbow and the wrist as much as possible (to put the flexor tendons on slack), then manually unlock the finger(s).

 

The H1 wrist work has helped, definitely. I'm a massage therapist and so self-massage helps a lot as well.

It's in a very early stage, so no locking. With Dupuytren's contracture, the flexor/extensor tendons are not affected. It is a thickening of the subcutaneous connective tissue in the hand, which looks like a triangle extending between the wrist, the first knuckle of the index finger, to the first knuckle of the pinky. Over time, the thickened connective tissue extends out into the pinky and ring finger, contracting them and preventing extension.

I have no loss of motion whatsoever, yet.

Update:

My MD confirmed that the condition is Dupruytren's Contracture, and I have been referred to a hand surgeon for further investigation/advice/treatment.

The condition is not yet at a stage where surgery is an option.

Hi NickM,

No locking of the finger here.  Early on I noticed some tightness.  The tightness left once I started some mobility work.