Episode 1639 - Accessories for grip & hand issues

Dr. Dustin Jones // #GeriOnICE // www.ptonice.com

In today's episode of the PT on ICE Daily Show, Modern Management of the Older Adult division leader Dustin Jones covers some good accessories to have on hand (ha) when working with older adults. Links to these accessories and TONS of other equipment ideas are in our NEW Ultimate #Geri Equipment eBook. Download now by clicking HERE.

Take a listen to learn how to better serve this population of patients & athletes, or check out the full show notes on our blog at www.ptonice.com/blog.

If you're looking to learn more about live courses designed to better serve older adults in physical therapy or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab.

EPISODE TRANSCRIPTION

INTRODUCTION Hey everyone, this is Alan. Chief Operating Officer here at ICE. Before we get started with today's episode, I want to talk to you about VersaLifts. Today's episode is brought to you by VersaLifts. Best known for their heel lift shoe inserts, VersaLifts has been a leading innovator in bringing simple but highly effective rehab tools to the market. If you have clients with stiff ankles, Achilles tendinopathy, or basic skeletal structure limitations keeping them from squatting with proper form and good depth, a little heel lift can make a huge difference. VersaLifts heel lifts are available in three different sizes and all of them add an additional half inch of h drop to any training shoe, helping athletes squat deeper with better form. Visit www.vlifts.com/icephysio or click the link in today's show notes to get your VersaLifts today.

DUSTIN JONES What's up crew? This is Dustin Jones. You are listening to the PT on Ice daily show brought to you by the Institute of Clinical Excellence. I'm one of the lead faculty within the older adult division. Today we are going to be talking about accessories for grip in hand issues. We do not want a sore hand, sore grip, sore wrist be the limitation of us being able to achieve higher intensities, right? This is a very common thing that we run into, right? When you are working in that old not weak mindset and philosophy that you are trying to put higher intensity loads on individuals, right? You're gonna run into bears, and we're gonna talk about how we can overcome these with different accessories and different strategies, all right? The first one I wanna speak to is a very important intervention that we will do very often in the realm of geriatrics, and that is weight bearing, floor transfers, think ground mobility, right? The ability to have confidence and independence in a floor transfer just has huge implications for folks in so many areas of life that it really reduces their fear, their fear of falling, and ultimately improves their confidence in what they can do. The walk across the room, if they fall, becomes a little bit less scary. And just think of the implications of that, right? But when we often go to do those transfers, when we go to bear weight on the ground, that can be kind of troublesome for the wrist in particular. but we don't want that to be the reason we don't do this type of intervention or transfer. WEIGHT BEARING: THE SURFACE So if we're bearing weight, one thing I want you to think about is the surface. If we're going to and from the ground or maybe a higher level like a bed or a therapy table, think about the The surface in the sense of, you know, you probably want a little bit of cushion, a little bit of softness is great, but if you have too much, that can actually be troublesome for folks. It may feel great on their knees, but it's not gonna feel great on their wrists for most individuals. If it's too soft, what ends up happening is when we go to bare weight, our palms really press down, we end up going into wrist hyperextension, which for a lot of folks is not a comfortable situation. So when we think about surface, when we're going to do floor-based activities, ground mobility, Soft, but firm. Soft, but firm. You don't want a super soft, cushy surface. Soft, but firm is going to be better, provide a little bit of cushion for the knees and a little bit better for the upper extremities and the wrists, for example. WEIGHT BEARING: CHANGE TE HAND Next thing you want to think about is maybe if we don't go open hands, maybe we go fists. That'll be a little bit easier. We could also think about using the forearms as well. And so that's the first trouble area, very common trouble area for a lot of folks. We can work around that. We could also use an accessory as well. This is the first one I want to bring out. This is basically going to be show and tell, all right? So for those that are listening, for those that are watching, I'm gonna share where you can get links to all of these things at the end of the episode, but if you're listening, I'll be sure to kind of describe these as well, so you'll get just as much out of it as the folks that are watching. So weight-bearing, floor-based activities, think about the strategies, think about the surface. WEIGHT BEARING: THE WRIST WRAP Also think about compression using something like this, a wrist wrap, a wrist wrap. Basically, a little elastic loop that you put your thumb through and then a lovely you know kind of elastic strap that you wrap around your wrist and applies compression and that can often allow people to bear a little bit more weight through their hands also typically allows them to to hold a little bit more weight particularly with something like a overhead press for example makes it a little bit easier on folks so wrist wraps our wrist wraps can be helpful in in the situation of a floor-based transfer all right so that's The first thing I wanted to mention out the bat, now I'm going to be talking about some different accessories that are focused more on working around hand grip issues, alright? WORKOUT GLOVES So, the first one, and I cannot believe I'm going to say this, because this is an accessory that I often have maybe made fun of, never thought I would ever recommend, or even wear at some point, and that is workout gloves. I said, I never thought I would say this, but workout gloves, yes. The ones with the fingers cut out and the padding, you know, you see them, right? You see them all over the place. A lot of our folks here at Stronger Life will wear them, and I was very critical of this initially, and then once I checked my bias and just dug in a little bit of why people actually like these, particularly for folks that may have arthritis, that may have a painful grip, With that workout glove, it obviously reduces friction so you don't get blisters and all that stuff. Whatever, right? I don't care about that. But what's really cool about these workout gloves is when you wrap that hand around that barbell, that dumbbell, that kettlebell, that padding basically increases the circumference of the grip and if you've ever worked with anyone that has you know that kind of arthritic pain just grip issues that the wider the circumference of the grip up to a certain point the more comfortable they're going to be. It can be very painful to kind of lock down on a barbell or a dumbbell or a kettlebell, but when you increase that circumference of the grip, even by a little bit with that padding, it makes it a lot more tolerable. And so we found a lot of folks really respond well to using workout gloves for that manner. Never thought I would say that, but I'm going to go ahead and recommend them now. So workout gloves is going to be the first one that can be helpful if we do see a grip kind of limitation or pain. WEIGHTLIFTING STRAPS Next one, weight lifting straps. All right, lifting straps. So this is basically a glorified piece of nylon that's stitched so it has a loop and you basically wrap that strap around your wrist and then you wrap it around either the barbell, dumbbell, or kettlebell. Traditionally you see it with the barbell, but I've used it with dumbbells and kettlebells with a lot of folks and they've responded really well. And it basically That strap helps support your grip strength so you can lift a lot more weight and it distributes that load more across the wrist and so you're able to hold more weight and it's usually a little more tolerable if folks do have painful, you know, painful grips while they're loading heavily. The only drawback with this one, particularly with the folks that I work with, we're talking geriatrics, I typically have to assist them in setting this up. It can be kind of clumsy to get a really good grip, a good purchase with that loop on the weight, and so I'm usually helping them out. If you're in home health or you don't have a weightlifting strap, you can kind of rig this up with something like a gait belt. Wrap that gait belt around the wrist, loop it around the weight and hold on on top of that and you've functionally created a lifting strap. S