Continue with onX Maps
Sign in with Facebook
Dupuytren's??
 |
|
Dupuytren's Contractures usually only affect one or two fingers. Usually on one hand. The tendon becomes stiff and shortened and sometimes locked in place. In the picture below, you can even see the fibrous material that has built up around the tendon. This doesn't appear to be what's happening with you at all. Since it's all your fingers, and on both hands, I think you just have very stiff tendons. It doesn't look pathological to me. I wouldn't worry about it. You could just do light stretches like you would for any habitually tight tendon or muscle (mine are the hamstrings). But I'm also not sure if you are actually experiencing any disruption or impediment at the moment. Like, does not being able to bend your fingers past 180⁰ affect your life or your ability to climb?  |
|
I have it and it hasn’t held me back. Been stable for about 15 years. |
Colonel Von Spanker wrote: Did you get treatment for it at all? How many nodules/cords? Thanks man! |
|
I'll revive this thread with a monster post as I just recently (on July 19, 2023) had surgery in my right hand for Dupuytren's contracture. I'll edit/update as things progress. [NOTE: There are several other threads on this topic if you do a search on this site.] Why did I elect surgery? My right hand had slowly gotten worse over the past 7-10 years or so. It was never really painful at all and it never affected my climbing. I have no idea if climbing made it worse or caused its development to slow down. From what I understand, a lot of that is simply up to hereditary factors. This disease tends to hit older, white, northern European males more than others--my exact DNA profile. I had gotten to a point to where I could not lay my hand flat on a surface. To do pushups, I had to put a block under the butt of my palm as I couldn't bend my hand 90 degrees to my arm. It was also getting difficult to insert my hand into a tight jeans pocket. I suppose, eventually, getting my hand into tight hand cracks would have been affected. So... I elected surgery and the doc thought it appropriate as well. There were other, less invasive (quicker recovery), options beside this "open" surgery but none that offered better final results. Here is what it looked like in the days before surgery. Note the three bumpy nodules which mainly affected my three smallest fingers:  The surgery took about two hours and I was initially fully asleep. They had also used a "blocker" on my right arm to numb the limb. However, apparently I was twitching my hand a bit in my "sleep" so they woke me up... I was then conscious and listening to the two surgeons' conversation working on the other side of a sheet barrier. I felt no pain at all. After the surgery, they wrapped my hand in a thick bandage that included a bulky wad over the palm for protection:  They sent me home after a couple of hours in recovery with pain pills and stomach protector pills, but I ended up only taking one of each and probably didn't even need that. There was some pain in my hand, but it was easy to deal with without medication. More uncomfortable was the thick bandage with the summer heat. I was told to move my fingers and wrist as often as I could but (obviously) not force things into the pain zone. On Day 11, I thought I'd see if I could climb something, so headed to the gym with my wife and did a few routes on autobelay (5.6-5.8 range). I found I could actually pull on my fingers at maybe 50-60% of normal and there was no pain at all with the tendons. I tried a 5.10 route, as a test, but backed off on the small holds near the top as it felt like I might put too much pressure on the wound and the stitches. The bulky wad on my right palm was a major hinderance as well. Recommendation...yes, maybe try some very, very easy climbing, maybe some one-handed traversing--but DON'T pull hard on that injured hand yet! Let it heal! On the pink route (in the corner!) at the gym:  When they took off the bandage on Day 12 (what a relief... and I could wash it!), the wounds and stitches looked like this:  They trimmed off a few stitches, but left most of them intact for the next appointment... can now use my right hand to wipe myself (ew, gross!) I guess I had not done any damage to the wound or stitches with my one easy climbing session the day prior. (Much relief--and I didn't mention it to the doc.) I still couldn't completely extend my hand, though, but that was likely because of the wound not being at all healed and the tightness of the stitches. I could see and feel (sense?) that the issue of the trapped tendons had been resolved by the surgery. The Dupuytren "bumps" were gone. From here on, whenever I went outside, I would slide a thin net-like cuff over my hand and put a gauze pad under that and over the wound for protection. At home, I kept the wound open to the air. Without the big bulky bandage, and with just a light protective bandage, I went to the gym twice more--always just climbing the easiest routes on autobelay and working on the best possible form, trying to take it easy on the hand. It was sooo tempting to try harder stuff to "test" my hand, but I managed to resist. During the second session, I climbed and downclimbed something like 20 total routes 5.6-5.8 (and afterwards thought I might have overdone it). I made sure to thoroughly was my hands after. On Day 16, I came back to the clinic and they removed the rest of my stitches. Apparently, the climbing had not done any damage to the wound/stitches (again... relief) and it looked like this:  Note that the top right of the "Y" scar is beginning to heal nicely. Just below the junction of the "Y" you can see a lot of healing still needs to happen (you could still see down to the dermis a bit). I was instructed to keep the wound open while safe at home, but cover it whenever I went out. I was given a disinfectant cream to put on it (very lightly) in the morning and Benadine just before going to bed. There are some random small spots on my palm, mostly near the scar, that feel numb, but they say that will improve over the next few months. The doc will do a follow-up via telephone in January when we return from some planned long-term travel. I am to call if anything unusual transpires in the meantime. Overall, I'm pretty happy with the surgery so far, even if I probably won't feel comfortable climbing outside/belaying/handling a rope for another 3-4 weeks (about six weeks total). If I'm careful, I can get my "fix" in the gym on autobelay--and consider the time as an opportunity to do some balance and one-handed drills as well as trying to maintain perfect form and breathing on easy routes... not a bad life, really. Oh, and all this was totally free, as I'm in Spain (well, we do pay taxes). No bill whatsoever, not even a copay, and two months from initial appointment, through pre-op, to surgery. Interestingly, the two surgeons, the anesthesiologist, and all the nurses, were female... Elizabeth Blackwell is surely smiling about that. ; ) I'll update once I get out on the rock, probably in early September. Day 21:  This looks bad, but the surgery wound is actually healing quite well. There is new "baby" skin under all that ugly crust. I have to resist the urge to pick at it--need to let it sluff off naturally. In the rock gym, I'm pretty much back to where I was before surgery, except I have to avoid fat slopers that require a full right-hand palm (for obvious reasons), but crimp strength seems fine with no pain at all in the tendons. I'll still wait a couple more weeks before going outside, though--I want to be at 100% for climbing, plus just handling/belaying with the rope with this hand is important. Normal flexibility with fingers and wrist has not yet returned, that is, ability to bend them back. I think this is because I couldn't bend them that way for years due to Dupuytren's. It remains to be seen if I can regain that original/normal flexibility with some exercises. That type of flexibility, though, doesn't really seem to affect my climbing. Day 28:  The surgery wound is mostly healed, although the new skin underneath is very tender (slopers with this hand still out). Also, a small area right in the middle of my palm is still numb with no feeling. The doc said it may take months for that to go away. It's obvious in the photo that the Dupuytren's "bumps" are now completely gone. I'm trying to work on bending back my fingers and wrist now to regain flexibility--another long process (months?). In the gym, I'm basically full up on crimps and normal holds (with the aforementioned caveat of avoiding routes with palm-sized slopers). In another week I should be healed enough to get outside and handle the rope, belay, etc. with no major issues. At 5 Weeks:  At 6 Weeks:  I'm pretty much 98% recovered at this point. The new skin is still a little sensative on slopers, but the scabbing is all gone. There are still small areas of numbness on my palm, but hopefully they will recover over the coming months--and they don't really affect climbing or daily tasks at all. My wrist and finger flexibility will take some months to get back to "normal" (after years of being slightly and abnormally "contracted") but both are at about 90% and don't affect climbing. Hope this has been helpful for anyone contemplating Dupuytren's surgery. |
|
P.S. Maybe if Climbing Weasel could come back and edit the title so it is spelled correctly then maybe more folks could find this post in the future. Just a thought... |
Daniel Joder wrote: Oh thanks. What can I say, my inflexible weasel paws aren’t good at typing. |
|
Sent you a DM… |
|
Or the VA… despite some past issues and some remaining pockets of problems. Yes, health care was a key issue for my wife and I in our decision to move to Spain. No system is really perfect, but some are certainly better (read: more humane) than others. Headed to the gym tomorrow to do one and a half handed repeats on the pink 5.6 in the corner. I’m a happy camper! ; ) |
Daniel Joder wrote: I’m trying and don’t see an option to do so; haven’t had to edit anything yet. What’s the process? |
|
Hmmm. I assumed you as the OP would have an “Edit” option for your initial post which would include the title. If that isn’t the case, I’ll have to defer to someone who is less IT-challenged than I am. Sorry to be of no help Were you definitively diagnosed, by the way? Or is your appointment still to come? |
Daniel Joder wrote: Not seeing any edit button. Also not diagnosed with anything I think I just have stuff hands and spooked myself. |
Climbing Weasel wrote: Look at the bottom of your last post. There should be an edit button. |
|
Dupuytren's is associated with a gene inherited from Neandertal ancestors:
|
|
Dang, Neandertals... I have a relatively high percentage inherited from them. Although, I seem to remember reading somewhere that they were more peaceful than the homo sapiens who eventually dominated. True? No idea. Ms. Google probably knows. EDIT: Thanks, Climbing Weasel, for the title spelling edit!!! |
|
@Daniel Joder. How are things with your hand? Im considering the surgery on this paw. I still climb, but Ive been playing more hockey than climbing lately and the dupuytrens seems to be leading to a weaker grip strength and total muscle mass in that arm which leads to worse stick handling and fewer won stick battles etc in that sport. Hockey is much more like weilding a sword so the “viking disease” moniker kind of resonated. Ive not seen anything that indicates hockey players have a higher prevalence though so I chalk mine up to grinding my facia and tendons against the rock I’m hoping surgery would improve both activities.
  |
|
Hey, bus driver. Wow, that looks like a hand that might very well be recommended for surgery. You'll have to consult a specialist to be sure, though, as I am certainly not a doc. My hand was getting close to that when I had my surgery done. Maybe they have some new techniques out now??? (For what it's worth, my specialist said, yeah, there are other options one could try but none will clean things out as well as just opening up the hand and scraping away the crap.) So, how is my hand a year after the surgery? I have a pretty obvious scar... I can extend my fingers in plane with my palm (flat on a table)... I almost have 90 degrees of bend with my wrist (for doing push ups), but not quite. Pertaining to the latter, it could be for two reasons: 1) For years I had poor flexibility there due to the developing Contracture, so maybe I'll never get it back, and 2) I didn't do any post-op PT and was kinda lazy about doing flexibility exercises. I would say, though, that it is significantly better than it was pre-surgery. As to climbing, I feel like I'm absolutely full strength and do not feel hindered in any way. In fact, I think I was back to full strength within about two months post-surgery. One minor complaint might be that the scar tissue (see pic below) is a bit sensitive when scraped on the rock and there are still a couple of very, very small areas of my palm where I have lost sensation. There is really nothing that affects my climbing, though, that I could trace to my hand (I'm 65, so there are other, bigger, limiting factors now).  |
