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Planning Retirement Online

Home Exercise and Rehab

September 2012


Gina John Gina John is a Pilates Practitioner and Registered Osteopath who has spent many years offering help and advice, especially to the over 50 age group.

She is founder of The Osprey Clinic in the St. Johns Wood area of London and now specialises in Home Exercise and Rehabilitation Programmes. For further advice on exercising safely, and a selection of exercise films for general fitness and medical conditions, visit the website:




This month Gina looks at dealing with aches and pains in the hands.

Q: I don’t usually have aches and pains in my hands, but since returning from holiday they feel very stiff especially in the morning. Does that mean that I have arthritis in my hands and will exercise help to improve the problem? 

This is usually a busy month for sorting out bills and outstanding paperwork, especially if you’ve been away for a summer holiday. And, as you get back to the computer or start sifting through the papers, you may be aware that your hands are feeling stiff and creaky, in which case some gentle exercise, as explained below, will help.

Many people assume that pain in the hands indicates the onset of arthritis, but it is important to bear in mind, that any muscle in the body may complain when you resume your activities after a break or start a new activity.

The muscles and tendons in the fingers and wrists may become sore if you are typing letters for a period of hours, so it is sensible to take a break from the computer every 40 minutes for stretching your hands, not to mention giving your eyes a break from the screen!

Degenerative arthritis in the hands is common and is characterised by stiffness or soreness in the morning and after working with your hands. The affected joints and soft tissues surrounding them may be red, painful and swollen.

Commonly the middle finger joints are affected and in the more advanced stages of arthritis and bony spurs referred to as Bouchard’s nodes, may form around the joints. If nodes form on the distal joints, closest to the fingertips, these are referred to as Heberden’s Nodes. These nodes typically start to develop in middle age, either after a period of swelling of the joints or after a sudden painful onset. A permanent bony nodule arises from calcification and new bone formation, which commonly skews the fingertip sideways and affects manual dexterity.

Especially, if you have arthritic hands swelling may occur in the tendon sheaths which surround the tendons between the wrist and the fingers. This condition is called Tenosynovitis and tends to present with widespread swelling, pain and redness in the hands and you will need to seek osteopathic or physiotherapy treatment and exercise advice to help resolve it. When only swelling of the tendon sheath between the wrist and thumb occurs, this is referred to as DeQuervain's stenosing tenosynovitis, and movements of the thumb become very painful. Activities such as knitting, cooking or using tools may bring on the condition.

If one finger or the thumb becomes fixed in a bent position or if there is a clicking sensation on extending the digit, this is referred to as Trigger Finger. It occurs if a small nodule forms along the tendon, which then creates the click as it passes through the tendon sheath on flexing and extending the digit. Trigger Finger is most prevalent in the 50 – 70s age groups and may occur in association with Carpal Tunnel Syndrome or hand injuries.

Another common condition of the hands is Carpal Tunnel Syndrome. This condition arises when the nerve which passes through the wrist is pinched or compressed. The ‘Median nerve’ as it is termed, is involved with movements of the wrist, thumb, fingers and forearm as well as sensation of part of the hand and wrist.

Characteristic symptoms of Carpal Tunnel Syndrome include pain, tingling or numbness in your hand, especially in the thumb, index and middle fingers. Pain may also be felt in the forearm in muscles are served by the same nerve. Wasting or weakness in the muscles at the base of the thumb is a common feature. People who work computers or use vibrating tools are particularly at risk of developing the condition.

As symptoms are often worse at night and disturb sleep, wearing wrist splints overnight is a typical part of treatment for the condition. Patients may be offered steroid injections or surgery if symptoms persist.

In all of the conditions discussed, anti-inflammatory gels are helpful if the wrists or hands are painful or swollen. After washing in hot water and after using your hands, always hold them under cold water for about ½ a minute. This helps to control reddening or swelling.

Here’s a selection of gentle exercise which should be performed 2-3 times daily.

Sit with your elbows into your waist with the palms of the hands facing the ceiling to start.

1. Scrunch up a sock in both hands, hold for 10 seconds and repeat 10 times.

Hand Exercise 1
2. Keep your fingers straight while you open out the fingers, widening the gap between them as much as possible, and close them again. Repeat 10 times.
3. Straighten your left arm fully and bend the left wrist, by pulling down the left fingers with your right hand. Hold for 10 seconds and repeat the stretch to the right wrist. Hand Exercise 3
4. Keeping the left arm straight, bend the left wrist by pulling up your fingers to the ceiling. Hold for 10 seconds and repeat the stretch to the right wrist. Hand Exercise 4
5. Circle your wrists 10 times clockwise and 10 times anti clockwise

Please send your questions for future columns, or feedback, by email to Gina John on

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