Any advice for a frustrating, 15-month old hand injury?
August 8, 2012 4:53 PM   Subscribe

Any advice for a frustrating, 15-month old hand injury?

Yes, YANMD. Nevertheless...

I injured my right (dominant) hand in a punching accident last year, roughly 15 months ago. Stupid but unintentional, I was fooling around in front of the mirror in my bathroom and smashed the head of my 2nd metacarpal (index finger) into a vertical piece of hard wood. Spent the next two months or so with a splint and the index and middle finger taped together. The head of the metacarpal was driven back into the shaft a fraction of a centimetre, shortening the bone slightly. The bone and finger did not rotate though - apparently very positive.

I am a student and basically as soon as I could peck out words on my MacBook with my right hand I went back to using my computer as much as possible. I was told by fracture clinic specialists in my city that the bone would heal fine and they confidently told me it would be back to normal soon enough. I didn't do any hand exercises after the splint came off - I was told my hand muscles would be weakened though. However after about 11 months from the injury I realised it was not good. It was sore and stiff all the time, and the joint felt tight and crunched when I extended my index finger. Typing was painful and any extended use of my MacBook trackpad to swipe or scroll with my right hand was impossible. I can no longer remember what it's like to use a computer without pain (tapping this out with a stylus on the iPad which I bought to give myself some way to stay connected - which is frankly naughty of me.)

At this point I returned to the fracture clinic and was referred to a hand physio specialist. Sandra told me that the tendon sheaths running over the joint capsule had adhesions and had me rub the knuckle in circular motions to try and loosen them. I also did finger stretching exercises with rubber bands. Nothing really changed and after a while I started to get pain in my left hand knuckles and both wrists. Sandra told me it was most likely developing RSI and I needed to stop using computers, walk away from them permanently (for the time being), to let my hand(s) heal. She remained blithely positive that my hand will be just fine in the future.

Now it's been a few weeks since I last touched my MacBook. I have tried to stop texting, although I use my iPad more than I should (this is the first, and last, long piece of writing I will do for the time being). This is excruciating. Left to my own devices, I am an internet speed-freak. I surf, I read, I think, I research, I comment, I chat as fast as my fingers and mind will let me - which until this injury was pretty fast indeed. Having to slow down - and really I should stop completely - has been a nightmare. There is a whole world of learning, debate and networking that I am desperate for - in fact depend upon utterly if I want to move forward and make anything of my life and my skills - that is completely transparent as long as you have strong, painless fingers to tap, click, scroll and swipe upon flat, hard surfaces, and which turns completely opaque as soon as you lose that asset. I am slowed to a crawl in feeding my mind and translating my thoughts into words on the screen. I am 23. I'm smart, but after finishing my aimless university years with an aimless (though accomplished) degree in history, I feel like an overgrown man-child. I want to find a solid career direction and start learning properly and build some momentum. I can barely surf my Facebook newsfeed.

What do.

No specific questions but I would hugely appreciate any advice on any facet of my problem. Feel free to pick at underlying assumptions. Similar experiences would be awesome to hear about. Hell maybe you have career ideas for me. Shoot.

1) the thought that the most effective treatment for this sort of thing starts early and I left it too long freaks me out.
2) the idea of being locked off to one side while the internet moves faster and faster - and all the jobs and opportunities and adventures I want and need to plan and achieve using the net pass me by - freaks me out
3) looking at my hand and seeing this cramped up crippled stiff sore thing freaks me out. I used to play pretty good piano you know. Fuck. And apparently it's not even that bad. Will it ever be normal? Or do I just have to accept it being a shadow, and learn to live with drastically lowered expectations of my self-education, entertainment and career prospects?
4) I'm sick of being assured that it'll be just fine. It's been 15 months. That's a fucking long time - or is that normal? I don't know!
5) I'm not sure if I should be doing absolutely nothing with my hands, or doing stretches, or what. I have no idea what the balance is. I go for a while doing almost nothing but soaking it in hot water + Epsom salts and/or old water - then suddenly get furious at it and want to beat it into submission or cut it off.
6) yes, I know I shouldn't even be tapping out this post. Sorry, this is a once-off. I'm so frustrated and I guess I need some support.
7) if I was a Roman patrician with a small flotilla of slaves I'm sure this would be a bit easier to handle. As it is, my mum is incredible and is taking care of me and doing anything and everything I ask of her. But I can't use her to live my private net life for me...

Thank you very much in advance for your time and consideration in reading my story :)
posted by schmichael to Health & Fitness (8 answers total) 1 user marked this as a favorite
Time for a second opinion from a hand specialist. Also, step away from the computer/keyboard/iPad. Step. Away. While you wait for your second opinion appointment please follow your physio's instructions to the T. A couple of weeks of rest is not sufficient rest for a RSI.

This may be really wrong of me, but I want to tell you to, "Snap out of it, man!". I had carpal and cubital tunnel syndrome in BOTH arms and suffered for 18 months before I could get surgery. Some days I ate food off my plate like a dog because I was in too much pain to use my hands. All you can do is keep following doctor's orders while you keep looking for an answer. A third opinion surgeon is responsible for my ability to type today. Go find a new doc!
posted by PorcineWithMe at 5:25 PM on August 8, 2012 [3 favorites]

I broke my right index finger (I am also a rightie), had surgery, suffered in constant (but medium-level) pain for 3 years until I decided to get a second surgery to fix it. I now have regular but not constant low-level pain, which is much, much better. I have zero use of my right index finger, but can type just as fast as I ever could. There are a few things I can't do that require a very specific sort of fine motor control, but otherwise I have no limitations.

Quit using your right hand for now. Find a second physio, and also a second opinion from a doctor. Do the exercises they suggest, especially if you have adhesions. Learn to type with your left hand: it's slow, but not THAT slow, and then you won't be left out of whatever it is you miss about the internet.
posted by jeather at 5:32 PM on August 8, 2012

I don't have advice for your specific hand injury, but I can tell you my own experience. They told me "this is going to be a long, difficult process for you but eventually you're going to barely remember this happened," and 15 months post injury I wouldn't have believed that, but now, 6 years later, I basically do. My hand definitely doesn't work right, but over time you learn new ways to do things. The hand surgeons and the occupational therapists know what they're doing -- do as they say.

And remember -- there are people with brutal RSI who find ways to use computers effectively. The IT guy where I work is completely blind, and he can use computers effectively. So can you. Brains are amazing. Learn how to do what you want to do in a way that works for your body, and your brain will eventually become very efficient at doing it that way.
posted by escabeche at 6:06 PM on August 8, 2012 [1 favorite]

Ok, after you see a specialist, you should start getting a workspace set up that is more ergonomic.

This page has lots of nice guidelines for how to set up a workstation to prevent yourself from being injured. A key thing to think about is how laptops are designed. They are designed to be portable. They are not designed to be ergonomic. In order to use a laptop in the ideal typing position, your neck must be angled in a non-ideal viewing position. In order to use a laptop in the ideal viewing position, your wrists must be angled in a non-ideal typing position. Put some thought into how you are using your computer because it is more complex than it seems, and you can really hurt yourself with continued repetitive usage!

If your iPad hurts to use, sell it and use the money to buy ergonomic equipment. You never know what you can find used, either. I have recently begun moving in the direction of developing an ergonomic work setup for myself, and found on Craigslist just a few days ago this wonderful keyboard tray which I promptly installed into my desk. MSRP, $280. I paid $50. So look around for these sorts of things on the used market too because you'll never know what you'll find.
posted by oceanjesse at 6:13 PM on August 8, 2012 [1 favorite]

Have you tried voice recognition software instead of typing? Do whatever you need to do to help yourself follow the physio's advice and give your hand the rest it needs.
posted by snorkmaiden at 10:38 PM on August 8, 2012

Try some alternatives to using the mouse and trackpad with your dominant hand.

First, see just how dominant that hand is. Switch the buttons (for example, instead of "right click", you'll be using the same finger on the other hand to press that button) and try it with your left hand for a while.

There are such creatures as a foot mouse, head mouse, and eye mouse. If you are lucky insurance might even pay for them.

Try using a trackball mouse that you can move with the thumb of your dominant hand, and use the buttons on the trackpad with your left.
posted by yohko at 8:28 AM on August 9, 2012

I have a similar problem with my dominant hand after an injury -- it is slowly improving, but it is very very frustrating. So I sympathize. But take a deep breathe. See another physical therapist and hand ortho and make a plan to rehab your hand.

IANAD but I do have hand and wrist problems and my personal experience has been that the iPad is way, WAY worse on my carpal tunnel/tendonitis than the laptop is. I think you would be better off using your actual computer when you need to.
posted by Countess Sandwich at 11:30 AM on August 9, 2012

My wife suffered a massive infection in her dominant hand last spring, surgery for draining the infection, or the infection itself damaged the tendon sheath in her index finger.

While her hand has recovered completely and even looks normal, the last joint on her index finger no longer bends on it's own, even after months of twice a week PT and wearing a weird finger brace for hours per day.

Don't know if her typing is affected, she's been too busy child rearing to be using our PCs and doesn't have a cell.

The physical therapy has made her hand stronger than it was pre-surgery but she still can't "pinch" or pick up a thin sheet of paper. the therapists have "done all they can" so she's going back to the plastic surgeon to find out if there's a solution or can be referred to a hand specialist.

More surgery is probably the solution but at this point in her life since it causes no pain, she's not sure if the surgery is worth it.

In your case I'd follow up with a hand specialist / surgeon for other opinions.
posted by DBAPaul at 6:54 AM on August 10, 2012

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