For humans, how we use our hands has shaped how we work, express and play as an extension of our big frontal lobes. Recently, the rise in use of keyboards and smartphones has led to a rise in hand, wrist and finger issues, with risk of carpal tunnel syndrome shown to increase with keyboard use above 20 hours per week (J Orthop Res. 2008; 26(9): 1269–1273).
Those who do keep up skills in accord with how our hands evolved to use tools – crafts, woodwork and gardening – may also find themselves prey to finger, hand and wrist issues if they are doing similar actions over and over again. The repetitive strain injury (RSI) that occurs from constant use following any repeated motion is a risk factor for arthritis in the finger and wrist joints.
If you feel yourself stiffen, stop immediately and move your hands in a different way. Tingling is a common first sign that we need mobility through the architecture of the hand, where nerves have become compressed and blood flow compromised. Any signs like aches, numbness, cramps, weakness, tenderness and cramps are to be listened to and if do not abate when we change movement, warrant investigation with an osteopath or physiotherapist.
The hands as a part of the whole
Our hands are an extension of whole-body expression and in fascial (connective tissue) terms, as with any other part of the body, they are connected to every other. In Thomas Myers’ Anatomy Trains system, the ‘arm lines’ run between the fingertips, to join at the wrists, then up to the shoulders, where they reach out up to the collarbones and chest at the front and also to all many parts of the back, reaching as far down as the pelvis. So our hands and wrists can affect how we move in exercise – both from the inside out where stress in the belly effects out to the periphery and vice versa, where tightness in hands, feet and jaw can ripple into the centre.
Stress and the hands
We express so much with our hands and touch is concentrated here, representing our innate need for physical connection and love for health and healing. Compassion and kind touch are vital for our ability to self-soothe and move into the calming, parasympathetic tone of the nervous system. When we feel the opposite end of the scale and retract into survival, protection and stress, our hands can curl in or even clench like a fist, prepared to fight. As with any body part expressing a continual need for protection, this can shut us off from the receptivity to reach out, show the open palms of trust or to meet the vulnerability of another.
Well-documented trauma symptoms are numbness in the fingers, cold hands and sweaty palms, where part of the fight-or-flight (sympathetic nervous system) response is to retract blood flow from the periphery to the centre, the brain and larger muscles of movement. Fine motor finger skills are also impaired as stress demands larger motions of defence.
In a 1992 paper published after the rise of both keyboard work and psychosocial stress in the workplace, over 900 newspaper employees (with no previous injuries) filled out detailed questionnaires and their workplaces were examined. Findings reported that “psychosocial factors were more important predictors of cumulative trauma disorders of the hand and wrist” than the biomechanical criteria studied in all participants, (Scand J Work Environ Health, 1992; S2:119-20). This suggests that the hands and wrists of a stressed person with tight tissues, as with any other, are more prone to injury.
Practices for hand health
Attending to the full mobile capability of the whole hand means that we can retain strength and flexibility there. This both helps to relieve the repetitive strain of only using one set of motions and allows us to put weight on hands and wrists. For exercises where just the hands are moving, sit in any position where you can most easily rise up from your seat, so a chair if necessary.
Mobilising the wrists
Creating movement through the wrists is important regain free-flow of movement through the whole hand. Interlink your fingers and squeeze the heels of your hands together. Drop your shoulders and elbows, then make figure-of-eight shapes, limiting the motion in the elbows. Keep squeezing in the palms to the bottom, so that all movement is into the wrists. Repeat in the other direction, breathing fully to find the smoothest motion on this side that may not be your most favoured.
Mobilising the finger joints
Open out your wrists and hands to firmly interlink the fingers and open out the palms wide. Lift one wrist and drop the other, to create a continual wave-like motion through the finger joints. Keep the shoulders dropping, so you feel the motion originate from the hands. Then change the wave to the opposite direction, which as before may feel less easy and smooth, (like writing with your least dominant hand), but this is great for focus and cognition.
Opening the backs of the wrists
- From all fours – or against a wall – turn the right hand in, palm up, towards the left. Keep most weight on the left hand and play with shifting a little more and more over onto the right wrist to stretch out the back muscles, connective tissue and skin, that can commonly become compressed and seized. Move to the other side gently, noticing the difference on each and breathing fully to stay attentive to these individual needs.
- Then turn the whole hand, palm down, fingers towards the hips. Your range of motion may not be fully turned down as pictured, so even if your fingers are pointing out to the side or somewhere on the way to the full position, find the place where you can open the fronts of the wrists comfortably. This is where the carpal tunnel lies and the median nerve can become compressed and affect the thumb and first few fingers.
- Repeat with the other hand.
Stretching through the finger joints
Taking one hand out in front of you, palm out and fingers down, starting with the little finger, draw each finger down separately with the other hand to open out each joint. Be gentle and listen to your needs – this may feel quite stiff. Make your way across all fingers to the thumb, taking your time and letting your breath flow open with a calm nervous system. Then do the other hand.
Opening the inner wrists and palms in different positions
As well as feeling like a good stretch, interlinking the fingers and pressing the palms away from us also reaffirms the lines of connective tissue that can become compressed and segmented with repetitive movement. This gesture creates a big loop of space around top of the back to the inner arms (now turned to face out) and across the palms and through the fingers.
- In any comfortable seated position, interlink your fingers and push your palms away from your chest, head dropping in towards your chest to open out areas between your shoulder blades that can be the seat of much tension felt in the shoulders, hands and arms.
- From there, we can squeeze between the shoulder blades and open the chest to raise the arms above the head, engaging lines up from the hips to wrists and creating a circuit across the fingers.
- This can be extended further, standing up (heels up or down) to feel the reach up from the sides of the legs, breathing softness in the jaw and the shoulders.
Opening the fronts of the wrists with the chest
The opposite (balancing) stretch is to then open the backs of the hands and wrists, with the fingers interlinking and palms facing inwards, this creates a loop squeezing between the shoulder blades, whilst space is created in the front body. Keep the lower ribs drawing in so this is felt in the upper, not lower spine.
Body intelligence through the hands
Many exercises involve pressing up through the wrists from the ground – on all-fours and from there to position like plank or down-face dog in yoga. Mobilising and stretching joints first is key to avoiding strain from the hands rippling through the whole body. After dedicated hand and wrist exercise, we can most safely strengthen for uplift by replicating the resistance this involves against a wall.
Placing fully open hands shoulder-width apart on a wall and the same distance from the ground, step back so the feet are wider than the hips, heels under sitting bones. From here you can press all four corners of the palms into the wall and notice how this creates traction to lengthen through the side arms, side body and hips, allowing lengthen in the spine (gather up in the belly to support).
You can also notice how if you open your hands to their biggest handprint, this creates tension in the diaphragm, but a big surface area without pushing to the extreme still allows the room for breathing motion there.
Another observation is how, if we connect more with the base of the thumb and the index fingers (the pads there), we are engaging the front fascial lines that come into the chest and we can create more openness there. The little finger sides of the hands connect more to the back fascia and muscles. Those who tend to hunch may find it more difficult to connect the inner hands and the back muscles may be overstretched as the chest is caved in. Rotating the hands out can help balance this out and may be felt as a (necessary, breathe with it) squeeze between the shoulder blades as the chest opens. You can also play with these enquiries in any position from all fours on the ground.
The hands and feet together
From our evolutionary history, our previous life in the trees can be felt in the still present inter-relationship between our hands and feet. If you stand and wiggle your toes, it can feel natural to move your fingers at the same time. In a balancing position like tree pose in yoga, when we bring the hands together at the chest, this meeting can help us connect to how we press one foot into the standing leg (thigh or calf, whichever easiest) and lift up from there – up through the inner standing leg and spine. That helps the integrity of the balance, where we are continually gathering into wherever the midline is now, up through the centre of gravity. We can feel that press with fingers and palm has a push that is supportive, but not tense, so helps create strength without strain; so breathing fully into the exhalation to keep that attention to ease.
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