Diagnosis Explanation:

Dupuytren’s contracture is a progressive thickening and shortening of the palmar fascia, leading to finger contractures (most commonly in the ring and little fingers). This condition is caused by abnormal collagen buildup, forming nodules and cords that gradually pull the fingers into a permanently bent position. It is more common in older adults, males, and those with a family history.

Symptoms:

• Firm lumps (nodules) in the palm, often painless.
• Thickened, tight cords beneath the skin.
• Progressive finger bending, making it hard to straighten affected fingers.
• Difficulty gripping objects or placing the hand flat on a surface.

Specific Work Modifications:

• If your job involves typing or writing: Use an ergonomic keyboard, voice dictation software, and hand rests.
• If your job requires manual labor: Use adaptive tools with larger grips to reduce strain.
• If your job is desk-based: Take stretch breaks every 30 minutes to prevent worsening contractures.
• Avoid: Forceful gripping, repetitive hand use, and prolonged wrist flexion.

Specific Activity Modifications:

• If you play an instrument or craft: Use modified grips and finger splints to improve function.
• If you play sports: Avoid racket sports, golf, or weightlifting that require strong gripping.
• If you do gardening, knitting, or cooking: Use ergonomic tools with padded grips.
• Avoid: Repetitive gripping, prolonged fist clenching, and activities that strain the affected fingers.

Recommended Supplements:

• Collagen Peptides – 10g daily to support connective tissue health.
• Vitamin C – 500mg daily for collagen regulation.
• Magnesium – 300-400mg daily to improve muscle relaxation.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief and inflammation reduction.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support connective tissue health.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain tissue flexibility.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to support tissue elasticity.

Home Exercise Prescription (Rehabilitation for Dupuytren’s Contracture)

Early Phase (0-2 Weeks, Reducing Stiffness & Maintaining Mobility):

• Finger Stretch Against Table – Place palm flat on a table, gently press fingers down, hold 10 seconds, repeat 10 reps, 2x/day.
• Passive Finger Extension – Use the opposite hand to gently straighten fingers, hold 10 seconds, repeat 10 reps, 2x/day.
• Finger Lifts – Place hand flat, lift each finger individually, 10 reps per finger, 2x/day.

Strengthening Phase (2-6 Weeks, Improving Hand Strength & Endurance):

• Soft Ball Squeeze – Squeeze a soft ball 5 seconds, repeat 10 reps, 2x/day.
• Rubber Band Finger Extensions – Wrap a rubber band around fingers, open hand against resistance, 10 reps, 2x/day.
• Towel Scrunches – Place a towel on a flat surface, scrunch it using fingers, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Preventing Progression & Maintaining Function):

• Finger-to-Thumb Opposition – Touch thumb to each fingertip, 10 reps, 2x/day.
• Wrist Circles – Slowly rotate wrists in both directions, 10 reps, 2x/day.
• Grip Strengthening (Light Resistance) – Squeeze a foam ball or therapy putty, 10 reps, 2x/day.

Helpful Books:

1. The Hand and Wrist Pain Solution: Simple Exercises for Relief – Dr. Ross Clifford.
2. Living with Dupuytren’s Disease: Understanding, Treating, and Preventing Hand Contractures – Dr. Charles Eaton.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.