Patient instructions desensitization

THERAPY TO MAKE YOUR HANDS LESS TENDER

Hand injuries are often very tender during the early healing phase. Often, tenderness in scars gets worse starting one to two weeks after injury or surgery. Unfortunately, this tenderness does not always go away by itself.

The nerves in the hand are special and are more sensitive than other parts of the body. After any injury, the skin of the hand must get used to being touched again for the tenderness to go away. If you do not touch the sore areas of your hand, they may remain very sensitive and tender. The techniques of PERCUSSION and FRICTION MASSAGE outlined in this pamphlet will help speed up the process of recovery from tenderness in your hands and fingers.

The goal of these exercises is to make your wounds less tender. It is normal for these exercises to be somewhat uncomfortable while doing them or shortly afterwards. If the exercises are too painful, try using less pressure. If that does not work, then give yourself a several hour break and try again. If pain again is a problem, speak with your doctor or your therapist. These exercises will not be recommended until it is safe to do them.

PERCUSSION (Tapping):

This technique activates the automatic reflex which makes us ignore things which are very repetitive. This reflex will dull the tenderness in areas of your hand that are touched repeatedly. Here is how to do percussion:

1. Tap lightly on the area of your hand which is tender. You can tap on the sensitive area with a finger tip of your other hand or with a light object such as a pencil.

2. Find the spot which is the most tender.

3. Note the time, and begin to tap rapidly (2-3 times a second), lightly and continuously on the most tender area..

4. Keep tapping without a break for three minutes or until you notice the feeling in the area change. The area may start to feel numb or it may simply feel a little bit less tender.

5. Take a minute rest and begin again. You may find that a different area is now the most tender spot.

This exercise should be done as many times as possible during the day. It takes many thousands of taps to really change the tenderness in a sore area. The sooner you accumulate that many taps, the sooner your wounds will be more comfortable.

FRICTION MASSAGE:

The goal of friction massage is to STRETCH the scar tissue beneath the skin. As with percussion, it should be done many times during the day. This exercise not only helps improve tenderness, but helps restore the contour of the skin to a more normal appearance. Here is how to do friction massage:

1. Place a finger tip of your other hand against the central area of the scar.

2. Mentally note four directions that the skin can be pushed sideways: near, far, left and right.

3. With your finger tip pressed firmly against the scar and without sliding, gently but steadily push the skin to one side as if you were trying to slide the skin off of the bone. Hold this position for five seconds.

4. Briefly relax and then repeat this maneuver in one of the other directions. Make sure you attempt to slide the skin in all four directions.

5. If the scar is wider than your finger tip, repeat this stretching exercise on every point of the scar.

This exercise is done without any skin lubrication. Remember to do this exercise before applying any antibiotic ointment or moisturizing creams.