089. Combating hand wrist injuries part 2 - Objective assessment with Ian Gatt

Your knuckles getting crushed in an overenthusiastic handshake by hands the size of watermelons isn't a fun experience. Do these knuckle-crushers know they're squeezing that hard, or do they just regularly snap pencils while taking notes, and wonder why pens and pencils are so fragile nowadays?

How much grip strength do you actually need, even if you're not planning on crushing any knuckles the next time you meet someone? How much grip strength do your patients need when recovering from a hand, wrist or upper limb injury?

Testing and building grip strength is a really important part of helping your hand, wrist, elbow pain and injury patients get back to work and day to day life. Gripping also pre-activates the rotator cuff, so you can use gripping as part of your patients shoulder rehab exercises.

Grip strength tests using handheld dynamometers (HHD)* test your "Power Grip", but this test doesn't assess thumb or pinch grip strength. There are two other grip strength tests that are pretty easy to perform, that are going to be better suited to some of your patients. What are they, and how can you test the different types of grip strength in your patients?

In this podcast with Physiotherapist (English Institute of Sport Boxing Technical Lead Physio) Ian Gatt, we discuss assessing and building grip strength, assessing hand and wrist injuries and more, including:

• 3 different types of grip strength you need to measure in your hand and wrist patients
• How grip strength measures help guide your assessment and prognosis
• What is the "Power grip" and how is it useful?
• How can you test thumb strength?
• Low-tech, simple grip strength tests you can use in your clinic
• The high-tech approach to grip strength testing
• How strong should wrist flexors and extensors be?
• How can you assess weight bearing tolerance of the hand and wrist?
• Why your patient can have a painfree grip and still be painful with weightbearing on the hand
• What exercises, weights and reps should you use following upper limb injury?
• How can you accurately measure wrist range of movement?
• How are the proximal radio-ulnar joint (PRUJ) and radio-humeral joint (RHJ) involved in hand and wrist injuries, and how can you assess these?

Like the tests demonstrated in the Clinical Edge online courses on Assessment & treatment of the elbow

Links associated with this episode:

• Download and subscribe to the podcast on iTunes

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• Infographics by Clinical Edge

• LinkedIn - Ian Gatt

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• Sheffield Hallam University - Ian Gatt

• Courses - HE Seminars

CLICK HERE for your spot on a free shoulder assessment webinar with Jo Gibson, available soon.

Resources associated with this episode:

Video - How to wrap a boxer's hands with Ian Gatt

Loosemore et al. 2016. Hand and Wrist Injuries in Elite Boxing: A Longitudinal Prospective Study (2005-2012) of the Great Britain Olympic Boxing Squad.

Other Episodes of Interest:

PE 088 - Combating hand and wrist injuries part 1 with Ian Gatt

PE 043 - Sporting Shoulder with Jo Gibson

PE 027 - Sports Injury Management with Dr Nathan Gibbs