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Wednesday, October 23, 2013

 

Henrik Stenson Wrist Injury - Preventable?

News is just out that Henrik Stenson is suffering from a left wrist injury in Shanghai which may complicate his plans to play 7 tournaments in a row on the 'Race to Dubai.' Of course it is no surprise to us at Handmaster Plus that a golfer of this stature is having problems with his wrist, especially the extensor side of the left arm as a right-handed golfer. This is the same mechanical imbalance that has lead to innumerable famous golf injuries including Tiger Woods left elbow and Mike Weir's right elbow. But wait a minute Henrik Stenson has a wrist injury, whereas Tiger Woods and Mike Weir (and probably nearly every journeyman PGA golfer) had an elbow injury? That's different, right?

The leading medical health experts would say that these are not the same. One is elbow. One is wrist. And that is how the statistics are kept - i.e. according to 1) the name of the joint and 2) the catchy medical sounding name of the condition of which the 'symptoms' are to be treated (of course usually by drugs and surgery, the main tools of the medical 'expert'). Do you recognize tennis elbow (lateral epicondylitis), golfer's elbow (medial epicondylitis), carpal tunnel syndrome and wrist tendonitis? These are the four main golf injury conditions of the golfer's distal upper extremity. All are categorized separately. All are common in golfers, but as individual categories, they each fall behind the number one golf injury, back pain.

This is where the archaic thinking of the joint injury and not the mechanics of the joint injury leads to a limited understanding of the cause of the problem. Because back injury is not the #1 health problem in golf, hand and wrist muscle imbalance is. Repetitive grip in training and practise and getting through heavy rough is. And the result of chronic hand and wrist imbalance, to name a few, are tennis elbow (lateral epicondylitis), golfer's elbow (medial epicondylitis), carpal tunnel syndrome and wrist tendonitis. Sound familiar? So group all hand, wrist carpal tunnel & elbow injuries into one category called 'repetitive grip imbalance injuries.' Let's call this 'new' condition RGII's and then see what the #1 injury in professional golf is.... is it back pain or RGII?

We know, through sEMG studies, that when we grip anything (whether it be a golf club, a tennis racquet, a guitar, a dumbbell, a kettlebell, etc.), BOTH the muscles that close the hand contract AND the muscles that open the hand contract. Grip is a co-contraction.
This means that the hand opening (extensor/abductor) muscles contract to support the contraction of the hand closing (flexor/adductor) muscles so that the hand can grip. Stay with me now... The problem is that the 9 muscles that close the hand contract through a relatively full range of motion, BUT the muscles that open the hand contract in relatively one position STATICALLY.
Thus, the entire extensor chain of muscles (from the back of the fingers to outside of the elbow) contract over and over in one position - creating a weak, overused, inflexible stabilizer band that is very open to INJURY.


This extensor band of muscles also affects the stability of the fingers, hand, wrist, carpal tunnel & elbow because it also offsets the flexor band to keep the joints balanced. In other words imbalance between the flexor band and the extensor band are a root cause of a lot of injures and painful conditions, not just elbow injuries!!!

Balanced hand exercise where all muscles that open and close the hand is the key to minimizing these debilitating injuries. We developed Handmaster Plus FOR golfers, because Dr. Terry Zachary was a professional golfer and noticed this same training imbalance in the 1990's. Since then golf equipment technology research has expanded exponentially, grip training not so much. Only recently have the trainers of the big tours started to take notice since Handmaster Plus is now in the hands of many pros on all senior and regular circuits around the world.



Henrik Stenson is predictably experiencing wrist extensor tendinitis on his lead wrist (the left wrist for right handed golfer). Tiger Woods experienced elbow tendonitis in his lead elbow (the left elbow for a right handed golfer). Mike Weir experienced elbow tendonitis in his lead elbow (the right elbow for a left handed golfer). Though grip hand, wrist and elbow imbalance can also lead to elbow injuries in the trail elbow (i.e. John Daly), the lead wrist and elbow are most common. The lateral elbow and posterior wrist of the lead arm are most open to injury in golf, as are the medial elbow and anterior wrist of the trail arm. That said, 'the imbalance is the imbalance' and golf is a stressful game on the hands, wrists and elbows. All golfers 'grow' differently to adapt to their body types and swing technique patterns differently. The location of injury can be anywhere and somewhat unpredictable (John Daly's elbow injury was lateral elbow on the trail arm, the right arm, not easily predictable).

What is completely predictable is that unless accomplished golfers, both professional and amateur, start to train their grip muscles properly hand, wrist, carpal tunnel & elbow injuries will continue at a high rate.

Visit #1 complete hand strengthener to find more information about Handmaster Plus.

Contact us at info@doczac.com for more information regarding grip and grip muscle training for golf or any other grip related sport, music or workplace activity.

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Friday, October 4, 2013

 

Guitar Finger Exercises for the Picking Hand



















Do I need to do wellness guitar finger exercises for my picking hand?

This is an important question. The balance of the muscles on the picking hand, finger and thumb are greatly affected because of the size of the article that is being gripped, i.e. in this case a pick or a string. Thus, the finger and thumb flexor muscles are shortened regularly and, if not properly exercised, will become imbalanced. 


Handmaster Plus allows a complete and simple finger exercise that will easily offset this imbalance - and is also an amazing warm up and warm down exercise. So many musicians develop hand, wrist, carpal tunnel and elbow imbalances and wonder why. Yet it is easy to explain - and to offset through proper exercise.


But why is there a thumb and finger muscle imbalance on the picking hand? And why have we missed it in the past? Especially when so many guitarists have experienced carpal tunnel syndrome, tennis elbow, and finger and thumb tendonitis & injury issues.


Firstly lets talk about why.


The hand, fingers and thumb work most efficiently when they hold items that are neutral in size. By this I mean not too small, not too big. Too small might be, as an example, a guitar pick or a surgical tool. Too big might be a basketball. When they are extreme, the workload required to manipulate the item is increased.


When we grab something that is especially very small, 
the function of all the hand, finger and thumb muscles that have to hold and manipulate that item is amplified. What this means is that the grip stabilizer muscles (the muscles on the back of your hand, wrist and elbow) are contracting to support the fine motor flexor muscles that are holding the small items, such as a guitar pick in the picking hand. As well, note that these muscles are contracting statically (in one position) in a small range of motion which means that if used repetitively they are eventually going to become short static with poor blood flow, just like any other muscle in the body that is exercised through only a tiny range of motion.


So to summarize, small items that are required to be manipulated repetitively will indeed lead to imbalance unless specific offsetting exercises are utilized. The picking hand of the guitarist is a classic example, but so  are surgeons, dental professionals, artists (painters,sculptures, etc.) and beauticians/barbers. the smaller the tool that is being manipulated and the longer and more repetitively it is held, the worse the potential for imbalance and injury.

Why have we missed this imbalance? Because just like other grip dominated activities (i.e. sports & workplace) we focus more on the 'symptoms that grip imbalance causes (carpal tunnel syndrome, tennis elbow, golfer's elbow, DeQuervain's Syndrome, tendonitis, cramping, etc.)' rather than 'what causes grip imbalance?'

Thumb & fingers exercises must be done to maintain the natural balance of the finger, thumb, hand, wrist, carpal tunnel, forearm and elbow. There is no other way.


We designed Handmaster Plus so that all guitarists have an easy to understand & easy to do thumb and finger exercise to offset the repetitive finger muscle activity required to hold a pick or even to finger pick. The repetitive flexing and gripping aspect of the picking hand must be offset if finger, thumb, hand, wrist, carpal tunnel, forearm and elbow mechanics are to be strong, stable and neutrally maintained.


For more information or to purchase your personal product, visit Handmaster Plus 
or send us an email at info@doczac.com

Keep healthy, keep playing and look for every advantage that can make you be the best artist that you can be...





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Tuesday, September 10, 2013

 

Finger Exercise for Classical Guitar Carpal Tunnel

I recently ran into a great blog for classical guitarists, for whom I have the utmost respect (and strong hint of jealousy as a wannabe guitarist, especially picker). Classical guitar is beautiful, difficult to learn and can be challenging on the body, especially the hand, carpal tunnel wrist and elbow... all due to repetitive gripping. When I see classical guitarists not understanding the finger exercise application of Handmaster Plus as a MUST-HAVE training aid to keeping them strong, performing well and preventing injury, I have to comment... otherwise carpal tunnel syndrome and tennis elbow will continue to run rampant.
I have been working with repetitive grip injuries for 20+ years. If you play guitar, you WILL develop finger muscle imbalance - it is simply a fact relating to the mechanics of gripping. If your technique is better, the imbalance may be less. Regarding carpal tunnel syndrome, there is a basic muscle imbalance at play here which will be shared by ALL guitarists. Several of the intrinsic finger muscles that contract repetitively in both the cording hand and picking hand are attached to the transverse carpal ligament, the roof of the carpal tunnel. There is nothing to offset the shortening of these small muscles and thus the space within the carpal tunnel changes and pressure within the carpal tunnel increases putting the median nerve at risk. Strengthen the muscles that oppose flexion (grip) and you remain strong, healthy and in balance. It is not an emotional topic to me, just factual. I used to see musicians come in over and over with this same simple muscle imbalance displaying as carpal tunnel syndrome or tennis elbow mostly - and yet no one in the music industry to this day has any idea of what to do except 'treat' the symptoms (rest, ice, cortisone, etc). It appears that no one (other than my group) has worked to understand the imbalance itself. It is not complicated. It is the same imbalance seen in repetitive-grip athletes and workers for over 20 years.
We used to give patients multiple exercises (elastic bands, grippers, etc.). But they would not resist accurately through full ROM's and the patient wouldn't find time or wouldn't remember them. Now since developing Handmaster Plus, the musician will easily be able to exercise all 18 hand muscles (the 9 that close AND the 9 that open the hand) through full natural ROM's in one easy, continuous exercise. Muscle balance couldn't be easier. The only barrier to proper training for the hand, wrist and elbow NOW is the musician or poor advice.
Do not misunderstand, Handmaster Plus is a 'training tool' and a 'rehabilitation tool', not a stand alone treatment tool. It is designed to maintain balance, prevent injury or rehab/rebalance injuries (after proper treatment). If you are have acute pain Handmaster Plus is not meant as a panacea in place of a health care professional. See your doctor for acute treatment - and then advise them about using Handmaster Plus as a complimentary rehab and rebalancing exercise after treatment protocol. In other words, SO IT DOESN'T DEVELOP AGAIN! Most doctors do not understand the mechanics of grip or the cause of carpal tunnel syndrome and tennis elbow. If they did this simple flexor vs extensor muscle tone imbalance would not be such a neglected issue and musicians would understand and act accordingly. When I see musicians say to visit a doctor and not use Handmaster Plus, I find it humorous. Repetitive grip activities CAUSE muscle imbalance. If you do not think for yourself and learn about your body (in this case the interplay between the grip muscles and the hand opening muscles (the grip stabilizers), you will never understand this imbalance and always be chasing your symptoms. You must offset this inherent muscle imbalance if you expect to stay healthy and strong, play well and prevent injuries from classical guitar. Keep in mind the flexor/extensor muscle balance issue is also at the root of most classical guitar elbow, wrist, finger and thumb problems as well - so it is no small subject if you are serious (which I find most classical guitarists are!). Thanks for the opportunity to speak on this most vital muscle imbalance. I hope I can influence classical guitarists toTHINK and train properly BEFORE this conversation so that they likely never enter it. Your performance and injury risk are both at stake. Feel free to ask me any questions at info@doczac.com or visit www.handmasterplus.com for more information.

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Wednesday, February 20, 2013

 

Hand and Finger Exercise In 2013 - Why Handmaster Plus is a Must Have



There is much misinformation and misunderstanding regarding hand muscles and proper balanced hand and finger exercise. To follow is a summary why we have spent the last 13 years researching and developing Handmaster Plus so that proper hand exercise principles could be followed and understood easily. Poor hand exercise and repetitive grip (RSI) has been the root cause of finger, thumb, hand, wrist, carpal tunnel and elbow imbalance conditions and poor performance for decades - and is especially the case in our current computer, smartphone and video game crazy society.

Here is a recap of hand muscles, Handmaster Plus and balanced hand exercise applications.

The 9 muscles that close the hand are located generally on the front of the hand, wrist, forearm and elbow. The 9 muscles that open the hand are generally located on the back of the hand, wrist, forearm and elbow. Most people have very strong closing (grip) muscles, due to repetitive gripping, but very weak hand opening muscles. This imbalance threatens the health of the lower arm and hand. Due to the diversity of the hand muscles, in order to have strong, healthy hands, wrists, carpal tunnels, forearms and elbows, the muscles that open and close the hand must be in balance. 

Handmaster Plus™ is unique due to its ability to exercise the hand through full, natural planes of motion, through both the opening and closing actions. It strengthens and balances all 18 hand muscles in one exercise.

Other products dictate how and where the hand must move in an exercise, often only in 2-dimensions and not through the full range of motion. Not Handmaster Plus™… It allows the natural motion of the hand to dictate the motion of the exercise. The result is optimal muscle strength, balance and flexibility, as well as comprehensive nerve stimulation, blood flow and venous/lymphatic drainage to and away from the area.

Compare the Handmaster Plus™ to other products and consider:

  1. Is the hand moving through all ranges of motion, both opening & closing?
  2. Is the hand moving naturally, in 3 dimensions?
  3. Are all peripheral nerves to the hand being stimulated (median, ulnar & radial)?

The Handmaster Plus™ is an all-around hand, wrist, carpal tunnel, forearm & elbow training, rehabilitation and injury prevention solution.

The product is designed by Dr. Terry P. Zachary, a health care professional and former professional golfer. 

“I originally designed the product to train finger and thumb extension and abduction for performance enhancement and injury prevention”, says Dr. Zachary. “It worked out as well as I could have ever imagined. As I used it in practice, it also became my perfect final phase protocol for most hand, wrist, carpal tunnel, forearm and elbow conditions.”

“Explain the desired exercise to your patient and send them on their way. Daily use of the product will improve their muscle strength, balance and stability, as well as improve blood flow and lymph drainage to all tissues and joint surfaces in the area. This will re-establish the efficient supply of oxygen and nutrients and improve the transport of toxins away from the tissue. Ultimately, the tissue is brought to an optimal situation and the risk of reoccurring adhesions and scar formation is greatly reduced. The key to the success of the product is how the body naturally reacts to daily, balanced exercise through full, natural planes of motion. The user just opens and closes their hand. So simple.”

 

Handmaster Plus™ Practice Applications:

(**Use 1-3 times/day until comfortable fatigue. Practitioner determines strength of product used.)



Summary
Why Handmaster Plus?

1. Carpal Tunnel Syndrome

Repetitive flexion activity resulting in shortened and/or inflamed flexor tendons is most often causative. Bone & joint alignment are affected. Muscular imbalance and/or swelling precipitate a decrease in the space of the carpal tunnel. Median nerve pathology results.
1. Equalizes the ratio between flexor and extensor muscle strength. 
2. Strengthens finger and thumb abduction.
3. Increases blood flow and lymph drainage through the CT.
4. Exercises muscles through full, natural planes of motion.

2. Lateral Epicondylitis

(Tennis Elbow)
Overuse or direct injury occurs to the tendon(s) of a finger and/or wrist extensor muscle at its origin, the lateral epicondyle (of the humerus). Weakness and/or  tendon pathology (usually avascularity) is often causative.
1. Strengthens all finger extensor AND wrist extensor muscles (see tennis elbow exercise).
2. Equalizes the ratio between flexor and extensor muscle strength. 
3. Increases blood flow and lymph drainage.
4. Exercises muscles through full, natural planes of motion.

3. Medial Epicondylitis

(Golfer’s Elbow)
Overuse or direct injury occurs to the tendon(s) of a finger and/or wrist flexor muscle(s) at its origin, the medial epicondyle (of the humerus). Weakness and/or  tendon pathology (usually avascularity) is often causative.
1. Strengthens the finger flexor muscles.
2. Equalizes the ratio between flexor and extensor muscle strength. 
3. Increases blood flow and lymph drainage.
4. Exercises muscles through full, natural planes of motion.

4. Osteoarthritis

Many varying causative factors for joint inflammation including overuse, traumatic, metabolic & genetic origins. Painful swelling, nodules & reduced ROM are common physical findings.
1. Increases blood flow and lymph drainage to/from cartilage.
2. Improves range of motion.      3. Exercises muscles through full, natural planes of motion.
*Begin by using soft product & progress as indicated. If patient cannot perform basic exercises with soft product, discontinue.

5. Osteoporosis

Decrease bone density resulting from factors such as metabolic factors, sedentary lifestyle, aging and poor diet. Fracture potential resulting from minor trauma is greatly increased.
1. Resistive exercises stimulate increased Ca+/element absorption and bone formation ,Wolfe’s Law
2. Increases blood flow (O2 & nutrients) and lymph drainage.
4. Exercises muscles through full, natural planes of motion.
6. Circulation/ Post-mastectomy, / Reflex Sympathetic Dystrophy/ Raynaud’s Disease
General group of conditions resulting in a reduction of normal blood flow to the hand, wrist and forearm.
1. Stimulates an increase of blood flow and lymph drainage to the area.
Repetitive Stress Injuries (RSI’s)
Repetitive, imbalanced daily actions result in overuse, tissue imbalance and/or injury. Ergonomic and wellness exercise principles are generally ignored. Workers are physically not prepared for their workload.
1. Equalizes the ratio between flexor and extensor muscle strength (strength & balance).
2. Increases blood flow and lymph drainage to the area.
3. Exercises muscles through full, natural planes of motion.
4. It is a complete, convenient and cost-effective workplace injury solution. Everyone happy. 
Neuropathy/ Stroke Rehabilitation/ Nerve Palsies/ Spinal Cord Injury/Intention Tremor/ Parkinson’s Disease
Many causative factors result in an interruption in the conduction or coordination of nerve messages to cells, tissues (especially muscle) & organs.
1. Classically, putty or sponge balls are used in rehabilitation. The radial nerve is not stimulated unless extension & abductor muscles are used. Handmaster Plus™ stimulates ALL peripheral nerve roots. *Begin by using soft product  & progress as indicated.
Injury, Sprain & Fracture Rehabilitation/Post-Surgery Rehabilitation
Sprains & fractures are generally not rehabilitated and instead left to heal without thought of scar formation & ROM recovery. Post-surgery cases usually include very little or no follow-up exercise program. Any post injury/surgery exercise is usually limited to putty or a squeeze ball.
1. Exercises muscles through full, natural planes of motion.
2. Ensures blood flow and lymph drainage for prevention of chronic adhesion.
3. Equalizes the ratio between flexor and extensor muscle strength, ensuring optimal ROM & recovery.
Athletic Performance Enhancement & Injury Prevention
Generally accepted principles in athletic training involve strengthening reciprocal muscle groups and preparing the body completely for competition. Any edge that can be given to the athlete increases the chance of success. Many sports are based on daily repetitive gripping in competition, practice and training.
1. The only product to strengthen finger/thumb extension and abduction (7 muscles previously neglected). Increase speed, control & stamina of muscles that open and spread the hand.
2. Equalizes the ratio between flexor and extensor muscle strength, ensuring optimal performance and injury prevention. 
Musician Performance Enhancement & Injury Prevention
Stamina, coordination, range of motion and injury prevention are all important for musical performance and longevity. Many musical pursuits are based on daily repetitive gripping in competition, practice and training.
1. The only product to strengthen finger/thumb extension and abduction (7 muscles).                2. Equalizes the ratio between flexor and extensor muscle strength, ensuring optimal performance and injury prevention. 

DeQuervain’s Syndrome

Caused by repetitive motion where the thumb is constantly being required to move up and down - such as when using a computer keyboard or typewriter.
1. Equalizes the ratio between flexor and extensor muscles.
2. Increases blood flow and lymph drainage to the area.
3. Strengthens thumb extensor and abductor muscles.

 For more information regarding Handmaster Plus or to purchase, visit www.handmasterplus.com or for information email info@doczac.com

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Monday, February 6, 2012

 

Hand Strengthening Exercise as Treatment for an Active Tennis Elbow


Q: recently I received a common question that I am asked about - an active extremity condition and whether it should be treated using Handmaster Plus as a hand strengthening exercise treatment. This particular question was about tennis elbow, but I commonly get asked questions of the same nature about carpal tunnel syndrome, extensor tendinitis, golfers elbow, and DeQuervain's tenosynovitis. Because of this day and age of the Internet and such vast information exchange, we can never advise the user to ‘treat’ their condition with an exercise. The reason is that only a skilled health care professional can assess whether it is the right time to challenge the tissues with rehabilitative exercise. Muscle, tendons, ligaments and/or joint surfaces may be too instable for such challenge. The result could be aggravation of the condition causing further to complicate the condition and its correction. It is highly recommended that individuals with hand, wrist forearm or elbow problems consult a healthcare professional that is educated and skilled in diagnosing and treating extremity conditions. By default, my recommendation is to locate an ART (www.activerelaese.com) or Graston technique (www.Grastontechnique.com) practitioner as they are consistently the most well-versed in diagnosing and treating extremity injuries such as tennis elbow.

For more information on Handmaster Plus, please visit: hand exercise & grip strength.
To follow is the response that was sent to the individual.

A: Thanks for your question; is a very important one. If the tennis elbow condition has already developed, we must recommend that you consult with a healthcare professional. This is standard protocol because we cannot advise treatment without examination, as this would be an irresponsible suggestion. Handmaster Plus is used in the rehabilitation aspect of treatment. Again, because tennis elbow at its core usually involves hand and wrist muscle imbalance is vital that these muscles be strengthened and rebalanced, as well as be maintained, so that the condition does not continue to recur. Most of our education involves prevention, because changing poor understanding of grip related activities and how they affect the hand, wrist and elbow is what we are passionate about. That said, when I originally developed Handmaster Plus it was to complement treatment as a rehabilitative tool.

For more information on doczac products, please visit: Handmaster Plus hand exerciser

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Wednesday, August 13, 2008

 

Handmaster Plus Hand Strength "How It Started"

Dr. Terry Zachary originally developed the Handmaster Plus in response to a professional golfer's injury, while playing professional golf in California in 1996. A fellow player had developed a painful condition known as tennis elbow and sought advice. Upon interview, Dr. Zachary observed that the player’s hand muscle strength exercise included only flexion (squeezing a racquet ball with fingers and thumb) exercise, with no extension nor abduction exercise. This resulted in the player developing a finger and hand muscle imbalance (causing elbow joint imbalance) while not supporting healthy tone and blood flow to the extensor muscles, tendons and tissues of the elbow. Dr. Zachary soon developed his first working prototype resulting in full relief of the condition. Now, in 2008, the Handmaster Plus is distributed around the world and is used on all major professional golf tours for finger, thumb, hand, wrist, forearm & elbow strength and stability!

See Dr. Zachary's Golf Grip & Hand Strength video for golf:

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