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Tips for Almost Fused Wrist/Shoulder Problems

My wrist is a ways from being fused, and I hope it never gets there.  However, I can only rotate it a bit--not enough to, say, open a door knob, unless I compensate at the elbow/shoulder. That is, if I keep my elbow and shoulder fixed, I couldn't
open a door with my right hand.
 
So I'm starting to have some pain in my right shoulder.  I think it may be related to the compensation.  Does anyone have any experience with this? 
 
Also, I used to do maybe 20 pushups a day (regular and triceps) to keep my arms in decent shape.  Well now, I can't flex my wrist to do a push up, and I doubt I should be holding a weight either.  Any tips on how to keep my upper arm in shape without hurting my wrist? 
 
Thank you!!!
hi katie... my 2 wrists are near fused and something has collapsed inside.. i have no solution
to this problem .. i did attempt push ups on the arm of the couch using my forearms.
but only put pressure on other places.. my muscles used to be pretty good but now are
near gone..Unhappy  i would surgest long handle levers instead of door knobs..
as the ra can affect neck shoulders elbows i would say a physiotherapist the best way to go.i thought i was doing ok then hospital sent me to hydro pool where i got dizzy while
in the water.. testsrevealed a slight instability of the neck . so i am more wary of what
i do now
Boney    Thumbs%20Up


1) you need to go see a hand surgeon as soon as possible and get an evaluation on the wrist.  If it is fusing you really need to do it surgically so that it is placed in the correct position and the proper precautions are taken to preserve rotation.  It may simply be inflammtion but the hand surgeon (or better yet a true upper extremity specialist who handles all the hand and arm joins) needs to take a real look. 
 
2) you need to go to a hand therapist to have the correct splints made as well as receive threapy to maintain what motion you have.  They can also show you exercises to help that shoulder
 
3) what does your rheumatologist say...if you are losing motion you made need a medication change
 
4) exercise bands are probably your best bet.  You can get a complete upper body workout with them.  Also swimming is great for the upper body.  If you've been doing the same 20 pushups for while you probably have not been seeing any real benefit from them..the body gets used to the same motions and becomes pretty efficiant at them.  You need to mix things up to continue to get toning and strengthennig benefits
Thanks for your response!  I am sorry about your wrists.  Lucky for me it is just one wrist for now, although the other occasionally swells a bit.  I guess I should get a PT referral.  I keep forgetting to do so, every time I am at the RD!  I just get so flustered and distracted that I forget.  My RD is convinced that this damage may reverse with the MTX but another well regarded RD said it is permanent.  I will just have to stay skinny so the floppy-ness of my arms is lessened.  Tongue
 
The door knobs at my house are even worse because we have childproofed them.  So then I have to carry the baby in my right arm (which I shouldn't) so I can open with left hand.  Luckily he is 14 months and almost walking!
Thanks for you response Buckeye!  Just saw it.  I have only been dx with RA for a few months and by the time I got on MTX all this damage was mostly done. It may be getting worse. I was just upped to 15 mg.  I have read that combination therapies may work better so I'm hoping that Plaq. will be added when I go back next, in about 5 weeks.  I've just been on MTX for 5 weeks now.
 
I really should see an ortho or something.  My RD wanted to take a biopsy from this wrist to ensure it wasn't septic, which is why I saw the second RD up at Vandy.  He said no way it's septic, just treat it as RA, and treat it aggressively, fast.  RD here probably wouldn't have started me on MTX so soon without that opinion, as only my one wrist is this badly affected.  However my left ankle now has prominent swelling.  I bet this is a spondylarthropathy but it's all sort of the same I guess.
 
Bands may be a good idea!  I will try that.
hi buckeye wonderd what are the exercise bands you mention..
i have not seen all these specialist you mention only a hand surgeon. by the time
my rheumatologist sent me there the wrists were near fused and i was given 2 hospital
wrist supports.
Boney
My favorite doctor is my hand surgeon.   My right wrist autofused and I never really had a problem with it until my elbow went and I had it replaced.  At that point becuase of the autofusing I couldn't rotate it and it was causing pain in my nice new elbow.  We went in and removed the distal head of the ulna and now I have no problems.  Hand therpay can do alot and its a specialty that is way underutilized by people with RA.  There are many things that can be done to preserve function if we see a therapist when the problems first occur.  But too many people don't go.
 
Exercise bands are also called resistace bands.  They are bands of rubber tubing of various strengths that you use like you would dumbells.  But becuase they use resistance they are much easier for some with hand/wrist/shoulder problems to use.
 
Katie
don't go see just any ortho...you want a hand specialist for the wrist
Buckeye is right. I use these bands at Pilates. Wide, thin stretchy bands, mines purple!
 
Many ways they can be used. If you are sitting properly, core muscles engaged, they can really give the biceps and triceps a burn... you may not feel like you are doing much good but the premise is little, properly done is good.
thanks for the info and the link they look very good . i will have to look in the shops
and have a look . i have tried a technique called dynamic tension.were you simply
tense the muscles in the chest and stomach but this does nohing for upper body
strengh..
Boney


YIKES I didn't know your wrists could fuse by themselves! I thought people were having it surgically done to relieve pain!

My wrists are what bother me most and the only place I get inflammation. Are there wrist exercises I can do to prevent this?

For me, it was gradual.  In November--before I was in any pain--I noticed I couldn't quite bend my hand all the way back.  X-rays were fine, it was dx tendonitis. By late December, my hand/wrist were totally swollen.  I wasn't on NSAIDs or Aleve during this time b/c I was breastfeeding.  Started Aleve in January.  All this time I was supposed to be wearing a splint, but rarely did, because it hurt to put in on.  But I was not doing exercises.  I even got a steroid shot mid-January, which took away the pain, but didn't restore the range of motion.  Weaned and went on Mobic in February.  By that time, I was just about at the limitation I have now.  I think it's maybe gotten worse.

I don't know what's going on.  Boney had mentioned severely erosive RA.  But it seems like I may have had some RA in my feet 9 years ago, but my x-rays are fine now, no erosion.  But I was only 20 at the time.  Who knows.  And RD said maybe this was damage to cartlidge, not bone?
 
My advice (which isn't worth much) would be to go through the full range of motion every day.  But I had part of mine before I was in extreme pain.  Not as much as now though, I guess that took place when I was in so much pain, it was so swollen that I couldn't even drive--that was a period of less than a month though. I have no idea. 
Another tip: don't just check your movement in terms of flexing your hand back and forth.  Also, put your elbow to your side, so you can't rotate it, and see if you can rotate your palm up, like you were going to ask someone to put something in your hand.  I didn't even realize I'd lost the ability to do that until I went to the RD and they were checking it. 
 
It's probably nothing to worry about, just make sure you check it every now and again.
Thanks for the tips Katie. I am certainly going to add some extra and a variety of ROM exercises for my wristsKatie if the xrays aren't showing any erosions in the wrist then its possible you have reversible damage.  It could be muscular rather than bone problems.  I can't empathize enough that NOW is the time to see a hand surgeon and then a hand therapist.   The hand therapist can build you splints that don't hurt (splinting should NEVER hurt) and are appropriate for your wrist issues.Thanks.  I will definitely pursue that.  The last x-ray I had was in late December.  This kind of goes along with the other thread, I may check that, but how hard should I push to have x-rays again, and how soon?
 

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