severed thumb tendon - second opinion needed severed thumb tendon - second opinion needed

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Thread: severed thumb tendon - second opinion needed

  1. #1
    Join Date
    Feb 2020
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    Thumbs down severed thumb tendon - second opinion needed

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    Hi everyone, my name is Yorrick, I work and live in Belgium

    I am 28, I have been training since 2011 and run a texas method style routine. I have a 180kg squat, 90kg press, I weigh +-95kg.

    on the 6th of januari, A careless accident with a woodworking axe caused me to sever a thumb tendon, cleanly cut through.

    I was operated upon that very day, and the surgery was 'a succes'. The tendon is the flexor of the last phalanx of the thumb. (i.e. the tendon that bends your thumb in a 90 degree angle).

    After a week of wearing a hard cast, I got a thermoplast cast with a mechanism around the thumb which allows me to passively move the tendon through thumb extension. Fysiotherapy was prescribed and started that very week.

    After a month of fysiotherapy I am starting to doubt whether or not the tendon is still attached. The range of motion is limited to mere milimeters, and it just so happens that a friend of mine severed the exact same tendon (which was never re-attached), and he had a similar ROM. against the wishes of my fysio, I attempted some careful active contractions, but this doesn't work. If I move the thumb into full flexion, I do not even feel a tendon that I could actively contract to keep it there. Should not my attempt to contract actively contract at least result in some pain?

    The reason why I ask my questions here is because at this point I would rather finish the job and sever the thumb entirely than having to deal with another condescending lecture from a physician. The arrogance and reluctance to answer questions that i have experienced these past few weeks has been mind-boggling.

    I am not a paranoid man, but I have started to suspect that my fysiotherapist might already know that the tendon is severed, but continues to put me through the most ridiculously low-risk hand exercises just because she receives 25 euros per session, of which 24 euros are refunded to the patient by the tax payer (Belgium). I consider them arrogant enough to think us mortals too stupid to see through their spiel.

    To maintain my fitness i have been forced to use the plate loaded leg press, and i have started doing a front squat, put I am using restraint.

    So here is what I would like to ask: Who of you could shed some light on the situation, and what parameters could I use to ascertain of the tendon is still there or not.

    I have already called the hospital for additional x-rays but they are so backed up that waiting times exceeded my original consultation later this month.

    I greatly appreciate your input. I am a long time Starting strength fan and I have been following all the recent developments of the Starting strength-brand attentively. I read the books and this was the first and only forum where I felt I could share this problem. Thank you

  2. #2
    Join Date
    Aug 2010
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    Olympia, WA
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    2,056

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    Quote Originally Posted by Yorrick1991 View Post
    Hi everyone, my name is Yorrick, I work and live in Belgium

    I am 28, I have been training since 2011 and run a texas method style routine. I have a 180kg squat, 90kg press, I weigh +-95kg.

    on the 6th of januari, A careless accident with a woodworking axe caused me to sever a thumb tendon, cleanly cut through.

    I was operated upon that very day, and the surgery was 'a succes'. The tendon is the flexor of the last phalanx of the thumb. (i.e. the tendon that bends your thumb in a 90 degree angle).

    After a week of wearing a hard cast, I got a thermoplast cast with a mechanism around the thumb which allows me to passively move the tendon through thumb extension. Fysiotherapy was prescribed and started that very week.

    After a month of fysiotherapy I am starting to doubt whether or not the tendon is still attached. The range of motion is limited to mere milimeters, and it just so happens that a friend of mine severed the exact same tendon (which was never re-attached), and he had a similar ROM. against the wishes of my fysio, I attempted some careful active contractions, but this doesn't work. If I move the thumb into full flexion, I do not even feel a tendon that I could actively contract to keep it there. Should not my attempt to contract actively contract at least result in some pain?

    The reason why I ask my questions here is because at this point I would rather finish the job and sever the thumb entirely than having to deal with another condescending lecture from a physician. The arrogance and reluctance to answer questions that i have experienced these past few weeks has been mind-boggling.

    I am not a paranoid man, but I have started to suspect that my fysiotherapist might already know that the tendon is severed, but continues to put me through the most ridiculously low-risk hand exercises just because she receives 25 euros per session, of which 24 euros are refunded to the patient by the tax payer (Belgium). I consider them arrogant enough to think us mortals too stupid to see through their spiel.

    To maintain my fitness i have been forced to use the plate loaded leg press, and i have started doing a front squat, put I am using restraint.

    So here is what I would like to ask: Who of you could shed some light on the situation, and what parameters could I use to ascertain of the tendon is still there or not.

    I have already called the hospital for additional x-rays but they are so backed up that waiting times exceeded my original consultation later this month.

    I greatly appreciate your input. I am a long time Starting strength fan and I have been following all the recent developments of the Starting strength-brand attentively. I read the books and this was the first and only forum where I felt I could share this problem. Thank you
    Yorrick, sorry it took me so long to get to this question.

    It would be difficult for you to palpate the tendon in question because it is fairly hard to appreciate. That said, tendon reconstructions, oftentimes, result in extremely tight tendons that are difficult to move. So, I might offer this perspective: if the tendon has ruptured completely, what is physiotherapy going to do for you that barbell training will not? Barbells, and the physical manipulation of the barbell, are very therapeutic for hand rehab. The barbell is a perfect shape to grip and it doesn't cost you 25 euros per session to do so.

    Unfortunately, clinicians are condescending and reluctant to answer questions because, so often, we do not know the answers to the questions you ask. So, then, we have to make stuff up on the fly and when a patient doesn't bite immediately, a lot take it as a personal challenge to their education, expertise, etc.

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