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algebraist

Thumb Injury

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I've been away from the wheel for about a month due to a thumb injury -- I woke up one night with severe pain in my right thumb.  I hadn't been throwing that day, so I've been clinging to the hope that it's unrelated to pottery, but today, feeling mostly better, I sat back down at the wheel and immediately found the problem (and set my healing back some...).  Basically, throwing is pretty stressful on the thumb.  In particular, when centering by the "cone up, push down" process, during the push down phase my right thumb is braced against my left hand for stability, and there is a lot of pressure exerted on the thumb.  Based on the way it hurt, I think I can safely say that it's this pressure that's giving me trouble.  (The thumb also does lots of other work -- during the cone up I've been using the edge of my thumb to keep a hole from developing at the top of the mound, for example, and I suspect it gets plenty of work as well during pulling up the walls of the ware -- I couldn't fully investigate today because, in a rare show of prudence, I stopped.)

 

I went to the doctor a couple of days after it first started hurting, and was diagnosed with "DeQuervain's Tenosynovitis," which is an inflamation of the sheath that the tendon that connects the thumb to the forearem passes through.  For that I was told to wear a brace with a thumb "spica" (stabilizes the thumb), and given some exercises to do when it started healing.  I now think the diagnosis is wrong, and will have to go back to my doctor to discuss it, but I figured I should also ask here in case this is the well known "Potter's Thumb" or some such.  (Just Googled "potter's thumb" -- don't.  Yuck.  It's not that.)  Experimentation has shown that wearing the brace at night is a good thing, but wearing it during the day as well is definitely bad.  So far the exercises seem to neither hurt nor help.

 

Finally, in case it helps identify the trouble for anyone who's had something similar, the pain that started suddenly one night happened when I extended my thumb out straight -- I got an immediate shooting pain accompanied by a spasm in my thumb.

 

So I guess I am back on the injured list for a while.  Luckily I have enough sitting around for a bisque firing, so I can do that and then keep myself busy glazing for a little while.  If necessary I can also focus on slabs while the thumb heals.  In the end, though, I definitely want to get back to the wheel, and might have to look into alternative centering techniques.

 

Thanks in advance for any suggestions.

 

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Thanks -- thumbless throwing in the future.

 

For what it's worth, I read more about DeQuervain's Tenosynivitis (you'd think it wouldn't have taken me a month to do so), and maybe the doc got it right.  In any case, I'd still like to hear from anyone else who's had similar troubles.

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I have had surgery on my rt thumb, because of a cyst and bone spur. In the end, came to the conclusion it was a poorly adjusted angle in my bowling balls. Seems our bodies are constantly changing, and things that are regularly used in repetitive motions should be measured/assessed every year or so. Did not know that about the bowling in particular, but do now.

 

best,

Pres

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Ow, thumb pain is no fun.  I have quite a bit in my right hand. I do not throw - mostly pinched forms. I have learned to do this pretty well with the left hand.  Every year or so I get a cortisone shot in my right thumb. It helps for a few months. Also use a hot paraffin bath and microwaved heating pads.  Its really hard to rest your thumb even if you stay out of the clay. What about everything else in life that needs your hands?    Not much advice here except to not overdo it.   Most every potter i know who is beyond age 40 has some hand issues.     rakuku

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I had a conversation about throwing and thumbs with my dad only today. A few years ago he cut the tip of his left thumb off (accidentally) with a saw and he said he thinks that makes throwing harder. 

 

When I throw I use the heels of both hands mostly for centering, and in fact tend to keep my thumbs out of the way entirely except when working on the rim. I didn't learn to throw this way on purpose, I just happened to realize today that I could probably throw even if I had no thumbs.

 

I can take a picture or video of my hand positions for you if you think it might help. 

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I truly appreciate the offer, but I don't think it's necessary.  Yesterday I searched through the many posts on centering here, and then looked up Tim See's YouTube videos on centering.  Very graceful, with very little stress on the hands, and very little use of thumbs.  My centering was okay in the sense that I could do it, but it seems I was powering through with bad technique.  Once I'm back in the game, I'm going to be trying to mimic his technique.  Thanks again.

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I suggest you wear the brace as much as you can so it can rest.

Learn to center without your thumb.

This condition is only for a hand specialist to diagnose really well.

Our area has no hand specialist so hopefully you have one who only works on the hand and elbow

I had to leave our area for that kind of specialist

Usually they give you a cortisone shot and a brace and you rest it for a few months

I think this is also known as trigger finger

I had this diagnose once but it was by doctors who where not specialists and it turned out to be something entirely different

Thats why I asked you if the doc was a  hand specialist.  

 

If this persists you can have a simple surgery to open the sheath so it has more space for the tension to slide.

Try the rest -brace and shot 1st.

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Thanks.  It was my primary care physician who made the diagnosis; I'll be seeing him again soon and will ask about a specialist.  And I'm trying to avoid the cortisone shot -- probably it's the right thing, but I've had a couple.  Depending on where they do it, it can be no big deal or horribly painful.  The thumb sounds like the second of those options...  

 

Thanks for the advice.

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Thanks.  It was my primary care physician who made the diagnosis; I'll be seeing him again soon and will ask about a specialist.  And I'm trying to avoid the cortisone shot -- probably it's the right thing, but I've had a couple.  Depending on where they do it, it can be no big deal or horribly painful.  The thumb sounds like the second of those options...  

 

Thanks for the advice.

 

Shot horror story: I had stitches in 2014 for a deep cut on my pinky and she gave a shot of local anesthetic in the joint at the base of the finger. The shot crunched in through cartilage and everything and I believe she damaged a nerve because the location of the shot throbbed worse than the cut and four stitches and hurt for a long long time after the rest of the finger had healed. Also recently I happened to bang the side of my hand on a corner table right on that joint and the pain came back again for weeks. 

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Simple things to consider:

  1. Try taping the thumb that hurts to the rest of your hand. It's one thing to "try not" to use it, vs. "not able" to use it. Awkward, but it works by forcing you to use everything else but your thumb.
  2. If tape adhesive bothers your skin, put a non-latex glove on your hand, then tape that together as above. I suppose a plastic bag would do the same, but the goal is only to trap the thumb, not your whole hand.
  3. If you're throwing more than 7-8lbs of clay, use the butt of your left hand (clay spinning counterclockwise) while holding your thumb out of the way with your right hand. Think of "persuading" the clay, rather than forcing it, since you'll have no counterbalance. Also think of putting the force down towards the wheel head and curling under it with your left palm. When the load is centered, tape your thumb as above. (There are probably videos of this technique on the intertoobs.)
  4. Get an ice pack, and ice your thumb (where it hurts) after you throw whether it *hurts* or not. Be super careful not to freeze your skin, by keeping some type of cloth between the ice bag and your skin. This just helps back the swelling process off just a tad. If this injury continues, play with gentle heat if that feels better.
  5. Massage the muscles all over your hand, fingers, palm, etc. including the wrist. Enlist helpful beings if necessary. Dogs with big tongues can be helpful (I suggest Newfoundlands, but I'm partial, and they're so handy for me.)

Finally, although no one has mentioned this I think, strongly consider getting a referral to an Occupational Therapist from your doc. OTs deal with hand issues, and they can give you more in depth information about exercises to counter balance the weaknesses that have caused this. (Don't be surprised that they start working on exercises for your shoulders; it's very likely that you are overusing your thumb because the general strength in your arms and shoulders is inadequate for wheel throwing.) It's worth paying for a session for the exercises, do's and dont's that they dispense, and way easier than getting shots or surgery, depending on the diagnosis.

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I feel (rather, I felt) your pain, Algebraist. It's been nine months since my first hand surgery (the right) and a little over 3 months since I had the left hand done. Degenerative arthritis from more than 35 years of abusing my hands as a remodeling contractor was the reason for the surgeries. The surgery was called a Carpometacarpal hematoma distension arthroplasty. The surgeon removes the "trapezium" bone between the thumb and the wrist. Full recovery takes from 6 months to a year. The right hand is just about perfect, the left less so because of a problem with the next joint up.

Anyway, after six weeks in a hard cast and six weeks of physical therapy and  hand exercises 3 times a day, the left is progressing pretty well and I'm just itching to get my hands throwing again. An appointment with my orthopedist later this AM will give me a clue as to when that can happen.

As such, a session with an orthopedist and some x-rays might better get you moving in the right direction regarding the diagnosis.

Good luck,

JohnnyK

post-17674-0-70226900-1456931964_thumb.jpg

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JohnnyK,

 

How does the thumb respond to you telling it to move without a connection to the wrist? I have incredible pain in the same area you are talking about and am going to a hand doc in April - will ask about the Carpometacarpal hematoma distension arthroplasty. Have had Carpal tunnel release done on both hands. took about a year each to regain the strength in the hands.

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An update, in case anyone else finds themselves with similar trouble:

 

I finally had my appointment with the hand specialist; it's "trigger thumb," which is "trigger finger" of the thumb.  As you bend the thumb, it snaps open or closed, and this mostly happens after resting it for a long time -- like when you wake up.  He wants me to spend another 8 weeks using a brace pretty aggressively -- always at night and sometimes during the day, and if that doesn't do it I get the cortisone shot, maybe another if necessary, and eventually there is surgery.  But probably it won't go that far.  I've been doing almost no throwing, and will have to keep it that way for a while.  

 

And my other thumb just started having the same problem -- no pain yet, but occasional snapping open and closed.  Probably it got stressed by picking up all the slack of going thumbless with my right hand -- try turning a key or closing a ziploc bag -- nightmare.

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The thumb is still connected to the wrist with muscles and tendons. Over time, scar tissue builds up in the area where the bone was removed. It's been 10 months since my right hand was fixed and it's pretty much back to full strength. Five months on the left hand...there is still some weakness and it's improving every day.

 

There are a number of other versions of this surgery, most of which incorporate the splitting of a tendon in the forearm and rolling it into a ball, then placing the tendon ball in the joint to provide the cushioning. It is called "the Anchovy Method" because the tendon apparently looks like a rolled anchovy. I've spoken to a few folks who have had it done this way and a year later they are still having pain in the joint.

If you look on YouTube for Thumb CMC arthroplasty you will see many of this type of videos. I was never able to see a video of my type of surgery, but considering the results I've experienced, I am not complaining.

If you go the surgery route, you may have to do some research to find an orthopedic surgeon in your area who performs  the hematoma distension arthroplasty.

 

Good luck with whatever you do!

JohnnyK

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The hand doc I went to is in a Large ortho group and do sports medicine ortho. The hand doc said he does not like to do this surgery on anyone younger than 65. He gave me some cream, Voltaren, and a hand wrap. The joint is bone on bone. Basically I am living with the pain as I am allergic to all arthritis medicine and cannot take Nsaids or anti-immflammatories of any kind. Still throwing pots!

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