While it is not an affliction that will ultimately result in death, Dupuytren\u2019s Disease can cause a significant reduction in quality of life.<\/p>\n
For those who are unfamiliar with the condition, Dupuytren\u2019s Disease, also known as Dupuytren\u2019s contracture, causes a thickening of the fascial tissue surrounding the muscles of the hand (1<\/a>). The fingers and muscles on the medial side of the hand (the pinky and ring finger) are most frequently affected. However, in some cases, the thumb and other fingers may also be involved. As the disease progresses, the fingers start to close more and more until, in extreme cases, the fingers are squeezed so tightly that the skin underneath the closed fingers can become macerated (2<\/a>).<\/p>\n Some fast facts about Dupuytren\u2019s Contracture include:<\/p>\n But even though many patients will require surgery to address Dupuytren\u2019s contracture, there is a pressing need for effective non-operative treatments (4<\/a>, 7<\/a>), and massage combined with gentle stretching shows promise as an intervention (7<\/a>, 8<\/a>).<\/p>\n As was stated in the introduction, Dupuytren\u2019s affects the fascia surrounding tissues. Therefore, a brief review of fascial<\/a> anatomy and physiology will help to put the discussed treatments, detailed later in this article, into context.<\/p>\n If you\u2019ve never had the experience of working with a cadaver before, take the word of those that have: there is a layer of fascia covering nearly every structure in the body.<\/p>\n This ubiquitous fascia creates an interconnected web that links organs, muscles, tendons and many of our other tissues. Additionally, it may even provide a means of force transmission (9<\/a>).<\/p>\n Because of this, many massage therapists will incorporate \u201cfascial massages\u201d into their practice in order to address musculoskeletal issues and even organ-related conditions. The belief is that these fascial massage techniques will relieve tension in the fascia which, in turn, will relieve pain or tension in the associated area. This is a specific treatment philosophy that is examined to a greater depth in this paper<\/a> (10<\/a>).<\/p>\n There is a thick layer of fascia that encapsulates the various muscles and tendons of the palm of the hand known as the palmar fascia (11<\/a>). This tissue is intimately connected with the fascia, nerves, and arteries that are associated with all of the other areas around the hand, forearm and upper arm (11<\/a>, 12<\/a>).<\/p>\n With Dupuytren\u2019s Contracture, the appearance of a thick band running parallel with the hand would seem to indicate that tendons are involved in the process and are causing the contractures specific to the condition. However, the only tissue directly involved with Dupuytren\u2019s is the palmar fascia overlying the muscles and tendons (5<\/a>).<\/p>\n For the novice massage therapist, or even just the casual observer, it may seem like kneading and applying a significant amount of pressure to a Dupuytren\u2019s contracture would help to release the tension. When it comes to Dupuytren\u2019s Contracture, relatively gentle pressure is the best way to proceed (13<\/a>).<\/p>\n Light, circular pressure throughout the areas of the contracture combined with mild stretching or passive ROM are the primary massage treatment guidelines for Dupuytren\u2019s Contracture (7<\/a>, 8<\/a>, 14<\/a>).<\/p>\n As you\u2019ll see in the detailed video below, taking your time and paying attention to the small details of the hand will go a long way in the treatment of the condition (14<\/a>).<\/p>\n\n
Massage Therapy for Dupuytren\u2019s Contracture<\/h2>\n
Fascia A&P<\/h3>\n
Hand-Specific Fascial Considerations<\/h3>\n
Contracture Massage: How Hard Should You Push?<\/h3>\n
Circular Massage and Gentle ROM<\/h3>\n