Central Florida Health and Wellness Magazine Health and Wellness Articles of the Villages
Related Articles
Dupuytren’s contracture is a progressive hand condition characterized by the thickening and tightening of the fascia beneath the skin of the palm. As the disease advances, tough fibrous cords form and contract, pulling fingers—most commonly the ring and pinky fingers—toward the palm. This contracture significantly impairs hand function, making everyday tasks from shaking hands to putting on gloves increasingly difficult.
While surgical intervention was once the primary treatment, collagenase injections, specifically Xiaflex (collagenase clostridium histolyticum), have revolutionized Dupuytren’s management. These enzyme-based injections break down the collagen deposits forming the problematic cords. However, the journey to restored hand function doesn’t end with the injection—occupational therapy (OT) hand rehabilitation plays a crucial role in maximizing outcomes.
Understanding Xiaflex Treatment
Xiaflex works by enzymatically dissolving the collagen cords responsible for finger contractures. The procedure typically involves an injection directly into the cord, followed by a manipulation procedure 24-72 hours later where the physician extends the affected finger to rupture the weakened cord. The immediate result can be dramatic—fingers that haven’t straightened in years suddenly gain newfound freedom.
However, this freedom comes with responsibility. The tissue disruption from both the injection and manipulation creates a healing environment where new patterns of movement and tissue organization will establish themselves. Without proper guidance, the healing process may lead to suboptimal results or even recurrence.
The Critical Role of Hand Therapy
Post-Xiaflex occupational therapy serves several essential functions that significantly impact long-term outcomes:
First, OT helps maintain the range of motion achieved during the manipulation procedure. Without consistent stretching and movement, newly released tissues may contract again during healing. Therapists provide customized splinting programs, often including night splints that hold fingers in extension while sleeping and dynamic splints for daytime wear.
Second, therapy addresses the compensatory movement patterns patients developed while living with contractures. Many patients unconsciously alter how they use their hands to accommodate limitations. These ingrained habits don’t automatically disappear when range of motion improves and can impede full functional recovery if not addressed through targeted retraining.
Third, professional guidance helps manage common post-injection complications. Swelling, bruising, and temporary pain are expected responses that benefit from therapeutic interventions like compression, manual edema mobilization, and modalities to control inflammation and discomfort.
Fourth, therapists provide progressive strengthening exercises once the initial healing phase passes. Many patients experience weakness after years of altered hand use, and rebuilding strength in newly available ranges of motion is essential for full functional recovery.
Evidence Supporting Combined Approach
Research consistently demonstrates superior outcomes when Xiaflex injections are paired with structured therapy programs. Patients receiving comprehensive hand therapy show greater long-term maintenance of extension gains, improved grip strength, and higher scores on functional assessments compared to those receiving injections alone.
Additionally, recurrence rates—a significant concern with all Dupuytren’s treatments—appear lower when patients participate in ongoing hand therapy and adhere to home exercise programs.
Practical Considerations
Typically, hand therapy begins shortly after the manipulation procedure and continues for 8-12 weeks, with frequency tapering as progress is made. Patients should expect an active role in their recovery, including performing home exercises between sessions.
Insurance coverage varies, but most plans recognize the medical necessity of post-Xiaflex therapy. The investment in therapy often pays dividends through improved function and potentially decreased need for retreatment.
For optimal results, patients should seek hand therapists with specific experience treating Dupuytren’s contracture. These specialists understand the condition’s unique challenges and can provide targeted interventions that general physical therapists might not offer.
By embracing the partnership between Xiaflex injections and specialized hand therapy, patients give themselves the best opportunity to overcome the limitations of Dupuytren’s contracture and return to the activities that matter most to them.
Innovative Therapies Group has certified hand therapists that specialize in specific treatments post ziloflex injections for duptyrens contractions and will help you to regain function post procedure.
Types of Treatment Available with Physical Therapy
• Assessment and Evaluation Programs
• Difficulty Walking
• Fall Prevention and Balance Retraining
• Fitness and Wellness Programs
• Functional Training
• Gait Training and Balance Programs
• Manual and Massage Therapy
• Neurological and Neurodegenerative Retraining
• Vestibular Rehabilitation
Innovative Therapies Group, Inc.
352-433-0091 | innovativetherapiesgroup.com
