WEP Hand Center and Physical Therapy – Day 5

Today was my last day working with the Hand to Shoulder Center and Cary Athlete’s Performance Center. Both were kind of slow days at these two locations, but there were a few things that I took out of each. Firstly, the coolest thing that I saw today at the Hand to Shoulder Center was a patient with trigger finger. This is like the opposite of Duputryen’s Disease, where you aren’t able to bend your fingers down, as they lock up. We saw a patient who didn’t have severe trigger finger, but it was bad enough to do treatment right there. Dr. Messer injected a cortisone shot into the patients hand and right away, you could see how the finger was loosening up. The patient was able to bend his finger further down to his palm. I did get to see what happens when the finger “triggers” and becomes locked in a bent position. Then, the coolest things that I saw at Cary Athlete’s Performance Center was that there were quite a few new patients who hadn’t been in yet and were getting everything checked. It was cool to see how they measure the angle of every joint to see what needs to be loosened and what is concerning. Another interesting thing that I saw today was two different types of dry-needling. There was the type that I saw on Friday where one needle is placed into the sore area and moved up and down and the other one was multiple needles in various spots of the sore area. I asked Mr. Meszler what the different purposes are and he told me that the one needle is for a specific muscle and is used to get deeper down in the muscle and the second with multiple needles is for a tendon where multiple spots of the tendon hurt. Overall, I was very grateful for this experience to shadow two new people and I learned a lot!

WEP Hand Clinic and Physical Therapy – Day 4

Today I had an even newer experience as I wasn’t with Dr. Logel. I started my day off at the Raleigh Hand to Shoulder Clinic with Dr. Messer. He has been doing hand and upper extremity surgeries for years and was a great teacher today, explaining to me before and after each patient he saw. There happened to be a big theme today in the hand clinic and according to Dr. Messer, it was very uncommon to see so many Dupuytren’s disease cases in one day. Dupuytren’s disease is where the “cords” under the skin become thick and tight over time and cause the fingers to curl downward into the palm of the hand. It was cool how today played out because I started the day by seeing a few patients who had come in for other issues, but Dr. Messer had me feel their thickening cords that weren’t bothering them. I then saw a patient who recently had shots injected into her hand, a treatment for Dupuytren’s disease, and was back for a check up. Without even seeing her before pictures, it was crazy to see how straight her fingers were able to get. However, I was still very interested in seeing how bad Dupuytren’s disease could get, and lucky enough, an elderly man came in as he had a cyst on his nail bed, but happened to also have severe Dupuytren’s disease on his other hand. I was shocked to see how deformed the fingers really could get and their lack of mobility, yet the patient was used to it. I saw some other patients with broken bones or arthritis, but Dupuytren’s disease was definitely a common theme.

Dupuytren’s Disease

Around noon, I left the hand clinic and went to Cary Athletes Performance Center with Mr. Meszler. He works with Raleigh Ortho as their sports therapist and does a lot of their physical therapy work. I got to observe all of their therapists there and saw a variety of different cases. This was very interesting because I could watch the patient through the whole process of getting dry needling, to laser treatment, to their exercises. One of the main therapists that I stuck around was Damion who was from Ireland and he would also explain to me what the purpose of each machine was and would even let me test out some of the exercise machines and stretches. Although I didn’t see as many patients as this morning, I still learned a lot and it was a great experience!

Key terms used in the hand clinic
Raleigh Hand to Shoulder Center
Cary Athletes Performance Center
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