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EDC muscle strengthening exercise for post-burn intrinsic tightness: Important precaution for safe execution

Vita Yu-Hsien TU, Occupational Therapist and Project Manager

Sunshine Social Welfare Foundation

exercise for post-burn intrinsic tightness

In our previous blog post EDC muscle strengthening exercise for post-burn intrinsic tightness: Are you doing it correctly?, we explained that to strengthen EDC muscle, the focus is on MP extension. In the same explanation video, when doing EDC training, we recommended using self-adherent elastic bandage to wrap the PIP and DIP joints in flexion, in order to avoid wrong movements of PIP and DIP extension, and encourage the accurate performance of MP extension. However, there are important precautions to consider.


EDC muscle strengthening exercise for post-burn intrinsic tightness: Be careful with DIP flexion!

Some therapists may ask: Can DIP be fixed in flexion? In the article Exercises for the distal interphalangeal joint? Use caution and avoid passive flexion exercises!, doesn’t the article remind everyone that because of the terminal tendon's lack of elasticity, DIP passive flexion stretching in itself may cause the terminal tendon to become too loose or it may even rupture, which will affect active movements? Burns can also cause damage to the tendon, which can then be made more serious when passive flexion is done. So why in this case do we teach that DIP joints can be bandaged into flexion?


This question and concern are correct! Not causing damage to the extensor tendon in the DIP area is definitely the first priority. Pre-assessment and careful intervention can help avoid this problem. Here’s what to do.


Do a proper evaluation of DIP joints first

First assess the condition of the DIP joints. Is it the site of a direct burn injury? Are there still wounds present? Are there active movement restrictions for DIP flexion and extension?


If the assessment at this time determines that passive flexion of the DIP joint risks causing extensor tendon injury, obviously it is not recommended to use self-adherent elastic bandages to fix PIP and DIP joints in flexion.


If the assessment determines that the above-mentioned risk factors are not present, the bandaging method can be used but the therapist must still make sure that it doesn’t cause any damage to the extensor tendon at the DIP site. Therefore, as long as the effect of restricting unwanted extension of PIP and DIP joints is achieved, the tensile tension and range of flexion can be reduced when bandaging the fingers.


First, do no harm. This is absolutely the priority principle. Through prior evaluation and adjustment of practices, EDC muscle strengthening exercise for post-burn intrinsic tightness can be carried out safely.


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