Burn injuries are some of the most complex and unique afflictions that an individual can sustain. No matter the location and severity, burns can introduce both physical and emotional discomforts that can take months, and in some cases, years to resolve. In addition, the hand is one of the most intricate parts of the human body. It’s a fine-tuned machine that allows us to access and perform all sorts of tasks and activities in our daily lives. Any dysfunction related to the hand can make it difficult to accomplish even the most basic of tasks. Combine the two into hand burns and now things are really heating up…
Luckily, hand therapists are trained to handle such traumas. Our hand therapists at Spooner Physical Therapy combine years of training with their own unique experiences to make sure our patients are getting the best treatment possible. One of our hand therapists, Paul McManus, MOTR/L, completed a rotation at the Arizona Burn Center while in graduate school. While there, Paul developed a passion for the complexities of burn injuries, as well as an appreciation for the individual recovery process for each patient.
Paul helps shed some light on the complex nature of hand burns and explains the role of hand therapy in the healing process.
What Makes Burn Injuries So Unique?
“Burn injuries are very complex and different, and they can affect function unlike any other injury,” Paul states. This is mainly due to an array of different conditions that are working against you from the moment you sustain a burn:
Contractures – A state of tight or shortened tissues. The formation of scar tissue is a big contributor to this condition. This is because inelastic tissue begins to take over in areas where elastic tissue used to exist. For hand burns, this can severely limit your ability to open and close your fingers, as well as bend your wrist. If left untreated, these will solidify overtime, and it will become very difficult to overcome the mobility deficits you’re currently facing.
- Fun fact, contractures are more likely to occur with burns to the palm-side of the hand. This is because your hand is more comfortable in a flexed/closed position. If you stay in that place for too long, the tissue will begin to harden in that state, and it will become more and more challenging (and painful) to move your hand away from a closed position.
Swelling – Fluid will begin to build up underneath the skin near the injury. This can cause pain, discomfort, and increase infection chances. It can also decrease blood circulation, which can delay or stop the healing process altogether.
Atrophy – Because you may not be able to use your burned hand right away, you’ll begin experiencing a loss of strength and ability in your affected hand. Not only that, because you may not be able to perform the same tasks and activities with said injury, you will most likely experience this atrophy in other areas of the body.
Scar Tissue – Not only do these contribute to contractures, there are other scar tissues that can form that affect the appearance and function of the burn site. Hypertrophic scars are raised scars that have an excess of tissue forming at the site of injury. Keloid scars are also raised due to an excess of tissue, but keloid scars extend beyond the boundaries of the wound. These scars can further limit movement of the hand, and often times are itchy and uncomfortable to deal with.
Learn more about Astym® scar tissue treatment at Spooner Physical Therapy.
Syndactyly – In severe cases, hand burns may cause the tissue in between your fingers to fuse together.
Pain – Burns are painful, sensitive, and uncomfortable, even months beyond the initial burn. Because of this discomfort, one may delay coming to treatment, put off their stretches and exercises, and begin to feel discouraged.
There’s no shortage of hurdles when it comes to recovering from a burn injury, especially to the hand. It can require constant attention and treatment to ensure that your body is healing properly. Fortunately, our hand therapists are locked and loaded with the tools and skills necessary to get you through the recovery process and living your best life!
The Role Of Hand Therapy In The Healing Process
As Paul illustrates, “Treatment for hand burns is very individualized, like many other conditions, but they do not have a linear path. It is unpredictable how a person may do from one day to the next, and there are no specific guidelines on when and how healing will occur.” Because of this, hand therapists are constantly adapting and making use of a variety of different treatment techniques to help facilitate your healing process:
Splinting – Because contractures are so common among burn injuries, hand therapists have the tools and skills to fashion together custom splints to ensure your hand is resting in an optimal state to help protect it from becoming stiff and stuck in any position.
Massaging – This helps breakdown scar tissue, reduces swelling and itching, and increases blood-flow to the area to promote healing. Furthermore, the lotion used during massage can moisten and soothe the skin, which is helpful for mobility as well as pain management.
Stretching – Your therapist will help maneuver and mobilize your hand into various positions to help keep the skin elastic and combat against scar tissue and contractures. They’ll also give you some stretches to perform at home so you can keep your hand moving outside the clinic.
Exercises – Your hand therapist will prescribe you specific exercises that focus on strength and dexterity. The exercises are not only designed to improve function, but also allow you to gain the independence and confidence to live a normal and active life, once again. These workouts are performed in the clinic and at home as part of your home exercise program. Furthermore, your hand therapist will continually adapt these exercises based on your needs and how you are recovering.
Recovering from a burn injury is no small feat, and our therapists are ready to tackle this journey right along-side you. As Paul states, “Each patient and injury are so different from the next, that it makes problem solving more complex. We must collaborate with the patient every step of the way to make sure they are getting their most meaningful goals addressed throughout treatment.”
How To Know If I Should Seek Treatment?
It’s clear that hand therapy is a crucial process in the road to recovery from a burn injury, but how do you know when it’s appropriate? If you’ve suffered a seemingly mild burn and are unsure of the severity or if you should seek medical attention, take note of the warning signs. As Paul explains, you should seek treatment if you are experiencing any of the following symptoms:
- If you are having a hard time with everyday tasks like eating, dressing, bathing, etc.
- If you are experiencing sleep disturbances from the burn.
- If the burn is near or over a joint, like the wrist or fingers. This can cause difficulties with functional movement.
- If you are suffering from soft tissue or muscle tightness.
- If your burn is either white, or starting to turn white all over or in some areas. Deeper burns are white, and you need to seek medical treatment.
- If you have had a burn and you do not feel any pain. Ironically, this may be a sign that you have a more complex burn, and the nerve endings have been damaged.
- If your pain continues to get worse over time.
- If your burn begins swelling and emitting an unpleasant odor. This typically indicates an infection.
When in doubt, don’t delay seeking medical attention. Every day you put off proper treatment can make the recovery process that much more difficult, painful, and possibly ineffective.
Sustaining a burn injury to the hand, no matter the severity, can be a dramatic event in one’s life. It is physically painful, mentally exhausting, and can alter the way you go about your daily life. The road to recovery isn’t always as easy and straightforward as we’d all like it to be. It takes a strong team of committed medical professionals and patients alike to get through the ups and downs. At Spooner Physical Therapy, we have the right team to help support and guide you through this journey. We’re here to get you moving better, feeling better, and most importantly, living better!
Learn more about Hand Therapy at Spooner Physical Therapy. Ready to schedule an appointment? Click Here to schedule an appointment or complimentary movement screen with a Spooner physical therapist at one of our locations throughout the valley.