DUPUYTREN’S CONTRACTURE
Dupuytren’s contracture is a condition most therapists have seen at some point in their careers. Characterised by contracture of the connective tissues of the palmar aponeurosis which cover the flexor tendons of the hand (Chaitow, 2014), Dupuytren’s commonly affects older men particularly of Scandinavian and Celtic ancestry (earning it the title “Viking disease”). Alcoholism, diabetes and epilepsy can be further confounders predisposing the onset of this condition.
Chaitow tells us in the early stages, the vertically-oriented fascial fibres connecting the skin and the aponeurosis shorten, forming pits in the palm. This process can progress variably in different individuals, and involves fascial tissue proliferation (fibroblasts, myofibroblasts and contractile smooth muscle cells). The resulting “sticky” nodules may adhere to the skin, creating the “feel” of dense, intractable, disorganized mesh that restricts tendon glide. Over time, longitudinal vectoral forces develop that restrict metacarpophalangeal extension, and the characteristic flexion of digits into the palm is observed, severely reducing functionality of the effected hand.
It seems an inexorable path from a manual therapy perspective (if you follow the literature. Please let us all know if you’ve had success in reversing this disease through conservative means! We’d love to hear from you. I suspect early intervention would be key!). Drug therapy and surgery have been trialed with varying outcomes.
Stay tuned for more “WHEN FASCIA GOES ROGUE” and #StayFascianated!
