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Thumb (CMC joint) arthritis surgery

Hi friends,

Am thinking about having my CMC joint replaced this winter as it is a pain in the *joint* paddling with a sore base of the thumb. Anyone had this surgery (any of the variations) and returned to paddling? Already had steroid shots, voltaren gel, icing: the less invasive criminals so am specifically asking about return to paddling: how long, rehab, successes, problems?

Thanks,

John

Comments

  • I had surgical pinning of a Bennetts
    fracture 40 years ago and it turned out well. But I don't know about joint replacement. Back then, replacement joints for digits were squidgy and insubstantial. So you want to ask about the ability of a replacement joint to take load and survive unexpected twisting.

    Ironically, now my repaired thumb is fine, but I get "arthritic" pain in the corresponding left thumb.

    Short of surgery, you might check out small diameter bent shaft paddles as an alternative to your GP. A proper bent shaft would take some strain off the joint at the base of the thumb. So would a smaller diameter shaft. A GP is a good alternative, though one custom made with a smaller shaft size might be best.
  • if you go ahead with surgery........
    Might wanna give it time to heal totally and you want to go to a paddle with different sized/shaped shaft....essentially a different angle and hardness(again density) of wood against those bones/joint, at the particular points of contact.
    $.01
  • I don't have much to add
    except to say that I am sorry to hear about your condition. All the advice I could give has been said, find a paddle shaft/design which allows you to not put pressure in the injured area of the thumb. Possibly, changing your grip in conjunction with this may provide a bit more protection from injury, but there is a caveat there.

    As we learn to perform any activity, we develop muscle memory and habits about how to perform that activity. It takes a very concerted effort to make the necessary adjustment and, more importantly, to KEEP making that adjustment in times of stress.

    For example, I know a cop who quickly changed the location of his 2nd pair of cuffs after he completely his training (he, and others on that force decided that the new location was more quickly and easily accessed). After a particularly violent arrest, he reached for that pair of cuffs in the location he'd been trained to find them and there was a hesitation while he fumbled around to finally extract them.

    So, if in a situation where you need to, say, execute a brace or capsize, the question becomes one of have you trained enough to ensure that you don't revert to a motion that would force you to rely upon that injured thumb - and worse - would you aggravate the contition or be unable to execute the move due to the pain of injury? I've had to address these questions myself, which is why I no longer can do some of the activities I once enjoyed.

    It is possible that a thumb splint might help both protect you from pain and also add support for the digit during rehab and/or retraining your paddling technique. It is also possible that a thick neoprene glove on that hand might help (it would provide both support and would limit your ability to clench down hard with that thumb. Such a glove may or may not cause additional pain, I've had injuries where my diving gloves were a wonderful protection, but putting it on and off was an exercise in rather intense pain.

    Wish you the best.

    Rick
  • Very Sorry About the Pain
    No, I haven't had the surgery. I'm just thinking that some very padded gloves might help paddling during recovery. Best of luck.
  • Did you have the surgery?
    I have the same issue and need the surgery, but am afraid to have it. I do kayak with full finger paddling gloves, which help. I've got a bad habit of gripping my paddle too tight, which I'm sure only makes things worse...working on changing that. I was out today using a friend's straight shaft paddle and noticed some new pain in my wrists and base of thumb, so will go back to a bent shaft. If you've had the surgery, I'd love to know how it and your recovery went!
  • Thumb arthritis and kayaking
    -- Last Updated: Jul-04-15 1:42 AM EST --

    Especially for John--jsmarch. By now you may have done the surgery; maybe not. I am posting what I know to help others beside you. I am going to some trouble to send this information which I gathered from my hand surgeon and occupational therapist (OT), so I would appreciate answers to my questions too.

    Thumb (basal) carpometacarpal (CMC) arthritis is the most common type of hand arthritis. If you have it, there is no real “healing," but a reduction of inflammation can occur and pain can subside if you lay-off irritating it. An X-ray will show a narrowing of the "space" between the bones of the joint. The cartilage has worn and you have painful bone-on-bone grinding. You might try a cortisone shot, but these are temporary relief and frequent shots would degrade ligaments. My OT has made hard plastic hand splints for both of my hands for when I want to lift weights. They extend from about my metacarpophalangeal joint to about my CMC joint. In addition, my PT recommended weight gloves by Schiek, Platinum model 540. This model is padded and has “fins” (glove folds at the back of each finger) so it usually doesn't hurt to pull the gloves off. We have found that putting the splints into the gloves makes it easier to help protect me from too much pain. I use at least a large size I think, though my hands are medium.

    When lifting weights, I make a point of trying to let the main force rest on the ulnar (pinky finger) side of my palm. My surgeon and OT also recommended the Comfort Cool Splint neoprene gloves, but I found them less protective and irritating if fastened too tightly.
    www.ncmedical.com/item_77.html

    For surgical relief from pain, see www.mayoclinic.org/diseases-conditions/thumb-arthritis/basics/treatment/con-20027798
    My surgeon thinks the best method is the trapeziectomy to prevent pain, however, he said it will decrease strength and flexibility and it would be “a crime” to perform if I am still very active.

    I encourage anyone who wants to stay active as long as possible to conserve their body for what is most important to them. Most of us only have so many "nautical miles" before wear takes away our activities.

    Now my questions:

    1. Did anyone do the surgery and, if so, how well did it work-out for you?

    2. I am not a kayak enthusiast, but I have been invited for a short, casual, sunset kayak event on a lake (~2 hours.) Last time I tried to use a canoe paddle with a kayak, thinking it would cause me less pain, but the pain was terrible. For this evening event, I don't want my partner to end up without me with her group. But I may have to forego my pride, end the pain, and save my thumbs for other activities. What type of paddle should I ask for at the rental place? I assume their selection will be very limited.

    3. What type of paddle shall I buy if I take up your sport: low angle (30 degree) feather, asymmetric dihedral, bent shaft, oval-shaped, smaller diameter shaft, or something else in any of these designs?

    THANKS!

  • Had the surgery...
    -- Last Updated: Jul-04-15 2:03 AM EST --

    I had the surgery on my right hand 12/5/14. It went well, but I've still got pain and some weakness -- still dropping things more than I did before this problem. The surgeon and PT said it'll take a full year for it to completely heal, so I'm only halfway there. I've paddled about 6 times this summer and ended up pretty sore each time (thumb and wrist), so am laying off for a bit. My left hand needs the surgery too, so both sides hurt, but the pain is different; not as bad on the side that I've had fixed. My guess is that the surgical outcome will eventually be what I'd hoped for. I'm back lifting weights (combination of free weights and machines) without trouble, but I do wear lifting gloves.

    I'm just paddling class 1-2 water right now -- I don't trust the hand on anything more. When I go out, though, I paddle hard, often against current for several miles on large, slow moving rivers, then turn around and head back with current. Great exercise, but that's what's causing the pain.

    I'm using a Werner Shuna paddle, shortish for high angle. Low might be less stressful, but old habits die hard... It's a bent shaft, which I love, and I vary feathering based on wind and such. It's a breakdown paddle, so can be adjusted. I like it, but probably should have gotten a small shaft instead of medium.

    That's what I know... Good luck! And have fun :-)

  • CMC arthritis
    Hi Friends,

    Thanks for these comments...

    I ended up having a cortisone shot from my hand surgeon and backing off paddling for a few months. That did the trick and, currently, I am having no problems paddling and few problems in other settings.

    Agree with the need to strengthen support--have been doing a lot of hiking using trekking poles and my thumb joints have been happy...

    Best of luck with yours,

    John
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