Deep Dupuytren massage and gentle stretching works best

Dupuytren massage can be a helpful therapy for hand and finger contractures when it is done in a very specific way and especially when it is applied early in the disease process; massage therapy can be successful later during the course of Dupuytren contracture but more time and effort is required.

In the DCI therapeutic model for at-home physical therapy that is used for Dupuytren contracture, it is the combination of massage and stretching that are considered as one combined therapy.  Doing only Dupuytren massage will not be very effective; the same can be said for Dupuytren stretching by itself.  Both work together in a synergistic way just as with the vitamin, mineral and enzyme supplements that are also used for Dupuytren treatment.

While the Dupuytren massage has a direct therapeutic effect on the soft tissues around the nodules and cords, it also has the indirect effect of increasing local blood circulation, relaxing muscle tension, and increasing lymphatic drainage in the upper extremity.  So in this sense Dupuytren massage has a dual action, but it still is not as important therapeutically as direct slow, gentle and frequent palmar fascia stretching.

During the early phase of Dupuytren development the greatest beneficial effects of physical treatment comes from using light and prolonged lengthening stretches of the palmar fascia.  This soft tissue technique increases lymphatic drainage and local blood circulation, stimulates cellular activity to assist cartilage reabsorption and mobilization of fibrin producing cells.  These efforts can be beneficial for reducing or eliminating the Dupuytren cords and nodules on the palm of the hand.

As Dupuytren’s contracture slowly advances, the palmar fascia thickens and shortens, and cords develop that keep the involved fingers in a flexed position closer and closer to the palm, it becomes increasingly more difficult to stretch the contracted soft tissue.

As the soft tissue (fascia) continues to shortening it leads to the development of fibrous restrictions in the palm of the hand.  It is important to find a treatment strategy that will reduce or eliminate that shortening via gentle and sustained traction or stretching massage.  This can be accomplished by using an aggressive plan of self-administered stretching and massage to the palmar soft tissue so these restricted and thickened tissues frequently have the greatest opportunity to release the fibrous binding that is taking place within. Stretching not only the involved fingers, but also the wrist and forearm in gentle relaxed hyperextension is the sensible approach that will earn the greatest benefit for Dupuytren contracture.

The method of Dupuytren massage suggested by DCI is not to be applied directly to the nodules or hand lumps.   In fact, do not do Dupuytren massage anywhere near the nodules or contractures since this might aggravate your problem.

Dupuytren massage research project

Currently, DCI is very close to completing a research project to develop a method to specifically stretch the palmar soft tissue nodules and finger contractures.  If you are interested in learning about this new Dupuytren research, please send an email to Dr. Herazy at herzy@sbcglobal.net and ask for information about “Hand Contracture Graduated Stretching.”

Further, DCI is beginning another research project to develop a special method to deliver a Dupuytren massage without risk of aggravating the hand contractures.  If you are interested in participating in this Dupuytren massage research, please send an email to Dr. Herazy at herzy@sbcglobal.net and ask for information about the “Dupuytren Massage Project.”