PT on the Net Research

Red Tingling Hands


Question:

My hands turn red when I do any kind of vertical pressing or butterfly type motion. They start tingling, and it makes me stop my exercise. What is going on?

Answer:

The first thing I have to mention is that whenever there is a tingling sensation going down the extremity, it is a good sign to see a specialist of some sort to rule out some of the major stuff. With that said, I have an idea of what it actually could be. I need to assume some things for the basic reason that I cannot see you face to face or do any type of assessment on you. My first thought is that you are probably internally rotated at the shoulder. An easy way to check this out is to look at your self in the mirror and relax. In your natural stance, where do your palms face? More than likely they face towards the back rather than towards your body. The next thing to look at is each arm.

Do they hang in front of your body or right at your sides? They should hang pretty even to your torso. You had mentioned that you broke your arm quite severely and then with complications they had to actually break it again. This would entail your arm being in a sling for quite some time. When your arm is in a sling inside a cast, you have to keep your arm internally rotated for quite a long time. Although the affects seem minimal when you are young, the cumulative effect of being in that posture for so long can cause some real imbalances in your musculature at first around the shoulder complex and eventually throughout the entire skeletal structure. This is called a serial distortion pattern.

The first thing we need to find out is if any nerves are being pinched in the shoulder capsule. Stand about arm distance from the wall. Place your hand against the wall with your wrist extended maximally. Slowly bend your neck laterally away towards the shoulder on the opposite side of the hand. Do not hold it for more than a couple of seconds and do not force this test. If you feel any sharp pains running down your arm, there are some nerve issues and I think it best you see a specialist. Repeat the sequence again only this time flex your wrist maximally. Slowly move your head towards your opposite shoulder again and see if you feel any sharp pains that way. Once again, if you feel any sharp pains running down your arm, I suggest you see a professional.

If these tests do not effect you, we should move on to the muscular system. The posterior shoulder capsule is probably quite stretched. If you were to measure the distance between your shoulder blades or scapula, how far apart are the medial borders? Shirley Sahrmann states in her book, Diagnosis and Treatment of Movement Impairment Syndromes, that scapula should only be about three inches from the midline of the body. I am assuming once again that if I am on the right track, the bottom edge of your scapula are probably more than eight or nine inches away from one another.

What tipped me off to these thoughts are when you said your hands turn red when you do butterflies on a machine. The starting position for that machine is what we call closed-packed position. That means the shoulder has hit its true limits in range of motion. It is commonly called the 90/90 position. The shoulder is abducted 90 degrees, externally rotated fully, and the elbow is flexed to 90 degrees. If there are any imbalances in the shoulder structure, they will come very apparent quite readily in this position.

Now what should you do? My suggestion is to open up the anterior shoulder capsule and strengthen the posterior shoulder capsule. One of the best ways to do this is to use a foam roller. Place the roller under your armpit. Flex your elbow to 90 degrees and go through internal and external rotation. When you hit a tender spot, try to hold it there for at 30 seconds or until the tenderness decreases. Be careful when you first try this because it may be really tender. While you are in that position, rotate your body slightly forward and try to roll on your upper chest and shoulder. When you are done, immediately go to a four- point stance (on your hands and knees) and lift one arm, go to the 90/90 position with your shoulder and slowly contract your rhomboids to bring the scapula closer together about 15 to 25 times if you can. Repeat this sequence on both sides two or three times.

You can do this type of stretching and exercise therapy about every day. If you don’t feel as though it is helping after the first week or so, discontinue the movements and see a professional in your area. If you like this type of training you may want to consider becoming a certified Exercise Therapist. It is amazing how much we can help people in their everyday lives when we truly understand the way the body is supposed to function and make little adjustments to get them back on track. Let me know if I assumed correctly and these exercises helped. Thank you and good luck.