Weak hands

[Piebaldi]

Hey peeps,
Need some advice. Doing my pain fellowship. Having some occasional issues pushing meds into joints during procedures - particularly SI joints ugh.
I have small hands, attending jokingly (or not so jokingly? ) asked me if I was using weights.

Any suggestions? Becoming frustrating.

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[soccrwz]

smaller syringes 3 mL or 5 mL; or larger gauge needles; rotate needle

 

[BobBarker]

On SI joints it should be quite hard to inject the medication with a 10ml syringe if you are intra-articular. Look at is as another reassuring sign you are in the right place.

 

[Piebaldi]

On SI joints it should be quite hard to inject the medication with a 10ml syringe if you are intra-articular. Look at is as another reassuring sign you are in the right place.

Yes, but I spazz out when this happens - it recently happened where I was right on spot wise, but no medication would go in! So I put my whole body into it and both hands. It's so frustrating.

 

[willabeast]

Use a 3 cc syringe. Work out by squeezing a tennis ball during meetings.

 

[BobBarker]

Use 3ml syringe or spin and pull it back slightly until it injects. There is a decent study that basically says if you are close to the si joint it doesn’t matter whether you are intra-articular or not. This is not a reason to spazz over.

 

[Agast]

Withdraw slightly or rotate bevel tip and then inject

 

[lobelsteve]

Make sure you have a catheter securely attached to both the needle and syringe. Can push harder and no worries about moving the needle tip.

 

[Piebaldi]

Make sure you have a catheter securely attached to both the needle and syringe. Can push harder and no worries about moving the needle tip.

That would be nice,unfortunately it's not my practice, and have to go with whatever attending wants but I plan on doing this when I am out on my own indeed.

 

[Baron Samedi]

Hit the gym. Pullups, rows, deadlifts.

 

[Piebaldi]

Hit the gym. Pullups, rows, deadlifts.

I don't even know what deadlifts are. I can't do pullups. Also not sure what rows are sadly. I'm not a dude btw

 

[Monterosso]

For finger strength such as injections, rock climbing is fantastic! Women do great in the sport too.

 

[Baron Samedi]

I don't even know what deadlifts are. I can't do pullups. Also not sure what rows are sadly. I'm not a dude btw

What does not being a dude have to do with anything? Hire a personal trainer for a session or two and learn some of these very basic exercises. Building strength will not only help you in your job, but also in life.

 

[callmeanesthesia]

Maybe it’s just the anesthesia training talking, but if you have to push that hard something’s not right. You may have had the tip buried in periosteum. Agree with what several people said - pull back until it flows ok

 

[Aether2000]

If you use a 12 ga needle, things flow much better ;-)

 

[Ducttape]

don't try to squeeze depo through a 25 gauge needle.

use 3 ml syringe and rotate or pull back slightly, as stated above.

 

[Baron Samedi]

Also don't try and push viscosupplements through anything smaller than a 20G and not through tubing.

 

[lobelsteve]

Also don't try and push viscosupplements through anything smaller than a 20G and not through tubing.

Why not through tubing?

 

[DubVille]

Why not through tubing?

I've had the tubing explode. I use 3cc syringe and 22 g needle.

 

[SSdoc33]

this is not unusual. i do a lot of shots, but my hands sometimes hurt afterwards, and it can sometimes be tough getting the medication in to a frozen shoulder or an SIJ. with epidurals, you should not see this sort of resistance.

not sure how a deadlift is going to help intrinsic finger strength.

the biggest factor in the ease in which the medication flows is the gauge of the needle. you should probably be doing most of your work with a 22g needle. it is tough to get some stuff thru a 25.

also, you are asking for a explosion when you over-pressurize the system. the connections at the tubing will eventually give way, and you will end up with an unhappy xray tech with contrast on her face.

 

[Baron Samedi]

Deadlift is amazing for training grip strength.

 

[lonelobo]

Deadlift is amazing for training grip strength.

and HNPs

 

[SSdoc33]

Deadlift is amazing for training grip strength.

is you want to get technical, you need to strengthen your opponens, APL, and APB -- not hamstrings and gluts......

 

[Ferrismonk]

I do my visco with a 25G. No crazy pressure needed as long as you're not in a ligament.

 

[Baron Samedi]

and HNPs

I herniated my disc sitting at a desk. Gotta roll the dice sometimes!

 

[SeniorWrangler]

My son likes rock climbing and got this widget to build hand strength that is great, it works each finger individually. It also gives you a crushing handshake, which is a great thing for a lady to have.

 

[Piebaldi]

My son likes rock climbing and got this widget to build hand strength that is great, it works each finger individually. It also gives you a crushing handshake, which is a great thing for a lady to have.

Haha. I am not sure a crushing handshake will be that helpful professionally.

 

[clubdeac]

Buy a couple of these online and do 5 sets of 15-20 reps every other day

Amazon product

 

[soccrwz]

hand in rice, move around very good for finger extension and flexion

 

[Centurion38]

Watch your posture, make sure you don't have hidden cervical radic. Very common in the iphone generation and those of us who wear lead all the time. Even with small weak" hands this shouldn't be happening routinely unless you are buried in periosteum.

 

[Taus]

If it’s not hard to inject an sij you’re unlikely to be truly in the joint and very unlikely to see arthrogram imo. 22g needle. 3cc syringe. No extension tubing. With one hand retract needle very slightly and rotate bevel with other hand keep firm pressure on plunger trying to inject entire time. Kind of like a reverse loss of resistance. You’ll feel a slight release and put maybe 0.2 cc contrast In. Use heel of hand/thenar emanance to help exert force. Not tip of thumb. It usually leaves a good circular impression on my hand.

 

[Ducttape]

maybe try this:
Amazon product

 

[SommeRiver]

Put apple in pt's mouth first Ducttape.

 

[Laryngospasm]

Hydraulic principle..