Hand Problems in EDS with Corinne McLees, OT and Hand Coach

[00:35] Dr. Linda Bluestein: Welcome back, every bendy body. This is the Bendy Bodies Podcast, and I'm your host and founder, Dr. Linda Bluestein, the Hypermobility MD. This is going to be a great episode, so be sure to stick around until the very end so you don't miss any of our special hypermobility hacks. As always, this information is for educational purposes only and is not a substitute for personalized medical advice. Hand pain, weakness, and injuries are super common problems for those with joint hypermobility, so we're tackling this really important topic today. And we actually had over 40 questions submitted by followers of the free Instagram broadcast channel, which I was really excited about. If you want to submit a question for a future episode, search for Hypermobility MD on Instagram and tap on the broadcast channel icon near the bottom of the profile page. And then from there, you can turn on notifications. And I want to thank everyone who submitted a question for today. Your guest today is Corinne McLees. She has a connective tissue disorder herself and has been an occupational therapist specializing in hands for almost 8 years. She is the owner of a hand clinic in Richmond, Virginia, and also virtually helps people around the world understand how hypermobility is often their missing hand pain puzzle piece and teaches them what to do about it so they can get back to their favorite activities with happier hands. Corinne, hello and welcome to Bendy Bodies.

[02:09] Corinne McLees, OT: Thank you so much, Dr. Bluestein. I'm so excited to be on here. I'm an avid listener and it's such an honor to be here with you today.

[02:17] Dr. Linda Bluestein: Oh, wonderful. And I'm so excited to have you here. Okay, let's jump in. What is an occupational therapist and how does this differ from a physical therapist? And also, why is this so important for people with EDS and HSD?

[02:30] Corinne McLees, OT: This is such a good question, and I have a few different responses. The first is what I will tell you what the difference is not, because I feel like there's an old-school way of looking at the difference of occupational and physical therapy, and then there's a more holistic approach. So an old-school definition might be like an occupational therapist or an OT looks at your arms and your hands and treats those parts. So we kind of divide the body like top, and then the PT would be the bottom, like the trunk, the legs, the feet. But that is not at all what we do. That's not our difference. I would say that the major difference between occupational and physical therapy is what we emphasize — the purpose or the goal of therapy. While OT and PT might have the exact same interventions, OTs look at everything through the lens of improving your function so that you can engage in everyday meaningful activities. Our goals are very activity focused. For example, I know you help a lot of dancers. Maybe a goal might be that your dancer or gymnast could weight bear on a bar with 3 out of 10 pain or less, whereas the physical therapist might emphasize more like strength or range of motion goals.
[04:01] And so we might have very similar interventions, like wrist strengthening for this one example, but the OT's focus would be on the outcome of that occupation or that everyday activity, if that makes sense.

[04:15] Dr. Linda Bluestein: It does, and that's fascinating. I always learn so much when I have these conversations because I've definitely had that old-school impression that occupational therapists dealt with the shoulders, elbows, wrists, hands, and physical therapists dealt with pretty much every other part of the body. So that's really fascinating, and thank you for explaining that.

[04:32] Corinne McLees, OT: Of course. And I think it's easy to make that distinction because when we think about our everyday activities, we do a lot with our hands — a lot of focused things with our hands, such as cooking, or helping crafters and knitters. Those are very classic occupational therapy things because we also really focus on activities that provide meaning and bring us joy. We do the whole spectrum of activities, all the activities that you want and need to do. Occupational therapy does tend to focus more on those fine motor and hand things. And there are a lot of different opinions and explanations out there. So if you are listening and you're an OT or a PT and you have a different way of explaining it, please message me on Instagram because I always love to hear other perspectives.

[05:29] Dr. Linda Bluestein: And I love to hear that too. So definitely sending a message and/or commenting, because we'll be sharing this episode via some social media posts. That's a great place to have a conversation where other people can see what people are saying as well. So, can you tell us what some common reasons are for hand pain with connective tissue disorders like EDS or other conditions involving joint hypermobility like HSD?

[05:55] Corinne McLees, OT: Yeah, there are so many reasons why people's hands might hurt with connective tissue disorders. And I want to briefly talk about hand anatomy in general to help this make sense, because hands are so complex. It's not just one joint — it's not just a shoulder, or just a hip. There are roughly 29 joints in just one hand alone. And when we think about how there's a lot of connective tissue that surrounds joints, there's a lot of connective tissue in our hands. In addition to that, hypermobility can affect each of these joints separately. So each of the 29 joints in your hand might not be very well supported, and this can create a lot of hypermobile movement patterns within your hands as you're engaging in your everyday activities — where you are hyperextending your finger joints without realizing it, every single one of them, over and over again every day.
[07:00] So creating that picture of, if you look at your hand and you look at all the creases in your hand and maybe you bend your fingers and see all the different joints that are within your hand and within your wrist that have to work together — hypermobility can affect each of those individually. And then it creates this whole picture of hypermobile movement patterns that are not supportive.
[07:24] Because of all of this, it can present itself in a lot of different ways. People might have just general pain and swelling, or their hand might just feel tired all the time because it fatigues faster — their joints are in hyperextended positions all day, which means the muscles that are supposed to be powering these movements have to work a lot harder. You might also have a lot of subluxations, feelings of your finger joints getting stuck in a hyperextended or backwards position where you have to overcome a sort of resistance. You might feel popping or locking when you go to make a fist or use your hands. This can often actually mimic trigger finger. I've had several people with hypermobility get diagnosed with trigger finger, and then we find that it's simply their ligaments subluxing out of place. Finding the appropriate hand supports for that makes a big difference.
[08:27] Nerve impingement is another thing that affects hypermobile humans a lot more than non-hypermobile humans, and this creates a numbness and tingling sensation in your hands. But just because you're having these symptoms in your hands doesn't necessarily mean the hand alone needs to be treated. We need to look at all of the areas where it could be impinged, starting with the neck. It might be your neck, it might be your shoulder, it could be your elbow — like cubital tunnel syndrome — or your wrist, like carpal tunnel syndrome. That sensation in the fingers, the numbness, the falling asleep, the tingling — those are common complaints.
[09:13] And then one more: arthritis is also a common factor. There are several studies that have linked the development of hand osteoarthritis — especially at the CMC joint, that joint at the very base of the thumb where the thumb meets the wrist — with joint hypermobility or instability. A few studies have specifically linked hypermobility with the development of osteoarthritis in that CMC joint. So all of these reasons, and probably so many more, are why people with hypermobility tend to have sore or fatigued hands.

[09:54] Dr. Linda Bluestein: That's a lot of reasons. And for those that are listening, Corinne is at times showing us her hands, and I would encourage you to watch the YouTube video if you can. And there's small fiber neuropathy as well that can influence numbness and tingling in the hands. There's a lot of different things. So if people have hypermobility in their hands or in various different joints in their hands — we're going to get into real specifics — but can you give us a 10,000-foot overview as to what people can do if they have hypermobility in their hands?

[10:38] Corinne McLees, OT: Yes, I love a 10,000-foot overview. I like to approach it not just with one thing, but with an umbrella of things. I take a fourfold approach. Number one would be looking at hand support options. I say this very broadly because it's not just braces or splints — it's everything from ring splints to kinesio tape to braces. I categorize all of those as hand supports, being that first dimension of support.
[11:15] The second is what I call gadgets, also known as assistive devices or tools to make your activities more ergonomic for your hands. For example, this might be an electric can opener. Using a vertical mouse would be another example — that's just an ergonomic computer mouse that keeps your wrist in a more neutral position.

[11:40] Dr. Linda Bluestein: I have one too.

[11:40] Corinne McLees, OT: Oh, that's a good gadget. Yeah, so those would be that second category of gadgets. The third category that I love to teach on is helping people develop a pain flare toolbox specifically for their hands. This might be heat if heat feels good, cold, use of TENS, massage, compression gloves — the things that can bring the pain down, especially when we're in a flare. And then finally, the fourth dimension that I like to look at is exercises. When done appropriately — not in a way that encourages hyperextension or joint strain, but keeping all of your joints reined in and aligned — this can be a very beneficial way to add natural support to your joints by strengthening your muscles.
[12:38] So those are my 4 things: hand supports, gadgets, pain flare toolbox, and exercises.

[12:45] Dr. Linda Bluestein: Awesome. I love those 4 things. And I have a lot of hand problems. I've had all kinds of different devices over the years. I use a lot of gadgets. I obviously have this mouse. And I've had some surgeries. So I particularly want to know how we can strengthen our hands without making things worse. I know this is a question that came up a lot from followers. And I definitely need to know this as well. My orthopedic hand specialist actually told me not to go to therapy and not to do any specific exercises. Maybe he thought I would make things worse, but I would love to know how you work with people to strengthen their hands, because hand grip strength is really important, right?

[13:31] Corinne McLees, OT: It is. It is very important. And I'm actually shocked that that's what he told you — or didn't tell you to do. Have you had hand therapy before?

[13:42] Dr. Linda Bluestein: I have after— so I had a submuscular ulnar nerve transposition and I also had a bone grafting surgery in my wrist. And I got CRPS after my bone grafting surgery. And I got the impression that maybe he felt like because my pain was well controlled, he was worried that if I started to do more therapy I might have more pain. So I've worked with OTs a lot, but I haven't done it for years.

[14:13] Corinne McLees, OT: Well, I feel honored to be able to answer your question about this. And of course, all our listeners' questions as well. When we're talking about increasing hand strength, there are so many different hand exercise tools and gadgets out there. Amazon has a bajillion that they'll try to sell you on. But as an OT specializing in hands, I just keep coming back to Theraputty. Have you had any experience working with Theraputty before?

[14:38] Dr. Linda Bluestein: I have. Yeah. And are you going to show us some?

[14:47] Corinne McLees, OT: Yeah. And I was thinking I would try to describe it for those who are listening, but I'll also show. I love Theraputty because it's a great way to begin strengthening your hands, especially if you're not used to hand exercises. When you do Theraputty exercises with the lightest resistance possible, it's honestly like fun — it's like silly putty, almost like a fun fidget. When you begin with a lower resistance, it's more gentle on your joints. It's a more gentle way to introduce this concept of hand strengthening. Theraputty often comes in 4 or 5 different resistance strengths. You can find it on Amazon or Google, but I would recommend you get one that has at least 3 to 5 different resistances so that you can slowly upgrade over time.
[15:51] The last reason I want to talk about why I love Theraputty for people with hypermobility is because it offers amazing proprioceptive feedback to your finger joints. People with hypermobility often have poor proprioception. If you have poor proprioception in your hands, you might find yourself dropping things a lot, or squeezing your steering wheel really hard, or squeezing your writing utensil too hard, overreaching or underreaching — those are all signs. Theraputty offers really good feedback to your finger joints and helps to improve that connection from your brain all the way down to your hand so that you are more aware of what your fingers are doing in space. That's why I love Theraputty for people with hypermobility.
Here are just a few exercise ideas. You might just have it in your hand and slowly squeeze the putty, driving your fingertips all the way to the middle. You should be able to see nice indentations in the putty once you've done this, and then do it again. What we're looking for is that we're not over-flexing, not over-squeezing, not trying to hyperflex so tightly and make such a tight fist — because part of what I like to use exercises for with our hands is practicing a more controlled range of motion. Just squeeze within what feels like a therapeutic range rather than really hyperflexing everything. That will increase your grip strength and your ability to grip items more easily.
[18:27] Another option would be to roll it into a log, and then—

[18:33] Dr. Linda Bluestein: As you're doing that, can I ask you a follow-up question?

[18:35] Corinne McLees, OT: Yes, please.

[18:35] Dr. Linda Bluestein: You were showing that, which was really helpful. So you're holding it in the palm of your hand and then squeezing with your fingers. Is your thumb not involved in that?

[18:45] Corinne McLees, OT: That's a great question. I want you to do whatever works and feels natural to you. A lot of people leave their thumbs out of that. I leave my thumb completely out of that one because the one I'm about to show you has your thumb included, and my thumb likes to just kind of be out of the way for my finger exercises. But you can include it if it feels natural to you.

[19:09] Dr. Linda Bluestein: Okay, great.

[19:12] Corinne McLees, OT: So we've rolled out our putty into a log — kind of feels like preschool — and then you can pinch it. I would have it down on my tabletop surface, but I'm going to hold it up here for those of you watching. You would just pinch the log: I'm taking my index finger and my thumb and just pinching it, then my middle finger and my thumb, then my ring finger and thumb, then my pinky and thumb, and then we start over again. Practicing pinching the Theraputty log is a great way to improve your fine motor coordination, which comes into play with things like writing or clasping a bracelet. All those teeny tiny finger joints and muscles have to coordinate together very well and have some strength behind them to be able to do our daily activities.
[20:15] Once you have your log, you can also make it into a circle — the Theraputty sticks to itself — and put that Theraputty ring around your fingers. You could do this with a rubber band or a hair tie too: just put one over your fingers and then slowly open up your hand. That would be strengthening the back of your hand, those extensor muscles.
[20:44] I feel like that's a good array of strengthening the different muscles of our hands in different movement patterns. Another thing too: for people that are hypermobile, I really encourage going low and slow. Your therapist may prescribe 3 sets of 10 repetitions, but when you're starting out, you might just do 8 of them and see how it goes, rather than overdoing it. Our joints are so small, and as hypermobile humans we're more prone to inflammation. So really meeting yourself where you're at with a low level of resistance and slowly upgrading over time is what I would recommend if you're just starting out.

[21:36] Dr. Linda Bluestein: I think that's really smart, and I will definitely be ordering that putty this afternoon. I love that.

[21:47] Corinne McLees, OT: Yes, keep it at your desk as a good fiddle or a good cue.

[21:51] Dr. Linda Bluestein: Yes, that visual reminder will be great as well. And so traditional therapies — I think a lot of people listening are going to say they've tried some more traditional things and they haven't worked. What are some reasons why those traditional therapies might not have worked for people with hand pain and hypermobility?

[22:12] Corinne McLees, OT: Yeah, this is a great question. And oftentimes someone comes to a generalist doctor with hand pain, and as you know, there's just not enough awareness of the signs of hypermobility in our medical system. I personally feel like there are blatant signs of hypermobility, especially in the hands. Like if you just looked at somebody gripping a writing utensil, you could see it there. But it's often missed.
[22:43] And again, we have 29 different joints in our hands that could be causing pain and soreness. I personally feel like the catch-all term for hand pain is tendonitis. I had a hunch it was so common that I polled my Instagram audience on this, and 88% of respondents reported that they were first diagnosed with tendonitis before they realized they had hypermobility or suspected they might.

[23:20] Dr. Linda Bluestein: Wow.

[23:20] Corinne McLees, OT: Yeah, often De Quervain's tendonitis, that thumb tendonitis specifically. And then if someone is diagnosed with tendonitis, they go into a hand therapy clinic and all the clinician sees is: okay, this is tendonitis, what is our protocol? We're going to ice the area for 4 to 6 weeks and have them wear a brace that keeps their thumb and their wrist completely from moving. So now the person with hypermobility might be in more pain because they're in a brace, they don't like ice maybe, and they're having to overcompensate — their fingers have to move in different ways, in hyperextended ways.
[24:11] And so oftentimes the people diagnosed with tendonitis in their hands don't get better with that traditional treatment, and they're left with the same issues because the root of the problem — hypermobility in their hands — was never addressed or even recognized.

[24:33] Dr. Linda Bluestein: Sure. And they have the wrong working diagnosis.

[24:36] Corinne McLees, OT: Yes, absolutely. 100%.

[24:41] Dr. Linda Bluestein: Oh, interesting. What are some helpful low-profile braces and hand support options? And one of the followers asked: is it okay to wear compression gloves long-term?

[24:53] Corinne McLees, OT: Oh, that's a good one. Yes, it's totally okay to wear compression gloves long-term. Just make sure — especially if you're using them for nighttime use, which is actually a really amazing way to avoid sleeping with your hands all bent up — that they're not too tight, and that the seams aren't leaving marks on your hands for hours after you take them off.
[25:28] Compression gloves are one example of a low-profile hand support. Some other examples include kinesio tape. I have a really popular kinesio tape tutorial for thumb pain on my Instagram — I've pinned it at the top of my feed, so if you find me, make sure you check that out. Kinesio tape for the thumb is amazing. It offers fully customizable support, and it can also improve the wearer's proprioception so that when you have the tape on, it's not going to restrict anything. You might look at kinesio tape and think, I don't understand how this is making such a difference. But it might be improving your proprioception and your awareness of what your thumb is doing, so that you're engaging with your activities in a way less strenuous way — improving those almost unconscious movement patterns just by simply having kinesio tape on your thumb.
[26:34] In a similar way, if you Google or look up on Amazon "silicone thumb supports," these are made of a stretchy silicone material that offers targeted compression to your thumb and wrist. Again, I suspect this helps to improve proprioception. You can still fully move your thumb, which is really important, but it offers some good pain relief and support.
[27:01] The Push Metagrip — I don't know if you've heard of it, Dr. Bluestein, but it's one of my favorite thumb braces.

[27:09] Dr. Linda Bluestein: I have not heard of that one. And by the way, I will have a link to that pinned video you have on Instagram in the show notes.

[27:18] Corinne McLees, OT: Oh, awesome. Perfect. So this is the Push Metagrip. For those of you listening, please look it up. It's a very unique thumb brace. When I say the words "thumb brace," you're probably picturing this itchy, bulky, black brace that has a metal bar running from the top of your thumb all the way down into your forearm. With that kind of brace, you can't really use your hand at all — your thumb is out of the picture, and our thumb gives us almost half of our hand's functionality. We are humans with opposable thumbs and we need to be able to use them.
[28:01] So I love the low-profile options because you can still be supported in your everyday activities. You might use a wrist brace or a thumb brace when things are really flared up or when you're sleeping or resting, but having these more functional thumb and hand support options is great. The Push Metagrip is made by BraceLab, and it's considered a brace — there's actually a metal bar that runs around the thumb. But it leaves my thumb fully mobile. The way it's positioned and the way it works is that it offers a good squeeze to that first bone of my thumb that connects it to my wrist. That provides better alignment of my CMC joint, that joint where the thumb meets the wrist. And once we have that stable base of support for the thumb, it really helps a lot of the pain. My kayakers love this, my sporty people, people who paint or crochet or knit — you can cook in this brace. It's a really good one where you can still get really high-quality support.
[29:32] I also want to show you the Wristable — another—

[29:35] Dr. Linda Bluestein: Yes, before you go on to that, I have to ask — because I feel like this question comes up all the time about overusing bracing. Is there a downside? I'm thinking I have bad CMC arthritis bilaterally. You can see I have almost no thenar eminence. But is there a downside to wearing that on a really regular basis?

[30:03] Corinne McLees, OT: Such a good question. There is a downside to wearing your traditional run-of-the-mill brace that has a metal bar in it all the time, because that will weaken our muscles. But the Push Metagrip is designed in a way where you can actually see the muscles of your thenar eminence contracting better with this thing on, because it's more aligned. With these types of supports, I don't personally feel like you can really overdo it, especially when you're using it in an intentional way for certain pain levels or certain activities. I have had people start wearing the Push Metagrip who end up feeling almost more fatigued in that thenar area because those muscles are being recruited — muscles that weren't normally recruited. But this brace actually helps to recruit all of the right muscles around your thumb. So you should definitely look into it.

[31:04] Dr. Linda Bluestein: I definitely will. I've got my little shopping list. We'll have links for all of this so that everyone can find all of these things that you're mentioning. So thank you so much. This is great.

[31:13] Corinne McLees, OT: Of course. I know you help a lot of gymnasts and dancers — is that right? Okay, so this is called the Wristable. BraceLab makes the Wristable. It can be quite annoying to get on, but if you're watching the video or looking this up, it really helps people to weight bear better. The targeted support it has for your wrist doesn't block any functional motion. BraceLab actually tested the Wristable — that's W-R-I-S-T-A-B-L-E — on gymnasts to see if they could still do all of the things they needed to do. And they could. They didn't have any complaints, but they were just a lot more supported, especially in that weight-bearing position. They were still allowed full functional range of motion, just better wrist stability. And this is a relatively new brace that BraceLab just came out with, which is really cool.

[32:28] Dr. Linda Bluestein: That's fantastic. I've never heard of that one.

[32:31] Corinne McLees, OT: Yeah, it's a good one.

[32:33] Dr. Linda Bluestein: So what particular things should people be looking for with compression gloves? Because I know there are so many different options — full fingers, fingerless, copper-infused, and so on. What should people look for?

[32:43] Corinne McLees, OT: Yeah, this is a great question. I would encourage you to think about what you need to use them for. For example, when I drive, I like to wear compression gloves and I actually like to get the ones that have grip in the palm so that when I grip my steering wheel, my hands aren't sliding off. But you want to consider the texture and the fabric too. I would never wear those driving gloves to sleep in because I really don't like the texture. For sleeping, you would want something softer — something with 100% cotton that feels good on your hand.
[33:18] If you're trying to decide between full finger or open fingertip gloves, you probably don't want the full finger for daytime use, but that can be great for nighttime use if you like the idea of your fingers enclosed. Some people really don't at all. The open fingertip ones are more popular. And it's funny that you mentioned copper — there's no scientific evidence to support that copper helps. Some gloves are also infused with magnets near the wrist and the thumb, and there's no scientific evidence that supports that either. But some people swear by it. So if you think that would work for you, or if you've had a good experience with copper or magnets in the past, you might want to look for compression gloves that have those things in them.

[34:10] Dr. Linda Bluestein: Okay, that makes sense. And I want to move on to ring splints. I noticed that you're wearing a number of ring splints yourself.

[34:18] Corinne McLees, OT: Yes, yay.

[34:19] Dr. Linda Bluestein: And I actually was prescribed a ring splint for my index finger on my right hand, and I wish I had worn it more. As you can see, it's now pretty arthritic. I don't know if the ring splint would have helped that or not. But I would love to know your thoughts on ring splints, and also if you have any thoughts on getting them covered by insurance — one person did ask that specifically.

[34:41] Corinne McLees, OT: It's a good question. I'm a fan of ring splints if they work for you — if you're not averse to the feeling of metal or if you don't have a metal allergy. In my opinion, especially with the hypermobile population, I don't really feel like we can overwear our ring splints, because most traditional ring splint designs do not prevent any sort of functional range of motion. You can still open and close your hand and move your fingers. You can wear them for any activity you could possibly think of. But the ring splint itself is preventing that hyperextension or that subluxation. It's bringing your joints into better alignment, into more stability. They're basically doing what your connective tissue is failing to do in all of those joints of your hand.
There is also a time each day where they all have to come off because my sensations are just overwhelmed. I would never recommend sleeping in them or using them for heavy sports — if you wouldn't wear jewelry to the thing you're doing, ring splints aren't meant to be there either.
As for insurance coverage — you're in the US, right? The pretty much only way I know that you might be able to get them covered is through Silver Ring Splints, which is a US-based carrier. Is that the kind that you got?

[36:36] Dr. Linda Bluestein: I did, and it actually was covered by my insurance, so I was very fortunate.

[36:43] Corinne McLees, OT: Oh, that's amazing, because it really depends on your insurance plan. It also depends honestly on how the therapist bills for it. The therapist definitely has to have a measuring kit for Silver Ring Splints, and more than that they have to be a DME provider in the US. At the place I worked at last, I couldn't bill L codes to insurances — those would be the codes for the ring splints — so even though we would measure them and order them for our patients, I was never able to have my clients get their ring splints covered. But you can always call your insurance company and see.
[37:23] If they're not covered by insurance, there are a lot of makers on Etsy that make ring splints that are a little cheaper than Silver Ring Splints, and they make it very clear on their checkout pages how to measure yourself. And a lot of them — Eva Bell Jewelry in particular — have a really good return or exchange policy. If you get your ring splints and they're just not fitting right, I think there's like a 30-day policy where you can send them back and have them resized for free.

[38:07] Dr. Linda Bluestein: Okay, yeah, that's great. And then what about plastic ring splints? Because people make those as well, right?

[38:14] Corinne McLees, OT: Yes, Oval-8 ring splints — they're the beige-pink plastic ring splints that you can find on Amazon, or probably at your local hand therapy place too. Those are a great way to try out ring splints. If you're curious whether ring splints would be right for you or feel right for you, instead of spending over $100 on a ring splint, you could get a pack of Oval-8 plastic splints for maybe $20 that have different sizes you could try out. They're also great for people with metal allergies or irritation from metal. They do tend to slip off a lot more — I've had a lot of people lose these, but not really lose their metal ring splints.

[39:09] Dr. Linda Bluestein: Sure. That's really good to know. And what about — I imagine you work with children who are in school and needing to write and hold books and things like that, and you've probably worked with elderly people and everything in between. In terms of hand exercises for people that are hypermobile, how does your advice differ based on people's age?

[39:37] Corinne McLees, OT: Yeah, that's a really good question. Honestly, what we talked about with the Theraputty in particular — no matter what age you are, if you're starting low and slow — that applies across the board. I don't work with too many children, but if you're trying to get a child to engage in their hand muscles, they would probably love to play with putty. It would probably be less about repetitions and exact technique and more like putting some fun beads in the putty and having them try to take them out to make it a game.
[40:11] So aside from making it more playful for children, I would say no matter what age you are, as long as you're slowing down the exercises and making sure that you're not straining or hyperextending or subluxing your finger joints as you do them, generally I recommend starting with maybe just 8 to 10 repetitions and working your way up to 2 to 3 sets of 8 to 12 reps — where once you've done that, your hand might feel fatigued, but not so fatigued or sore that you're unable to use your hand for the rest of the day. Older adults also have a really good experience with Theraputty, especially because it offers that wide range of different resistances.

[41:05] Dr. Linda Bluestein: Okay, and what are some things that people should avoid doing?

[41:09] Corinne McLees, OT: That's a great question. Oftentimes, we have a lifetime of using our bodies and our hands in ways that feel normal to us but don't really serve our joints. So I feel like most of the work is bringing more awareness into the less than ideal ways that you're using your hands throughout the day and trying to shift that.
I typically recommend trying to avoid hyperextended finger, thumb, or wrist positions as much as you can. You might not think that you're regularly hyperextending your hand joints or finger joints or thumb joints, but if you are hypermobile, I can almost guarantee you probably are. So you might need to really start slowing down during your day, especially when you do something with your hand — like when you lock or unlock your door, or look at how you're gripping your writing utensil, or how you're carrying a heavy tray in the kitchen. Just slow down and pay attention to your hands. Maybe set a reminder on your phone twice a day that says, hey, what are my hands doing right now? Start to cultivate this awareness of what your fingers are doing so that you can begin to shift how you're using your hands — so that they're not in an unergonomic, super strained position over and over again each day.
[42:43] We use our hands so much, it's often unconscious. A lot of the work is bringing more awareness to how you're using them. If you feel like this might be you but you're having a hard time understanding where to even start or finding accountability, you should check out my free masterclass, which I believe will be in the link in the show notes below. It's a free hour to hour-and-a-half long masterclass where I've got really clear pictures and you'll have a better understanding of what activities you might be straining your fingers in and how to shift out of that.

[43:28] Dr. Linda Bluestein: That's great. I look forward to sharing that with people. And I think that there's no such thing as paying attention to your hands too soon.

[43:37] Corinne McLees, OT: Exactly. 100%. A lot of the work is preventative.

[43:42] Dr. Linda Bluestein: So important for us. Okay. What about tips for traveling? If we're traveling, especially by ourselves, and we have hand problems, what are some tips that you have for people?

[44:00] Corinne McLees, OT: Yeah, are you picturing like an airport situation?

[44:00] Dr. Linda Bluestein: Yeah, picking up luggage and yes, all of the things that you have to do.

[44:09] Corinne McLees, OT: Yeah, absolutely. Definitely wear your hand supports — don't just pack them in your suitcase, actually have them on. Especially important for your thumb and/or your wrist if you have discomfort there and you're having a hard time managing your luggage. Wearing a good hand support in the airport is a great way to navigate this.
[44:34] Also, look for luggage that has 4 wheels that you can easily push, instead of the clunky kind with 2 wheels that's always getting unbalanced. Make sure you have good luggage that you can roll. And I would always say — don't be afraid to ask for help when you need it. If you need help loading your carry-on bag up into the overhead bin, just ask. Especially if you know it's going to cause a flare.

[45:16] Dr. Linda Bluestein: So I got one of those spinner suitcases and my son kept saying, Mom, you have to get a spinner suitcase. You just have to.

[45:24] Corinne McLees, OT: Is that what they're called?

[45:25] Dr. Linda Bluestein: Yes. And all 4 wheels spin in every direction. They're amazing. I got mine at Costco, and it was life-changing because I do travel a lot by myself. It really makes a huge difference because I can have it next to me — so it's a lot easier on my shoulder, my elbow, my wrist, my entire upper extremity. I can do it with my non-dominant hand. Whereas if I'm pulling something behind me, that strains my shoulder, my elbow, my wrist. So yeah, I'm glad that you mentioned that, because I think a spinner suitcase is a really good one.

[46:08] Corinne McLees, OT: I'm so glad. I don't travel that much, so I didn't know the name for it — I was just calling it "the luggage with four wheels." A spinner suitcase. That's amazing. Okay.

[46:15] Dr. Linda Bluestein: Yeah, I love that. Awesome. Okay, and you also had a post recently where you said our current medical system isn't set up for people in chronic pain, which I totally agree with. Can you elaborate on what you were thinking with that, and in particular, what people can do if they feel like things are not working for them?

[46:38] Corinne McLees, OT: Yeah, I'm glad we're on the same page about that. There are multiple reasons why it's not set up for people in chronic pain. One is that, as we've talked about, there's just simply not enough awareness among medical professionals of the complexities of hypermobility. So the working diagnosis is different from what's actually at the root of the issues.
[47:28] Another reason would be just the way our insurances are set up. They do not want to reimburse for chronic conditions. They want to see people get better within a really predictable, what they would call reasonable amount of time — which they can't even determine for us. And so they might stop reimbursing or not approve any more visits for therapy. Then people feel left in the dark.
[48:05] I think if you're here, then you know there's an amazing online presence of wonderful educators trying to help you. You kind of have to be your own advocate and do a lot of the work yourself. Things like coaching programs, things that are outside of the traditional medical system that aren't necessarily insurance-reimbursable — those are things that I feel typically can help us more than that structured model where you get 8 visits for the year and then you're done. It really is more of a long game than that.

[48:49] Dr. Linda Bluestein: Yeah, I totally agree. And the insurance situation is so incredibly frustrating. They expect you to get enough better, but in some ways not too much better — it's ridiculous. They have way too much control.

[49:08] Corinne McLees, OT: They do. It's icky writing my notes for insurances. It's like: they're improving in this way, but they're not improving in this way, but they're still improving enough to get therapy. It's like mind games. Why can't we just — yeah.

[49:31] Dr. Linda Bluestein: People end up working basically for the insurance company and not for the patient. Yeah, it's a huge problem. Okay, so I want to move on to the questions from followers who submitted these on the broadcast channel. I was really excited that we got so many questions.

[49:48] Corinne McLees, OT: Yay.

[49:49] Dr. Linda Bluestein: Some of these we might have already covered a little bit, but I think it doesn't hurt to go into them again because they're really important. So the first question is: why does it hurt to write?

[50:00] Corinne McLees, OT: That's a good question. Like, why does it hurt, or how to address the hand pain if it is hurting?

[50:08] Dr. Linda Bluestein: I think what the person was thinking is why do so many people get hand pain with handwriting?

[50:16] Corinne McLees, OT: Yeah. Most of us hypermobile people are characterized by a classic hyperextended death grip where our topmost finger joints — I don't know how you are writing. I love that pen.

[50:34] Dr. Linda Bluestein: I'm showing a pen. I don't even know what this is called, but I'll put the pen again in the show notes.

[50:39] Corinne McLees, OT: Well, I think that's the generic term for it — the "pen again." It's like a Y pen. Yeah, a Y pen. We're often characterized by this hyperextended grip. And when our fingertip joints are hyperextending on our writing utensil, we actually lose a lot of force on the utensil itself, so our muscles and joints have to work a lot harder to write — most of our force is going toward hyperextending our fingertip joints. That's when we see a lot of hand fatigue.
[51:20] Another common reason for pain with handwriting is that maybe we're only using our hand and fingers while the rest of our arm is glued to our side. Instead, we can try to loosen everything up a little bit in our shoulder and elbow and make it more of a flowing, fluid movement.
[51:42] Another common reason I see — especially if you're getting pain or fatigue on the pinky side of your hand, in the meat of your palm — is that when we write, our pinky is actually almost forced into a super hyperflexed, almost bent-in-half posture. That can be a reason why handwriting is so strenuous on that side of our hand as well. There are a lot of things we can do about it, and I'd be happy to get into it.

[52:20] Dr. Linda Bluestein: And that's the follow-up question. How can people avoid aggravating their thumbs and causing hand pain while either holding a book to read or writing?

[52:30] Corinne McLees, OT: Awesome. I would love to address writing first since that's on my mind, and then we can talk about books too. For hand pain in general with writing — you showed us the Y Pen, which is amazing because it changes the way that you grip the writing utensil entirely. If you don't have a Y Pen, you could try out this concept by just switching where the eraser is. You would put it in between your index and middle finger. So if you're listening, please come back and watch this. It's a very simple shift where it's almost like your index and middle finger are surrounding the writing utensil, and it forces a more bent-forward posture of your fingertip joints, and it puts your thumb in a better position too. It can take a lot of practice to make this feel natural and easy, but it's worth it, especially if you have to write a lot.
Another way to modify your writing utensil — have you seen that foam tubing, that cushiony stuff?

[53:47] Dr. Linda Bluestein: Oh yes, you have one! I should have had all of these out and ready to go before we started. But as you were saying that, I was like, wait, maybe I have one in my drawer.

[53:57] Corinne McLees, OT: Yes, that's amazing. And look, you also have those hand-friendly scissors.

[53:59] Dr. Linda Bluestein: Yes, the spring-loaded scissors, so good. I love these things. Anyway, sorry, I didn't mean to digress.

[54:08] Corinne McLees, OT: Good gadgets. Yeah. So just looking for a writing utensil that's either already wider — there's a pen called the Big Fat Arthritis Pen. It's chunky, a nice fat pen. Or modifying your current writing utensil the way you've done, Dr. Bluestein, with the foam tubing that you could find at Lowe's or on Amazon by searching "foam tubing." And then of course, wearing ring splints, especially where you are hyperextending, is another really great way to more evenly balance that force on your writing utensil so that you're not having to death-grip it so much.

[54:55] Dr. Linda Bluestein: Yeah, that makes sense. And books too, right?

[55:03] Corinne McLees, OT: Yes! You could wear a thumb support while you're reading — whether it's the Push Metagrip like we talked about, or kinesio tape, or a thumb brace. You can also try a book stand. They make book stands that prop up and hold the pages for you. There's also this thing called a book page holder. It's almost like a ring that you would put on your thumb, but it has wings on the sides so that when you're holding the book, it disperses the force of your thumb onto the pages more broadly. If you want to try that as a ring while you read, that would be another way to reduce some pain.

[55:57] Dr. Linda Bluestein: Okay, I love all of those. And is there anything differently that you would suggest for someone whose issue is more cramping in their hands?

[56:12] Corinne McLees, OT: With cramping or fatigue, I think all the things we talked about — really focusing on the ergonomics of how you're holding your utensil and trying to engage more of your whole arm rather than just your fingers — are helpful. Cramping is common when we're gripping our writing utensil too tightly. So if we can widen the writing utensil, wear some ring splints, and maybe even change how we're gripping it entirely with that grip I showed you, or by using the Y Pen — those are all things that could help with that too.

[56:49] Dr. Linda Bluestein: Sure. And maybe taking breaks if you can.

[56:51] Corinne McLees, OT: Absolutely. Yep.

[56:53] Dr. Linda Bluestein: Okay. And someone asked about clay therapy, and I'm not sure if that's different from putty therapy, but they asked how effective is clay therapy.

[57:00] Corinne McLees, OT: I think they're referring to the Theraputty. I would say it can be effective, especially when you're using it in the ways that we've talked about. A lot of people with hypermobility who don't have a hand therapist that specializes in hypermobility are just given a thick wad of clay or putty and told to squeeze it. They don't really know if they're overdoing it, or how to squeeze it, or how to not over-squeeze it, or how to use it in a therapeutic way. So if you've ever used Theraputty or clay and it hasn't helped your hand, I feel like if you try the tips that we've talked about, you might have better results.

[57:47] Dr. Linda Bluestein: All right, and what about people who have hands that go numb in their sleep? Do you have thoughts about sleeping positions and/or people who have problems with numbness developing while they're sleeping?

[58:02] Corinne McLees, OT: Yes, that's pretty common in people with hypermobility. I would first want you to determine if your numbness is on one side of your hand or the other, or if it's all throughout your hand and fingertips. If it's on the pinky side of your hand and into the ring finger, you very likely have cubital tunnel syndrome. A lot of us sleep with our elbows in a bent-up position, and our ulnar nerve runs through our funny bone. When you think about how it feels when you hit your funny bone — that sensation that goes through your hand, especially that pinky side — cubital tunnel syndrome is like that, but it doesn't go away.
[58:48] If you're sleeping and you're noticing numbness and tingling in your pinky and ring finger, I would really encourage you to try to sleep in a more elbow-extended posture. That can be really hard without an external support, since the natural position for sleeping is that flexed posture. You could try a soft elbow brace that keeps your elbows in a relatively more extended position. Or, if you don't want to buy a new brace, you could try folding up a towel and wrapping it around your elbow, then putting some duct tape or a tie around it to try to keep your elbows straighter at night.
[59:37] If your numbness and tingling is more on the other side of your hand — in your thumb, index, and middle finger — then we would be looking more at carpal tunnel syndrome. Again, this is all for educational purposes; seek medical care. But if you have that distribution, wearing a wrist brace at night that really supports the wrist and keeps it neutral — doesn't allow you to bend your wrist — would be incredibly helpful. When we sleep with bent wrists, that puts a lot of compression over our carpal tunnel. If you wake up feeling like your hand has fallen asleep and you need to shake it out, and it's mostly on that one side of your hand, it's probably carpal tunnel syndrome. Finding a good wrist brace and sleeping in it every single night would definitely help.

[1:00:41] Dr. Linda Bluestein: Okay. Those are super great tips. Awesome. What about thumbs that go out of socket?

[1:00:58] Corinne McLees, OT: I just got my thumb ring splint in the mail today, actually. And I was trying to pop my thumb out of socket because as a nervous tic growing up, I would pop my thumbs out of socket intentionally. Wearing a support such as a ring splint or the Push Metagrip — something rigid that will help hold it in place — can be really helpful. There are also a number of targeted exercises specifically for the muscles surrounding your CMC joint that could help as well. If you ask your therapist for CMC exercises, or look them up — I think I have a number of them on my Instagram feed too — building the muscles around your thumb so that there's more natural joint support can be really beneficial.

[1:02:03] Dr. Linda Bluestein: Okay, and we had some very specific questions about some specific conditions. I might start with: is there a link between carpal tunnel and joint hypermobility?

[1:02:15] Corinne McLees, OT: Yeah, that's a good question. I don't know any statistics on it, but I can tell you that I believe there is definitely a greater incidence of carpal tunnel syndrome in people with hypermobility — probably for a number of reasons: our sleeping position, the fact that our wrists can hyperflex a lot more than the average population, and maybe some surrounding inflammation. I have definitely seen it more in the hypermobile population.

[1:02:48] Dr. Linda Bluestein: Okay, and we just talked about cubital tunnel a little bit, and you mentioned wrapping a towel or getting a soft elbow support. Is there anything else people can do if they have cubital tunnel?

[1:03:01] Corinne McLees, OT: Yeah, great question. Aside from sleeping with straight elbows, try to avoid leaning on your elbows. If you're someone who sits at your desk and likes to lean on your elbow, that pressure over the funny bone area is what causes those symptoms. So avoid any sort of prolonged elbows-flexed position, and watch armrests and tables too — become more mindful of that.
Ulnar nerve glides are also a great way to decrease symptoms. And then they make elbow pads that protect your elbow — so if you are an elbow leaner and you're having a hard time quitting that, you could put on a Heelbow elbow pad.

[1:03:57] Dr. Linda Bluestein: Oh my gosh, I love that Heelbow. Okay, I'm going to have to look up all these links.

[1:04:09] Corinne McLees, OT: I'm so glad.

[1:04:10] Dr. Linda Bluestein: This is great — I love being able to offer so many really super specific things for people. They're going to love this. So, okay, Heelbow. Got it. And I see what you mean about actually having the elbow on a table. Oftentimes if I'm giving a talk in a dance studio, all the kids are sitting on the floor and I'll see people leaning back on their elbows with their elbows incredibly hyperextended. I just, you know, it's cringy. I have to call them out on it.

[1:04:38] Corinne McLees, OT: Yes, you do. It's that lack of trunk support — we rely on our extremities to prop us up.

[1:04:47] Dr. Linda Bluestein: Exactly. And even if it doesn't hurt now, it just makes me think, oh, what's that going to feel like later? So, okay. We talked about De Quervain's very briefly, but could you tell us again what De Quervain's is, and is it more common in people with joint hypermobility? And then, what can people do if they have recurrent De Quervain's?

[1:05:08] Corinne McLees, OT: Such a good question. De Quervain's tendinitis is also commonly called "mommy thumb" because a lot of new moms are diagnosed with thumb tendinitis. We have quite the intersection of tendons and nerves running through what's called the anatomical snuff box. When you lift your thumb up and see that little hollow right there — that is literally a snuff box. That is the space that is inflamed or has tendinitis with De Quervain's tendinitis. This is a lot more common in people with hypermobility, and a lot of the traditional treatments for it don't work too well when we're looking at an entire hypermobile hand and wrist complex.
[1:06:02] A lot of the traditional treatments include wearing a metal bar thumb brace or a custom-made thumb brace that completely shuts down your thumb and your wrist for 6 weeks or so. That's the typical intervention. But when it's recurrent and chronic and it keeps coming back, what's going to be more helpful is doing all the other stuff we've talked about today — the low-profile thumb support options, making sure your thumb is in an aligned place where it's not popping out of socket, using kinesio tape or silicone thumb supports or the Push Metagrip as low-profile ways to support your thumb, especially through harder or heavier tasks.
[1:06:55] Another big thing with this tendinitis in particular — it's called mommy thumb because of how we have to lift up our children, right? We scoop them up under their armpits with our thumbs, with all of the pressure on our thumb joints of their entire weight. So if you have a kid, try to pick them up differently — maybe with more of your elbow and shoulder joints. Or if you have to pick them up that way, really shift out of it quickly and prop them with your hip and elbow. Try not to engage in that lifting position with a lot of strain placed on your thumbs.

[1:07:37] Dr. Linda Bluestein: Another question that somebody asked was about torn triangular fibrocartilage complex, or TFCC, and they wanted to know what you can do if you have a torn TFCC.

[1:07:52] Corinne McLees, OT: Yeah, this is very common. Subjectively, I see torn TFCCs a lot in hypermobile people. The TFCC is a piece of connective tissue — or a group of connective tissues — that helps to stabilize the ulnar side of our wrist, the pinky side. If it's torn, people often jump to surgery, but it's helpful to try more conservative measures first, because recurrence after surgery is not uncommon, especially if this is more of a chronic tear. And I feel like a lot of us have a sort of chronic TFCC issue.
[1:08:44] The first thing you could do is work on wrist stability exercises, like some wrist isometrics. Are you familiar with the True Balance? It's like a gravity puzzle — it's technically a kids' game, but I give it to my people with persistent wrist pain and TFCC tears a lot of the time because it acts as a way to stabilize your wrist and practice that stability and engage the surrounding muscles.
The other thing is a very specific wrist support that was actually invented by an occupational therapist — a certified hand therapist — called the WristWidget. Do you have one?

[1:09:40] Dr. Linda Bluestein: Yes, I do. This is what it looks like. It has these Velcro straps and the hole goes in here, right?

[1:10:06] Corinne McLees, OT: Yeah, it kind of hugs that ulnar head, that bone on the back of your hand towards the pinky side of your wrist.

[1:10:16] Dr. Linda Bluestein: And then the Velcro would go down like that.

[1:10:18] Corinne McLees, OT: Yeah. So that provides very targeted support.

[1:10:26] Dr. Linda Bluestein: It feels good.

[1:10:26] Corinne McLees, OT: It does feel good, right? It's kind of a similar concept to the Wristable from BraceLab — where it's squeezing you in a very specific way, right here around and then on the bottom. I will say, it seems to work really well for some people — they essentially heal and never have issues again — and for others it doesn't really work for their specific situation, because everybody's different. But there's no way to know until you try. And I love the design of it. It's absolutely genius.

[1:11:02] Dr. Linda Bluestein: And I love these conservative things that people can try because you can't undo surgery, and surgery has potential complications. And of course, as you pointed out, there can be failures and recurrences, and if it's a chronic problem, that's very different from going into surgery for a more acute injury. So I think it's really important to consider what the likelihood of a truly successful outcome from any given surgery actually is, because it's a big deal.

[1:11:37] Corinne McLees, OT: Yeah, I absolutely agree. I'm so glad we're on the same page about that.

[1:11:38] Dr. Linda Bluestein: Yeah, awesome. The last specific question on a condition was about trigger finger. Can you explain what trigger finger is? And then the question was: how effective are steroid injections for trigger finger, in the context of EDS or HSD?

[1:12:02] Corinne McLees, OT: Yeah. So trigger finger — we have a lot of connective tissue in our hands, as we've talked about. Sometimes when there's a lot of inflammation, or we're doing a lot of the same task over and over again like heavy gripping for work, we can get almost a palpable knot of fascia right where our tendon runs. We have a bunch of tendons that go through our hand and up to our fingertips, and each tendon has to be able to move and glide smoothly to allow our hand to open and close. When we have this knot of tissue surrounding one of those tendons — picture a thread that has frayed a lot and you're trying to get it through the eye of a needle — it's just going to catch.
[1:13:09] So what happens is when we make a fist, the tendon will go through, but then as we try to open our hand it will lock and catch because of that accumulation of tissue surrounding the tendon. You might be able to pop it back up on your own — your finger just sort of pops and you think, that was weird. But you might not be able to do that; you might have to physically lift up your finger to get it through. When it's a chronic condition, this can become rather painful.
As for steroid injections — they would put a steroid injection into the area that has all that tissue knotted up around the tendon. And don't take my word for this as I've done research but want to be accurate — when combined with splinting for 4 to 6 weeks, where you wear a trigger finger splint that keeps just that first MCP joint from bending while the rest of your finger can still bend, the corticosteroid injection plus splint approach in more acute cases has a rate of improvement I believe over 50% in the general population. Now in the hypermobile population, that's probably a different story, and I don't really have any stats on that because we need a lot more research.

[1:14:48] Dr. Linda Bluestein: I don't have any stats on that either.

[1:14:50] Corinne McLees, OT: We probably don't have any stats yet. I should go conduct a research study. But I also want to say — a lot of people with hypermobility think that they have trigger finger, or they might even get diagnosed with trigger finger by a generalist who just looks at their hand and thinks, oh, that popped, it's trigger finger, when in reality it is more like a subluxation where we've hyperextended at one of our joints and then have to almost overcome those ligaments going out of place before it pops on the way back down. So I really want to make sure that if you think you have trigger finger, you have the correct diagnosis, because traditional treatments for trigger finger are not going to work if it's actually a subluxation.

[1:15:43] Dr. Linda Bluestein: And so if I understand you correctly, trigger finger normally pops when you straighten your finger, and otherwise if it pops when you're bending your finger, it could be because you overextended and then you go to flex it. So maybe they pop at different times.

[1:16:00] Corinne McLees, OT: That's a really good distinction to make. Yeah, I like that as a broad distinction.

[1:16:06] Dr. Linda Bluestein: And as a corollary to this — I know this is a more niche question — for rock climbers, it's my understanding that they can get a lot of pulley-type injuries in their fingers. Do you think that the kind of brace you've talked about for trigger finger could be worn during healing of a pulley injury, and maybe accelerate the healing process?

[1:16:34] Corinne McLees, OT: Oh yeah, I think that's a great idea. That's definitely worth a shot.

[1:16:41] Dr. Linda Bluestein: Do you know what those braces are called for trigger finger?

[1:16:44] Corinne McLees, OT: If you just look up "trigger finger splint," the Amazon brand Vive — V-I-V-E — has one. A lot of them are black and they just kind of go into the palm and then come up and block that MCP flexion at the finger, but you still have mostly a functional hand.

[1:17:06] Dr. Linda Bluestein: Okay, great. And did we miss any questions, or did you have any final thoughts — anything you were just dying to get out there? And then after that, we're going to get into the hypermobility hack and where people can find you.

[1:17:19] Corinne McLees, OT: Awesome. Yeah.

[1:17:22] Dr. Linda Bluestein: You've shared so much wonderful information. This has been so fantastic. But was there anything else that I didn't ask you that you wanted me to ask?

[1:17:30] Corinne McLees, OT: No, I don't think so. I think we've covered so much today.

[1:17:35] Dr. Linda Bluestein: Yeah, we definitely did. And can you tell us some of your favorite hypermobility hacks? I mean, you've already given us like a whole episode full of hacks, but—

[1:17:43] Corinne McLees, OT: Yeah, I would really — I can give you one for the hands. I just want to reiterate and hit the ball home on our big takeaway from this episode. And then I also wanted to share a few of my own personal mobility or dysautonomia hacks, if that's okay.

[1:18:00] Dr. Linda Bluestein: Of course.

[1:18:00] Corinne McLees, OT: Okay, awesome. Our home run takeaway is: when you become more aware of how hypermobility is affecting your hand movement patterns every single day, and then you make small changes in how you're using your hands in more ergonomic ways, that alone could serve you so well. Yes, all the gadgets are fun. All the braces are fun. All the things we've shown and talked about today — I love our show and tell. They're great. But you could start right now, without spending money, just by becoming more aware of how your fingers are bending backwards and during which tasks, and really getting curious with yourself about how that could be affecting your hand pain. That's my big takeaway and my big hack for hypermobility in your hands.
[1:18:53] And then 3 quick personal hypermobility and dysautonomia hacks that I've learned about myself over the past year. Swimming is an incredibly accessible form of exercise for me with my POTS symptoms. I love it, it's amazing. So is abdominal compression. I tried compression socks, but I feel like abdominal compression really helps me personally more than compression socks.
[1:19:21] And then my last one — go ahead.

[1:19:24] Dr. Linda Bluestein: Well, I was going to ask — when you say abdominal compression, is there a certain brand or style you're talking about? Almost like a corset, right?

[1:19:33] Corinne McLees, OT: Yes, that level as well. I have like a postpartum abdominal binder that I used when I was postpartum for really symptomatic days. Even just compressive yoga pants that have a compressive waistband seam are helpful for me. And I like those more than socks. My last personal hack — because I've been on my own journey of understanding and discovering my own health issues — is that over the past year I've really prioritized 30 minutes of movement each day, however that looks, even if it's just a walk. And that is so important to me.

[1:20:24] Dr. Linda Bluestein: That's amazing. Those are really great tips. I love all of those. And you mentioned your free masterclass, which is going to be fantastic, and I'll definitely share the link so everyone can see that. And I'll share the link to your Instagram account as well. Are there other places that people can find you online?

[1:20:48] Corinne McLees, OT: I have a website — it's handcoachcorinne.com — where you can find my masterclass. You can find free guides, like a few free hand support guides with links and ideas for ways to support your hands. And I'm also on Facebook and TikTok, both under "Hand Coach Corinne." Yeah, it's all the same — Hand Coach Corinne.

[1:21:10] Dr. Linda Bluestein: Okay, fantastic. Well, I'm so grateful to you, Corinne, for coming on the Bendy Bodies Podcast today. I just want to remind everybody that they've been listening to the Bendy Bodies with the Hypermobility MD Podcast, and your guest today was occupational therapist and hand specialist Corinne McLees. Corinne, this has been such an incredible episode and such an incredible conversation. I'm so grateful to you for sharing your knowledge with us.

[1:21:39] Corinne McLees, OT: Thank you so much. This has meant so much to me that you would want me on your podcast, to have this space here. I feel like I've been fangirling over you and your podcast, but just being able to be here and be a part of the amazing free wealth of knowledge that you share — it means so much to me. I really appreciate your time.

[1:21:58] Dr. Linda Bluestein: Oh, thank you so much. People are going to be loving this and I'm sure just so grateful for the information. Thank you again. And thank you to all the listeners. We'll see you next time on the Bendy Bodies Podcast.

[1:22:12] Corinne McLees, OT: Awesome. Thanks.

[1:22:17] Dr. Linda Bluestein: Thank you for listening to this week's episode of the Bendy Bodies with the Hypermobility MD Podcast. Visit our new website at bendybodypodcast.com where you can now view guest profiles and show notes with links to products and journal articles. Leave me a comment, sign up for updates, leave a review or a voicemail, and access the podcast on your favorite player all directly from our website. You may hear your voicemail in a future episode where we answer your question or dive into your gracious feedback. Follow us on Instagram @bendy_bodies. We love seeing your posts and stories. So be a buddy and engage our community by using the hashtag BendyBuddy. That's hashtag B-E-N-D-Y-B-U-D-D-Y. You can also find me, Dr. Linda Bluestein, on Instagram, Facebook, Twitter, or LinkedIn at HypermobilityMD. Visit hypermobilitymd.com for information about medical services and one-on-one coaching. This podcast is for general informational purposes only and does not constitute the practice of medicine or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. Do not disregard or delay obtaining medical advice for any medical condition you have. Opinions shared are those of the guest and do not necessarily represent the views of the host or any particular organization. Sponsorship of the podcast does not necessarily mean an endorsement. Thank you for being a part of our community, and we'll catch you next time on the Bendy Bodies Podcast.