S. PICKING THINGS UP – THUMB POSITION
My advice:
When you go to sleep try to position your fingers in a fist with the tip of your thumb tucked inside your first finger. The point of this is get the tendons in your thumb to set in a position that results in a good tenodesis grip between your thumb and first finger when you extend your wrist.
My experience
In the first few months after I became a quad I was advised by an older quad to sleep with my fingers in a fist, and the tip of my thumb tucked inside the first finger. He was able to pick up remarkably small and/or heavy objects compared to me at the time. So I followed his advice, and have continued to every night ever since.
It works. After a very short time my thumbs ended up in a position that meant whenever I extended my wrist the thumb and first finger would pinch together. This means I can pick up lots of things. Some things remain difficult or impossible. For example, very small, smooth or heavy things, especially things that are all three at once.
As I understand it the reason this works is that it has allowed the tendons in my thumb to set in a position that results in a good tenodesis grip between my thumb and first finger.
I have had this theory more or less confirmed recently in a very unfortunate way. My left thumb has developed mysterious and almost constant spasm. This means it is being straightened regularly which has stretched the tendons in my left thumb so it is no longer stuck in a good position. As a result my left thumb and first finger no longer meet when I extend my wrist, and therefore I can no longer pick up much with my left hand.
Picture
my right thumb showing how the bend in it, and its position, has given me a very useful tenodesis pinch
my left thumb showing how it is now straight, and in a bad position, which results in a non-functional tenodesis pinch
What the experts say
CLICK HERE for an article that concludes “In the long term, most C6 and C7 tetraplegics attain a high level of hand function despite poor lateral grasps’
Rule number 19 – The thumb is the key to a good C6 grip. Thumb position can be the difference between dependence and independence.
The Independent Quad (C6) 
Have you come across Active Hands gripping aids – they may be useful to you. http://www.activehands.com
Hi,
I see your fingers are fairly straight. Most quads have curled-up fingers. Do you go out of your way to keep them straight?
I’ve had 3 operations on my right hand/thumb these past two years. Tendon transfers. The thumb works okay now and I’ve got quite a good pinch grip there. The fingers(flexors) though were very tight after the 2nd opp.. On the up side it gave me the ability to hold a tooth brush again, easily grip and pick-up things like wine bottles, kettles, clothes, and anything else really…I had a decent grip again if I extended my wrist. On the down side though the fingers were very tight so it was a bit difficult opening them up to hold bigger items like a can of Coke or something that size. So with the last operation they tried to adjust those fingers to be a bit more loose. I put too much strain too soon on them after the operation so the stitches on the inside snapped. Have to go back for them to tie those tendons together again in June.
Have you never considered tendon transfers? Also, the ones that can give you triceps again? I passed on that one because it would require me to be 3 months away from work.
There’s actually a Prof Sorensen from your country who specialized in that field. He was over here a few years back to share his knowledge.
i have never had those types of operation – couldn’t face all that time out of action