Hand Longevity Care
Hand Longevity Care
A proactive, preventive approach to hand care — especially for individuals over 30 — focused on three goals:
LifespanLiving a longer time than average.
HealthspanLiving longer without impaired hand function or hand diseases.
BeautyspanControlling and reversing the external hallmarks of hand aging.
Standardized Aging Hand Evaluation System
For the diagnosis and documentation of age-related changes in the hand, we use a standardized aging hand evaluation system, looking at:
Basic Patient information
- Personal Identification
- Contact Information
- Emergency Contacts
- Insurance details
- Medical History
- Allergies
- Current Medication
- .....
Basic Hand information
- History
- Inspection
- Palpation
- Basis Hand Function Tests
- Functional Performance Tools
- Medical Imaging
- Medical Examinations (NCS, EMG, ....)
- Laboratory
- .....
Systemic Age Drivers
- Environment
- UV exposure
- Chemical exposure
- Mechanical overuse
- Hormonal changes
- Menopause
- Adrenopause
- General Health
- Nutritional Deficiencies
- Metabolic Syndrome
- Cancer
Specific Aging Hand Information
- Skin
- Nail
- Blood vessel
- Muscle
- Tendon
- Nerve
- Joint
- Bone
Depending on the findings, a personalized care & support plan is created, taking into account the changes for the different tissues.
Full-Spectrum Hand Longevity Care Concept
Based on many years of research and clinical experience in hand surgery, Prof. Hierner developed the “Full-Spectrum Hand Longevity Care Concept” and successfully implemented it in his daily practice. Hand longevity is not created with one magic procedure — it is the artful layering of policies and procedures covering all levels of preventive and reactive care.
Prevention→ Pro-active care
- Education
- Lifestyle Adjustment
- Screening
Regeneration→ Maintenance
- Regenerative Wellness
- Regenerative Medicine
- Precision Medicine
Cover-up & Repair→ Rejuvenation
- Pain Management (pharmacological, non-pharmacological)
- Repair of Function (conservative, operative)
- Repair of Aesthetic (conservative, operative)
The different care options are not competing procedures, but complementary forms of care that very often build upon each other. Because no single discipline can offer the entire spectrum of modern longevity care, a multidisciplinary patient care is mandatory.
A Full-Spectrum Care Concept for Every Tissue
Age changes affect every tissue of the hand. Explore the full-spectrum care concept for each one:
Skin
Age Changes
- Pigment disorders:
- “age spots”
- uneven tone
- thin skin: Collagen loss causes loss of thickness of dermis
- Wrinkles:
- Dryness
- Loss of contour:
- loss of thickness of dermis
- loss of subcutaneous fat tissue
- loss of intrinsic muscle
- Increasing visibility of dorsal veins and tendons
Full-Spectrum Care
Prevention→ Pro-active care
- Basic Skin Care
- Cleansing
- Moisturization
- Sun Protection
- Sun screen (SCF 50)
- Protection (gloves)
- Skin Protection
- Harsh Chemicals & Irritants
- "Wet Work" Dermatitis
- Extreme Physical Conditions
- Mechanical Stress & Friction
- Hydration
- Nutrition
- Does
- Antioxidants (Vitamin C, E, Polyphenols):
- Protein (Collagen)
- Healthy Fats (Omega-3s)
- Vitamins A & D:
- Minerals: (Zn, SE, Cu, Mg)
- Don’t’s
- Refined Sugars & Carbohydrate
- Processed & Fried Foods
- Does
Regeneration→ Maintenance
- Advanced Skin Care
- Cleansing
- Moisturization
- Repair (Retinol)
- Sun Protection
- Silicone gloves (over night)
- Hormone Replacement Therapy
- Women (< age 60 or within 10 years of the onset of menopause)
- Men: (low testosterone)
- Collagen Booster (Vit A, C, B3, ..)
- Topical Serums/Creams
- Injectable "Skin Boosters":
- Microneedling
- Radiofrequency/(RF) (Morpheus8, …)
- i.v.-Therapy (Peptides)
- Hyaluronic acid
- Platelet-Rich Plasma (PRP) therapy
- Stem Cells therapy
Cover-up & Repair→ Rejuvenation
- Epidermis/Dermis Repair
- Laser Therapy
- Cryotherapy
- Chemical Peels
- Microdermabrasion
- Subcutaneous fat tissue replacement
- Filler
- Fat transfer (Lipofilling)
- Skin removal/thightening procedures
- Mini (Finger) Lift
- Total (dorsum + fingers) Lift
Nail
Age Changes
- Wrinkles at dorsal and lateral nail fold
- Texture
- Vertical Ridges (onychorrhexis)
- Brittleness and Splitting (onychoschizia)
- Color: (dull, opaque, pale, yellowish or grayish tint)
- Thickness (fingernails often become thinner)
- Contour (change of natural curve, curling)
- Slower Growth: (decline of 0.5% per year after age 25)
Full-Spectrum Care
Prevention→ Pro-active care
- Basic Nail Care
- Trim nails straight across
- Do Not Cut Cuticles
- Nail Protection
- Harsh Chemicals & Irritants
- Extreme Physical Conditions
- Mechanical Stress & Friction
- Hydration
- Nutrition
- Antioxidants (Vitamin C, E, Polyphenols):
- Protein (Collagen)
- Healthy Fats (Omega-3s)
- Vitamins A & D:
- Minerals: (Zn, SE, Cu, Mg)
Regeneration→ Maintenance
- Advanced Nail Care
- Longitudinal nail grooves
- Japanese Manicure
- Hormone Replacement Therapy
- Women (< age 60 or within 10 years of the onset of menopause)
- Men: (low testosterone)
- Collagen & Peptide Treatments
- Specialized Serum
- Arkada Serum TC16
- IBX System
- Nail Reconstruction Kits
Cover-up & Repair→ Rejuvenation
- Nail cover-up
- Ingrown nail management
- Weakening of the nail plate
- Partial nail plate removal
- Emmert Plasty
- Chemical Peels
- Microdermabrasion
- Subungual hematoma management
Veins
Age Changes
- Prominent Veins
- Venous Dilatation & Weakness
Full-Spectrum Care
Prevention→ Pro-active care
- Basic Skin Care
- Cleansing
- Moisturization
- Sun Protection
- Sun screen (SCF 50)
- Protection (gloves)
- Skin Protection
- Harsh Chemicals & Irritants
- "Wet Work" Dermatitis
- Extreme Physical Conditions
- Mechanical Stress & Friction
- Hydration
- Nutrition
- Does
- Antioxidants (Vitamin C, E, Polyphenols):
- Protein (Collagen)
- Healthy Fats (Omega-3s)
- Vitamins A & D:
- Minerals: (Zn, SE, Cu, Mg)
- Don’t’s
- Refined Sugars & Carbohydrate
- Processed & Fried Foods
- Does
Regeneration→ Maintenance
- Advanced Skin Care
- Cleansing
- Moisturization
- Repair (Retinol)
- Sun Protection
- Silicone gloves (over night)
- Hormone Replacement Therapy
- Women (< age 60 or within 10 years of the onset of menopause)
- Men: (low testosterone)
- Collagen Booster (Vit A, C, B3, ..)
- Topical Serums/Creams
- Injectable "Skin Boosters":
- Microneedling
- Radiofrequency/(RF) (Morpheus8, …)
- i.v.-Therapy (Peptides)
- Hyaluronic acid
- Platelet-Rich Plasma (PRP) therapy
- Stem Cells therapy
Cover-up & Repair→ Rejuvenation
- Subcutaneous fat tissue replacement
- Filler
- Fat transfer (Lipofilling)
- Occlusion of prominent vein
- Laser
- Sclerotherapy
Muscle
Age Changes
- Reduced Muscle Mass
- Reduced Strength and Power
- Power grip
- Reduced Speed
- Reduced Endurance
- Reduced Mobility/Increased rigidity
- Decreased Coordination
- Physical Changes:
- Contracture of the 1st wep space
- Increased Injury Risk
- Metabolic Impact
Full-Spectrum Care
Prevention→ Pro-active care
- Hydration
- Nutrition (total calories)
- Antioxidants (Vitamin C, E, Polyphenols):
- Protein (1.2–2,0g per kg of body weight/d
- Leucine
- Healthy Fats (Omega-3s)
- Creatine
- Vitamins D
- Minerals: (Se, Mg, Ca, Fe)
- Quit Smoking
- Functional Daily Movements
- Daily Activity Integration (Carry heavy grocery)
- Proper Posture
Regeneration→ Maintenance
- Exercise
- Aerobic Exercise
- Targeted Hand Strengthening Exercises
- Warm-up
- Strengthening Strategies
- Cool down
- Recovery Support
- Rest
- Active Recovery
- Hormone Replacement Therapy
- Women (< age 60 or within 10 years of the onset of menopause)
- Men: (low testosterone)
- Complementary and Future Strategies
- Physical Modalities:
- Low-level laser therapy (LLLT)
- neuromuscular electrical stimulation (NMES)
- Growth Factors & Proteins
- Exosomes Therapy
- Stem Cell Therapy
- Satellite Cell Activation
Cover-up & Repair→ Rejuvenation
- Muscle Injury Management (RICE+)
- Rest
- Ice
- Compression
- Elevation
- + Rehabilitation
- Muscle/Tendon transfer
- Augmentation
- Replacement
Tendon
Age Changes
- Pain
- Swelling
- „moving nodule“
- click
- block („trigger finger“)
- Reduced Strength and Power
- Power grip
- Reduced Mobility/Increased rigidity
- Decreased Coordination
- Increased Injury Risk
Full-Spectrum Care
Prevention→ Pro-active care
- Hydration
- Nutrition (total calories)
- Antioxidants (Vitamin C, E, Polyphenols):
- Protein (1.2–2,0g per kg of body weight/d
- Proline, glycine
- Healthy Fats (Omega-3s)
- Vitamins C
- Minerals: (Zn, Cu, Mg, Ca)
- Avoidance of Dietary Factors Accelerating Tendon Aging
- Advanced Glycation End-products (AGEs)
- Excessive Sugar/Processed Foods
- High LDL Cholesterol
- Quit Smoking
- Functional Daily Movements
- Daily Activity Integration (Carry heavy grocery)
- Proper Posture
Regeneration→ Maintenance
- Exercise
- Progressive Loading
- Tendon glide exercises
- Warm-up
- Strengthening Strategies
- Cool down
- Recovery Support
- Rest
- Active Recovery
- Hormone Replacement Therapy
- Women (→ Estrogene)
- Men: contraindication
- Complementary and Future Strategies
- Physical Modalities:
- Low-level laser therapy (LLLT)
- neuromuscular electrical stimulation (NMES)
- Growth Factors & Proteins
- Exosomes Therapy
- Stem Cell Therapy
- Satellite Cell Activation
- Physical Modalities:
Cover-up & Repair→ Rejuvenation
- Ergonomic Aids
- Conservative treatment
- Pain Management
- Antiphlogistic Management
- Local: cooling
- Systemic: (CoX1, CoX2)
- Minimal-invasive treatment
- Tendon sheath Injection
- (Cortisone)
- PRP
- Stem Cells
- Tendon sheath Injection
- Operative Treatment
- Tendovaginitis stenosans de Quervain: → Release/revision 1st extensor tendon compartment
- Trigger finger: → A1 pulley Release
Peripheral Nerve
Age Changes
- Sensory Changes
- Loss of Vibration sense (2PDs)
- Numbness
- Tingeling
- Pain at night
- Motor Changes (Muscle atrophy)
- Reduction/Loss of power
- Reduced/Loss of function (thumb oposition)
- Compensatory movements („Froment sign“)
- muscle cramps
- slower reflexes
- increase Clumsiness (Reduced Dexterity)
- small objects are fallen out of the hand
- problems/inability to close the 1st button
- Increased Risk of Injury
- Autonomic Changes
- Temperature Regulation
Full-Spectrum Care
Prevention→ Pro-active care
- Calorie Restriction
- Nutrition
- Antioxidants (Vitamin C, E, Polyphenols)
- Alpha-lipoic Acid
- Omega-3 & 6 Fatty Acids
- Vitamins
- B : B1, B6, B9, B12
- E
- Minerals: (Mg)
- Avoidance of Dietary Factors Accelerating Nerve Aging
- Processed Meats: Bacon, deli meats, and sausage
- Advanced Glycation End-products (AGEs)
- Excessive Sugar/Processed Foods
- Refined Carbohydrates
- Physical Activity
- Metabolic Management (diabetes, ..)
- Blood Flow Support
- Nutritional Deficiencies and Aging
- Lifestyle Habits to Avoid
- Smoking
- Excessive Alcohol
Regeneration→ Maintenance
- Physiotherapy
- Nerve gliding exercises
- Resistance Training
- Dexterity Exercises
- Pharmaceutical Agents
- NSAIDs (celecoxib, ibuprofen)
- Hormone Replacement Therapy
- Women ("critical window" within 5–10 years of menopause onset or before age 60)
- Men: with clinically low testosterone
- Molecular and Gene Therapy
- Senolytics: (Dasatinib, Quercetin)
- Targeting c-Jun:
- Monoclonal Antibodies
- RNA Interference (RNAi)
- Complementary and Future Strategies
- Mesenchymal Stem Cells (MSCs)
- Exosomes
- Growth Factor Deliver
Cover-up & Repair→ Rejuvenation
- Pain Management
- Conservative treatment
- Correction of water balance
- Correction of Nutritional Deficiencies
- Physiotherapy
- Night splinting
- Antiphlogistic Management
- Local: cooling
- Systemic: (CoX1, CoX2)
- Minimal-invasive treatment
- Carpal Tunnel Injection
- (Cortisone)
- PRP
- Stem Cells
- Carpal Tunnel Injection
- Operative Treatment
- Carpal Tunnel Release
- Cubital Tunnel Release
Joint
Age Changes
- joint swelling („rings do not fit anymore“)
- morning stiffness
- pain at effort
- pain at rest
- Joint thickening
- joint instability/deformity
Full-Spectrum Care
Prevention→ Pro-active care
- Hydration
- Nutrition
- Antioxidants (Vitamin C, E, Polyphenols)
- Bioactive Spices: (Turmeric, ginger)
- Glucosamine & Chondroitin
- Fiber Intake
- Omega-3 & 6 Fatty Acids
- Vitamins
- D
- K
- Minerals: (Zn, Cu, Mg, Se, Ca)
- Avoidance of Dietary Factors Accelerating Tendon Aging
- Processed Meats: Bacon, deli meats, and sausage
- Advanced Glycation End-products (AGEs)
- Excessive Sugar/Processed Foods
- Refined Carbohydrates
- Physical Activity
- Metabolic Management (diabetes, ..)
- Lifestyle Habits to Avoid
- Smoking
- Excessive Alcohol
Regeneration→ Maintenance
- Physiotherapy ("Motion as Lotion")
- Low-Impact Exercise
- Strength Training:
- Hormone Replacement Therapy
- Women ("critical window" within 5–10 years of menopause onset or before age 60)
- Men: with clinically low testosterone
- Joint injections with regenerative intention
- Hyaluronic Acid (Viscosupplementation)
- Prolotherapy
- PRP
- Amniotic Injections
- Exosomes
- Mesenchymal Stem Cells (MSCs)
- Growth Factor Deliver
- Complementary and Future Strategies
- Gene Therapy
- Molecular Therapy
Cover-up & Repair→ Rejuvenation
- Pain Management
- Supportive Devices
- Conservative treatment
- Correction of water balance
- Correction of Nutritional Deficiencies
- Hand Therapy (Physiotherapy)
- Antiphlogistic Management
- Local:
- Cooling with ice
- Low-dose Radio Therapy
- Systemic: (CoX1, CoX2)
- Local:
- Minimal-invasive treatment
- Joint Injection
- (Cortisone)
- Radionucloitids (Radiosynovectomy)
- PRP
- Stem Cells
- Operative Treatment
- Joint denervation
- Cartilage repair
- Arthroplasty
- Joint Fusion (Arthrodesis)
- Total joint Replacement
Bone
Age Changes
- Common General signs
- Spine issues (indicate bone loss at the spine)
- Dental issues (indicate bone loss in the jaw)
- Fracturing easily
- Spine
- Hip
- wrist
- Common Signs in the Hand and Wrist
- Persistent localized Hand/Wrist Pain
- Visible Changes or Deformity (dinner fork deformity at the wrist)
- Fragility Fractures:
- Microfracture
- Macrofracture
- wrist/Colles fracture
- proximal phalanx
Full-Spectrum Care
Prevention→ Pro-active care
- Hydration
- Nutrition
- Antioxidants (Vitamin C, E, Polyphenols)
- Protein
- Vitamins
- D
- K 2
- Minerals: (Ca, Mg, Ph, Zn, Cu, Se)
- Avoidance of Dietary Factors Accelerating Bone Loss
- Excessive Sodium
- Excessive Sugar/Processed Foods
- Refined Carbohydrates
- Physical Activity
- Lifestyle Habits to Avoid
- Smoking
- Excessive Alcohol
- Metabolic Management (diabetes, ..)
Regeneration→ Maintenance
- Physiotherapy ("Motion as Lotion")
- Resistance Exercise
- Strength Training
- Hormone Replacement Therapy
- Women ("critical window" within 5–10 years of menopause onset or before age 60)
- Men: with clinically low testosterone
- Complementary and Future Strategies
- Regenerative Fracture Treatments
- Platelet-Rich Plasma (PRP)
- Mesenchymal Stem Cells (MSCs)
- MSC Exosomes/Secretome
- Bioactive Scaffolds
- Molecular Targets & Growth Factors
- Regenerative Fracture Treatments
Cover-up & Repair→ Rejuvenation
- Pain Management
- Conservative treatment of Osteoporosis
- Correction of water balance
- Correction of Nutritional Deficiencies
- Hand Therapy (Physiotherapy)
- Non-operative fracture treatment
- Medical treatment of osteoporosis
- Bisphosphonates (first line of treatment to slow bone loss)
- RANK Ligand Inhibitors
- Parathyroid hormone analogs (Anabolic Agents)
- Bone-building medication (Ca, Vit D)
- Fracture Treatment
- Non-operative Fracture treatment
- Operative fracture Treatment
- Minimal-invasive approach
- Rigid osteosynthesis with early mobilization
Ask the Expert: Hand Aging & Hand Longevity
Discover a personalized hand longevity plan with Prof. Dr. Robert Hierner.
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