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Have you noticed any weird, annoying changes with the functionality of your hands and fingers when attempting normal day-to-day tasks? For instance, have any of these changes affected your ability to button up a shirt, hook your bra, apply makeup, tie your shoes, put on jewelry, hold or use utensils, or write a check? These are just a few examples of the many activities that require a certain level of proficiency in hand and finger dexterity and coordination. When our hand function and fine motor skills begin to decline, it’s not only frustrating, our stress level, emotional well-being, and overall quality of life can be negatively affected. It's important to understand that multiple sclerosis is not the only disease or condition that can cause a loss of fine motor skills. This decline can also happen because of normal aging, with some rheumatic and neurological diseases, or injury. 

So, what causes a loss in hand dexterity and fine motor skills with MS? This can happen when the nerves cannot send the necessary messages to the brain properly because some or all of the neurons within the nerve are damaged or not functioning properly, such as a misfire. We may have issues with tremors, numbness, weakness, pain, and tingles that can affect our dexterity, coordination, and fine motor skills. Some symptoms are related to the central nervous system and others could be related to the peripheral nervous system. For a more in-depth look into this, take a look at this article: Loss of Hand Dexterity and Coordination with MS.

Over the years, I’ve noticed having more difficulties with my own dexterity. It seems my brain knows what I’m supposed to do, but my fingers won’t cooperate. Here are a few examples:

Attire and accessories

I have trouble putting on clothes with small buttons, hooks, or zippers, so I tend to wear things that are easy to pull on and off. Wearing jewelry is another problem. If a necklace or bracelet has any clasps, my fingers have a very difficult time putting them on. The same goes for earrings with those teeny tiny back pieces you must attach behind the ear in order to secure the earring post. I can’t tell you how many of those little earring backs I’ve lost or dropped into the carpet. I rarely wear jewelry anymore these days unless it’s something simple and easy to wear. The same applies to putting on makeup (particularly eye makeup) and styling my hair. I generally keep things low maintenance – the simpler, the better.

Writing

My handwriting has gotten worse over the years. My signature has changed too. Sometimes it’s unrecognizable and can look like a messy scribble. I’ve noticed my handwriting is usually worse when I’m tired or overly stressed. I’m exploring some exercises in hopes to improve my writing skills.

Cooking and food prep

I love to cook, and I love to eat. Sometimes my knife skills are a bit shaky and I try very hard to pay attention so as not to cut myself. The same goes for my use of other utensils, cookware, and various appliances in the kitchen. Sometimes I’ll get a tremor or a case of the dropsies that cause me to leave food tidbits on the kitchen floor. This makes my dog quite happy. Whenever I’m in the kitchen, she’s right there with me – watching and waiting for her “floor buffet” to appear.

Dexterity and fine motor skills – an overview

Finger dexterity refers to the ability to use coordination and manipulation of objects in the hands with precision. Dexterous motor skills can be broken down into areas: grasp and release, coordination within the hand (in-hand manipulation), and proprioception (knowing how much effort is needed to manipulate objects without dropping them). There are many other contributions that affect finger dexterity too. If you are experiencing difficulties with your fine motor skills, there are some things you can do to strengthen, improve, and maintain a more functional level of dexterity. No matter what, don’t give in or give up. You might want to try a few of these basic exercises, or occupational and physical therapy tools to see if you notice some improvement in coordination and your fine motor skills. There are also some occupational therapy tools and other “hacks” that can be used when you need some extra help. Scroll through Amazon or similar resources to find kits and other occupational therapy items that might be useful and worth your while. 

Finger dexterity exercises
 

• Picking up small beads.
• Opening a tube of toothpaste.
• Threading a needle.
• Writing – jot down favorite quotes, to do lists, and practice writing your name/signature.
• Try crafts or puzzles with small objects.
• Peel stickers off a page.
• Opening or closing a clasp on a necklace.
• Make bows using ribbon or sashes.
• Opening a bread tie.
• Putting a ponytail holder in hair.
• Braiding hair.
• Maneuvering a pencil within the hand (rotating the pencil, erasing a small spot on the page).
• Turning a pencil in a handheld pencil sharpener.
• Lacing, tying your shoes.
• Empty several coins onto a table and pick them up one at a time – stack them according to size and cents (pennies, nickles, dimes, etc.).
• Make a chain of paper clips.
• Flip, sort, and shuffle playing cards.
• Flip and turn pages in books or magazines.
• Learn to play a musical instrument (piano or guitar are excellent options).
• Art – paint or draw.
• Knit, crochet, and sew.
• Play games requiring hand-eye coordination. 
• Explore other tasks that require small, detailed motor skills.

These are just some of the skills that can enable us to pick up an object with the right amount of pressure and motor dexterity so you can grasp the object accurately taking hand-eye coordination skills into consideration. It can be frustrating at first, but keep practicing. Improvement is possible and there are tools available to help if or when you need an extra boost.

Additional resources
flintrehab.com
thetoolbox.com
thenoteninjas.com