Grip Strength and Hand Exercises for Older Adults

Why grip strength matters

• Daily independence: opening containers, dressing, cooking, personal care, using tools and phones.
• Safety: gripping a rail, a stick or a walker handle.
• A marker of general strength: weaker grip is associated with muscle loss, frailty and a higher risk of problems after illness; see sarcopenia, muscle loss and food and frailty in older adults explained.
• Quality of life: hobbies such as writing, sewing, cooking, gardening and music depend on hands.

Common reasons for weak or stiff hands

• Osteoarthritis of the finger joints and base of the thumb, with pain, stiffness and bony knobs.
• Rheumatoid and other inflammatory arthritis, with swelling, warmth and morning stiffness; see osteoarthritis vs rheumatoid arthritis.
• Carpal tunnel syndrome (compressed nerve at the wrist), with numbness, tingling and weak grip, often worse at night; see wrist supports for arthritis, carpal tunnel and weak grip.
• Trigger finger, where a finger catches or locks.
• Muscle loss with age or illness, and poor nutrition.
• Nerve problems: diabetes neuropathy, neck problems (cervical spondylosis), vitamin B12 deficiency; see neuropathy foot care and cervical collars and neck pain.
• Stroke or Parkinson's disease; see exercise after a stroke at home and exercise for Parkinson's disease.
• Thyroid disease and other medical conditions.
• Injury or past fracture of the wrist or hand.
• Medicines and, rarely, other conditions.

Because many of these have specific treatments, new or sudden weakness needs a medical opinion.

When to see a doctor before exercising

See a doctor promptly, before doing exercises, if you notice:

• sudden weakness or numbness in a hand or arm, especially with face droop, slurred speech or confusion: call 112, as it may be a stroke; see stroke warning signs and first hour;
• numbness or tingling that wakes you at night or persists;
• a hot, red, swollen finger or wrist joint, or fever;
• severe pain, or pain after a fall;
• a finger locking or a deformity;
• progressive weakness with muscle wasting at the base of the thumb;
• neck pain with arm symptoms;
• clumsiness with buttons or writing that is new.

Hand exercise principles

• Warm the hands first: a warm shower, warm water soak for a few minutes or a warm pack on the hands; see heat or cold for joint pain and hot pack safety for older skin. Never use heat on numb skin or hot, swollen joints.
• Sit comfortably with forearms supported on a table.
• Move slowly, within comfort. Mild stretch is fine; sharp pain is not.
• Breathe normally.
• Start with a few repetitions (5 to 8) once or twice a day, and build slowly.
• Rest if the joints are inflamed: during an arthritis flare, do only very gentle movement.
• Do not force stiff or deformed joints, or use heavy gripping.
• Stop if pain lasts more than an hour afterwards, if swelling increases, or if numbness or tingling worsens.

Gentle range-of-motion and flexibility

Do these daily, each 5 to 10 times.

1. Finger lifts: with the palm flat on the table, lift each finger in turn, then lower. 2. Make a fist and open: curl the fingers slowly into a loose fist, then stretch them wide open, like opening a flower. 3. Hook fist: bend the finger tips down to touch the base of the fingers (a hook shape), then straighten. 4. Tabletop bend: bend the knuckles at the base of the fingers while keeping the fingers straight, then straighten. 5. Thumb to fingertips (opposition): touch the tip of the thumb to the tip of each finger in turn, making an "O". 6. Thumb stretch: gently draw the thumb across the palm toward the base of the little finger, then out to the side. 7. Wrist bends: rest the forearm on the table with the hand hanging over the edge, then bend the wrist up and down, and side to side. 8. Forearm turns: with the elbow bent against the side, turn the palm up then down. 9. Finger spreads: spread the fingers wide apart, then bring them together. 10. Prayer stretch: gently press the palms together in front of the chest and slowly lower the hands towards the waist to feel a stretch in the wrists. Stop if painful.

Hold gentle stretches for 10 to 15 seconds.

Gentle strengthening

Do two or three days a week, with rest days between, once the hands are warm and comfortable.

1. Soft ball or sponge squeeze: squeeze a soft ball, a sponge or a rolled towel, hold for three seconds, release slowly. 8 to 10 times each hand. Choose a firmness that does not cause pain. 2. Therapy putty: knead, squeeze, pinch and roll the putty with the fingers and thumb. Use a soft grade first. Five minutes. 3. Finger squeezes with the thumb: pinch the putty or a soft ball between the thumb and each finger in turn. 4. Rubber band spreads: place a loose rubber band around the fingers and thumb and slowly open the hand against the band, then close. Use a band that is not too tight; skip if painful or if you have latex allergy. 5. Finger presses on the table: press each fingertip on a table for three seconds. 6. Towel wringing: twist a small damp towel gently as if wringing it out, with a light grip. Skip if it hurts the wrist or thumb base. 7. Wrist curls with a very light weight or a tin can: rest the forearm on a table, palm up, hand over the edge, curl the wrist up slowly and lower. 8 times. See dumbbells guide for seniors for care with weights. 8. Hand roller or hand grip trainers: soft devices with adjustable resistance; start at the lowest level. 9. Resistance band exercises for the arms and shoulders also help hand function indirectly; see resistance bands guide.

Avoid pushing hard on painful, swollen joints, and avoid repeated forceful pinching if thumb-base arthritis is painful.

Dexterity and everyday practice

Fine control matters too.

• Pick up small objects, such as coins, beans or beads, and place them in a container.
• Turn pages, shuffle and deal cards.
• Button and unbutton a practice board or shirt.
• Write or draw in larger letters, using a thick pen.
• Sort pills or dry grains with the fingers (not medicines unsupervised).
• Pour water from a small jug into a cup.
• Use a tablet or phone with a stylus, if helpful; see phone and remote aids for arthritis.
• Craft, knitting, kolam or rangoli, playing an instrument, gardening and cooking are excellent hand exercises if comfortable. Take breaks; see how can hobbies help seniors with arthritis.

Protecting the joints

If you have arthritis, combine exercise with joint protection:

• Use larger joints and both hands to carry.
• Use built-up handles, lever taps and jar openers; see arthritis daily living gadgets, jar opener and kitchen aids and easy grip cutlery guide.
• Avoid prolonged tight gripping, and take breaks.
• Avoid positions that push the fingers sideways.
• Wear a wrist or thumb support during painful tasks, if advised; see wrist supports.
• Pace tasks.
• See an occupational therapist for splints and joint-protection advice.

Supporting muscle in general

Hand strength reflects whole-body strength. Keep active, with walking and strength training; see strength training after 60: how much is enough and walking programme for older adults. Eat enough protein and calories, and check for B12, vitamin D or other deficiencies if suggested by your doctor; see how much protein do seniors need and vitamin b12 in older vegetarians. Treat underlying conditions such as thyroid disease and diabetes.

Safety cautions

• Do not exercise on joints that are hot, red and swollen.
• Avoid heavy gripping with trigger finger or severe thumb-base arthritis without advice.
• With osteoporosis and a past wrist fracture, avoid forceful twisting; ask your doctor.
• After hand or wrist surgery, follow the surgeon's and hand therapist's plan only.
• With numb hands, take care with heat and sharp objects; see hot water and scald safety for older skin.
• With cognitive problems, supervise tools such as rubber bands and putty.
• Keep a phone nearby; call 112 for chest pain, stroke signs or emergencies.

When to ask a professional

Ask a doctor about new or worsening weakness, numbness, pain, swelling or locking. A hand therapist or occupational therapist can design hand exercises, make splints and advise on aids. A physiotherapist can assess neck and shoulder contributions. A dietician can advise on nutrition for muscle. In an emergency, call 112.