Let’s talk fingers, and more specifically, finger sprains!
Spraining a finger can be extremely painful and also can be a lengthy process of recovery depending on how bad you have injured it.
Finger injuries are notorious for taking extended periods of time to heal due to how the fingers are made up.
Fingers have many different bones and articulations within them and a wide variety of connective tissues which all heal at different rates.
This article looks at all the vital information that you need to know to manage a finger injury including the anatomy, causes, symptoms and treatments and rehab to get you back to full health!
General Basic Anatomy
Finger anatomy for such a small part of their body is quite detailed as they have so many moving parts and different tissues.
The fingers of our body are built to mainly flex and curl but also to extend and straighten. Fingers offer little to no rotation.
The simple finger joints are known as hinge joints which allow each section of the finger to move forwards and backwards only.
The 3 small bones in the fingers (2 in the thumb) are called phalanges and they come in the form of a proximal, middle and distal.
The 3 phalanges are connected by small ligaments which attach the bones to each other.
Where the 3 phalanges meet each other it forms the joints which are more commonly known as knuckles.
The fingers are able to move in to flexion, extension, abduction and adduction by the muscles and tendons that attach to them.
The skin that covers our fingers has one of the highest distribution of touch receptors and thermoreceptors among all areas of the human skin making them extremely sensitive to pressure, temperature and moisture.
Finger sprains are common because of the design of the finger. It is only designed to essentially move in 2 main directions so anytime it is placed under any due stress, because the joints are so small and their limited range of motion is usually taken outside of its capability which causes the sprain to occur.
What is a Sprain?
What is a sprain?
A sprain is a ligament injury which involves trauma to the joint.
Ligaments hold bones to bones and typically occur with impact, twists, hyperextension and overuse.
Here is the classification of sprain injuries:
Grade I – structural damage only on microscopic level, with slight local tenderness and without joint instability.
Grade II – partial tear (rupture) of the ligament, visible swelling and noticeable tenderness, but without joint instability (or with mild instability).
Grade III – a severe sprain: complete rupture of the ligament with significant swelling and with instability of the joint.
Timeframes for sprain recovery of the finger vary a lot depending on severity. A mild one will only take 2 weeks to resolve but worse sprains can carry symptoms of 3+ months depending on what has been injured and how it is managed.
Symptoms
Here are some of the classic symptoms you will experience with a finger sprain. The severity of these will depend on each injury. You may only have some of these symptoms with your injury, not all of them will apply to everyone.
- Pain – localised pain to touch and also when moving the finger.
- Dysfunction – loss of movement, power and normal function of the finger.
- Swelling – fingers easily swell and the joints of the knuckles can also appear enlarged when they have been sprained.
- Heat/Warmth – if there is a considerable injury you may feel some warmth in the joint of the finger, this is due to the body inflaming the injury and trying to heal.
- Instability – if an injury to a finger tendon and ligament has occurred to the point at which it has caused a tear in the tissues that stabilise the finger, then you may find the finger is not as stable as it could or it has difficulty remaining in certain positions.
Treatment
Therapy for fingers and hands is often a specialised business. Physiotherapy typically offer a specialist hands physiotherapy service as the care for the hands and fingers is deemed a specialist area.
If your sprained finger has some severe symptoms, it is always worth getting checked out by a healthcare professional to ensure you aren’t missing a bigger injury,
It is quite common for finger sprains to be mismanaged with the example of tendon ruptures, if not managed correctly will result in dysfunction and poor future outcomes.
So first off – get the correct diagnosis and ensure that you are doing the right thing.
Physiotherapy management of the hands often will be movement and exercise based which we will take a look at but in terms of treatments, these are the types of things which are commonly useful:
- Massage – combining firm and gentle strokes to the hands to allow for improved movement, increased circulation and relaxation of soft tissues. This can also help to reduce swelling.
- Ultrasound – ultrasonic waves which are generated by a probe can help to accelerate the healing process ion the soft tissues of the hand.
- Heat – using warm water, hot water bottles and even wax baths are a great way to relax tissue and help movement to improve. This is especially great for stiff joints which are finding difficulty moving.
- Shockwave – shockwave therapy is proven to accelerate healing by up to 40% when applied to soft tissues like ligaments and tendons and combined with rehab.
- Acupuncture – needle based therapies have the ability to provide pain relief and relaxation of the muscles and in turn this can help with recovery of finger injuries.
- Joint mobilisation – if it is too painful for the finger to be moved, the therapist will passively apply movement to the joint of the finger in order to help restore movement. This is essential to gaining full movement back.
- Laser therapy – low level laser therapy again provides increased circulation and may accelerate healing of tissues in the hand and finger to help recovery.
- Bracing – as mentioned in the symptoms section – a brace may be required if the finger is unstable or is becoming stuck in certain positions. A common problem can be trigger finger where the finger has difficulty in straightening and can repeatedly fall in to flexion. The brace can be used to hold the finger in certain positions to allow tissues to heal and the finger to stabilise.
Rehabilitation
This is the most important part of recovery from a sprained finger as it helps to establish strength and reduce pain. This is essential to getting your pre injury level of function back.
Fingers are a key part of our everyday routine unlike other body parts. Your fine motor control which is the use of your fingers to pinch and grip are used for many daily tasks which are essential.
If you injure your dominant hand – this can make everyday tasks like washing, feeding, dressing and even work very difficult.
Rehabilitation of the finger is important as if it is left then it can actually remain in a poor state which will affect its long term use.
Before you begin your rehab sessions – apply heat to the hand in order to increase blood flow and relax the muscles of the hand and allow more movement.
- Basic range of movement exercises – passive
Initially start by using your other hand to gently move your injured finger. Take it backwards and forwards and gently ease it through its full range of movement if possible.
If you can’t do this straight away – be patient and gently look to increase its movement each session.
- Basic Range of movement exercises – active
Once your finger starts to become a bit more free with its movement – then actively start to move it more and more yourself.
This helps to reduce joint irritation, increases blood flow for healing but also strengthens the finger.
- Gentle Resisted Flexion and Extension
Time to start building the strength back in the finger – use your other hand and gently resist your fingers movement. This helps to build the flexors and extensors of the fingers back up.
- Gentle Resisted Lateral and Medial Stress
This exercise is the same as the one above but focuses on strengthening the ligaments at the side of the fingers.
Use gentle pressure with this as it may be uncomfortable to begin with. Focus on gentle 5 second holds and build from there.
- Advanced Finger Range of Movement
If you can bring your finger all of the way down to the palm and have gained flexion and extension fully.
Think about the other movements that are available to the finger by wiggling it in circles and trying to move it from side to side.
- Advanced Finger Strength
There’s 3 different options for this exercise – the aim being improving strength and making the finger resilient.
Using either an elastic band you can work on flexion and extension of the finger – this can be progressed with different types of elastic bands
Thera-putty is great product which is like playdoh but a bit tougher and can help to give your fingers a workout by pressing the clay in to different shapes.
Using a stress or tennis ball is another excellent way to improve your finger strength.
That concludes our guide to finger sprains and how to manage them. Remember, finger sprains can take time to heal. Stay consistent with your rehab and get help if needed from a physiotherapist. If this blog has helped you then please send it to someone who you think can benefit