I find that injuries to our fingers as a result of overuse are often overlooked or ignored. Especially when you consider the importance of our hands in daily life, they really are the tools of our trade. An injury known as the ‘trigger finger’ is most likely ignored initially because it may only start as a slight popping or clicking sensation when straightening your finger. Sound familiar? Either way, let’s take this opportunity to build your awareness of this irritating condition.
The major strength in your fingers when gripping is achieved by the muscles that are located in your forearms. These muscles turn into long cord-like tendons at the wrist, then run through the palm of your hand and attach along your fingers. Therefore, contracting your forearm muscles slides these tendons back and forth, allowing your fingers to bend and straighten. Trigger finger arises due to one of the tendons becoming thickened, most commonly at the junction between your palm and finger. At this point, the tendon slides through a tough fibrous tunnel which is designed to hold the tendon snug against the bones of the fingers. Excessive thickening of the tendon in trigger finger means as the finger is straightened the tendon gets caught at the tunnel and pops or clicks as it releases.
Trigger finger may only start as a minor pop or click but if ignored it can progress to cause pain and in severe cases even cause the finger to lock in a bent position. It is generally repetitive tasks with forceful gripping that can irritate the tendon or even the tunnel that it runs through. If the irritation persists, the area will become inflamed and eventually cause abnormal growth of the tendon or its tunnel. Operating clippers when pruning in the garden, forceful and repetitive use of pliers or even rock climbing are a few common situations where this irritation can occur. Diabetes and rheumatoid arthritis can also predispose to this condition.
Always remember that with an overuse injury like this, the best cure is prevention! If you are feeling a click developing you need to alter the task in order to minimize further irritation. If the condition continues to be felt or pain is developing, you are best to see your medical doctor or physiotherapist. Initially, their most likely course of treatment will be to splint the finger in order to prevent further movement of the tendon. Your doctor may also recommend anti-inflammatory medication, while your physiotherapist is likely to employ some localized soft tissue therapy to help reduce the tendon thickening. In more severe cases, steroid injections may be used by your doctor to help reduce inflammation. Surgical management is also considered in severe cases in order to partially release the fibrous tunnel around the thickened area, therefore allowing smoother movement of the tendon.
Nick Black is a Registered Physiotherapist at Sun City Physiotherapy Winfield. He can be contacted at the Winfield clinic (250.766.2544) or by email at winfield@suncityphysiotherapy.com.