Chartered Physiotherapist John Jordan documents the more common hand injuries that we come across in our clinics.
Hurling, football, rugby (both tag and full contact), basketball, volleyball and basically any sport that requires the handling of a ball, are all easy ways of injuring your fingers or thumbs. It may seem like an innocuous place to get an injury but if you have a problem with even your little finger, believe me you’ll know about it.
These are common and can require surgical or non-surgical treatment. Diagnosis, as with most fractures, is via an x-ray. Common signs or a fracture are persistent swelling, pain and lack of movement. These symptoms are fairly universal with a number of other injuries so frequently fractures are not spotted for a couple of weeks when symptoms persist. Whether a procedure is needed or not depends on how bad the fracture is. Either way, a period of immobilisation (splinting, etc) is needed followed by a period of rehabilitation to recover full range and power. This is where a chartered physiotherapist comes in.
Dislocation of Fingers
Dislocations can occur in a couple of directions, with fingers being pushed off to the side or backwards, (which can lead to a staircase shaped finger). You might think treatment for this is to ‘pop it back in’ immediately, but it’s a little more complicated than that. Fractures are common with dislocations and to relocate the digit (which should only be done by a trained professional) requires a fair bit of force, correct technique and some kind of anaesthetic. If you already have a fracture, an amateur relocation can cause further damage to the bone. An x-ray is a common first step if you attend A&E with a dislocated finger/thumb. After relocation, there is a high possibility of ligament damage (see Sprain) and a chance of tendon damage as well.
Various Sprains of the Hand
Sprains are basically ligament and joint capsules overstretched, very common in the ankle and occur frequently in the thumb as well. These injuries are usually gained from a bang to the finger/thumb, which temporarily forces the joint where it shouldn’t go. Without going too much into the physics of it all, if the force is greater than the ligaments can resist ligament damage can occur. In very rare cases, if a ligament is completely torn, it may require surgery but usually a period of immobilisation is required, followed by strengthening up the area. Weakness and a lack of movement are common with any period of immobilisation. Again, a chartered physiotherapist can help restore that.
Supports, strapping and taping can speed up a return to sport to aid the stability of the joint (not to mention aiding the confidence and peace of mind of the returning player). These should not be relied on in the long term. If problems are persisting for longer than a couple of months, the problem should be looked at by a trained health professional.
Damage of Muscles/Tendons in the Hand
There are actually very few muscles in the hand, with most of the muscles that move the fingers based in the forearm. The tendons of these muscles attached to the fingers and these can avulse (detach/tear) usually in combination with another injury. This usually requires surgical repair. Muscular injuries of the thumb can occur, again in conjunction with another injury, and these are usually easy to fix with the help of a chartered physiotherapist.
To sum up:
Fractures are easy to get, easy to miss and should be ruled out before any other treatment. Never let an amateur (or yourself) relocate a dislocation.