Stop Forcing Your Fingers And Start Healing

Chapters

• 0:00 Welcome And Credentials
• 0:19 Why Forceful Finger Stretching Fails
• 0:42 Tendon Connections And Tethering
• 1:18 Pain Limits And Inflammation Risks
• 2:03 Gentle Taping And Heat Strategy
• 2:27 The Dangers Of Forced Flexion
• 3:11 Early Care And Specialist Guidance
• 4:31 Balance Flexion With Extension
• 5:11 Final Reminders And Disclaimer

Transcript

SPEAKER_00: 0:03

Welcome back to the Hand to Shoulder Solution where pain meets its match. I'm your host, Carl Petito. I'm an occupational therapist and a voice certified hand therapist. I specialize in the rehabilitation of orthopedic conditions that affect the fingertips through the shoulder. Today I want to talk about stiffness of the fingers and one important thing not to do, and that's forceful movements. So the small joints of the fingers are very intolerant to forceful movements. Any stretching should be done slow and steady, and all the fingers should move down together. It's important to note that they are connected in the back. And you can see some of these connections right here, where there's the tendon which connects the bones to the muscles down into the forearm, but then horizontally there's these connections. So if, for example, you're stretching your middle finger because your middle finger is really stiff from arthritis, and you're holding the other ones kind of out of the way, then you're having a tethering effect, and the other ones are resisting the stretch that you're giving to your middle finger. So if they just go all together, that makes all of the difference, you'll get a better stretch. Stretching should be gentle, it should be light to where you only feel a pulling sensation and not pain. If you have a little bit of discomfort, one or two out of ten discomfort, sometimes upwards of three and four. I'll allow some patients to handle. But if you're wincing or grinning your teeth and just kind of forcing yourself through it, what that is going to do is elicit inflammation within the joint and also a strong stretch reflex in the soft tissues where the tissues will try to protect themselves instinctively and actually stiffen up. So your work will result in more stiffness. I also educate my patients on how to tape their fingers, which we'll do on a on a future episode, and tape them down into a light sustained stretch to where then they can wrap a heating pad around their hand for about 20 minutes or so for a light sustained stretch that they can advance as the stretching sensation decreases. But let's get back to forcefulness. So occasionally I'll have patients complain that their stiffness is worse, their pain is worse, because they went somewhere where the finger was forced down and shoved down into a fist. There are many, many structures of ligaments which connect bone to bone, and of tendons which connect muscle to bone within the fingers. The fingers are very, very complex, and there's a lot of really fine, thin little structures, especially the extensor apparatus over the top of the finger, which we can discuss in more detail in future episodes. And that likes to tear, and that's just one example of many things that can go wrong. I've had a patient in the past who was forced down, and a tear did occur, and now they ended up with a what's called a mallet finger where the end is drooping down, and often that turns into a swan neck deformity where this is swooped up, hyperextended. That's not supposed to hyperextend, but that's hyperextending, and then that's drop dropping down. So now they have a deformity or an injury on top of their original injury. So again, stretching should be progressive and should slowly, not painful, and it should start early. Early is the key. A lot of people, a lot of even practitioners will underestimate the fingers. Make sure you go to a uh fellowship-trained hand surgeon. So that's an orthopedic surgeon who went to further specialized training to become a hand surgery specialist, a hand physician. I'm a hand therapist. Okay, that's our specialty. It's very important because it's such a complex area. So again, never force, it should be gentle and steady. And if you work too hard at your range of motion, then regarding aggressiveness, stiffness will, even if an injury doesn't occur, stiffness will increase. And we do not want increased stiffness, we want nice fluid supple motion for function because we have to be able to get around small objects and grab things, and we also have to extend. A lot of times, working on flexion, you know, to get that grip, it's easy to forget about extension, and that's where your hand therapist will sometimes I have to fabricate a custom orthosis for patients to wear at night when they're sleeping to preserve their extension. And then during the day, we're working on flexion because why is extension so important? We have to be able to extend or straighten our fingers so we can get around what we want to grab. Well, that's some information. I hope it helps. Again, this is not treatment or treatment advice, this is information sharing. It's very important that you have the knowledge to make the best decisions for you. Thank you, subscribing, for subscribing to the hand to shoulder solution, where we are the solution to your pain.