Finger and thumb injuries are common in ball sports such as football, netball and basketball. Injuries can vary from a joint sprain to a fracture, which may require treatment such as bracing, splinting or even surgery. Not all finger injuries require time off sport. Assessment, diagnosis and appropriate management is important to avoid long term pain and functional impairment.
Our fingers and thumbs are made up of phalanges (bones) that approximate at our interphalangeal joints. They are required to be flexible and strong. A lot of small muscles, tendons and ligaments exist in the hand and fingers to assist this. The thumb joint functions a bit differently to the fingers, due to it’s different range of movement. Because of the large range of movement at the thumb, it can be more susceptible to injury.
Injuries of the fingers can vary. The most common injury occurs due to impact to the end of the finger. However finger injuries also occur from getting caught in other player’s clothes, falling awkwardly onto the hand or even being trod on. There are different types of injuries and multiple structures can be injured at a time, such as:
- Joints – dislocations
- Ligaments – sprains
- Tendons – over use, ruptures
- Muscles – tears, strains
- Bones – fractures
The specifics of the more common injuries
Any of the joints in the thumb and fingers can be dislocated. Sometimes the joint only comes part way out (subluxation), and other times it can come out all the way (dislocation). Dislocations can sometimes relocate themselves, but if they haven’t it is important you seek medical advice to have it relocated. After a dislocation you may require imaging, so it is important to check in with a health care provider.
Fractures can occur in the bones of the fingers and thumb (phalanges), or even through the joints. An x-ray needs to be done to determine if you have a fracture. These require appropriate treatment and healing time frames.
Joint sprains often occur due to impact. The impact can strain the ligaments supporting the finger resulting in pain, swelling, bruising and sometimes loss of function. These often get better with time, but ultimately the prognosis depends on which ligament is affected and the severity of the injury.
A mallet finger is where the end of the finger cannot be actively extended (straightened) due to an injury of the tendon/tendon attachment. This can be caused by direct impact to the end of the finger. This injury requires splinting (being held out straight) to allow it to heal. Time frames differ depending on how long it takes you to seek treatment. Getting on top of this as soon as possible means you will be back to normal faster.
A jersey finger is where the distal finger rests in extension due to an injury to the tendon/tendon attachment. This commonly occurs when fingers are caught in others players clothing. Again, prognosis is better if you seek early intervention.
Injury management depends on the type of injury sustained. Rest, ice, compression and elevation are the first steps you can start yourself. You then need to see an appropriate health professional (physiotherapist!) to direct the next step in your care. If any major deformity has occurred, such as a joint dislocation or a bone is sticking out, you need to seek medical assistance as soon as possible.
How can physiotherapy help?
As mentioned, with many of these cases early intervention is important. Seeing a physiotherapist will help you get a diagnosis, splinting and referral for other services (imaging, specialist) if required.
Once you have a diagnosis a plan can be made to assist you with managing the injury, strengthen/get the finger/thumb moving and keep it strong. Not all finger injuries require time off sport or work, but it is important you know how to care for your finger injury as they can be quite debilitating if not managed appropriately. If not managed properly permanent deformity and functional deficits may occur.
About the Author:
Renae has a Masters of Physiotherapy and a Bachelor of Exercise Science. Renae works at both our Devonport and Ulverstone clinics and her professional interests include musculoskeletal injuries (particularly sporting injuries) and Clinical Pilates.
Renae’s personal interests include fishing, camping and cycling.