Hand Injuries in Happy Valley
Treatment of Extensor Tendon Injuries
Your tendons are comprised of connective tissue that, as the name implies, connect your muscles to your bones. The extensor tendons are positioned on the back of your hand and function to bend the wrist back and straightening of your fingers. Injuries here are typically related to blunt trauma or from laceration accidents. Here are a few commonly seen extensor tendon injuries with relevant treatment strategies:
- Boutonniere Deformity – This occurs when the middle joint of your finger becomes locked in a flexed position, while your fingertip is locked in a relatively extended position.
- Treatment Strategy – Splinting will begin immediately to facilitate correct resting tension during healing of connective tissues. After tendons are stabilized, targeted restoration of finger motion and function ensues. In situations that began as a result of chronic degenerative changes such as with osteoarthritis or rheumatoid arthritis, this condition could be permanent and should be comanaged appropriately.
- Mallet Finger – This occurs when the tip of your finger is unable to be fully straightened by your own muscles. The most likely mechanism for this injury is a direct unexpected impact of “jamming” of your finger. The fingertip should be able to straighten if assisted by your other hand.
- Treatment Strategy – Conservative treatment will result in immediate splinting of the finger to facilitate appropriate tendon healing tension. After tendon healing is complete, restoration of normal finger mechanics and function begins.
Treatment of Flexor Tendon Injuries
The flexor tendons are positioned on the underside of your forearm into the palmar side of your hand. As their name implies, they are responsible for the curling of your fingers, balling your hand into a fist, and flexing the wrist. Due to the length of these tendons, your body creates small sheathes at the joint creases in your fingers to prevent a bow stringing effect.
- Trigger Finger – The tendon becomes irritated and inflamed, usually from overuse, and gradually over time may develop a thickened nodule which gets stuck on the sheathes. As it is forced through (if able) it will make a sudden jerking release with a possible popping sound or sensation. If the nodule becomes large enough it will be unable to pass through the sheathe and your finger will become stuck in a partially flexed position (like your finger is on a trigger).
- Treatment Strategy – Size matters. If the nodule has reached a large state, conservative treatment may be quite difficult and a surgical intervention may be more appropriate. If the nodule is still relatively smaller, treatment can be applied to restore the mechanics of the tendon and sheathe while breaking down the nodule safely.
Treatment of De Quervain’s Tenosynovitis – This condition describes inflammation of the tendon sheathes located on the thumb side of your wrist. This injury is commonly produced from repetitive stress or overuse. *Caution if you chose to attempt to reproduce your pain with the following examples. The most pain is typically felt during thumb extension (giving a thumbs up sign) or if you tuck your thumb into your fist and bend the wrist toward your little finger.
- Treatment Strategy – Elimination of the aggravating factors early will greatly expedite your recovery. Relative rest and reduction of strain through the painful region is encouraged. Once inflammation is well-managed, full restoration of motion and strength via prescriptive exercises and targeted stretches are performed.
Carpal Tunnel Syndrome (CTS) – Your carpal tunnel is, as its name implies, a tunnel that connects several structures from the forearm through the wrist and into the hand. The tunnel itself is made of thickened connective tissue with little flexibility available. With prolonged compression from either the outside in, such as, resting your wrist on the edge of a desk, or from the inside out, such as, swelling inside the tunnel trying to press outwardly; loss of nerve function will begin to occur. A lesser known contributor to carpal tunnel syndrome is vibration and gripping. Think – construction power tools, motorcycles, road cycles, and sports that use a racquet or club. Individuals who work in assembly-line style jobs are up to 3x more susceptible to developing this than an average person. Due to a mixture of lifestyle, work, and physical activities, carpal tunnel syndrome is relatively common. It is estimated that 5% of the population is suffering from carpal tunnel syndrome at any given time
- Treatment Strategy – The vast majority of individuals who suffer from carpal tunnel syndrome are able to be healed through physical therapy interventions. In cases of severe or notably prolonged symptom presentation, a surgical widening of the carpal tunnel may be required to provide adequate reduction of pressure. A mixture of specific wrist/hand strengthening, targeted stretching, and prescriptive bracing should resolve your symptoms. Your therapist will also be able to assist in identifying prevention strategies to minimize risk of symptom return later on.
If a hand injury or condition has been interfering with your life, call us today to get started on a plan of care that works for you. Ascent Physical Therapy is conveniently located off Sunnyside Road in Happy Valley. We also love treating our neighboring communities of Damascus, Gresham, Clackamas, and Sandy at our top rated physical therapy clinic!