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Post-season niggles: a 'handy' overview

As the football and netball seasons are coming to an end, players are presenting with their unresolved hand and wrist injuries. Fat fingers that still won’t bend or straighten properly. Droopy finger tips that will not straighten no matter how hard you try. Thumb pain when turning a key or opening a bottle. Unable to take weight through your wrist. These are common complaints caused by some common hand and wrist injuries in ball sports which I am going to discuss.

Many athletes manage to push through the season with the help of a little tape (or a lot!) and hope things will just get better. Sometimes they do and unfortunately sometimes they don’t, in fact sometimes they actually get worse over time.

Common Injuries, include: 

  • Mallet finger, usually occurs when the fingertip is forcefully hit by a ball or on an opponent, causing the tip to droop. This can damage the tendon that straightens your fingertip, or chip off some bone where the tendon attaches. Treat by full time splinting of the finger tip into a straight position for 6-8 weeks followed by a careful splint weaning process and graded exercise program.  Mostly managed successfully without surgery, some larger unstable fractures may require surgery. Specialised splints can be taped on for sport to protect the injury.

  • PIP joint injuries – as per my recent blog, ‘Is it just a ‘jarred’ finger?’ – the PIP joint is commonly injured in sports, usually as a result of a hyperextension injury. The thick ligament at the front of the PIP joint is known as the Volar Plate which stops the finger from hyperextending. There are also ligaments on each side of the joint known as collateral ligaments which prevent sideways movement. Injuries can include partial or complete tears of the ligaments, avulsion fractures (a small piece of bone is chipped off) or  occasionally more extensive fractures. Sometimes these injuries will involve a dislocation of the joint. Treat by Splinting or taping to allow the ligament or fracture to heal, usually for 2-6 weeks. Exercises are important immediately to prevent stiffness, particularly bending movements whilst straightening is initially restricted to the limits of your splint. Compression tape to reduce swelling is also important in the early stages. Specialised splints or taping techniques will be required for protection when you return to sport, depending on which sport you play.

  • Thumb MCP joint sprains, usually involves a hyperextension injury from a ball or falling onto an outstretched hand. Commonly referred to as ‘skier’s thumb’ where the inside ligament (UCL) is damaged from a fall whilst holding a ski pole. In ball sports such as football and netball it is often the ligament on the outside which is damaged (RCL). Sometimes the ligament will avulse a piece of bone off which will be seen on Xray. Treat by a thermoplastic splint which immobilises the thumb MCP joint but leave the tip joint free which is generally needed for 2-6 weeks. A graded exercise program to regain full movement, strength and stability of the thumb. A custom made sports guard can be taped on for return to sport.

  • Wrist sprains usually occur from a fall onto an outstretched hand, and severity will often depend on the speed or force of the fall. The wrist is a very complex joint and there are many ligaments that provide support.
    Damage to the scapholunate ligament is a common and serious wrist injury. Just like the ACL is very important to knee stability, the scapholunate ligament provides overall stability to the wrist so if not treated correctly this can result in wrist instability and progressive degeneration. The TFCC (Tringular Fibrocartilage Complex) is a group of ligaments and soft tissue structures on the little finger side of your wrist which can also be damaged in a fall, especially when combined with twisting/rotation. Damage to the TFCC can result in pain and instability. Treatment for severe injuries may require surgery, otherwise a combination of splinting and specific ‘wrist stability’ exercises are essential to ensure the best possible outcome and functional capacity is achieved.

If you have sustained a hand injury this season make sure you get it sorted and make sure it doesn’t stay with you forever…we all know that person with wonky, bent fingers from that ‘old injury’!

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