WHAT IS TRIGGER FINGER?
Trigger finger is a painful and frustrating condition in which a finger can get caught, click, or get stuck into a bent or a straight position. The problem is a pulley system in the palm causing the tendon, a rubber-band like structure, the inability to glide in and out of that pulley. This is typically due to a nodule of scar or thickened tendon structure which limits the glide and excursion of the tendon through the pulley. Most commonly, this occurs at the A1 pulley, however, the A3 pulley can also have an issue.
HOW CAN OCCUPATIONAL THERAPY HELP?
Occupational therapy, especially hand therapy, can help significantly with trigger finger in many ways. In the clinic, we have strategies to help! Modalities including ultrasound, electrical stimulation, fluidotherapy or paraffin wax play a large role. Also, hands-on specific types of stretching, using tools for Graston techniques (see below) to manage swelling and adhesion to the flexor tendons will improve tendon glide and decrease pain. Custom orthosis fabrication (see below) to block the pulleys to allow tendon excursion but without triggering. Our custom orthoses provide an opportunity to function and utilize the hand without causing the trigger to occur. They allow treatment without impairment to your daily life.
This is an MCP flexion block custom orthosis for traditional A1 pulley trigger finger.
Here is another view of that MCP flexion block orthosis.
This is a custom PIP flexion block orthosis, or Oval-8 orthosis.
Here is the volar view of that PIP flexion block orthosis.
Pictured are 3 versions of Graston technique tools that are utilized for scraping and blood flow management with trigger finger.
WHAT ARE SOME EXERCISES THAT CAN HELP?
You will often hear therapists say “avoid the trigger like it is the plague”. This point is so true! The more frequent your finger triggers, the more severe the condition can become. Below are a few exercises we recommend to assist with this condition.
- Intrinsic Stretching: Curl the finger to bend from the PIP (proximal interphalengeal) and DIP (distal interphalengeal )together, keeping the digit flexed without a trigger, pull the digit backwards to stretch the palm open from the MCP (metacarpal phalengeal) joint.
- Long Extrinsic Flexor Stretching: Extend the digit fully from the MCP joint, stretch the digit into hyper-extension. Within this position, soft tissue massage at the A1 or A3 pulley can be initiated in addition to Graston techniques with training to do so.
Intrinsic stretch of the index finger.
Extrinsic long flexor stretch of the index finger with massage to the A1 pulley.
View 2 of the extrinsic long flexor stretch.
Our dedicated team of therapists at Desert Hand and Physical Therapy is ready to assist you with all types of pain and impairments in the hand. If you have trigger finger or are worried you may, please give us a call at 855-828-6361 and we are ready and excited to help! Please click HERE to inquire about scheduling an appointment.
Brittany Moya MS, OTR/L, CHT
Please click the photo for Brittany’s full bio!
