(Also known as Finger Sprain)
What is a sprained finger?
A sprained finger is a relatively common condition characterized by damage or tearing of the connective tissue (such as ligaments, cartilage and joint capsule) of one or more finger joints.
Each of the 4 fingers (excluding the thumb) comprises of 3 small bones known as phalanges. These small bones join to each other at the IP joints (Interphalangeal Joints) and to the bones of the palm (metacarpals) at the MCP joints (metacarpophalangeal joints) forming 3 joints for each finger (figure 1). Each of these joints comprises of strong connective tissue wrapping around the bony ends and cartilage which lies between the joint surfaces, cushioning the impact of one bone on another during activity.
Figure 1 – Anatomy for a Sprained Finger
During certain movements of the fingers, stretching or compression forces are placed on the finger joints. If these forces are excessive due to too much repetition or high force, injury to the joints may occur. This may involve damage to the cartilage or tearing to the connective tissue surrounding the joint. When this occurs, the condition is known as a sprained finger and may affect one or more IP or MCP joints.
Causes of a sprained finger
Sprained fingers are extremely common in ball sports such as basketball or netball and frequently occur due to a specific incident such as a hyperextension force (backward bending of the finger) or a sideways force. A sprained finger may also occur in contact sports due to a collision with another player or when tackling, or in martial arts or boxing (e.g. following a forceful or awkward punch). Occasionally, a sprained finger will occur due to repetitive strain associated with overuse. This may be the case in patients who perform repetitive activities involving end of range movements of the fingers.
Signs and symptoms of a sprained finger
Patients with a sprained finger often experience a sudden onset of finger pain during the causative activity. However, patients may also experience pain and stiffness after the provocative activity, particularly the next morning. Symptoms may be felt on the front, back or sides of the affected finger joint. There may be an audible snap or pop sound at the time of injury. Swelling or bruising will often develop around the affected joint. Symptoms are generally exacerbated with activities that involve use of the hand and fingers such as catching balls, opening jars or doors, writing, typing, picking up heavy objects, general gripping activity, cooking, household activities or placing weight through the affected hand and fingers. It is also common for patients to experience pain on firmly touching the affected region, and, in some cases, a feeling of weakness in the hand and fingers may also be present. In severe cases, the finger may be completely dislocated. All dislocations need to be managed by a medical professional and should be X-rayed before and after being put back into place to confirm relocation and to exclude fracture.
Diagnosis of a sprained finger
A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose a sprained finger and to determine the likely structures affected. Investigations such as an X-ray, MRI or CT scan may be required to confirm diagnosis and rule out other injuries (particularly fractures). Generally all traumatic finger injuries should be X-rayed.
Treatment for a sprained finger
Most patients with a sprained finger make a good recovery with appropriate physiotherapy. One of the key components of treatment is that the patient rests sufficiently from ANY activity that increases their pain until they are symptom free. Protective taping or a protective brace is often required for a period of time to stabilize the joint and protect it from further damage.
Rest from aggravating activities ensures the body can begin the healing process in the absence of further tissue damage. Once the patient can perform these activities pain free, a gradual return to these activities is indicated provided there is n