Trigger finger physical therapy in Carmel, Indiana

The tendons that bend your fingers run through a series of tunnels called pulleys that keep them close to the bone. When the tendon or its lining thickens, it can snag on the first pulley at the base of the finger, the A1 pulley, and then suddenly snap through. That snap is the trigger.

The American Academy of Orthopaedic Surgeons notes that trigger finger is most common in women between the ages of 40 and 60, and that diabetes, rheumatoid arthritis and repetitive, forceful gripping raise the risk. The ring finger and thumb are frequently involved, and more than one finger can be affected.

Symptoms tend to be worse in the morning and ease as the hand warms up. Over time a finger may stop catching and simply stay stuck in a bent position, which is a reason not to wait too long before getting it looked at.

• Early: tenderness in the palm, occasional click, no locking.
• Moderate: catching you can straighten yourself.
• Advanced: locking that needs the other hand to straighten it, or a finger that will not fully bend or straighten.

A small splint that keeps the affected finger straight while you sleep is a standard first step recommended by AAOS. Overnight, many people bend their fingers into a fist, which keeps the tendon catching; holding the finger straight gives the pulley area a rest. Some therapists use a splint that holds only the knuckle at the base of the finger, leaving the rest of the hand free during the day.

Tendon gliding exercises take the fingers through a sequence of positions: straight, hook fist, full fist, tabletop and straight fist. Done slowly and without forcing the catch, they keep the tendons moving smoothly and the joints from stiffening. Your therapist will also show you how to reduce load on the palm, for example padded or thicker handles, gloves for gardening, and a looser grip on the steering wheel.

When the finger is no longer sore, light grip strengthening and forearm work help you return to tools, golf or the gym without simply overloading the same spot again. Hand-focused care like this is often provided by certified hand therapists; read about hand therapy in Carmel for how the matching team approaches it.

• Night extension splint for the affected finger
• Slow tendon gliding sequence several times a day
• Padded or larger handles and gloves for tools
• Gentle massage around, not on, the tender nodule
• Grip strength work once triggering settles

Warm the hand first thing, for example in warm water, then move the fingers slowly through the gliding sequence without forcing the catch. Avoid repeatedly snapping the finger through to test it, which keeps irritating the tendon.

During the day, loosen your grip: wider pens, a padded steering wheel cover, foam tubing on garden tools and gloves for lifting. Golfers can try larger grips. If you have diabetes, keeping blood sugar steady supports tendon health, and your physician should know about the finger.

If you are also noticing pain at the base of the thumb with pinching, compare with thumb arthritis. When the catching is getting worse, use the questionnaire for hand and wrist problems and the matching team will get back to you, usually within one business day.