| Preview of Trigger Finger: Trigger Finger is a form of | | | | the sheath swells and pinches down more so it |
| overuse injury with symptoms ranging from a | | | | irritates the adhesion even more, and continuing to |
| painless annoyance with occasional snapping/jerking | | | | go back and forth again and again with both the |
| of the finger(s), to severe dysfunction and pain with | | | | tendon and its sheath contributing to the |
| continuous locking of the finger(s) in a flexed | | | | cause-effect of Trigger Finger.NOTE: Other |
| downward position into the palm of the | | | | contributors/factors of Trigger Finger are Rheumatoid |
| hand.Anatomy of Trigger Finger: The tendons that | | | | Arthritis, partial tendon lacerations, repeated trauma |
| move the fingers are held in place on the bones by a | | | | from pistol gripped power tools, or long hours |
| series of ligaments called "pulleys". These ligaments | | | | grasping a steering wheel.Trigger Finger may also be |
| form an arch on top of the bone that creates a | | | | caused by an infection of the synovium, resulting in |
| tunnel so that when the flexor muscles are | | | | the scarring and formation of a nodule on the tendon. |
| contracted, the tendons can move along the bone in | | | | Trigger Finger can also be caused by a congenital |
| a straight path. In order to make sure these tendons | | | | defect that forms a nodule inside of the tendon. The |
| travel in a smooth manner and reduce friction of the | | | | condition is not usually noticeable until the infant |
| tendon and its sheath, the body produces and coats | | | | begins to use its hands.Treatment(s) for Trigger |
| the flexor tendons with a slippery coating called | | | | Finger: Sometimes the swelling can be treated with |
| "tenosynovium" which allows the tendons to glide | | | | rest, activity modification, oral anti-inflammatory |
| through the tunnel formed by the pulleys when the | | | | medications, or steroid injections. The tendon sheath |
| fingers/hands are used to grasp objects.Symptoms | | | | will usually return to its normal, pain-free condition. |
| of Trigger Finger: Trigger Finger may affect any of | | | | More severe cases may require surgery to release |
| the fingers (1-5) as well as any one of the finger | | | | the tendon, but is suggested as a last resort after all |
| joints (MP, PIP, DIP Joints). The occurrence of this | | | | other conservative methods have been |
| injury usually results from overuse of the flexor | | | | attempted.Often times, Trigger Finger will be |
| muscles/tendons and the formation of an adhesion or | | | | persistent because either no rehabilitation efforts |
| fibrotic nodule on the tendon. If left untreated, the | | | | were attempted or improper forms of rehabilitation |
| adhesion/nodule becomes larger, therefore creating a | | | | were utilized pre- or post-surgery. In most cases of |
| conflicting ratio between the size of the tendon and | | | | Trigger Finger, injections and surgery both attempt |
| the size of the entrance of the tendon sheath. There | | | | to cure the disorder by treating the symptoms |
| may also be thickening of the pulley ligament as well, | | | | instead of treating the "Actual Injury". In the case of |
| due to the friction of the adhesion/nodule against the | | | | Trigger Finger, the actual injury is the adhesion, |
| pulley ligament. In most cases, if the adhesion/nodule | | | | nodule, and scar tissue buildup on the tendon due to |
| is not treated, it will continue to increase in size | | | | excess strain, overuse, or direct trauma to that |
| (Depending on activity/use of affected finger) to the | | | | specific location on the tendon. Because Trigger |
| point where it still has the ability to pass into and | | | | Finger and those afflicted with Repetitive Strain |
| through the tendon sheath when flexing the finger, | | | | Injuries, Cumulative Trauma Disorders, Including |
| but becomes stuck and cannot move back through | | | | Carpal Tunnel Syndrome ALL HAVE THE SAME TYPE |
| the tendon sheath and/or pulley when trying to | | | | OF HISTORY (For the most part), this Trigger Finger |
| extend/straighten the finger, thus causing the finger | | | | would be treated in the same manner, through the |
| to lock in the flexed downward position (Palm of | | | | implementation of a variety of stretching and |
| hand). At first, this is experienced as a snapping of | | | | strengthening exercises to break down adhesions, |
| the affected finger when relaxing a fist. If the | | | | thin the tendon and create stability.Successful |
| condition worsens, the finger may need active force | | | | Treatment for Trigger Finger: (Perform in the |
| from the opposing hand/fingers to straighten, or the | | | | sequence listed) Transverse Friction Massage - |
| affected finger(s) may not straighten at all.Cause(s) | | | | Perform across the nodule/adhesion on the affected |
| of Trigger Finger: Most clinicians believe that the | | | | finger to help break it down, reducing its |
| disorder is caused by the tendon sheath because it | | | | size.Stretches - Immediately follow Transverse |
| becomes thickened or swollen and pinches the | | | | Friction Massage with passive and active stretches to |
| tendon and prevents it from gliding smoothly. But | | | | the affected finger to help thin the tendon.Exercises |
| common sense reveals that the history of patients | | | | - Immediately follow the stretches with active |
| suffering with Trigger Finger have one common | | | | strengthening exercises for the OPPOSING MUSCLE |
| denominator, overuse, excessive use and/or abuse | | | | GROUP, in this case the extensor muscles that |
| of the hands from work and recreational | | | | extend the fingers and wrist, in order to hold and |
| activities.Trigger Finger is usually (not always) the | | | | maintain the length to the tendon that you just |
| result of direct injury to the tendon via micro-tears | | | | stretchedHydrotherapy - Ice the affected tendon in |
| resulting from direct and sudden trauma or tasks that | | | | a stretched position to maintain the length of the |
| required repetitive use of the hands over long | | | | tendon that was just created through the stretches |
| periods of time. And as the body attempts to heal | | | | and exercises. Icing the tendon also removes swelling |
| itself causes the formation of scar tissue / fibrotic | | | | and toxins created through the use of massage, |
| adhesion, and the swelling of the tendon sheath is a | | | | stretches and exercises. Ice the tendon no longer |
| secondary injury caused by friction between the | | | | than 1-2 minutes. Take a break for 3-minutes and |
| adhesion and the tendon sheath as the finger is | | | | repeat the ice cycle two more times.Jeff P. Anliker, |
| flexed and extended. This friction causes irritation, | | | | LMT, is a Therapist, Inventor of Therapeutic Exercise |
| swelling, and inflammation to both the adhesion on | | | | Products that are utilized by Corporations, Consumers |
| the tendon and to the tendon sheath, thus resulting | | | | and Medical Facilities around the world for treating |
| in a cyclic injury, starting with the adhesion on the | | | | musculoskeletal disorders of the upper extremity. |
| tendon, then the adhesion irritates the sheath, then | | | | |