Treatments
Sports and work related injuries
Mallet finger, also known as drop finger or baseball finger, involves damage to the tendon that extends the tip of your finger or thumb. Tendons connect bones to muscles, allowing for movement and stability. When this tendon is injured, it can either tear or detach from the bone, and sometimes the bone itself may also be affected. With mallet finger, you’ll find it difficult or impossible to straighten your finger; it will droop at the tip and may be painful, bruised, or swollen.
This injury is common in sports like baseball, basketball, or football, especially when a hard ball strikes the fingertip. It usually affects the finger on your dominant hand.
The triangular fibrocartilage complex (TFCC) is crucial for stabilizing your wrist. Composed of ligaments and cartilage, it connects your forearm bones (the ulna and radius) to each other and to the small wrist bones. The TFCC provides essential support, stabilization, and cushioning for your wrist.
This structure enables you to rotate your wrist and grip objects firmly. If the TFCC tears, you may experience weakness and instability in your wrist joint.
TFCC tears can result from two main causes:
- Injury: A TFCC tear can occur from a sudden impact, such as falling on your hand or wrist. A fractured radius can also damage the TFCC. Additionally, a sudden, excessive twist of the arm can lead to a tear. It can occur as a repetitive motion especially for those who play some sports like basketball.
- Degeneration: Over time, the TFCC, like other tendons and ligaments, naturally deteriorates and thins out with age, making it more prone to tears. These degenerative tears often develop gradually. Repetitive activities, such as swinging a bat or racket, can also accelerate the breakdown of the TFCC tissues, leading to tears.
The scapholunate ligament is located in the middle of the wrist, connecting the scaphoid and lunate bones. It plays a crucial role in allowing smooth and painless wrist movement. Injuries to this ligament can range from stretching to complete tears, all of which can lead to wrist instability and pain.
Scapholunate ligament tears often result from significant stress on the wrist, such as when you fall onto your hand. Typically, the injury occurs when the wrist is bent backward or placed in an unusual position. In some cases, the ligament may gradually stretch over time due to repeated strain or natural loosening with age. Chronic inflammation, such as that caused by gout, can also contribute to the gradual breakdown of the ligament.
This injury affects the ulnar collateral ligament of the metacarpo-phalangeal joint in the thumb. This strong ligament supports the thumb during pinching and gripping. Damage to this ligament can lead to chronic instability in the thumb, which can significantly impair its function.
The injury typically occurs when you fall onto an outstretched thumb, especially if the thumb is gripping something at the time. A common cause is falling while skiing and holding a ski pole, which is why this injury is sometimes referred to as “skier’s thumb.”
In rarer cases, the ligament may be stretched gradually without a specific incident, a condition known as “gamekeeper’s thumb.” Individuals with this issue often report a loss of strength when pinching or gripping with the thumb.
Hand and wrist injuries
Arthritis and other rheumatic diseases are widespread conditions that cause pain, swelling, and limited movement by affecting joints and surrounding connective tissues.
Arthritis specifically refers to inflammation in a joint, where two or more bones meet. There are more than 100 different types of arthritis. Rheumatic diseases cover a broad range of conditions that cause pain, stiffness, and swelling in joints, muscles, tendons, ligaments, or bones. Typically, arthritis is a chronic condition that persists over time.
These conditions are more prevalent in women than men and are often associated with aging, though they can affect people of any age.
De Quervain tenosynovitis is a painful condition that impacts the tendons on the thumb side of the wrist. If you have this condition, you are likely to experience pain when turning your wrist, gripping objects, or making a fist.
While the precise cause of de Quervain tenosynovitis is not fully understood, repetitive hand or wrist movements—such as gardening, playing golf or racket sports, or lifting a baby—can exacerbate the symptoms.
The scapholunate ligament is located in the middle of the wrist, connecting the scaphoid and lunate bones. It plays a crucial role in allowing smooth and painless wrist movement. Injuries to this ligament can range from stretching to complete tears, all of which can lead to wrist instability and pain.
Scapholunate ligament tears often result from significant stress on the wrist, such as when you fall onto your hand. Typically, the injury occurs when the wrist is bent backward or placed in an unusual position. In some cases, the ligament may gradually stretch over time due to repeated strain or natural loosening with age. Chronic inflammation, such as that caused by gout, can also contribute to the gradual breakdown of the ligament.
Dupuytren contracture is a condition where one or more fingers bend toward the palm and cannot fully straighten. This happens as knots of tissue form beneath the skin, eventually creating thick cords that pull the fingers into a bent position. The condition tends to worsen gradually over time.
Typically, Dupuytren contracture affects the two fingers farthest from the thumb, which can make everyday tasks such as putting your hands in your pockets, wearing gloves, or shaking hands more challenging.
Trigger finger is a condition where a finger gets stuck in a bent position and may suddenly straighten with a snap. While it can affect any finger, it most commonly involves the ring finger and thumb.
This issue arises when the tendon responsible for moving the finger can’t glide smoothly within its surrounding sheath. This difficulty can be caused by swelling in part of the tendon sheath or the formation of a small lump on the tendon.
Trigger finger is most prevalent in women over the age of 50. Your risk of developing the condition may be higher if you have diabetes, low thyroid function, or rheumatoid arthritis.
Elbow injuries
Golfer’s elbow is a condition that causes pain at the point where the tendons of the forearm muscles attach to the bony prominence on the inside of the elbow. This discomfort can radiate into the forearm and wrist.
Similar to tennis elbow, which affects the outer part of the elbow, golfer’s elbow is not exclusive to golfers. It can also affect tennis players and others who engage in repetitive wrist movements or gripping activities.
Tennis elbow (lateral epicondylitis) involves inflammation of the tendons responsible for extending your wrist away from your palm. Tendons are strong bands of tissue connecting muscles to bones, and in the case of tennis elbow, the tendon most commonly affected is the extensor carpi radialis brevis. This condition typically occurs in individuals aged 30 to 50.
As the name suggests, tennis elbow is frequently caused by the repetitive force exerted when hitting tennis balls with a backhand stroke. This repeated strain can lead to soreness in the forearm muscles, which attach to the outer part of the elbow. The tendons that extend over the elbow’s end can become damaged due to the excessive strain involved in making backhand shots.
Elbow bursitis affects the olecranon bursa, a small, fluid-filled sac situated at the bony tip of the elbow (the olecranon). Bursae are cushioning structures found throughout the body, positioned between bones and soft tissues like skin. They contain a small amount of lubricating fluid that facilitates smooth movement of soft tissues over bones.
Under normal conditions, the olecranon bursa is flat. However, if it becomes irritated or inflamed, it can accumulate excess fluid, leading to bursitis.
Nerves injuries
Cubital tunnel syndrome occurs when the ulnar nerve, which travels through the cubital tunnel—a passageway of muscle, ligament, and bone on the inside of the elbow—becomes inflamed, swollen, and irritated.
This condition often causes pain similar to the sensation you get when you accidentally hit your “funny bone.” The “funny bone” is actually the ulnar nerve, which runs along the elbow and extends from the side of the neck to the fingers.
Cubital tunnel syndrome can develop due to frequent bending of the elbows, such as during pulling, reaching, or lifting activities, excessive leaning on the elbow, or injuries to the area.
Carpal tunnel syndrome is a prevalent condition affecting the hands. It results from pressure on the median nerve within the carpal tunnel, a tight passageway in the wrist bordered by bones and ligaments on the palm side. This compression of the median nerve can lead to symptoms such as numbness, tingling, and weakness in the thumb and fingers.
Factors contributing to carpal tunnel syndrome include wrist anatomy, existing health conditions, and potentially repetitive hand movements.
Fractures
A wrist fracture refers to a break in one of the bones in the wrist. The wrist comprises eight small bones that connect with the two long bones of the forearm—the radius and ulna. While a fracture can occur in any of these ten bones, the radius is the most commonly broken. This specific type of fracture is known as a distal radius fracture.
The scaphoid bone is one of the carpal bones located on the thumb side of the wrist, just above the radius. It plays a crucial role in both the motion and stability of the wrist joint.
This bone is vital for wrist function because it connects the proximal row of carpal bones (those nearer to the radius and ulna) with the distal row (those closer to the fingers). Proper movement of the scaphoid is essential for optimal wrist motion.
You can most easily locate the scaphoid bone when your thumb is in a “thumbs-up” or “hitchhiking” position. It is situated at the base of the hollow formed by the thumb tendons on the back of the wrist.
A hand fracture is a break in one or more of the bones in the hand, which include:
- The small bones of the fingers (phalanges)
- The long bones within the palm (metacarpals)
Hand fractures can result from various causes, such as a fall, crush injury, twisting injury, or direct impact during sports.
The most common type of hand fracture is the fracture of the fifth metacarpal—the bone in the hand supporting the little finger. This is often referred to as a “boxer’s fracture” and typically involves a break near the neck of the bone, adjacent to the knuckle joint. A boxer’s fracture usually occurs from punching or striking a hard object with a closed fist but can also result from a fall, motor vehicle accident, or other forms of trauma.
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