What is Trigger Finger and How Do I Fix It? (Stenosing Tenosynovitis) - Hooper's Beta Ep. 31

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In this weeks video we answer a viewer question in depth regarding trigger finger (stenosing flexor tenosynovitis, but that's just word vomit so let's stick with trigger finger).

I know that this is a tricky time for everyone but I hope everyone is doing well and staying home if you can. Hopefully you can spend this time learning new things, planning your training out, learning new body weight exercises, learning to be happy and OK with calm, and are able to respect the climbing areas by not overloading them.

Now is a great time if you have any questions I will do my best to answer them or create a video or two this weekend, so please, if you do have any questions respond here or on any of the videos you are watching.

With that being said, below you'll find the time stamps and then the show notes. I hope you enjoy this weeks episode.

Video Overview (00:16)
Anatomy (00:25)
Symptoms (01:12)
Causes (01:47)
Testing (02:28)
Treatment (02:56)
Final Notes & Outro (06:14)
Outtakes (06:45)

[WHAT IS TRIGGER FINGER]
Trigger finger simply put is caused by a disparity in the size of the flexor tendons and the surrounding retinacular pulley system at the first annular pulley, the A1 pulley. The tendon will catch on the pulley as it attempts to glide through, until enough pressure is developed to allow it to jolt through, hence, "trigger finger". Keep in mind, this will be relative to the size disparity which may be correlated to how long you have been dealing with this issue. A subtle catch may be an early warning sign, whereas a hard catch may be a more chronic issue that needs to be dealt with professionally. The cause is sometimes unclear, but it is often attributed to overuse or repetitive behaviors.

[SIGNS AND SYMPTOMS]
Signs and symptoms for this are much more straightforward. Someone suffering from this will initially describe a painless catching, snapping, or locking of one or more of the fingers during flexion of the affected joint. This will progress to painful episodes and the person may also develop difficulty extending the fingers.

--Symptom Progression
Initial: Painless catch/snap/lock during finger flexion
Subacute - Chronic: Painful catch/snap/lock
Chronic: Difficulty extending

Other signs and symptoms may also include tenderness at the base of the finger at the MCP joint. A tender nodule may be felt near this area, and symptoms may be provoked by stretching the affected tissue into extension

[TESTING]
Testing for this is more straight forward. Simply place the hands in the palm up position and actively flex and extend the fingers. Try different ranges and angles in an attempt to make the finger catch.

If you notice that this mainly bothers you climbing but does not happen on rest days, these are likely signs of acute inflammation causing a closing of the space and the subsequent catching, which then reduces once the swelling has subsided, hence, only catching while climbing. If this is you, this may be an early sign and that means there is still a good chance to recover from this.

Finally, while it does take a fine touch, you may be able to look for nodules or differences in the tissue comparing side-to-side or joint-to-joint. To do this, place your hand over the PIP, and perform flexion and extension, while looking for any abnormalities such as catching, clicking, etc. Compare this to other fingers on the same hand as well as comparing it to the same joint on the other hand.

[TREATMENT]
1) Activity modification
- Pay attention to activities that involve excess or constant flexion at the MCP and possible PIP joint. Pay attention to your climbing style and your activities of daily living. Don't make dramatic changes, rather practice good load management.
2) Splinting
- Oval 8 - available on Amazon (https://amzn.to/2vxGx3u). This blocks MCP and PIP mobility
- Custom - available from an occupational therapist. Blocks the MCP mobility but allows for PIP flexion, which is more functional.
3) Stretching of the A1 pulley - see the video
4) STM may be indicated if you feel a nodule this may be connective tissue and/or adhesions that need to be reduced. You have to be careful because if you are too aggressive you can just cause more inflammation and more locking.
5) Physician prescribed NSAIDs

For patients not advancing with conservative care
Corticosteroid injections
Injection #2
If all else fails →
Surgery

[REFERENCES & DIFFERENTIAL DIAGNOSIS]
- continued on the block www.rocktherapypt.com/blog

// Products (Amazon affiliate links)
Oval 8 Splint: https://amzn.to/2vxGx3u
Lacrosse Ball: https://amzn.to/2x4KRrr

Thanks as always for watching.
Train. Climb. Send. Repeat.

Written and Presented by Jason Hooper, PT, DPT, OCS, CAFS
IG: @hoopersbetaofficial

Filming and Editing by Emile Modesitt
www.emilemodesitt.com
IG: @emile166

Видео What is Trigger Finger and How Do I Fix It? (Stenosing Tenosynovitis) - Hooper's Beta Ep. 31 канала Hooper's Beta