Bust trigger finger with splints & exercises!

DISCLAIMER: This article is for informational and educational purposes only and should not replace seeking individualized medical advice. Thank you!

Every conversation I have with anyone surrounding trigger finger first starts with some hand anatomy…

In order for trigger finger solutions to make sense, it’s helpful to first know the cause!

Your hand anatomy

Most people believe all the muscles that control their hand are within their hand - and while this is partially true, hear me out! Many of the muscles which control our hands, ESPECIALLY the full-fist motion, actually START in our forearms, and their TENDONS come up through our wrist and into our hand and fingers/fingertips.

Mind. Blown.

Am I right??

Ok so stay with me here…

Our tendons are surrounded by a connective tissue called the retinacular sheath.

This sheath is comprised of annular pulleys in multiple aspects of each of the fingers which serve to maximize the flexor tendon’s force production and efficiency of motion.

As we use our hands, the tendons glide underneath these pulleys.

The first annular pulley (A1), located at the metacarpal head, is the most often affected pulley in trigger finger.

Due to its location, the A1 pulley is subjected to maximal stress during pinch and grip activities. As we use our hands, the tendons glide underneath these pulleys.

Now picture this…

You’re trying to thread a needle with thread that’s just too large. It begins fraying at one end of the eye of the needle, making it nearly impossible for it to smoothly fit through. Once it finally fits, it catches and makes a noise because of how thick the frayed mess the thread had become.

SIMILARLY…

Your tendon is the thread.

Your A1 pulley is the eye of the needle.

Trigger finger happens when inflammation of the retinacular sheath surrounding the tendon occurs, thus creating this difficult threading-the-needle situation described.

The retinacular sheath on the outside of your tendon swells and frays, and it doesn't fit smoothly under the A1 pulley anymore.

In some cases it can even cause a lump under your skin, a palpable nodule that you can actually feel with your other hand.

Earning its name from its popping or clicking sound, trigger finger is most commonly found in the ring finger, middle finger, and thumb. It often affects women more than men, and you’re more at risk for trigger finger if you have rheumatoid arthritis.

If you suspect you have trigger finger, it's important to go to a doctor to rule out any other cause for your symptoms, and it's also important to understand which stage of trigger finger you are in.

The levels of trigger finger

• Grade 1: pain/general history of catching, can't reproduce on the spot.

• Grade 2: catching/popping easily reproducible; no locking down. Your finger that’s triggering can lift itself up.

• Grade 3: locking down- often, you can't actively extend your triggering finger as you would in Grade 2. You need to force it back straight by using your other hand.

• Grade 4: contracture (stuck), can't passively correct. Your finger stays down all the time.

Grades 1-2 respond really well to what I am about to share. Grade 3 can as well, it definitely depends on the person, but it's absolutely worth it to do these things before considering surgery.

OK Corinne…so what should I do???

👉 Wear an anti-trigger splint for 4-6 weeks. You could try an oval 8 splint or a more traditional anti-trigger splint.

• Avoid full fist or bringing that finger all the way into your palm / locking or causing the finger to trigger - your splint will help with this.

• This matters because every time your finger pops, snaps, catches, or locks - this is contributing further to the inflammation, and the goal of wearing a splint for 4-6 weeks is that it heals itself…but it really needs 4-6 weeks of no triggering.

👉 Do exercises!! Every day, 10 reps each, 2 times each day is probably all you need.

• If any of these cause locking or popping, don't do them! Remember, the goal is no triggering for 4-6 weeks. These exercises keep your finger loose and mobile (when we wear a splint for 4-6 weeks, we can get stiff) and they can also help to pump the swelling out of the area and glide the tendons in a healthy way.

👉 Change how you're doing certain activities. For example, use a food chopper rather than a knife, widen the grip on your toothbrush, and try to avoid full repetitive gripping.

👉 If all that fails, then consider a corticosteroid shot

👉 Your doctor will likely bring up surgery and while this is a good option for some, as with all surgeries make sure you've exhausted the above options first!

If you’d like to watch some of the exercises from your exercise guide for trigger finger, check out a video I made for you!

PS: all the amazon links I provided you in this post are affiliate links!