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When recovering from an injury, the balance between rest and movement is extremely important. Without movement and after wearing a finger splint, you may experience excessive stiffness and loss of hand strength, making for a longer and harder road to recovery.
You will want to wait to start specific mallet finger exercises until your finger tissues are almost completely healed, done with splinting, and upon clearance from your doctor (especially after surgery).
A few signs that you are ready often include:
These 6 exercises will progress from gentle passive stretching to more active hand movements. Start at the beginning and progress by adding the next exercise as you feel ready. Use your symptoms as a gauge and never force any of these moves.
One of the first exercises you can start is a gentle stretch into finger extension. Right after the injury, the finger will be resting in flexion and unable to extend the distal (last) joint on it’s own. Thus, you can facilitate this movement and range with the opposite hand. This will help minimize loss of range and keep the fingertip limber as it heals.
After an extended amount of time spent in a splint, the healing finger extensor tendon will feel stiff. A tendon glide exercise can help keep the tendon moving smoothly with less stiffness or catching during daily activities. There are many different options and positions to progress to as you are ready. We will focus on demonstrating the first exercise. You can then progress to further options (illustrated in the video) as tolerated.
As your flexibility and comfort with moving your finger improve, it’s time to get started with some basic strengthening moves. One of the simplest ones you can start is a full-hand gripping exercise. You may notice your splinted finger is stiff at first, start in a range of motion that is comfortable and progress it as tolerated. You may also need to guide your finger into a bent position with your opposite hand initially until you gain more strength.
An important next step in the rehab process is to be able to properly pinch your fingers together. You need good strength and balance between the finger flexor and extensor tendons when pinching. Without this balance, it will compromise the integrity of the fingertip joint with daily hand use and lead to problems in the future.
This exercise addresses the healing finger extensor tendon directly. Thus, start slowly and see how your finger tolerates this move first. It’s why it’s one of the last moves you will try in your rehab program.
This exercise is similar to the finger extensor exercise above, except that it works the entire hand at once. Working on coordinating all of the extensor muscles in the hand and forearm at once will help you build functional strength for getting back to daily activities and sports.
All of the exercises listed above, and any other moves that you progress to, are easier to do with the help of hand therapy tools. These tools are easy to take with you anywhere and use to stretch and strengthen your fingers on the go or when you have a spare moment. These top rated tools have already been discussed in the exercises above and they include:
Hand exercise balls are a great addition to your hand exercise tool kit. They come in a variety of colors that differ in resistance, depending on your hand strength and where you are in your recovery journey. You can throw one in your bag or car and use it throughout the day to keep your hand strong. Plus, squeezing a ball will promote circulation to enhance the healing process and reduce overall pain as well.
The use of putty is a very versatile tool for hand and finger strengthening. The ways you can use it are practically endless. It also comes in a variety of strengths that you can utilize with your rehab program. Many people find the use of therapy putty therapeutic for their minds as well. The one disadvantage with this is when you want to increase your hand endurance with higher repetitions and you have to continually manipulate the putty for use between every single repetition.
A ring gripper can be considered a cross between the exercise balls and therapy putty. It is more versatile than the ball but has slightly less versatility than the putty. Outside of hand grip exercises, this tool should be reserved for later in the rehab process since it is less flexible and offers more resistance. Thus, this is a great tool that you can start with gripping in early rehab and then build to more extensive exercises with time as tolerated.
Choosing an exercise program for the mallet finger doesn’t have to be complicated with the right health information. Simply start with gentle stretches and progress to more dynamic strengthening as tolerated. This will ensure that you can return to your daily routine or sport with less risk of reinjury. However, if you’re feeling unsure of where to start, it’s always best to discuss treatment options and exercise with a physical therapist or occupational therapist. Don’t forget to maximize your exercise program results by combining it with other mallet finger treatment options to managing swelling and pain relief.
As always, if you experience a sudden change in symptoms or they simply aren’t getting better on their own within a week or two, it’s time to get in touch with your healthcare provider as soon as possible for further medical advice. They may need to rule out more serious issues like fracture (known as a bony mallet finger).
Sources:
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=bo1658
https://hhma.org/healthadvisor/aha-malletfi-rex/
http://www.tcomn.com/wp-content/uploads/2017/02/Mallet-Finger-Home-Program-Phase-2-Exercises-1.pdf
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