• Reference Number: HEY-250/2021
• Departments: Orthopaedics, Physiotherapy
• Last Updated: 19 January 2021

Introduction

This leaflet has been produced to give you general information about your injury.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and the healthcare team but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is a soft tissue injury?

The term soft tissue refers to muscles, ligaments and tendons that surround and support our joints. Injuries to the soft tissue surrounding the fingers joints are usually caused by a forceful stretch or direct blow, for example when playing ball sports.

What are the symptoms?

A soft tissue injury to one or more of the fingers may result in:

• Pain.
• Heat, redness or bruising.
• Swelling.
• Stiffness and loss of function.

Pain relief

To manage your pain it is advised that you regularly take simple pain relief which can be bought over the counter. If you have allergies or conditions which prevent the use of pain relieving or anti-inflammatory medication please seek advice from your doctor or a pharmacist.

What should I do in the first 72 hours after the injury?

The most important initial treatment is aimed at controlling the pain and swelling by following the principles of RICE:

R – Rest

Complete rest is not advisable but it is important that you prevent putting the finger under strain in the early stages of healing. Ensure you continue to move the other fingers and wrist as normal as it is common to quickly become stiff in these joints.

I – Ice

Ice will help reduce the pain in your finger and so should be applied for 10-15 minutes. This will help to reduce the swelling.

There are many different ways in which ice can be applied however it believed crushed ice, in the form of frozen peas for example, is the most effective. Whichever method you choose it is important that you wrap the ice in a damp towel, in order to prevent it from ‘burning’ the skin.

Please Note:
Only use an ice pack on areas that have normal skin sensation i.e. where you can feel hot and cold.
Do not apply over an open wound.
Do not apply an ice pack to an area that has poor circulation.
When you apply ice to your skin, check the skin every five minutes and discontinue its use if:

• the area becomes white, blue or blotchy.
• the area becomes excessively painful, numb or tingles.

C – Compression

You may have been given a special compression bandage to wear to help control the swelling in your finger. It is important this is removed if you develop any signs of poor circulation such as tingling, numbness, blueness of the skin around the finger and increasing pain. The bandage should be removed when you go to bed at night as when you are asleep you cannot monitor these symptoms.

E – Elevation

If you have swelling in your fingers sit on a chair and place your elbow on cushions so that it is level or slightly higher than your shoulder. In this position point your hand towards the ceiling then open and close your hand as this will help to reduce any swelling further.

What not to do

Consuming alcohol, massaging the injured area and applying heat can all be detrimental in the early stages of healing and therefore should be avoided. It is important to note that smoking may also delay the healing process.

Rehabilitation and recovery

If you follow this basic advice your injury should take around six weeks to heal. However, everyone recovers from injuries at different rates and it is dependent on the severity of the injury and the presence of any other medical problems. It is possible that you may be back to normal in two weeks, however it is also possible you may suffer symptoms for up to three months.

After 72 hours it is very important you try to start using your hand and fingers normally again when doing everyday tasks like washing, dressing and eating.

The exercises below will help you to regain full function, flexibility and strength and you should try to practice them on each injured finger 10 times, 4 times per day.

You may experience more discomfort when you start the exercises. However, this is normal and does not mean you should stop. If your symptoms remain worse for more than two hours after the exercises then you should decrease the number of each exercise that you do and build up again slowly.

1. Hold your finger with your other hand just below the top joint, preventing the other joints from moving.

Now bend the top joint of your finger down as far as you can and feel it stretching. Hold 10 seconds and then straighten.

2. Hold your finger with the other hand just below the middle joint, preventing the bottom joint from moving.

Bend the middle joint of your finger down as far as you can and feel it stretching. Hold 10 seconds and then straighten.

3. Support your elbow on a table with your wrist straight and fingers pointing towards the ceiling.

Bend your fingers across the knuckles and middle joints only. Keep your fingertips straight and trying to stretch them towards your wrist. Stretch for 10 seconds and then straighten your fingers again.

4. Support your elbow on a table with your wrist straight and fingers pointing towards the ceiling.

Bend the top two joints of your fingers down as far as you can into a hook grip and feel them stretching. Hold the stretch for 10 seconds, and then straighten.

5. Support your elbow on a table with your wrist straight and fingers pointing towards the ceiling.

Bend your fingers into your palm as tightly as you can and feel them stretching. Hold the stretch 10 seconds. Now stretch your fingers as wide as you can and feel them stretching. Hold the stretch for 10 seconds.

All photos with kind permission of ©Physiotec™

When can I return to normal activities?

If your job involves activities using your hand and fingers regularly you must ensure that you practice similar tasks so that you build your strength and function up gradually.

If you participate in an active hobby then it is advised that you do not return to this until you have full range of movement, strength and you can use your hand normally without experiencing pain or swelling.

If you play a sport involving use of your hand, practice sports specific activities like throwing and catching to prepare and build this up gradually before returning to full training sessions and competition.

Do I require further treatment?

You may be advised that you require physiotherapy following this type of injury, unless your symptoms are minimal on your initial appointment. Your physiotherapy could be at a variety of locations in the Hull and East Riding area.

You can self-refer to physiotherapy by contacting the following number depending on the location of your doctor:

• Hull GP patients self-refer to Healthshare: 01482 300003
• East Riding GP patients self-refer to East Riding Physiodirect: 01377 208300 or self-refer online at chcpmsk.org.uk

On occasions the clinician may wish to refer you to the physiotherapy team within the hospital trust. If this is the case they will advise you of this and you should receive an appointment at Hull Royal or Castle Hill Hospitals within 5 to 7 days of your attendance at the Emergency Department. If you have received no contact within this time please call the physiotherapy admin team on (01482) 674880.

When to seek further help

If 10 days following your injury you are unable to use the hand and it remains painful and swollen, despite following the above advice, please contact the physiotherapy team that you were advised to contact at your Emergency Care attendance.

Additionally if, after doing the exercises regularly and following the advice for three weeks, you notice that you are still unable to straighten your finger out fully please contact the physiotherapy team that you were advised to contact at your Emergency Care attendance.