domingo, 27 de fevereiro de 2011

Stenosing Tenosynovitis (Trigger Finger) - Part II

Physical Examination
The physical examination of the physical therapist relies on the patient history and description of the symptoms and its location, complemented by observation of the triggering phenomenon. A tender nodule can be palpated overlying the proximal metacarpophalangeal joint.
The goal of the treatment in trigger finger is to eliminate the clicking sensation and allow full movement of the finger without discomfort. This can be accomplished by diminishing the swelling around the pulleys and the tendon, allowing a smooth gliding of the tendon. We can start of the treatment by educating the patient to stop all the activities that make use of the affected finger, and apply a splint. A deep tissue massage of the nodule will help reduce the swelling and the inflammation, and the fibrosis. Soft mobilization of the metacarpophalangeal joints will help the tendon to glide smoothly under the pulleys. We can also stretch the flexors and strength the extensors, in order to maintain the length of the tendon. Ice at the end of the treatment can be done on the finger to help reduce the inflammation. When the triggering of the finger is gone, it may also be needed to work on the patients hand grip and finger pinching skills.

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