trigger finger

[Dance Dance Revolution]

Any one know about trigger finger anwhy it locks up and how to treat?
I have a client who gets trigger finger in her 3rd metacarpol

 

[Wems]

trigger finger

In trigger finger (tenosynovitis), the synovial sheath that surrounds the tendon of the finger flexor develops fibrous adhesions that prevent the tendon from gliding smoothly in the sheath and is generally a repetitive use type of injury. I've treated several cases of trigger finger using massage and it's pretty easy and quick. I use warming, frictions and stretching with pressure to help break up the adhesions and create more movement in there. The adhesions are found in the flexor side of the finger, and you'll be able to feel where the adhesions are as it will be somewhat thicker than the rest of the finger.

My sessions for that condition are a half hour, I'll look up the kinetic chain to check out their pec's, neck, shoulders, lateral upper body and work where is tight and then move on to the finger for the last part of the session. (Of course there's always the hips and such to check out but they come in for the trigger finger, so I keep it to that area and then after it's resolved we talk about other areas of the body). I usually work on it for only about five to ten minutes and the frictions I only use the within the pain tolerance of the client, meaning I only friction for maybe twenty seconds or so around the area or until the pain worsens but never longer than a minute. A little pain is okay but once it worsens I stop and move on to the compressions and deep effluerage to the area and then return to the frictions one or two times. It is usually resolved after a session or two, especially if you show them how they can do it once a day on themselves at home.

The only hard part is that you might develop trigger finger yourself working on too many of these, you really have to get into a tiny area-- ha ha (sorry, bad joke)

 

[Christen]

trigger finger

thanks kathryn,
I will try your suggestions and let you know how it worked. she had a shot of cortisone and it went away. (i know temporally)but when i was putting compression on her palm she stated the trigger finger came back. :-( . So she has scheduled another apt with me on fri to work with the trigger finger and to also work with her fibramyalgia. I seen her a few days after the massage and she stated she hurt more after the massage,(fibromyalgia) it felt good but she didn't sleep well that night and had pain in her legs. She wanted to know if the pain would go away. any suggestions on this one.

 

[BigAl]

trigger finger

Oh sorry to hear that. I wouldn't recommend friction to the area until several weeks have passed after the cortisone shot. Cortisone has been shown to destroy tissue, so frictions will just aggravate it. When you put pressure on her palm, the pressure probably translated into a pulling sensation that was felt into the site of trigger finger and made it seem like it returned, when really the tension just showed it was still there. Cortisone just deadens the tissues, it doesn't resolve the issue. Let her know that it didn't "come back" from the pressure on the palm, but she was just feeling how it really didn't leave, just the pain did. That way she doesn't think the bodywork created the issue, which can happen when the client misunderstands what is happening with the tissues and then you might not see her again.

Not sure how long your session was with the fibro but many clients with it do better with just a half hour soothing work, no deep tissue. Very few people enjoy deep work for any length of time with fibro, or enjoy longer than a half hour session. If they say they do, ask if they've experienced a flare up within 2-3 days after the massage to make sure. If they did have a flare-up, then no, they don't need deep/or longer work.

It may be better to just do the soothing type work until the cortisone has left the tissues for now.

 

[???????? Vixen ????????]

trigger finger

Thanks kathryn,
Ill suggest a half an hour.
Hour sessions are hard for me to stay within the hour I can't imange doing a full body in 1/2 hour and doing slow MFR work. In my half hour sessions I usually only do back,neck shoulders and some peck work if I have time
Going to be a challange

 

[CipBerGreelia]

trigger finger

My mom got a trigger finger a number of years ago which she had problems with for about 4 years before finally seeing the Ortho. Since we weren't able to do anything that would make the problem go away during that time (see kathryn's details for session work above), he gave her a cortisone shot and informed her that if it worked, the problem would not come back. If not, she'd notice it come back in about a years time. It came back and she had surgery for it. The problem was taken care of with surgery, and it was a simple thing for her - day surgery, out patient, cut a slit in a particular tendon and the healing was easy as well. No scar as he cut in a skin fold.

I am not saying massage won't work, but other options may eventually be needed, and I'd like to pass on that in my mom's case it was with a good result. Granted, I absolutely love the Ortho, as he is someone I refer to and he refers to me (knee replacements, shoulder surgeries, rotator cuff issues, plantar fascitis, etc..) I completely trust his judgement on something like this and he is a very conservative MD, so, if he says surgery, I know it's coming from a mindset of caring.

 

[Harmony ~beat it~ trolls]

trigger finger

Kathryn's suggestions are right on the money!

I have a training client that recently had surgery for trigger thumb in both hands. It was the 3rd time for one hand, the 4th or 5th for the other. Though he has worked with me for a little while already, he didn't bother to mention the condition until the surgery had been scheduled, and we were unable to take preventative action. He is recuperating well, and soon we are going to spend some special time on things he can do to recover full use of his thumbs and then prevent future procedures. Prehab is always better than rehab, and trigger finger is generally preventable with some neuromuscular re-education and client awareness of contributing factors.