Finger injury...

[andyoxon]

Around 7 weeks ago I came off my bike and injured my knee and second finger.  The knee is doing better, but the finger still has some restricted movement*/joint tightness/ache focused on the proximal interphalangeal joint (yes, I googled it) i.e. second joint up from finger-tip…  Ache seems worse in the morning until general movement frees it up.   Finger looks normal apart for the PIP joint appearing to be larger.  My GP (last week) said that said any recovery would be slower now to the 3 month mark, and I could have a chip of bone interfering with the joint – but because I had a reasonable degree of finger movement, perhaps try ‘sponge ball’ exercises… 

So what are people’s experiences with ‘bashed’ fingers, what was your road to recovery like?  Anyone tried Aloe Vera?

Andy

* can't quite press second finger into palm, as with other hand...

[CrazyEnglishTriathlete]

In June 2013 I ran in to a 4x4 (my fault) in a narrow lane.  They'd stopped but I hadn't and my right little finger was caught between the brake lever and the front of the vehicle splitting the bone down to the first joint and with deep trauma to the flesh - basically my fingernail and a tendon were holding the tip of the finger on.  A&E sewed the finger back together and gave me a finger splint. 

I was hectic at work and was supposed to have been travelling that week so did all my meetings at home via webex.  Had to do a lot of typing/computer work so kept the hands moving albeit with my little finger strapped up in the Eric Bristow position.  One of my hobbies is piano playing and was concerned that I'd not be able to use that finger for a long time - its often what carries the theme - so tried to rework a couple of my pieces into a Frodo-Baggins style 9 fingered arrangement, with reasonable success. 

When the fracture clinic finally got me a physio appointment I had pretty much full flexibility in the joint, which surprises all those who see the excellent scar and get the above description.  So the lesson I would offer is to keep the hands and fingers as active as possible, whilst accommodating the injury.  I don't have any medical background but getting good blood circulation into the area (by using related muscles) I guess can't do much harm.

GWS

[mrcharly-YHT]

Prettymuch what CeT said.

I've had lots of cuts, burns and crush injuries to my fingers. No special ointments really make any difference, IMHO, just maintain mobility, don't strain while it is healing, just gentle movements.

One caveat; using STI levers strains joints ('cause fingers were not designed to push things sideways). Avoid pushing the levers with your fingers for a bit. Use the edge of your hand or something.

[andyoxon]

Thanks CET & mrcharly.

Keep thinking that I should have given more attention to my finger (left hand) in the couple of weeks post, as my knee was of more concern at the time -  probably because there wasn't any actual pain.      Compared to my other hand, the joint 'restriction' means I can't (by ~1cm)  press my second middle finger into my palm.

Good point about STI levers - being mostly trying to do this with three fingers AFAIA.  Actually nearly had a bad moment when on a tester ride a few weeks back - having difficulty changing to big ring, I tried to push the lever over while the holding bars with right hand only...   

[hellymedic]

CET might not have any medical background but early vigorous mobilisation improves the outcome of hand injury (though chrisbainbridge otp is the man for this).

CET had his own reasons for early vigorous mobilisation and pushed himself beyond what 'softie' medics might have tried, with excellent results.

Keep the hand moving.
Damaged interphalangeal joints often remain swollen.

Medics refer to fingers by name, not number to reduce confusion; I still don't know what a 'second' finger is!
So it's thumb, index, middle (or long), ring and little finger (or pinkie in Scotland), please.

[T42]

Corollary: missus had a fall when running a couple of years back and dislocated a little finger.  ER intern immobilized it in a straight splint and now she has limited movement in it.

[andyoxon]

Thanks.  I can straighten injured 'second'/middle finger normally, just notice it more with a hard grip.  Re. keeping finger moving - perhaps this is why it seems to be more 'achey' first thing in am...

[Fab Foodie]

I damaged 3* outer fingers on my LH and my little finger on my RH when I fell-off back in June.  I also didn't seek any medical attention thinking they were just strained.  When they remained painful after several weeks I saw the Doc who said they'd have only splinted them together anyhow .... but the outcome might  have been better .... but might not.  It seems that the ligament that stabilises the sideways movement of the fingers has become detached (I can feel a bit of floating bone by the joint)
As a result the fingers are painful and stiff at the PIP joint every morning and whilst better after movement, remain slightly achey and stiff most of the day.  I don't have issues gripping/squeezing things and can use the brakes just fine, but can't use a twisting grip on my LH like opening jam jars for example.
I also suspect a bit of Arthritis creeping in to the other fingers as well.

I don't think there is much that can be done in my case ... apart from avoid screw-tops .... but I would like to go back to Saxophone lessons at sometime and it may actually be good exercise for them.


* The second of these was already damaged in a 'Go-Ape' incident ..... tsk.

[chrisbainbridge]

Short answer is ask for a referral to a specialist.

Long answer is that collateral ligament injuries take 6-12 months to settle and if you are over 40 will ache intermittently for the rest of your life.

Sponge balls are stupid.  They limit your movement to no more than the size of the sponge ball which means you never get full range.  Better to push it down with the other hand as far as possible and then hold for 10-20 secs.  If the joint seriously wobbles when you try to move it side to side go back to GP and ask for immediate referral

[andyoxon]

Short answer is ask for a referral to a specialist.

Long answer is that collateral ligament injuries take 6-12 months to settle and if you are over 40 will ache intermittently for the rest of your life.

Sponge balls are stupid.  They limit your movement to no more than the size of the sponge ball which means you never get full range.  Better to push it down with the other hand as far as possible and then hold for 10-20 secs.  If the joint seriously wobbles when you try to move it side to side go back to GP and ask for immediate referral

Thanks Chris.  I'm 50.  There is no wobble in the joint, finger is pretty much straight if I do a 'flat hand' - joint itself feel 'secure'.  If I feel around the slightly enlarged joint with thumb and index finger of other hand, I can't detect anything 'untoward', only tenderness if I squeeze joint hard (apart from ache described).   Once 'settled', could an intermitment ache mean as high a frequency as every day, or just occasionally if finger pushed beyond new restricted limits.  I've just tried to press fingers into my palm, and the injured finger physically doesn't feel like it can be pressed into contact with palm, but I'll start this exercise and keep going. 
Given I visited the GP just a few days a go, is it worth trying the exercises for 2-3 weeks/longer then going back, or is there a 'time of the essence' factor.  I'm wondering what the likely options might be likely should I get to outpatients (perhaps with my finger in much the same condition as now).  I'm guessing that that there's a chance high res xray/ultrasound(?) might not actually reveal anything if soft tissue damage only?


Hi FF, I didn't know you'd come off.  In Abingdon?  Sounds similar to me fingerwise.

[chrisbainbridge]

Ok sounds like a sprain or a solar plate injury.  I would continue with the exercises for a while longer and perhaps try and find a private physio you could see for some advice.  An X-ray may show a fracture but it is highly unlikely that anything would be done at this distance in time given the latest information.

Aching is very variable.  If you have severely damaged cartilage ache may be daily, just spring the ligaments may be once a month.

[hellymedic]

um... solar plate or volar plate?

[Fab Foodie]

Hi FF, I didn't know you'd come off.  In Abingdon?  Sounds similar to me fingerwise.

Hiya, I came-off somewhere near Crawley on the cycle-path back from Brighton on my own.  Took a short-cut over a grass verge at speed without knowing there was a concrete gutter hidden in the grass!  Threw me clean off onto the cycle-path where I came to rest with my back against a lamp-post (which was lucky to say the least).  Apart from a gashed knee, a sore back and some bruises it felt like my fingers had been bent over backwards.  A bit shocked I thought the best plan was to get back on the bike (fortunately OK) and carry-on.
The reason I was cycling from Brighton was because I had dropped my car there the day before the L2B which I needed in Brighton to bring some friends home 
It could have been a lot worst so I count my blessings.

[chrisbainbridge]

um... solar plate or volar plate?

Well caught volar

[CrazyEnglishTriathlete]

Short answer is ask for a referral to a specialist.

Long answer is that collateral ligament injuries take 6-12 months to settle and if you are over 40 will ache intermittently for the rest of your life.

Sponge balls are stupid.  They limit your movement to no more than the size of the sponge ball which means you never get full range.  Better to push it down with the other hand as far as possible and then hold for 10-20 secs.  If the joint seriously wobbles when you try to move it side to side go back to GP and ask for immediate referral

I was 3 days short of 49 when I did my finger, so similar vintage.  Oddly enough I almost certainly broke the other pinkie that year, sledding on Beacon Hill by the A34 south of Newbury, using hands to break and catching a large frozen tussock awkwardly.  The boys were having too much fun for me to consider stopping and by the time we got back home it was early Saturday evening and time to avoid A&E and so I left it.  It was the left pinkie that Lifeboat (one of our better seam bowlers) had bent backwards with several consecutive balls that were too good for the batsman and almost to good for me as wicket-keeper (when I was in my late thirties).  I thought the joint was just bruised and carried on keeping, but realised later that year that it had been broken.  So now the left pinkie has an S-shape.  I'm still able to play the piano as effectively as before.

Thanks Chris.  I'm 50.  There is no wobble in the joint, finger is pretty much straight if I do a 'flat hand' - joint itself feel 'secure'.  If I feel around the slightly enlarged joint with thumb and index finger of other hand, I can't detect anything 'untoward', only tenderness if I squeeze joint hard (apart from ache described).   Once 'settled', could an intermitment ache mean as high a frequency as every day, or just occasionally if finger pushed beyond new restricted limits.  I've just tried to press fingers into my palm, and the injured finger physically doesn't feel like it can be pressed into contact with palm, but I'll start this exercise and keep going. 
Given I visited the GP just a few days a go, is it worth trying the exercises for 2-3 weeks/longer then going back, or is there a 'time of the essence' factor.  I'm wondering what the likely options might be likely should I get to outpatients (perhaps with my finger in much the same condition as now).  I'm guessing that that there's a chance high res xray/ultrasound(?) might not actually reveal anything if soft tissue damage only?


Hi FF, I didn't know you'd come off.  In Abingdon?  Sounds similar to me fingerwise.

[andyoxon]

Hi FF, I didn't know you'd come off.  In Abingdon?  Sounds similar to me fingerwise.

Hiya, I came-off somewhere near Crawley on the cycle-path back from Brighton on my own.  Took a short-cut over a grass verge at speed without knowing there was a concrete gutter hidden in the grass!  Threw me clean off onto the cycle-path where I came to rest with my back against a lamp-post (which was lucky to say the least).  Apart from a gashed knee, a sore back and some bruises it felt like my fingers had been bent over backwards.  A bit shocked I thought the best plan was to get back on the bike (fortunately OK) and carry-on.
The reason I was cycling from Brighton was because I had dropped my car there the day before the L2B which I needed in Brighton to bring some friends home 
It could have been a lot worst so I count my blessings.

Sounds nasty.  My last two offs and one near miss have all involved shortcuts of some description.    

----

I was looking at pics of finger joints, and thinking about the way I fell to my left.  I wonder if the volar plate is most likely injured through hyperextension.  Could have done this, or, crushed the collaterals against the tarmac and my bars... but had no abrasions to my swollen middle left finger at all (unlike getting blood everywhere from my right hand, which had no swelling and which seems fine now)...   

[hellymedic]

Highly likely IMHO.
The volar plate is often injured in hyperextension and dislocation injuries
Volar plate injuries usually result in long term swelling.
There are often other PIP problems, like stiffness, following volar plate injury.

[Fab Foodie]

Hi FF, I didn't know you'd come off.  In Abingdon?  Sounds similar to me fingerwise.

Hiya, I came-off somewhere near Crawley on the cycle-path back from Brighton on my own.  Took a short-cut over a grass verge at speed without knowing there was a concrete gutter hidden in the grass!  Threw me clean off onto the cycle-path where I came to rest with my back against a lamp-post (which was lucky to say the least).  Apart from a gashed knee, a sore back and some bruises it felt like my fingers had been bent over backwards.  A bit shocked I thought the best plan was to get back on the bike (fortunately OK) and carry-on.
The reason I was cycling from Brighton was because I had dropped my car there the day before the L2B which I needed in Brighton to bring some friends home 
It could have been a lot worst so I count my blessings.

Sounds nasty.  My last two offs and one near miss have all involved shortcuts of some description.    

----

I was looking at pics of finger joints, and thinking about the way I fell to my left.  I wonder if the volar plate is most likely injured through hyperextension.  Could have done this, or, crushed the collaterals against the tarmac and my bars... but had no abrasions to my swollen middle left finger at all (unlike getting blood everywhere from my right hand, which had no swelling and which seems fine now)...   

Ha!  Shortcuts .... never what you expect them to be!

From those pictures, Volar Plate seems to be where my pain and 'lump' is coming from.  And hyper-extension would be the cause.