No matter if it’s you or your child participating in a sport, you’re familiar with the fact that injuries can occur during athletics. Injuries to the hands are fairly widespread and account for 25% of all sports-related injuries.
Injuries of this nature usually occur due to accidents or rough handling, like gripping a ball the wrong way or applying excessive pressure to the hand when falling. Injuries to the hand and wrist may occur from excessive or frequent motions. For example, pitching a baseball or playing a round of tennis may bring about the same muscle group activation multiple times.
We will examine some of the most common injuries to the hands and wrists, as well as what one can do to stop them from happening.
Common Sports-Related Hand or Wrist Injuries
1. Sprained Wrists and Fingers
When one or more of the ligaments that help link two bones together become hurt, it is known as a sprain. These bands of fibrous tissue are important for connecting the bones in your body. When a ligament is subjected to excessive force or strain, it can become overstretched or ruptured.
The potential for injury arises when your finger or wrist is twisted in an unnatural way – For instance, when snatching a basketball, if your finger is pulled back too far or if you take a tumble and land on an outstretched hand when you are trying to scoop up a ground ball.
What are the symptoms of sprained wrists and fingers?
Soreness and enlargement of the wrist or finger are indications of the problem, and it is aggravated by movement. Additionally, there may be discoloration or an audible sound when you try to move the area.
What should you do if you have a sprained wrist or finger?
In many instances, you are capable of caring for a minor sprain in the comfort of your home. Allow your hand to relax for a day or two, then start using the hurt area as much as the discomfort will let you while also making sure it won’t get hurt further by accidental contact. Movement of the injured wrist or finger circulates fluid to and from the area, which is essential for the healing process. Furthermore, a moderate amount of tension on damaged tendons encourages robust tissue development.
In most cases, you should see improvement quickly. If the swelling or pain persists for more than two days, you should go to a doctor. The amount of time needed for a finger or wrist (that has sustained a sprain) to recuperate fully could range from a few weeks up to a few months. If the sprain isn’t serious, it could recover quickly – in a matter of weeks. Recuperating from serious injuries may take months.
2. Jammed finger
A jammed finger is an injury to the end of the finger or thumb. This kind of sports finger damage occurs when something strikes the end of the finger or thumb when it’s completely outstretched.
The force of the impact can cause your finger to be shoved back into your hand, stretching the ligaments in your finger beyond their limit. In certain occasions, the ligament might rip, bringing about a finger sprain.
What are the symptoms of jammed fingers?
A jammed finger may cause pain, swelling, and redness in the top part of the finger. It will be hard to flex or shift your finger. If you cannot move the outermost joint of your finger at all, you may have what is known as a “mallet finger,” something we will be examining in the subsequent part of this discussion.
What should you do if you think you have a jammed finger?
Do not attempt to manipulate your finger by yanking on it in an attempt to fix it – it will only worsen the situation.
Discuss with your mentor, healthcare provider, or manual therapist how to manage a jammed finger in the comfort of your own home. It won’t be long until you see an improvement in your injury, and it should be completely healed within two weeks. If there is no change for the better, it is advised to schedule a meeting with a physician or an expert in hand care. You might have a bone fracture that necessitates additional care.
3. Mallet finger
Mallet fingers and jammed fingers are similar in that they both involve an injury at the end of a person’s finger or thumb. Mallet fingers are more serious than jammed fingers and require extra attention.
A mallet finger is produced by a strong bump to the end of the finger or bending it too far. In both scenarios, any resistance requiring exertion with your fingers or thumbs can lead to a fingertip injury, keeping you from extending it. You will observe that you are unable to keep your finger straight without placing something under it for support. This affliction can encompass either the tendon that permits a person’s fingertip to be extended or the bone.
What are the symptoms of mallet finger?
The most apparent indication of mallet finger is the inability to extend the tip of the finger, leading to a drooping appearance. It is impossible for individuals to correct this on their own. Discomfort, inflammation, and soreness around the injury may also be experienced. Sometimes blood may accumulate underneath your fingernail, or your nail may come away from the skin.
What should you do if you think you have a mallet finger?
This kind of injury has to be examined by a medical professional without delay, so you should go to an orthopedic medical clinic that offers emergency services. The medical professionals will be able to evaluate your wound and make certain that you receive the proper care in a timely fashion. Delaying treatment could result in finger deformity.
4. Broken wrist
This joint is made up of a compilation of eight small bones in the wrist region, along with the outermost part of the radius and ulna in the forearm.
A break can happen anywhere in the wrist joint. On the other hand, a pronounced break in the distal radius, which is where the radius bone meets the wrist joint, is a frequent type of wrist fracture.
The most common cause of a wrist fracture is falling while having your arm extended. Wrists might be affected due to a direct blow from something such as a hockey puck or stick.
What are the symptoms of a broken wrist?
One should prepare for suffering, inflammation, and tenderness in the area surrounding one’s wrist. It is likely that it will be a troublesome and agonizing experience to shift your wrist or thumb.
If the pain persists on the side of your wrist that is nearest to your thumb, you should go to the doctor to investigate the possibility of a broken scaphoid bone.
What should you do if you think you have a broken wrist?
Getting medical attention for a broken wrist is important, and doing so in a timely manner is ideal. If you don’t know if your wrist is injured or sprained, it is all right to wait a day to check if your signs are relieved with treatment from home. If there is a noticeable abnormality to your wrist, such as a bent structure or a deformity, it is advised to visit a doctor immediately.
Essentials Of Assessment
History
The mechanism of injury is the most important in diagnosis. A quick investigation into the history of any high-speed or rotational trauma, along with pain from repeating strain, will limit the possible diagnoses. For illustration, a slip and trip resulting in an outstretched arm can lead to the scaphoid, distal radial bone breaks, or injure the triangular fibrocartilage complex. Rotating the wrist in a certain way may cause a tear in the triangular fibrocartilage complex.
It should be established where the patient is experiencing pain (whether it is on their back, the palm of their hand, the ulnar side of their forearm, or the radial side of their arm) and what makes the pain worse. Signs of inflammation may be present when an individual experiences soreness with continuous movements and tightness when idle. Night pain is often found in carpal tunnel syndrome. Pain that grows more intense shortly after activities or gradually worsens over time should be noted—determining if the pain started suddenly or slowly can help in narrowing down the possibilities of what is causing the pain.20,27,28 If you experience gradual-onset discomfort, think about potential systemic issues that could be causing your hand or wrist pain.
The degree of swelling, its specific site, and whether it developed suddenly after an injury or gradually can help differentiate between an acute injury and a recurring condition.
Previous traumas or operations may influence the consequences of the damage.
Expressions of feeling different sensations or changes in the hue of the skin may be helpful in finding out if the nerves and blood vessels have been impacted. It is important to record any crackling sensation, the intensity of the pain, discoloration, and/or reduced capacity. Clicking in the joints might be indicative of carpal instability, ruptures of the triangular fibrocartilage, or dislocation of the extensor carpi ulnaris.
It is critical to remember, yet often disregarded points of the past like hand dominance, vocation, and if there was continuous arm swelling.
Physical examination
Look for signs of swelling, bruises, severe deformity, and muscular wasting, such as in the areas of the thenar and hypothenar eminences. Take note of how the individual is supporting their wrist or hand as well as any marks or changes to the skin. Testing the capacity of the wrist and fingers to both moves and stay still can demonstrate practical issues that will guide the examination. Identify movements and positions that cause pain or discomfort. At the extreme range of passive movement, pain is likely to occur due to stretching of tight, contracted musculature. It is important to palpate the wrist and fingers, especially if there is the possibility of scaphoid fracture, Dupuytren’s contracture, trigger finger, or joint arthritis of the first carpometacarpal joint. This methodology relies on the contraction of muscles as well as the movement of nonmuscular parts. Checking someone’s strength can uncover any uneven power levels, which might be the result of carpal tunnel syndrome or an ulnar nerve issue.
Special tests
For Ligament, Capsule, and Joint Instability:
The thumb ulnar or finger collateral ligament stress test is used to evaluate the integrity of the ligaments in the digit. Murphy’s sign is indicative of a lunate dislocation and is tested by having the patient make a fist and looking to see how the distal end of the 3rd metacarpal relates to the 2nd and 4th. The Supination Lift maneuver can be used to assess whether the triangular fibrocartilage complex (TFCC) is damaged or not. The axial load test discovers any potential arthrosis in the metacarpophalangeal joint and any fracture that might exist in the metacarpals or bones located close by. Watson test and/or a Shuck test identify scapholunate dissociation.
For Tendons and Muscles:
The Finkelstein maneuver and the Axial Grind Test are examinations used to assess thumb pain that could be related to De Quervain’s tenosynovitis or carpal metacarpal (CMC) arthritis. Elson’s and Boye’s exams can identify harm to the central slip of the extensor digitorum. The Sweater Finger or Flexor Digitorum Profundus test is used to determine whether there is any tearing or detachment of the tendon from the bone in the hand.
For Neurologic Dysfunction:
The opposition of the finger versus the thumb, as well as opening and shutting the hand, necessitates regular joint operation, intact extensor and flexor ligaments, and undamaged ulnar and median nerves. To ascertain whether carpal tunnel syndrome might be present, tests like Carpal Compression, Tinel’s test at the wrist, or the Phalen test can be performed. The evaluation of a potential ulnar neuropathy can be aided by a Froment’s sign or Tinel’s test at the elbow and an Ulnar Compression Test. Spurling’s maneuver for assessing nerve root pain. Pain that is sent from an area near the neck or another spot close by needs to be thought about.
Other Special Tests:
It is possible to get an objective assessment of how well the muscles of the hand and forearm work by testing grip strength. A grip dynamometer is accurate and reproducible.
Functional assessment
Different metrics have been used to assess the results of hand and wrist injuries in patients. A single in-depth review of measuring tools designed for rehabilitating persons with injuries to their hands was appraised to be of superior quality. It is possible to observe an enhancement in the standard of clinical metric characteristics by utilizing popular checklists such as COSMIN. When planning a study, it is necessary to recognize the research question and then pick the fitting tool that fulfills the goals of the investigation. Significant research has been conducted to analyze the effects of varying region-specific interventions like the DASH, QuickDASH, and the MHQ in this group of patients.
The DASH, an extensively studied questionnaire consisting of 30 questions that are particular to a certain area, is the most popular assessment tool used when examining individuals with wrist and hand injuries. The MHQ offers great benefits to individuals who have sustained hand injuries. The CTQ appears to be highly sensitive to alterations in the clinical characteristics of carpal tunnel syndrome, yet the DASH and MHQ have both been demonstrated to be suitable for use in outcome research associated with the condition. The construct validity and responsiveness of the PRWHE is not much higher than that of the DASH when it comes to evaluating patients who have wrist injuries.
Laboratory studies
If the initial approach to the situation is unsuccessful, it is necessary to investigate and evaluate any other potential causes. The erythrocyte sedimentation rate and C-reactive protein are two tests connected to pain brought on by inflammation. Laboratory tests might be undeterminable but can point to inflammatory rheumatic sickness, above all, if only moderate inflammation is detected. The levels of rheumatoid factors may be high in people who have Rheumatoid Arthritis. However, they may also be increased in other illnesses, including Sjögren’s syndrome and Systemic Lupus Erythematosus.
Imaging
For wrist injury, it is recommended to have an X-ray taken with the wrist in a neutral position, as well as an X-ray with the hand positioned in both radial and ulnar deviation.
It is difficult to detect scapholunate instability on initial X-ray images right away, as it can take months for the scaphoid and lunate bone to sufficiently spread apart.
Ultrasonography can be used expeditiously to investigate potential problems involving soft body tissue, such as tendon grievances, increase in synovial tissue, cysts in the joint membrane, and ganglions.
An MRI can be reliable for the same degree as a bone scan in recognizing fractures and likewise gives details about the structures of softer tissue.
The Patient-Rated Wrist and Hand Evaluation is a survey about pain and incapacity with 15 questions for individuals to answer which is carried out after a hand injury to monitor the outcome.
A dynamometer can test grip strength and be used to spot such things as decreased muscle function caused by disuse, arthritis, carpal tunnel syndrome, epicondylitis, and issues with motor function that may be a symptom of radiculopathy.
The Purdue pegboard test can be utilized to evaluate agility with activities that demand large movements of the arms, wrists, hands, and digits.
The DASH questionnaire consists of 30 questions that evaluate a person’s capacity to perform activities involving their arms, shoulders, and hands. Every individual is asked to rate the amount of difficulty they experience in specific tasks and the amount that it disrupts their daily routine on a 5-point scale.
