Should your finger get itself in a jam, here's how to rescue it, and prevent it happening again:
With all the focus on knee, ankle, hip, back and shoulder problems associated with sports, debilitating injuries to the fingers often receive little attention, even though they are relatively common. The fact that finger injuries occur in a wide variety of sports, from football to basketball to rugby and tennis, should not be a surprise. An athlete's two hands contain a total of 30 finger bones (each finger has three bones, or phalanges, and thus each hand has 15 finger bones), and these bones are connected at their joints by bands of collagenous material called ligaments. Each joint is vulnerable to sprains (partial tearing and disruption of ligaments), strains (over-stretching of the ligaments), dislocations and complete ligament tears during sporting activity.
A 'jammed finger' is simply a finger which is troubled by a sprain, strain, or dislocation of one of its joints. The jamming may result from an impact with an opponent or teammate, sudden contact with a ball, a fall, or any sudden stretching of a finger. Falls onto hard, unyielding surfaces (for example, a basketball floor) are particularly likely to produce jams. As mentioned, the ligaments between finger bones may tear, especially if the joint is dislocated (ie, if bones move out of their normal relative positions). In a typical jam, a finger joint is forced together, with twisting of the joint involved as well. This compression and torquing often leads to dislocation, which can resolve itself within seconds or might persist until medical attention is received.
Interestingly enough, the joint between the middle bone of a finger and the bone closest to the hand is the one which is most frequently harmed during sporting activity. Also interestingly, the middle finger of the hand is the most likely candidate for jamming. Theories abound about why this is so, but perhaps the best explanation is the simplest one: the middle finger is usually the longest one and thus tends to be most exposed to contact injuries.
What to look for
How do you know that you have jammed a finger? If your normally straight finger is suddenly crooked, that's clearly an obvious sign of jamming. If your finger joints are not dislocated but your finger is severely painful, swollen, discoloured, and/or relatively immobile, you probably have a jam - and you should stop your sporting activity and seek medical help.
Not surprisingly, many athletes react to a jammed appendage by saying, 'It's just a finger; it will get better on its own in a day or so'. The reality, however, is that untreated jams often get worse over time, with pain and swelling increasing over a period of several days, especially if the finger receives further contacts during training or competition.
If you have dislocated a finger joint, you must first get the joint restored to its normal position. When you look for someone to put you back together, a teammate may be willing to oblige, but you should search for a health-care professional with finger-jam experience instead; inexperienced persons who try to straighten out your finger might actually increase the extent of injury at the damaged joint.
Ice should be applied as soon as possible after a jam occurs (however, if there is a dislocation it should be rectified before the ice is utilised). Icing should occur in 12-minute intervals, with 20-minute breaks between ice applications, for at least the first 24 hours after injury. The injured finger should be elevated, and compression (via an elastic wrap) can be applied; the compression bandage can remain in place continuously. However, you should be certain that the compression is not too great by noting the coloration of your finger nails; if even a faint blue colour appears, the compression is too tight. If over-tightness is identified, remove the compression bandage for a while and reapply it more loosely later.
What to do if the pain persists
What if these treatment modalities fail to relieve your pain? If your finger joint is still swollen and 'kicking' with discomfort after 24 hours of treatment, you should consider getting an X-ray of the injured finger to check for a fractured bone. If X-rays show a fracture of one of the finger bones, the finger may need to be set and supported (splinted) or - in some cases - either placed in a cast or corrected surgically. If there is no break, you can try alternating cold and heat applications to the injured digit, 12 minutes of icing and 12 minutes of heating are probably about right. There is debate about which should come first, but a heat-ice sequence may be the correct one; any increase in inflammation induced by the heat will be toned down by the subsequent ice application. Try this alternating pattern three to four times daily.
One of the most popular treatments for jammed fingers involves 'buddy taping', ie, taping the injured finger to one its adjacent partners. A buddy-taped finger is protected to a certain extent by its neighbour, particularly if the neighbour happens to be the middle finger, and injured athletes can often return to training or competition within a day or two after sustaining the injury, provided the damaged digit is satisfactorily buddy-taped.
Once the injury has occurred, athletes can take non-steroidal, anti-inflammatory drugs for two or three days post-injury to control inflammation and pain; a diet which is rich in omega-3 fatty acids should also be followed (such a diet should actually be used routinely). In a typical case of jammed finger, when the injury does not include a broken bone and when any related dislocation has been properly reduced, pain, swelling, and inflammation usually are gone or significantly reduced within three to five days. On the other hand, if there is a break of a bone, a splint or cast may need to remain in place for three to six weeks, and even after this relatively prolonged period there may be some pain or swelling which persists for weeks.
As mentioned, if the injury is limited to a strain or sprain, an injured athlete can often return to play soon after sustaining the injury, as long as the injured finger is taped to its adjacent uninjured neighbour (failure to do this increases the risk that a strain will become a sprain or that a sprain will lead to a significant dislocation). The taping, of course, should be undertaken only if pain permits and with the consent of the treating health-care professional. If the pain and/or swelling are severe, however, an athlete may be out of action for a couple of days, and in the case of a break, sport participation may be delayed for a month or more, depending on the sport and the severity of the injury to the joint.
What preventive action to take
Athletes need to know about the steps they can take to reduce their risk of jammed fingers, and it is obvious that increased strength of the fingers, hands, wrists, and forearms should be helpful in warding off injury. Within limits, improved flexibility of the fingers, hands, and wrists should also be injury-preventing. However, in many sports which involve rather violent contacts and falls (for example, basketball, football, American football, rugby, volleyball, softball, baseball, and cricket), jammed fingers can occur even in individuals with very strong and flexible hands. If a ball coming off a cricket bat at 90 miles per hour strikes the end of your finger dead-on, for example, all the strengthening routines in the world may not prevent your finger from getting a serious jamming, or even a fracture.
Nonetheless, we do recommend a series of strengthening exercises to lower the risk of jammed fingers which might occur as a result of less-high-speed, lower-force impacts. Of course, these exercises are the same as the ones used to 'rehab' a jammed finger after symptoms have subsided. The exertions are designed to upgrade strength and range of motion in the fingers (the latter effect is particularly important when a finger has been immobilised as a result of injury). Here are the key exercises:
(1) The ball squeeze. Place a tennis ball or equivalent in the palm of the injured hand and squeeze as forcefully as pain permits for five seconds. Slowly relax the hand. Rest for five seconds. Repeat 10 times at least three times a day. Generally, the more often the sequence can be repeated in a day, the better. From day to day, pain should subside until the exercise can be performed without pain.
(2) Finger extensions. Place your hand, palm forward, on a wall or other flat surface. Press the palm toward the flat surface as fully as pain permits and hold for five seconds. Return to starting position and rest for five seconds. Repeat this sequence ten times at least three times a day. The more often the sequence can be repeated in a day, the better. From day to day, pain should subside until you reach a point at which the exercise can be done without pain.
(3) Finger push-ups. Assume the regular push-up position, with your arms slightly beyond shoulder width and your body perfectly parallel with the ground, but support full body weight on your finger tips, not your palms. Bend your elbows and lower yourself until the tip of your nose touches the ground, and then immediately push yourself back up into the starting position. Don't forget to fully extend your arms when you come back up. No cheating - don't rest your chest on the ground!
(4) Diamond finger push-ups. Just like No. 3, but your feet should be spread shoulder-width apart and your hands should be placed together, making a 'diamond' shape with your thumbs and index fingers. Again, support body weight with your fingers instead of palms, and feel the burn!
(5) The scorpion. Get down on your hands and knees, and place your hands directly under your shoulders, with your palms spread on the floor and your knees directly under your hips (the tops of your feet should be resting on the floor). Straighten your arms, but do not 'lock' your elbows. Place your right forearm on the floor, with your right hand just behind your left wrist. Reach behind you with your left hand, twisting your torso slightly to the left, and grab your right ankle. As you inhale, lift your right knee off the floor, raise your chest until it is roughly parallel with the floor, and look up. Find a comfortable height for your chest and raised leg. Now, lean slightly forward to increase the pressure on your forearm, and steady yourself by pressing your right forearm and right fingers on the floor. Stay in this position for about six inhalations and exhalations, and then repeat the overall manoeuvre with your left forearm bearing body weight. The scorpion improves hand and forearm strength as well as overall coordination and balance, all of which are important during the kinds of falling movements which can create jammed fingers.
If you complete the above exercises faithfully, your fingers will be 'stronger than the next man's,' and - most importantly - your risk of getting a painful finger jam will significantly decrease.