This series on injuries serves to highlight a few common, everyday injuries and provide some background. Any physical damage should be dealt with by a medical practitioner or trained physiotherapist, who will recommend if any specialist intervention is required.
A Quick Look at Hand Injuries
The hand is composed of 19 bones (5 metacarpals and 14 phalanges), more than 30 tendons and numerous complex structures. The metacarpals are long, thin bones that are located between the carpal bones in the wrist and the phalanges in the digits (fingers).
A metacarpal fracture is a break in one of the five metacarpal bones of either hand and can occur either at the top (head), middle (shaft) or bottom (base) of the bone. Falling off your bicycle or onto your hands in an accident are dominant causes. Boxers are susceptible to a fracture of the fourth or fifth metacarpal as they punch objects (and other boxers) with a closed fist.
Patients with metacarpal fractures generally experience:
– Pain, swelling and/or bruising
– Limitation of movement
– Deformity or finger misalignment
– A metacarpal head fracture may be the cause when you cannot extend your finger(s)
– In a metacarpal base fracture, movement of the wrist or stretching your hand open wide increases the pain.
A fracture may occur in your wrist (radius/ulna) from direct impact or falling on an outstretched hand. The most common type of fracture in the wrist is called a ‘colles fracture’ and is often referred to as a ‘dinner fork fracture’ due to the deformation the wrist makes.
You will experience the following symptoms if you have fractured your wrist:
- Tender to touch
If there is a deformity, it is best to visit your GP to get X-Rays done before coming for physiotherapy.
How does physiotherapy assist with wrist and hand injuries?
Fractures of the hand generally take between 4-6 weeks to form a callus and 6-12 weeks to be fully healed. The physiotherapist’s role is to regain any loss of movement that you would have sustained during the period you are in a cast (Plaster of Paris), help you strengthen the affected muscles and return you to your previous level of function.
How do we achieve this? By using hands-on techniques, a physiotherapist can loosen the muscle, joint capsules, and any other muscle or joint structures keeping you from moving your hand like you did before. Thereafter, a graded rehabilitation programme will be prescribed to regain your strength in the injured area.
You can start physiotherapy six weeks after a fracture occurs, but some doctors will require that you start sooner.