Trigger finger, also known as stenosing tenosynovitis, is a common condition that affects the flexor tendons of the hand, causing a catching or locking sensation in the fingers or thumb. Affecting an estimated two to three percent of the general population, this condition can significantly impact daily activities. Non-surgical management, including targeted exercises, is often the first line of defense. These specific movements are designed to promote smoother tendon movement and reduce stiffness, offering a practical path toward relief and improved hand function.
Understanding Trigger Finger
Trigger finger is a mechanical problem resulting from a disproportion between the flexor tendon and the pulley system that secures it to the bone. The hand’s flexor tendons glide through a series of fibrous tunnels called pulleys. The A1 pulley, located at the base of the finger in the palm, is the site most commonly involved in this condition. The issue arises when the tendon or its surrounding protective sheath becomes inflamed, causing it to thicken or develop a small nodule. This enlargement prevents the tendon from smoothly passing through the narrow opening of the A1 pulley, leading to the characteristic clicking, popping, or painful locking. Symptoms often present as morning stiffness and tenderness at the base of the affected digit.
Specific Therapeutic Exercises
The primary goal of therapeutic exercises is to encourage the affected tendon to glide more freely through the pulley system. These exercises focus on gentle, controlled movements that avoid forcing the tendon to catch. A cornerstone of this therapy is the sequence of Tendon Gliding Exercises.
Tendon Gliding Exercises
Tendon Gliding involves a series of five specific positions, starting with a straight hand. The sequence moves to a “hook fist” where only the middle and end joints are bent. This is followed by a “full fist,” where the fingertips touch the base of the palm, and then a return to the straight position. Performing this sequence slowly and deliberately helps to maximize the differential movement between the flexor tendons and their surrounding sheaths.
Blocking Exercise
Another beneficial movement is the Blocking Exercise, which isolates movement to specific joints in the finger. For the affected finger, hold the middle joint straight with the opposite hand. Then bend only the fingertip joint (Distal Interphalangeal joint). This isolates the tendon’s excursion and can increase the range of motion at the end joint.
Gentle Passive Stretching
Gentle Passive Stretching can also help alleviate stiffness, particularly a prayer stretch for the wrist and fingers. Start with palms together in front of the chest and slowly lower the hands toward the waistline, keeping the palms touching, until a mild stretch is felt. Each position within the exercise sequence should be held momentarily before smoothly transitioning to the next, never forcing the movement to the point of a painful click.
Integrating Exercises with Conservative Care
Exercises are most effective when they are part of a broader conservative management plan and performed multiple times daily. For initial relief, performing the exercises three to five times per day is recommended, gradually increasing the frequency to once every hour as tolerated. It is important to perform the movements slowly, aiming for smooth motion rather than speed or force, and always stopping before triggering occurs.
Complementary treatments include activity modification, which means avoiding repetitive gripping or heavy pinching that exacerbates the condition. Specialists also recommend nocturnal splinting, which holds the affected finger in a straight position while sleeping. This prevents the finger from bending into the position where it typically locks, allowing the irritated tendon to rest and reduce inflammation. Applying ice to the base of the finger for 10 to 15 minutes, three to five times a day, can help manage acute swelling and discomfort.
When to Seek Professional Guidance
While exercises are an important first step, a hand specialist or orthopedic doctor should be consulted if symptoms persist or worsen despite four to six weeks of consistent exercise and rest. Failure to improve with conservative measures suggests the condition may require more advanced intervention.
Immediate consultation is advised if the finger becomes permanently locked in a bent position, known as a fixed flexion deformity. This indicates a more advanced stage of the condition that will likely not resolve with exercise alone. Further medical steps may include corticosteroid injections to reduce inflammation in the tendon sheath, or a surgical release of the A1 pulley for severe, persistent cases. Patients with underlying conditions like diabetes may also benefit from earlier specialist consultation, as their trigger finger often has a higher rate of recurrence and treatment failure.