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CzechM8
02-14-2010, 04:30 AM
Having searched for threads dealing with the trigger finger (the symptom has been mentioned in many threads, with this one being the most informative http://tt.tennis-warehouse.com/showthread.php?t=42312; btw, thanks a lot to scotus for his great input regarding this topic), I found that most of them were not very recent and thought I'd bring the topic back to life to get some feedback from the members who have some experience with this problem since the last posts were made.

Trigger finger refers to the inflammation of the tendon sheath in the fingers, which is typically demonstrated by the stiffness, "locking" or "popping" of finger joints, mainly in the morning. It is not as painful as it is bothersome - at least for me at this point.

I have the trigger finger symptom on two fingers on my dominant hand - the middle finger and the pinkie. On the middle finger it was caused by an injury about eight months ago. It is not particularly troubling and I can only feel it in the morning. Giving up tennis for several days/weeks helps temporarily but the problem is back the morning after I play. The pinkie is worse, there's a palpable lump or bulk under the first joint on the upper side of the pinkie. As it's probably a big obstacle in the movement, the flexed finger appears a little deformed. Contrary to what scotus mentioned as advice from his doctor (http://tt.tennis-warehouse.com/showpost.php?p=354398&postcount=4), I developed (or perhaps coincidentally noticed?) it after I'd put an overgrip on my racquet with an L4 size grip. I've changed racquets since then and now play with an L3 with an overgrip but the symptoms are still the same. Adding an additional overgrip does not help. Neither does taping the finger or using a flexible splint for me once the symptom's developed.

I've talked to a friend of mine who's a respected hand surgeon. He says the surgical procedure to remedy the problem is really simple and requires only about ten days until full recovery. Now I'm in the process of scheduling my league matches to finish my indoor season early, have the surgery, and still have time to play a little before the outdoor season begins. BTW, my friend strongly advises against cortisone shots, saying it's only a (rather painful) temporary solution and that I'll eventually end up under his scalpel anyway, especially if I'm not willing to give up tennis.

What's your experience with trigger finger, not only therapy-wise but also in terms of prevention? For example, did getting a more "cushiony" replacement grip help? Changing grip size? Exercises? Thanks to anyone that contributes.

topher.juan
02-14-2010, 08:03 PM
When I first took up tennis I had a k90 and absolutely no idea how to swing it. I did everything wrong, squeezed the racquet like a hammer and tried to muscle the ball as much as possible. It didn't take long for me to develop trigger finger in my right pinky; it was especially noticeable in the mornings (extend hand and pinky would hold back and then snap open). I stopped playing for 4weeks once this happened, I also taped my finger to a popsicle stick at night; used my hand minimally throughout the day. It went away, that was about 2years ago and I haven't had it come back since.

charliefedererer
02-14-2010, 08:15 PM
I have a friend that developed trigger finger of his thumb in late summer. He had two steroid injections about two weeks apart, and was back to playing tennis all fall.

Vyse
02-14-2010, 08:39 PM
I have it in my dominant hand pinkie. Actually, I don't really notice it anymore and it never really hurt. Just weird and annoying in the morning. Now since I think about it, it has been gone for awhile. I haven't done anything differently and I guess it just went away. Then again, I will probably think about it tomorrow morning and notice that it is still there.

scotus
02-15-2010, 10:55 PM
Hi, I am glad that my posts here have been of some use and help.

As you know, I have had chronic trigger finger for over 20 years.

I am persuaded that surgery might be the only way to truly be rid of this, but I am doing all I can to keep it under control without taking the surgical route.

My basic approach to managing trigger finger is 4-fold:

(1) Reduce shock to the finger joint/tendon
* Just as you would with tennis elbow, use equipment that reduces shock (That includes racquet and string)
* Having an additional overgrip definitely helps (now, that's 2 overgrips).
* Caveat: Since making the grip too big may force you to grip the handle too tightly,
(which would then force unnecessary flexion of your finger muscles),
it is best to go down a grip size, and then add 2 overgrips.

(2) Avoid repetitive or excessive finger flexion
* Use computer mouse with your non-tennis hand. Trust me, after about 3 days to a week of use,
your left hand will feel just as comfortable as your right hand.
* Change tennis technique if needs be
i.e., If you are gripping too tight, you need to loosen your grip.
For example, I used to volley with my grip too tight. But my coach taught me
that I need a firm wrist and loose grip instead.
Even on groundies and serves, watch all the top pros. They use loose grips.

(3) Strengthen the extensors
* We use finger flexors much much more than extensors, which results in muscle imbalance.
* Do extensor exercises as I described in previous threads.
Or purchase a finger exercise equipment. There are at least 2 devices being marketed for finger extensor exercises.

(4) Bring swelling down
* When the condition gets bad, use ice. Icing always brings swelling down.
* In addition to icing, an overnight splint is recommended (to keep the finger from flexing overnight).
It is the same principle as used in plantar fasciitis treatment.
* For those of you experiencing a great deal of locking and pain, you seriously need to ice and use splint.
I have not had to do this for quite some time.

I hope this helps. If you do opt for surgery, let us know of your progress.

Suezee
02-16-2010, 09:31 AM
As a PT, this is what I know: The flexor tendons in the palm and fingers travel within sheaths and are tethered-down by structures called pulleys. Aberant or repetitive motion can result in localized inflammation, swelling, and subsequent fibrotic nodules in the tendons. If caught early and before the tendon thickens with fibrotic changes, a cortisone shot can help. Once the nodule gets so thick that it continues to catch on the pulley, surgery is usually indicated. There's a treatment I do that might help someone who does not want to do surgery...it's called ASTYM and it can help the body to resorb some of this fibrotic tissue. I have only done it on 3 people, and it helped 2 of them right away...the third it didn't help at all. (The company's outcome data shows a success rate of 79.5%). "Regular" PT with friction massage and anti-inflammatory modalities never work for me, and splints only work during the inflammatory phase. Finally, ASTYM does not work if you have an underlying disease process that causes the problem, like Dupertyn's.