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-   -   When can I play tennis after sustaining a mallet finger injury? (http://tt.tennis-warehouse.com/showthread.php?t=442694)

markcoop 10-11-2012 09:32 AM

When can I play tennis after sustaining a mallet finger injury?
 
I hurt my middle finger on my dominant hand playing basketball a couple of days ago. I will have my finger in a splint for 6-8 weeks. Anyone have this injury and try to play tennis with it? If so, how soon after the injury? Obviously I can't fully grip the racket, but I think I can grip it enough to hit balls. I usually drill once a week and play in a league once a week at a 4.0 level.

Thanks for any input

LeeD 10-11-2012 10:19 AM

As soon as it don't hurt when you hit a volley, overhead, or serve.
Modern tennis is loosely held grips, and losing one finger means little.
Don't tape your middle finger to your index finger.

Vlad_C 10-11-2012 10:38 AM

After 10 weeks at least.

LeeD 10-11-2012 10:49 AM

OK, maybe the question should be, ...."HOW TOUGH ARE YOU?" or how dumb?
I raced motocross while in a cast, 6 pins, wire, and plate in the tib/fib. RACED, not just practice.
I raced motocross 3 weeks after breaking a collarbone, twice.
I windsurfed in high winds 3 weeks after breaking a collarbone.
I practiced for 2 weeks at the end of summer with the varsity high football team, with a broken fibula, displaced and overlapped by 1". Got it pinned first game of the season (surgery, 3 screws, 21 stitch opening), and played the final 2 games of the fall season in late Nov.
Am I stupid? Of course! Am I tough? You decide.

Chas Tennis 10-11-2012 12:05 PM

There are a few threads on mallet finger in Health & Fitness.

markcoop 10-11-2012 04:27 PM

Thanks for the responses. My biggest concern is hurting my finger further, or delaying the healing process. I would wear a splint that prevents the finger from bending, but I'm concerned about the vibration traveling to the finger.
I think the pain will be ok.

I did read through some of the other threads. I didn't find specifically what I'm looking for (will I cause further damage if I'm wearing the splint).

LeeD 10-11-2012 04:35 PM

Accidents can happen.
You can hit for an hour without your middle finger just fine, and then ONE stroke, you forget and use your middle finger, and instant reinjury.
But you know that. Any body part that is not 100% is your weak point.
Just what is tennis worth to you?
Nobody can guarantee your tennis future. It might be fine, it might not. You can only control the NOW part of life.
As in life, goes tennis.

markcoop 10-11-2012 04:53 PM

Quote:

Originally Posted by LeeD (Post 6949178)
Accidents can happen.
You can hit for an hour without your middle finger just fine, and then ONE stroke, you forget and use your middle finger, and instant reinjury.
But you know that. Any body part that is not 100% is your weak point.
Just what is tennis worth to you?
Nobody can guarantee your tennis future. It might be fine, it might not. You can only control the NOW part of life.
As in life, goes tennis.

I understand and appreciate your attitude. I've seen it in other threads as well. Of course tennis means alot to me or I wouldn't be posting this thread. I understand an accident can happen and I'm willing to live with that. I'm trying to understand if an accident doesn't happen, will I further hurt my finger just by normal play.

Chas Tennis 10-11-2012 05:04 PM

Quote:

Originally Posted by markcoop (Post 6949164)
Thanks for the responses. My biggest concern is hurting my finger further, or delaying the healing process. I would wear a splint that prevents the finger from bending, but I'm concerned about the vibration traveling to the finger.
I think the pain will be ok.

I did read through some of the other threads. I didn't find specifically what I'm looking for (will I cause further damage if I'm wearing the splint).

You need to ask your Dr those important questions, not people on the internet.

There is plenty of information searching. Here is a more detailed description by some Dr. I would not accept anything from this article but use it to extend your research of your injury.

http://www.togct.com/downloads/berns...let-Finger.pdf

http://www.bssh.ac.uk/patients/commo...etfingerinjury

A friend of mine has it. I do not think that his injury will completely heal. He was injured catching a platform tennis ball. If it were my injury I would do everything your Dr says and more to give my tendon every chance to reconnect or otherwise heal.

How did it happen, did the BB hit the end of your finger?

LeeD 10-11-2012 05:05 PM

Most of my doctors knew I was going to resume my sports while still in the recovery process.
Before my time, the accepted course of action for any injury was rest rest rest, no stress and rest some more.
During the late '60's, a new idea was put forth by some "medical experts"... maybe use the body to promote whatever the body needs to heal and recover is better than sleeping an laying around ???
With any usage, there is always in increased chance of a re injury, while the injured part is still healing. That is countered by the effects of exercise to accelerate the body's natural healing process.
Every doctor told me not to exercise (do my sport) as their first course of counsel, to cover their butts. EVERY doctor smiled and said, "good luck, don't crash, and let's see" when I told them I was going back to racing in a cast, or while the collarbone was one week set.
I made the decision to take the chance. They reaped the benefits of the dumb test dummy.
After 5 days removed from my 13 month left leg cast, I went surfing in the heaviest WestCoast waves, OceanBeachSF at 6' and hollow. I had made a fiberglass "cast" to tape around my shrunken leg, to support and protect it in case the surfboard hit it wrong. I used crutches to get to the water's edge.

charliefedererer 10-11-2012 07:51 PM

Don't screw up your finger for life.



After an acute injury, the process of inflammation begins.

Cells at the site of injury release chemicals (cytokines) that cause protein strands to be laid down to heal the torn tendon.

Those protein strands are thin and flimsy like a spiders web.



Like a spiders web, those strands are easy to break with any movement.



Over time though (six weeks) those strands are bound together, just like the many strands in a rope or cable are bound together to form one strong rope or cable.









The problem is that with early movement, the ends of the tendon pull apart again, tearing the fragile protein strands.

The body has to start over again.



If too many restarts happen, each end of the tendon seals over in scar tissue.

Only surgery to cut away the excess scar tissue and fixation of the two ends surgically would then result in healing.

But with such extensive inflammation and surgery around such a small joint as exists at the end of the finger, you increase the chance that the joint "freezes" from getting involved in the inflammation - with excessive internal scar tissue freezing the joint movement.



So don't blow your chance at healing by playing tennis. You have to grasp the racquet too firmly to avoid motion.




I gave up playing tennis for 6 weeks when I incurred a mallet finger when I attempted to catch a smashed tennis ball, rather than let it fly into an adjacent court.
That was years ago and I am pleased to have a normal functioning finger.

makinao 10-11-2012 09:04 PM

Did you get it x-ray'd? I had the same problem in my non-dominant hand may years ago, and an x-ray revealed one joint was broken into 3 parts. It required surgery, a retaining pin and splint for 3 weeks, then another 3 weeks of physio-therapy. Got back most of its range of motion. While it was my non-dominant hand, I have a 2-handed backhand. I had to re-learn a 1-handed backhand before it was completely healed. So now I have both in my arsenal.

Chas Tennis 10-12-2012 12:52 AM

Quote:

Originally Posted by charliefedererer (Post 6949458)
............................................

I gave up playing tennis for 6 weeks when I incurred a mallet finger when I attempted to catch a smashed tennis ball, rather than let it fly into an adjacent court.
That was years ago and I am pleased to have a normal functioning finger.

I'm trying to understanding this injury and so far have the following picture: The tendon that goes to the end of the finger on the top attaches at more than one location on the bones of the finger (I have to check this). ?. The last attachment on a finger is small and if an impact or other stress occurs in an unfortunate way the tendon rips off at the last attachment. There is difficulty in healing if the tendon is completely off the bone and somehow must find & reattach to the bone. If some of the tendon is still attached I guess healing is much more likely. ?



There's often a lot of uncertainty with injuries even after MRI's and other imaging. Since you had this injury, do you know the nature of your tendon damage, complete or partial detachment? If you don't know, can you speculate on what might have happened especially since you healed so well?

markcoop 10-12-2012 05:55 AM

I didn't go to a doctor. After some quick searches, it seems so obvious what I have. I guess I don't know if there is a fracture or a tear (an x-ray would show the fracture), but the treatment is the same (splint). I guess I'm guessing a bit here that there's not a big (or multiple) fracture that would require surgery. It didn't seem that bad when it happened. No pain. Just caught the tip of my finger on the basketball. It was a bit freaky that I couldn't lift the tip of the finger. I felt the top of the joint and didn't feel anything crazy. So, no doctor to ask.

charliefedererer - That was a great explanation. The best I've seen and consistent with everything I've read.

So assuming I want to do something stupid (like play tennis while it's healing), I guess the longer I wait the better. I mean playing after 3 weeks would most likely be much better than playing right now because those strands are stronger. Remember, I'm not going to bend my finger for 6 weeks. Just want it to heal to the point where it could withstand some vibration.

charliefedererer 10-12-2012 08:43 AM

Quote:

Originally Posted by Chas Tennis (Post 6949778)
I'm trying to understanding this injury and so far have the following picture: The tendon that goes to the end of the finger on the top attaches at more than one location on the bones of the finger (I have to check this). ?. The last attachment on a finger is small and if an impact or other stress occurs in an unfortunate way the tendon rips off at the last attachment. There is difficulty in healing if the tendon is completely off the bone and somehow must find & reattach to the bone. If some of the tendon is still attached I guess healing is much more likely. ?



There's often a lot of uncertainty with injuries even after MRI's and other imaging. Since you had this injury, do you know the nature of your tendon damage, complete or partial detachment? If you don't know, can you speculate on what might have happened especially since you healed so well?


Most with this injury have a complete tear of the tendon from a very sudden force applied to the finger tip:




Besides the more common complete tear of the tendon, if the force is applied more slowly, it is more likely that the tendon pulls off a piece of the bone it is attatched to, as in the second pic below (fracture of distal phalanx):




Both types of injuries usually respond to a splint.


Occasionally, a more complex injury occurs where the bone and tendon retract. My understanding is that complex injuries are more likely with unusually high forces like in an auto accident, or a crush injury involving machinery.
The examining hand surgeon would then more likely find on physical exam a larger bony fragment palpable under the skin, or the bump of a retracted bone and tendon further down the finger.
These unusual circumstances might prompt an MRI to further investigate what is going on, but I don't think an MRI is obtained with mallet fingers that occur with a common ball injury, and that don't have a larger fragment of bone or curled up tendon under the skin.
More complex injuries may have to be surgically repaired, to pull the retracted tendon/bone into alignment and fix it there with sutures or a pin.



["Mechanism of injury" is a term taught to all who are involved in trauma care.
The greater the force involved, the greater the resultant injury.
Also understanding the way the injury incurred often allows one to predict the type of injury, or at least be more alert to order further imaging to better delineate the extent of the injury.]

OHBH 10-12-2012 08:53 AM

Practice lefty, it will do wonders for your game when you return to playing with your dominant side

Chas Tennis 10-12-2012 09:00 AM

Quote:

Originally Posted by markcoop (Post 6950063)
I didn't go to a doctor. .................................................. .................................................. ...
So assuming I want to do something stupid (like play tennis while it's healing), I guess the longer I wait the better. I mean playing after 3 weeks would most likely be much better than playing right now because those strands are stronger. Remember, I'm not going to bend my finger for 6 weeks. Just want it to heal to the point where it could withstand some vibration.

If the tendon is completely detached it may or may not reattach - permanently. To maximize your chances of healing you need to see a well-qualified Dr.

LeeD 10-12-2012 09:05 AM

So, is the joint still red, swollen, sensitive, and seems to itch as well as sting?

markcoop 10-12-2012 06:30 PM

Quote:

Originally Posted by LeeD (Post 6950453)
So, is the joint still red, swollen, sensitive, and seems to itch as well as sting?

The joint is a little swollen, sensitive, a little discolored, not itchy or sting.

Chas Tennis - I do understand the suggestion to see a doctor. There's a part of me that agrees. Since I really don't believe there is any major fracture in there (based on touch, lack of pain, low swelling, not a huge impact), a small fracture or tear will both be treated with a splint. I immobilized the finger the first night (Tuesday). If I do go to a doctor, most likely on Monday, they will certainly bend the finger and I'd be a week behind the heeling practice.

LeeD 10-12-2012 06:40 PM

I think most of the guys who played under the basket in high school got that, me included. Red, swollen, can't move it, stinging pain, a little itchy bother.
I always was careful to go up with my other hand, not the shooting hand, to rebound. Also, when attempting a shot block, same thing, save your shooting hand. Took half the season to heal, usually after the Bball season was over.
I still have 5 crooked fingers from breaks and sprains, no biggie. Badge of stupid, that's all.


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