commentary Miscellaneous trigger finger

Trigger finger release

I have recently had a surgical procedure to release a bad trigger finger condition on the middle finger of my right hand which I previously discussed in my post titled ‘Trigger Finger and RSI?‘. The problem is also accurately summarised with diagrams on this page about trigger finger.

Trigger finger is where a finger in a gripping position appears to lock in place. When you pull the finger open, it unlocks with a click (or in my case a loud ‘clunk’ which made anyone around me squirm!), hence the name trigger finger. The condition is caused by a nodule growth on the tendon which gets stuck on the pulley (sheath) system that is there to guide/hold the tendon in place. Doctors have minimal knowledge about why this nodule forms. Nodules on tendons can come and go on their own, but this one has been bad and persistent.

The build up to the operation had certainly been playing on my mind for several months. Unsurprisingly the mental prospect of the surgery was the worst part since the operation itself was only 15min in duration and was carried out under local anaesthetic (although I avoided the temptation to watch it!).

The procedure itself involved cutting open the sheath(pulley) that was causing the tendon restriction to occur, which freed the movement of the tendon (and nodule). The surgical entry point was  on the palm of the hand just below the finger, and the incision itself was only about 1 inch long.

Recovery time has been fast. I am now nearly 3 weeks post op, the stitches are out , and the skin on the scar has fully healed over. I still have joint stiffness, and a bit of swelling which causes my finger to stiffen up in the bent position, but I expect this to gradually subside over time, especially after I keep stretching it like I have been instructed to do by the physiotherapists.

It is too early to do a complete assessment of the experience, but I can say that it’s great not having an annoying triggering finger condition any longer!

I wish there was a simple solution like this to my RSI condition!

UPDATE : 1 month post op

It’s now been about 1 month post operation, and I thought I’d update this post. Although the scar on the plam of the hand is healed over, however I still have a lot of  sensitivity about the entrance wound, as well as a lump under the wound. Not sure at this point if the lump is scar tissue or the nodule. The triggering has gone, but I still have a lot of stiffness in the joint, and the finger still likes to stick in the bent position (I have to physically bend it straight with my other hand). Hopefully this is just a result of the swelling and that this will go away on time. I am using the finger, but it can be sore depending on the task at hand.

Update: 2 1/2 months post op

The finger is getting  better all the time. It doesn’t stiffen up as frequently as before, but it still can stiffen quite badly and there is no cause I can determine for this. I recently had a follow up with the surgeon, and was advised that post op stiffness is common, and recovery can be as much as 18 months for some individuals – they don’t tell you that before the op! He suggested massaging the joint to reduce the swelling. The scar has totally healed up now, and is a whole lot less sensitive than it was a few weeks ago.

Update: 6 months post op

It’s certainly taken it’s time, but the finger is showing very little stiffness now. I can extend it fully contract it fully, grip things tightly, and have no sign of that horrible triggering any more. I can officially say the op was a success. It does go to show that there is a 3-6 month recovery term for this operation. Good luck with the operation if you are someone who is considering having it done and just factor in a few months for the recovery.

Rate this post! [ratings]

Ergonomics fitness Lifestyle Miscellaneous Review

Move Well and Avoid Injury DVD : Review

DVD : Move Well Avoid Injury : What everyone needs to know about the body (by Barbara Conable and Amy Likar, Andover Productions, 2009)

movewell_frontcoverI may not be a medical professional, but I am able to tell when I encounter descriptions of body motion that just make plain sense, and this DVD contains some enlightening information. In a collection of well narrated chapters complete with diagrammatic video illustration, the evidence is laid bare of our common tendencies to keep our bodies out of balance, causing pain through muscle tensions that, in turn, keep our bodies in bad posture. This is due in part to us having mapped the body in a particular way, eg in relation to position, when in reality the position is entirely different.

This DVD is broken into multiple sections covering the many aspects of posture imbalance, and covers areas from the head to the feet and just about everywhere in between. Posture is translated by the authors as ‘Body Maps’ which are essentially memories in your mind of where you think your individual body parts are and how you use them. The DVD highlights how you may have had a flawed map (understanding) of your various body parts in your mind from a very young age. This may have led you to actually move according to those flaws and results in the straining of some parts of your body which can lead to pain. As the narrator tells us, “We move in the way in which we think we are constructed …”, either consciously or unconsciously. Wrong body maps can be responsible for many bad posture related problems, from walking to sitting, to using a computer.

Subjects covered in the DVD include –

  • Body maps – identifying flaws in the human body map and how to recognise those errors
  • Balance – identifying correct balance with core posture, and identifying posture related pain
  • Kinesthesia – learning free and fluid movement to correct body imbalances
  • Arms – covering shoulders, elbows,  wrists and hands
  • Legs – covering hips, pelvis, knees and feet
  • Breathing – covering lungs, skeletal/muscular system, diaphragm
  • Mapping the whole body
  • Correcting the map
  • Inclusive attention

The areas I can relate to most pertain to the shoulders, arms, wrists and hands. These are covered in detail and are very applicable to the RSI sufferer. The main posture/skeletal issues with RSI type injuries are listed, adding to the viewer’s knowledge and understanding through plain and straightforward explanations along with clear diagrams and video.

From previous experience, I knew that over-supination of the wrists was a bad thing, but now I know about the natural axis of rotation of the forearm and how it ties in with a neutral position wrist, as well as why supination causes so many injuries.

The company website rather generously shows sample videos of some chapters which are well worth checking out, and will give you a sneak peak of the DVD content and style as well as some key body map information!

I also found the section on breathing very interesting. It’s probably the first time I’ve been able to picture the role of the diaphragm in breathing, and I certainly had my lungs mapped as being a bit lower than they actually are. The related section on the ribcage was also revealing to me having just recently strained my sternum connective tissue whilst gardening. It  also reinforces the benefits of some breathing practices including Yogic breathing (Pranayama).

The DVD run time is a substantial 2hrs,  and certainly lends itself to being watched in stages. There is the temptation to skip straight to the section you are most interested in, however it should be watched as a whole to get the complete picture and overall message firmly ingrained in your mind. I expect that multiple viewings would be best to fully absorb the detail.

All in all this DVD is an excellent resource for just about everyone. It is not solely aimed at one specific group of people eg RSI sufferers, but covers the whole body, and should be a useful education tool for everyone, including ergonomists, physiotherapists, fitness instructors, yoga teachers etc, as well as many others including in the medical profession.

If you have posture related pain it’s likely that it’s down to your bad body map and it’s certainly time to re-educate yourself!

Rate this post! [ratings]