Mallet Finger – Diagnosis, Treatment, and Rehabilitation

How to take care of and recover from a common but sometimes vexing finger injury.[1]

Mallet finger usually results from forced flexion of the distal (most distant) part of the finger (distal phalanx – DP) during active extension of the DP. The condition is caused by a rupture of the extensor tendon (on the back of the finger) that crosses the distal interphalangeal joint (DIPJ) from the proximal phalanx (PP) to the DP. Part of the bone may also be avulsed (pulled away). Mallet finger is the most common closed tendon injury in athletes.[2] Often, patients explain that a ball hit their partially flexed fingertip. Patients complain of pain, swelling, and an inability to fully extend their DP.

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Sticks and Stones

The world tells us that we are helpless against the insults of others. It insists that every hardship leaves a wound that will never heal. Our forebears thought differently, and better. 

“Sticks and stones will break my bones but words can never hurt me.” I am old enough to remember a time when parents taught this pithy little rhyme to their children, and society at large believed it. We live in a new day, in which many Americans consider emotional injury as deadly, and more enduring, than physical injury. News accounts of emotional abuse, cyber bullying, and their mental health consequences such as depression, anxiety, and even suicide, pull at our heart strings. Girls, the lonely, and the young are at greater risk. Colleges, including those which my children attend, have safe spaces, trigger warnings, and strict rules against insensitivity and inflicting emotional trauma.

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Rehabilitation – Bringing Injured Bodies Back to Health

Everyone wants to be physically better than they are, but for most of us, getting back to a good baseline of health is the goal. In our increasingly out of shape and older population, rehabilitation is the best thing to do. 

Recently I introduced the three different general goals of fitness; rehabilitation, basic fitness and performance.  Today we will discuss the first of these goals…rehabilitation.  How many of us have been injured in the past?  Probably everyone over the age of five can remember a significant injury.   What do we normally do after the injury?  Most people wait until the pain and swelling resolve, assume it has healed, and go on about their normal activities, never thinking about the injured part of their body until it is hurt again.  Whether we are competitive or part time athletes, or just people who’ve had injuries and is not quite back to normal, everyone needs to know some basics about rehabilitation.

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