P.T. For The M.F.

          Forgive me, I don't mean physical therapy for the mother fu...er. It's for the mallet finger. After having a consultation with the orthopedic specialist, he said that I didn't need surgery even though my middle finger was drooping slightly. He asked me if I needed physical therapy and I said yes, since I felt I needed more guidance with what rehabilitation exercises to do other than just sending me home with Theraputty® like the previous doctor did. 

 

          So I was given six sessions of physical therapy (three times a week for two weeks). During the first session, the physical therapist asked me about the history of the injury then proceeded test my grip strength

and make measurements of how much angle I could flex and extend the finger to get a baseline. She then told me to show her what types of exercises I had been doing with the Theraputty® and showed her two ways I would squeeze it. She showed me a few more things I could do which included digging into the putty with my fingers and other extension and strengthening exercises. In addition, I was shown exercises I can do with a rubber band and a dumbbell. Afterwards, she held my hand (without even buying me dinner first!), and started torturing me. OK, just kidding, but it sure felt that way initially. What she did was hyperextend the finger ever so slightly to the point of pain indicated by my yelling OWW! She did that a few times until the finger looked slightly straighter. She also did some passive range of motion exercises to the point of resistance which also resulted in some pain. Not that I wasn't expecting any pain at some point. Then she provided me some relief by attaching four electrodes on my fingers - two on top and two on the palm side. She connected the electrodes to a T.E.N.S. unit (transcutaneous electrical nerve stimulation) and turned up the power and started electrocuting me. Well not exactly. She turned the knob slightly and asked me to tell her when my fingers started to tingle and when I indicated as much, she stopped. The same was done for the electrodes on the palm side and a timer was set for twenty minutes. Oh I forgot, my hand was also wrapped with a heating pad. The T.E.N.S. treatment was supposed to improve circulation and break up scar tissue. 

          So I sat there and explored the room with my eyes to pass the time, wishing I had picked up a magazine to read from a rack at a corner of the room. Other patients came and went to do their therapies. Pretty soon the timer started beeping and I survived my time on the electric chair or Taser. The electrodes were removed and kept in a plastic bag with my name on it to be reused in the next session.

Lastly, they tried to make strike anywhere matches with my left hand which was dipped about 5 times in a container of lavender colored hot paraffin wax, then it was wrapped in white paper which somehow reminded me of fish and chips, then the papered hand was inserted in a terry cloth fingerless glove to keep the heat in. When the paraffin wax cooled in 5 to 10 minutes, off came the glove, the paper, and the wax had to be peeled off from the hand like a second skin. The lavender scent from the wax remained in my hand for a few hours and people were probably wondering why I was sniffing my hand so much despite the absence of white powder on it. 

          The session went for slightly more than an hour which I thought would last only half as long, although the time passed pretty quickly. Except for the initial measurements, subsequent treatment sessions were similar to the first. In my subjective assessment, after 5 treatments, my finger feels slightly stronger and more flexible, although I have more work to do by myself for further improvement after the 6th and final session.

          Much thanks are in order for the physical therapist and her assistant for guiding me and helping improve the function of my left hand and more specifically my healing middle mallet finger.  For privacy reasons, they declined to allow me to use their names. Even though the finger injury has been a major inconvenience to my daily activities, whenever I went in for physical therapy and was asked what my pain level was from 1 to 10, I always felt no pain. In contrast, the other patients who came in always mentioned some pain.

Left Middle Finger Injury Update - From Stax to Oval 8

From this makeshift splint
to

the Stax splint,
and now

the OVAL 8 splint

          The 8 week period for me to wear the splint on my left middle finger passed 2 weeks ago, and I was looking forward for the doctor to tell me it was okay to remove it and begin rehabilitating the finger. After 8 weeks of wearing the Stax splint as recommended for mallet finger injuries, the finger had become very stiff and swollen and I've been having a difficult time restoring the range of motion due to scar tissue that formed around the joints. Not only that, but the other fingers also got stiff because with the splint, I couldn't close my fist. I was given a week trial without the splint and was instructed to do active range of motion exercises and try strengthening my grip with Theraputty. When I returned to the doctor a week later, he didn't like the way the finger looked so he ordered the Stax splint put back on and also got authorization for an orthopedic specialist consultation. Unfortunately it would take another 3 weeks before the orthopedist can see me. Since I can't make a fist with my left hand and have a hard time grasping, at work, I am not able to assist my co-workers in case we have to restrain a patient.

          I've been searching for other kinds of splints and found the Oval 8 splint, but I've been holding off buying it myself hoping that 8 weeks on the Stax was enough to heal the torn tendon of the DIP (distal interphalangeal joint)or the knuckle near the nail. The advantage of the Oval 8 is that it's more open and less restrictive so that I could try bending the PIP (proximal interphalangeal joint) or the middle knuckle of the finger. When I learned that it would take more time to see the orthopedist, I finally measured my finger and ordered a set of 3 Oval 8 splints from Amazon.com. Since it was not supplied by the doctor, I had to pay for them myself. The set came in 3 different sizes and was recommended that way so in case my finger became swollen, I could switch to a bigger size or if the swelling went down, the finger would fit better in a smaller size. The Oval 8 also didn't require Coban tape to be used so I was able to wash my hands better. With the new splint, I could start to aggressively restore the range of motion to the PIP while the DIP remained immobilized and kept straight to hopefully continue to strengthen the healing tendon. I find that the joint is tight when I wake up in the morning, gets looser when I exercise it, then becomes more swollen in the evening thus more stiff. Meanwhile, I hope the orthopedist has better news when I see him in a couple of weeks.