Within the hand are rope-like structures called tendons that bend and straighten the fingers. These tendons attach to muscles in the forearm and onto bones in the fingers. When the muscle contracts, they pull the tendon which moves the finger. These tendons are located on the back and front of the arm.
The tendons on the front of the palm are called the flexor tendons (because they bend or flex the digit). There are two flexor tendons per finger, the deeper of the two is called flexor digitorum profundus (FDP). This tendon pulls the fingertip into flexion and is the one injured during a Jersey Tendon Injury.
Definition
A Jersey Tendon Injury is a rupture of the FDP tendon where it inserts onto the tip of the finger. The tendon pulls off the bone, sometimes taking a small piece of bone with it. This results in an inability to bend the tip of the finger.
Causes
These injuries are often sports-related. The name (Jersey Tendon Injury) relates to the common way this injury occurs. When an athlete grabs an opponent’s jersey or top, their finger can get caught as their opponent tries to get away. This creates opposing forces to the tip of the finger, i.e. the hand is trying to maintain its grip while the finger is being forced straight. The forces acting on the tendon can cause it to tear or pull off from the bone.
Signs & Symptoms
Jersey Tendon Injuries may present with the following symptoms
- Pain in the fingertip
- Inability to bend the fingertip
- May have felt a “snap or pop” at the time of the injury
- Loss of grip strength
- Swelling or bruising in the fingertip
Treatment
Ideally, this type of injury needs surgery as soon as possible, preferably within 10 days. The reason for this is that the tendon can retract up the arm and becomes very difficult to pull back into place. During surgery, the tendon is reattached to the bone, often requiring an anchor.
Post-op a thermoplastic splint is fabricated by your hand therapist over the back of the forearm and hand. This splint prevents the fingers from straightening completely so that the tendon can heal without tension. Once the tendon is deemed ready, an exercise program is commenced. There are various exercise protocols that can be used, and a discussion with your surgeon will determine which one is most suitable for you.
Exercises are designed to gently move the operated tendon. Regardless of the type of exercise program, you will be unable to use the operated hand for any activities, even light tasks, for the initial post-op period. Unexpected force or movement through this hand can result in the tendon rupturing again.
Post-surgery, you will need to wear a splint for approximately 6 weeks full-time, after which it will be weaned. Strengthening exercises are generally commenced at 8 weeks. The tendon will take 12 weeks to fully heal. Throughout this time, your hand therapist will work closely with you to ensure return of movement, strength, and use.
Melbourne Hand Therapy Can Help You
At Melbourne Hand Therapy, our team works closely with your medical team and are able to assist you with splinting and rehabilitation. Our treatment is tailored to your individual needs and is dependent on the presentation and severity. Book an appointment today to see one of our highly skilled therapists if you are experiencing any of the symptoms above.
