What is Trigger Finger and How Do I Fix It? (Stenosing Tenosynovitis)

[@HoopersBeta]

What do you think our next video should be? Suggestions welcome! :)

[@vince21412]

I have a problem with both my hands being stiff when I try to make a tight fist. No problems with extension only flexion. It gets worse after climbing and is the worst in the morning and sometimes evenings. But after slowly squeezing my hand to a fist and holding it tight for a min it goes back to normal for a while. It's completly pain free. I tried not climbing for a month and it got a bit better but did not disappear completly. When I climbed again it came back in full force. Ibuprofen 400mg x3 for a week did not help. I've had this problem for about a year now. What's going on? There are no climbing doctors or physical therapists in my area.

[@valeriatsygankova9643]

How to train at home -- for climbers at different levels of ability -- now that climbing gyms in many cities are closed. (Please!)

[@croissant9157]

I believe i strained my lumbrical muscles a couple weeks ago and am still unable to pull in an open hand position without my pinky. Videos on rehab for that would be great as I have been unable to find some material on it!

[@HoopersBeta]

Lumbricals, got it! Thanks for sharing / commenting.

[@Valdesgreen]

mine is at the thumb join closest to the nail

[@lmansur1000]

Love the end part of this video...light-hearted and fun!

[@justanotherperson584]

This was informative. My symptoms are unfortunately acute. I’ll get through it, this helps. Thank you.

[@urnisi]

Easy fix, one teaspoon or more of raw unfiltered honey for two weeks.

[@kwokcheung73]

Thanks for showing putting a ball in your hand and squeezing it. I found it useful for my trigger finger. Much appreciated.

[@HoopersBeta]

So happy that it helped!

[@markjelderda]

Very informative, thanks for all the info!!!!

[@kamusalah9428]

Such a blessing to find this video. I am a pianist and just went trough trigger finger surgery at my right hand middle finger, 2 months ago. Now my finger doesn't stuck anymore but there is still stiffness in my 3rd finger so I cant play piano evenly. What should i do? Should i just wait till finger fully restored, ora this is my final and permanent condition.? Please help me since I had very bad access to reach nearby Surgeon. I live in very small town in Indonesia. Any response for my case here would be very meaningful to my job, familiy, and life. 🙏

[@ruparkyitin]

I do not have over using or over work of that joint. But I suffered trigger finger in middle finger

[@gamotousername]

When tendon gliding I am getting a crack on DIP on ring finger. Is that trigger finger as well? It's not painful but my ring finger is more prone to pains or tenderness.

[@brazilianfernie]

I think mine is being caused by mountain biking. The death grip on the handlebars plus I’m 5 months out from having a broken wrist

[@tgibo1275]

And after the operation, what to do if the hand brushes again from time to time?

[@marvinevasco6347]

Hi.when I tried some Deadhangs(30secs) with 3 reps,the 1st 5 secs was I feel small pain,but afterwards and doing the reps,I feel comfortable...Also when I climb in our local gym,I didn't feel I have trigger finger,but well on the 1st to 3rd 6a grade warm up, there's a little discomfort,but when I go along,it becomes normal.My problem is the post climb experience 😅..I feel the the trigger finger in my left hand ring finger.

[@acoustically9201]

Don't know if this applies to you, but I just read an academic paper saying the incidence of trigger finger is higher on ring fingers of married people....i.e. the ring mght be doing something or have done something in the past to contribute to the condition.

[@janakobsch5571]

I started climbing half a year ago and I really fell in love with climbing… I also studied piano, work as a piano and music teacher and I have really flexible hands. I am also very cautious with increasing the level of the routes. But despite of all this there was a sudden strange pain while I clipped at the end of my three hour climbing session, I also think I had a tiny bruise or haematoma on the nuckle of my ring finger at the back of my left hand. Now I can’t squeeze my left hand and relax it without pain in my ring fingers knuckle and a springing sensation. This squeezing and quickly releasing is a finger and hand movement I normally don’t do frequently, except when belaying (to give out rope). Could there be any relation between this (untrained) movement and my predicament? What can I do to prevent this?

[@etadeanograceland4708]

What a lovely man, thankyou 👍

[@Yes-yq1oi]

My thumb hurts whenever i press down on my joystick so i wondering if this was it

[@benjaminengelberg6847]

Thanks for the informative video, just subscribed! I have a puffy inflamed knuckle at my PIP on my index finger. I don’t really feel anything getting “stuck” when I do the sliding/curling motion like you described but I do feel pain and tenderness right around the PIP knuckle, which gets worse the more I curl my finger inwards. Do you think it’s trigger finger? My hand will also “pop” around the same area and go numb sometimes for a few seconds when doing pull ups on jugs. No lasting pain though as with a standard pulley type injury. Any help with diagnosing this is appreciated!

[@HoopersBeta]

It doesn't sound like it. Inflammation at the PIP joint and pain when you curl the finger inwards is more so related to the joint as you are closing the joint space down. There may be some collateral ligament irritation as well. Possible diagnosis could include synovitis, arthritis (depending on age and other factors), or collateral ligament strain. The pop and numbness is interesting. Typically a pop without pain is either a joint cavitation or a tendon/muscle sliding over a bony prominence, but the association numbness is interesting. There are possible reasons for that but it would warrant further analysis.

[@benjaminengelberg6847]

Hooper's Beta Thanks for the response. Okay that’s good to note. Yeah the interesting part is that I have the same puffy tender knuckle on each hand. Left hand index and right hand middle. I also get the same popping and numbing sensation on each hand and they started around the same time. I’m 30 years old, the only other activity where I’m using my hands is piano which I’ve heard can cause carpal tunnel, not sure if that would be related at all. As apart from the temporary numbness there’s no lasting pain, do you think this is a serious issue that I should temporarily stop climbing over? I saw you are a PT at UCSD as well, is that correct? Maybe I can make an appointment to see you there. Thanks again.

[@HoopersBeta]

numbness / tingling can vary in the level of intensity and it's dependence on ceasing activity or not. It's really about understanding the cause of it to understand if there is a need to stop climbing. Until the cause it's understood, can't really say. Yes, you are correct, I am at UCSD and taking patients.

[@magic8ball3mt]

Thank you so much for posting the only climber-specific video on trigger finger! I was wondering if I could hear your thoughts since my clicks are triggered slightly differently: The click actually feels like it's in the A3/A4 area of my index rather than A2, and it actually only occurs after I grip open-handed. My half crimp is just as strong as prior to the clicking, and my open hand strength is 15% weaker than before (before it's uncomfortable to crank more). My best guess right now is that the inflammation is getting caught in a higher up pulley than A2. Would you say that the rehab stretches with the lacrosse ball are still worthwhile? Also, would you say it's safe for me to climb below my limit with a half crimp instead since open-hand is the one giving me discomfort? FWIW, I'm booked with a PT in a couple weeks, but I'm hoping this video has put me in the right direction.

[@HoopersBeta]

Great question. I think you are are the right page with the inflammation causing the clicking and it is possible in the open hand position you are also causing more pressure on that area which leads to the inflammation. The lacrosse ball stretch may not be as beneficial since the research was targeted to a different pulley but that brings up a case of cost / reward. The cost of you doing that stretch is relatively low and the reward is moderate, so it may be worth your time to try. Other things to consider would be avoiding exacerbating / inflaming the area in the mean time to see if it is an injury that needs to heal. Example: the index finger in that region can get inflamed and irritated from full crimping which may then cause the trigger finger you are experiencing.

[@magic8ball3mt]

​@@HoopersBeta Thanks for the reply! I learned that with some pretty deep massaging and rest, I can get it to calm down for several hours. Time will tell if it's something I can just rest through :)

[@Knn84]

@@magic8ball3mt i hope u r well now... How is your trigger finger?

[@youngolf1]

i have thumb trigger, not too bad yet. from roadbike riding. i work in the OR though and got the diagnosis from a surgeon while talking in the hall! lol. one of the benefits of working in surgery. no copay no deductible for diagnosis! said may eventually need steroid injection, no biggy.

[@sairenuka4813]

can we get back to climbing after symptoms subside? what if symptoms keep returning after every climb?

[@davidlarge8894]

I have trigger finger in both hands middle finger and ring finger on both hands ,have a nodule in my left palm that is obvious to see ,this all was caused by having Piraformis syndrome with gluteal amnesia could not stand up from a chair unless I used my hands and arms to push myself up and my middle fingers bore my weight for a few seconds ,am waiting for injections at the hospital .

[@VS-qd3tz]

I too have both palms ring trigger finger with nodule n cause of that was high LDL cholesterol, Now it's over 4 weeks have stopped majority of oily fast foods very good improvement there pain has minimised can move n bend the finger previously not flexibility coming , probably by next 2 weeks it will normalise. Find out the cause n rectify. 😁😁

[@chicac.7600]

Great video as always Doctor Jason Hooper! Just made hang board and cant wait to train and follow your plan for the intermediate hang boarding. Also I need your help if you have the time. My left ankle(i think my achilles tendons) started really hurting after wearing a couple month into my climbing shoes. I chose a snug fit climbing shoes so there was no issues for the first 2 month but then it started hurting the part where it rubs the back of my feet. Like whenever i'm going to wear my climbing shoes, i know its going to hurt, after wearing it for a while, the pain does dimishes a bit but its quite sensitive at certain angles. I have trouble walking while wearing climbing shoes. I don't know if it's achilles bursitis. Currently, It doesnt hurt anymore since i followed the P.r.i.c.e and i haven't climbed a while cuz of the current situation so if you have any suggestion to prevent this pain, it'll be greatly appreciated! Thank you and have a great day!

[@HoopersBeta]

If you haven't made any other major changes (started a new running program, changed shoe ware at work, made significant changes to your exercise routine, etc) then it sounds like the shoes are probably just poorly fit for you. Yes, aggressive shoes are often uncomfortable to walk in, but if it is irritating the retrocalcaneal bursa or the Achilles tendon, then you may be too much movement in the shoes or (more likely) they are probably creating a pressure point rather than evenly distributing it. Thank you for watching and I hope you continue to tune in!

[@chicac.7600]

@@HoopersBeta I really appreciate the quick reply! My left foot is slightly bigger by half a size to my right so it is probably with the fitting of the shoe. Now that i know the issue is most likely my shoe and not my feet, I'll figure a way to make the heel of the shoe more comfy on me. Thank you so much and ill definitely stay tune to your amazing content!

[@HoopersBeta]

Oh yes that is a significant difference in sizing! I would consider looking into stores or shoe companies in the future that will allow you to purchase different sizes.

[@McCrisper]

I got mallet finger from a volley ball and it finally healed and straightened and now everytime I try to bend the tip it freezes at one spot and hurts and I’m wondering if my mallet finger caused trigger finger

[@janakobsch5571]

Thanks for pointing out the necessity of hydration 💦

[@pogeybait1194]

Do you have a video for the thumb? I have my left thumb that was catching so i got injected. Its not catching but it still hurts.

[@dannymulv]

Hi Dr Hooper, Great video! I will definitely incorporate the lacrosse ball stretch into my routine. I injured my finger about 6 weeks ago from going a bit too hard at the gym after a year off of gym climbing. I had some relatively minor pain the next day and have been experiencing a clicking or crackling sound in the area of the A1 pulley. Occasionally, the finger does get a little stiff or stuck and hurts a good deal when I flex it, but the pain goes away right after. This is fairly rare and doesn't really hurt otherwise. I have been climbing fairly mellow since. Does this sound like Trigger Finger to you and will this crackling noise in my joint go away once the finger is fully healed? Could I be dealing with another type of injury?

[@juscamarena]

Did it get better?

[@sarojsen6628]

I hve pain in palm that is in thumb side sivere pain can't extend thumb can't hold anything

[@sarahblumenfeld2099]

If we have tenosynovitis, how long do we immobilize? I’m scared to resume activity and reinjuring after waiting.

[@HoopersBeta]

If you're nervous / scared about resuming activity, definitely best to reach out to a skilled provider who can help guide you!

[@sheilayungk7815]

Hi, I think I got my Trigger thumb from doing too much at the gym. After about three weeks I got this. It is at the point where it is hard to bend my thumb. It really "sticks". I think it is getting worse. I was wearing a splint that I had gotten in a pharmacy, but I don't think it helped. I am a bike rider and never had a problem so I am still riding. Should I maybe stop riding? My sister believes that all pain is due to muscle imbalance. She wants to work with me in a pool, but I'm afraid she will insist on me flexing my fingers. I watched other videos and some people say that you can do stretches, but to avoid triggering the finger. My sister is very stubborn in her beliefs, but I think she might hurt me. I know she will want me to bend the finger. She doesn't believe that there is any inflammation. Do you think I should see a doctor?

[@bashirsalh4817]

What about thumb excercise

[@ms.janwms4724]

Does being a type2 diabetic,have anything to do with it

[@aportadaesquerda]

Is it possible to have trigger finger on the a3/pip joint?

[@pgijsbers]

Thank you very much! For me the snap in movement happens at the PIP joint, without pain. Only in the mornings, only for about 5~10 extensions, and only if I have climbed/done pull ups recently (and I think, only when extending?). This also means I can't reproduce a catch with the movement around 2:40 outside of those conditions. At 1:00 you explain the process of what causes the snap and use the PIP joint for demonstration. Is a snap at the PIP joint also caused by a too narrow A1 pulley? Or should the A3 pulley be stretched somehow? Also how long should the streches be held, and how often?

[@HoopersBeta]

The fact that you have it mostly in the mornings and after climbing would make me think about the amount of fluid surrounding the joint. At night, since we don't create movement, we usually have a build up of interstitial fluid which may cause an increase in swelling and the resulting symptoms you feel. The best way to further test would be to isolate one joint flexion at a time and see if it creates more of a restriction. You may be in a very acute stage of this and want to be cautious to not allow it to advance. I would recommend a few shorter stretches (3-5 seconds) to warm it up, then do 2-3 30 second stretches. This can be done daily.

[@pgijsbers]

@@HoopersBeta Thank you for taking the time to answer :) it's much appreciated! Will start doing the stretches daily. Not sure if I understand the further testing - if I unroll (flex?) one joint at a time, it is definitely in the PIP joint the snap happens.

[@HoopersBeta]

@@pgijsbers the addition testing to see if you / I totally understand it. Flexion of the PIP causes the catch, but is the catch at the MCP or PIP? That's more my curiosity / clarification.

[@pgijsbers]

@@HoopersBeta I can't tell at which pulley the tendon gets stuck, if that's what you are asking (sorry, English isn't my native language so being precise for a medical diagnosis is hard). But I did make this illustration indicating where the finger snaps from one position to the next when extending it while keeping the finger fixed around the mcp joint imgur.com/a/YSgXk3K . When extending the finger, it snaps from the start of the red section to the end of it, i.e. starting at about a 90 degree angle to roughly 60-45 degrees (if 0 degrees is straight). I could try to take a video when I notice it next, but since I haven't been climbing due to COVID-19 I haven't had many mornings with symptoms.

[@HoopersBeta]

@@pgijsbers that helps! It certainly can be as it is usually the flexion of the PIP or MCP which causes it but the climbing hiatus may be a positive! A chance to rest the tissue and ensure that it does not become more serious.

[@FatimaGarcia-r4g]

I feeling a popping or catching sensation when I do tendon glides. It this frogged finger ?

[@Eddysamson1]

Hey awesome video! Very helpful. I have recently developed trigger finger in my left middle finger. It pops on open/closing my hand, although only when the DIP is fully curled. I have almost zero pain. Some occasional soreness/tightness. I've also climbed some of the hardest stuff I've ever done since it started so there is no loss in finger strength. I was just going to take a week off and see how it feels after. Is that smart? Or should I continue climbing with open hand on my left? I do notice that ibuprofen and my joint supplements help. The popping will go away completely on open/close within an hour or so of taking ibuprofen but it eventually comes back. Is this just a really minor case then? Also I'm not convinced mine is caused by my A1 pulley since it doesnt pop until the DIP is fully engaged. Could other pulleys cause trigger finger as well? My A1 isn't swollen and I know what it feels like when an A1 is swollen (it feels like a ring). I find myself constantly opening and closing my hand to test it. Should I stop that and try to minimize how much its popping even if there's no strain (not climbing) when I do it? Are the splints recommended for wearing at all times or only during climbing? What about a full finger splint that stops all movement? Any benefit there? Last thing. It pops all day, not just the morning. The only thing that ever makes it go away is anti-inflammatories and they are temporary. Thanks!

[@HoopersBeta]

OK *cracks knuckles* Let's get this.... First, sorry about your trigger finger! Let's answer your questions to get you handling it well. Yes, taking a week off is a great idea. Most climbers do not rest enough, so actually taking a rest week is always welcome, especially since you are climbing your hardest. Often times when we are climbing hard, we are developing little issues we are not resting from. Taking ibuprofen to relief it is simply reducing the inflammation. It does help indicate that it is not a "major" case, otherwise it would have little to no impact. Yes, other pulleys can cause it, but it is hard to tell which one it is. The exactly location is less relevant than the path to treatment. No, you should not be constantly testing it. You don't want to cause the click/catch. You want to rest it when you can to avoid more clicks. the splints are more recommended for your day to day activities, not during climbing. It is meant to prevent you from causing the irritation with the hundreds/thousands of movements you do daily, not the fewer ones you do while climbing. Full finger splints would also work, they simply limit a lot more of your function so you want to use the most minimalist splint you can find that works for you (If it doesn't prevent enough motion, it will still allow the click which means it's not doing it's job) The anti-inflammatory is just a band-aid to reduce the inflammation which helps it go away. Once the anti-inflammatory effect wears off, symptoms will return. Hope that helps! *phew*

[@finite934]

nice vid. Im 47 and had 3 ligaments/tendons fail in last 2 years, one in each hand and now trigger thumb. I get it, im in that age, but i disagree it's over-use. Ive also had several tendons fail in last 5 years (shoulders, knee, heel and foot). Is there a syndrome whereby due to nutrient deficiency all of your tendons and ligaments become fragile? Because it doesn't feel normal to have so many fail in such a short period of time. How would you test for that?

[@mariliacalixto3093]

I’m not a doctor, but are you doing some workout to strength your muscles? This looks like a colapse in your nerves or muscles structures. A visit to a neurologist would be indicated too.

[@weneedmoreconsideratepeopl4006]

this is what I wonder too... maybe it's because of a nutrient deficiency that regeneration is impaired. I read that it takes the span of 3 days for people to gather all the building materials they need for their body to pump out those new cells to maintain the body. Not sure how credible it is but that detail stuck out to me. It probably isn't very relevant to what you're saying but couldn't stop my rambling at this point hahah

[@Frank_in_Iowa]

If you take corticosteroids, like prednisone, for extended periods they cause tendons and ligaments to weaken. They can actually snap under relatively light loads.

[@totalglitch]

Will this work for the thumb as well? I'm going on over a month with my thumb on and off

[@HoopersBeta]

Some of the same principles apply to trigger thumb but the treatments such as the specific stretch may not perfectly translate. May need to be modified.

[@SavageSenzu]

I have been having trouble in my hands, and I was wondering if it could be trigger finger, I get pain and tightness in my fingers when flexing towards my palm and when there’s a lot of pressure on them. There’s no catch feeling or anything just pain at the base of my fingers and sometimes below them. Could this be trigger finger?

[@IAmSaveRio]

Sounds like a lumbrical injury, check out his video on that.

[@jaimenavarrogutierrez6337]

Hi Jason! What if I only get the trigger finger when I sleep? I got an A2 pulley strain that developed trigger finger after a month but it only happens in my sleep. Is there a way to know what is causing it? Thanks for all your help!

[@HoopersBeta]

Good question! There may be a number of reasons, but what first comes to mind is either the position you're sleeping on (perhaps clenched fist, flexed wrist, flexed fingers as examples0, or it could just be that the swelling increases during night since you are not moving, but quickly dissipates in the morning as the movement starts reducing the swelling.

[@jaimenavarrogutierrez6337]

@@HoopersBeta would you say is an acute case? I take time off sport cranking and go alpine climbing a lot and that seems to help with not getting the trigger finger at night. Would taking anti inflammatories help?

[@growden100]

thank you very much!! 2022

[@HoopersBeta]

You’re quite welcome! :)

[@Knn84]

Hi dude, please help me 🙏 There is a nodule on my left palm. The spot is near A1 pulley of little finger. Noticed it 5 days ago. Doc prescribed nimes gel and dikloron. I have been applying them. But i want to know that is there any possibility to recover apart from surgery. If i have an operation, after the doc cut the a1 pulley to release the nodule, my gripping power would be effected or not? Thanks so much for reply...🙏

[@HoopersBeta]

Start with conservative measures and see if the nodule will reduce. If not, surgery may be your best bet. It will have an acute affect in your climbing but the body I amazingly adaptable and your strength can definitely return!

[@Knn84]

@@HoopersBeta thanks... will apply your directions 🙏

[@bizfrizofroz]

Thank you, this was immensely helpful! Prior to watching this I wasn't sure why my finger was clicking (many months after an acute finger injury) and I was regularly bending my finger to 'work out the click'. Given that the correct treatment is the exact opposite approach, I'm very relieved to have already built a homemade splint. You should really start a Patreon or something, even if only as a way for people to send you money in thanks. Also I have an affinity for taping my DIP joint in an effort to reduce the force on my A2 pulley (research be damned it helps!). Any thoughts on whether the force of the tape digging into the tendon could be a cause of tendon inflammation?

[@HoopersBeta]

Perhaps not the force of the tape digging into the tissue but rather maybe the tape allows you to pull harder on sharper edges without the same pain feedback which causes pressure on the tendon and producing the inflammation? It's possible but not likely the cause of the issue.

[@bizfrizofroz]

@@HoopersBeta Thanks for the responses!

[@kashifrana6798]

Great video. I have A1 pulley diagnosed in middle finger of right hand. I was doing a lot of mouse scrolling in my job since 8-9 months. I did not have pain, only trigger fingure. GP gave me injection. Should I continue that job as still I have to use excess mouse clicking. Any advise like exercise or splint? Appreciated

[@pcobra5427]

What about thumb trigger finger

[@HoopersBeta]

It is, go figure, referred to as "trigger thumb" lol. Some of the same principles apply to trigger thumb but the treatments such as the specific stretch we showed in this video may not perfectly translate. May need to be modified.

[@tickletipson9517]

Just wanted to find a name for it, I don't want to fix it, I've had that my whole life. And isn't even my dominant hand

[@MinMin-lk3ew]

❤❤❤❤

[@bambang8688]

Trigger thumb so make tired

[@AngelitoPajarillaga]

like

[@tsedeketakechanneltvandony5963]

please doctor help me my finger middle one is not working where are you staying I will come to you please help me

[@HoopersBeta]

Sorry to hear about your finger! You can make an appointment through our website if you’d like. Here’s the link: www.hoopersbeta.com/private-sessions

[@wonder7798]

Fashionably late, as usual...like 4 yrs

[@HoopersBeta]

Sorry you're dealing with this!

[@MinMin-lk3ew]

❤❤❤❤❤