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Volar Plate Rehab (Read 2855 times)

Catcheemonkey

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Volar Plate Rehab
March 07, 2017, 11:03:13 am
I posted on the Hallamshire Physio thread a couple of weeks ago but, as I guess they're not giving free consultations at the moment and I can't find anything in the archive specific to this injury, I thought I'd broaden the question I asked.

I'm pretty sure I've ruptured the Volar Plate in my pinkie and have been attempting to rehab it myself. I know the obvious advice is 'go to a doctor / physio' but as a time-poor imbecile who is rarely in the same place due to work this is easier said than done. Also, as the injury is slowly improving I'm keen to try and rehab it myself.

Has anyone else on here acquired this injury? I've done pulleys and a DIP joint before - but feel much more cagey with this as the joint still feels quite unstable and doesn't generate much pain when worked... until the day after.

If you have any advice for specific excercises or progression to rehab this I'd be grateful.


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#1 Re: Volar Plate Rehab
March 07, 2017, 11:11:55 am
I damaged / tore the one on the back of my thumb early last year skiing. After it healed (takes ages) the scar tissue seriously restricted movement and was really painful.

I saw a specialist and they recommended friction massage and painful stretching to free up movement. I've been doing this over the last 6 months, and mobility is slowly returning, back to about 80% of full range.

Which joint is it in your finger?

Catcheemonkey

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#2 Re: Volar Plate Rehab
March 07, 2017, 11:24:36 am
It's the PIP joint on my right pinkie.

The main issue is engaging it (as a drag) in a half crimp. When the angle is more acute it doesn't cause a problem, but when dragging the joint doesn't like being 'stretched'.

What kind of stretches did your physio give you - just pulling the finger back as far as it would go?

Also - how long after injury did you start stretching and massaging?

abarro81

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#3 Re: Volar Plate Rehab
March 07, 2017, 01:23:23 pm
That doesn't sound like a volar plate - I did mine in dip joint the other year.  You could tell as the whole end of the finger pointed upwards. Specialist surgeon guy put it in in a splint for 6 weeks...

abarro81

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#4 Re: Volar Plate Rehab
March 07, 2017, 01:27:49 pm
Ignore me, Pip and dip will be fundamentally different here. Will reply properly later

Catcheemonkey

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#5 Re: Volar Plate Rehab
March 08, 2017, 08:04:16 am
OK. Cheers Alex. I'd be interested to hear your thoughts.

I understand you're always breaking your hands.


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abarro81

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#6 Re: Volar Plate Rehab
March 08, 2017, 08:52:18 am
Yeah, so I did mine in mid finger DIP joint. The specialist got me to wear a moulded plastic blocking splint 24/7 for 6 weeks to avoid any possibility that the finger could hyperextend (or even go to totally straight) at that joint - essentially holding it in flexion. After that 6 weeks there was a reduced range of motion due to the scar tissue, but he said that that was basically the point - the splinting gave it time to rebuild. (There was also unwanted reduced range of motion in the PIP joint due to the splint). I gradually wore the splint less and gradually increased range of motion by simply trying to move the finger through the whole range voluntarily when the splint wasn't on, and then later by stretching only at the (uninjured) PIP. I didn't stretch the injured DIP joint and he didn't recommend that I did so, though I never asked.

If the injury is healed and scar tissue is the problem then stretching to increase range of motion might work. If, as it sounds like you think is the case, there's still an injury then stretching it into extension would presumably just reinjure the volar plate so tread carefully unless you're sure the original issue is fixed - stretching the injured PIP into extension to fix it sounds analogous to hanging off crimps to fix a pulley injury: sure you have to do it again gently and gradually once the initial fix is done, but if it's at the acute stage of the injury then it sounds to me like a bad idea.

For reference, mine never really hurt or swelled, it just felt 'funny'/weak/exposed and the injured joint naturally sat in a hyperextended position by a few degrees (you could even see that on the x-ray). I could climb on it but shouldn't have been doing so - was doing hard boulders open handed (DIP volar plate means crimping is the enemy) until the day before I saw the specialist and he unexpectedly told me it should be in a splint!

Catcheemonkey

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#7 Re: Volar Plate Rehab
March 08, 2017, 08:47:31 pm
Thanks. You've convinced me I need to get it checked out. I can also climb on it, but the joint is definitely unstable - so I may well be sustaining the injury, rather than bringing the joint back into use. The relative absence of pain makes it hard to judge. Arse.


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