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The Best Mallet Finger Exercises

by Jaydee Vykoukal, PT, DPT July 22, 2021 0 Comments

finger tip pinch

Mallet finger, or baseball finger, involves an injury of the finger extensor tendons, causing the tip of the finger to droop. In most cases, wearing a splint can help the finger return to a normal resting position within a few short weeks. Once recovered from mallet finger, exercises will help to loosen stiff, tender, and weak muscles in your hand due to inactivity. Keep reading to learn why exercises are important and for the best mallet finger exercises to restore normal finger and hand function.

Why Exercises Are Important

When recovering from an injury, the balance between rest and movement is extremely important. Without movement and after wearing a finger splint, you may experience excessive stiffness and loss of hand strength, making for a longer and harder road to recovery.

When to Start Exercises After a Mallet Finger Injury

You will want to wait to start specific mallet finger exercises until your finger tissues are almost completely healed, done with splinting, and upon clearance from your doctor (especially after surgery).

A few signs that you are ready often include:

  • No evidence of swelling or pain
  • Normal resting position for the tip of the finger (usually around 4 to 6 weeks). 
  • No additional pain or swelling with exercises of uninjured fingers, hand, wrist, elbow, and even shoulder exercises. 

Exercises that Help with Recovery

These 6 exercises will progress from gentle passive stretching to more active hand movements. Start at the beginning and progress by adding the next exercise as you feel ready. Use your symptoms as a gauge and never force any of these moves.

Finger Extension Stretch

One of the first exercises you can start is a gentle stretch into finger extension. Right after the injury, the finger will be resting in flexion and unable to extend the distal (last) joint on it’s own. Thus, you can facilitate this movement and range with the opposite hand. This will help minimize loss of range and keep the fingertip limber as it heals.

  • Hold your affected hand so that the palm is facing downward
  • Place your opposite hand around the last joint (distal) of your injured finger
  • Your thumb should be just below the joint, with the pointer finger and other finger supporting the entire finger underneath 
  • If you’re having trouble relaxing the hand and fingers, try sitting down and propping your entire hand comfortably on a table for support
  • Gently push with the tip of the finger up toward the ceiling while keeping the rest of the finger still with the thumb
  • Go as far as is comfortable without pain
  • Hold for 20+ seconds for 2-3 sets
  • Note: the exercise video listed below demonstrates extension of the entire finger. This is a progression of the stretch we just reviewed (since it focuses only on the distal interphalangeal joint or DIP). Progress to the full finger range of motion as tolerated

Extensor Tendon Glide Exercise

After an extended amount of time spent in a splint, the healing finger extensor tendon will feel stiff. A tendon glide exercise can help keep the tendon moving smoothly with less stiffness or catching during daily activities. There are many different options and positions to progress to as you are ready. We will focus on demonstrating the first exercise. You can then progress to further options (illustrated in the video) as tolerated.

  • Hold your hand out in front of you with the fingertips up toward the ceiling and as straight as possible
  • Make a “duck” bill shape with your fingers and thumb by keeping the finger and thumb joints straight while you bend at the knuckles only
  • Bring the palm side of the thumb and fingers as close to each other as possible without pain and avoiding bending of the distal and proximal interphalangeal joint (PIP)
  • Hold the position for 5-10 seconds for 10-15 repetitions total

Power Squeeze

As your flexibility and comfort with moving your finger improve, it’s time to get started with some basic strengthening moves. One of the simplest ones you can start is a full-hand gripping exercise. You may notice your splinted finger is stiff at first, start in a range of motion that is comfortable and progress it as tolerated. You may also need to guide your finger into a bent position with your opposite hand initially until you gain more strength.

  • Grab some putty, a hand exercise ball, or anything else that you can squeeze
  • Hold your tool of choice in the palm of your affected hand
  • Wrap all of the fingers and thumb around it
  • Squeeze the ball in your hand as you attempt to further curl your fingers
  • Hold for 5 seconds for 10 repetitions, 2-3 times total
  • Increase the intensity of your grip, the difficulty of the putty or ball (if applicable), and finger flexion range of motion as tolerated

Fingertip Pinch

An important next step in the rehab process is to be able to properly pinch your fingers together. You need good strength and balance between the finger flexor and extensor tendons when pinching. Without this balance, it will compromise the integrity of the fingertip joint with daily hand use and lead to problems in the future.

  • Grab putty or a small towel to pinch and sit in a chair near a table
  • Roll the putty or towel into a narrow cylinder and place it in front of you on the table
  • Place your thumb and affected finger around the cylinder to pinch
  • Pinch the thumb and finger together as you focus on keeping an “O” shape with the fingers (do not let the joints of the finger flatten or extend)
  • Hold for 3-5 seconds for 10 repetitions, for 2-3 sets total
  • You can complete this exercise for your unaffected fingers too
  • To progress, increase the intensity, putty strength, or grab a ring gripper

Finger Extension

This exercise addresses the healing finger extensor tendon directly. Thus, start slowly and see how your finger tolerates this move first. It’s why it’s one of the last moves you will try in your rehab program.

  • Sit comfortably in a chair with your hand resting on the table palm down
  • You can start without any resistance or grab some finger putty or a small resistance band (such as a basic rubber band)
  • Without resistance, simply extend the entire injured finger up toward the ceiling while keeping the finger joints straight
  • With resistance, place a rolled string of putty or the band around the affected finger between the middle and top joint (with your forearm resting on the table this time)
  • Extend the entire finger backwards against the resistance as far as you can comfortably go
  • Repeat 10 times for 2-3 sets
  • Progress by increasing your hold time or resistance level

Full Finger Spread

 

This exercise is similar to the finger extensor exercise above, except that it works the entire hand at once. Working on coordinating all of the extensor muscles in the hand and forearm at once will help you build functional strength for getting back to daily activities and sports.

  • Grab a small resistance band or putty (rolled into a circle)
  • Bring all your fingertips and thumb together in the center of your hand
  • Wrap the putty or band around your fingers between the middle joint and the end of the finger
  • Extend all of the fingers and thumb away from each other as far as possible, pushing again the resistance
  • Keep the finger joints straight as you spread your fingers apart and extend them to what you can tolerate
  • Hold for 1-2 seconds and repeat for 10 repetitions, 2-3 sets total
  • To progress, you can try stronger resistance from a band or putty, otherwise you can try a ring gripper or hand extension exerciser as well (note you will not be able to complete full finger range of motion with this option)

Helpful Exercise Tools

All of the exercises listed above, and any other moves that you progress to, are easier to do with the help of hand therapy tools. These tools are easy to take with you anywhere and use to stretch and strengthen your fingers on the go or when you have a spare moment. These top rated tools have already been discussed in the exercises above and they include:

Hand Exercise Balls

Hand exercise balls are a great addition to your hand exercise tool kit. They come in a variety of colors that differ in resistance, depending on your hand strength and where you are in your recovery journey. You can throw one in your bag or car and use it throughout the day to keep your hand strong. Plus, squeezing a ball will promote circulation to enhance the healing process and reduce overall pain as well.

Therapy putty

The use of putty is a very versatile tool for hand and finger strengthening. The ways you can use it are practically endless. It also comes in a variety of strengths that you can utilize with your rehab program. Many people find the use of therapy putty therapeutic for their minds as well. The one disadvantage with this is when you want to increase your hand endurance with higher repetitions and you have to continually manipulate the putty for use between every single repetition.

Ring grippers 

A ring gripper can be considered a cross between the exercise balls and therapy putty. It is more versatile than the ball but has slightly less versatility than the putty. Outside of hand grip exercises, this tool should be reserved for later in the rehab process since it is less flexible and offers more resistance. Thus, this is a great tool that you can start with gripping in early rehab and then build to more extensive exercises with time as tolerated.

Other Hand Exercise Tools

Healing Mallet Finger with Exercises

Choosing an exercise program for the mallet finger doesn’t have to be complicated with the right health information. Simply start with gentle stretches and progress to more dynamic strengthening as tolerated. This will ensure that you can return to your daily routine or sport with less risk of reinjury. However, if you’re feeling unsure of where to start, it’s always best to discuss treatment options and exercise with a physical therapist or occupational therapist. Don’t forget to maximize your exercise program results by combining it with other mallet finger treatment options to managing swelling and pain relief.

More Mallet Finger Treatments

As always, if you experience a sudden change in symptoms or they simply aren’t getting better on their own within a week or two, it’s time to get in touch with your healthcare provider as soon as possible for further medical advice. They may need to rule out more serious issues like fracture (known as a bony mallet finger).

Sources:

https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=bo1658

https://hhma.org/healthadvisor/aha-malletfi-rex/

http://www.tcomn.com/wp-content/uploads/2017/02/Mallet-Finger-Home-Program-Phase-2-Exercises-1.pdf

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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