Just wondering if anyone has had one of these before, and if so what corective actions were required to rehab? What was the timeline like? Did you fully recover?
For those that don’t know what it is:
I was on a rope swing a couple weeks ago and my fatass was about to fall off, so I gripped the piss out of the rope with my left hand and caused the trauma when my weight shifted. I thought I had broken it but the ER doctor confirmed boutonniere. I’m just wondering what the impacts will be to my grip strength (especially deadlift) once I am healed up.
I’ve never encountered anything like this so take my advice with skepticism please. Perhaps discuss with doctor about rehabilitation programs and therapists who do manual therapy on fingers. If you get the go ahead, work on grip, finger, pinch, etc strength within reason, not dinosaur training reason
haha thanks man…yeah I’m seeing a hand specialist about it Monday, but I’m sure I’ll get the usual overly conservation doctor advice to not do anything except rest it…great advice if you are a geriatric grandma with osteoperosis and rheumatoid arthrtitis, but a bit too conservative for my tastes.
If it is a true Boutonniere Deformity, you will probably be splinted in something similar to this (Rehab Products, Sports Medicine Supplies, Physical Therapy Equipment | Performance Health) depending on the severity of the tear to the extensor tendon. If conservative methods (splinting or casting) do not work, then you may need surgery to fix the torn tendon in your finger. Also, depending on the severity of the tear, you may be able to buddy tape the finger into extension and still perform certain activities (heavy gripping may be an issue), while continuing to wear the splint when not performing your sport or training. If there is any fracture associated, then surgery is likely required.
You are taking the right steps in seeing a hand specialist. There is a reason hand specialists make so much money - there is so much that goes on in the hands and they need to know all of the minute details that go into the hand. Even if the doc gives the “usual overly conservation doctor advice to not do anything except rest it”, I would take his/her advice. If the doc does say that and you aren’t happy with it, ask him/her specifically what you can and cannot do with that hand, what types of rehab can be started, and if there is a manual therapist that they can refer you to.
Thanks for the awesome advice LH. The doctor in the ER diagnosed it as a boutonniere and from the pics I’ve seen it looks like a reasonable diagnosis. I guess the hand guy will tell for sure.
I’ve got a couple pics of it for info too. It is a huge pain in the ass. This is of me trying to straighten it before they put the splint on there.
I guess I never mentioned it in my post, but it is the middle finger on my left hand. There was some trauma to the ring finger on that hand as well (slight fracture) but not as severe as the middle.
It does look like you are getting a good bit of extension at the DIP, so it does look to be a boutonniere. The hand specialist will be able to give you a definitive diagnosis.
I don’t know if I had this exact thing as my doctor never mentioned it but my finger kind of looks the same. Spiral fracture and the “sheath” or whatever they called it never seemed to adjust properly. This is a permanent injury at this point- I’ve had 3 surgeries, 3 screws, and 3 tendon tightenings and nothing has worked.
My recommendation:
See the doctor. If he wants to throw you in surgery, get a second opinion. If they both agree surgery, get the best damn doctor you can afford. LISTEN to everything he tells you. I am sure my stubbornness was what made this a permanent injury as my doc was/is one of the best hand docs on the east coast. I was in the gym lifting the next day. Bought hooks to make it so I could grip but they would slip and I would hit the finger. The lifting was probably the worst as I was able to strengthen my flexor but not the extensor, both of which were weak and now I suffer this. Also, go to PT and do the work. Rubber band tricks and all. Perhaps purchase the finger extensor bands from IronMind. A lot of guys focus on grip but tend to neglect the extensors which play a role in optimal hand health.
Don’t be like me. Listen to your doctor. I have what looks like a swollen finger that will never straighten out. I’ll never be able to wear a ring on that finger haha. As to whether that’s good or bad, I don’ know.
Your grip strength should theoretically be ok. My friend has a similar look to his finger that he crushed in a bench rack but never got checked out. He pulls 600+ routinely.
Nate: I dont think yours is exactly the same…whenever I try to straighten it, the tip of the finger actually rolls upwards while the middle joint stays the same or bends downwards…
Had the appointment with the hand specialist Monday and he basically told me that it was a boutonniere but wasnt severe enough for surgery. That was awesome…the unawesome part is that I have to wear a splint for 6 weeks…I did get credit for the 1 week that I was in the half-ass splint, so only a few more weeks to go…
He actually referred me to a therapist, but I don’t think I’m going to go. He said what they would do is make a special splint for it, but the one I have is working fine and keeps it straight at the joint, and lets the tip move freely. I’ve found a list of exercises online that I will use to rehab it, and I expect to make a fully recovery
