Trigger finger is a common condition that causes stiffness, catching, or a painful locking sensation when you try to bend or straighten your finger or thumb. This occurs because the flexor tendon, which connects muscle to bone and controls finger movement, becomes inflamed and has difficulty moving smoothly within its protective sheath. Tendon glides are a sequence of hand exercises designed to manage these symptoms and help restore more fluid motion in the affected digit. They represent a non-invasive physical therapy approach that can be performed easily at home to encourage the tendon to slide more freely.
Understanding Tendon Glides and Their Purpose
The mechanical issue in trigger finger involves the flexor tendon and a structure called the A1 pulley, which is a thickened band of tissue that holds the tendon close to the bone. The A1 pulley is located at the base of the finger, near the palm, and acts like a guide for the tendon as it moves. In trigger finger, the tendon sheath swells or the A1 pulley thickens, creating a narrowed space. This constriction makes it difficult for the flexor tendon to pass through the pulley, often resulting in the characteristic catching or locking.
Tendon glides aim to promote smooth movement of the flexor tendon within this sheath. By moving the finger through specific, limited ranges of motion, the exercises encourage the tendon to utilize its full length and glide smoothly. This action may help reduce local swelling and inflammation by promoting fluid exchange. Consistent gliding also helps prevent the formation of adhesions or scar tissue, which can further restrict movement and worsen the condition over time.
Step-by-Step Guide for Performing Glides
Tendon glides are performed as a sequence of five distinct hand positions, each designed to maximize the movement of the flexor tendons through the pulley system. Begin with the hand relaxed, palm facing up or away from you, with all fingers and the thumb completely straight. This is the starting position you will return to between each movement in the sequence. Perform all movements slowly and deliberately, stopping immediately if any sharp pain or increased catching is felt.
- Tabletop or Hook Position: Bend only the top two joints of your fingers, keeping the knuckles at the base of your hand straight. The fingertips should curl toward the palm but not touch it, creating a hook shape.
- Straight Fist or Duck Bill Position: Return to the starting position, then bend the fingers at the knuckles where they meet the palm, keeping the fingers straight so they rest against the upper part of your palm.
- Full Fist: Return to the starting position, then slowly curl all of your fingers down to make a complete, gentle fist, bringing the fingertips to the center of your palm. The thumb should wrap around the outside of the curled fingers.
- Claw Fist or L-shape: Return to the starting position, then bend the fingers so that only the fingertips touch the base of the palm, just below the knuckles.
- Return to the fully straight starting position to complete one full cycle.
Integrating Glides into Recovery and Daily Life
For the best results, consistency is recommended, with most protocols suggesting you perform the full sequence multiple times per day. A common recommendation is to complete 10 repetitions of the full sequence, three to five times daily. Each position should be held briefly for a count of two to three seconds to ensure the tendon fully glides. The movements should always remain gentle, using only the muscles of the hand and forearm, without forcing the finger into a position that causes pain.
Improvement often takes time, and results are not immediate. Many people may start to notice a reduction in stiffness and catching after several weeks of consistent practice. However, if symptoms worsen, or if there is no noticeable improvement after a few weeks of consistent performance, it is advisable to consult a physical therapist or physician. A healthcare professional can assess whether additional treatments, such as a splint or corticosteroid injections, may be necessary to resolve the inflammation and allow the tendon to move freely.