The arrival of fall marks the return of football season. Despite growing awareness of football-related injuries, conditions of the hand and wrist are often overlooked. While some injuries can allow for early return to play, others require time to heal, or surgery. The injury risk and type varies by position, with lineman at greatest risk of injury to the hand. Familiarity with the most common Football-related Hand and Wrist injuries can expedite seeking treatment from an orthopaedic specialist, letting you know when you can get back in the game.
While not all sport-related injuries are avoidable, general prevention strategies include:
- Appropriate stretching and warm up before practice or games
- Hand and finger strength and flexibility
- Protection of the hands including gloves, taping, or splinting - particularly in the case of prior injury
The most common injuries to be aware of include:
Jammed Finger: Seen in all forms of ball sports, this occurs when a ball strikes the tip of an extended finger. This causes the finger to hyperextend. This over extension of the finger can result in strains or tearing of the ligaments within the finger. This will present with swelling of the injured finger along with pain and stiffness when trying to bend the affected digit. The decision to return to the game should be discussed with your athletic trainer or orthopedic specialist.
Finger Dislocation: A more severe form of a jammed finger. This can occur from a direct blow to the finger, or from a twisting or landing injury. In a finger dislocation, the ligaments surrounding a finger joint are torn and the two bones that make up the joint are no longer in proper alignment. Symptoms include pain, obvious deformity, and inability to move the affected joint. Treatment includes prompt repositioning of the bones, which should only be performed by a medical professional. The finger will require a period of immobilization following this injury. Occasionally, surgery is required.
Mallet Finger: A tendon injury that prevents active straightening of the tip of the finger. This can occur when a ball or object strikes the tip of the finger. Symptoms include pain and swelling along the tip of the finger. Individuals are able to passively straighten their finger, but are unable to actively hold the finger straight. Treatment includes immobilization in a specialized splint. Occasionally, surgery is required. The decision to return-to-play should be discussed with an orthopaedic specialist.
Jersey Finger: A tendon rupture that prevents active bending of the tip of the finger. This can occur when trying to grip the jersey of an opposing player, but the other player is able to break away. In doing so, the finger is forcefully extended when the tendons are trying to hold the finger flexed, rupturing the tendon. Symptoms include pain and swelling along the tip of the finger along with inability to actively flex the tip of the finger. These injuries require prompt surgical care and an appointment with an orthopaedic hand surgeon should be made.
Finger Fracture: Fracture involving the small bones of the finger, which may or may not involve the joint. This can occur from a direct blow to the finger. Symptoms include pain, swelling, and possible deformity of the finger. Treatment includes immobilization in a splint or brace, though surgery may be required to ensure proper bone alignment. The decision to return-to-play should be discussed with an orthopaedic specialist.
Boxer’s Fracture: Fracture involving a bone in the palm of the hand. This can occur if a clenched fist contacts a helmet or when punching an object. Symptoms include pain and swelling along the back of the hand. Treatment includes ice, anti-inflammatories, and a period of immobilization in a cast. Occasionally, surgery is required to realign the bones prior to casting.
Thumb Sprain: A tendon injury caused by stretching or tearing of a small ligament at the base of the thumb. They can occur when the thumb is pressed forcibly away from the rest of the hand. Symptoms include pain and swelling along the base of the thumb and difficulty with gripping objects. Treatment varies based on the severity of injury, and can include ice, anti-inflammatories, thumb spica bracing, and surgery. Before returning to the game, seek advice from your trainer or orthopaedic surgeon.
Scaphoid Fracture: The scaphoid is one of the small carpal bones in your wrist. Unfortunately, this is a common bone to injure in football as injury can occur from concussive force to the wrist seen in falls or blocking. Symptoms include pain and swelling in the wrist along with point tenderness just below the base of the thumb. This fracture is notorious for healing slowly. Treatment depends on the type of fracture with the options being immobilization in a cast or surgery.
With the use of protective bracing or taping, many players can continue to play despite these injuries. This may be challenging for skill positions, which rely on full finger mobility for optimal function. Consult a physician prior to resuming play if an injury is suspected. Rothman Orthopaedics partners with select local high schools to provide sideline injury assessment and treatment.
Dr. Michelle Mullins is a non-surgical sports medicine specialist who serves as the team physician for Orangewood Christian School. Dr. David Hirsch is a hand and wrist orthopaedic surgeon who specializes in the treatment of hand and wrist injuries, fractures and pathology.
For more information on sports-related tips or injuries, or to make an appointment, visit RothmanFL.com
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