Physiotherapy is crucial for a successful recovery from Jersey finger, especially after surgical repair. It plays a vital role in regaining strength, range of motion, and function in the injured finger.

Phases of Physiotherapy

I. Post-Surgical Immobilization (typically 0-3 weeks)

• Splinting: A protective splint is usually fabricated to keep the finger and wrist in a specific position (e.g., wrist in slight flexion, MP joints in flexion, IP joints extended) to reduce tension on the repaired tendon.
• Wound Care and Edema Reduction: Managing swelling and ensuring proper wound healing.
• Passive Range of Motion (PROM): Gentle passive flexion to each digit joint may be initiated by the therapist within the limits of the splint to prevent stiffness and promote tendon gliding.
• Active Extension: Active extension within the limits of the splint may also be encouraged.
• Scar Massage: Once sutures are removed, scar massage may begin to prevent adhesions.
• Restrictions: No active DIP flexion of the operated digit, no active wrist flexion, and no passive finger extension beyond the splint.

II. Early Mobilization (typically 3-6 weeks)

• “Place and Hold” Exercises: Patients start gentle “place and hold” exercises for digit flexion, where the therapist passively moves the finger into flexion, and the patient then holds it there with minimal effort.
• Splint Adjustment: The splint may be adjusted to allow for more movement.
• Gentle Active Flexion: As healing progresses, gentle active flexion may be introduced under strict guidance.
• Tendon Gliding Exercises: These are crucial to prevent scar tissue from adhering to the tendon, which can limit movement. Examples include hook fist and full fist exercises, performed gently and within pain limits.
• Restrictions: No functional use of the hand or resistive exercises.

III. Strengthening and Functional Return (typically 6-12+ weeks)

• Progressive Strengthening: Gradually increasing the intensity of exercises to build strength in the finger and hand muscles. This may involve using resistance bands, therapy putty, and grip strengthening tools.
• Full Range of Motion Exercises: Working towards achieving full active and passive range of motion in all finger joints.
• Fine Motor Control: Exercises to improve dexterity and coordination.
• Activity-Specific Drills: For athletes, sport-specific drills are introduced to prepare them for a safe return to their activity.
• Gradual Return to Activity: The hand therapist will guide the patient on a gradual return to daily activities and eventually sports.

Common Physiotherapy Exercises (post-surgical, under therapist guidance):

• Isolated DIP Joint Flexion: Bending only the fingertip joint.
• Hook Fist: Bending the tips of your fingers towards your palm while keeping your knuckles straight.
• Full Fist: Making a complete fist.
• Tendon Gliding Exercises: Specific movements to ensure the flexor tendons glide smoothly within their sheaths.
• Finger Spreads: Using a rubber band around the fingers to spread them apart against resistance.
• Soft Ball Squeeze: Squeezing a soft ball to improve grip strength.
• Towel Squeeze: Crumpling a towel with your fingers to improve grip.