Advanced physiotherapy for MCP injuries aims to restore full hand function, strength, and dexterity, minimizing long-term complications like stiffness or chronic pain.

• Pain and Swelling Management:
  • RICE Protocol: Rest, Ice (cryotherapy), Compression (gentle bandage/taping), Elevation.
  • Modalities: Therapeutic ultrasound, low-level laser therapy (LLLT), or TENS to promote healing and reduce pain/inflammation.
  • Gentle Massage: Once cleared by the therapist, soft tissue mobilization around the injured area to reduce swelling and improve circulation.
• Immobilization (Initial Phase):
  • Splinting/Taping: Often, the injured finger is splinted in a specific position (e.g., slight flexion for MCP joint sprains) or “buddy-taped” to an adjacent finger to provide support and protect the healing structures while allowing limited movement of the healthy fingers. The duration and type of immobilization are crucial and determined by the therapist.
• Restoring Range of Motion (ROM):
  • Early Gentle Active ROM: As soon as pain allows, and under guidance, gentle active flexion and extension exercises are initiated to prevent stiffness. This might involve “blocking exercises” where one joint is held stable while another is moved.
  • Passive ROM: Gentle passive stretching, if appropriate and carefully controlled, to regain full motion.
  • Tendon Gliding Exercises: Specific exercises (e.g., hook fist, full fist, straight fist) to ensure tendons move freely and prevent adhesions.
  • Joint Mobilization: Advanced manual therapy techniques by a skilled physiotherapist to gently restore joint play and glide within the MCP joint, especially if stiffness persists. This is done with extreme caution and only when the ligamentous healing is sufficient.
• Strengthening:
  • Isometric Exercises: Gentle contractions without movement (e.g., pressing against a resistance without moving the finger) to activate muscles early and prevent atrophy.
  • Progressive Resistance Exercises: Gradually introducing resistance using therapy putty, resistance bands, or small weights for finger flexion, extension, abduction, and adduction.
  • Pinch and Grip Strengthening: Using pinch gauges, grippers, or everyday objects to improve functional strength.
  • Intrinsic Hand Muscle Strengthening: Exercises targeting the small muscles within the hand, crucial for fine motor control and stability of the MCP joints. Examples include finger spreading/closing against resistance.
• Proprioception Training:
  • Balance and Coordination: Exercises to retrain the joint’s sense of position and movement. This might involve manipulating small objects, picking up coins, or using fine motor tools.
  • Sensory Re-education: If nerve sensation is affected, exercises to restore normal feeling.
  • Functional Tasks: Integrating exercises into daily activities to make them more purposeful and build confidence. Examples include buttoning shirts, writing, typing, or preparing food.