Diagnosis Explanation:

Mallet finger occurs when the extensor tendon at the tip of the finger (DIP joint) is torn or ruptured, causing an inability to straighten the fingertip. This injury typically results from a direct blow to the tip of the finger, such as catching a ball or hitting an object.

Symptoms:

• Drooping fingertip that cannot be actively straightened.
• Pain, swelling, and bruising at the DIP joint.
• Tenderness over the back of the fingertip.
• Possible nail bed injuries or avulsion fractures (small bone fragments pulled off by the tendon).

Specific Work Modifications:

• If your job involves typing or writing: Use voice dictation software or a splinted finger rest while typing.
• If your job requires manual labor: Avoid gripping, pulling, or lifting heavy objects with the injured hand.
• If your job is desk-based: Use a soft keyboard rest, keep the hand elevated, and take frequent breaks.
• Avoid: Repetitive hand use, forceful gripping, and applying pressure to the injured finger.

Specific Activity Modifications:

• If you play sports: Avoid ball-handling sports (basketball, baseball, volleyball) and contact sports until cleared for return.
• If you play an instrument: Modify technique to accommodate the splint and prevent strain.
• If you do crafting, gardening, or cooking: Use larger-handled tools to reduce finger strain.
• Avoid: Repetitive gripping, excessive finger flexion, and weight-bearing activities on the affected hand.

Recommended Supplements:

• Collagen Peptides – 10g daily for tendon and joint repair.
• Vitamin C – 500mg daily to support collagen synthesis.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint and tendon health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to aid tendon healing.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain joint lubrication.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to support tendon recovery.

Home Exercise Prescription (Rehabilitation for Mallet Finger)

Early Phase (0-6 Weeks, Immobilization & Healing):

• Splinting – Wear a DIP extension splint full-time for 6-8 weeks to allow tendon healing.
• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression, Elevation.
• Avoid Finger Bending – Keep the splint in place to prevent re-injury.

Strengthening Phase (6-8 Weeks, Improving Mobility & Function):

• Gentle Passive DIP Flexion – Remove splint (as directed), slowly bend fingertip with other hand, hold 5 seconds, repeat 10 reps, 2x/day.
• Isometric Finger Extension – Place hand flat, try to lift the fingertip (without resistance), hold 5 seconds, repeat 10 reps, 2x/day.

Advanced Phase (8+ Weeks, Preventing Recurrence & Restoring Strength):

• Soft Ball Squeeze – Gently squeeze a soft ball 5 seconds, repeat 10 reps, 2x/day.
• Rubber Band Finger Extensions – Wrap a rubber band around fingers, extend hand against resistance, 10 reps, 2x/day.
• Finger-to-Thumb Opposition – Touch thumb to each fingertip, 10 reps, 2x/day.

Helpful Books:

1. The Hand and Wrist Pain Solution: Simple Exercises for Relief – Dr. Ross Clifford.
2. Arthritis and Hand Therapy: A Self-Help Guide to Managing Joint Pain – Susan J. Barnhart, PT.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.