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What is Trigger Finger & PIP Capsulitis?

Sep 11, 2022

In this blog article, we’re going to talk about trigger finger and PIP capsulitis. It's very important to understand these two so that you know how to deal with them and, as much as possible, avoid them on your next climbing trip.  

What is Trigger Finger?

Trigger finger is also known as Stenosing Tenosynovitis. Stenosing Tenosynovitis happens when inflammation narrows the space between the sheath surrounding the affected finger’s tendon. If the trigger finger became severe, you would notice that the finger looked locked in a bent position. 

Let’s look into the etymology of the word Tenosynovitis. 

  • Teno = Tendon
  • Syn = Sheath
  • Itis = Inflammation. 

Also, Stenosing =  Space getting smaller

The tendons at your fingers are covered in what's called a synovial sheath, and that allows them to glide smoothly. So with the trigger finger, the A1 pulley becomes swollen. 

Then, it makes it harder for the tendon to move through the A1 pulley, so over time, if it doesn't get treated, it can develop a bump or a node. That bump or node is what ends up causing the tendon to catch or trigger, which is why it's called the trigger finger. But if the swelling gets too big or too great, then the tendon can't pass through the pulley and your fingers can get stuck in a bent position.  

Leaving the Trigger Finger Untreated

If you leave your trigger finger untreated, then that friction causes this node or this bump to swell bigger and bigger. Ultimately, if it gets too big, then your finger gets stuck in this position because that bump can't get through the A1 pulley. 

Why Does Trigger Finger Happen?

It's due to the forceful and repetitive gripping motions. The sheath is supposed to be lubricated, and it's allowing the tendon to glide through your pulleys. However, if you have an injury or a node and it can't glide through, then that friction causes it to get more bunched up. 

And if it gets too big because you keep climbing on it, for example, then it can get big enough to where it gets stuck. And ultimately, you might need surgery to fix that. That’s why you need to get treated as early as possible to avoid any possible complications or infections. So make sure you get your trigger finger injuries treated early by a PT who understands rock climbing and finger injuries. Of course, if you're in Austin, Texas, I help climbers who suffer trigger finger injuries and I also help them get back to climbing.

Talking About PIP Capsulitis

As you can remember, PIP has been thoroughly explained in the previous blogs on this site.  PIP stands for Proximal Interphalangeal Joint. So by definition, capsulitis is the inflammation of the capsule. 

The capsule is the ligaments that surround the joint. That capsule is filled with what we call synovial fluid. This fluid keeps the joint lubricated and helps deliver nutrients into the joint. The joint gets the nutrients through movements as you bend, extend your fingers, and move them around. That motion is what causes the synovial fluid to get pumped through and deliver the nutrients. 

So looking into the meaning of the word Capsulitis, it’s the capsule, and the “itis” means inflammation or swelling. Putting them together, as mentioned earlier, means an inflammation of the capsule. 

The Manifestations of the PIP Capsulitis

With capsulitis, you don't get that immediate feedback when climbing on the wall. So what ends up happening is you climb on it, and because it's your joint, you don't feel anything when you do it. But after you're done climbing, you may then feel the ache in your fingers for hours or days. However, if you don't address it and keep climbing on it, then you can cause more damage and ultimately, your finger gets really swollen consequently. 

But if you’re not sure what’s causing your finger pain? Book your FREE online consultation with a qualified Physical Therapist TODAY!

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