Most sports, particularly involving balls or rackets will involve some kind of
contact with the hand and fingers and mostly we'd rush that off as part of the
experience of the game and if you have pain and swelling around your knuckles
that doesn't settle after a couple of days of doing sensible things like
resting them, icing them and maybe taking anti-inflammatories you should probably
have it checked out because it's quite an injury to have a dislocation or a
fracture around the knuckles. Some sports are more prone to that such as netball, basketball,
where something quite heavy hits the
fingers and extends them, so if your injury isn't settling down quickly have
an x-ray and then we can see and advise you on early active movement. Joints can
stiffen very quickly and once they become stiff they're very hard to get
better again, so the sooner action is taken the better.
Almost any contact sport may end up in the players ending up on the ground or a fall onto the outstretched
hand is something that we do unconsciously to stop ourselves from
injury and it may be that at the time of the fall or the tackle or coming off the
snowboard, you don't notice an immediate trouble with the wrist, but there may be
swelling that develops in the next few hours or overnight and the wrist may feel
stiff and one of the questions I would ask myself if I heard a patient telling
me this story was; is there a ligament injury inside the wrist? Fractures we tend
to notice straight away. You see the change in shape and you see
the bruising and you see the swelling coming on very quickly, but ligament
injuries, though very important may be more insidious in their appearance,
so if you feel your wrist is sprained and it's really not settling
down, you should probably have it checked out. There are a number of important
structures inside the wrist holding the little bones together and if they're
partially injured or torn and that may have an impact on how the wrist works in
later life, so the reassurance of an x-ray or a scan
helps us all support repeat patients in their rehabilitation after injuries such as this.
Any sport or activity that takes place at speed can result in an injury if the player or participant comes to a sudden halt.
For example, coming off a snowboard or a push bike and making contact with the road surface.
It's important to remember that most people enjoy these activities
without risk of injury, but if it happens and the unexpected can, you should
probably get it checked out. If we're traveling at velocity and the limb makes
contact with the hard surface, there can be a ligamentous injury or even of a
break in the bone and these vary on where they occur really with the time of
year. At Easter time, we see a lot of people coming back from the slopes,
mostly with their arms in plaster after a scaphoid fracture or a distal
radius or wrist fracture. In the summer, when contact sports have us more in
contact with grass and softer ground, we might see more ligamentous injuries or
dislocations. So if you have an injury coming off at speed and making a sudden
stop and the swelling or the pain doesn't settle after a couple of days, it
would be a good idea to have it looked at in case something needs addressing.
Most of us have very busy lives and pain anywhere can be quite an inconvenience.
What we should do is take sensible measures straight up if we are aware
we've got an injury. Some people are able to take anti-inflammatories, rest, ice and
gently let things recover, but sometimes even after those sensible measures
discomfort doesn't settle down and particularly if pain wakes us from sleep
at night it should be investigated, just to put everyone's minds at rest.
We may not have had a fracture which is quite quickly obvious,
or maybe a sprain, a cartilage injury or a ligamentous injury and under those
circumstances it can take a while to settle down but if there's been damage
that discomfort may not settle down and it may lead to some difficulties later
on in life. So my advice would be if you've taken sensible measures and it
hasn't settled down after a week or so you should probably get it checked out.
Sometimes just a simple x-ray or a scan can put people's minds at rest and help
us support you in your rehabilitation.
The most important part of getting better from an injury is identifying
what that injury is. There are different rehabilitation plans for the different
things that can be upset, for example, it's extremely important to start early
active movements for joint dislocations or ligamentous injuries around the
knuckles, but it wouldn't be a good idea to get it moving quickly if there was a
fracture or break in the bone. So it helps us to help you to identify what
the injury is right from the beginning and then together we can plan
your rehabilitation. Not every injury requires an operation, not every fracture
requires fixation. So there are many things that can be done but the key to
getting better is understanding what the problem is in the first place.
If there is a fracture to a bigger bone such as the wrist, this too may be
managed either in a plaster cast or occasionally with surgery depending on
the fracture pattern and it may be helpful to get x-rays or a CT scan to
help progress that forwards. Once the diagnosis is made and we've worked out
what it is and we can plan how to fix the situation, improve the situation and
plan your rehabilitation, in concert with my colleagues in hand therapy who are
specialist therapists able to get your joints moving as quickly as possible.