biking finger injury

Discussion in 'Playing and Technique' started by nsbucky, May 8, 2008.

  1. nsbucky

    nsbucky Member

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    I totally slammed my finger into the ground riding my mountain bike like 3 weeks ago. It was pretty sore and hard to fret an open C chord, but since then its gotten better to where I can play for at least an hour. Anybody else had this happen to them? How long did it take to go away? I'm just worried that it would be something that will hinder my playing in the future.
     
  2. ?&!

    ?&! Member

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    If you don't want it to affect your playing in the future, take some time off. I injured my left hand ring finger (skateboarding, not mountain biking) a long time ago. I had gigs, so I played through the pain. It's been years, and it still bugs me. I should have taken some time off and let it heal properly.
     
  3. The Captain

    The Captain Supporting Member

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    Both of you guys sound like you may have had a ligament injury. An impact to the tip of a fnger, common in ball catching games and after falls like this, casues a lateral flexion at eth last joint, damaging the collateral ligaments. I had this to my right index a few years back , after falling while skateboarding.
    It takes a year or to heal fully. There may be associated avulsion fractures as well, which actually heal quicker. Depending on how old you guys are, there may be osteoarthritis as well after an injury like this.
     
  4. ?&!

    ?&! Member

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    Oh yeah, I've most definitely got a ligament injury. Lots of soft tissue pain at the first knuckle. Yuck. Unfortunately for me, the finger injury is the least of my concerns. I herniated 3 discs in my neck when I aggravated an old snowboarding injury, which made me lose feeling in my left hand pinky and ring finger. It amazes me that I can still play at all! If only skateboarding/snowboarding/surfing wasn't so darned fun...
     
  5. The Captain

    The Captain Supporting Member

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    I'll be honest, I don't snowboard much anymore, cos the falls hurt too much. I took my sonwboard out one time on my last ski trip, and flipped forwrad over a stuck edge at precisely the same spot on the same schuss at Whistler that I flipped on last time 3 yrs previously.
    I stick to ski-ing now. I quit the skateboard after smashing my finger that day and tweaking my ankle too. I still surf, but I'm wary of shallow water after smashing my neck one time. Weird how you picked out teh three sports I've actually hurt myself doing.
     
  6. nsbucky

    nsbucky Member

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    yeah i didn't jam my finger per se, i caught myself in a push up position on the ground after being thrown over the handle bars, most of the pain is in the knuckle, sometimes it feels like im trying to close my finger over a pencil if that makes any sense.

    i have just felt like maybe it would heal in a few weeks, im 33 so yeah things take longer, but if its a year to heal, then i should go easy on it day to day im thinking.
     
  7. townsend

    townsend Member

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    There's some really good stuff in this thread. As a physician assistant, I now work in neurosurgery, but 4-5 years ago, I spent 2 1/2 years with an orthopedic hand surgeon.

    I think it is more likely (it's a matter of leverage) that the lateral collateral ligament gets strained or torn at the next to last joint, the PIP joint (shorthand for "proximal interphalangeal joint";), rather than the last joint, or DIP joint (= distal interphalangeal joint). It is characterized by pain/tenderness along the sides of that joint, and in fact, on exam, you can actually "deviate" the finger ever so slightly and note the laxity.

    I saw this A LOT, but I really understood it after I had it once. And the poster who said it takes a year to heal isn't far off; it took me 8 months to heal. One thing that might facilitate heaing is to "buddy" tape your "injured" finger to a adjacent finger, in order to avoid reinjurying the lateral collateral ligament. After it heals, your knuckle might be a little larger, because there might be some scar tissue in the ligament, but it's no big deal.

    Sorry to hear about the poster who herniated 3 discs in your neck . . . are you sure they are "herniated"? Some patients describe all disks as herniated when in fact some are herniated (same as protruded) whereas others are "bulging discs." On the ring and pinky being numb, that is definitely a C8 radiculopathy.

    If this is going on, I'd see a neurosurgeon. Perhaps you could benefit from some form of conservative therapy (i.e, traction kit you could use at home, etc.). Best wishes for your healing.

    Finally, and I don't mean to be long winded, if you ever have a situation where the "tip" of your finger, after an injury (like when a basketball or football hits you directly on the end of your finger), "droops down" (i..e, it is flexed and you can't extend it to straight out), you must see a hand orthopedist PRONTO.

    This injury occurs because the extensor tendon is no longer connected to the distal portion of the finger (either the tendon purely tore off, or an avulsion fracture, where the tendon took a piece of bone with it).

    This injury is serious because if is not treated in a "timely" manner, it will become permanent. Don't get me wrong . . . it is not an emergency, but if it took place several months ago, it may be too late. Your finger will have to be splinted for approximately 6 weeks, and during that time, you can never break the extended position it is splinted in. This needs to be managed by an othopedist.

    Don't hesitate to find a good doctor who you trust, and seek treatment in a timely manner.
     
  8. The Captain

    The Captain Supporting Member

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    ^^^^
    Yeah, well I'm a GP, so I've seen a lot of these injuries.
    It's interesting that you've seen more PIP probs than DIP, maybe related to the type of activities.
    There are a lot of ball catching spots in Oz, esp cricket and Aussie rules, both of which involve catching hard balls without gloves at high velocity, which have often gone high in the air, coming down at a steep angle or been stuck forcibly and it's easy to misjudge teh angle slightly, causing the ball to strike the finger tip, and it's usually the DIP that gives.
    Hockey and gridiron will have a lot more side-impact forces, I imagine, in which case it's easy to see the stick, ie finger, breaking in the middle and the PIP copping it.
    I was about 33 too when I dinged my finger and it took a year, children heal a lot more quickly than that.
    I also injured my ulnar collateral lig on the left wrist playing hockey once, and that made me oput teh guitar sown for so long that I didn't really pick it up again until someone stirred my interest 5 years later.
     
  9. Jon

    Jon Member

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    I get arthritis in the finger joints - if I clench my fist there's stiffness & pain in the middle & end joints (DIP & PIP?) of my middle & ring finger - however it doesn't really seem to affect my guitar playing - it's rare that I notice any pain or stiffness when I'm playing. Les Paul's hands look pretty gnarled but he seems to be able to zip around the fretboard still so maybe there's hope for me yet.
     
  10. The Captain

    The Captain Supporting Member

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    Yes, there is hope. Keith Richards is another example of a guy with tons of primary nodal osteoarthritis , but he hasn't slowed down either. Neither rest or work make a difference to the progression of this disease, so just keep playing. I'm starting to get a bit in a bunch of joints, and I'm just 44. I won't be surprised if my hands look like keef's by the time I'm 50.
     
  11. ?&!

    ?&! Member

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    I did see a neurosurgeon after the injury, and I was actually scheduled for a triple cervical laminectomy. They had to cancel my surgery date because of a scheduling conflict, and I decided not to re-schedule the appointment. I did a lot of research, and all the horror stories I read about the procedure convinced me to focus on physical therapy, and hope for the best. I completed my PT (including the ol' home traction kit), and I've regained most of the mobility and feeling in my fingers. There is still some numbness on the top of my fingers, and some burning pins'n'needles on the outside of my pinky and hand, but overall it's a huge improvement.
    I actually played shows for 6 months with no feeling at all in the tips of fretting hand pinky and ring fingers. Scary!

    Out of curiosity, what's the difference between a "herniated" disc and a "bulging" disc? I've always thought they were interchangeable terms. I saw my MRI, and I have one disc that protrudes about 1/3 of the way across my spinal canal, and then two more that stick out to a lesser extent above. I felt like throwing up when I first saw the photos.

    I've also read that there are new arthroscopic methods of dealing with this problem that are far less invasive. Any information you could provide me about surgical alternatives would be greatly appreciated. Thanks!
     
  12. nsbucky

    nsbucky Member

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    wow thats what it is exactly. thx so much for the post, makes me feel better just knowing what it probably is, and im ok with waiting, just to know that it should get better. :dude
     
  13. townsend

    townsend Member

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    A disk has two components: the softer, inner material is called the nucleus pulposis. The tougher, outer (surrounding) ligament is called the annulus fibrosis. There is no exact analogy but we often use comparison to a "jelly-filled donut."

    With a herniated disk, the tough, outer ligament--annulus fibrosis--has torn or ruptured. This allows the softer, inner material--nucleus pulposis--to "herniate" or "protrude" through the torn ligament. That is a herniated disk. We use the terms herniated, protruded and ruptured disk as roughly equivalent terms. Sometimes the herniation is focal . . . not broad, but at a specific point.

    With a bulging disk, the tougher outer ligament is still intact. It is not torn or ruptured. As we age, the disk, through wear-and-tear, begans to degenerate. The outer ligament becomes weaker. This allows the disc to bulge. The posterior edge of the disk (which faces the spinal column/spinal cord) is normally slightly concave (kind of like a lima bean). When the disk bulges, it may be more flat rather than concave. the disks may "bulge" into the spinal canal (or neural foramen). The disk shows signs of degeneration, the outer ligament is weakened, but it hasn't yet actually ruptured, allowing disk material to herniated through the torn ligament.

    In general, bulging disks usually don't compress either the spinal cord or spinal nerves, so conservative treatment is warranted. Bulging disks may cause mechanical neck or back pain, but normally don't cause "radicular symptoms" (pain, numbness, or tingling radiating down arms [from neck] or down legs [from back]).

    Nonsurgical alternatives: cervical traction (home units are inexpensive and effective for some), lumbar traction (not sure this works that well, pulling your trunk ain't as easy as pulling your neck/head!), physical therapy, pain management injections (epidural steroid injections, facet joint injections).

    I confess I don't know of arthroscopic methods for neck or back surgery. There are microsurgical techniques, involving microscopes and/or high-powered magnification, but not an arthroscopic approach like orthopedists use to operate on knees.
     
  14. townsend

    townsend Member

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    Good points, and I think we basically agree; I need to clarify my comments. In my limited experience, DIP gives way exactly as you describe. That produces "mallet finger", with a torn extensor tendon. The plane of deviation is flexion/extension; the ball striking the tip of the finger rapidly and forcefully deviates an extended finger into flexion, tearing the extensor tendon.

    The original question was about collateral ligaments. I've seen this most commonly at the PIP joints, and the plane of deviation is lateral bending (not flexion/extension)-toward the thumb would be "radial deviation", and toward the small finger would be "ulnar deviation."
     
  15. ?&!

    ?&! Member

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    Thanks so much for the info! If I had to guess, I would say at least one is herniated. When I broke my neck snowboarding (hairline crack), I had crazy pins and needles all down my arms and through my hands, instantaneously. That subsided after awhile (a couple of months). I reinjured the same spot a few years later playing air hockey (seriously). It's strange to spend your whole life jumping down stairs and handrails on a skateboard relatively unscathed, only to nearly cripple yourself playing AIR HOCKEY, of all things.

    I may not have used the right medical term when I said "arthroscopic". The stuff I'm talking about uses microsurgical techniques and lasers, and it's an outpatient procedure. Much more appealing than a triple laminectomy!
     
  16. The Captain

    The Captain Supporting Member

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    Ok, but in my somewhat greater than limited experience, a collateral lig injury at DIP is quite common with a ball striking injury, though a mallet finger obviously can occur. As a PA, you see referred patients, whereas I work in primary care, where the spectrum of problems is greater. It's likely that fewer collateral lig injuries get referred, as they seem less dramatic, and require less active treatment.:AOK
     

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