A break in the little finger (5th) metacarpal (hand bone) is often coined a Boxer's Fracture. This is because a common mechanism of injury is from a punching a hard surface with a clenched fist. The bone is usually broken at the neck (close to where the little finger joins the hand) or the base (back of wrist on little finger side of hand).
Pain surrounding the break in the bone and swelling in the region usually occur directly after the blow. However it is important to get an x-ray early, because if the bone has shifted in position it may need an operation to fix it. There is a real chance, that if the bone is left to heal in an incorrect position, that permanent changes in the way the little finger moves will result.
A Hand Therapist will make a custom fit thermoplastic splint to protect the bones as they heal, whilst allowing for maximal safe use of your hand. As swelling over the back of the hand is common with Boxer's Fractures, managing swelling is critical, as is getting the healing fracture moving as soon as it is safe to do so. An experienced Hand Therapist can help guide you through this process.
Strain to the neck, shoulders, forearms, wrist and hand is not uncommon for musicians who play for prolonged periods of time each week. This usually results from awkward arm or body positioning in handling the instrument or sitting to play. Or overuse of different muscles or tendons from playing for long periods. And can result in aches, pain & swelling in the wrists, forearms and shoulders. In some cases compression on a nerve can cause pins & needles or tingling in the hands can be experienced during or after play.
To help prevent upper limb strain from prolonged play there are some simple and effective things you can do.
1. Warm up before you play
Before picking up your instrument or sitting down to play, stretch the muscles of your fingers, wrists, forearms, shoulders & back. By gently stretching the muscles we increase blood flow, this will warm & lengthen the muscles & joints- and help prevent strain. Always move into stretches slowly, and try to hold them for at least 10 seconds each.
TIP It can help to start by playing familiar & easier pieces before leading into complex ones.
2. Set a timer, check your posture
Getting into the routine of regularly checking your posture can help to prevent strain. Consider setting a timer as a regular reminder. As a general rule it is beneficial to engage your core, relax shoulders, keep neck upright, and relax tight muscle groups.
3. Take a break
Factor in regular short rest breaks throughout practice. It is easy to get caught up and concentrate on playing and loose track of time. Taking regular breaks, pause, move, stretch, drink water and take note of any built up tensions. Resting and changing position will help prevent nerve compression & tendinitis.
4. Strengthen up
It is beneficial to strengthen particular muscles which work to position the arm and hold the instrument with aim to preventing injury. Bring your instrument into clinic (if possible), and we can customise a strengthening program to suit you and how you play.
Carpal Tunnel Syndrome is the name given to a condition where the nerve that travels through the wrist (the Median Nerve) is compressed. The tunnel in the wrist that the nerve travels through is called the Carpal Tunnel.
The nerve can be compressed by surrounding soft tissues (such as swollen tendons), a tight 'roof' to the tunnel (ligament or retinaculum), or a build up of pressure in the tunnel (fluid) due to hormone changes or other reasons.
When there is pressure on the nerve, messages can not travel along the nerve as normal. And this is what results in the symptoms associated with carpal tunnel syndrome.
Author Jo Marsh
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