Commonly known as a “droopy” finger, a mallet finger is when the extensor tendon, the tendon that straightens your finger, is damaged.
This can be caused when you fracture (broken bone) or tear your tendon from an injury. There are two types of mallet finger injuries, bony and tendinous.
- Bony mallet finger.
The bony mallet finger is when you actually avulse a piece of the bone off, so it’s basically a fracture because your tendon pulled a small piece of the bone off with it.
That’s usually the better one to have because bone heals better to bone. Typically, all you need to do is wear your splint for about six weeks while the bone heals.
- Tendinous mallet finger.
This is when your tendon is completely pulled off the bone without taking a piece of bone off. So you won’t have a fracture or broken bone associated with this mallet finger type.
However, the tendinous mallet is not the better of the two because, unfortunately, it takes longer to heal. It is more difficult for your tendon to heal to bone. Usually, you’ll need to wear your splint for 8 weeks for the tendon to heal.
This can happen when a ball or other object strikes the tip of your finger or thumb, and forcibly bends it. This condition is caused by an injury to the extensor tendon at the DIP joint. It can also be caused by a laceration, or cut, to the back of your finger. But most commonly results from direct trauma, often during sports when a ball hits the tip of your finger when it’s straight.
This can violently flex the tip your finger, rupturing the extensor tendon. In some cases, the tendon is pulled away from the bone, breaking a piece of bone from the tendon’s attachment point. This type of injury is called a bony mallet finger. Or as I stated previously, the tendon can break off without bone, leaving you with a tendinous mallet finger.
The most common treatment for your mallet finger injury is splinting. Your affected finger is typically placed in a splint for six to eight weeks. Sometimes longer depending on the length of time you’ve had the mallet finger injury.
Occasionally, if you sustained a bony mallet finger and the bone fragment is too big, well then, surgery may be needed. Surgery can include, but not limited to, a pin placed in the finger until the bone is healed.
Most importantly, it is important to know where you are in your mallet finger recovery process. If you have been wearing your splint for less than 6 weeks then typically, you can not start any exercises to the tip of your finger. Now, you are usually cleared to exercise the uninvolved fingers and joints, basically, whatever is not splinted.
On the other hand, if you are 6 weeks or more and have been cleared by your doctor, then you can begin a gentle progression of exercises. Normally, specific exercises to the tip of your finger are not introduced until several weeks after you have started coming out of your splint.
To learn more, start our clinically proven self treatment program: Mallet Finger on Demand. Where I show you how to remove the splint and slowly introduce exercises to ensure safe return to normal hand use.
Occasionally, even if you follow the direction of your doctor, therapist, and this program, there is a chance you may still end up with a droopy finger. It is not uncommon to have around a 10 degree extensor lag, also known as a droop, to the tip of your finger. That is just the nature of this annoying little injury. Fortunately, a 10 degree lag is not enough to affect your hand function.
Now if you have a larger lag- just like when you first injured your finger- then there is a chance you may need surgery. Sometimes a swan neck deformity is misdiagnosed as a mallet finger injury.
More importantly, a swan neck deformity requires a completely different type of treatment that only a Hand surgeon or Certified Hand Therapist are familiar with. Watch our video here to learn more about swan neck deformities.
According to Americanfamilyphysician.org, most people can still play sports with a finger in a splint. However, some sports are harder to play due to having a bulky splint on your finger. If you have to catch, grip a ball, or wear gloves, you may find it more difficult. You may also feel as if you are not playing at your optimal level. Which could leave you feeling frustrated.
Of course, you always want to ask your doctor before you participate in any sport or strenuous activity when you have an injury. The reason is because you are more likely to re injure yourself and potentially undo all the healing that has occurred.
Since a mallet finger injury is a fairly minor injury then you may be able to play more low impact sports such as golf. But remember, you still have to splint your finger when you golf or play sports while your mallet finger is healing.
Your doctor can tell you for sure when it is safe to play sports again without the splint. This typically won’t occur for at least 10-12 weeks.
I highly recommended you go to an Occupational Therapist (OT) or Physical Therapist (PT). Most OT’s or PT’s that specialize in the hand and arm are Certified Hand Therapists (CHT).
They have undergone additional training, education, and clinical experience in common conditions and diseases of the hand and arm. Often a doctor will refer you to a CHT after your diagnosis, however, many will not.
If you do get referred to a CHT, more than likely he or she will make you a splint, educate you on your injury, as well as many of the key concepts addressed in our Mallet Finger on Demand program.
However, therapists and doctors are usually very busy and are often unable to take the time to answer your questions or explain all the important details regarding your healing mallet finger.
More often than not, you will only see your doctor or therapist a handful of times over a 12 week period. That is a long time. Leaving you struggling to find answers to the questions that may come up over the next few months of recovery.
Ultimately, your doctor will prescribe you therapy. However, if he/she does not you do have a right to request therapy services. If you are unable to attend therapy due to time, cost, accessibility, etc. then the Mallet Finger on Demand program is a great alternative.