Did you know that a quarter of all athletic injuries involve the hand or wrist? Although many sports injuries are similar to those that occur in the general population, use of the hand and wrist in different sports affects the way they may be injured. Here’s a brief guide to some of the more common sports injuries.
Most common hand injury: Cyclist’s or Handlebar Palsy
Vulnerability: The ulnar nerve, one of the three main nerves in your forearm, is vulnerable to compression injury at the base of the hand during cycling because up to a third of the body weight is exerted onto the handlebars. This can cause Ulnar nerve palsy (also known as Cyclist’s or Handlebar Palsy). Numbness in the little and ring fingers and weakness of the hand usually start after a very long ride, especially over rough terrain, or may develop gradually over time.
Diagnosis: Electrophysiologic tests and an MRI may be needed.
Prevention: Wearing padded gloves, periodic grip changes during cycling, using drop handlebars and adjusting seat height and position to improve pressure distribution.
Most common hand injury: Mallet Finger & Fracture Dislocation of the Proximal Interphalangeal Joint (PIPJ)
Vulnerabilities: Most hand injuries are caused by the fast, hard ball hitting the finger while catching or batting. Mallet Finger occurs when the ball hits the fingertip, causing a rupture of the terminal extensor tendon or a fracture of the distal phalanx. This results in a bent fingertip and inability to straighten the distal phalanx. Fracture Dislocation of the Proximal Interphalangeal Joint (PIPJ) is a complex fracture of the anterior base of the middle phalanx with the rest of the middle phalanx being dislocated dorsally. Untreated, the finger stiffens and the PIPJ develops degenerative arthritis.
Treatment: Closed Mallet injury will require splinting and fractures will need surgery.
Most common hand injury: Hook of Hamate Fracture & Extensor Carpi Ulnaris (ECU) Tendon Instability
Vulnerability: Hook of Hamate Fracture is the most common bony injury in golfers and happens when the golfer strikes the ground forcefully. It affects the upper hand, with pain in the palm and weakness on gripping. Numbness of the little and ring fingers may occur. Painful movements, clicking and rupture of the flexor tendons of the little and ring fingers may occur. Extensor Carpi Ulnaris (ECU) Tendon Instability happens when the tendon sheath is disrupted, usually due to sudden impact like hitting the ground with the wrist in ulnar deviation and supination. During the golf swing, painful snapping or clicking occurs as the tendon shifts in and out of position.
Diagnosis: Dynamic ultrasound, X-ray, MRI or CT scan maybe required.
Most common hand injury: Skier’s Thumb
Vulnerability: Skier’s Thumb, or rupture of the ulnar collateral ligament of the metacarpo-phalangeal joint of the thumb is caused by the handle or loop of the ski pole or the ground when the skier falls and the thumb gets pulled sideways. Sometimes a piece of bone may be fractured as well. The thumb is painful and gives way by displacing away from the index finger when pinching.
Diagnosis: X-rays and MRI to assess the severity of the injury.
Treatment: If the ligament is completely torn, if the joint is unstable or if the fracture is displaced, early surgery will be required to reattach the ligament or bone fragment. In mild injuries, cast immobilisation will be required.