Finger Rehabilitation After Fracture or Stiffness: Exercices & Tips

Have you fractured your finger and been given the go-ahead to start rehabilitation? Or are you wondering how to regain the flexibility, strength and use of your stiffened finger after a fracture or other problem?

I’ll guide you, along with the personalized help your physiotherapist can provide!

♻️ Last update: March 19, 2024.
👩‍⚖️ Declaration of financial interests: none directly related to the subject. My complete declaration of interest is in the legal notice section.
Written by Nelly Darbois, physiotherapist and scientific editor

1 – Identify the instructions given by your physio, doctor or surgeon

There are different types of finger fractures in terms of location, severity and treatment:

• conservative: with immobilization (or not) in a cast, splint or syndactyly, for varying lengths of time. This is often the case for non-displaced finger fractures;
• surgical: you’ve had an operation, and you may also need conservative treatment. This is often the case for displaced finger fractures.

You will normally have received fairly precise verbal or written instructions on what to do once a fracture has been diagnosed.

Here are the 3 most typical scenarios after a fractured thumb or other finger. It’s up to you to identify which scenario you’re in 🙂 !

Scenario 1: mobilization of the whole finger is totally forbidden for a few weeks.

Usually up to an appointment is a check-up X-ray.

Scenario 2: mobilization of a finger joint is totally forbidden for a few weeks.

Sometimes, it’s not the whole finger, but just one joint that is immobilized in a strict manner: between 2 phalanges or the joint between the metacarpus and the proximal phalanx.

In this case, be sure to identify which joint you should avoid moving.

Example:

• the first phalanx with the metacarpus: metacarpophalangeal joint ;
• the first phalanx with the second phalanx ;
• or the distal finger joint at the very end.

This means you’ll be able to move the other joints in your hand and finger normally!

Scenario 3 : You are allowed to mobilize all your joints.

This is sometimes possible in the first few days following the fracture.

And sometimes, it’s after a period of more or less strict immobilization, and a check-up X-ray showing the progress of consolidation.

🟢 Wherever you are in the consolidation of your injured finger, you can mobilize your other fingers and wrist joint. It’s even recommended, to avoid stiffening and loss of strength through under-use.

🟠 If you also have tendons that have been ruptured (flexors or extensors of the fingers or thumb, for example), you probably also have specific instructions.

2 – Be reassured that pain is not necessarily the sign of a problem

When you start mobilizing after an injury, it’s quite normal to feel a certain level of discomfort, even pain.

Firstly, your finger has adapted over a period of time to not being mobilized. During this time, your muscles, tendons and ligaments may have weakened or stiffened from lack of use.

When you start moving it again, these structures are called upon to support your body, which can lead to discomfort.

Secondly, the injured area itself may still be healing. Fractured bones, injured joints or the operated area are undergoing various stages of repair.

When you introduce mobilization, it can exert pressure on these healing tissues, causing sensations of pain or discomfort.

In addition, your nervous system plays a role in how you perceive pain and discomfort.

It can become more sensitive during the recovery process, amplifying your perception of sensations.

The key to a successful transition lies in finding the right balance between pushing your limits and allowing adequate healing. Be progressive, don’t do too much at once!

Start with small-amplitude mobilizations, following the guidelines provided by your healthcare professionals.

As you adapt, you can gradually increase not only the amplitude but also the frequency of mobilization (over days or weeks).

3 – Identify your most important finger discomforts

The self-education exercises you can set up will depend on the instructions you have received: are you “allowed” to move your finger?

But also the state of your finger at any given moment, determined for example by a check-up with your physiotherapist.

You can compare each time against the same finger on the side of your healthy hand.

• Is this or that joint in your finger stiff in flexion or extension? Move it analytically, without moving the other joints.
• Can you spread your finger to the right and left, or is this movement also stiff? Does your thumb move in all possible directions, to its maximum amplitude?
• Can you bend and extend all the joints of the fractured finger at the same time?
• Do you feel you’re lacking in strength, having trouble bending or stretching your finger?
• Do you find it difficult to grasp objects, zipper up a zipper, tie your shoes, use a computer keyboard, sew, open a jar of jam, write… or any other activity that is important to you and requires the use of your injured hand?
• Do you feel that other parts of your hands or arms have stiffened or become less functional? Another finger? Thumb? The wrist?
• Is it mainly the pain that bothers you?

4 – Think about a reasonable frequency and duration of daily exercise

If your finger has become stiff, or if it has been partially immobilized for several weeks, a daily exercise routine, either on your own or with your physiotherapist, is essential for a good recovery.

Here are a few tips to help you decide how long and how often to exercise.

Duration: Start with short sessions of a few tens of seconds, including all exercises.

It’s normal to sometimes feel discomfort at night, or pain that doesn’t stop immediately after exercise. This may be a sign that you’ve overdone it.

The next day, reduce your activity level slightly, then gradually increase it over time if this happens.

Frequency: Start with one exercise session a day. Make sure you give your joints enough time between sessions.

Progression: as you become more comfortable, gradually increase the duration and frequency of your exercises.

You can try to find several slots during the day to do your exercises, a few tens of seconds each time.

Monitor your body’s response and adjust accordingly.

Try to make it a routine, or use downtime to do a few exercises. For example:

• in the morning when your coffee’s running;
• when you’re queuing somewhere;
• watching a film, etc.

5 – Use these exercises or ask your physiotherapist!

I’m now going to show you some exercises you can do with equipment you have at home.

🚨 Not all of these exercises are necessarily relevant: it’s up to you to identify which ones are in your case, and to ask your physio for advice if you’re unsure!

In relation to any contraindications you may have. But also in relation to the difficulties and limitations you encounter!

Some hand splints are also custom-designed to enable you to perform certain exercises. In this case, your physiotherapist or orthopaedist will normally have informed you of the exercises you can perform!

➡️ Exercises to recover passive extension and flexion of the distal phalangeal joint of a finger, in this case the index finger.

(I’m not a photographer… hence the backlit photos 🤦‍♀️!)

Instructions : position the finger so that only its tip bends and unfolds.

➡️ Exercises to recover global and active finger flexion and extension.

Instructions : stretch or flex all your fingers as far as possible, without forgetting your thumb (especially if it needs to recover!).

➡️ More functional exercises to restore hand strength and dexterity.

Instructions for exercising with the bottle: start with little water (easier because less weight) then increase until you’re doing it with a 1.5L bottle!

Any situation that calls on all your fingers is a good one: be imaginative!

➡️ Exercises to recover flexion.

Instructions: position your fingers in flexion at the joint you wish to work on. Then gently bend forward so as to put part of your body weight on the fingers to help them bend better, depending on the pain.

🚨 These exercises place considerable stress on the bone. They can only be performed when bone consolidation has been achieved.

➡️ Muscle-strengthening exercises for finger extensor muscles.

Instructions: use your other (uninjured) hand to counter-press as if you were trying to prevent your fingers from stretching. The injured hand must “force” against your fingers to tighten. Find the right balance to make the movement possible, or perform the contraction statically (pushing against your fingers without movement).

🚨 These exercises place considerable stress on the bone. They can only be performed when bone consolidation has been achieved.

➡️ Exercises to regain flexibility in finger adbuction and thumb opposition.

Instructions : move the fingers as far as possible to the right and left sides, and the thumb to the palm of the hand.

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That’s all I wanted to say on the subject! Any questions or comments? See you in comments!