Trigger Finger Syndrome Questions & Answers By Jeff Anliker, LMT





Question / Comment:
I fail to see the need to use Flextend. For a disorder like Trigger Finger, and to some point Carpal Tunnel Syndrome, the repetitive exercises that you are recommending will actually increase the symptoms. 

The exercises and stretches that you suggest contradict the proven treatment protocols for both Trigger Finger and Carpal Tunnel; neither of which are a result of a weakness existing in the muscle groups you mention.

Have you consulted with Occupational Therapists, Physical Therapists or credible physicians regarding your programs? Their level of expertise may help.

Answer / Reply:
Thanks for your comments! I work with a number of PT's, OT's, DC's and physicians who all agree with me regarding the treatment approach that firmly involves the use of the FLEXTEND Trigger Finger stretches and exercises when treating Repetitive Strain Injuries of the upper extremity.

Trigger Finger Syndrome is a result of an adhesion that has formed on the flexor tendon of the affected finger(s). Performing repetitive "flexion" against resistance would certainly increase the symptoms, but performing a set number of exercises utilizing finger extension forces the affected flexor tendon(s) to relax via a process known as Reciprocal Inhibition, allowing it to stretch and lengthen (thin) so that it can pass through the tendon sheath without "snapping" or  "catching". As the exercises are performed over time, the adhesion reduces in size and disappears.

In most cases of Carpal Tunnel Syndrome I believe it to be a simple muscle imbalance between the strong, short, tight, overused wrist/finger flexors and finger adductor muscles that close the hand and the long, weak, underdeveloped wrist /finger extensors and finger abductor muscles that open the hand. The extremely restrictive palmar fascia lies over the top of the thenar and hypothenar muscles that crisscross the front of the wrist joint and anchor not only into the carpal ligament, but also the carpal bones on opposite sides of the wrist joint, resulting in the collapse of the carpal tunnel and a much-reduces space for the nine flexor tendons and median nerve to function in.

This reduced space within the carpal tunnel causes increased friction and swelling of the flexor tendons and median nerve as they attempt to slide past each other in this now-confined space. The results in the cycle of finger flexion, friction, inflammation and swelling, compression and debilitating symptoms.  

The key to preventing and or rehabilitating Carpal Tunnel Syndrome is to stretch and lengthen the thenar, hypothenar, palmar fascia and carpal ligament which in turn will help to increase the space within the carpal tunnel. But stretching alone doesn't do a thing in of itself.  It must be in conjunction with the strengthening the antagonists (finger extensors / abductors), which in turn will maintain / hold the length created from stretching the agonists (finger flexors / adductors). The reason for this is that the finger and wrist extensor muscles function as a support system, stabilizing and holding the carpal bones in their correct position, which keeps them from being pulled inward and collapsing the carpal tunnel. In the medical world, the carpal bones are viewed as the "floor" and the carpal ligament as the "ceiling", but only because we view the layout of the anatomy as we learned it from pictures in books in a classroom which showed us everything in the "anatomical position", which is palm-up when lying on your back or palm-forward when standing.

My concern with viewing anatomy in the "anatomical" position is that it is not the "real-world".  The reason I say this is because humans mainly function in the palm-down position, which I refer to as the "functional" position, where the carpal ligament is the floor and the carpal bones are the ceiling/roof, collapsing inward/downward, just as if it were caving in. This is the reason that strong finger and wrist extensor muscles are VERY IMPORTANT ( See: Flextend exercise regimen for Carpal Tunnel Syndrome ), as these muscles act as support/supension cables that are attached to the "roof" from above, and hold it in place, keeping it from collapsing inward/downward into the carpal tunnel, thus impinging the median nerve and flexor tendons. 

By creating a strong support/suspension system for the "roof", it will not collapse, thereby reducing the chances of becoming afflicted with the symptoms of Carpal Tunnel or some other form of Repetitive Strain Injury (RSI).

Question / Comment:
I'm a Certified Hand Therapist with many years of experience in treating trigger finger syndrome and I can't believe that Flextend is necessary and that you are misleading the public. Yes, the exercises may help because of the extension exercises, but you certainly don't need any product. Where's your data?

Answer / Reply:
I really appreciate your thoughts and comments but certainly have to refute them as they are sorely incorrect! Many Occupational Therapists (OT's) tout their expertise as "hand" therapists, but with few results for Trigger Finger.

It is interesting how Occupational Therapists, known for their expertise as hand therapists, ever sold the industry and became recognized for their ability to treat repetitive motion disorders.

So how did this come about you ask? When there is damage to the brain, like that which happens with head trauma, the coordination of the extremities is often affected. Occupational Therapists help people with coordination exercises to get their brain and extremities in communication with each other again so they can function properly and perform day-to-day activities. Addressing coordination issues affecting the hands due to brain trauma is a far cry from dealing with hand disorders associated with repetitive strain injuries; two completely different sources of injury.

With that said, my dealing with Occupational Therapists subsided some years ago when I came to realize that many of the OT conferences were combined with those of hand surgeons. I found that to be a moral travesty as the patient's "care" was traded for the almighty dollar. In so many cases you find that patient's with a Repetitive Strain Injury will see an OT 6-8 times with minimal results and then the OT refers them to surgery, with a price tag of $5,000 for 30-minutes of work (See National Statistics), and then a counter-referral back to the OT for post-surgery rehabilitation. It is a circle of money that is obtained as a result of patients suffering.

Flextend on the other hand simply and effectively corrects muscle imbalances in the fingers, hands wrist and elbows to provide relief from muscles that are either too strong or too weak to keep joints in balance. These results come with years of treating Trigger Finger in clinics and hospitals in the U.S. Try one, you'll love it!