Finger Injuries Prevention in Handball

“Finger Injuries Prevention in Handball” is a title of the research work about the finger injury prevention in handball that I wrote in 2013 for the 2nd EHF Scientific Conference.

Finger injuries are among the most common, and the most overlooked injuries in handball, ranging from simple sprains to complex fractures and dislocations. Understanding these injuries and implementing prevention strategies is essential for every goalkeeper and player aiming to maintain peak performance.

You can find the PDF with all published works from the 2nd EHF Scientific Conference by following this link.

Finger Injury Prevention in Handball

While speaking about the prevention of injuries in handball, it’s very important to mention the finger injuries, since they occur relatively frequently. The finger injuries are especially quite common for handball goalkeepers.

With all the focus on knee, ankle, hip, back and shoulder problems associated with handball, finger injuries often receive little or no attention at all, even though they are relatively common in our sport.

How many times you have had “jammed finger” which has irritated you during the practice for days? And how annoying is it to tape 2 fingers together, as one of the main, fast fix solutions after the injury occurs, just so that you could get through your training or a match?

That kind of fast solutions for finger injuries are good and important, but we should also consider the finger injury prevention in training process!

Sprained Fingers in Handball

Because of its dynamics, injuries are unfortunately an integral part of the handball game. One of the injuries to which is not given enough attention in handball literature are finger injuries. Finger injuries are common in many ball sports with the most common injury being a sprain to one of the ligaments located within the finger.

Sprained fingers occur when the ball contacts the end of the finger and causes significant swelling of a single joint. A traumatic injury to fingers involves mostly a battle on an outstretched finger, which coats the ligaments and joint capsule. For example, when player or goalkeeper tries to catch (or save) a ball and the ball hits an outstretched finger. But the sprain may result from an impact with an opponent player or a teammate, and then for both handball players and goalkeepers sprain can be caused by a fall or any sudden stretching of a finger.

The sprain can happen to handball goalkeepers while accidentally hitting the goal post. Or even while performing some of the variations of the middle save reactions – so called “leg kick”. When the save reaction movement requires lifting up the leg and covering the same area also with the hand, then sometimes in the speed of movement it can happen that the goalkeepers hit in the wrong way their own finger with their reacting foot.

Anatomical Structure of Hands 

Let’s see what is there inside of our hands – each hand has 27 bones including the wrist.

There are 14 bones in the fingers: 2 in the thumb and 3 in each of the other four fingers. These bones are called “phalanges”. There are 5 bones in the palm or “metacarpus”. These bones are called “metacarpals”. The hand is attached to the forearm by a joint called the wrist or “carpus”. There are 8 bones in the wrist. These bones are called “carpals”.

Hand bones – Top view. Photo source.

And all these bones are connected at their joints by bands of collagenous material called ligaments (sounds familiar, I guess?). Each joint is vulnerable to sprains (partial tearing and disruption of ligaments), strains (over-stretching of the ligaments), dislocations and complete ligament tears during the practice or a match.

Each finger has three small bones (phalanges) separated by two interphalangeal joints. The thumb is unique and has one interphalangeal joint and only two small phalange bones

Common Finger Injuries in Handball

Each joint is vulnerable to sprains (partial tearing and disruption of ligaments), strains (overstretching of the ligaments), dislocations and complete ligament tears during the practice or a match.

Examples of finger injuries in handball include

• sprains
• fractures
• dislocations
• ligament injuries and
• tendon injuries

Sprains

Ligament injuries often occur when the finger is bent awkwardly, leading to pain, swelling, and limited mobility.

Fractures (broken finger bones) 

Fractures of the phalanges (fingers) and metacarpals (long bones in the hand) are less common than joint dislocations but occur also as a result of being hit on the end of the finger in handball. Direct impact or excessive force can lead to broken bones in the fingers, requiring immediate medical attention.

Dislocations

A forceful impact can cause the joints in the finger to displace, often seen in goalkeepers saving shots. The little finger and the thumb are most commonly affected. Dislocation occurs when the bone comes out of its ‘socket’ causing damage to the ligaments and capsule around the joint. Dislocations of the joints in the fingers can be combined with fractures. Some dislocations are very difficult to reduce (put back into place) as the bones can push through tendons in the fingers. Also some dislocations will not reduce because of an associated fracture causing instability in the joint – a good example of this is a Bennett’s fracture (fracture and dislocation) at the base of the thumb.

Ligament injuries

Ligaments are the tough tissues holding two bones together at a joint. A ligament may be torn by a forceful stretch or blow, leaving the joint unstable and prone to further injury. A sprain is an injury to a ligament. Each of the joints located in the finger have collateral ligaments that run along each side of the joints. It is these collateral ligaments that are commonly sprained in handball and many other sports.

The Volar Plate is a hyperextension injury which is essentially a ligamentous injury although it may involve a portion of bone avulsed off by a ligament. It usually involves a piece of bone avulsed off the base of the middle phalanx by the volar plate which is usually not significantly displaced and usually will heal without problem.

The Volar Plate injuries are often referred to as a “jammed finger”. The Volar Plate can be defined as a very thick ligament that prevents hyperextension from occurring. If there is enough force during hyperextension, the disruption may cause a rupture of the Volar Plate at its insertion on the middle phalanx of a finger. This would result in a small piece of bone from the middle phalanx being avulsed, (pulled off), by the ligament as it is hyper extending. This injury can often involve a collateral ligament tear. Collateral ligaments provide stability from excessive side-to-side motion at the finger joints.

Tendon injuries

Overuse or sudden force can lead to strains or tears in the finger tendons, affecting grip and finger movement. Tendons are the fibrous bands that attach muscles to bones and allow the flexible, precise movements of the joints. Tendons lie just under the skin in the fingers and are covered by a protective sheath. Both the tendon and its sheath can be damaged by a laceration (cut) or a crush injury.

Tendon injuries include “Mallet finger” and “Jersey finger” where tendons are pulled off bone. Mallet finger is a deformity of the finger that occurs when the tendon that attaches to the end of the finger just below the nail is 129 detached from the bone. This may happen when the end of the finger is bent forward when hit on the end, by a ball for example. Mallet finger always requires special splinting and occasionally surgery. Symptoms include pain and swelling in the end of the finger accompanied by a deformity of the finger where the end of the finger is permanently bent forward. This is very common finger injury in handball.

Prevention of Finger Injuries

Preventing sports injuries to the hands and fingers is really difficult. In handball or any ball sport where an object is being thrown at the hand with a rapid rate, players and goalkeepers are likely to get fractures along the fingers, tears of ligaments, and tears of tendons.

What Can be Done For Finger Injuries Prevention? 

Handball goalkeepers and players need to know that there are few things which they can do in their everyday training routine to reduce risk of finger injuries. It is obvious that increased strength of the fingers, hands, wrists, and forearms should be helpful in avoidance of an injury. Within limits, improved flexibility of the fingers, hands, and wrists should also be injury-preventing.

After recalling the tragic accident that occurred in July 2008 to Croatian national team player Ivan Cupic, we must all be aware that it is entirely forbidden for players and goalkeepers to wear rings or other jewelry during a handball practice or a match. Namely, Cupic missed the XXIX Olympic Games in Beijing, after losing his left ring finger in bizarre accident.

During a training season, Cupic fell and caught his wedding ring on a wire fence. The force of the fall severed his finger at the first joint. Though the amputated portion of the digit could not be reattached, his career has since been unaffected by having only nine fingers.

Handball goalkeepers and players need to know that there are also few things which they can make in their everyday training routine to reduce risk of finger injuries. It is obvious that increased strength of the fingers, hands, wrists, and forearms should be helpful in avoidance of an injury. Within limits, improved flexibility of the fingers, hands, and wrists should also be injury-preventing.

However finger injuries in handball can occur even in players with very strong and flexible hands. If a very fast ball is coming towards a player or a goalkeeper and strikes the end of his/her finger, for example, all the strengthening routines in the world may not prevent that finger from getting a serious sprain, or even a fracture. Nonetheless, a series of strengthening exercises are recommendable to lower the risk of jammed fingers which might occur as a result of lower-force impacts.

Also these exercises are the same as the ones used for rehabilitation of a jammed finger after symptoms have subsided.

Tips for Finger Injury Prevention

Warm-Up Properly – Start each practice session or match with a thorough hand and finger warm-up to increase blood flow and flexibility, especially if you are a goalkeeper.

Use Protective Gear – Finger tapes and guards can offer added support and protection, especially for players and goalkeepers with a history of finger injuries.

Strengthening Exercises – Regularly include finger and grip strengthening exercises in your training routine to build resilience.

Proper Technique – Make sure you’re catching and throwing the ball with proper technique to reduce undue stress on your fingers.

A Few Exercise Suggestions for Fingers Injury Prevention

Push-Ups on Fingertips

The fingertip push-up is a classic exercise that can take hand strength and fingers injury prevention to an upper level. If you don’t have strength to do fingertip push-ups yet, you can practice the isometric plank position on your fingertips (see the image below).

If you are not yet able to perform even this plank position, then you can try a modified version of plank on your knees.

Start with a few seconds at a time – eventually building up to a ten-second fingertip plank. Once you achieved that, you will be ready to start practicing fingertip push-ups (just like in the video below).

Every time when there are some normal push-ups to be done during the practice, you can always dedicate at least a few repetitions to make fingertip push-ups, too!

A Ball Squeeze 

Place a tennis ball or equivalent in the palm of the hand and squeeze forcefully for a few seconds. Slowly relax the hand. Rest for a few seconds. Repeat.

Finger Extensions

Place a hand, palm forward, on a wall or other flat surface. Press the palm toward the flat surface as fully as pain permits and hold for five seconds. Return to starting position and rest for five seconds. Repeat this sequence ten times few times a day. The more often the sequence can be repeated in a day, the better.

Finger Flexions and Extensions With a Rubber Band

Use a rubber band around all five fingers.
Spread your fingers apart against the resistance, then slowly bring them back together.
Perform 3 sets of 10-15 repetitions.

Finger Curls

Hold a hand gripper or a soft ball in your hand.
Squeeze tightly, then release gradually.
Repeat for 3 sets of 10-15 squeezes.

Thumb Opposition Stretches

Touch the tip of each finger with the thumb of the same hand, creating an “O” shape.
Hold each touch for 5 seconds, working through all fingers.
Perform 2-3 sets per hand.

Wrist Extensions and Flexions

Use a light dumbbell or wrist exerciser.
Keep your forearm supported on a table, holding the weight with your palm facing down (for extensions) or up (for flexions).
Move your wrist up and down slowly.
Perform 3 sets of 10-15 repetitions for each movement.

Tools for Finger Strengthening and Protection

• Finger Tapes – Provides support and limits excessive movement, reducing the risk of sprains and dislocations.
• Grip Strengtheners – Devices designed to improve grip strength, contributing to stronger and more durable fingers.
• Resistance Bands – Can be used for various finger and wrist strengthening exercises.

Any kind of the finger extensors resistance bands, or resistance bands for fingers with a ball combinations (see images below) can be extremely beneficial!

In Conclusion

This article indicates that modification of simple and already used exercises in training process can contribute to fingers injury prevention in handball. As the most simple example is listed a fingertip push-up exercise. Since push-ups are anyway widely used in handball training both by players and handball goalkeepers. Fingertip push-ups should be integrated permanently into the training process, starting at the very young age. And in that case combined through the games. In a long term this will strengthen fingers and help in fingers injury prevention.

Preventing finger injuries in handball is crucial for a player’s longevity in the sport. By incorporating the right protective measures, proper techniques, and targeted exercises into your training regime, you can significantly reduce the risk of injury. Remember, prevention is key. Regular practice of these exercises, combined with mindful playing and adequate protection, will help keep your fingers safe and ensure you stay at the top of your game. Stay safe and play smart!

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