fingertip push-ups

THE 2ND EHF SCIENTIFIC CONFERENCE

This article about the finger injury prevention in handball that I wrote in 2013 was published in the 2nd EHF Scientific Conference!

 

 

 

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

 

FINGER INJURIES 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 INJURIES 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

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

 

EXAMPLES OF FINGER INJURIES

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

  • fractures
  • dislocations
  • ligament injuries and
  • tendon injuries

 

FRACTURES (BROKEN FINGER BONE)

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.

 

DISLOCATIONS

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

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.

 

HERE ARE SOME OF THE SUGGESTED EXERCISES FOR FINGERS INJURY PREVENTION

1.FINGERTIP PUSH-UPS

The fingertip push-up is a classic exercise that can take hand strength and fingers injury prevention to upper level.

If you don’t have the ability to do fingertip push-ups yet, you can practice the isometric plank position on your fingertips (see the image below).

fingertip push-ups

Isometric plank position on fingertips

 

 

If not yet able to perform even this plank position, they can try with modified plank on the knees.

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

 

Every time when there is a task to do normal push-ups during the practice, you can always dedicate at least a few repetitions to make fingertip push-ups, too!

 

2. THE 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.

 

3. 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.

 

4. TOOLS FOR FINGER EXTENSORS STRENGTHENING

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 fingertip push up exercise. Since the 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.

 

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