Sports Physiotherapy for Proximal Interphalangeal Joint (PIP) Injuries

Proximal interphalangeal joint (PIP) injuries are very common in athletes particularly in those associated with throwing and catching. Most of these injuries are minor and would easily respond to resting, icing, and elevation but some injuries that result in structural deformity or loss of motion needs special care. It must be added that although minor interphalangeal joint injuries do recover within a few days by itself but it should be given appropriate attention by a physiotherapist. It will help the athlete to recover quickly without any scarring and return to mainstream sports promptly.

The proximal interphalangeal (PIP) joint is situated in the middle of the three joints in the human fingers. Injuries to PIP joints is common in contact sports such as karate, rugby, volleyball, etc. If your finger is injured, you should take extra care in order to protect it from further damage. One good idea is to buddy tape the injured finger with the one next to it. Appropriate attention should be given not to involve the injured finger in further physical activities.

What are the causes of PIP joint injuries?

Unacceptable levels of outside trauma or stretching are the main causes of sprain in the PIP joints. Once the ligaments in the area is stretched too far, it will tear and rupture completely. Hyperextension of the volar plate, present at the floor of the PIP joint, is another cause of PIP ligament rupture. Small pieces of bone may be pulled away during this process from the PIP joint. If the tear is minimal, it could be treated with conservative physiotherapy but for complete ruptures and bony avulsions surgery is required.

What are the symptoms of PIP joint injuries?

PIP joint injuries will result in immediate pain and swelling around the area. In most of the cases, athletes lose complete functionality of the finger instantaneously after the incident. Deformities may be observed if the bony fragments are avulsed.

How is PIP injuries diagnosed?

For a trained physiotherapist, PIP injuries are obvious from a thorough medical history and physical examination. X-rays may be needed to confirm PIP injuries or to understand the dislocation in detail.  Once the physical examination is complete depending upon the level of injury you may be required to undergo a surgery or conservative treatment.

Conservative physiotherapy for PIP injuries

At Happy Physio, we will initiate an exercise regimen only after the pain and swelling has been subsided considerably. Appropriate resting, icing, and elevation would be provided so that the pain and swelling settle down swiftly. PIP joints are very sensitive to immobilization leading to stiffness around the area. If you have only a minimally torn ligament or sprain, early exercises and short period of buddy taping would be all for the recovery. One advantage of the buddy taping is that the injured finger could be put to some minor exercises that will prevent the stiffness from taking over.

Even when the volar plate is completely ruptured, our physiotherapists prefer to treat it conservatively without adopting a surgical procedure. Our experts may use a brace to prevent your finger from hyperextension while allowing some movements to the fingers.  The brace assist in stabilizing the joint and you may need to wear it for three to four weeks before complete healing could take place. A surgery is only required when the dislocation is such that the therapist is unable to realign your joint manually. Depending upon the level of injury, conservative treatments require three to six weeks of physiotherapy before the athlete can return to everyday sports. As always, a personalized exercise program will be designed for you so that complete range of motion and strength of the joint could be regained.

One major issue with the PIP joint injuries is that the joint remains swollen even after complete recovery. It is due to the scarring that develop during the healing process. Although the scarring continues to remodel, your finger may remain swollen even after a year.

How is PIP injuries after surgery managed in physiotherapy?

In order for the healing process effectively take place, you may need to live with a splint for up to 3 weeks. An active participation in physiotherapy would be needed for at least 3 months and we have seen that it can take even four months before complete functionality is regained. An ideal postsurgical physiotherapy program usually start with measures that can eliminate the swelling and pain in the area. Once we have it under control, you will be started on gentle range of motion exercises. As time progresses, you will begin to do strengthening exercises that will provide your finger joints the much needed mileage to resist future injuries. We don’t want to you to do too much too quickly. As a result, your progress would be slow but certainly in the right direction. Later on you will be started on exercises that are quite similar to your daily activities. We will give a revival to your motor abilities and range of motion and you will be good to participate in everyday sports within a time span of four months.

Call us at (08) 9272 7359 today and let us help you with your postsurgical physiotherapy program.