‘Trigger Finger’ refers to a condition where flexing and extending one or more fingers has a ‘step’ in the action, sometimes a ‘lock’, rather than a continuous smooth movement. Pain is often but not always present through the ‘step’. Interestingly, passive movement through range of motion most often produces no ‘step’ or ‘lock’; the movement is smooth. Somewhere along the path of the tendon(s) connective tissue has built up and the tendon is ‘jumping’ over that build up. There would be only one reason for this build up from a bodyworker’s perspective – chronic hypertonicity focusing pressure on that area. (If there is a ‘step’ with passive movement also, then the buildup of connective tissue is greater than usual, and the pattern has been there longer. Treatment will be the same, but will probably take longer.)
From webmd.com – The problems often stem from inflammation of tendons that are located within a protective covering called the tendon sheath.
I completely disagree. I feel inflammation is never a cause of a problem, but always the effect of a situation, and the root of that situation is chronic hypertonicity. Put another way, hypertonicity causes inflammation, which can then lead to symptoms.
T/F will have a tensegrity pattern similar to ‘frozen shoulder’, just as there would be with anything going on in the arm. Start with the opposite side of the neck, usually mid-neck (C-3/4 area), and go through the sacro-iliac joints. Also (and always), check out occiput/C-1/C-2 on the same side as the T/F; this is the most common pattern producing arm pathologies.
To review the ‘patterns’ theory, the reasoning here is that all forces in the body must pass through the S/I joints (in LMD-speak, the #1 lever), and above that the head must balance over the spine (the #2 lever) along with the forces fed into the structure by the arms as part of #2 lever. A future article (soon) will go through Three-Lever Theory much more thoroughly.
Once you have response from the S/I’s and neck, and so are affecting the ‘sponsoring pattern’, you can address the effect it has in the arm. Using a massage lube of choice, thoroughly strip out the forearm. I like using thumbs and/or fingers to get a feel for the myo-fascial scene going on in there, and then use knuckles to do the work. Very slow and very thorough is the game.
Use the same idea in the entire arm, wrist, and hand. You are looking to break up the myo-fascial restrictions that the pattern in the torso (centered through levers 1 & 2) have created in the shoulder/arm/wrist/hand. I’m emphasizing the wrist, because the ‘trigger finger’ effect usually has created fascial issues/restrictions in the wrist.
The pattern can be further assessed by squeezing the client’s forearm at various points with your fingers while he/she flexes the T/F. In my experience, the degree of severity of the T/F always changes when I’m on the associated tendon, always becoming less severe. This can help with fine-tuning where I focus my fascial stripping.
Check out the range of motion in all the joints of the arm and shoulder looking for associated myo-fascial restrictions and treat as necessary. As you relieve the pattern in levers 1 & 2, this will be easier to accomplish.
Home exercise suggestions I like are using a child’s football and tennis ball to work the neck, SI/low back, shoulder, and any place particularly sensitive. I suggest that the client start face up on the softest, cushiest carpet in the house. Yoga mats work fine. I suggest they go slow and easy, exploring how it feels. Notice the word ‘suggest’ rather than ‘tell’. The difference between staying within our scope of practice and stepping outside of it simply comes down to the words we use: the outcome is the same.