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How to Rehab a PIP Fracture?

pip fracture

Rehabilitating a proximal interphalangeal (PIP) joint fracture involves several stages, and it’s important to follow the guidance of a healthcare professional throughout the process. 

This rehabilitation typically includes a combination of immobilization, pain and swelling management, range of motion exercises, and gradual strengthening. The goal is to heal the fracture while preventing stiffness and maintaining the mobility of the joint. It often involves the guidance of healthcare professionals, such as physical therapists, and requires patience and adherence to a structured recovery plan. The specific approach to rehabilitation can vary depending on the severity and nature of the fracture.

How to Rehab a PIP Joint Fracture?

So, how to rehab a PIP fracture, there’s three major steps. One, you wanna get motion. Two, you wanna work on either your swelling or your scarring. And three, the last thing you wanna work on is your strength. So, I’m gonna go into a little bit more detail about what those things, actually, mean.

My name is Hoang, I’m an occupational therapist and certified hand therapist. And if you have sustained a fracture at this middle joint, your PIP joint, I just wanna tell you that this is probably one of the hardest parts of the hands that you could have injured and fractured. I wanna say that first because every single time I work with patients with that type of fracture, they get really, really frustrated that, you know, why isn’t it getting better faster? And I just wanna tell you that so that you can help to, like, set your expectations,So, number one, one of the top things that we wanna do is try to get better motion fast.

And one of the most important types of motion that you wanna get, I know you think that it’s about bending your finger, but this little joint tends to get stuck in what’s called a flexion contracture. So, it gets stuck in this middle range of not quite bending all the way down, but not straightening all the way up. So, one of the most important things you wanna do is get the motion. First, I always talk about getting the motion to get it as straight as possible and then also to bend it down as much as possible.

So, you wanna get the extension as much as possible. You want it to be as zero as possible. So, I always say that my fingers, I have very hypermobile fingers. That means they bend up way straight. So if I had broken my finger, I would wanna make sure I get it straight as well. And that’s one of the ways that I could get rid of the pain and the swelling. So, you wanna make sure you get that mobility, get that motion in this middle knuckle, and then once you start working on getting it straight, you can also work on bending it. That is one of the most important things when you’re talking about rehabbing a PIP fracture.

Number two is the swelling. So, sometimes people think, “Oh my god, but I gotta get the swelling down to get the motion.” Actually, if you get the motion first, as you’re getting the motion, you’re going to help with the swelling coming down and down and down. Now, if you have had surgery, the other thing you’re worried about and working on is moving that scar because if you take a look at your fingers, it is so different than any other parts of your body because there’s muscles, there’s tendons, and everything is so, so small that it gets stuck down to the bone.

So, one of the most important things I talk about is you see how you have wrinkles on the back of your knuckles and then on top of your fingers. You, also, have creases on the palmer side of your finger, But everything is so small and it gets stuck really fast. So, you wanna make sure you’re moving that scar.

So, one of the best ways to do it is you just think I need wrinkles. I always say, “It’s the only place you want wrinkles,” So, you wanna make sure that you’re moving? So, it requires some massaging. So, the direction of how you massage can play a role as well. So, you can massage it up, you can massage it down, you can, actually, look at my skin. You can roll it a little bit as well, So, number one, motion number two, the swelling and the scarring is gonna really help you. And the last thing you’re gonna work on is, actually, the strength. And the reason why I mentioned how to rehab a PIP fracture, a lot of times people are like, I need to work on strength. Let me squeeze on a ball.” But if you put a ball in your hand and you don’t have motion, well guess what?

You’re gonna keep not moving because you put something in your hand. So, strength, once you get the motion, the strength part is, actually, the easiest part and you’ll get your hand much stronger as long as you work on getting the motion, working on getting the swelling down, and making sure that your skin and your scar if you’ve had surgery moving better. So, those are the three steps to rehab a PIP fracture.

Can a PIP Fracture be dislocated?

Yes, a PIP fracture can be accompanied by a dislocation. This type of injury, known as a fracture-dislocation, occurs when the bones of the joint are not only broken but also displaced from their normal alignment. Fracture-dislocations of the PIP joint are considered serious injuries because they can significantly affect the joint’s stability and function. Such injuries typically require prompt medical attention to realign the bones and stabilize the joint. Treatment may involve splinting, surgical intervention, and a carefully structured rehabilitation program to restore function and minimize complications such as stiffness or chronic instability. The complexity of a PIP fracture-dislocation necessitates a tailored treatment approach, often involving a team of specialists, including orthopedic surgeons and physical therapists. 


And you wanna make sure that you have a plan to see progress, you wanna plan to see progress because like I said, it can get really stiff, really fast, and it’s extremely frustrating to work with. So, I want you to see that it’s possible for you to get the best possible results. So, find somebody in your area that could really help teach you, like, where, based on where you’re at, to get the best possible results. 

My name is Hoang, I’m an occupational therapist and certified hand therapist. And we see these types of fractures all the time in our practice. We see them at different stages, So sometimes we see them new, sometimes we see them old, and sometimes we see them chronic. So depending on like what part of the journey you’re on, it’s important to get the right kind of help so that you can get rid of it, so you don’t need another surgery, so you don’t have a first surgery to begin with, so you don’t continue to suffer with hand pain over years and years and years.

CLICK HERE! to learn more about PIP Rehab

About Hoang Tran – an expert in physical & occupational therapy  

Hoang Tran is a Miami certified hand therapist , the owner of Hands-on Therapy Services and the author of the book “The Hands-On Approach”. She loves helping people with hand, neck and shoulder problems because she knows how bad and debilitating they can get if not addressed and treated properly (once and for all!). 

The aim of her occupational therapy practice is to bring patients back to full functionality, without pills, injections or surgery. Occupational and Physical Therapy are both offered at Hands-On Therapy by our experienced therapists who provide a comprehensive approach to your care. 

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