Accidents and Injuries

During a fall individuals tend to automatically outstretch their hands to help break a fall, which can slam onto the ground causing a falling onto an outstretched hand or FOOSH injury. Should individuals get checked by a healthcare provider if they believe there is no injury?

FOOSH Injuries

Falling down usually results in minor injuries. A FOOSH injury occurs when falling and trying to break the fall by reaching out with the hand/s. This can result in an upper extremity injury like a sprain or a fracture. But sometimes, falling on one's hands can lead to serious injuries and/or create future musculoskeletal issues. Individuals who have fallen or suffered a FOOSH injury should consult their healthcare provider and then a physical therapist or chiropractor to safely develop a treatment plan to rehabilitate, strengthen, and expedite recovery.

After The Injury

For individuals who have fallen down and landed on their hand, wrist, or arm, here are a few things to ensure the proper care for the injury, including:

• Follow the R.I.C.E. protocol for acute injuries
• Visit a healthcare provider or local emergency clinic
• Contact a physical therapist

A FOOSH injury could be or become serious, so to avoid letting small issues become big problems, get examined by a musculoskeletal specialist. The healthcare provider will obtain an imaging scan of the injured and surrounding areas. They will perform a physical examination to determine the type of injury, like a sprain or muscle strain. Not getting appropriate medical treatment after a fall can result in chronic pain and loss of function. (J. Chiu, S. N. Robinovitch. 1998)

Common Injuries

A FOOSH injury can injure different areas. These usually involve the wrist and hand, but the elbow or shoulder can also be injured. Common injuries include:

Colles' fracture

• A wrist fracture where the end of the arm bone is displaced backward.

Smith's fracture

• A wrist fracture, similar to a Colles' fracture, is where the end of the arm bone is displaced towards the front of the wrist.

Boxer's fracture

• A fracture of the small bones in the hand.
• Typically, it occurs after punching something, but it can happen from falling on an outstretched fist.

Elbow dislocation or fracture

• The elbow can pop out of the joint or can break a bone in the elbow.

Collarbone fracture

• The force from falling with the hands and arms outstretched can travel up to the collarbone, causing a fracture.

Proximal humeral fracture

• Falling onto an outstretched hand injury can cause the arm bone to get jammed into the shoulder, causing a proximal humeral fracture.

Shoulder dislocation

• The shoulder can pop out of the joint.
• This can cause a rotator cuff tear or labrum injury.

Regardless of the injury, individuals should visit a healthcare provider to evaluate the damage. If the injury is serious, the practitioner can make an accurate or differential diagnosis and develop a treatment plan. (William R. VanWye et al., 2016)

Physical Therapy

Individuals can benefit from physical therapy to help recover and return to their previous level of function. Physical therapy varies depending on the specific injury, but generally, a physical therapist can help individuals return to function after a fall on an outstretched hand. (William R. VanWye et al., 2016) Common treatments can include:

• Treatments and modalities to decrease pain, inflammation, and swelling.
• Instruction on how to wear an arm sling properly.
• Exercises and stretches to improve the range of motion, strength, and functional mobility.
• Balance exercises.
• Scar tissue management if surgery was necessary.

The therapy team will ensure the proper treatment is utilized to quickly and safely return to normal activities.

Chiropractic Care For Healing After Trauma

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Chiu, J., & Robinovitch, S. N. (1998). Prediction of upper extremity impact forces during falls on the outstretched hand. Journal of biomechanics, 31(12), 1169–1176. https://doi.org/10.1016/s0021-9290(98)00137-7

VanWye, W. R., Hoover, D. L., & Willgruber, S. (2016). Physical therapist screening and differential diagnosis for traumatic-onset elbow pain: A case report. Physiotherapy theory and practice, 32(7), 556–565. https://doi.org/10.1080/09593985.2016.1219798

Finger sprains and dislocations are common hand injuries that can happen during work, physical/sports activities, or in automobile collisions and accidents. Can recognizing the symptoms help in developing an effective treatment strategy?

Finger Sprains and Dislocations

Finger sprains and dislocations are common injuries of the hand that cause pain and swelling.

• A sprain happens when the finger tissue that supports a joint gets stretched beyond its limits in a way that stresses the ligaments and tendons.
• The ligament tissue can be partially or completely torn. If the damage is bad enough, the joint comes apart.
• This is a dislocation - A dislocation happens when the joint in the finger gets shifted out of its normal position.
• Both injuries can cause pain and stiffness in the finger and hand.

Sprains

Finger sprains can happen any time the finger bends in an awkward or unusual way. This can happen from falling on the hand or getting hurt when engaged in physical activities like sports or household chores. Sprains can occur in any of the knuckle joints in the finger. However, most commonly, the joint in the middle of the finger gets sprained. It's known as the proximal interphalangeal or PIP joint. (John Elfar, Tobias Mann. 2013) Symptoms of a finger sprain can include:

• Pain when you move your finger
• Swelling around the knuckle
• Tenderness in the finger and around the joint
• For a sprain, individuals may need to have imaging done to see if any of the bones in the hand are broken or fractured. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)

Treatment

Individuals are encouraged not to move the injured finger while in recovery and healing. It can be hard to do, but wearing a splint can help.

• Splints are supports that are usually made from foam and pliable metal.
• A sprained finger can also be taped to one of the fingers next to it while in recovery, known as buddy-taping.
• Splinting a sprained finger while engaged in activities can protect the hand from worsening or further injury.
• However, splinting the finger when it is not needed can cause the joint to become stiff. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)

1. An injury known as "gamekeeper's thumb" is a more serious type of sprain.
2. Injury to the ligaments at the thumb joint can cause difficulty in pinching and gripping.
3. This injury must often be taped up or splinted for a significant amount of time for full recovery and could require surgery. (Chen-Yu Hung, Matthew Varacallo, Ke-Vin Chang. 2023)

Other treatments to help a sprained finger include:

• Elevate the hand if swelling and inflamed.
• Gentle finger exercises/movements to prevent stiffness.
• Icing the injured finger.
• Take an anti-inflammatory medication.

Individuals who have not broken bones or dislocated the joint will probably be able to move their finger in about a week. A doctor will set a timeline for when to start using the finger normally.

1. Individuals who sprain their finger that feels swollen and stiff for longer than a few weeks are recommended to consult a doctor or specialist.
2. They will need to check the hand to make ensure there aren't any breaks or fractures. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)
3. Thumb sprains and finger sprains in children may need to be splinted or taped for longer periods, as the ligament is not fully developed or as strong, which could lead to a tear.

Dislocations

A finger dislocation is a more severe injury involving the ligament, joint capsule, cartilage, and other tissues that causes misalignment of the finger. The ligaments and the joint capsule get torn when a joint is dislocated. The joint needs to be reset, which can be a simple process, or in severe cases, patients may need to be placed under anesthesia or undergo surgery to reset the joint properly.

• In these cases, tendons or other tissues might be preventing the joint from getting into position.
• Putting the finger back into the right position is known as"reduction." Once reduced, the finger needs to be splinted.
• Individuals also need an X-ray to ensure the joint is lined up correctly and that any bones were not broken or fractured when they sustained the injury. (James R. Borchers, Thomas M. Best. 2012)
• Once reset, caring for a dislocated finger is basically the same as a sprained finger. Using ice on the finger, keeping the hand elevated to reduce swelling.
• Individuals need to check with their doctor to find out when to start moving the finger. (James R. Borchers, Thomas M. Best. 2012)

The Chiropractic Approach To Improving Health

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Elfar, J., & Mann, T. (2013). Fracture-dislocations of the proximal interphalangeal joint. The Journal of the American Academy of Orthopaedic Surgeons, 21(2), 88–98. https://doi.org/10.5435/JAAOS-21-02-88

OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Hand fractures.

Hung, C. Y., Varacallo, M., & Chang, K. V. (2023). Gamekeeper's Thumb. In StatPearls. StatPearls Publishing.

OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Finger fractures.

Borchers, J. R., & Best, T. M. (2012). Common finger fractures and dislocations. American family physician, 85(8), 805–810.