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Pulley Injury

The balance between strength and dexterity in our hands and fingers is what allows us to be as functional and perform as many tasks as we do. The muscles that control your fingers actually originate on your forearm or elbow, with a series of tendons in control of your dexterity.

In order for this to work, there are a series of ‘pulleys’ that are made of soft tissue (much like ligaments) that fixate the tendons closer to the bone. As well as keeping the tendons attached to the arm, they also allow tendons to influence and move specific joints in the hand. Injury to your finger pulleys can have a huge effect on the overall function of your hand, and will need to be addressed by a health professional.

Carpal Tunnel Syndrome

The carpal tunnel is made up of the carpal bones (wrist bones) and the transverse carpal ligament. Through the ‘tunnel’ that these structures create, travels 9 tendons and the median nerve.

When structures in the carpal tunnel become inflamed or thickened, they decrease the space available for normal movement, often compressing the median nerve. In other cases, the size of the carpal tunnel is naturally too small for these structures, increasing the chances of median nerve compression.

De Quervain’s Syndrome

De Quervain’s Syndrome is characterised by pain on the radial (thumb side) side of the wrist when you rotate your wrist, grip or pinch.

A thickening of the sheath that covers the extensor pollicus longus tendon causes this pain. It is often described in new mothers, as they have to continually deviate their wrist to lift their baby, and is frequently seen in people who have to perform ‘wrist dominant’ activities.


Hand pain can be caused by a wide range of different things, depending on your age, regular activities and other medical conditions. Conditions like osteoarthritis and rheumatoid arthritis are more prevalent as you age. Conditions like De Quervains syndrome tends to be more prevalent amongst new mothers and people who repeatedly laterally flex their wrists. Trauma to the hand, wrist or fingers can cause a few different types of injuries, and should be correctly assessed.


Yes, as with most injuries to the body, your hand injury will recover well in most cases. Given the high level of dexterity and the specific functions of your hand however, it is important to have your recovery and rehabilitation managed by a health professional. Talk to your physiotherapist about how you can best manage the recover from your hand injury.


There are a few types of arthritis that can be a cause of pain in the hand. Typically, it will be associated with pain, stiffness and swelling at specific joints in your hand and will follow a specific pattern. Your physiotherapist will be able to guide you as to whether any further investigation is needed into the cause of your specific hand pain.


Scans to the hand are only immediately necessary if you have received some form of trauma or laceration that has caused your injury. In most other cases, your physiotherapist will be able to conduct a thorough examination into the causes of your hand injury and guide you on the best management. If they feel that more investigation is required then they will be able to assist you with the correct referral. If you already have scans that is fine, bring them with you and your physiotherapist will be able to go through them with you.


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