The conservative treatment of Trigger thumb using Graston Techniques and Active Release Techniques

Abstract

Objective: To detail the progress of a patient with unresolved symptoms of Trigger thumb who underwent a treatment plan featuring Active Release Technique (ART) and Graston Technique.

Clinical features: The most important feature is painful snapping or restriction of movement, most notably in actively extending or flexing the digit. The cause of this flexor tendinopathy is believed to be multi-factorial including anatomical variations of the pulley system and biomechanical etiologies such as exposure to shear forces and unaccustomed activity. Conventional treatment aims at decreasing inflammation through corticosteroid injection or surgically removing imposing tissue.

Intervention and outcome: The conservative treatment approach utilized in this case involved Active Release Technique (ART) and Graston Technique (GT). An activity specific rehabilitation protocol was employed to re-establish thumb extensor strength and ice was used to control pain and any residual inflammation. Outcome measures included subjective pain ratings with range of motion and motion palpation of the first right phalangeal joint. Objective measures were made by assessing range of motion.

Conclusion: A patient with trigger thumb appeared to be relieved of his pain and disability after a treatment plan of GT and ART.

Figures

Figure 1

Flexor Pollicis Longus muscle (FPL), A-1 pulley (A-1), A-2 pulley (A-2), Oblique pulley (O).

Figure 2

ART of 1st right metacarpophalangeal joint capsule.

Figure 3

Graston Technique performed on 1st right metacarpophalangeal joint capsule volar surface.

Figure 4

Graston Technique performed on 1st right metacarpophalangeal joint capsule dorsal surface.