Dr. Timothy K. Durnin - 10/16/2007

Question
I recently went to the orthopedic surgeon for stiffness in my left ring finger with a snapping sound when I bent it (following no injury or trauma). He told me that he was not sure but it might be a tendon that was not gliding properly and to exercise it and have physical therapy for a few weeks to get it back on track.  When I went to a physical therapist who specializes in hands she told me that the only time she sees this snapping and stiffness in such a young person (22) is when there is a cyst on the tendon that cannot be felt but is slipping under the tendon and back out and thats what the snapping noise is.  She splinted in and told me that if its not better in a few weeks I should see a surgeon about having the cyst removed. These seem like two different opinions and I am not sure whose to trust--the orthopedist who seemed unsure or the therapist who deals with hands all the time and has seen this before? I don't know who to believe or where to go from here...thanks for your help!

Answer
Hi Halle,

The Orthopedic was not only wrong but even if he/she was correct, he prescribed the wrong therapy. You don't exercise a tendon gliding out of groove, this creates more inflammation and swelling therefor aggravating the condition. Only specific strenghthing exercises are prescribed for tracking issues.

Your therapist is most likely correct, resting it with regular ice may bring it down, otherwise, find another competent Ortho and have it aspirated or removed.


Good Luck!

Dr. Timothy Durnin