Hand Therapist Nigel Chua Dupuytren’s contracture pulls fingers into a bend over years via cords in the palm, not the tendons. The timing rule flips everything: never treat the lump, treat the bend. The table-top test tells you when the window opens.
Skier’s thumb is a torn UCL ligament at the thumb knuckle, and a complete tear often cannot heal on its own because tissue slips into the gap. The repair window is weeks. A “sprained thumb” with weak pinch needs assessment this week.
A boxer’s fracture is a broken little-finger metacarpal from punching something solid. Most heal with 3 to 4 weeks of splinting, but a rotated finger or any cut over the knuckle changes everything. Here’s the honest sorting.
Knobbly knuckles and morning stiffness that loosens in minutes: finger osteoarthritis, common, genetic, and usually kinder over the years than it feels now. Heat, daily motion, and joint protection do the real work. Stiffness lasting over an hour is a different disease.
Trigger finger release takes 15 minutes and the locking is gone on the table. The recovery questions start on day 3. Here’s the honest week-by-week: move early, respect the palm scar, and know the two situations where hand therapy earns its place.
Most wrist sprains settle in 2 to 3 weeks. But “sprain” is the most overused label in the upper limb, worn by scaphoid fractures, TFCC tears and De Quervain’s on day one. Run the 3-location sort before you wait it out.
The TFCC is your wrist’s meniscus, and a torn one is the classic missed injury: a “sprain” that still hurts with rotation and pushing at week 3. Most recover without surgery, if the brace-rebuild-reload sequence starts early.
That smooth lump on the back of your wrist is almost certainly a ganglion cyst: trapped joint fluid, not cancer, and about half vanish on their own. Here’s how to tell, when to treat, and why the Bible-smash method needs to die.
Thumb base (CMC) arthritis is the most common hand arthritis: a deep ache that flares with every pinch. It’s about management, not cure, and managed early most thumbs stay functional for years. The alarm isn’t pain level. It’s avoidance.
Tingling ring and little fingers point to the elbow, not the wrist: cubital tunnel syndrome, the funny bone nerve being squeezed by hours of bent elbows. Early, it’s fixed mostly by habit changes. Late, the nerve doesn’t fully come back.