There are numerous soft tissue structures that provide stability to the various joints of the finger including the flexor tendons (flexor digitorum superficialis [FDS] and flexor digitorum profundus [FDP], flexor pollicis brevis [FPB], and flexor pollicis longus [FPL]), extensor tendons (extensor digitorum [ED], extensor indicis [EI], extensor digiti minimi [EDM], extensor pollicis brevis [EPB], and extensor pollicis longus [EPL]), sagittal bands, volar plate, and collateral ligaments. An injury to the flexor and extensor tendons are classified as strains. An injury to any of the other structures, including sagittal bands, volar plate, and collateral ligaments can be classified as a sprain. There are different grades of sprains:

• Grade 1- Mildest. Stretched soft tissue, but not torn
• Grade 2- Partial tearing of soft tissue
• Grade 3- Complete tearing or rupture of soft tissue. May require surgery to repair

• Jamming of finger during everyday activities including a fall or sports
• Falls

• Pain
• Swelling
• Tenderness
• Decreased range of motion
• Decreased strength
• Popping or clicking sensation during motion

• Take a break from repetitive life tasks such as typing, knitting, cleaning, or other work tasks when possible
• Stretch on your rest breaks. Perform tendon gliding exercises 3-5 times a day (VIDEO)
• Avoid bending your wrist in either direction too often. Keep your wrist as neutral as possible to avoid increased pressure in the carpal tunnel
• Avoid repetitive forceful gripping, which causes the tendons to increase pressure inside the carpal tunnel. Use a less forceful grip, or take breaks from repetitive gripping activities and perform above stretching exercises.
• Make sure you are performing all of your life activities with good posture to avoid compression of the nerve in your neck or shoulder, which can increase carpal tunnel symptoms 
• Contact an occupational therapist for further help to adapt your activities for better prevention

• Tinel’s- tapping over the carpal tunnel to determine if pain or tingling/numbness symptoms are reproduced in the hand
• Wrist flexion/compression test- Forcibly bending the wrist or placing pressure over the carpal tunnel for 10-15 seconds to determine if pain or tingling/numbness symptoms are reproduced in the hand.
• Electromyographic studies (EMG)- a thin electrode needle is placed into the muscle that the nerve operates to determine electrical activity and muscle strength
• Nerve Conduction Studies (NCS)- electrodes are placed on the skin along the nerve course. The nerve is then shocked to determine the signals and rate of conduction.

• Typically, following preventative measures, treatment is started conservatively including avoiding positions and motions that increase pain and symptoms and modifying activities to help decrease symptoms. 
• Rest, ice, splinting, anti-inflammatory medications, and occupational therapy for exercises and education. 
• If conservative treatments fail, surgery may be considered to decrease pressure on the median nerve in the carpal tunnel. Consultation with a hand surgeon may be necessary to discuss the appropriate treatment plan.

• Splinting- custom thermoplastic splint is created to immobilize the wrist in a neutral position to allow for a rested position and prevent increased pressure in the carpal tunnel. Often this splint is worn at night to start, but can be progressed to daytime use if necessary
• Modalities- moist heat, ice, ultrasound, infrared laser to decrease inflammation and pain
• Manual therapy- this includes scar massage after surgical intervention, soft tissue mobilization, or manual edema mobilization to decrease edema in the hand and wrist and improve symptoms
• Therapeutic exercise- exercises such as tendon glides, median nerve mobilizations, strengthening when symptoms are resolved, and sensory re-education.
• Home exercise education- education on activity modification, prevention, and treatment plan