Standard First Aid Training, Courses and Re-Certifications.

Bone bruise caused by running

January 14th, 2016 | Posted by corinne grace in Skeletal Injuries - (Comments Off on Bone bruise caused by running)

Bone bruise is also known as bone contusions or sometimes bone swelling. The injury is similar to tissue bruises and fractures. The bruises can be due to injury or blunt trauma caused by forceful impact when playing sports and accidents. It can cause severe pain that can last for weeks or even months.

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  • Sports bruises happen when the body comes in direct contact with hard surfaces, such as falling, bumping into the equipment of another player. Players should wear protective gear such as a helmet and shin guards in order to help lessen the impact on the bones.
  • Impacts caused by vehicular accidents, falling and slipping can result to a bone bruise.
  • Twisting accidents and sprains on the joints can cause a bruise bone, usually on the ankles and knees.


Bone bruise

Sports bruises happen when the body comes in direct contact with hard surfaces, such as falling, bumping into the equipment of another player.

  • A common symptom of bone bruise is swelling.
  • There is pain and stiffness after the injury and becomes severe after a day.


  • Stop running if there is a bruise. Cool down with a brisk walk going home or another way is to perform a 5-minute walk on the treadmill. Avoid running when there is pain in order to prevent making the condition worse.
  • Immediately apply an ice pack or ice wrapped in a thin cloth over the knee. If ice is not available, a bag of frozen vegetable can be placed on the affected knee at least 20 minutes every day as needed.
  • Elevate the affected knee on a soft chai, and place a pillow under the knee in order to help prevent hyperextension and provide cushion. Keep the knee above the level of the heart in order to help lessen any swelling.
  • Apply an elastic compression wrap if the affected knee is swollen. Start wrapping beneath the knee going upwards in a diagonal motion. Avoid wrapping it too tight. It should be supportive and snug in order to help increase blood circulation in the area.
  • Take 2-3 days of rest from the running routine for fast healing of the condition.
  • Massage the area using ice by rubbing it on the affected area at least 10 minutes every day. Wrap the ice cubes in a cloth or bag before applying on the affected area. Avoid applying the ice directly on the skin in order to prevent frostbite.
  • Wear a knee brace in order to help support and protect the bone found near the joint from becoming worse. The braces help to lessen pain and strengthen the affected area.
  • Take the prescribed anti-inflammatory medications in order to help lessen severe inflammation and pain such as ibuprofen.

Seek medical help immediately if swelling and pain cannot be minimized within a week.


Avoid running on hard surfaces in order to help prevent injuries on the knees for developing.


Broken knuckle

January 8th, 2016 | Posted by corinne grace in Skeletal Injuries - (Comments Off on Broken knuckle)
Black mold

Knuckles or metacarpals are bones found between the proximal phalangal bones of the finger and carpals bones found at the palm of the hands. The 4th and the 5th metacarpal bones are susceptible to damage due to indirect force. A broken knuckle is also called boxer’s fracture which affects the neck of the metacarpal bone which is the fragile part of the bone.

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A broken knuckle can be caused by direct impact of a clenched fist using a hard and immovable object. Usually, the knuckle of the ring finger leads the knuckles in a hard punch and it is the 4th metacarpal that is prone to damage.


  • Pain and tenderness can be felt on the affected metacarpal joint.
  • A snapping and popping sound can be heard
  • There is swelling, bruising and discoloration around the affected area and also cuts or lacerations can also happen in the area. The affected area is swollen due to the accumulation of blood and extracellular fluid. The knuckles can become lacerated and there is bleeding from the wound.

    Broken knuckle

    Pain and tenderness can be felt on the affected metacarpal joint.

  • There is difficulty moving the ring and the little finger and sometimes the joint of the finger can be misaligned.
  • There is a shallow depression when clenching the fist
  • The nerves that are near the knuckles can become damaged and result to numbness and the finger is not capable of bending properly.


  • Wash any open wounds such as cuts and scrapes using warm water and hand soap or other antiseptic products immediately after the injury in order to help lessen the risk for infection.
  • Cover any open wounds using a clean bandage in order to help stop the bleeding and minimize any infections from getting inside the wound.
  • Apply a cold compress on the broken knuckle or ice pack wrapped in a towel or a face towel immersed in cold water is also helpful with the condition. The cold helps lessen the swelling and pain in the area.
  • Immobilize the hand by wrapping it using an elastic bandage to help minimize movement of the hands that can make the condition worse.
  • Elevate the damaged knuckle above the level of the heart to help in draining blood from the area and minimize any bleeding from any open wounds and also lessen the swelling of the area.
  • Consume turmeric and crushed fresh garlic flakes mixed with raw honey to lessen pain.
  • Stick with a diet rich in calcium and increase the intake of dairy products, soy and green leafy vegetables. Take calcium and magnesium supplements. Magnesium helps with the absorption of calcium in the body.
  • Once swelling and inflammation is minimized, the affected area can be strapped to the next finger in order to keep the knuckles straight for at least 2-3 weeks so that the fracture can fully heal.


November 27th, 2015 | Posted by corinne grace in Skeletal Injuries - (Comments Off on Hammertoe)

Hammertoe is a painful deformity of the toes where it bends unusually and becomes claw-like in appearance. This deformity is due to the tendons of the toes that contracts abnormally and forces the toe to bend downward while the middle joint of the toe protrudes upward. Any toe can be affected by this condition but it commonly affects the second toe which is in a claw-like position and there is difficulty in straightening the toe. When wearing shoes, the toe is rubbed and walking becomes painful if a callus occurs in the sole of the foot or a corn develops on top of the toe.

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There are two types of hammer toes. The flexible hammer toe where the toe can still be moved from the joint and rigid hammer toe in which the tendons found in the toe becomes stiff and the toe cannot be moved which requires medical help.


  • Pain at the top of the bent toe when wearing shoes
  • The joint of the toe is swollen along with redness or burning sensation of the area
  • Development of corns on top of the joint of the toe


    The joint of the toe is swollen along with redness or burning sensation of the area

  • There is pain when trying to move the affected joint of the toe
  • Pain can be felt on the ball of the foot under the bent toe.
  • If the area becomes severe, an open sore can develop


  • People with flat foot and high-arched feet are susceptible to develop the condition.
  • People with arthritis have the tendency to develop hammertoe
  • Wearing ill-fitting shoes such as shoes that are too tight, too short or too pointy can push the toes out of balance. Pointy and high-heeled shoes can cause severe pressure on the toes and women are more susceptible to this condition than men.
  • Diabetes mellitus can cause damage to the feet and can lead to the development of this deformity.

If the toe becomes painful and there is difficulty walking, seek medical help immediately.


  • For mild hammer toe, use corn pads or felt pads, toe caps which are small padded sleeves that are fitted around the tip of the toe to lessen hammer toe pain.
  • Wear wide shoes with elastic soles to avoid pointed shoes
  • Perform exercises by using the hands such as moving and stretching the toes gently and picking soft and small objects like marbles or towels in order to help make the joints of the toe flexible. Another way is putting a towel flat under the feet and by using the toes, crumple the towel to stretch and strengthen the muscles.
  • If the affected area becomes painful, apply an ice pack at least several times every day to lessen the swelling and soreness of the affected area.
  • Take the prescribed anti-inflammatory medications such as ibuprofen or naproxen to lessen the inflammation and pain.

Broken collarbone

August 21st, 2015 | Posted by corinne grace in Skeletal Injuries - (Comments Off on Broken collarbone)

The clavicle or the collarbone is the bone found in both sides of the chest. These bones and the ligaments function in connecting the sternum or breastbone to both shoulders. A broken collarbone is a common injury among children and adults. It can be caused by injuries from sports, fall on a shoulder and vehicular accidents. This condition causes severe pain and tenderness of the joint and there is limited movement of the joint and inflammation and swelling of the affected area.

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Causes of a broken collarbone

  • A weak structure of bone due to genetic or from an acquired condition such as osteoporosis or cancer
  • Sometimes, during delivery, the force used in delivering the baby can cause breakage of the collarbone.
  • Sometimes in rare cases, the doctor has to break the collarbone of the infant in order for the baby to be delivered safely and this only happens when a process called shoulder dystocia will develop.
  • Caused by falling directly on the shoulder or an outstretched arm during playing or sports.
  • A direct blow to the collarbone such as tackling in football without wearing pads or crosschecked during playing hockey or lacrosse.
  • An attack of seizure can damage the collarbone.
Broken collarbone

Sudden pain in the area of the fracture

Symptoms of a broken collarbone

  • Sudden pain in the area of the fracture
  • A snapping sound can be heard on the affected area
  • The affected side is drooping downward and forward caused by gravity.
  • There is a severe pain when touching the collarbone along its length
  • The skin sometimes bulges outward and becomes discolored to reddish-purple which indicates an early bruise.

An individual suspected with a broken collarbone will manifest any of these signs and symptoms.

Management of a broken collarbone

  • Apply an ice pack over the affected area at least 2-3 days after the fracture. All you have to do is wrap a few pieces of ice cubes in a cloth or an ice bag and apply over the affected area. This helps minimize the pain, inflammation and tenderness.
  • The individual should get plenty of rest in order to help with the fast healing of the condition.
  • Wear an arm sling or a “figure-eight” strap that will fit around both shoulders to keep the bone in position. The duration of the immobilization will depend on the extent of the injury. The joining together of the bones takes about 4-6 weeks while children requires 6-12 weeks.
  • Take the prescribed medications in order to minimize the swelling and pain.
  • Perform some rehabilitation exercises and physiotherapy in order to help restore the strength of the muscle, movement of the joint as well as flexibility.
  • The pain from a broken collarbone is usually minimized within 2-3 weeks. After this period, the individual can continue with the activities such as playing sports within 12 weeks.

Tibial stress fracture

August 21st, 2015 | Posted by corinne grace in Skeletal Injuries - (Comments Off on Tibial stress fracture)

A tibial stress fracture is a condition where there is an incomplete crack found in the lower leg bone or shin bone. When engaging in weight bearing activities such as running, severe force is placed on the tibia and several muscles that are connected to the tibia. When they contract, a pulling force is being exerted on the bone. Forces that are excessive, repetitive and beyond the capacity of the bone can gradually cause damage. With continued damage, it can result to a tibial stress fracture. Stress fractures require proper treatment in order to avoid further damage.

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Causes of tibial stress fractures

  • Running long distance that causes fatigue in the muscle as well as puts stress to the bone and cause a fracture.
  • Excessive weight-bearing on the bone caused by continuous contraction of the muscles such as in running.
  • Changes in the training regime such as running on uneven surfaces after running on even surfaces such as road or grass.
  • Repetitive stress or impact that is subjected to the bone can result to a fracture.
  • Other causes such as bad foot posture, strenuous training, poor biomechanics, stiffness of the joints, ill-fitting footwear, weakness or fatigue, unequal length of the legs, irregularity of menstruation and obesity
  • Poor eating habits
  • Individuals who have flat feet and high arches face a higher risk of developing stress fractures in the shin bone.

Symptoms of a tibial stress fracture

Tibial stress fracture

Severe pain that becomes worse when engaging in activities and minimized when resting.

An individual suspected with a tibial stress fracture usually have the following signs and symptoms.

  • Severe pain that becomes worse when engaging in activities and minimized when resting.
  • Pain can be felt in the outer area of the lower third tibia
  • The affected area is swollen
  • There is difficulty in walking along with pain
  • The individual experiences pain during night time and while at rest
  • Pain can be felt when pressure is applied to the shin.

Treatment and home remedies for a tibial stress fracture

  • Encourage individual to rest for at least 8 weeks. Avoid engaging in any weight-bearing exercises such as running. Running in water with a buoyancy aid or belt can be done instead of running in the road.
  • Apply an ice pack for 10 minutes at a time in order to minimize swelling and pain for 3-4 times every day.
  • If the cause of the fracture is caused by changes in training, these activities should be avoided in the future.
  • Using crutches can help avoid full weight bearing.
  • Massage the affected area.
  • Gradually return to training and sports.
  • Perform exercises that maintains strength and flexibility in the lower leg such as light calf raises if there is no pain felt and also perform exercises in the wobble balance board
  • Use appropriate footwear for any activity engaged in.
  • Maintain proper nutrition in order to keep the bones strong as well as eat foods rich in calcium and other nutrients.

First Aid for Wrist Sprain

July 5th, 2015 | Posted by Mikha Canon in Skeletal Injuries - (Comments Off on First Aid for Wrist Sprain)

A wrist sprain is a common injury that usually occurs when an outstretched hand is used to break a fall or a hard impact. This stress on the ligaments of the wrist that connect it to the bones of the hand may be overstretched or in more severe cases, partially or completely tear off. A ligament is a tough fibrous connective tissue that provides stability to the wrist joint and thus, explains the loss of function or the limited range of motion of the wrist experienced after injury. The most commonly injured ligament is the ligament that connects the scaphoid bone to the lunate bone, which are the two small bones found in the wrist. This ligament is otherwise known as the scapho-lunate ligament.

A wrist sprain is usually common in athletes such as basketball players, volleyball players, gymnasts and skaters just to name a few. A direct blunt force trauma to the wrist may also cause this injury.

Signs and Symptoms of a Wrist Sprain

A wrist sprain often presents with acute pain with some reports of hearing a popping sound upon the moment of injury. Other signs and symptoms are as follows:

  • Swelling and tenderness of the wrist
  • Bruising of the skin around the wrist
  • Inability to achieve full range of motion
  • Pain that is exacerbated when the wrist is moved

Grading of a Wrist Sprain

Grading of a wrist sprain depends on the extent of the injury on the ligaments. The grading is as follows:

  • Grade 1 – the ligaments are overstretched with or without minor damages to the fibers of the ligament but are not torn. This often presents with minimal tenderness and swelling.
  • Grade 2 sprain – a partial tear in the ligament that present with abnormal laxity of the wrist joint, moderate tenderness and swelling and decreased range of motion
  • Grade 3 sprain – a complete tear in the ligament that present with severe tenderness, swelling and loss of function

First Aid Treatment of a Wrist Sprain

Treatment of a wrist sprain will depend on the grading of the injury. A grade 1 sprain or even some grade 2 sprain may resolve with first aid and home remedies. The following can be done:

Apply ice on a wrist sprain to reduce swelling

Apply ice on a wrist sprain to reduce swelling

  • Rest – immobilize and rest the injured wrist for at least 2 days. A splint may be used if necessary
  • Ice – apply ice compress over the injured area for 2 to 3 times a day for at least 10 minutes
  • Compress – a compression bandage can ease the swelling
  • Elevate – elevate the injured wrist above the heart while sitting or lying down
  • Non-steroidal anti-inflammatory drugs such as ibuprofen or aspirin can help ease the pain and swelling
  • Physical therapy or occupational therapy may also be recommended to restore mobility and to strengthen the wrist


For more severe injuries, such as a grade 3 sprain, surgery may be required in order to repair the detached ligament. This is followed by physical rehabilitation in order to strengthen the wrist and regain full range of motion.

To learn how to properly give first aid on wrist sprain, enroll in First Aid Courses.

A wrist sprain occurs when the ligaments found in the wrist are stretched beyond its limits producing pain, discomfort and in more severe cases, loss of function.

Wrist stress fracture

June 26th, 2015 | Posted by corinne grace in Skeletal Injuries - (Comments Off on Wrist stress fracture)

Stress fractures are small cracks in the bone that are caused by overuse and repeated use of force. These fractures usually occur in the lower leg and the bones of the foot. Among runners, the bones in their legs and feet carry most of the weight, thus long repetitious exercises such as jogging can cause stress fractures. In some cases, stress fractures can also occur in the wrists.

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A stress fracture is an injury where the muscles are exhausted due to repeated physical stress. These tiny cracks in the bone are called stress fractures. Individuals who play tennis, gymnastics, basketball and diving face the highest risk of overusing their wrist, thus they can suffer from wrist stress fractures. There are eight tiny bones in the wrist and a hairline crack can happen in any of these bones.

A hairline crack found in the wrist usually occurs among women above the age of 40 years old or in menopausal women. Even women who play sports and athletes are also prone to stress fracture of the wrist due to eating disorders such as anorexia, osteoporosis and irregular menses.


The pain becomes worse when moving the wrist joint or working on certain activities such as writing or holding an object.

Symptoms of a stress fracture

  • Pain in the joint of the wrist when there is hairline fracture. In a severe stage, the pain is sharp and gradually reduces and becomes dull and achy. The pain becomes worse when moving the wrist joint or working on certain activities such as writing or holding an object.
  • Bruising in the wrist area is the next common symptom. This occurs due to a leak in the blood vessels of the bone or other tissues. In most cases, the bruise appears bluish or greenish in color. After a few days, the color turns black and will remain for a few days and then steadily vanish.
  • There is swelling of the joint of the wrist and palm that can be seen in hairline fractures of the wrist joint. This occurs due to the inflammatory reaction of the bone and the tissues.
  • There is accumulation of fluids in the first two days of the injury.
  • A tingling or loss of sensation on the affected area.
  • A limited movement of the joint of the wrist.

Treatment and home remedies of stress fracture of the wrist

  • Rest the affected wrist at least three weeks and avoid activities that cause stress fractures of the wrist.
  • Apply an ice compress over the affected area since this helps in minimizing the swelling and pain.
  • Apply a compression bandage, splint or a cast since these can help promote faster recovery from cracks of the hairline.
  • Elevate the wrist in order to minimize swelling for the first two days.
  • Drink warm milk that is mixed with a teaspoon of turmeric powder every day to promote faster healing.
  • Eat foods that are rich in calcium during this period in order to strengthen the bones and accelerate the callous formation.

Buckle fracture of the wrist

March 6th, 2015 | Posted by corinne grace in Skeletal Injuries - (Comments Off on Buckle fracture of the wrist)

Torus fracture is also called as a buckle fracture and it occurs when one side of the bone is pushed in and the other side of the bone is bending out but will not cause a break in the bone. Children and older people are more susceptible to torus fracture and it occurs in any bones of the body but it usually affects the long bones such as the radius, ulna, humerus or femur. The recovery from a buckle fracture is quick compared to other fractures where the recovery takes months.

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Causes of buckle fracture

Fractures can happen due to a variety of mechanisms, sudden trauma or fall or it can be caused by some conditions such as cancer. The inclinations of some people by putting out their arms in order to break a fall can lead to a buckle break in bones, especially in the radius and the ulna.  Sometimes, a break can also be caused by blunt force trauma or accidents.

Buckle fracture of the wrist

Difficulty in moving or using the injured part of the body

Symptoms of buckle fracture

  • There is warmth that is accompanied by bruising or redness in the affected areas.
  • Pain and swelling of the affected area
  • Difficulty in moving or using the injured part of the body

The young and the elderly are most susceptible to buckle fractures because their bones are still soft and more likely to break due to diminished flexibility. Buckle fractures usually occurs when a child falls and lands with an outstretched arm. Among the elderly, osteoporosis can be a cause of an increased risk of having a fracture. Good nutrition is the key in ensuring bone health and strength.

A buckle fracture can cause the forearm bones to be compressed creating a “buckle” or a bump that can be found in the dorsal surface of the bones that can be seen on an X-ray and the opposite side of the bone is normal.

Treatment and home remedies of buckle fracture

With a buckle fracture, the affected arm can be put in a cast for at least 4-6 weeks. Some individuals prefer splinting of the wrist in order to protect the bones and keep them in place while they are healing.

  • Elevate the affected area above the level of the heart in order to minimize swelling and pain.
  • Place an ice pack or ice placed in a plastic bag that is wrapped in a towel. Leave the ice pack on the affected area for 15-20 minutes at least 3-4 times a day for 2-3 days.
  • If the affected area has plaster or fiberglass cast, you have to keep the cast rested on a pillow for the first 24 hours until fully hardened and instruct the individual to avoid scratching the skin under the cast using sharp objects. Check the skin under the cast every day. You can apply a lotion on any red or sore areas and always keep the cast dry and clean.
  • If the affected area has plaster splint, the individual should wear the splint as directed. Loosen the elastic found around the splint if the fingers become numb, there are tingling sensations or the fingers turn bluish in color.
  • Avoid putting pressure on any part of the cast or splint since it might break.
  • Take over-the-counter or prescribed medications to ease the pain.

If you want to properly manage the symptoms of a buckle fracture, all you have to do is enroll in a class on first aid today.

How to treat a broken arm

January 30th, 2015 | Posted by corinne grace in Skeletal Injuries - (Comments Off on How to treat a broken arm)

A broken arm is when one or more of the bones found in the arm are cracked and common in children and adults. The arm consists of three major bones. The humerus starts at the shoulder up to the elbow which is called the upper arm. At the elbow, the humerus is connected to two bones – radius and ulna. These are found from the elbow to the wrist which forms the forearm.

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Causes of a broken arm

Any injury to the arms that results to broken bone can be caused by falls and direct trauma.

A fall that will result into a fracture happens when falling on an outstretched hand. The fracture can occur from the wrist up to the shoulder and depends on the direction of the fall, age of the individual and other factors and stresses placed on the bone.

A direct trauma can be a direct blow from an object such as a bat, vehicular accident and other forces that causes a direct force on any part of the arm.

Broken arm

Any injury to the arms that results to broken bone can be caused by falls and direct trauma.

Symptoms of a broken arm

  • There is evident swelling
  • Pain that becomes severe when the affected arm is moved
  • Deformity of the affected arm
  • An open wound maybe caused by a bone that pierces through the skin or there is a cut in the skin during the injury.
  • Decreased sensation or there is difficulty in moving the limb which may indicate nerve damage.

Severe symptoms

  • There is large amount of swelling or deformity of the affected arm if compared to the opposite arm.
  • Diminished functionality of the affected arm and there is pain when it is pressed
  • Pain that cannot be relieved by application of ice and pain medications such as acetaminophen.
  • There is bone sticking out of the skin along with heavy bleeding from an open wound
  • Lack of sensation or movement on the affected arm
  • Loss of consciousness

Treatment and home remedies

  • Stabilize the affected arm by using a towel as a sling. Place it under the arm and then around the neck. By preventing the arm from moving, place rolled newspaper along the area that is swelling and tape it in place.
  • Apply an ice compress on the injured area in order to minimize pain and swelling for 20 to 30 minutes at a time. Place a towel between the ice compress and the skin to prevent it from getting too cold. Avoid placing ice directly to the skin. You can learn more about cold therapy by enrolling in a first aid course.

Preventive measures

  • Wear seat belts when riding a vehicle, use wrist guards when skating and skateboarding as well as use appropriate pads when playing contact sports in order to prevent fractures.
  • Prevent and treat conditions such as osteoporosis which is a disease that causes loss of bone in older women since it can increase to risk for fractures as they age.

How to treat a dislocated finger

December 26th, 2014 | Posted by corinne grace in Skeletal Injuries - (Comments Off on How to treat a dislocated finger)

A dislocated finger is a common injury among athletes. The fingers become dislocated when the bones are moved from the usual position, but a finger can become dislocated at any point and happens in the knuckle found in the middle of the finger.

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Dislocated fingers can be a result of accidents like a person may fall and attempts to break the fall with an outstretched hand. Players of basketball experience dislocated fingers if the ball hits them in their fingertip when trying to catch or rebound it. Baseball players sustain dislocated fingers when the baseball hits them on exposed fingertips. As for football players who make tackles are at high risk of dislocated fingers because the fingers can be bent in an awkward manner or be caught in a pad or jersey.

Dislocated finger

Pain is the initial symptom of a dislocated finger.

Pain is the initial symptom of a dislocated finger. The finger may look crooked along with swelling and it can be bent at an odd angle or straight up. A severe dislocated finger causes numbness or tingling sensations and the fingers becomes pale. A dislocated finger that breaks through the skin will require an immediate medical attention. If you want to properly manage this injury, read here.

Treatment of a dislocated finger

  • Watch for symptoms of swelling or joint pain immediately after the accident
  • Separate the area and prevent additional movement by using splints that can be made out of newspapers, magazines, sticks or anything on hand. Do not try to realign the bones by yourself since this can cause further injury to the affected area.
  • Apply ice compress to the affected area immediately and elevate the affected area in order to reduce swelling and pain.
  • Take acetaminophen or ibuprofen for pain relief
  • Seek the help of a physical therapist regarding range-of-motion exercises in order to restore the range of movement and the strength.
  • Avoid eating foods or drinking fluids before the treatment in order to prevent aspiration of foods or liquids into the lungs when the person is sedated.

Exercise for a dislocated finger

  • Stand over a table or against a wall with the palm facing downward and fingers spread. Press the hand against the flat surface and hold for five seconds. Repeat the procedure for ten times for a single set at least three times a day.
  • Curl the fingers into the palm of the hand to make a fist. If the dislocated finger cannot move, utilize the unaffected finger when moving the dislocated finger to make a fist. Hold the fist position for five seconds and repeat the procedure ten times for a single set at least three times a day.
  • Wrap the fingers around the sides of a tennis ball and then squeeze the ball with the hand and fingers as hard as the person can squeeze for five seconds then relax the hand. Repeat the procedure ten times for a single set at least three times a day.