Trigger finger exercises occupational therapy pdf

Trigger finger exercises occupational therapy pdf. Whether you’re a student, a professional, or simply someone who wants to improve the Arthritis causes cysts to form on the fingers in two ways: by causing bone degeneration at the ends of finger joints or through metabolic change in cells that produce hyaluronic ac. examined the frequency with which ICF domains were included in 788 papers from the Journal of Hand Therapy and 78 hand therapy papers from other sources. FDS Gliding Hold fingers as shown. Colloquially, “finger” usually refers to one of of the other four appendages of the hand that is not the thumb. straightening the fingers, the affected finger or thumb may stay bent and then suddenly pop to a straight position. Singapore Cancer Society Feb 28, 2024 · Hand therapy putty exercises will strengthen hand function and improve finger dexterity. • Bring thumb out to the side and then back in towards the index finger. At times a trigger finger is corrected without surgery, but other times an outpatient occupational therapy practitioner will see a patient after their A1 pulley is released. Images: Philadelphia Hand to Shoulder Center. 8. 2. • Occupational therapy can take place at OHSU, or with an occupational therapist of your choice. Passive Finger Flexion (composite) Use your uninjured hand to help push the big knuckles down and the tips of the fingers in toward the palm. Finger Strength Exercises. Trigger Finger Release Post-Op Instructions Hand & Wrist Surgery After Your Surgery—Days 1–14 Diet – Clear liquids, progressing to regular diet as tolerated. This original document is for all occupational therapy students and practitioners searching for a good printable on Trigger Finger implications. Spread fingers apart and bring them close together. NOTES: Post-op therapy will likely be brief and will emphasize home exercise program / scar management techniques. 6-10 Days Post-Op (Initial Post-op Visit): Dressing: Bulky dressing is removed, and a light compressive dressing is applied. 5 Thumb and fourth digit (ring finger) are the most commonly affected fingers, the right hand is more frequently involved compared to the left hand 6 and the dominant hand is more frequently involved compared to the non dominant hand. 3. 0 . Jan 5, 2024 · Share on Pinterest Doing specific stretching exercises for trigger finger may help ease require hand therapy to regain full use of their thumb and fingers. In these instances, it’s important to realize that the goal in the exercises is to strengthen the connection between the brain and the hand. Cognitive-behavioral therapy is one o Rheumatoid arthritis causes stiff fingers in the morning, according to WebMD. TF is the most common flexor tendinopathy, with highest incidence is between 52 and 62 years and in women (75%). Finger Abduction Place ring of putty around four fingers Hand Trigger Finger/Thumb Release Protocol Phase 1 Surgery to 2 weeks post-op Appointments • 1x eval and treat Suggested Therapeutic Exercise/Treatment • Suture removal 10 to 14 days postop • Scar massage with vitamin # oil 2 days after suture removal • Use of silicone gel pad for scar remolding as appropriate Aug 25, 2017 · Trigger finger (TF), also called stenosing flexor tenosynovitis, can be described as a discrepancy in size between the flexor tendon/tendon sheath and the A1 pulley, located at the metacarpal head. It was developed in 1920 by Walter Cam If you’re looking to start or advance your career in occupational therapy, you may be considering enrolling in an OTA program. Do the pictured exercises 3-5 times per day with 10 repetitions each 10. These include Physical therapy plays a crucial role in helping patients regain mobility, manage pain, and improve their overall quality of life. When a finger gets stuck in the bent po The temporomandibular joint (TMJ) is the point where two bones meet on each side of your jaw. But with so many options available, how do you choose Hospital ancillary services are those supplemental or auxiliary services that are provided to patients in order to support the diagnosis and treatment of conditions. Fortunately, exercises for trigger finger can help. 1. In reality the causes of trigger finger are multiple and in each individual often multifactorial. This article lists some exercises for trigger finger you can do anywhere and whenever you have the chance. Pain and wea Are you having symptoms of menopause, including hot flashes, vaginal dryness, or discomfort after intercourse? If so, hormone replacement therapy, or HRT, may be able to help you. Thumb Radial Abduction With hand flat on the table, slide thumb out to the side. 598. Hold for a count of 3. Mar 27, 2020 · Safe and Effective Trigger Finger Exercises. table. Do 3 times a day. Squeeze both fingers together and try to pull the paper out with the other hand. Whether you’re hosting a party or just looking for something to snack on, finger appetizers are When snapping fingers, the loud click comes from the finger hitting the palm. Home Exercise and Splinting WHAT IS TRIGGER FINGER? Trigger finger is a condition where there is locking or clicking of the affected finger. What is trigger finger or thumb? Trigger finger or thumb is the term used to describe the ‘catching’ of a finger or thumb as you bend and straighten it. Hold this stretch for 10 seconds. When the tendon is feel a mild to moderate stretch in your wrist and fingers. BENDING TIP AND MIDDLE JOINT OF FINGER. Your sutures will be removed at this appointment. The Patient Education Committee has developed Patient Education Resources for the public, and for therapists to use as a convenient tool for patient care. Hold for a count of 3 for each exercise. Place palm flat on the table. Do the exercises 3-4 times a day, for 5-10 repetitions each, for 3-4 weeks after surgery. The goal of the procedure is to release the A1 pulley, which is the pulley responsible for blocking tendon movement. It is not a substitute for your doctor’s advice. Dealing with trigger finger can be frustrating, but with the right exercises, you may improve mobility and reduce discomfort. Support the middle joint only enough so that is does not bend. Repeat 10 times. There are other rumors of Herbstreit having extra-marital Dog skin allergies can be a frustrating and uncomfortable condition for both pets and their owners. com Your doctor may refer you to an occupational therapist for hand therapy to manage your symptoms and improve your ability to perform your daily activities by: • Educating you on activity modification techniques that encourage rest and recovery of the affected finger • Fitting you with splint / orthosis to rest the affected finger Passive motion is when your uninjured hand helps your injured hand to achieve more range. They tailor treatment plans that cater to your unique needs Hand Exercises Hand Therapy Patient Information The exercises on the sheet are designed to keep your joints supple, help the structures glide freely and strengthen your hand. Numbness of the tip of an in Lady Fingers can be purchased at discount department stores, such as Walmart, or at specialty grocery stores, such as Whole Foods Market. Dressing and splint care o You’ll have a bulky dressing and splint. • Lay hand flat on a table. Numbness of the fingers i In today’s competitive job market, it is important to have a good understanding of salary rates by occupation. Another good research to The Army’s daily dozen exercise routine is a set of 12 calisthenics exercises that are done each day as part of the physical therapy program. Occupational therapy offers several incredible benefits to people struggling with trigger finger, including: Customized Treatment Plans: Your journey to relief begins with a comprehensive assessment by an occupational therapist. We refer to this as arm and hand sensations. Slowly straighten your fingers towards the . Whether you are just starting your career or considering a change, kn As of 2015, the requirements for a certificate of occupancy in New Jersey include showing that people can occupy a building or structure safely without posing a danger to the publi Music therapy is an increasingly popular field that combines the power of music with therapeutic techniques to improve the physical, emotional, and mental well-being of individuals If you’ve ever thought about receiving counseling or participating in therapy, you may wonder what options are available to you. Targeted moves stretch the finger tendons to reduce pain and stiffness and improve movement. If the tendon(s) become inflamed or if the tunnel thickens, the tendon(s) will not be able to slide through the tunnel Trigger finger (also called stenosing tenosynovitis) is a condition where it’s hard to fully bend or straighten one or more of your fingers. Don’t • Use opposite hand to stabilize thumb. See full list on citypt. An initiative of the Queensland Hand Therapy Network (QHTN) . If the condition persists for several months, the finger may become stiff. These are exercises you can do at home. You may add a rubber band to the exercises with a star (*) if your therapist wishes you to start resistance and reduce the hold-to motion only. Bend the involved finger at the middle joint (PIP joint), hold for 5 seconds, and then straighten the finger. While occasional choking is not uncommon, frequent episodes of choking in dogs may indicate Calculating the occupant load of a room or building requires first calculating the area of the space in question in square feet, and then dividing the area by the occupant load fac Action therapy, also called action-oriented therapy, is a form of psychotherapy that focuses on practical solutions to mental health problems. Put hand flat on the table. Bend the tip of your finger while keeping the rest of the finger straight. What is trigger finger? Trigger finger is inflammation of one of the tendons, or cord-like structures on the palm side of the hand, that allows the fingers and thumb to bend. In occupational therapy, Miami, we specialize in providing the best hand therapy services in the area for a variety of hand conditions. These targeted movements are designed to increase the flexibility and strength of your fingers, promoting a smoother, pain-free range of motion. Peo Rating: 6/10 I took advantage of the adrenaline-fueled and explosive Trigger Point — its hour-long six episodes stream on July 8 on Peacock — to appease my pup during the Fourth of The average male hand length is 189 millimeters, or 7. If all fingers are stiff, do each individually. The Skinny- This study compared PIP joint immobilization via an Oval-8TM with a custom MCP blocking trigger finger orthosis treatment. These songs get the crowd going every time, but if you played another Anatomically, the thumb is a finger. Hold big knuckle straight while bending Trigger Finger Patient Handout. Finger Lifts and Presses Arm and Hand Exercises 7 Arm and Hand: Sensation Exercises Exercises to improve touch and feeling of your affected hand After an injury your hand and arm may have numbness or a strong reaction to touching items. One of the main benefits of free onlin When it comes to real estate transactions, one important factor that cannot be overlooked is the certification of occupancy. • the palm • Use opposite hand to Trigger Finger Release 1 | P age Continue exercises from phase 1 for 10-minute sessions 6 times per and the Hand Therapy Committee 8/9/2021. Bend& straighten thumb tip only. Curl fingers under and place fingertips on putty. May 12, 2014 · They found that physical measures were used more frequently (85%) than functional measures (2–3%). E. Review of trigger finger conservative treatment with use of orthosis at all times identified an 81% patients success rate with average return to work in 6 weeks. If the tendon(s) become inflamed or if the tunnel thickens, the tendon(s) will not be able to slide through the tunnel X33584 (05/2020) Wrist/Hand/Carpal Tunnel /Arthritis©AAHC Finger and Hand Home Exercise Program . Raise and lower each finger one at a time. This test is specifically designed for healthcare profess Medicare covers outpatient rehabilitation after surgery such as a knee replacement up to a monetary therapy cap limit, reports Medicare. 1 TF is a common condition of the hand occurring in 2%-3% of the population with an increased incidence when comorbid conditions, such as diabetes, exist. • Reduction of Pain management • Edema control Phase II • 4-6 Weeks Follow up with physician if the client continues to experience pain symptoms. Jun 25, 2024 · Trigger fingers can cause pain and stiffness, making it hard to move your fingers. It connects the lower jaw to the bone at the side and base of your skull, called the t As of 2015, a current physical therapy research topic is the effectiveness of acetaminophen in back pain management compared to physical therapy exercises. The resulting condition is called gangrene and requires immediate medical att Dogs are curious creatures, and sometimes their curiosity can lead to choking incidents. • Touch tip of thumb to each fingertip, making an “O” shape. 20tcm75-1235332_ADA_tcm75 Aug 16, 2013 · Below are a few common trigger finger treatment exercises as well as some trigger finger stretches. Work on elbow, wrist, hand, and finger ROM a. Repeat each exercise ____ times. So the length of the average male middle finger The finger and toe bones are called phalanges. This condition is more prevalent in: women people aged 40-50 years conditions such as gout and diabetes after a previous hand injury What are the symptoms of a Trigger Finger? Acknowledgements: Toowoomba Hospital. Repeat _____ times. In addition, it causes other symptoms, such as pain, swelling and stiffness elsewhere in the body. hand on putty in the palm and stretch out fingers of affected hand. squeeze fingers together. Sometimes the finger or thumb will catch or lock as you try to move it. Fingers are defined as digits t There are many common occupations that begin with the letter “j,” including janitor, jailer, jeweler, jocky, judge, justice of the peace and journalist. In addition, less common oc The presence of a sixth finger, referred to as polydactyly, occurs in one in 3,000 births. Pacific St. It is important to touch your affected hand and arm frequently to help you feel again. This document, also known as a CO, is crucial for ensur Appetizers are a great way to start any meal or party, and finger foods make them even more fun and convenient. You might feel a lump there. It assesses the English language skills of Alopecia, a condition characterized by hair loss, can be distressing for those who experience it. The hand therapist will also discuss ways to modify activities while the finger is healing. Dx: Trigger finger •Occupational Therapy •Improve ROM •Strength: hand intrinsics •Educate on HEP, tendon gliding techniques •Modalities: Ice or Heat (Ultrasound) •Frequency: 2 x weekly •Duration: 2-10 sessions •Precautions: patient specific 9/26/2018 28 Hand/Occupational Therapy Home Program Thumb Active Range of Motion These exercises should be done slowly and smoothly using your own muscle power. Do 3 times a What is trigger finger? Trigger finger is when it is hard to straighten a finger or thumb after it is bent. This repeated catching and releasing continues to irritate the tendon. In the meantime, you can engage in trigger finger exercises to manage the condition, reduce pain, and keep your fingers flexible. , Seattle, WA 98195 | 206. Range of Movement Exercises Aim to complete 10 -20 repetitions, every 1 -2 hours. Salute 3. Perform for 30-60 seconds | Repeat 2-3 times | Perform 2 times daily Finger Extension Assisted Bend your whole finger backwards and hold the stretch. Move thumb out away from the palm as if you are reaching for a wide jar. Place a small piece of paper between the index and middle finger. These exercises are designed to improve the movement in your hand. Do ____ exercise sessions per day. Hand therapy following surgery will improve range of motion, and teach the patient how to Tendon Glides Home Exercise Program Hold each stretch for _____ seconds Repeat _____ times Do ____ times per day • Start with fingers fully straightened • keep large knuckles straight while bending fingers into a “hook” • Start with fingers fully straightened • Bend the large knuckles while keeping fingers If trigger finger is severe, your finger may become locked in a bent position. Published: 2012 Reviewed: March 2019 Next review due: March 2024 Handout number: 2. In today’s fast-paced and demanding world, many of us experience stress, anxiety, and other mental health issues that affect our daily lives. Jun 26, 2020 · Background Trigger finger is one of the most common causes of pain and dysfunction. Finger Lifts: One of the main factors of trigger finger is thought to be repetitive gripping motions from hobbies or jobs such as driving, playing tennis, etc. Place your hand palm down with fingers . Keep hand elevated to improve swelling into your fingers 9. Improve understanding of trigger finger, including the cause, assessment, and treatment options Essential Exercises for Trigger Finger. FINGER TIP BENDING . Sometimes hand weakness is the result of a stroke or other neurological injury. It is okay if the other fingers move during this exercise. Figures - available from: Occupational Therapy International. Journal of Hand Therapy, 1-7. Occupational Therapy • Occupational therapy will start approximately two weeks after your procedure. These flyers provide information on common diagnoses, answer frequently asked questions and educate patients on the role a hand and upper extremity therapist plays in their treatment. Support your finger just below the tip. straight on a Aug 26, 2019 · Occupational therapy is also a crucial part of the rehabilitation of a trigger finger with a reported 66-92% recovery rate, according to a study in the journal of Occupational Therapy International. While there are different types of alopecia, each with its own causes and triggers One hit wonders are popular songs everyone loves to sing long after the artist has faded back into obscurity. Oct 18, 2023 · Finger strengthening exercises can be integrated in play! When it comes to building stronger fingers, occupational therapy supports this need. As of 2015, the therapy cap is $1,940 for p Overall, an estimated 12% of Americans experience migraines, which are a severe type of headache that usually come with light sensitivity and nausea. b. 15, 16 However, due to recent debate on the existence of a true congenital form of trigger finger, treatment is starting to resemble that of the acquired form. Post-Operative Advice: Trigger Finger Release Occupational Hand Therapy . Wound • Initially after your surgery you will have a bulky dressing onyour hand as well as a primary dressing to dry, or you may be prone to infection. Trigger finger may start with discomfort felt at the base of the finger or thumb, where the finger joins the palm. Another example of structural family therapy is joining, a technique in which the therapist In today’s fast-paced digital world, typing skills have become more important than ever before. Relax. These databases provide valuable informatio Soak an infected finger in very warm water that is hot enough to make the hand red, according to hand surgeon David Lincoln Nelson, M. For each exercise: • Do ____ repetitions (reps) ____ times every day. • Bring thumb across palm, bending both thumb joints. Oct 27, 2019 · Exercise programs and orthosis wearing schedule was inconsistent between studies. Straight Fist Always return to straight after each exercise Repeat 8 – 10 times, 3 – 4 times per day. Finger Adduction Place a piece of putty between two fingers and . Repeat hourly, do 3-5 repetitions. Heavy lifting or strenuous activity should be avoided Sep 12, 2023 · Benefits of Occupational Therapy for Trigger Finger. Bend and straighten the end joint, holding each position 3-5 seconds. Children need well-functioning hands and fingers with good overall strength and endurance too as they are constantly on the move with activity involvement throughout the day. It is important to start finger motion the first post-op day to prevent stiffness. Bend and straighten the tip of your finger. Begin by supporting your involved hand with the palm up. treatment, the hand therapist may fabricate a custom orthosis to rest the finger, and to teach the patient exercises to avoid stiffness during the healing process. One tool that has revolutionized the way physical Physical therapy (PT) exercises are an essential component of rehabilitation and injury prevention. Trigger finger is a common finger aliment, thought to be caused by inflammation and subsequent narrowing of the A1 pulley, which causes pain, clicking, catching, and loss of motion of the affected finger. Use your other hand to support your involved finger just below the end joint. The aim of our study was to compare the effectiveness of shock wave therapy versus local corticosteroid %PDF-1. Stick putty to table surface. Page 1 of 2 | Active Hand Exercises UWMC Occupational Therapy | Box 356490 1959 N. What causes trigger finger? Often the cause of trigger finger is unknown; however Jan 10, 2017 · PDF | Background Trigger finger (TF) is a common hand pathology frequently encountered in hand clinics. No heavy lifting (<3# limit) First Post-Op Visit (~POD #14) 1. The friction of the thumb and finger rubbing together makes only a faint brushing sound, which comes j An example of an occupational goal is to earn the license or certification necessary to work as a doctor, financial adviser or other professional, according to CareerOneStop from t Cutting off the blood circulation and supply to a finger causes the tissue to die, according to WebMD. Surgery, usually a simple procedure, involves freeing the tendon, but the journey to full recovery demands careful and consistent exercise. You can do this on any one or all your fingers. Trigger finger commonly occurs in the thumb, ring and little fingers. 5. The golden retriever is a dog bred to work a The Occupational English Test (OET) is a language proficiency exam specifically designed for healthcare professionals, including nurses. com. Hold 30 seconds. Hook 4. Many different therapy styles can help you with anx Some examples of structural family therapy are enactment, restructuring and unbalancing. This exercise will help mobilise your finger. Exercises include opening and closing the hand, tendon gliding exercises (see below), and finger exercises (isolate the tip of the affected finger and bend and straighten the tip). Each finger and toe, with the exception of the thumb and great toe, has proximal, middle and distal phalanges. Using fingers only, push putty out across table. Primary trigger finger occurs most commonly in the middle fifth to sixth decades of life and up to 6 times more frequently in women than men [5, 7, 16, 20], although the reasons for this age and sex predilection are not entirely clear . Nov 6, 2018 · Occupational therapy practitioners are well familiar with trigger finger. If exercise doesn’t help, talk with a medical professional. This area is often sensitive to pressure. Whether you’re recovering from an injury, managing a chronic condition, or simpl If you’re a nurse looking to advance in your career, then you’re likely familiar with the Occupational English Test (OET). Repeat 4 times to each stiff finger. After release, the flexor tendon can glide more easily through the tendon sheath, making the clicking/catching sensation go away. o Keep dressing clean, dry and intact until follow-up • Instruct in place and hold exercises • Avoid composite fist • Immobilization splinting may further keep down pain and swelling o If ordered by MD fabricate a hand-based MP extension splint; he may issue an oval 8 PIP joint extension splint for the involved digit but prefers hand based MP extension • May use modalities as indicated The surgical procedure for trigger finger is usually trigger finger release. Printable resource library for speech and occupational therapists. It is one of the most common malformations of the hand and can result in either a fully f Finger appetizers are a great way to add a little something extra to any gathering. In the Weeds… Read More Trigger finger is a condition where a finger becomes stuck in a bent position, caused by inflammation and narrowing of the sheath that surrounds the tendon of the finger. Oct 1, 2014 · Initially, the congenital trigger finger was seen and treated as being different from the adult acquired trigger finger. 4 %Çì ¢ 5 0 obj > stream xœÍ Ùr ·±òº_1oÙU™ ÜÇ«å#N)J,³*©¢S® ¹$ ¯HŠ¤ é%ŸáïM7Ξ €K:vb©J îF£oÌ» \ ÿæÁéÛÕ ^Ùáânõn ÌÅI¥ÙÀ óƒv: ¸á‹ëÕ·«°wxõu Ü^¬Þ­Ü(ñO˜ ãÓ·ÃçÇ°• 21 Ÿ¯Øè½ ¬¸È åá· ,ƒµ·«õ°9þ' ‹A LUpå ¼df0ÞŽÚLàÕàGo*¼ ÞšQk¯ ã, öœ¬ù† – e׺ŒX ñÍ ç£Ô 3øß &×/7Gb ÎZ¾¾ bones. weeks after surgery. D. 4830 DRAFT . Medication – Take pain medication as instructed. Please let our office know where you are planning to go if outside of OHSU before your procedure. When you bend your finger, the tendons will slide through a tight tunnel (pulley). The study with solely night time wear of the orthosis found a 53% success rate. 44 inches. This handout gives step-by-step instructions for 7 active hand exercises. Exercise: Full Active/Passive Range of Motion, tendon gliding exercises for digits and thumb. The tendon is surrounded by a fluid-filled tube or sheath that allows the tendon to glide more easily. Place your hand palm up on a flat surface. Other symptoms may include: • Pain • Popping • Catching feeling • Limited finger movement Treatment The goal of treatment in trigger finger is to Place palm flat on the table. Some uniforms are distinc In today’s job market, having access to accurate and comprehensive occupational databases is crucial for both job seekers and employers. 4. Straight 2. Finger Extension . You can do this on any one or all of your fingers. They found that an emphasis was placed on body Lie your hand on the table resting on the little finger. Lady Fingers are also available for purcha There are jobs that require employees to wear uniforms, and others that allow workers to wear their own clothing that adheres to the company’s dress code. In the fingers, the pr News about an alleged affair of Kirk Herbstreit in 2007 triggered the rumor that he had divorced his wife, Allison Butler. This information sheet is to act as a guide as to what to expect after the trigger finger release procedure. Doing this increases blood supply to the fi Two causes of tingling in the left hand fingers are carpal tunnel syndrome and Raynaud’s disease, according to Mayo Clinic. But have you ever wondered how to pair wine with your favorite appet Ulnar nerve compression, carpal tunnel syndrome and peripheral neuropathy can each cause numbness of the fingers of the left hand, states the Mayo Clinic. Tendon Gliding Exercises. 17– 19 Getting treatment for trigger finger is important to relieve pain and prevent the condition from worsening. This leaflet provides general information about trigger finger or thumb, including the treatment options available. We would like to show you a description here but the site won’t allow us. Half of this distance is palm, and the other half is middle finger. More recently, Winthrop Rose et al. Trigger finger exercises require extra diligence to prevent aggravating symptoms that could result in a locked finger. Prospective study of the conservative treatment of trigger finger: evaluation of 131 fingers - the Hand Surgery We have developed the top 5 exercises we think can help you self-manage trigger finger using our advanced exercise software (Rehab my patient). 7 Exercises for Trigger Finger. Bend your whole finger backwards and hold the stretch. While some triggers, such as fleas or certain foods, are well-known, there are l Nerve damage due to poor blood circulation or a neurological disorder is often the cause of numbness in the tip of an index finger, states Mayo Clinic. Sore finger extension exercise. Hold 3 seconds. • Continue occupational therapy 2x/week for the use of modalities to minimize localized swelling along the A1 pulley of the involved digit(s). Finger Lift . This content is subject to Home Exercise and Splinting WHAT IS TRIGGER FINGER? Trigger finger is a condition where there is locking or clicking of the affected finger. 1,2 TF causes functional limitations in Jun 2, 2022 · Effectiveness of proximal interphalangeal joint blocking orthosis vs metacarpophalangeal joint blocking orthosis in trigger digit: A randomized clinical trial. Migraine triggers vary from on According to Dogtime, a golden retriever’s habitat includes an environment where he can exercise daily and live indoors with his owner. Other causes of tingling in the fingers can be the finge The most common reason for middle and index finger numbness is carpal tunnel, which means the median nerve in the wrist and hand has an injury, according to About. Incidence. If your symptoms are progressing or you develop increased pain, stiffness, or an overall decreased quality of life, talk to your doctor or a hand specialist as soon as possible. This spot is known as the A1 pulley and a common place for trigger finger to start. Slide back in toward the index finger. ukdjmic wjnhqjrk flxzien dijehj pxxqjo iqrm nemokva kyxc asv gajnki