Address safety, settle excessive irritability and maintain useful movement.
What to do
Reduce repeated forceful gripping temporarily
Maintain comfortable tendon glide and full finger extension where possible
Consider night splinting in selected early cases
Exercise dosage
Gentle tendon-glide sequence: 5–10 cycles, 3–5 times/day if not locking painfully
Avoid forcing a locked digit
Progress when
Daily function is stable or improving.
No new red flags or progressive neurological deficit.
Exercise response returns to baseline by the following day.
Phase 2 — Mobility, Strength & Capacity
Restore the specific strength, mobility and control required by the condition.
What to do
Progress graded grip and dexterity without repeated locking
Restore finger ROM and hand function
Coordinate medical options if symptoms persist
Exercise dosage
Light putty/grip: 2 x 8–12 only when gliding is comfortable
Finger extension band: 2–3 x 10–15
Progress when
Target movement and resistance are tolerated with good quality.
Functional capacity is improving without sustained symptom flare.
Progression is based on objective performance and patient goals.
Phase 3 — Functional Restoration & Return to Activity
Rebuild real-world, occupational or sporting capacity.
What to do
Return to sustained grip, tool use and sport-specific hand tasks
Progress volume while monitoring catching
Exercise dosage
Functional gripping: short bouts, gradually increasing duration
Progress resistance only if triggering remains controlled
Progress when
Condition-specific return criteria are met.
Full task exposure is completed progressively.
No clinically meaningful deterioration during the following 24 hours.
Manual Therapy — Role & Application
Gentle hand mobility may address secondary stiffness.
Do not forcefully manipulate a locked finger or claim massage releases the pulley.
Modalities — Use / Avoid
Splinting may reduce tendon excursion, particularly at night.
Persistent cases may need clinician-led corticosteroid injection or surgical assessment.
Return / Discharge Criteria
Finger opens/closes without troublesome locking
Grip and dexterity meet daily/work needs
No worsening swelling or pain
Common Clinical Mistakes
Forcing a locked finger through painful range
Ignoring diabetes or multiple-digit involvement
Delaying referral when fixed locking persists
Clinical Pearls
A1 pulley tenderness plus catching is characteristic.
Exercise is not a substitute for medical management in persistent or fixed locking.
Continue learning
Connect assessment with management
Use the related PNA learning pathways to explore examination techniques and structured rehabilitation. A test result should always be interpreted alongside the history, full examination and clinical presentation.
Use these sources as a starting point for clinical learning. A reference being listed here does not, by itself, establish that every recommendation on this page is strongly supported. Check the original publication, study design, population and limitations before applying findings to an individual patient.
Educational resource only. Tests and treatment plans must be adapted to the individual patient, irritability, comorbidities, surgical restrictions and local scope-of-practice requirements.
