Finger Flexion

I. Description of Motion: Finger Flexion

Finger flexion is facilitated by the extrinsic and intrinsic muscles of the hand working across several joints. It is this motion that allows objects to be grasped by the hands ¹.

Flexor Digitorum Superficialis (flexes PIP digits 2-5). Nerve: Median Nerve. Spinal Level: C7-T1 ¹

Flexor Digitorum Profundus (flexes DIP digits 2-5) Nerve: Median Nerve (lateral part, digits 2-3), Ulnar Nerve (medial part, digits 4-5). Spinal Levels: C8-T1¹

Flexor Policus Longus (flexes digit 1). Nerve: Median Nerve. Spinal Level: C8-T1¹

Lumbricals (involved in MCP Flexion) Nerve: Median Nerve (lateral parts) Deep Branch Ulnar Nerve (medial parts)
Spinal Level (C8-T1)¹

Palmar interossei (involved in MCP Flexion) Nerve: Deep branch Ulnar (C8, T1)¹

II. Mobilizing – Increasing Range of Motion :

Finger Flexion range of motion (ROM) can be increased by stretching the extensor tendons. Below are three stretches that can increase PF ROM:

Finger DIP Flexion Stretch

1. Grab the affected finger below the most distal knuckle
2. Stretch gently into a more flexed position, which should not be painful.
3. Hold for 5-10 second. Perform 10 reps, 2 to 3 times daily, resting for a minute between each set.

Finger PIP Flexion Stretch

1. Grab the affected finger below the middle knuckle.
2. Stretch gently into a more flexed position
3. Hold for 5-10 second. Perform 10 reps, 2 to 3 times daily, resting for a minute between each set.

Finger MCP Flexion Stretch

1. Grab the affected finger below the proximal knuckle
2. Stretch gently into a more flexed position.
3. Hold for 5-10 second. Perform 10 reps, 2 to 3 times daily, resting for a minute between each set.

Thumb flexion stretch.

1. Grab the thumb on the affected hand and bend the thumb towards the palm
2. Stretch gently into a more flexed position, which should not be painful.
3. Hold for 5-10 second. Perform 10 reps, 2 to 3 times daily

III. Indications for Stretching:

Stretching is recommended when there is a loss passive range of motion at a particular joint²

IV. Strengthening:

Active Finger DIP Flexion

1. Grab the affected finger and brace below the distal knuckle.
2. Actively bend the finger at the distal interphalangeal joint.
3. Patient should perform 3 sets of ten reps. To progress, increase reps and/or sets.

Active Finger PIP Flexion

1. Grab the affected finger and brace below the middle knuckle
2. Actively bend the finger that the proximal interphalangeal joint.
3. Patient should perform 3 sets of 8-12 reps. To progress, increase reps and/or sets.

Active Thumb Flexion

1. Use your thumb to try and touch each finger.
2. Try to touch each finger 5 times. To progress, increase reps.

Finger Isometric Flexion

1. Flex the fingers of the affected hand fagainst the fingers of the unaffected hand.
2. Applying a maximal forcing and hold the position
3. Hold for 30 seconds or until fatigue. Repeat 3 times. To progress exercise, increase time.

Finger Towel Grippers

1. Grasp a rolled up towel in the affected hand and squeeze as hard as you can. Hold for ten seconds. Slowly release and relax for ten seconds. Repeat ten times.
2. To change the difficulty and to progress increase holding time

V. Potential Clinical Syndromes or Etiologies:

Injury to the flexor tendons²
Immobilization of the hand following injury²

VI. Additional Web Based Resources:

For more information supporting the need for stretching and strengthening, please explore these lecture notes:

Hand Evaluation
Hand Evaluation

Normal values for range of motion of joints. Merck Manuals Web site. http://www.merckmanuals.com/professional/special_subjects/rehabilitation/physical_therapy_pt.html Updated September 2013. Accessed December 7 2014.

VII. References (AMA format)

1. Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy, Seventh Edition. Baltimore, MD: Lippincott Williams & Wilkins; 2014.

2. Kisner C, Colby LA. Therapeutic Exercise. Philadelphia, PA: F.A. Davis Company 2002.