Written by Mavis Tham, Shamaine Soh and Yuna Zhuang, Principal Hand Occupational Therapists at Phoenix Rehab.Clinically reviewed by Nigel Chua, Founder and Clinical Director, Registered Occupational Therapist, AHPC A1300362Z.Last reviewed 2 October 2026.
A volar plate injury is the commonest jammed finger that gets dismissed. The middle joint of the finger swells, it hurts to bend backwards, and it will not fully straighten. The ligament on the palm side of that joint has been stretched or torn, usually by the finger being forced back.
It gets dismissed because the x ray is often clear and the finger still works. Then three months later the joint is thicker than the one next to it, will not straighten the last fifteen degrees, and nobody can explain why.
What it looks like
Swelling concentrated at the middle joint, sometimes with bruising underneath. Pain when the joint is pushed backwards, which is the movement that injured it. A joint that is stiff in both directions within a day or two. And commonly a finger that rests slightly bent and will not flatten on a table.
The classic mechanism is a ball on the fingertip, a hand put out in a fall, or a finger caught in clothing or a bag strap. Volleyball, basketball and netball produce a steady supply of them.
Why it matters more than it seems to
The middle joint of a finger, the PIP, is the joint in the hand that stiffens hardest and gives range back most reluctantly. A volar plate injury held in a bent position for a few weeks, which is the comfortable position, produces a flexion contracture, which is a joint that cannot straighten. That happens because the injured ligament and the joint capsule shorten to the length they are held at, and past the early months the range that is left tends to be the range you keep.
So the treatment is the opposite of what feels natural. The finger is protected from being pushed backwards and encouraged to straighten, early, rather than rested in a curl.
What the treatment is
For most of these, a short period of protection in a splint that blocks the joint from hyperextending while allowing it to bend and straighten, then early controlled movement. Buddy strapping to the neighboring finger is often part of it. Swelling management matters more than people expect, because a swollen joint physically cannot reach full range and the swelling itself drives stiffness.
The exceptions go to a surgeon. A joint that feels unstable, one where a fragment of bone has come away with the ligament and involves a significant part of the joint surface, or a finger that looks out of line, are all questions for a hand surgeon before therapy starts. Ask specifically about the joint surface if you have been told there is a small fracture.
Is it normal for it to stay swollen?
Yes, and for longer than you would think. A PIP joint that has been injured commonly stays visibly thicker than its neighbor for six to twelve months, and in some people permanently. That is scar and thickened capsule rather than ongoing injury. What is not normal is a joint that is getting stiffer week on week, one that is hot and red, or a finger that is drifting sideways.
It has been two months and it still will not straighten
This is the common arrival point, and it is the one that responds to specific work rather than to time. The measurement that matters is the difference between how far you can straighten the joint yourself and how far someone else can straighten it. If they can get further than you can, that is strength and tendon glide. If nobody can, the joint itself is short, and that needs sustained time at end range rather than stretching, which is what a serial cast or a dynamic splint does.
Either way it is a number taken with a goniometer, written down, and compared at the next appointment. Our Stiff Finger Joint Recovery Program is built around exactly this problem, and the Stalled Recovery Review is three appointments over three weeks with the same hand therapist, $690 nett, no GST, for a finger that has stopped changing.
Where are you with this right now?
1. It is settling on its own
Many hand problems settle with a well fitted splint, changes to what provokes them, and tendon gliding. A tender scar and weak grip for a few weeks after surgery are usual. If it is easing week on week, and grip is improving month on month, it is behaving as expected. You do not need us for this, and we would rather say so.
2. It has stopped improving
You hand the jar to someone else. You button the shirt one-handed. You have stopped using that hand for anything that matters and barely noticed when it started.
The hand is the part of the body where stiffness sets in fastest, because a hand that hurts gets used less within days rather than weeks. That is the gap worth measuring, and it is not measured by how you feel on the day.
The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a joint does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds. $690, nett, no GST, which is three appointments at $230.
3. You have had surgery, or you have a date
Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. See the recovery programs, or hand therapy after surgery if you are not sure which applies to you.
All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.
Next step
Find out which stage you are in
What our patients say
Google reviews from our clinics in Singapore.
Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.
Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.
Related reading
- Finger pain and finger joint pain: what where it hurts tells you
- hand therapy after surgery
- carpal tunnel
- What is a sprained thumb?
- Custom Made Finger, Hand & Elbow Splints Singapore
- Hand Occupational Therapist Singapore | Phoenix Rehab Group
- The Phoenix Recovery Protocol, and the four stages
- All recovery programs, hand and physio
- Finger sprain treatment and recovery
- Finger and Metacarpal Fracture Recovery Program
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