Welcome to Momentum Health's patient resource about hand injuries. The following is an article on hand anatomy. Please see the left hand menu for specific information.
Few structures of the human anatomy are as unique as the hand. The hand needs to be mobile in order to position the fingers and thumb. Adequate strength forms the basis for normal hand function. The hand also must be coordinated to perform fine motor tasks with precision. The structures that form and move the hand require proper alignment and control in order for normal hand function to occur.
This guide will help you understand:
what parts make up the hand
how those parts work together
Hear from some of our patients who we treated for Hand Pain
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I have seen several practitioners within Momentum West Springs for acute injuries involving a fractures wrist, L4-L5 disk injury and shin strain. I felt in these instances that I was focused on and my... ”
“ I have seen several practitioners within Momentum West Springs for acute injuries involving a fractures wrist, L4-L5 disk injury and shin strain. I felt in these instances that I was focused on and my injuries were well addressed with an appropriate care plan and follow up, I have resolved all of these issues and continue to see practitioners ( Jason) or ongoing maintenance and injury prevention. I have also seen pelvic floor physiotherapists within the clinic which have made incredible improvements in hypertrophic muscles due to heavy weight lifting and activity I am involved in as well more recently after having my first child and navigating postpartum to return to the level of fitness I am accustomed to. Susan has been an incredible resource and practitioner individualizing my care and helping me manage these issues in their acute stages and preventing these same problems from re-occurring. I cannot recommend this clinic enough for all of the issues I have encountered. ”
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Over the past few years I have suffered from back, neck, arm and hand ailments. I sought treatment by going to Momentum Health at Deerfoot City and have done so for some time now. All the staff have... ”
“ Over the past few years I have suffered from back, neck, arm and hand ailments. I sought treatment by going to Momentum Health at Deerfoot City and have done so for some time now. All the staff have been welcoming, courteous and professional. Mark Taylor has been my physiotherapist for the past year. He is very professional, friendly and skilled at his job. He has been successful at treating a number of my physical ailments and relieving the pain. I would highly recommend him to anyone seeking a physiotherapist. ”
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I would highly recommend Mark and Safia at Momentum Health for physiotherapy. I received treatment over 6 months for a WCB claim involving wrists, elbows and knees. They took the stress out of the WCB... ”
“ I would highly recommend Mark and Safia at Momentum Health for physiotherapy. I received treatment over 6 months for a WCB claim involving wrists, elbows and knees. They took the stress out of the WCB claim process and continued with thorough reviews to make sure treatment was complete and did not end prematurely. They assessed my condition, developed a treatment plan, and then patiently helped me carry it out. They selected and taught me exercises appropriate to my level of recovery and gave feedback through all the stages. I also received in clinic treatment including muscle release, heat and dry needling. To top it off, the atmosphere in the clinic was always friendly and happy, so treatment became the highlights in my week. They seemed to care for the whole person not just the physical condition in need. Thank you Mark and Safia! ”
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I am filled with deep gratitude as I express my heartfelt appreciation to Momentum Health Physiotherapy, with a special mention of immense gratitude to Amy and Nicole. Their unwavering dedication and... ”
“ I am filled with deep gratitude as I express my heartfelt appreciation to Momentum Health Physiotherapy, with a special mention of immense gratitude to Amy and Nicole. Their unwavering dedication and vast knowledge played a pivotal role in facilitating my recovery journey after enduring the challenge of breaking both my wrists and femur. Through their exceptional support, I was able to regain my strength and relearn the invaluable skill of walking. I am truly humbled and sincerely thankful for their outstanding contributions to my healing process. Thank you from the bottom of my heart. ”
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I had the best service possible. My first appointment Alisha assessed my wrist injury while explaining all that we needed to do to get my wrist back functioning. I returned 3 days later Katie was... ”
“ I had the best service possible. My first appointment Alisha assessed my wrist injury while explaining all that we needed to do to get my wrist back functioning. I returned 3 days later Katie was ready to get me started on a recovery program. She got me doing exercises that I could also do at home. 9 treatments and I'm as good as gold. I would recommend this team to everyone, so friendly and ready for your arrival. Also Its very clean. Nancy leclair ”
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I did some physiotherapy work over 3-4 months with Russ for Carpal Tunnel Syndrome. Although it wasnt fun work I was finally able to get the CTS to calm down and me back to doing the activities I like... ”
“ I did some physiotherapy work over 3-4 months with Russ for Carpal Tunnel Syndrome. Although it wasnt fun work I was finally able to get the CTS to calm down and me back to doing the activities I like to do. Thanks Russ! ”
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I seen Christina Ergang and I absolutely love the sub-occipital release she does. I found she did a nice deep massage in my forearms to help with my carpal tunnel. ”
“ I seen Christina Ergang and I absolutely love the sub-occipital release she does. I found she did a nice deep massage in my forearms to help with my carpal tunnel. ”
“
I have seen several practitioners within Momentum West Springs for acute injuries involving a fractures wrist, L4-L5 disk injury and shin strain. I felt in these instances that I was focused on and my... ”
“ I have seen several practitioners within Momentum West Springs for acute injuries involving a fractures wrist, L4-L5 disk injury and shin strain. I felt in these instances that I was focused on and my injuries were well addressed with an appropriate care plan and follow up, I have resolved all of these issues and continue to see practitioners ( Jason) or ongoing maintenance and injury prevention. I have also seen pelvic floor physiotherapists within the clinic which have made incredible improvements in hypertrophic muscles due to heavy weight lifting and activity I am involved in. Lee has been an incredible resource and practitioner helping me manage these issues in their acute stages and preventing these same problems from re-occurring. I cannot recommend this clinic enough for all of the issues I have encountered. ”
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Rachel and Kaylie have been very helpful when it comes to physiotherapy for my wrist. My range of motion has improved immensely since seeing them. They are always happy and a pleasure to be around :) ”
“ Rachel and Kaylie have been very helpful when it comes to physiotherapy for my wrist. My range of motion has improved immensely since seeing them. They are always happy and a pleasure to be around :) ”
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Joel and Amé recently helped me out with some reoccurring wrist pain I had been experiencing. After only 2 visits the pain has not returned and I am feeling much better! Joel helped to figure out the... ”
“ Joel and Amé recently helped me out with some reoccurring wrist pain I had been experiencing. After only 2 visits the pain has not returned and I am feeling much better! Joel helped to figure out the underlining issue so I don’t have to continue using creams and medications to numb the pain. Thanks for the help :) ”
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I've been going to Momentum Health for 2 years now with various injuries and Joel and Ame are a dream team! They are both so friendly and welcoming from start to finish. Having used them to resolve... ”
“ I've been going to Momentum Health for 2 years now with various injuries and Joel and Ame are a dream team! They are both so friendly and welcoming from start to finish. Having used them to resolve issues in my wrist, legs and shoulder, I know that no matter what my issue may be they will come up with a effective treatment program both in and out of the office to get me moving again! Thanks Joel and Ame for helping me reach my fitness goals! ”
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Its been amazing few months i started here with Lora and Amie. I had post car accident back pain for almost 3 years. Lora and Amie worked with my pain, determine my core muscles being weak and... ”
“ Its been amazing few months i started here with Lora and Amie. I had post car accident back pain for almost 3 years. Lora and Amie worked with my pain, determine my core muscles being weak and prescribed correct exercise. Its been improving drastically. Same time, they did amazing work with my palm pain which started to develop few months ago. Thank you for taking care of my pain. ”
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I am dealing with a lower back injury for a while now and i tried different treatments that didn't really work . With the supervision of Amie and the work of Nicole, i am seeing a lot of improvements.... ”
“ I am dealing with a lower back injury for a while now and i tried different treatments that didn't really work . With the supervision of Amie and the work of Nicole, i am seeing a lot of improvements. Nicole was massaging the painful area and pressing with her fingers on the sensitive spots which was relieving the pain away, she also gave me sets of exercices to practise at home, which were easy to get them done. I am happy with the results so far!! Thank you Nicole for your hard work and devotion for healing me and thank you Amie for following up. ”
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Carlee and her team was amazing. This is the second time I injured my wrist after a nasty fall on ice. Carlee's team took time to figure out and isolate where the pull was coming from. After a careful... ”
“ Carlee and her team was amazing. This is the second time I injured my wrist after a nasty fall on ice. Carlee's team took time to figure out and isolate where the pull was coming from. After a careful examination on the first day, they found it was deep within the tissue. They spent around 6 treatments of ultrasound therapy, tensor therapy, massage and gave me the exercises and stretches as homework to get me back into form. It helped and I was at 95% by the 5 session. Now back at doing normal things like opening jars and typing without pain. Thanks Momentum Health. ”
There are 27 bones within the wrist and hand. The wrist itself contains eight small bones, called carpals. The carpals join with the two forearm bones, the radius and ulna, forming the wrist joint. Further into the palm, the carpals connect to the metacarpals. There are five metacarpals forming the palm of the hand. One metacarpal connects to each finger and thumb. Small bone shafts called phalanges line up to form each finger and thumb.
Carpals
The main knuckle joints are formed by the connections of the phalanges to the metacarpals. These joints are called the metacarpophalangeal joints (MCP joints). The MCP joints work like a hinge when you bend and straighten your fingers and thumb.
Metacarpophalangeal Joints
The three phalanges in each finger are separated by two joints, called interphalangeal joints (IP joints). The one closest to the MCP joint (knuckle) is called the proximal IP joint (PIP joint). The joint near the end of the finger is called the distal IP joint (DIP joint). The thumb only has one IP joint between the two thumb phalanges. The IP joints of the digits also work like hinges when you bend and straighten your fingers and thumb.
The joints of the hand, fingers, and thumb are covered on the ends with articular cartilage. This white, shiny material has a rubbery consistency. The function of articular cartilage is to absorb shock and provide an extremely smooth surface to facilitate motion. There is articular cartilage essentially everywhere that two bony surfaces move against one another, or articulate.
Articular Cartilage
Ligaments and Tendons
Ligaments are tough bands of tissue that connect bones together. Two important structures, called collateral ligaments, are found on either side of each finger and thumb joint. The function of the collateral ligaments is to prevent abnormal sideways bending of each joint.
Collateral Ligaments
In the PIP joint (the middle joint between the main knuckle and the DIP joint), the strongest ligament is the volar plate. This ligament connects the proximal phalanx to the middle phalanx on the palm side of the joint. The ligament tightens as the joint is straightened and keeps the PIP joint from bending back too far (hyperextending). Finger deformities can occur when the volar plate loosens from disease or injury.
Volar Plate
The tendons that allow each finger joint to straighten are called the extensor tendons. The extensor tendons of the fingers begin as muscles that arise from the backside of the forearm bones. These muscles travel towards the hand, where they eventually connect to the extensor tendons before crossing over the back of the wrist joint. As they travel into the fingers, the extensor tendons become the extensor hood. The extensor hood flattens out to cover the top of the finger and sends out branches on each side that connect to the bones in the middle and end of the finger.
Extensor Hood
The place where the extensor tendon attaches to the middle phalanx is called the central slip. When the extensor muscles contract, they tug on the extensor tendon and straighten the finger. Problems occur when the central slip is damaged, as can happen with a tear.
Central Slip
Muscles
Many of the muscles that control the hand start at the elbow or forearm. They run down the forearm and cross the wrist and hand. Some control only the bending or straightening of the wrist. Others influence motion of the fingers or thumb. Many of these muscles help position and hold the wrist and hand while the thumb and fingers grip or perform fine motor actions.
Most of the small muscles that work the thumb and pinky finger start on the carpal bones. These muscles connect in ways that allow the hand to grip and hold. Two muscles allow the thumb to move across the palm of the hand, an important function called thumb opposition.
Hand Muscles
Thumb Opposition
The smallest muscles that originate in the wrist and hand are called the intrinsic muscles. The intrinsic muscles guide the fine motions of the fingers by getting the fingers positioned and holding them steady during hand activities.
Nerves
All of the nerves that travel to the hand and fingers begin together at the shoulder: the radial nerve, the median nerve, and the ulnar nerve. These nerves carry signals from the brain to the muscles that move the arm, hand, fingers, and thumb. The nerves also carry signals back to the brain about sensations such as touch, pain, and temperature.
The radial nerve runs along the thumb-side edge of the forearm. It wraps around the end of the radius bone toward the back of the hand. It gives sensation to the back of the hand from the thumb to the third finger. It also supplies the back of the thumb and just beyond the main knuckle of the back surface of the ring and middle fingers.
Radial Nerve
The median nerve travels through a tunnel within the wrist called the carpal tunnel. This nerve gives sensation to the thumb, index finger, long finger, and half of the ring finger. It also sends a nerve branch to control the thenar muscles of the thumb. The thenar muscles help move the thumb and let you touch the pad of the thumb to the tips each of each finger on the same hand, a motion called opposition.
Median Nerve
The ulnar nerve travels through a separate tunnel, called Guyon's canal. This tunnel is formed by two carpal bones, the pisiform and hamate, and the ligament that connects them. After passing through the canal, the ulnar nerve branches out to supply feeling to the little finger and half the ring finger. Branches of this nerve also supply the small muscles in the palm and the muscle that pulls the thumb toward the palm.
Ulnar Nerve
The nerves that travel to the hand are subject to problems. Constant bending and straightening of the wrist and fingers can lead to irritation or pressure on the nerves within their tunnels and cause problems such as pain, numbness, and weakness in the hand, fingers, and thumb.
Blood Vessels
Traveling along with the nerves are the large vessels that supply the hand with blood. The largest artery is the radial artery that travels across the front of the wrist, closest to the thumb. The radial artery is where the pulse is taken in the wrist. The ulnar artery runs next to the ulnar nerve through Guyon's canal (mentioned earlier). The ulnar and radial arteries arch together within the palm of the hand, supplying the front of the hand, fingers, and thumb. Other arteries travel across the back of the wrist to supply the back of the hand, fingers, and thumb.
Radial Artery
Summary
The hand is formed of numerous structures that have an important role in normal hand function. Conditions that change the way these structures work can greatly impact whether the hand functions normally. When our hands are free of problems, it's easy to take the complex anatomy of the hand for granted.
