Quick Summary
Mallet finger is an injury to the tendon that straightens the tip of your finger, leaving the fingertip drooping and unable to straighten on its own after being jammed or struck end-on.
The mainstay of treatment is a splint that holds the fingertip completely straight, worn continuously for six to eight weeks — research suggests splinting alone achieves a successful outcome in around three quarters of cases. Our physiotherapists support you through correct splinting, protect the movement of your other finger joints, and guide graded exercises once the splint period is complete.
What Is Mallet Finger?
Mallet finger is a disruption of the terminal extensor tendon where it attaches to the base of the distal phalanx, at the back of the last finger joint — the distal interphalangeal (DIP) joint. When this attachment fails, you lose the ability to actively straighten the fingertip, so it rests in a bent position that resembles a mallet or hammer (Beutel, StatPearls, 2025).
There are two main types. In a tendinous (soft-tissue) mallet, the tendon itself tears or pulls away from the bone with no fracture. In a bony mallet, the tendon avulses a small fragment of bone from the dorsal base of the distal phalanx — known as a mallet fracture (British Society for Surgery of the Hand, 2016). Roughly a quarter of mallet fingers seen in primary care involve a bony fragment (Krastman et al., BJGP Open, 2024).
The injury most commonly affects the middle, ring or little finger of the dominant hand, with a UK incidence of around 9.9 per 100,000 people per year (Clayton and Court-Brown, Injury, 2008). The droop — called an extensor lag — does not correct itself without treatment, which is why early, uninterrupted splinting matters. Left untreated, the imbalance can occasionally progress to a swan-neck deformity, where the middle joint hyperextends while the fingertip stays bent.
Do You Experience These Symptoms?
✓ The tip of your finger droops and you cannot actively straighten it at the end joint
✓ You can straighten the fingertip with your other hand, but it drops again when released
✓ Pain and tenderness over the back of the last finger joint
✓ Swelling and sometimes bruising around the fingertip
✓ A recent history of the fingertip being jammed, stubbed or struck end-on
✓ A small bump felt or seen over the top of the joint in bony mallet injuries
✓ Redness and tenderness of the skin over the joint, which can persist for a few months
These symptoms can be treated.
The sooner you begin, the better your chances of a smoother recovery.
What Causes Mallet Finger?
• Ball and contact sports
The classic mechanism is a ball striking the tip of an outstretched finger — for example in cricket, netball, basketball or rugby. The impact suddenly forces the straightened fingertip into a bent position, rupturing the tendon or pulling off a fragment of bone.
• Everyday household tasks
Mallet finger frequently follows seemingly minor incidents such as catching the fingertip when tucking in bed sheets, pulling on socks, or pushing a hand into a tight pocket. Only a small force is sometimes needed, particularly in older people.
• Knocks and stubbing injuries
Catching or stubbing the finger against furniture, a wall or a door can drive the end joint into forced flexion. Crush injuries can produce the same tendon disruption.
• Open cuts and lacerations
Less commonly, a cut across the back of the fingertip can sever the tendon directly. These open injuries need urgent medical or surgical attention rather than simple splinting.
How We Treat Mallet Finger at J&J Therapy
Hands-On Manual Therapy
Our physiotherapists support every stage of your recovery. During the splinting period we make sure your splint fits well, holds the fingertip fully straight and does not cause skin soreness, and we teach you to clean the finger and change the splint safely without ever letting the fingertip bend. We use gentle mobilisation of the uninvolved joints — the middle and knuckle joints, hand and wrist — to prevent stiffness while the fingertip heals. Once the splint is discontinued, hands-on treatment eases residual stiffness at the end joint, with soft-tissue and scar management as needed.
Shockwave Therapy*
Shockwave therapy has no role in the acute management of mallet finger, which heals with splinting and rehabilitation. In the rare case of chronic residual tendinopathy or stiffness after the injury has fully healed, Swiss Storz Medical MASTERPULS shockwave may be considered only if your physiotherapist identifies specific indications during assessment. Non-invasive, evidence-based, and never a substitute for splinting.
Targeted Exercise Programme
During the splinting period we prescribe active movement of the joints that are free — the middle and knuckle joints, thumb, wrist and the rest of the hand — while the fingertip stays completely still and straight. After the splint is removed, we introduce gentle, graded active bending and straightening of the fingertip, progressing gradually and avoiding early aggressive flexion, which can re-stretch the healing tendon and bring back the droop. Strengthening is added once extension is secure, guiding you back to work, sport and daily activities.
When to Seek Urgent Medical Help
While most symptoms are not serious, urgent medical attention is required if you experience any of the following:
An open wound or cut over the injured joint, or bone visible through the skin — open mallet injuries need same-day surgical attention
Signs of infection — spreading redness, increasing pain, warmth, pus or fever, particularly around a wound or the nail
A visibly crooked, dislocated or grossly deformed joint, which may signal a fracture with joint displacement
A pale, blue, numb or cold fingertip, which may indicate compromised blood supply or nerve injury
FAQs About Mallet Finger
How long will I need to wear the splint?
Most people wear a splint holding the fingertip completely straight, continuously day and night, for six weeks for a bony mallet or eight weeks for a soft-tissue mallet, followed by a further period of night-time splinting. The fingertip must not bend at all during this time — if it droops, even briefly when washing, the healing clock effectively resets.
Can mallet finger heal without surgery?
Yes. Evidence shows the large majority of mallet finger injuries heal well with splinting alone. Surgery is generally reserved for a fracture involving more than about a third of the joint surface, a joint that has slipped out of alignment, or an open injury.
I only noticed the droop weeks after the injury — is it too late?
Usually not. Research suggests splinting can still be effective even when started weeks after the injury, with tendinous injuries often responding to extension splinting begun up to three months from the time of injury. It is worth being assessed as soon as you can.
Will my finger be completely normal again?
Most people regain good, functional movement, but a small permanent droop or a minor bump over the joint is common, and the finger can stay swollen or stiff for a few months. These usually settle and rarely limit function.
Can shockwave therapy treat my mallet finger?
Not for an acute mallet finger — this injury heals with splinting and rehabilitation. Only if you were left with chronic residual tendinopathy or stiffness long after healing, and your assessment specifically indicated it, would shockwave even be considered, and always alongside, never instead of, appropriate care.
This page is for general information only and does not replace professional medical advice.
Reviewed by Lavya Arigalayan, MSc, HCPC Registered Physiotherapist.
Last reviewed:
20 August 2026