By Todd M. Narson, DC, DACBSP®, ICSC


Welcome to our guide on Baseball finger, also known as mallet finger, a common sports injury affecting the finger’s extensor tendon. In this article, we will explore the different types of Baseball (mallet) finger, the causes, symptoms, and available treatment options. We’ll also highlight the vital role of a Chiropractic Sports Medicine Specialist (Diplomate of the American Chiropractic Board of Sports Physicians / DACBSP®) in assisting with type-1 mallet finger cases.

Understanding Baseball Finger and Its Types:

Baseball finger (medically also known as ‘Mallet finger’ and commonly called hammer finger or drop finger) occurs when the extensor tendon that straightens the finger becomes damaged or torn. In a mallet finger injury, the terminal portion of the extensor tendon, and often, the oblique retinacular ligament are affected. This terminal portion is the part of the tendon that attaches to the bone at the distal phalanx of the finger, responsible for extending the last joint (distal interphalangeal joint aka: DIP) of the finger. When this terminal portion of the extensor tendon is damaged or torn, it results in the characteristic drooping or inability to fully extend the fingertip, a condition commonly known as mallet finger. In the game of baseball, the injury occurs when a baseball hits the tip of the finger, causing one of the different types of mallet finger (described below).

There are different types of mallet finger based on the severity of the injury:

Type I: Closed Injury with or without Small Dorsal Avulsion Fracture

In this type of mallet finger, the injury occurs without an open wound, and there may or may not be a small avulsion fracture on the dorsal side of the finger. This is the most common type of Mallet finger and is not always painful.

Type II: Open Injury (Laceration)

Type II mallet finger involves an open wound with a laceration that exposes the extensor tendon and surrounding tissues.

Type III: Open Injury

(Deep Soft Tissue Abrasion involving Loss of Skin and Tendon Substance)

This type of mallet finger injury is characterized by a deep abrasion that affects both the skin and the extensor tendon, resulting in tissue loss.

Type IV: Mallet Fracture

Type IV mallet finger involves fractures of the distal phalanx, and it is further classified into subtypes based on the extent of the fracture fragment:

A) Distal Phalanx-Physeal Injury (Pediatrics)

Type IV-A mallet finger is specific to pediatric cases, where the injury affects the growth plate of the distal phalanx.

B) Fracture Fragment Involving 20% to 50% of Articular Surface (Adult)

Type IV-B mallet finger occurs in adults when the fracture involves a fragment that covers 20% to 50% of the joint’s articular surface.

C) Fracture Fragment >50% of Articular Surface (Adult)

Type IV-C mallet finger in adults involves a fracture fragment that covers more than 50% of the articular surface of the distal phalanx.

Symptoms of Mallet Finger:

The primary symptom of all types of mallet finger is the inability to fully extend the affected finger at the last joint. Other common signs can include pain, swelling, and tenderness at the back of the finger.

Treatment Options:

For type-1 mallet finger cases, conservative treatment is usually sufficient. This includes RICE (Rest, Ice, Compression, Elevation) therapy and wearing a splint to immobilize the finger joint for a specified period to allow proper healing. Compliance with splinting is crucial for successful recovery, which generally mean, wearing a DIP extension splint 24/7 for 6 weeks. Your doctor may also proactively splint your finger to prevent you from developing a “Swan-neck” deformity as well.  During and after that time, various rehab techniques may be appropriate, which you should discus with your doctor.

How a DACBSP® Can Help with Type-1 Mallet Finger:

A DACBSP® is a specialized Chiropractic Sports Medicine Specialist with expertise in treating sports-related injuries. When it comes to type-1 mallet finger, a chiropractic DACBSP® physician can provide invaluable assistance in the following ways:

Examination & Evaluation:

A DACBSP® will conduct a thorough assessment of the mallet finger which will include a physical examination, and often, x-rays to rule out avulsion or other fracture type.  A chiropractic DACBSP® will manage and rehab type-1 mallet finger injury to determine the most suitable course of action, however the other types will be referred to an orthopedic hand specialist.

Customized Bracing:

The DACBSP® can prescribe a customized finger splint or brace specifically designed to support and promote healing for type-1 mallet finger cases. Splinting may also include protection from developing a Swan Neck deformity, which can be a complication of Mallet finger.

Rehabilitation Exercises:

After successful bracing, a targeted rehabilitation plan, tailored to the individual’s needs, can be designed to improve ROM and flexibility of the DIP, as well as developing/improving finger strength.


Incorporating physiotherapy techniques, such as ultrasound or manual therapies, ice, heat, and laser therapy can aid in reducing inflammation and accelerating tissue healing.


Mallet finger, with its various types, can be a challenging injury to deal with, especially for athletes and sports enthusiasts. While type-1 mallet finger is the most common and typically manageable with conservative treatment, which is where chiropractic sport medicine specialists can help. Their specialized knowledge and assistance with custom bracing, rehabilitation exercises, and physiotherapy can significantly improve the healing process and help individuals return to their active lifestyles safely. Remember, always consult a healthcare professional for personalized advice and care for mallet finger or any medical condition.  If the chiropractic sports medicine specialist (DACBSP®) determines your Mallet finger is a type II, III or IV, you will be referred to an orthopedic hand specialist for surgical evaluation and management.

The Road to Recovery:

If you’re here in Miami or Miami Beach, the Road To Recovery from running injuries starts by calling Dr. Narson.  Dr. Narson (click for bio) is a chiropractic sports medicine specialist (DACBSP®) that will evaluate your injuries, design a program specific to your injuries and help get you back on the road to recovery.

Click here to request an appointment with Dr. Narson

What If You’re Not In South Florida?

How to find a chiropractic sports medicine specialist if you’re not here in Miami Beach / Miami?  Go to enter your location and you can find a DACBSP® or CCSP® near you that can help you with your sports injury!


Todd M. Narson, DC, DACBSP®, ICSC

Chiropractic Sports Medicine Specialist

Miami Beach Family & Sports Chiropractic Center

975 Arthur Godfrey Road #102

Miami Beach, FL 33140

Phone:  305.672.2225


Click here to request an appointment with Dr. Narson

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