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Game of Thrones!

I recently had a patient in our clinic present with right index finger pain of about 2 months after no particular injury. The condition was particularly worrying for that patient, a dressmaker, as she had noticed reduced grip strength holding tongs at a BBQ the previous evening due to the pain involved and any loss of hand function had the potential to affect her ability to work.

On further questioning about change in exercise or normal work routine our patient explained that in her work she had been commissioned to create a ‘Game of Thrones’ inspired dress! The dress in question (modelled on the picture below) included some 75 hours of hand sewn foliage on the bodice and had been quite tiring on the fingers.


Examination of the patients affected digit revealed that the lateral-posterior part of the metacarpophalangeal joint had become enlarged and swollen and that the ‘dorsal interossei’ muscle which curls and abducts (moves from side to side) the finger had become overly tight and painful to touch. Knowing the history of the injury and having carefully taken note of the structures involved it seemed reasonable to conclude that the joint would return to normal function again now that the job was over. A little gentle muscle release of that dorsal interossei muscle seemed to help this process as the injury had resolved on that patients next visit.

The upshot of all this being that it is important to know the full history of any condition and carefully study the structures involved to be able to formulate a treatment plan specific to the injury.

Furthermore, if you need a dressmaker with particular attention to detail and dedication to her work you should consult Susan Ogg at

Dr Michael O’Doherty BChiro Sc., M.Chiro