Shawn Stachler, DO

Hand — In-Office Procedures

Trigger Finger Release (also called A1 pulley release)

Releasing a tight pulley so the finger no longer catches or locks.

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What it is

Trigger finger happens when the tendon that bends a finger no longer glides smoothly through the first pulley (the A1 pulley) at the base of the finger. The tendon or its sheath thickens, so the finger catches, clicks, or locks when bending or straightening. A release divides the A1 pulley so the tendon can move freely again.

Common symptoms

  • Catching, clicking, or locking of the finger, often worst in the morning
  • A tender bump in the palm at the base of the affected finger
  • Having to use the other hand to straighten the finger
  • Stiffness or, in longstanding cases, a finger that stays bent

Non-surgical options

  • A splint that holds the finger straight, especially at night
  • Activity modification to reduce gripping
  • Anti-inflammatory medication
  • A corticosteroid injection into the tendon sheath, which resolves many triggers — sometimes with a repeat injection

The procedure

The release is usually done in the office under local anesthesia. Through a small incision in the palm, the A1 pulley is divided so the tendon glides freely, and full movement is confirmed before the skin is closed with sutures. It takes about 10–15 minutes and you go home the same visit.

Recovery timeline

  • First few daysLight use of the hand is encouraged right away. Keep the dressing clean and dry and elevate the hand to limit swelling.
  • Weeks 1–2Sutures come out at about 10–14 days. Triggering is usually gone immediately; the palm incision stays tender for a few weeks.
  • Weeks 3–6Tenderness and any stiffness keep settling and full grip strength returns. A short course of hand therapy is occasionally needed for a stiff finger.
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The information on this page is provided for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. Individual cases vary. Always consult a qualified clinician about your condition. In an emergency call 911.