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Hello! I have a five and a half year old son, who’s been involved in track field and swimming for about a year, since he was four. For some time, he’s been cracking the fingers of his hands. I took him to the doctor, but I was assured it had nothing to do with stress. Could you please tell me what can I do to help my son stop cracking his fingers? Even though I kept his hands busy with other activities, it did not help. Thank you!

Cracking the fingers of the hands is a very common behavioural issue / habit  with both children and adults.  It is not a good habit to have, as although there is no evidence to say that cracking your knuckles is associated with the development of osteoarthritis (wear and tear of the joints), it can have a negative impact upon ligaments and strength of grip.  Furthermore, it can be quite annoying for other people nearby.

You were told that it is nothing to do with stress.  I don’t agree with this – I feel that a lot of the time it is a stress driven behaviour just like biting your nails or tapping your feet.  Often you are unaware that you are doing it because we often mull over things in our subconscience. Such behaviours are an external manifestation of our anxieties and concerns.

So to answer the crux of your question you need to deal with {login} a) the behaviour, and b) you need to deal with any stress or anxiety that your Son may have:

a) A good thing to try would be a reward system that is often used also for things like bed-wetting.  So, if he manages a day without cracking his knuckles he gets a gold star (buy some little gold star stickers that can be put on your calender). Getting the gold star and giving him a lot of positive praise is very good motivation in itself.  If at the end of the week he gets say 5 stars he can have a small prize.  Nothing too expensive maybe a small toy.  Then in order to receive further ‘prizes’ he would need to get 6 stars in a week for example and then 7 stars.  This positive rewarding system has been proven to be an effective way in which to affect children’s behaviours.  It is much more preferable to do this rather than to chastise for negative behaviours.

If you find that this isn’t working or it is a slow process then giving him something to hold like a stress ball or a little pencil to twirl in his fingers should be tried.

b) Try to find out if there is anything causing him stress.  Ask him whether there is anyone bothering him at school.  Consider chatting to his main teacher and find out whether there has been any behavioural change recently. For example has he become withdrawn; could there be any problem with bullying?  Talk to him about how he’s feeling.  Encourage him to take up hobbies such as drawing and crafts as these give something for his hands to do and also help with relaxation.  In the evenings have some relaxation time with him e.g bath time / reading together.

hopefully this will help you to solve this problem.

Best wishes,

Dr Simon Widdrington

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