Recurring Finger Injury

So about four months ago I was climbing on my homemade bouldering wall (45 degree angle) and did a move that put too much stress on my right ring finger (I think it had something to do with hyperextending it) and I heard a pop, not one of those loud crazy ones that I've heard about people hearing across a whole gym, but a knuckle crack noise all the less. My finger felt weird but not too painful and I stopped climbing for about a month plus. It started to feel better and I started climbing things with open right hand movements (thinking that avoiding crimps would allow me to climb). Then one day about a month and a half in I was pulling on a bit undercling and again kind of hyper extended it. This time it hurt and not on the finger but in the palm of my hand. I stopped climbing for another month. It started to feel good and I was on a ten day trip to Horse Pens, Rocktown, LRC (the slopers caused no pain), it was feeling fine, maybe a little sore after climbing but not much (I was stretching a lot and taping). Two months pass with no further pain, but not much climbing either, except for big holds on my wall. I just went on another ten day trip to Rocktown and it felt great, I could actually crimp fine again. I got back yesterday and went out to my local boulderfield (Reservoir Rocks, Great Barrington, MA). While working a new problem (not hard just a big move to an awesome but just in reach hold) I must have grabbed it with my pinky, ring finger, and middle finger and weighted primarily my ring finger - there was a sharp main in the inside of my palm around the middle finger. (Because I'm a jackass) I taped a bit tighter and climbed a bit more, this time going static and latching just with my pointer and middle finger, didn't hit it bad again thankfully. It hurts to fully extend my fingers (local pain around the ring finger), but not to squeeze, and the finger itself doesn't hurt.

So the break down..

September - Original injury
(Feeling better, started climbing easy stuff)
October - Tweaked finger
(Starting to feel a lot better, climbing harder)
February - Tweaked finger again

Can anyone please tell me what is actually injured. I originally thought it was one of the pulleys inside my finger, now I think it's the A1 or the Flexor Tendon. I now realize I'm an idiot and I should have just stopped climbing all together back in September and I may have been fully healed by now instead of escalating the problem twice again. Please help me. It has only been about 12 hours since re-injury.

Have the same thing, happened on Saturday. Reached for a crimp over a roof, feet blew out and tried catching myself on my way down. Heard a crack in what sounded like my wrist. I have pain in the palm of my hand all the way down that tendon into my mid wrist. Everything feels fine and has no pain unless I bend my left ring finger (that I fell on) and apply a pulling force (as in climbing exclusively).

I have been icing it and not climbing on it and it feels pretty much the same,maybe slightly better.

I have an x ray Wednesday and appointment with an orthopedic surgeon Thursday. I'll be sure to keep you posted if I find out anything ground breaking. It's shitty but it was nice to see that someone else has something similar and not an A2 problem like every other case on the Internet.

Sounds like you def tweaked it... base of the finger pain on the inside is the pully... or could be sheath damage or strained tendon in general. The finger injuries can be so many things the only way to be sure is to see a specialist. I have terrible pain and issues with my middle fingers after crimping on hard 12+ stuff and I have NEVER found a specialist who could actually tell me why my middle fingers swell and feel like someone is stabbing an ice pick through them. So to be honest it could just be a lost cause in which you just end up managing the symptoms as is my case.

Other then that without the specialist or PT, Ice Ice Ice, rest rest rest and more rest. But serisouly PT....Then start climbing 5.6's for a month or two, then for another month or two stay below 5.9 then maybe after 6 months get on some 9/10's, and so on... Oh and absolutely no plastic crimps or crimping. Avoid plastic altogether I say... I'd say expect at least 6 months before climbing full strength in general to be on the safe side but everyone is different. I've taken off a year from climbing only to be back at it and injured within a month or two, even taking it easy. Once you screw up ur fingers and tendons I've found it almost impossible to heal back to new. Sorry to hear your on the down and out... it's a great time to explore new stuff though ;-)

Can you touch your finger to the inside of your palm like when making a fist ? or does the finger float away while the rest touch fine? could be a joint capsule instead of the tendon itself.

CaptainMo nailed it...you need to be off for a while and then come back slow. No way around it.

Thanks for all the replies. I was planning on at least three months of no climbing of any kind and then easing back into it (especially not plastic-that evil shit wrecked it in the first place). I know that it's pretty bad..

I can make a crimp position and it feels fine. It's just when I extend (bend the finger back at all) that the pain comes. But it's only in the palm of my hand close to the knuckle to maybe the center, not all the way to the wrist. This is different from the first time I hurt it (when I couldn't squeeze a sponge without it hurting). I plan on asking my doctor and most likely seeing a specialist.

Trying to look at it in a good light..more time to work on other projects (not the climbing variety haha). If anyone else has input I'd be psyched to hear.

Also, icing method suggestions? Duration? Repetition? Frequency? Followed by heat?

-Ryan

Kind of sounds like a lumbrical muscle strain since you say the pain is in your hand. There isn't much info out there, but search it on google and see if it sounds like what you are experiencing. I was able to buddy tape the affected finger combo and continue to climb. I took like 5-6 months for the injury to fully recover though.

These links all have some good info about finger injury treatment, although you'll have to wade through a lot of BS, too. Also check out Dave Macleod's blog.

Having had several (maybe 5?) in my career, I've stopped getting too hung up on what exactly is damaged. There are lots of little things in our hands that can tear, and they're all kind of important.

What I've also learned is that simply not climbing isn't treatment. I've healed finger injuries with only taking 5 days off, although that is not the norm. I think two weeks of not climbing is usually plenty unless it's really severe. You'll know, too, because a severe injury won't get better in two weeks.

The key, as others have already mentioned, is how you come back to climbing. Connective tissue needs stress - the right kind of it - to heal properly. Things like putty, a bowl of rice, and controlled hangboarding are good ways to transition back to climbing. The general concepts are gradually increase stress on the tissue, maximize blood flow, and strengthen supporting muscles (the extensor muscles, in your case).

6 months to a year sounds pretty heavy. A 46-year-old dude who climbs 5.14 told me that he thinks climbers baby their injuries too much. There's probably some truth in that.

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Yeah, lumbrical tears are way more common in climbers than the rest of the population. Could be what is hurt, although it doesn't change the treatment all that much.

So it has been six days since I hurt my hand/finger and the pain has gone away. I wanted to clarify a couple things before I go on as to add as much detail as I can.

There was no swelling during any of my injuries (there being the initial injury (on plastic), and two following tweaks that were isolated and hurt enough to call them they're own event).

Also, I don't think the issue was crimping. This last time I hurt it was going for a big hold open handed.

I can now make a strong fist or crimp position and feel no pain. This time around there wasn't really any pain doing this at all. The issue was flexing my finger backwards. I can now do so without pain.

I do not plan to start climbing again, but do want to start doing PT/recovery exercises. Does anyone have suggestions? Here are a couple of things I was thinking about..

-Pull Ups (on a bar, or on the jugs and slopers on my hangboard)
-Power Putty (never used it, opinions?)
-Bucket of Rice (people have told me something about this, methods?)
-Finger Stretches (any good ones?)
-Dynaflex Powerball (I have one and heard it may be good for finger rehab)
-Massaging (techniques?)
-Ice Treatment (is this only for when it's inflamed?)

Obviously I have lots of ideas but don't know much about any of them. I've been trying to find techniques but there's so much to weed through. Anyone have personal stories of using any of these techniques.

I was planning on easing back into climbing about a month after the injury. But I'd like to start rehabing soon (it has been almost a week of no use). I am planning on using whatever techniques I choose on both hands. There are some fingers on my left hand that don't feel full strength though have never had a noticeable injury. I just want to be thorough.

Thanks for any input.

I read your OP again, and I think there's a pattern for the two recurring injuries: two weeks or so of intense climbing after a month or two of relatively low loads. This is a good recipe for a re-injury or a totally new one. Basically, it is ill-advised to thrash yourself without proper preparation. Often, you can get away with if for a session or two, but several days in a row of abuse will lead to disaster.

What has worked best for me is to progress from initial recovery (i.e. total rest) to full strength incrementally, making sure that there is no pain or aggravation with each new load. For example, this might mean taking a 4-7 days totally off from any kind of finger stress and only icing to reduce inflammation, then a week of low-load strengthening without climbing (like putty or rice bucket), then two weeks of gradual and controlled increase in load (like on a hangboard working from much less than body weight up to full body weight). Somewhere in there, you could climb a little bit, but make sure you're totally in control and never doing something to aggravate the injury. After three to four weeks of this, (assuming your finger has consistently adapted happily to the new load) you should be able to climb. I've found that in this time, it seems to work better to increase the load first, like trying harder moves/holds, but still taking 3-4 days between sessions.

Once you can climb hard again, and your finger feels good, it's important to keep up on the stress with adequate training and rest. Don't get back to 100%, then spend the next two months grabbing nothing harder than a doorknob, and then go to Bishop for ten days and expect your fingers to be ready.

As to the specific treatments you mentioned:

- Pull-ups: Knock yourself out.
- Power Putty: Buy Play-dough instead, way cheaper.
- Bucket of rice: awesome. Fill a bowl/bucket deep enough to immerse your hand; just open and close it (focusing on full range of motion) until you get exhausted or bored. Great TV-watching cross-training.
- Finger stretches: Move them in various directions, but focus on the forearm muscles. Go easy on stretching your fingers specifically.
- Powerball: Meh. Rice and Play-dough to the same thing.
- Massaging: effective but very easy to do more damage than good.
- Ice Treatment: true "ice treatment" is for inflammation, but ...

Cool water therapy and/or contrast baths are for increasing bloodflow, which you can never have too much of to heal finger injuries (or any other injury, for that matter). Macleod's blog has an explanation of cool water therapy. Contrast baths are usually done in 1:3 ratios of ice to hot water (like 15 seconds cold then 45 seconds hot).

Also, strengthen your finger extensors with the rice, resisted eccentric finger extensions, and reverse wrist curls.

Thanks for all of the info Chris, it's very helpful. Pyshced to start feeling better.

UPDATE:

First I took a week off of doing nothing other than normal life. My hand stopped hurting in about 5 days.

I have been doing contrast baths once a day for 20-25 minutes. I find 20 is better because by 25 the warm water starts to get pretty lukewarm. I do 4 minutes warm, the 1 minute cold (have been putting snow in the water, easier than ice hahaha). I feel as this has been really good for the bloodflow and healing.

I have ditched the Powerball. Though it really warmed up my digits I was getting sore around the outside of my hand. I think this was from gripping it (maybe too hard), but not a good sore (like when exercising something).

As a replacement I have filled a bucket with rice and have been working my hand in it. Doing 3 minute reps, alternating hands for 3 sets. So 9 minutes total each hand. I've found that I don't get the soreness and my fingers feel like they've gotten worked (but not too worked). It also gives the finger extensors a really good burn.

I have also been working on a conditioning plan so that when I can climb again the rest of my body will be in good shape. This includes about 25 minutes of stretches, including stretches for the wrists and forearms (no finger specific stretching). I've been using Eric Horst's Conditioning for Climbers and Training for Climbing. They are both pretty good resources.

Well that's where I'm at..day 17 of recovery now. Next week (week 4) I am going to introduce pullups and hangs on the jugs and maybe slopers of my hangboard, if I feel I am ready.

I also wanted to ask if it's normal to feel a little stiffness and soreness from rehab stuff (rice bucket)?

Rock Cricket wrote:I also wanted to ask if it's normal to feel a little stiffness and soreness from rehab stuff (rice bucket)?

If you're putting the right level of stress on the tissue, it will start out feeling a bit stiff/sore, and improve as you warm it up. Pain that increases with activity is bad - stop the activity and let it rest long or at least decrease stress. Also, it is okay if discomfort returns after exercise as long as it isn't worse than before you worked it out. Overall, there should be a general decrease in stiffness and soreness, although there might be little blips of increase at the beginning of a workout and the few hours after.