Internet Doctors Wanted

Here is another chance to be a fake doctor:
Symptoms:
-Middle finger PIP joint feels like it is going to explode when finger is weighted in crimp position
-No tenderness to the touch
-No pulley/tendon pain
-No limited ROM
-I have inured pulleys before. This is not it.

35 years old. Climbing for 12 years. Mostly bouldering indoors lately(3 young children). I have been training hard to break into the V11-12 range. I know that this may be the reason for my injury. I am looking to find out what it is.

Before you tell me to see a real doctor, I have been to all of the hand specialists in my network before. None of them have ever seen "rock climbing related" injuries before. They told me they had never seen a pulley injury in a young person before.

Break out your stethoscopes and diagnose me. Go.

Possibly a stress fracture?

rockrun.com/wp/finger-injur…

Thanks for the response. I looked it up, but I have no pain at rest or pain to the touch. It doesn't seem like a fracture.

At 35yrs old, climbing for 12 years, with 3 children, all the hand specialists in your network missed the obvious diagnosis:

Yer gunna die!

Disclaimer
I am not a Dr. but often portray one on the internet.

Hope you get this injury healed up.

david quatro wrote:Here is another chance to be a fake doctor:

probably rabies or lupus, but we can't rule out ectopic pregnancy

Arthritis?

I wouldn't rule out gonnasyphylherpeaids. The ectopic pregnancy is very unlikely.

I've sprained the pip collateral ligaments a couple times on my dominant hand index finger. Each time I took time off from climbing and avoided anything painful. Squeezing light theraputty provided it isn't painful might accelerate healing (regardless of which exact structure is injured)

You have what we call "idiopathic hand pain." Take 3-6 months off of climbing.

Signed,

Dr. Internet

Sounds like a question for
Dr Sanders

It's called threeyoungchildrenandboulderingitis. The only cure is a medication called Fuckitall. Available at your nearest dispensary...

Disclaimer: one of the side effects of Fuckitall is nomadism.

david quatro wrote:Here is another chance to be a fake doctor: Symptoms: -Middle finger PIP joint feels like it is going to explode when finger is weighted in crimp position -No tenderness to the touch -No pulley/tendon pain -No limited ROM -I have inured pulleys before. This is not it...

I'm a real doctor, but I'll try being a fake one just for you :-) My practice does include a fair number of rock climbers, mountain bikers, and whitewater kayakers, mainly because I am. And I have *definitely* seen young people with pulley injuries! All, come to think of it, overuse injuries from bouldering. Hmm... there's a lesson there somewhere, I think...

Which pulleys have you injured in the past? I'm guessing the usual A2 and A4. I suspect this one feels like "this is not it" because this time you've injured either C1 or A3. If I had to bet, I'd go for A3, because it's also the palmar side of the joint capsule, which gets stressed particularly when loaded in the crimp position.

Lee,
Thanks for the reply. The reasons I thought it was not a pulley are that there is no pain anywhere on the finger when I apply pressure and the pain is on the "non-palmar" side of my finger(top). The other pulley injuries I have had definitely resulted in pain whe pressure was applied. Does this change your "diagnosis?" Thanks
David

david quatro wrote:Lee, Thanks for the reply. The reasons I thought it was not a pulley are that there is no pain anywhere on the finger when I apply pressure and the pain is on the "non-palmar" side of my finger(top). The other pulley injuries I have had definitely resulted in pain whe pressure was applied. Does this change your "diagnosis?" Thanks David

Yes, it does. Is the pain right on the joint line, or is it on the base of the middle phalanx just past the joint line? I'm thinking you've either injured the extensor hood or the cartilage on the base of the phalanx dorsally. You may be subluxing the PIP joint when you load it in a crimp; can you tell if you are?

(I can just hear the rad techs trying to figure out how to do a "weight-bearing" view for that one!)

+10 for Lee.

Lee Green wrote: Yes, it does. Is the pain right on the joint line, or is it on the base of the middle phalanx just past the joint line? I'm thinking you've either injured the extensor hood or the cartilage on the base of the phalanx dorsally. You may be subluxing the PIP joint when you load it in a crimp; can you tell if you are? (I can just hear the rad techs trying to figure out how to do a "weight-bearing" view for that one!)

I am replying on behalf of my spouse who is a PT, climber and Internet Doc for you. She says:

"My guess is that you either have a volar plate injury/avulsion or an extensor mechanism hood tear. Either requires rest, possible splinting to avoid deformity, but ensure ROM when splint is off. Also check out buddy taping all the time for a short while (week or so)"

I'll put the word out to all the links to 'doctors' in India and Pakistan who surf the net looking for work.