Dreaded "pop" of A2 Pulley but NO swelling

I understand A2 Pulley injuries have been covered numerous times on MP, but couldn't find information regarding my "unorthodox" situation.

Was crimping a relatively good, albeit small crimp and all of a sudden I heard the dreaded "pop" from my ring finger A2 pulley. It wasn't too loud but definitely audible to those around me. I immediately stopped climbing and started reading up on a2 pulley treatment. Naturally, I want to heal asap. Most published articles talk about a 1 week complete rest and then recommend exercises that promote blood flow to the area (ice therapy, Deep friction massage, Theraband, stretching, etc.)

My Question : Since there is no swelling and there is no pain unless I put pressure on the finger, can/should I start these exercises right away and forego the initial 1-2 weeks of complete rest?

Obviously, my goal is to heal ASAP but more importantly, heal well.

Little background: been climbing for 9 years - sport, trad, boulder and love crimpy routes. I climb 5.12 sport, 5.11 trad and boulder V6.

Thanks for your help!

Well - for one... without a proper Dr. looking at your finger, you can't know for sure how bad your damage is. I'd suggest an Ortho if you want to heal quickly.

As for your situation, it sounds very similar to mine. Heard a pop. No swelling. I stayed off my finger for climbing for over three months though, not "one week". I also used ice and heat therapy, deep massage, and probably the most important thing I used was theraputty. Its cheap, comes in different difficulties, and allows you to work the tendons and pulleys GENTLY, and progressively.

After my finger started feeling better, I climbed everything open handed, slopey and big jugs for several months. In fact, all the LACK of closed crimping seems to have made my hands quite a bit stronger. I also learned a bit more about body positioning, since I was forced not to rely on finger strength.

Blood flow is crucial to soft tissue damage, and unfortunately the tendons and pulleys just don't get the kind of blood flow that muscles do. It takes a long time. Be carfeul, be NICE to it, and when it starts feeling better, don't make the mistake of going right back to the crimpy routes you love.

Good luck!

i never had swelling with either of my pulley injuries. It was painful to pressure and to a closed crimping motion, but no swelling. IME, one week off would have not been nearly enough. Mine required more like a month off and even then I had to be very careful to avoid crimping and only do easy climbing for the next ~8 weeks, all while doing things like ice therapy/massage. It was very easy to set myself back since I often would think it was getting better and then climb only to find out the next day I had made it worse. I'm not sure if recovery methods are useful in the first week in the acute phase of the injury, but I'd definitely not exercise the finger at all for a while.

I fully ruptured my A2 on my ring finger.

Swelling did not come until 2+ weeks after the tear.

working on 2.5 months of no use and the finger is still in bad shape.

Multiple hand surgeons, MRI, xray etc...

Everybody agreed, lay off of it for 6 months, tape it and put a plastic collar on it to protect the area.

worst hand injury I have ever had.

Good luck, but either way, lay off of it and tape it every day.

The internet is no substitute for a good doctor who knows something about climbing. That said, I've found that a few days to a few weeks off, and careful use for a period after is what facilitates recovery best for me, and as was mentioned, provides a good time to get strong in the core and improve technique. YMMV, drink lots of water.

I have had multiple tendon injuries and have come up with a really good recovery program. My mom is a physical therapist and from the long conversations we have had about rehab on any tendon it is clear that time off is not entirely that useful. That being said, I usually take one full week off then start very gently doing massage. I have heard icing can actually delay healing (but reduce immediate pain and symptoms) so I don't ice. Then when I feel like I can put it in a half crimp position I go back to the hangboard. It is invaluable to have a good hangboard for rehab. You can set up a pulley system to take weight off and start very slowly. Follow mike and mark Anderson's general hangboard routine (5 sec on, 3 sec off). Push it to a point where you have just a slight amount of not pain but, "yeah, I can feel something in my finger". I was back to full strength in a few short months. Best of luck!

Thanks for the info. I agree that I should get a diagnosis from a doctor. My family physician definitely doesn't understand climbing specific injuries but she can at least hook me up with an MRI or an ultrasound and go from there.

frankstoneline wrote:The internet is no substitute for a good doctor who knows something about climbing.

Much easier said than done. If you live someplace like Boulder, it might be easier to find a doctor that is knowledgeable about climbing injuries, but the ones I have seen about finger injuries were not especially helpful. They certainly did not tell me anything that I was not able to easily determine or research for myself, and they weren't cheap either. YMMMV.

csproul wrote: Much easier said than done. If you live someplace like Boulder, it might be easier to find a doctor that is knowledgeable about climbing injuries, but the ones I have seen about finger injuries were not especially helpful. They certainly did not tell me anything that I was not able to easily determine or research for myself, and they weren't cheap either. YMMMV.

This is true, though I suspect somewhere within 35 minutes of Davis there must be a doctor who climbs/can offer some insight. You might also check out the book Make or Break which (as much of it as I've read) seems to offer a volume of insight into handling injuries (full disclosure: I've just started reading it)

For me, I heard the pop, then stopped climbing. No pain or swelling, ever, but after a couple months the tendon constricted since it was a full rupture and now I can't straighten my finger.

Go see a doctor.

My insurance situation was/is such that I didn't see a doctor for either of my partial pulley ruptures. Both happened outside from yanking on tiny crimps. I didn't have much swelling either, nor too much pain. I took two months off for my ring finger (at first I couldn't even hang on a bar without feeling like I was doing damage). I took a couple weeks off for my index finger, but would splint/immobilize it when I started climbing again. I kept it immobilized for about 6 weeks (while climbing). I could still climb pretty hard without my index, but the ring finger was a deal-breaker. Both of these happened when I was climbing 5.12/v6.

Both times happened right at the beginning of spring seasons, and I was pretty devastated. I'm not sure what articles are recommending 1-2 weeks off, but everything I read said two months minimum. At the time, taking two months off seemed inconceivable, but looking back I'm glad I did. Since those experiences, I've made a greater effort to listen to my body, and haven't had an injury in the last four years.

You're not dealing with a muscle pull or tendon strain- you most likely partially ruptured a ligament- it takes a long time to heal. If you push the recovery, you'll end up weaker longer. You could try to get right back on it and have to baby it for 6+ months, or you could let it heal properly and be back at full strength in 3-4 months.

anna.gutwin wrote:I have had multiple tendon injuries and have come up with a really good recovery program. My mom is a physical therapist and from the long conversations we have had about rehab on any tendon it is clear that time off is not entirely that useful. That being said, I usually take one full week off then start very gently doing massage. I have heard icing can actually delay healing (but reduce immediate pain and symptoms) so I don't ice. Then when I feel like I can put it in a half crimp position I go back to the hangboard. It is invaluable to have a good hangboard for rehab. You can set up a pulley system to take weight off and start very slowly. Follow mike and mark Anderson's general hangboard routine (5 sec on, 3 sec off). Push it to a point where you have just a slight amount of not pain but, "yeah, I can feel something in my finger". I was back to full strength in a few short months. Best of luck!

Since your Mom is a PT, she should have informed you that finger pulleys are ligaments, not tendons.

Thanks for the great advice and anecdotes everyone. Not sure if I feel reassured or more scared ;) I did follow "go see your doctor advice" and went to see my family doc this afternoon. As I predicted, she had no clue but will refer me to a hand surgeon.

Mark Paulson wrote: I'm not sure what articles are recommending 1-2 weeks off, but everything I read said two months minimum.

This great article says 1-3 weeks : onlineclimbingcoach.blogspo…

This one says 1-3 weeks : thomasbondphysio.blogspot.c…

This one says 2-3 weeks : 919clinic.co.uk/Downloads/p…

This one says move right away as soon as pain subsides : cruxcrush.com/2013/10/24/cl…

Again, this is from the internet...

From the Nicros site:

"Depending on the severity of the tear, pain typically subsides in two to ten weeks. Becoming pain-free, however is not the go-ahead to resume full-on climbing! This is where many climbers go wrong—they return to climbing too soon and reinjure the partially healed tissue. As a general rule, wait an additional two weeks beyond becoming pain-free, then slowly return to climbing. In the case of a modest A2 pulley injury, this may mean a total of about forty-five days of climbing downtime.
A French study of twelve elite climbers with A2 pulley injuries found that eight subjects were able to successfully return to climbing after forty-five days of rest. More severe pulley tears, however, may require as much as two or three months of rest before progressively returning to climbing."