pain in ring finger DIP joint when crimping

Hello all, i've attempted to search for comparable injuries - but not all symptoms seem to match to anything. Any help or advice would be appreciated, as my local hand specialist has no experience with climbing injuries.

I have had slow-onset pain in my ring finger, that is mostly noticeable when crimping. Pushing on the A2 pulley makes it feel slightly tender, but i've had an A2 pulley tear before and i'm not having the same stiffness or lack of ROM (though this could just be because it is such a slight/partial tear, perhaps?) The pain is mainly noticeable on top of the DIP joint when crimping (i don't feel pain around the A2 when crimping.) It is possible to perform a crimp and hyperextend the joint, but the pain (top of DIP) makes me hesitant use it for sure.

I cannot recall any one instance that i heard any sounds or felt any acute pain - there was only slight soreness after a gym session. I climbed outdoors afterwards on mostly open handed holds, but after another gym session with more crimpers, the pain became much more noticeable. The thing that has my curiosity is the pain on top of the DIP joint, as i don't recall having any of this with my prior A2 pulley injury (index finger.) Any experiences or references would be much appreciated if this sounds familiar.

Thanks any and all for your help.

Blair

The flexors muscles are what allow gripping and they run on the palmar side of the forearm with the tendons inserting into the fingers. Its their tendons that are kept in place by the annular (A2 etc) and cruciform pulleys. Finger extension comes from the muscles on the back of the forearm and from the lumbrical and interossei hand muscles. These join together and extend through to the DIP on the top and sides of the fingers.

Check out boutonniere finger (PIP) and mallet finger (DIP) to get a better idea of what finger extensor tears usually do. Swan neck deformity would be another one as lots of people put their fingers in that position when they crimp.

I'm not sure that mallet finger could be caused by crimping though. Its a fairly common ball sport injury.

If you don't want to see the local hand guy about it then an orthopod would be your best bet. The hand guy probably will have some idea as to want is going on though.

free advice is worth what you pay for it.

based on your story alone, possibilities include: chronic repetition trauma leading to stress fracture of the dorsal plate vs stress reaction vs capsular inflammation vs ligamentous strain. systemic conditions unrelated to climbing are unlikely though not impossible.

options include: get an xray. or an MRI if you have the $$. or neither, rest it for 6 weeks without climbing on it, and see if it feels better, which is likely your best option irrespective of what is causing your pain. don't need an xray or mri to do that. surgery is unlikely to be of use.

best, jw

bboyd wrote: I have had slow-onset pain in my ring finger, that is mostly noticeable when crimping... Pushing on the A2 pulley makes it feel slightly tender...The pain is mainly noticeable on top of the DIP joint when crimping (i don't feel pain around the A2 when crimping.) It is possible to perform a crimp and hyperextend the joint, but the pain (top of DIP) makes me hesitant use it for sure. I cannot recall any one instance that i heard any sounds or felt any acute pain - there was only slight soreness after a gym session. I climbed outdoors afterwards on mostly open handed holds, but after another gym session with more crimpers, the pain became much more noticeable... TBlair

This is me, exactly! Except it's my middle finger, not my ring finger. bboyd, I want to know.. How did your recovery go? What remedies, if any, did you try? Did you climb through it, or rest? Any lingering problems?

I'd be interested in this too, I've had very similar pains at various points throughout my time climbing.

To treat I've only found success with some rest, climbing open handed as much as possible, and icing the finger.

I've tried taking time off and it always ended up feeling the same after 6 weeks of no use, so I've been trying to climb through it slowly.

I also have zero medical knowledge and am only running off of my limited trial and error.

Anson Call wrote: This is me, exactly! Except it's my middle finger, not my ring finger. bboyd, I want to know.. How did your recovery go? What remedies, if any, did you try? Did you climb through it, or rest? Any lingering problems?

I injured both middle fingers this spring, if I tape them using the method shown in the image I feel almost no pain while climbing, but if I don't, every gym session is followed by pain in both middle fingers.

Learning how to properly use this tape method made a huge difference for me.

Patrick Gillespie wrote:I'd be interested in this too, I've had very similar pains at various points throughout my time climbing. To treat I've only found success with some rest, climbing open handed as much as possible, and icing the finger. I've tried taking time off and it always ended up feeling the same after 6 weeks of no use, so I've been trying to climb through it slowly. I also have zero medical knowledge and am only running off of my limited trial and error.

sounds like your muscles are stronger than your finger strength... wait, does that make sense? Yes. It sounds like you need to do some very careful training of just finger strength so that your fingers can catch up to your bulging forearm muscles.

I have exactly the same issue in my right hand ring finger. Its been a month and any advice would be much appreciated :)

Anson Call wrote: This is me, exactly! Except it's my middle finger, not my ring finger. bboyd, I want to know.

Keep in mind that pain is a strange + funny thing. Like read up on "phantom limb pain", where amputees feel pain in a leg they don't even have any more.

Just because you have the same pains as another climber doesn't mean you have the same injury.

Just because you feel a pain somewhere doesn't mean that's the spot where the primary injury is - (read about "referred pain")

Problem is that unless you go for expensive forms of imaging, pain is one of key diagnostic pointers that you have access to. And some injury-rehab practitioners who do not have direct authority to order more expensive tests might tend to rely on (more intelligently systematically elicited) pain reports (together with palpation) -- because that's what they've got to work with.

Even after some more expensive diagnostic imaging, results might be inconclusive -- so making some educated guess based on your experience of pain might turn out to be as good as anybody's going to do.

Can be tricky stuff. Hopefully for you it turns out to be simple. Good luck.

Ken

kenr wrote: Keep in mind that pain is a strange + funny thing

Good point. I worry so much that when I'm climbing, I'm constantly thinking about it. Maybe my stress was creating some "phantom pain."

Anyways, the good news is that it hasn't bothered me since I took a 3 week break from climbing. Went to the gym two days ago, and I didn't feel any soreness at all!