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Finger injury: questions and possible plan...
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By fOXEN
Aug 19, 2013

So first, relevant information....
I'm 21 climb around v5/5.12. v6/5.12+ at the hardest. I boulder, sport climb, and trad. I weigh around 160... Drink rarely, don't smoke.

Anyhow, I was yanking on an awkwardly angled crimp and several days later I began to notice a pain in my ring finger between the first knuckle and the base of the finger. (about 10 days ago)

Since then I have been climbing slightly less aggressively, staying off overhung crimp-fests... etc.

It ONLY hurts when I press in on the "pulley" (at least what im guessing that is) and when I crimp CLOSED-handed. No pain occurs on open handed holds even when campusing.

In the past I have dealt with this tendon shit by just resting a good 7 days (Ice and Ibuprofen) and easing back in. So that's my plan as of now.

I don't want to rest, get weak, then still be injured. (Enter shitty cycle of never getting strong) I also don't want to keep climbing half-assed and never get stronger. (always dodging pain never getting rid of injury) HELP!!!!

Any advice or from-the-hip diagnoses would be great!
Also, taping? buddy taping? How should I, if at all, tape for this injury?

TL;DR: Fucked finger up, want to climb still. pls help.


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By Jon Zucco
From Denver, CO
Aug 19, 2013
yaak crack Red Rock Canyon, NV

It sounds like a pulley injury. I sprained my A4 pretty bad in January on a slopey crimp in a closed grip position. It is still giving me issues on certain holds. I have been taking fish oil, and a joint complex (glucosamine, msm, chondroitin, etc) to help with the tissue recovery, and ibuprofen and ice for painful days.

If you have functionality in that finger and just pain, it is probably also just a sprain. If you couldn't move it at all or had very limited mobility, it could be a tear or partial tear.

I've spoken with a couple docs about it, the answer seems to just be: time. Unfortunately, they're probably right. Take a week or two off altogether. Then, just baby the hell out of it, and train yourself to avoid the closed grip like the plague. Some people recommend taping that digit up to remind you to go easy on it. Otherwise, taping is not proven to help very much. At least not according to anything I've read. I'm sure there are others who can chime in to disprove everything I've just said though.

TL;DR: Expect it to take a looong time to heal. Do what you can to expedite that process. But don't over do it!

Good luck.


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By Daryl Allan
From Sierra Vista, AZ
Aug 19, 2013
Me and my Fetish I guess.. ;)

Although it's not a sure thing, it very much sounds like a pulley injury. I had a pulley injury and a good friend told me it would be a 5-8 month recovery. I chose to take the light-duty approach and took it very easy on the injured finger. Mine happened to be my right ring finger so I just began leaving it off the rock when crimping. Definitely not an easy thing to do but eventually I developed the habit of sticking it straight up and not using it. Sure enough, 6 months later, it was healed and a few weeks after that I was back to using it 100%. My advice, don't tape it bc you'll be tempted to use it.. allow it to heal.

Ibuprofen will just reduce the pain and swelling; both bad ideas. I'm of the mentality that our bodies are the product of lots of evolution or Grand design (depending on your point of beliefs - take your pick). Either way, swelling is there to increase blood flow to facilitate healing and immobilize the injury so you don't use it as much while it heals. Pain is there also to stop you from using it as much. The whole ice and pain relievers thing have never made sense to me.

Anyway, sorry to hear about your injury. Hope you have a speedy recovery!


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By dave wave
Aug 19, 2013
sierras

Sounds like a typical pulley injury...

Stay away from the crimpers for like 3-4 weeks...crack climb, or work slopers.

Ice, and massage the area after climbing.

Using half width pieces of tape - tape just below the joint, just above the joint (or) in an x pattern(where the middle of the x crosses over the joint itself.

For the first few weeks take more rest days per week.

Thats it...physical therapy and time heals!

Good luck, and go easy.


Dave


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By fOXEN
Aug 19, 2013

Good stuff. No snarky MP-esque replies yet... *Crosses fingers*

So I will take a WHOLE 6 days off. Keep icing, taking Ibu, and I'm gonna pick up some fish oil/glucosamine.


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By Abram Herman
From Golden, CO
Aug 19, 2013
Viking helmet cover, yep.

I'd save your money on the glucosamine, and buy yourself a beer instead ;-)

saveyourself.ca/articles/reality-checks/nutraceuticals.php


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By fOXEN
Aug 19, 2013

Abram Herman wrote:
I'd save your money on the glucosamine, and buy yourself a beer instead ;-) saveyourself.ca/articles/reality-checks/nutraceuticals.php


Don't see fish oil on there. But ok fuck glucosamine then...

Even if shit doesn't work. It makes me feel better knowing that I'm doing SOMETHING that's SUPPOSED to help it heal...


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By Brendan Blanchard
From Strafford, NH
Aug 19, 2013
Obi Wan Ryobi - Darth Vader Crag, Rumney NH

There are ways to tape the right joint so that you actually can't use it in a closed crimp. Depending on which pulley you may have injured, I would look into taping to avoid using it accidentally. Good luck and I wish you a speedy recovery!


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By Abram Herman
From Golden, CO
Aug 19, 2013
Viking helmet cover, yep.

fOXEN wrote:
Even if shit doesn't work. It makes me feel better knowing that I'm doing SOMETHING that's SUPPOSED to help it heal...


Glucosamine is not cheap! Just have a friend buy you some sugar pills; they can tell you it's morphine, and you'll get most of the effects via placebo.

There are things you can do to make it heal faster that are actually backed by science, so you might focus on those first ;-) Light cross-fiber massage may help, stretching, etc.


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By Jon Zucco
From Denver, CO
Aug 19, 2013
yaak crack Red Rock Canyon, NV

Abram, you sure hate glucosamine! And, yeah -- I've read similar debunk articles regarding that and many other supplements that seem to tote a good reputation within alternative health circles. I decided to give it a try anyhow as I was getting pretty desperate by the 3rd month of injury with little to no improvement. Couldn't say whether or not it's helped though.

They say it takes a couple months of regular use before you start to feel a difference. But maybe they are just saying that so you're stuck with paying for at least two months worth before you realize it's a hoax...


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By fOXEN
Aug 19, 2013

What about buddy taping? Any input on that. For those who don't know this is taping another finger of the same tendon-group together with the injured finger...


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By Brendan Blanchard
From Strafford, NH
Aug 19, 2013
Obi Wan Ryobi - Darth Vader Crag, Rumney NH

fOXEN wrote:
What about buddy taping? Any input on that. For those who don't know this is taping another finger of the same tendon-group together with the injured finger...


I believe you mostly need to prevent yourself from using the affected pulley by stopping a crimped position. You might be able to buddy tape, but I think cross-taping over the affected joint is a better option. Google might be your best resource on this one.


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By Abram Herman
From Golden, CO
Aug 19, 2013
Viking helmet cover, yep.

Jon, I don't hate glucosamine specifically, I hate any pseudoscience that gets passed off as real medicine in an effort to turn a profit. Sure, it "works" for some people, but you know what they say: "The plural of anecdote is not data." I just don't like seeing people misled (not by you, I mean by the supplement manufacturers) into spending their hard-earned money on ineffective treatments, when there are proven methods they could be using instead.


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By SeanPeter2
From IL
Aug 19, 2013

Stay off Ibuprofen- it actually weakens or slows tendon growth. Really it's not a huge deal in terms of it's weakening power - but unless you're in great pain stay away from nsaid pain killers. Tylenol should be fine.
Ideally total rest for 4 weeks. That's real tough though. Buddy taping is not a bad idea. (I blew out an A2 and buddy taped for a while- but doc eventually made me stop for 4 weeks anyhow) IF you tape it- tape it HARD so that you really can't bend it much at all. But the knuckles you wanna keep from bending (starting from the palm) are really the first and second ones. The little knuckle at the tip shouldn't affect that pulley.
If you are taking 6 days off- take it off of EVERYTHING- don't even pick up stuff around the house with that hand- milk jug- whatever.


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By John Johnson
From Boulder, CO
Aug 19, 2013

Dealing with a similar injury myself, most likely a Grade 2 strain of my A1 and A2 pulleys, involving also the cruciform ligaments around A2. Here's a great article about rehabbing it. I laid off for 2-3 weeks and I'm now returning to climbing.

onlineclimbingcoach.blogspot.com/2010/05/pulley-injuries-art>>>

Also, for the record, glucosamine sulfate does work to strengthen connective tissue, despite what the narrow-minded naysayers out there say. There are lots of studies showing its efficacy. We have no source of cartilage in our diets here in the USA, as all our meats are stripped of any 'texture surprises', and people take ibuprofen which only delays healing. Arthritis doesn't just strike you when you're 65; it's happening right now if you don't have any glycosaminoglycans in your diet, and you'll begin to feel it once it progresses to a disease state.


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By Abram Herman
From Golden, CO
Aug 19, 2013
Viking helmet cover, yep.

John Johnson wrote:
narrow-minded naysayers


Yeah, those darn narrow-minded, double-blind, randomized, placebo-controlled studies! ;-)

jama.jamanetwork.com/article.aspx?articleid=186168

www.ncbi.nlm.nih.gov/pubmed/20525840

You're right, there are studies showing its efficacy, and there are more carefully controlled—and independently bankrolled—studies that show it's not effective, but meta-analysis of the studies that are out there points to no benefit.
What's with the "naysayers" thing? I don't care if it is or isn't effective, I don't have any personal stake in it—if further research proved it worked, that's fine too. The research is out there, believe it or don't.


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By John Johnson
From Boulder, CO
Aug 19, 2013

Sorry I said "narrow-minded", not a good choice of words. But we can cherry pick our research to further any point of view. The truth is there are over 700 studies on glucosamine and arthritis alone (see www.ncbi.nlm.nih.gov/pubmed/?term=glucosamine+osteoarthritis ). Many of the positive studies are double-blind, placebo-controlled studies.

JAMA, which furthers the POV of the American Medical Association, has a lot of stake in pharmaceutical arthritis treatments. But glucosamine is a legal, unpatentable nutrient that supports tendon and ligament health. Of course they're not going to support a nutrient that can help prevent arthritis, or your need for arthritis drugs. Nobody makes any money until you get sick in the USA.

Best of luck to the OP on the injury!


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By Abram Herman
From Golden, CO
Aug 19, 2013
Viking helmet cover, yep.

I looked through the search you posted, and I couldn't find many positive studies on glucosamine... If you have one in particular that shows efficacy, I would love it if you could link me directly, as I'm having a hard time finding anything among the studies that are publicly available.

You are certainly entitled to believe that there may be outside interests in the JAMA or AMA's endorsement, but don't think for a second that there isn't as much or more of a financial stake from the companies that sell these neutraceuticals. It's basically unregulated, and they make a killing selling supplements, vitamins, and everything else. Follow the money, as they say, but don't forget there's just as much money riding on proving things like glucosamine "effective."


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By Abram Herman
From Golden, CO
Aug 19, 2013
Viking helmet cover, yep.

John Johnson wrote:
Best of luck to the OP on the injury!


Absolutely! I know it sucks fOXEN, I busted something in my middle finger a month ago, and am going through the same right now. I expected the worst, so the reality really hasn't been half bad! I can still climb easy stuff without risking further injury, and it's given me the chance to focus on all the other things I love to do that climbing often overshadows, so try to look on the bright side :-)


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By lucander
From Stone Ridge, NY
Aug 19, 2013
Lucander off the GT Ledge on p. 2 of Keep on Struttin.

Listen to your body. Take a month off and avoid a serious injury. All of your soft tissues will repair and come back stronger. By mid-September, you'll be super motivated and ready to roar into autumn. In the meantime, stay active in other projects: run, backpack, spend time with loved ones, read good books, build a shed, whatever.


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By lucander
From Stone Ridge, NY
Aug 19, 2013
Lucander off the GT Ledge on p. 2 of Keep on Struttin.

fOXEN wrote:
What about buddy taping? Any input on that. For those who don't know this is taping another finger of the same tendon-group together with the injured finger...


stay off that - it makes people think their bad finger is good so they crank too hard...kinda like beer goggles.

If you're not a pro athlete whose in this until you retire a millionaire at 32, you're probably in climbing for life - fix this thing...for good.


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By Jon Zucco
From Denver, CO
Aug 20, 2013
yaak crack Red Rock Canyon, NV

lucander wrote:
Take a month off and avoid a serious injury. All of your soft tissues will repair and come back stronger... ...fix this thing...for good.


Probably the best advice so far.


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By Shawn Heath
Administrator
From Forchheim, Germany
Aug 20, 2013
I couldn't resist uploading this cool silhouette my friend Aran took of me on Panische Zeiten.

Jon Zucco wrote:
Probably the best advice so far.


I agree. You can't stay at 100% 100% of the time, so embrace and enjoy the time off and come back way more motivated in Fall. Don't worry about not improving. You definitely will continue to improve.

However, if you refuse to listen to this advice, you could plan a trip to the Frankenjura... It's famous for the two- and one-finger pockets! ;-)


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By dave wave
Aug 20, 2013
sierras

Just climb ow's or slab for the next month.


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By Will S
From Joshua Tree
Aug 20, 2013

In 21 years of climbing I've had 11 of these injuries. Twice each in middle and ring, once in each pinky, and one more in a ring.

Time to pain-free has ranged from 3 weeks to 18 months.

What has worked best for me, and keep in mind this is just one person's experience, is this:

Rest a week or two until the pain is dulled. Still present, but not as sharp, hot, etc. During this rest time, I use the 20min ice baths (hand in a coffee can full of icewater), usually once a day, sometimes twice. I gently massage and stretch it throughout the day.

Then, I will sometimes tape it so it precludes getting into a crimp, sometimes not. But in either case, I start climbing on it again, being mindful not to load it too much or at funny angles, etc. No dynamic moves onto it. Within a month or two, the pain is basically gone and most strength is still there.

In the early ones, I tried the "take time off until it doesn't hurt" approach. Never worked well or quickly. Climbing on it, once it's past the initial inflammation response, and gradually increasing how hard you are climbing on it, has worked best for me.

Good luck to you. Play this game long enough and you'll probably rack up a few of these injuries unless you are geneticall disposed to having especially tough or oversized pulleys.


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By Christopher Barlow
Aug 20, 2013

Will S. is on the right track here. The idea of extensive rest for these kinds of injuries is outdated and is probably the cause of the multi-month recovery times.

The most recent trends in physical therapy are toward much quicker return to activity and extensive "active recovery." The idea is that the right amount of stress will facilitate scar tissue restructuring into healthy tendon more effectively.

The key here is the right amount of stress. Finger injury recovery should look something like this:

- Rest until there is no inflammation and full range of motion with no pain (usually 5-14 days). Lots of ice, no meds.
- Begin with gentle active range of motion, like squeezing putty or very light eccentric finger extensions (this is using your other hand to straighten your finger while gently resisting it). Your finger should start out feeling aggravated with the exercise but consistently get better with more reps. You can also do eccentric finger flexion to strengthen your extensor muscles. Do these a lot, like three times a day. Also do something to increase blood flow - heat, ice, contrast baths, whatever you think works best.
- When you can do tons of eccentric exercises with pretty high resistance (maybe like another week or so), you should start loading it by climbing. The key here is to be controlled and scientific. Hangboarding might be a good way to start for the first few days at the very least so that it is very static and consistent. But, gradually over a few weeks, keep increasing the loads as long as you have the same pattern: initial aggravation with stress that improves through the work out and doesn't cause more than diffuse soreness/stiffness afterward.

I actually prefer bouldering as my first step back to real climbing as it is easier to maintain good control and let go if I have to pull too hard or in a weird way. It seems best at first to increase volume and maintaining low loads (like lots of easy, static moves on friendly holds). Then, increase the load by doing harder moves on smaller holds but doing much fewer moves total. Keep those first hard days short and take at least two days off after to let the tissue recover. Eventually, you'll forget which finger you hurt in the first place.

All told, unless you've really wrecked your finger (meaning you probably need surgery), you shouldn't take more than a week or two away from climbing-like activity and should only need three to four weeks until you're back to trying as hard as you want.

There are several other threads that have addressed this as well as other resources in the interwebs. Go here: mountainproject.com/v/recurring-finger-injury/107987946#a_10>>>, and on that post I reference several other threads. Best of luck healing.


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