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Good hand surgeon/therapist?

Original Post
T.Chin18 · · Unknown Hometown · Joined Nov 2011 · Points: 0

Does anybody know of a good hand surgeon or hand therapist that is familiar with working with climbing injuries, in the Hudson Valley/New York Metro area?
I saw an orthopedist a couple months ago for a ring finger injury and was told it was flexor tenosynovitis. They told me to stay off of it for a month or so and to do warm epsom salt soaks 3x day, and that I could return to climbing in about a month. I've been away from climbing for almost 12 weeks now, just tried to lightly climb and the same pain in the 1st digit of my right ring finger immediately returned. Perhaps its not tendonitis after all?
I'm looking to see a hand surgeon or certified hand therapist, but don't know of any that is familiar with climbers? Also considering possible alternative medicine measures, acupuncture? Thoughts?

Sam Lightner, Jr. · · Lander, WY · Joined Apr 2006 · Points: 2,732

Dr. Volker Schoeffl, Bamberg, Germany
You can find him on facebook... mention me.
Sam

doligo · · Unknown Hometown · Joined Sep 2008 · Points: 264

Try this guy. He's in NYC and I have seen him both for my wrist and years later shoulder fractures, I'd also sent friends his way and they were all happy. His office is full of newspaper cutouts with these amazing hand reconstruction surgeries he had performed. He won't try to cut you open if he doesn't have to. Not sure about climbing (he wasn't amused with me climbing with my shoulder SLAP tear...), but he sees a lot of tennis elbows, natural of course being situated on Park Avenue...

Mark E. Pruzansky, MD PC
Hand and Upper Extremity Surgery, Sports Injuries and Wrist Reconstruction, Peripheral Nerve and Elbow Surgery
(212) 249-8700

Monomaniac · · Morrison, CO · Joined Oct 2006 · Points: 17,295

Its sad that your orthopedist doesn't have a clue how to treat something as common as tendonitis, but that is the state of the medical profession. Maybe one of the many medical types around here can explain why doctors have no interest in treatments that don't require knives or drugs (I think it has something to do with money).

Anyway, you need to do rehab to treat tendonitis. Doing nothing will accomplish nothing.

Do this:

1) Easy warmup
2) controlled training stress on the affected area
3) ice bath
4) 2-3 times as much rest as you normally allow between workouts

Repeat.

If you need help with this, see a physical therapist.

Jay Samuelson · · Colorado · Joined Nov 2006 · Points: 1,896

If it's a sharp pain or more painful than you can climb on I would say it's not tendonitis, especially if you've stayed off of it for 3 months and it still hurts. Sounds more like an A2/A4 pully tear/rupture or a partial C2/C4 tendon tear. Tendonitis typically is sore joints from overuse, but most of us can/still do climb with it.

I would try to find a good diagram of the pulleys and tendons of the hand online and try to correlate where your pain is originating from. Might give you a good idea of the injury or at least what you potentially injured.

Were you climbing when you injured it? did you hear the classic 'pop' that accompanies tendon/pully tears?

T.Chin18 · · Unknown Hometown · Joined Nov 2011 · Points: 0

Hey everyone, thanks for all the great feedback!
@ Jay Samuelson - I was climbing when the injury occured, I think it started when I latched onto a crimp with my right hand but didn't quite get all my fingers on it and tried to inch each finger onto the hold (indoors). I thought I heard a pop, but I can't honestly say I remember it for sure. It isn't a sharp pain, just an aching pain upon direct pressure to the 1st digit on the right ring finger. I have full range of motion and can fully flex and extend my fingers. The pain comes when I grab some and load the finger with pressure on the affected digit. Otherwise I never feel any pain. Unfortunately this takes me away from climbing. Funny enough, that I can crimp and feel no pain (because nothing is touching the digit) but I can't hang on jugs! (because the jug is in direct contact with the 1st digit). Very strange. I have had an xray which revealed no fractures or breaks, and bloodwork negative for lyme's disease or rheumatoid arthritis.
@ dolgio - I will definitely look into that NYC doc, sounds like he knows what he's doing. Thanks!
@Monomaniac - And I agree, it is sad when you just get the "oh its probably just tendonitis and you need to take it easy" response or the "if we can cut into it, here's a cortisone shot!" response. Oh well, that's when it's time to look for a new doc. What kind of a warmup and controlled training were you referring to? Any exercises in particular? I work in a PT clinic, and have been using a digiflex hand flexor, putty, finger clips, and doing warm epsom salt soaks everyday. Any new exercises are welcome!
Thanks again everyone!

T.Chin18 · · Unknown Hometown · Joined Nov 2011 · Points: 0

@Sam Lightner, Jr. - Unfortunately I am in the States...Germany is a bit far... haha. Thanks though!

Monomaniac · · Morrison, CO · Joined Oct 2006 · Points: 17,295

I would warm up with easy climbing. There are two things in particular that I think you should avoid when treating tendonitis in your fingers: 1) direct pressure (massage, etc) and 2) range of motion exercises. These seem to aggrivate tendonitis more than anything else, I think because 1) inflamation doesn't like to be poked and 2) there is a lot of friction between the various structures in the fingers and ROM exercices result in lots of rubbing of parts, which inflamation doesn't like. So in short, I would recommend against squeezing a ball or any other contraption that results in dynamic contractions, and I would recommend against massage, which are both typical methods of warming up. If you can find a way to warmup with static contractions that does NOT involve climbing, that is fine too.

Once warm, I would do static contractions, under progressively increased load. I like to do deadhangs on a hangboard for this for lots of different reasons, but mostly because its easy to control the resistance, which allows you to progressively increase the load, and back off if things get too intense. This is pretty much impossible to achieve through climbing, which is why climbing almost always makes tendonitis worse. There is a lot of information on here about how to use a hangboard. Don't forget to ice.

Guideline #1: Don't be a jerk.

Injuries and Accidents
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