Finger Injuries

I would like to start this post by saying that I'm not looking for a doctor, I'm just looking for opinions from people who have gone through this.

I currently have an A2 pulley strain in my middle finger. This is certainly due to overuse as I had a good spring climbing season. Problem now is I've taken almost 6 weeks off and it doesn't hurt nearly as bad as it used to but it still hurts when I apply pressure.

How long did it take for your pulley injury to fully heal? I'm committed to taking time off and since I've already taken 6 weeks I might as well get it back to 100%. How long after it didn't hurt anymore did you wait? Also, if you trained in a gym how long did you wait to go back to that? Any advice is greatly appreciated, my summer climbing season has been screwed I just want to get back by this fall. Thanks.

David
I'm plugging my own thing here, but it really is the best source. I helped Dr. Volker SHoeffle write a book on this. He is a 5.13+ climber and has repaired many of these (as well as had them). Our book, "One Move Too Many", gives all the relevant info on this injury and shows how to tape for it and what not. Petzl is distributing it.
The short of it is you are probably fine to go back to climbing, while taped, but you should try not to crimp too much for a while. It all depends on the severity of the original rupture.
Sam

The upside is that if you can't crimp, you can really work on your off-width technique. This could be a blessing.

Just imagine squirming, grunting, smearing, barring, and chicken winging your way to glory this year!!!!

Hope you recover well.

I had a serious injury in my right ring finger(probably A1 or 2, seemed to be the one directly at the base of the finger, had a good forearm injury too), luckily it was serious(extreme pain, extremely loud POP!), so I had no choice but to stop climbing. I got physical therapy(ultrasound, electroshock, cortizone ptach, massage) and was climbing easy stuff in 2 weeks and back to full strength in 4-6 weeks.

I injured my right pinky later on. Don't know how, but it "wasn't serious" so I climbed on it trying different tapings... bad mistake. I did end up getting some physical therapy, which I was not happy with my treatment. You gotta watch out for those physical therapists, some of that medicine might be quackery. It took about 4-6 months to completely heal. It wasn't serious, so that some serious taping eliminated most pain. I still have some significant scar tissue there and always tape that first segment on my pinky. ...but Pinky? weird...

So your healing time can really be anywhere from 2 weeks to a year or more, it just depends on how quicklky you stopped aggravating it after the initial injury, and I think physical therapy does help. I think massage is probably the most important thing for healing, break up that scar tissue. I think the cortizone and ultrasound helped, but who knows.. it at least felt good.

I liked the machine that was like a little electrode with a slightly rounded coin sized end, that did ultrasound and electroshock, it was like a massage, constantly rubbing the finger. I did not like the static electroshock, where you just get hooked up to an electrode and have electricity pass through your hand, that was dumb... and they sell a little vibrating massager that is good for fingers, haven't bought one yet, but always think about it. I think massage is key...

Sam Lightner, Jr. wrote:David I'm plugging my own thing here, but it really is the best source. I helped Dr. Volker SHoeffle write a book on this. He is a 5.13+ climber and has repaired many of these (as well as had them). Our book, "One Move Too Many", gives all the relevant info on this injury and shows how to tape for it and what not. Petzl is distributing it. The short of it is you are probably fine to go back to climbing, while taped, but you should try not to crimp too much for a while. It all depends on the severity of the original rupture. Sam

Thanks Sam, I have seen this book in the past but haven't needed this kind of advice till now. Probably a good time to pick it up.

Not So Famous Old Dude wrote:The upside is that if you can't crimp, you can really work on your off-width technique. This could be a blessing. Just imagine squirming, grunting, smearing, barring, and chicken winging your way to glory this year!!!! Hope you recover well.

I do enjoy this form of torture from time to time. Good post, put a smile on my face.

S.L., Jr.: That is a great book. Loads of good pictures and advice. To the OP: buy it now.

About a year after I started climbing I compltely ruptured my A2 on my non-dominant ring finger cranking on a crimp I had no business cranking on. Loud POP and then serious pain. I think I had the syndrome where I was more muscular and fit than my tendons were and I thought I could pull on anything. My neighbor at the time was a orthopedic surgeon and made the diagnosis (actually I made it after reading about finger injuries). I went to a hand surgeon who confirmed the diagnosis with an MRI and recommended surgery to fix it. I did a lot of reading about the injury and eventually decided against having a surgery. I never stopped climbing, but it was so painful that I taped very tight and climbed 1-2 times a week, very light (nothing over 5.8ish). The finger was always sore and swollen. By month 3 of this, I could pull pretty hard on the finger again. By month 6, my strength in the finger was back to where it had been, but the finger was still sore after climbing for a day or two. I taped pretty tight for about a year, and by a year post-injury, I stopped taping and there was no more pain. The finger never returned to it's normal size. I know this because I had to have my wedding ring resized 1.5 sizes up, and now 4 years later it still fits well. Never had any problem with the finger after that. I still can't make a complete fist, that finger never comes all the way down, but I never think about it. I was initially told if I didn't have surgery I would probably develop a contraction deformity making the finger useless but I'm still waiting for that to happen. I also never did any specific therapy like ultrasound, NSAIDs, heat, whatever. I did ice it before and after climbing for maybe a month but that got old quick.

I guess you have to play it by ear. I was too impatient to stop climbing on mine. And maybe it prolonged the injury and the pain, but I didn't really care. It all worked out in the end.

I think a strain is a different beast than a complete rupture. At least with a complete rupture, there can be no further damage to that pulley. It never heals back together, so there's no issue. However with a strain, you can continue to strain it as it's still intact. So in some ways it's (theoretically at least) worse to have a strain.

Happy to go into more detail if anyone wants. Just my experience. Good luck.

My experience has been rest was key. I tore a pulley in my ring finger. Loud pop, not terribly painful but movement and control over the finger were shot. Couldn't climb at all. I rested 45 days, tried climbing, no good. Rested another 45 days. So 90 days total, good to go. Started a little slow and by the time my confidence was back the finger was ok. That was 12 years ago...no recurring problems with that injury, which to me is important as I've known a few climbers to continually re-injure the same fingers by not allowing them to heal.

The time away from climbing sucked, had to ignore all of my friends basically. I focused on cross training and weight lifting during the time off (as I had no access to good off-width climbing ... if such a thing really exists ;)

Just my two cents...good luck.

I posted these links on a different thread about this topic a while ago, kind of interesting:

wemjournal.org/wmsonline/?r…;>>>> (large series of climbers to show what is best therapy for each type of pulley injury, ie. surgery versus no surgery)

physsportsmed.com/issues/19… (general reference from well-known hand surgeon on rock climbing hand injuries)

radiology.rsnajnls.org/cgi/… (good depiction of what exactly a pulley and pulley injury is)

I also put up a couple MRI shots of my injury:

mountainproject.com/v/chris…

mountainproject.com/v/chris…

mountainproject.com/v/chris…

OUCH!!

Chris/James/Joseph

Did you guys start back out inside or outside. Basically, I hate climbing in the gym but it really is great for training during the week. I'm actually more afraid to climb inside on my finger than out. Any thoughts are appreciated.

It was October when I did this (in Minnesota) so I stuck to the gym (Prairie Walls is a stellar gym) for about another 4-6 months, although I did go to JT in February 04 and climbed pretty well. You defintely have more control in the gym, and, I would argue you have more control bouldering as you can simply drop off whatever you are on if it starts to hurt. That's what I did.

I started back in the gym. There was numerous easy things to get on and no worry about gear. Gym climbing is where I get hurt, because I can do hard crimpy routes one after the other. I can't do that anymore... gotta pace myself.

Outdoors is of course ideal if you have some easy stuff to get on, and maybe a leader or partner willing to take shorter days, maybe be a third party so you don't have to belay(more stress).

David Hodges wrote:Chris/James/Joseph Did you guys start back out inside or outside. Basically, I hate climbing in the gym but it really is great for training during the week. I'm actually more afraid to climb inside on my finger than out. Any thoughts are appreciated.

I don't know if there is any research on injuries sustained indoor vs outdoor, but case studies seem to support the notion that climbing on plastic can wreak more havoc than climbing outside. Chris says, "You have more control," yet there is probably going to be a different coefficient of friction on greasy plastic that could play into why people seem to pop pulleys and strain tendons easily, not to mention that gym routes force you to use your upper body more, thereby constantly placing more forces on your fingers and hands than on your feet.

Chris treggE wrote:I think a strain is a different beast than a complete rupture. At least with a complete rupture, there can be no further damage to that pulley. It never heals back together, so there's no issue. However with a strain, you can continue to strain it as it's still intact. So in some ways it's (theoretically at least) worse to have a strain.

It also helps to know the difference between a strain and a sprain. A pulley cannot be sTrained, but it can be sPrained. A tendon cannot be sPrained, but it can be sTrained. A pulley is a separate entity from your flexor tendon; it merely holds the tendon in place. Just because you have a pulley injury does not mean you have a flexor tendon injury. They are totally different. Also, if your pulley ruptured, it had nothing to do with any supposed lack of strength in your flexor tendon, as they are not the same thing.

This whole notion of "my tendons aren't strong enough for my muscles" doesn't really make sense. Muscles usually fail before tendons do, unless you are old, have gout, take steroids, or a few other things. Most of what we think of as "tendon" injuries occur at the musculotendinous junction, and it involves the muscle tissue tearing away from the tendon. The tendon remains INTACT.

Well, I didn't have access to a decent gym...lived in NC at the time, we had a gym but it was not so great. I started climbing again outdoors. I did tend to stick to routes I knew well and could be fairly certain I wasn't going to max out the finger, worked up from there.

Sorry, Chris, wasn't trying to pick on ya, just trying to make some injury distinctions more clear! I always feel knowledge is empowering.

Otherwise, I agree, your experience was valuable input for the OP. :)

You know what, Chris, I stand corrected. Apparently pulleys are sTrained (as you said), not sPrained, although it is confusing because I have read a couple medical references calling them "ligaments," and I have never seen anything that depicts them as continuous with the finger tendon sheaths (in fact, I believe most of them arise from the outer covering of the finger bone). I do know they have 3 layers and some material composition that help them "glide" against the finger tendons, so apparently they must be more like a tendon and thus can be...strained!