Pulley inury

Had a nasty crunch in my left ring finger while throwing with my right tonight at the gym. I read the info on this site:

climbinginjuries.com/page/f…

1. Anyone dealt with what is referred to on there as a Grade III pulley injury?
2. Has anyone gone through their suggested rehab plan?
3. How well did it work?
4. Any other recommendations?
5. How long did you stay away from climbing?
6. Is aid climbing off limits?

I've dealt with a "grade II" extensively. I ended up taking an entire year off because I climbed on the injured finger for 2 years. I would tape it up and climb until the pain was too much to handle. I ended up seeing a hand specialist who told me I will probably never climb hard again without pain (but fuck that... I'll prove him wrong.)

I'm just now getting back into climbing and am pretty much following the plan they recommend. And by getting back in, I mean I am doing a lot of ring workouts (no fingers) and climbing a few routes a week below 5.8. (I was climbing 5.12 and V5/6 when I had to stop). I have two suggestions. First, stop climbing and let it heal early on. Climbing on a serious tendon injury leads to nothing but problems in my experience. Second, don't climb in gyms and stick to hand cracks and slabs when you first get back. Avoid all crimps until you are confident that they won't injure you further.

Find another sport/hobby to do for a while, I took up cycling and actually had a serious relationship that I could never balance while climbing.

Good luck and feel free to pm me if you have any questions about my experiences.

I climbed outside on a "grade II" in my left ring finger much of last summer until I fully ruptured A2 and A3 pulleys (in the gym, of course) at the end of August. It sounded like a chicken bone breaking. I followed the standard regimen, though I had the finger in a fixation splint under doctors orders most of the first two weeks.

I was popping IBU like candy, icing, elevating, and the swelling didn't dissipate for over six weeks. Once it did, I buddy taped it and went climbing---easy stuff, nothing over 5.7, avoiding every crimp with my left hand. I did this several times in October and the finger swelled afterward each time. The thing was, the swelling and pain persisted longer and longer after each climb. I realized my recovery was stalling and I finally gave up in November. I've done the cold water therapy (until January), and used progressively stiffer putties (up to blue now) to bring the finger along. Almost nine months in and the finger is still not the same, but I've returned to moderate climbing.

Here's my advice: go get a "deluxe finger injury system" kit from your local drug store. The little freezable finger sleeve is great for short icing sessions later and the neoprene/Velcro buddy straps are comfortable and should be used now to reduce the chances of further injury. Strap your ring finger to your middle finger for support (and to remind you not to use that finger). Follow the rest, ice, elevation, NSAID regimen and STOP CLIMBING.

I would recommend that you cease to even think, read or talk about climbing as it may encourage you to start back too soon like I did. If you can banish it from your nighttime dreams too, that would be good. Try cold water therapy once the swelling has subsided. A few weeks after the swelling and pain are gone, start using the softest power putty. Your finger will swell after you do, so use the cold finger sleeve for 10 minutes after a putty session. You can start massaging the pulley(s) once the swelling is gone, too. You may feel some very distinct ridges of scar tissue running lengthwise in each pulley. I used a cross-grain, very firm massage to break it down. It hurt, but it worked for me. Use stiffer putties as you can. When you think you're ready to get back to climbing, WAIT LONGER. I scoffed when my doc said I wouldn't be back to 90% for eight months. He was right.

One last thing. I'm not a doctor. You should see yours.

I had a ring finger go on me that was loud enough that people asked if I broke the hold. It was the first day of a week long bouldering trip and I went home that evening. Best advice is to stop immediately. Ice, and Vitamin I probably until it is no longer painful. I climbed after several months off (I think 3-4) and mostly traditional and slab easier than 5.10. It took a year almost to the day before I really crimped again and I still have to be more controlled about it, not jumping. On top of that there are times that I can't make myself crimp with that hand anymore, even if I'm staring at it thinking close damit, it won't stay closed.

On the other hand I've red pointed as hard or possibly harder since the injury as before and on sighted harder. I'm way better at open handing edges now.

I have no idea what the injury would have been on the scale since I never saw a doctor about it. I do know that there was a sound and it seemed to bowstring a bit at the time of the injury but I did not check that fact more than a couple of times at most since it was pretty uncomfortable.

To your last point. Aid climbing would make me nervous because you end up grabbing at slings and biners in weird positions and pulling on them. This could strain the healing process by both stretching the tendon into the healing "pulley" as well as causing point pain from the pressure.

Like Eddie, I cycle, though I do more now than I did then. Mountain biking was hard of the finger since you have to pull up on the bars. Road biking would be better, be careful grabbing the brakes early on.

If you haven't already, read Dave MacLeod on the subject of pulley injuries.

onlineclimbingcoach.blogspo…

What's the worse that could happen if you just continued to climb on a ruptured pulley? I know the pain would be a bitch, but do you really need a pulley? One of the strongest boulderers around these parts ruptured both of his ring finger A2 pulleys and rather than get surgery he just kept climbing - solid V12 boulderer - and now he just gets yearly cortisone injections in both fingers... Surely the pain would dissipate over the period of a couple years?

I'm still having trouble accepting what's happened. This is horrible. Thank you all for your responses. I've read through them all and made notes. I've ordered the putty, am going to look into the treatment kit, and am looking into sailing courses for this summer.

There's no reason you shouldn't be back to climbing in a month - granted you wont be climbing hard, but slab - crack - offwidth - scrambling - and climbing jugs at the gym should only accelerate your healing time.

The MacCleod info is the best stuff I've seen on the net about it. I've had seemingly good results from ice baths.

In 20 yrs of climbing, I've had audibly loud A2 injuries 4 times each in my ring ringers, and once in each middle finger (so 10 total). Thankfully none in the last several years. They've taken from as little as 6 weeks to as long as 18mo to be pain-free during climbing. I'm climbing as hard or harder now in all styles as before the injuries and I'm closing in on 40yr old.

I did not, and do not, take ibuprofen or NSAIDs in general. Pain masking is not something I want, and I've rarely had ANY type of injury (and certainly no finger injuries) that hurt so badly that I needed pain meds to think straight or sleep. There are conflicting theories on inflammation and injuries, with some postulating that inflammation is actually necessary and/or beneficial in the healing process. I am not a doctor, do your own research or see your medical professional on this issue. That said, it's taken as a given in the med field that cortisone injections are a last-gap, temporary measure and have potential serious issues with pain-masking that allows you to do permanent irreversible damage to structures without knowing your are harming them.

I have done "buddy taping" and have done "x" taping. I find it is fairly useless in general, but that the "x" style taping is useful not from a suppport standpoint, but because it restricts how much I can bend the finger and consequently keeps me from being able to get into a full crimp.

Years of periodizing my training (regularly switching from hangboard to bouldering to powerendurance to projects to rest) and not trying the same hard move over and over and over in the same session is what I credit with staying healthy. Hangboarding in particular has made me much stronger open handed than I was and I open hand almost everything these days.

Having the discipline to try a boulder problem a couple of times and if you don't send, walk away and find something else is very tough. Especially in the gym where you can try the same move over and over without skin being an issue, or when you're bouldering in a crew and there are some performance/competitive pressures.

I find a lot of routes and problems on plastic are injury prone because they involve very shouldery moves at full extension, or lots of throws and dynamic moves. When choosing something in the gym I'll often walk around and look at 20 problems or routes and immediately write off 5 of them just by looking at hold spacing or hold type. It's not worth losing 6mo to injury, after all you're in the gym to train for the main event, not because the blue and pink taped route is a classic worth doing in it's own right.

Hey buddy, super bummed to hear about the Pulley injury. I was recovering, and am still somewhat recovering, from a pulley injury (possible grade II) when we were hanging in Zion. The Dave Macleod site is where I took the most treatment info from. Definitely dont need to quit climbing outright, but best to take time off until pain free, which could really only be a few weeks. I found alot of solice at indian creek on handsize and larger cracks while i couldnt crimp.

I taped all the way from the base of the finger to inbetween the A3 knuckle and the one getting closest to the tip of the finger (A4 I think that is). This was mostly to reduce motion and inhibit crimping, but I also found it helped reduce swelling through compression. Combine with icecold water treatment for maximal swelling reduction. Once the pain and swelling are gone, do whatever you can to increase bloodflow to the site - theraputty, stretching, massage, and mild cold water treatment ala Macleod.

Good luck man. Also, dont forget that you should drink lots and lots of mountain dew. The red kind!

Adam Baxter wrote:Hey buddy, super bummed to hear about the Pulley injury. I was recovering, and am still somewhat recovering, from a pulley injury (possible grade II) when we were hanging in Zion. The Dave Macleod site is where I took the most treatment info from. Definitely dont need to quit climbing outright, but best to take time off until pain free, which could really only be a few weeks. I found alot of solice at indian creek on handsize and larger cracks while i couldnt crimp. I taped all the way from the base of the finger to inbetween the A3 knuckle and the one getting closest to the tip of the finger (A4 I think that is). This was mostly to reduce motion and inhibit crimping, but I also found it helped reduce swelling through compression. Combine with icecold water treatment for maximal swelling reduction. Once the pain and swelling are gone, do whatever you can to increase bloodflow to the site - theraputty, stretching, massage, and mild cold water treatment ala Macleod. Good luck man. Also, dont forget that you should drink lots and lots of mountain dew. The red kind!

Hey bud, I talked with Corey this morning and he reminded me that you're recovering from a similar injury. I was going to shoot you an e-mail asking for advice. Thanks for posting. The more I read the less depressing the situation seems to be. Being limited to hand cracks is not so bad! I just finished a big Mt. Dew...on the road to recovery!