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Ring finger Pulley injury?
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By LeeAB
Administrator
From ABQ, NM
Nov 30, 2011
Once we landed we headed to Font to find a place to stay for the night before doing a day of wine tasting and heading to Buoux.
abc wrote:
Thanks for the feedback Mark. If I say, "most world-class climbers avoid exclusively using a closed crimp position," would this feel more accurate? Any other possible suggestions?


I would lean towards, "the best climbers tend to use an open grip until forced to crimp by the nature of the holds"

I think that most people can hold a smaller hold using a closed crimp, but it seems to me that you have better endurance with an open grip so it is really just a question of what size hold forces you to close and how often you use holds that small or smaller. Of course you can improver your open handed grip through practice as well.

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By Brent Apgar
From Out of the Loop
Dec 1, 2011
Me and Spearhead
abc, nice article. It gives a good run down on the topic of hand injuries, I really like the more objective view on the efficacy(or lack of in most cases) of available treatments, from surgery to home therapy.

I definitely agree w/ MonoM on the importance of stressing the point that at some point you've got to start climbing on holds again and gradually work back to pulling hard on the offending hold type.
Too many times I here people say take 4wks off and then start climbing again when it doesn't hurt... which doesn't take into account the diminished performance capacity of the injured tissue or the detraining that has occurred. You can't simply take a month off and then jump back into projecting withing a week or two.

That goes along w/ the other part that I would also emphasize. The fact that soft tissue takes much longer (and via a different process than muscle) to adapt to training and become stronger than skeletal muscles. That is a point I am constantly trying to get across to folks, you've got to take into account that fascia takes a much longer time to respond to training.
Thanks for getting some good info out to the climbing community,
BA

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By Monomaniac
Administrator
From Morrison, CO
Dec 1, 2011
Insurrection, 5.14c.  Photo Adam Sanders.
abc wrote:
Thanks for the feedback Mark. If I say, "most world-class climbers avoid exclusively using a closed crimp position," would this feel more accurate? Any other possible suggestions?


I think that is correct, but Lee really hit the nail on the head.

Again, it comes down to how we define a crimp, etc. I think the most cut & dried way to define it is, its a closed crimp when you're wrapping your thumb over your index finger. That is definitely something to avoid. However, when you get to a certain point, the edges are just too small to get any purchase on unless your angle of attack is greater than zero (think re-curved ice pick). The only way to achieve that is with a closed crimp (um, except maybe by putting your fingernails on the hold--5.17 perhaps?).

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By Step hen
From Fort Collins, CO
Dec 1, 2011
Boulder Canyon <br /> <br />photo by Curt
Mono,

Is that a closed-crimp thumb-wrap that you are using in your profile photo? Route looks gnarly; maybe a situation where you had to use it.

For the OP, I injured my ring-finger more than a year ago. I might have tore my flexor tendon, but who knows, maybe it was tendonitis or a strain. I took more than three months off, until it no longer hurt when I applied the slightest bit of pressure with my thumb. I iced it a lot, but that only helps so much. My hand started to get cold even when I wasn't icing it, so I stopped. I did some light stretching several times daily, and that seemed to help. Also, when I finally started climbing, I used tape at first, which made my finger feel more stable. Maybe that was the placebo effect, as abc suggests. I still had pains in my finger for several months, like when I clicked away at my mouse or typed all day at work and when I climbed crimps.

Bottom line, rest (i.e. no climbing) and then climb easier juggy routes when you recover somewhat. Attack the crimps once you fully recover. All told, it took me eight or nine months to get back to 100 percent.

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By abc
Dec 1, 2011
LeeAB wrote:
I would lean towards, "the best climbers tend to use an open grip until forced to crimp by the nature of the holds" I think that most people can hold a smaller hold using a closed crimp, but it seems to me that you have better endurance with an open grip so it is really just a question of what size hold forces you to close and how often you use holds that small or smaller. Of course you can improver your open handed grip through practice as well.


Lee, well said. Thanks.

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By Christopher Barlow
Dec 1, 2011
abc wrote:
2. “Lewis Reaction” – Otherwise known as cool (not cold) water therapy, has a different goal than traditional icing, which is performed to decrease swelling/inflammation. Rather, this therapy increases blood flow, if done properly, to the affected area, which is critical for the healing process anywhere but even more so for tendons and ligaments. Soaking your affected area in significantly cold water causes the blood vessels to constrict in an effort by the body to protect the vital organs. While moderately cool water has the same initial effect, the secondary response is for the body to dilate the blood vessels and flush the affected area with blood flows reportedly greater than 500 % of normal. To perform this treatment, soak the injured area in water that is tap-water cool for thirty minutes. The first five minutes of the treatment will constrict the blood vessels, and your hand will feel cold. But for the next twenty-five minutes the body will realize that the vital organs are safe and will begin pushing blood into the injured area. Finding the correct temperature is critical, and it may take a couple of sessions to figure it out – too cold and the blood vessels never dilate; too warm and the blood vessels don’t have to dilate. It often takes a few sessions for the body to learn to adapt, but the process can be sped-up by wearing a winter jacket and hat while you execute the therapy, which should be performed two to three times a day until the injury is pain-free. Some argue that contrasting three to five minutes of very cold water with three to five minutes of hot water gives the same effect. There is very little research to support the effectiveness of this method while the “Lewis Reaction” has been proven a potent agent of healing by various studies.


I'm curious about this one, Brett. It hasn't been clear to me that it is the only research-supported treatment for improving blood flow. I tried this method awhile back for a tendon strain after reading about it on Dave Macleod's blog. I ultimately went to see a PT about the injury. This guy has a Ph. D. in physiology and has treated me and many other athletes, including some very elite ones, with excellent results. When I told him about the cool water soak, he laughed a bit. His response was: "Why don't you just increase blood flow with warm water instead of suffering through 30 minutes of cold?" My question, then, is if there are any other specific benefits from cool water therapy. In other words, is its efficacy in increasing blood flow its only advantage and purpose?

The reason I ask is because, after hearing my PT's response, I found a different method on an Australian climbing/training website. It's the method I outline in my first contribution to the thread (ice water for 15 seconds then very hot for 45-50 seconds for 10 rotations). When I get this exactly right, I can literally feel heart beat pulses in my hand. I can't say quantifiably how effective it is compared to cool water therapy, but it feels like at least as much blood flow, if not more. The added benefit is that it takes about 10 minutes and, at least to me, is relatively comfortable (switching between hot and cold frequently rather than keeping my hand in cool water constantly). To add on to my previous question, is there any reason that you know of to avoid heat as part of the treatment?

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By shakti
From Riverside, CA
Sep 15, 2012
I feel ya. All kinds of tendon pain, and the last thing I want to do is take time off. I'm not taking NSAIDs to remind myself why I'm not climbing. I've been told collagen containing foods are good for ligament/tendon health. Jello ftw.

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By tooTALLtim
From Boulder, CO
Feb 10, 2013
Loving it up in the Creek!
I just injured my ring finger this weekend, and found this article helpful (especially the article by Brett), and thought it deserved a bump.

Thank you MP community! Now to start the process of recovery (and heavy drinking to ward off depression :P )

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By handon broward
From Westminster, CO
Feb 10, 2013
Elk Range, CO
tooTALLtim wrote:
I just injured my ring finger this weekend, and found this article helpful (especially the article by Brett), and thought it deserved a bump. Thank you MP community! Now to start the process of recovery (and heavy drinking to ward off depression :P )


Lots of pushups, lots of dips, lots of forearm workouts and lots of 12 oz curls man. Still recovering from an A2 ring finger pulley injury that occurred in the first week of December. Self diagnosed as a Grade 2 strain...maybr morr like a heavy Grade 1. Best of wishes man. Rest for as long as you can take it and then tape as tight as you can for a long time. I honestly feel stronger and better about my grip as I start to reach full recovery. Weird.

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