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Train through finger injury or layoff climbing
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By reboot
From Westminster, CO
Mar 13, 2012
I've had what I think is a lateral ligament tear (and possibly mild A2 pulley tear) in my right hand middle finger (and some much milder swelling/tenderness in the left hand middle finger joint) for ~3 years. The finger used to feel a bit loose at the joint, but has since tightened up. Problem is it's pretty susceptible to swelling (and results in discomfort at the joint) from crimping, though all-in-all it's in better shape than when I first injured it. I've tried laying off climbing for a few weeks at a time. The swelling goes down pretty quickly, but any hard (full) crimping brings the swelling back. I've modified my grip to not rely on full crimp very much (but longer moves necessitates it some times) and have made progress in climbing, but the injury leaves me very little room for error from over-training.

I was resolved to taking a long (3-6 month) layoff at some point, but then I read Dave's new blog entry. Has any of you internez/real life hard man/woman tried one or the other approach? Did your injury eventually fully heal and you are climbing harder than ever (not purely from improved technique), or did you learn to just deal with it while pushing the grades?

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By Monomaniac
Administrator
From Morrison, CO
Mar 13, 2012
Insurrection, 5.14c.  Photo Adam Sanders.
I agree 100% with Dave's advice in this area. I think taking more than a few weeks off is just a waste of time at best; most of the time, once you start back up the injury will be right where it was when you stopped climbing. The key is to progressively stimulate the injured tissue, with proper amounts of rest between stimulus. This is unlikely to be achieved through cross training, trad climbing, "easy" climbing or whatever else most folks pass off as rehab. You need to control & quantify the amount of stress you place on the injured tissue, and control and quantify the recovery period, then progressively increase the load as the tissue heals.

Personally I think the best way to do this is with timed dead hangs on a hangboard, progressively adding weight from one session to the next (which will likely come in the form of removing weight, and steadily reducing the amount of weight you remove). Obviously I'm a bit biased toward the hangboard. I think other apparatus could work as well, but the hangboard is easily the most controlled system, and I happen to have one all ready and waiting when I need it to rehab, which is fairly often.

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By Geir
From Tucson, AZ
Mar 13, 2012
Toofast
Monomaniac seems to have a solid scientific approach on this. Mine is not nearly as objective but has worked for me:

1) Avoid the kind of climbing that makes it worse. You might need to back off the hard crimping for a long while.
2) Tape the finger regardless of the kind of climbing you are doing. It's hard to say if this helps because it supports the finger or because it helps remind you to take it easy. Probably a bit of both.
3) Anti-inflammatory meds. For whatever reason a dose before going to sleep seems to help a lot.

I have injured fingers several times in the past dozen years, and have been able to keep climbing through all of the injuries this way. Time for full healing has ranged from 6 to 12 months for me, but at least I could still climb.

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By Brent Apgar
From Out of the Loop
Mar 13, 2012
Me and Spearhead
"Be clear that despite itís psychological challenge for keen sports people, lay-off is in fact the easy option compared to the work and discipline of recovering from an injury without lay-off. This is because changing habits is really hard and requires iron resolve that most people cannot sustain as long as they need to. Hence the high recurrence rate of injuries. People just try to do things as they always did (including the things that caused the injury). If you are ready to climb differently - at the level the injured part demands, working daily to correct your bad technique habits, tactics, postural faults and specific muscle weaknesses, then recovery without lay-off is the short cut to successful recovery. Most folk donít have the discipline either to source the information on what they ought to change, or to put the work in and actually change it." -DM

I too agree w/ training through an injury. But I put in the last paragraph of the blog since MacLeod's point can't be overstated.
I was frustrated w/ my shoulder strength this last fall and worked diligently to shore up the weakness... it worked, and I blew out a pulley in my right hand. (my shoulders were no longer the weak link in the chain, I guess it was my fingers)

So it's been awhile since I've had to rehab a finger injury. This was in Nov 11 and now I'm pretty much back to 95% of what I was able to crimp on previously. I didn't get so technical as Mono, but went with avoiding reinjury by not using a crimp position (that's what caused the injury in the first place). So all open handed climbing, more volume at first and then moving into more pinches (which by the way also demand a lot out of the pulleys so there really a hold style to avoid on a fresh pulley tear...especially smaller, awkward ones.) And a bunch of aggressive self massage on the injured fascia.

The general rule being that as long as it's not painful to the point that it makes you think "maybe I shouldn't have done that" you're staying within the limits of the injured tissue. This is the incredibly hard part because every injury is different and how the hell are you supposed to know how much is too much.
Very slow trial and error. But if you can have no pain through the entire climbing/training session and have it be just a wee bit achey the next day, you've probably got the right intensity. At least for a couple of weeks until you need to re-evaluate and make things harder to keep moving forward.

Sorry for the long spiel. The blog link is great, it's hard to impress upon folks how tricky it is to keep improving the longer you've been at it. You really need to start looking into the little details of mechanics, imbalances and recovery.

Just my 2 cents as a healthcare professional, I'd get your finger looked at by someone that knows what they're doing. If it's still hurting after 3yrs, something didn't heal correctly after the original injury or you've adapted how your using your hand,arm,shoulder, something as a result and that's keeping this nagging problem going.
Good luck w/ resolving the finger issue,
BA

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By Rob Gordon
From Hollywood, CA
Mar 13, 2012
Tough Mantle Problem.  Haven't sent yet...
Such a tricky thing... Some injuries seem to require rest while others require rehab. You have to go with your gut I think.

For what it's worth I like to lay off till its usable then slowly strengthen it.

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By Kevin Chuba
From Salt Lake City, UT
Mar 13, 2012
There it is
Taping your fingers is really only a bandaid and will not allow your fingers to get stronger. Avoid taping when in rehab, you are trying to build strength in your digits not test the strenght of tape. If you must climb on those crimpers, tape up to avoid further injury. In my opinion if you tape all the time your never going to get stronger. But yes, I use tape when one of my pulleys are acting up and I want to climb hard.

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By slim
Administrator
Mar 13, 2012
tomato, tomotto, kill mike amato.
late last year i had a strain in a pulley and took 6 weeks off, and as mono pointed out, when i started up my training the pulley immediately got agitated again.

i started my hangboard routine out with ultra light load in the crimp position, and just monitored how my finger felt throughout the cycle. by the end of the cycle it was doing pretty well.

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By TheBirdman
From Eldorado Springs, Colorado
Mar 13, 2012
Couple things that worked for me and take my advice with a grain of salt seeing as how I'm not Dave McLeod nor do I work in any sort of medical field. This is instead just my anecdotal experience.

1) 2-4 weeks completely off immediately following the injury, length of off time determined by the extent of the damage. If you've been climbing through it since it happened, disregard this step.

2) Power Putty: I literally carry this crap everywhere; work, driving, walking the dog. Just squeeze it constantly. It stimulates blood flow to the injured finger without overstressing it. The hard part is staying on it. I literally have it in my hand at least 4 hours a day.

3) Easy dead-hangs on a hangboard followed immediately by bucket of sand/rice. Working the extensor muscles to failure by moving your fingers through sand and rice is a great way to get fresh blood flowing to the area, without risking greater injury, and this is also made more effective by the pump you build in your hangboard workout. Do yourself a favor and get a 5 gallon bucket and fill it with sand or rice. Hang out with it for 20 minutes after an easy hangboard workout and you will get the strangest and best feeling pump of your life.

You never go from injured finger straight back to full strength, no matter what rehab. There will be a transition period where you ease back into climbing on a finger you're not 100% confident in. Just be aware of it and yourself. Take the first month of climbing slow (no two-finger dynos) and slowly but surely, you'll notice that finger less and less.

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By Tony B
From Around Boulder, CO
Mar 13, 2012
Got Milk? How about forearm pump? Tony leads "...
shuminW wrote:
I've had what I think is a lateral ligament tear (and possibly mild A2 pulley tear) in my right hand middle finger (and some much milder swelling/tenderness in the left hand middle finger joint) for ~3 years.

Have you had an MRI yet? Are you sure it is the ligament and not the edge of the joint capsule?

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By reboot
From Westminster, CO
Mar 13, 2012
Tony B wrote:
Have you had an MRI yet? Are you sure it is the ligament and not the edge of the joint capsule?

Tony, the answer is no and no. I'm curious, but if it doesn't change how I need to recover, I don't really care enough to know. On the other hand, the symptom sure feels like collateral ligament tear (saw PT who though the same): hyper mobility on one side (bend finger laterally toward the index finger), though it has gotten better, buddy tapping to ring finger definitely helps.

At any rate, I've been doing some finger board workout lately and I felt stronger, it's the less controlled bouldering and bouldery routes that seem to easily aggravate it

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