Stress Fracture in the finger

I've had pain in the base phalanx for a few weeks now.(in between the knuckle on my hand and the first one on my finger)
it mostly just hurts when i apply pressure to the area top to bottom and also makes crimping painful.

My guess was tendovaginitis, but i saw my doctor last week and he told my it was a stress fracture, and to keep the finger in a splint for 2 weeks.

Has anyone else had this injury. Can it be brought on by overuse?
can the diagnosis be wrong?

Also, in another week i'll be taking off the splint. Any advice on rehabilitaton? how soon can i get back to the gym?
I need my climbing fix soon.

deleted. i'm sick of the childishness on MP.com. scott ayers is right about this site.

Jon,

Why would you think that this is not a stress fracture? Other than the fact that pulley injuries are more typical in climbers.

The doc seemed pretty sure. Not that i think he can't be wrong.
No X-rays wer taken to confirm.

As far as i know, and it's not a whole lot, pully injuries come on suddely with a specific incident. This kindda developed

I can also feel a small bump in the side of the same bone (it doesnt belong, i checked the other hand)
no pain there though so maybe unrelated

could it be a calcium build-up as a reaction the the injury?

is it on the "backside" of your finger, or the "palm" side of your finger? if it is on the backside of your finger, that would be pretty interesting. if it is on the palm side, my first guess would be a pully problem. i have had some soreness in this area for a long time. i absolutely can't carry a 5 gallon bucket of water because the sharp handle just crushes that pulley area. keep us posted!

johnL wrote:I've been suffering from tendovaginitus for quite some time now.

Does it itch?

johnL wrote:I've been suffering from tendovaginitus for quite some time now.

Try Vagiprofen!

Krys,

Although the location of your pain may be similar to A2 pulley injury, it is totally not possible for anyone on here to "diagnose" you with something like that, sight unseen, with no medical education and no questions asked--especially when it contradicts what your doctor said. Listen to your doctor! If you don't feel s/he is correct, ask to see a hand and wrist surgeon for a second opinion.

Hand and wrist injuries are very complex; further, finger injuries such as those sustained by climbers are virtually unheard of outside the climbing sport, so it doesn't hurt to see a specialist.

If your injury is indeed a stress fracture, bone will heal completely with no scar tissue or otherwise remaining weakness (unlike soft tissue) if allowed to heal fully. Rarely do stress fractures require any real rehab, either. Just take it easy when returning to activity.

You should seek a second opinion if you doubt the first. I've never heard of a stress fracture in a finger bone resulting from climbing...anyone else heard of that? It seems unlikely to me from a mechanics/strength of materials standpoint. Stress fractures are common in the lower legs of runners because they are loaded dynamically over many cycles. The fingers are not used in this way.

I went to a general practitioner with what I'm pretty sure was tendovaginitis and he told me he thought an avulsion had occurred (tendon pulls a chunk of bone off) and a bone fragment was irritating the pulley. This diagnosis didn't fit any of the circumstances leading up to the injury. IMO many of these GP's don't have a clue about climbing injuries (why would they?) and they're too arrogant to admit it.

I agree with Mike. This sounds to me like a soft-tissue over-use injury of some kind. I would be very skeptical of the stress-fracture diagnosis, especially if no imaging was done (not that X-rays are effective for identifying stress fractures anyway).

If its important to you to have an accurate diagnosis, you better go see another doctor. It sounds like the treatment for a stress fracture is quite a bit different than that for most soft-tissue injuries, so it might be important to know what you have. Or, you can assume the worst and take the most conservative treatment path. Either way I would strongly suggest you take it easy for a few weeks when you start climbing again.

First of all, pulley injuries are very common. The symptoms you describe are basically identical to what people have for an A2 pulley injury - the pain, the location, related to crimping, the small bump, etc.

Rock & Ice did a write-up on stress fractures within the last year about how they go under-diagnosed among climbers.

I've had several pulley problems, and never went to the doctor. The best advice I can give is to not climb if it gets stiff and swollen, but otherwise climb jugs and avoid closed hand crimping like the plague. I have climbed through several pulley injuries, but they are annoying and on average it takes about 2 months to get through one, although I'm sure climbing and stressing it somewhat in that time causes it to take longer.

johnL wrote:I've been suffering from tendovaginitus for quite some time now.

doesn't surprise me.

Could be environmental exposure from your geographical upbringing & proximity to sheep and their fungal std properties. Though it could be genetic, possibly fetal hermaphroditism; based on your climbing tick versus forum post score table. Maybe it's auto-immune or cancer, but nah. It could be neurological, nah. Probably more psychological, thinking sympathetic retardation brought on by weekly doses of internet drivel.

Mike Anderson wrote:Stress fractures are common in the lower legs of runners because they are loaded dynamically over many cycles. The fingers are not used in this way.

Not true. In climbing, this is exactly the case.

Stress fractures in the upper extremity are not common, but yes they are certainly possible because we are loading the bony structures over and over with low level forces.