Cortisone shot for tendon sheath inflammation

Hey MP,

I was wondering if anyone had experience with a cortisone shot in the lining of the tendon in their palm? I read the other thread but didn't see anything regarding hand problems and if the shot was a good idea.

I hurt my tendon through my middle finger/palm (no pop) and it has been slowly subsiding, but comes back 2 days after I climb, I have taken 7 and 10 days off in between. I'm sure its because I need a longer time off.

Thoughts?

Jake,

I got a coritsone shot in my index finger for tendon inflammation. It was really cheap on my insurance so I went and got it after a ortho doctor recommended it for me. It definitely helped in the long run, although I made the mistake of climbing a bit too hard on it after the shot and continuing to aggravate my tendon. My ortho said it typically requires 2 shots to get back to 100% (I don't know why). But the shot and doing a lot of finger re-hab got me closer to 100% and getting rid of the constant and long-term inflammation.

Had that perfect single digit lock on a sweet crack, foot blew, finger held. Oh shit. Could not close finger past 90º. After 2 months of non'recovery, doc said try cortisone shot. Miracle. Full closure, zero pain, full extension. Have since had elbow and hip (don't ask, but ouch) and am a true believer. Go fer'it.

If you go with a steroid injection, I would try to take it easy on that hand for a while.
There is decent evidence for an association between steroids and tendon rupture/deterioration...

Thanks for the great feedback you guys. It's feeling a lot better after a much longer time off, but if the problem returns I will plan on getting a shot.

If anyone has a similar issue and looks back on this thread, I will offer my suggestions.

The first thing I would do would be to see a specialized doctor. I went to an orthopedist in Boulder and it was a great decision. He suggested the cortisone shot and I was definitely hesitant. I waited a few weeks with no climbing and my hand felt fine, but it was really painful after moving some heavy boxes so I decided to get the shot.

Best decision I have ever made. the injection was at the base of my middle finger and hurt pretty bad. I waited 2 more weeks after the shot before climbing again. Then I slowly began climbing 5.6 for the next few weeks and slowly working my way up the grades, avoiding steep crimpy routes. I also kept up with a lot of physical therapy to strech out my hands, tendons, and muscles in my arms and shoulders.

Now 2 months after I am back to where I was and able to climb things that are at my limit. I am still very cautious and warm up alot before trying anything hard, and still keep up with injury prevention stretching. If anyone ever has a similar issue feel free to message me and I can fill you in on the exercises I did.

I hope this helps anyone!

Depends on the nature of the injury. I ruptured two sheaths which eventually healed on their own. However, both developed cysts where fluid was released and then healed over. The relapsing and remitting pain was due to the hardened cysts compressing against skin, tendon, bone, etc. Options were surgery or shots. Had surgery and can't even tell I ever had a problem. FYI, climbing balm makes great scar treatment!

Cortisone is amazing. I finally broke down and got an injection in my heel after severe PF pain. I had tried walking boots, physical therapy, night bracing, compression, ice/heat, etc... Pretty much everything and still had the inflammation in the tendon. It took 3 days before I felt any relief and I still have to brace and wear good supportive shoes. But 2 months out and I'm still pain, stiffness and inflammation free.

I don't see why it wouldn't help for a hand tendon. But as others have suggested, using it sparingly for a bit after the injection would be a good idea.

I'll offer my two cents as well after a couple months recovering from a long term injury.

In addition to regular climbing I have found hangboarding to substantially help with my finger strength recovery. It took me awhile to build up to body weight, but taking weight off (-20lb to -25lbs for a 135 lb individual) and doing repeaters helped get my finger strength back. I was hesitant to even try this since I originally injured my finger hangboarding, but I've found it to be a great recovery tool if used properly.

My routine was 1x a week, usually on Wed., and climbing on Sat/Sun. I started out with -20lb/-25lb and working my way up to -10 to eventually bodyweight (5lbs at a time). I would typically keep the same 7s on/3s off, 6-8x for a particular hold, and just increase the weight slowly every week.