Finger Injury - No Pain but Swollen Knuckle and Restricted Range of Motion

I have had this nagging finger injury for a year. My left hand's middle and ring fingers get swollen, especially the middle knuckles, during climbing. I hurt / sprained them when I fell funny while I was snowboarding. I took a lateral hit on my fingers (sprained them sideways?).  I initially took a break from climbing. However, ever since then, my fingers are not the same any more. They get swollen during climbing, stay swollen for days depending on the intensity of climbing and subsides over the next several days. Weirdly there is no pain climbing on these fingers. Icing, acupuncture rings, and voodoo flossing help decreasing the swelling. However, I feel like those are temporary treatments. I would like to know if anyone has had a similar injury.

The image below is my left hand with injured fingers. You can see the tips of my fingers are not touching my meaty base parts.

In contrast, this is my right hand - no injury. 

First of all go see a doctor, we are not doctors.

Secondly, it sounds like a pulley injury and those suck. Google them and you'll see how long the recovery process is. 

It actually doesn't sound like a pulley injury at all.  Collateral ligaments of the PIP joint are small and finicky, and once you mess them up, it seems like it takes forever (if ever) for things to feel normal again.  I, and several of my friends, have a similar situation of swelling, limited mobility, but no pain in one or more fingers.  My personal research in to the matter makes me think it's a result of scar tissue build-up from improperly healed collateral ligament injuries.  I find that H-taping prior to every climbing session helps to keep the swelling at bay.  I should probably  be using a finger massage ring to try to break up any lingering scar tissue and stimulate blood flow as well.  You could indeed see a doctor, but without pain, the only real way to diagnose the issue would be an MRI, and the prescription would probably still just be rest, manipulation of the joint, and at worst a cortisone/steroid injection.

As I said above none of us are doctors and Mark's response proves my point. I had the same symptoms as you and mine is a pulley injury. All you're going to get on here is anecdotal advice. Do yourself a favor and get checked out by someone other than a keyboard jokey. Or don't, but only you can evaluate the risks you're willing to take with your hands as a climber. 

Mark Paulson wrote: It actually doesn't sound like a pulley injury at all.  Collateral ligaments of the PIP joint are small and finicky, and once you mess them up, it seems like it takes forever (if ever) for things to feel normal again.  I, and several of my friends, have a similar situation of swelling, limited mobility, but no pain in one or more fingers.  My personal research in to the matter makes me think it's a result of scar tissue build-up from improperly healed collateral ligament injuries.  I find that H-taping prior to every climbing session helps to keep the swelling at bay.  I should probably  be using a finger massage ring to try to break up any lingering scar tissue and stimulate blood flow as well.  You could indeed see a doctor, but without pain, the only real way to diagnose the issue would be an MRI, and the prescription would probably still just be rest, manipulation of the joint, and at worst a cortisone/steroid injection.

I agree, sounds like a collateral ligament injury.  As Mark mentions these take forever to heal and will be at high risk of re-injury.  I've had great luck with Prolotherapy / dry needling to break up the scar tissue.  In my case I had calcifying tendonitis, meaning that my collateral ligament was calcifying and turning into bone, which is not good for a joint.  This was diagnosed with a simple X-ray, as the collateral ligament was showing up on the x-ray.  The needling was able to break up the calcification and allow the finger to heal while it was mobile, with light climbing.  Another thing that works for me is a strip of KT tape around the joint.

I would avoid a cortisone / steroid injection as they provide short / mid term relief at the risk of further degradation of the tissue.  

As others have mentioned go see a doctor, preferably someone who is familiar with climbing.  I've had the best luck with chiropractors who have experience with the hands.

Since it looks like you might be in the vegas area, I'd drive up to Salt Lake and see this person http://www.grassrootsphysicaltherapy.com/sports-physical-therapy/.  I've heard her podcasts on training beta and she has a wealth of information on climbing injuries.  Don't take this lightly, if it's a collateral ligament injury, then it's about 50 times worse than a pulley injury.

Both of my middle fingers are like this from collateral sprains. They have been getting better since I stopped taping them and started doing doing finger rolls. Avoiding climbing did nothing to help them.

I'm not a doctor, but I do have the same issue with my finger. I dislocated it at the PIP joint (middle knuckle) 2 years ago. "Healed" (so the doctors tell me), but with a lot of scar tissue, which restricts motion. Doesn't feel like the other fingers at all. Annoying as hell.

One thing I know for certain from a lot of research on my injury is that the PIP joint is very unforgiving to injury. My guess would be that you sprained it badly when you fell, and the resulting scarring is limiting your motion. A cousin of mine jammed his finger badly, and he has also lost motion at that joint permanently.

I've been told that scar tissue continues to mature until 18 months after the injury, so you might still see some improvement. Scar tissue massage might help.

I’ve had the same issues for years. Finally going to see a doctor and hand therapist about this. Been to several doctors and Pt’s who couldn’t give me a proper diagnosis or help in any way. I was recently referred to Lori Ann Hicks, a hand therapist at Glendale Adventist. She recommended Dr. Murtaza Rizvi, a hand surgeon at Huntington Orthopedics for all hand injuries. Saying he is one of the best. His schedule is booked out a few weeks, but I hope this helps. 

Could also just be synovitis and/or capsulitis of the PIP joint - caused by overproduction of synovial fluid in the joint capsule and thickening of the synovial membrane.

I haven't been able to close my fingers on either hand like you can with your right hand in years.

I think a collateral ligament injury would cause more pain specifically as you try to force a straightened-out finger sideways, whereas synovitis will just be dull generalized pain and swelling around the joint.

According to my hand therapist, you need imaging to get a proper diagnosis. If you can afford it, I recommend it. 

I have a similar "injury".  But I have no traumatic event in the past.  H-taping helps me a lot, I also have tried to limit the strain on it when gym climbing and trying to pay attention to how I crimp.  So far I've been experimenting with how to manage it, but real healthcare is on my mind too.

In my case, I have only soreness, never actual pain.  Swelling after a hard gym session, which can be somewhat managed with good taping.  My ROM is only restricted by maybe 10% at most, although I guess it would be if I really let it get out of control with swelling.  I return to 100% ROM after one day of rest.

Any healthcare specialist recommendations for the Front Range area?

I have had this for 2+ years. Saw doctor but it was useless. Resting didn't help, and eventually I just ignored it and kept climbing. Now both of my middle fingers are (permanently?) swollen and cannot extend completely straight, but I have been climbing consistently and harder than before without problem.

I have a meeting with a hand therapist tomorrow and doc in a few weeks. Hopefully I will be able share any gained knowledge with you all. Given it’s the same condition. An acupuncturist (in Korea) who I met with this summer told me the damage had already been done and management is the only way of dealing with it. He was trained in both western and eastern medicine but so far has been the only person to give me a clear answer.  

Ahram Park wrote: I have a meeting with a hand therapist tomorrow and doc in a few weeks. Hopefully I will be able share any gained knowledge with you all. Given it’s the same condition. An acupuncturist (in Korea) who I met with this summer told me the damage had already been done and management is the only way of dealing with it. He was trained in both western and eastern medicine but so far has been the only person to give me a clear answer.  

any info to share?

I've jammed (pretty severely) both of my middle fingers climbing (both jamming them into holds and tweaking them on awkward pockets/crimps) to the point that the first (PIP) joints are slightly painful and swollen pretty much nonstop. I've been to a couple hand surgeons over the couple years I've had the problem, one of whom frequently sees pro athletes and is therefore accustomed to the usual athletic finger injuries and requests to 'play through it'. They essentially said the following:
-It's mostly due to swelling/inflamation of/around the collateral ligaments
-The inflamation won't heal without substantial rest
-Continuing to be active won't hurt it long-term, and once I do decide to rest, the continued activity shouldn't affect recovery
-A cortisone shot could clear up the inflammation but comes with risk of joint damage
They gave me compression finger sleeves (digi-sleeves, I believe they're called) to reduce the swelling, which I've been less than diligent in wearing, but which help when I do remember them. I've basically decided that I can climb hard enough with the issue (barring the occasional tweaky pocket/crack) that I can live with the mild discomfort in exchange for not needing to take time off.

I'm bringing back an old post.  Hoping to hear some long term recovery stories from some of the posts here. 

I seem to be suffering from a similar injury. My index and pinky have been swollen for almost 3 months now. No pain, just swelling.  X-ray is normal. Been to a few climbing specialist chiro/PTs in the Boulder area. I can't get an official answer.  Probably tendinitis due to overuse and strain of collateral ligaments.  

I've been doing all the PT things. Massage, finger glides, heat, rice bucket, stretch, and super easy hangboarding. 

If it is a collateral ligament strain or some type of tendinitis, how long (if ever) did it take to fully recover?  Any updates info would be super helpful. Thanks!

Believe it or not, the swelling has actually gone down a lot.  Definitely a slow heal. 

dunno what my injury was as i was in spain and didn't have access to a PT or dr. I self-diagnosed as PIP and DIP synovitis. Took me ~3 months before i was back to normal. Your finger looks worse than mine did; however, it doesn't look like inflamation at the joints so maybe not the same thing?

Glad to hear it's back to normal. 

Unlike the OP, mine is not from blunt trama. It's just a persistent overuse thing that just doesn't want to go away. 

dsauerbrun wrote:

dunno what my injury was as i was in spain and didn't have access to a PT or dr. I self-diagnosed as PIP and DIP synovitis. Took me ~3 months before i was back to normal. Your finger looks worse than mine did; however, it doesn't look like inflamation at the joints so maybe not the same thing?

What did you do during those 3 months to recover?

i have a swollen finger that’s been like that for about a month. I haven’t climbed in all that time hoping it would go away, but hasn’t yet.

there’s no pain unless I do some pretty deep massage, but I also haven’t climbed on it.

Eze Sanchez wrote:

What did you do during those 3 months to recover?

i have a swollen finger that’s been like that for about a month. I haven’t climbed in all that time hoping it would go away, but hasn’t yet.

there’s no pain unless I do some pretty deep massage, but I also haven’t climbed on it.

I was fortunate in that I paid for my flights with miles so I was able to change things for free.

Basically I stayed in siurana for 6 weeks without climbing at all(it fucking sucked), I belayed a bunch and just worked as I was there working remotely.

My plan was to take a leave of absence in laos to climb there. I went for about a week and only climbed 5.9. Changed my flight to crash with my friend in the Philippines and go surfing.

Tl;dr: pick another sport that doesn't rely on a strong grip

These days I would make an appointment at the climb clinic in Colorado for a diagnosis and rehab plan. There are also climbing specific PTs in SLC and Los Angeles(Jared vagy) if you happen to live near there.