Does ruptured A2 pulley ever actually heal?

curt86iroc wrote:

in addition to the above suggestions (warming up, flossing your tendons etc.), preventative taping is never a bad thing. I still tape my left ring finger even though its been fully healed for about a year now.

When you tape, how tight do you wrap the tape? What’s the sweet spot?

Blew my first A2 climbing over 15 years ago on a middle finger.  it made a sound louder than a champagne cork coming out, audible and nerve wracking to people about 50' away, which I assume was a full rupture. Took a while to heal naturally, but after 1-2 years where there was at least a little tenderness, it seems totally fine and strong, no bend or loss of range.

Blown out two others on different fingers since then, all healed back to full strength as far as I can tell with no surgery or specialized work.  I have definitely cranked plenty hard on them since then with no ill effects.  

Stay out of 1-2 finger shallow pockets with traversing type motions where your fingers roll.

Warm up slowly, I think lack of warm up was a factor in 2/3.

Taping does nothing but protect skin, it's only a placebo effect for your mental health at best. You basically cannot tape tight enough to take any real load off your finger tendons/ligaments to protect them.  If it does take real load, it might even hinder strengthening and physical feedback to build up finger strength. Taping might temporarily restrict range of motion to aid healing shortly after injury, but after that, I'd stop. 

Ryan Johnson wrote: So it has been close to a year and a half since my injury and initial post.  It is probably good to return and report what I have learned and experienced.  In short, I actually seem to be better off now than I was before my A2 pulley ruptured.  For a couple of years before the accident I struggled with the pulley getting a little sore towards the top when I over did it, requiring taping and time off to recover--over and over again.  Now it never, ever hurts no matter how hard I push it.  However, I do have to be careful with my A2 pulley on my ring finger on the opposite hand.  

After the injury I sought advice from two hand surgeons.  The first one told me the pop I heard was a complete rupture, that it would never heal and that I was not worth more than five minutes of his time (the last sentiment was implied).  The second surgeon described a scenario where I would heal to an extent; that the pulley would never be very tight and supportive but that it would likely not be flapping around in my finger if I stayed off it and gave it a chance.  He also predicted that I would not have too much trouble with inflammation.   He was correct. I have not struggled with inflammation.  When I first started climbing again my knuckle felt really weird and strained but it has adapted so it feels normal now.  I do not tape it at all.  It bowstrings less now than after the initial injury so something happened that caused it to firm up a little in the area where the A2 pulley ruptured.  

I found the book "Climbing Injuries Solved," by Lisa Erikson to be helpful.  None of the doctors I saw wanted to splint my finger as recommended by the research Erikson cites so I splinted and tapped it myself in hopes something good might have come of it.  No surgery was definitely good advice.  The body is amazing at adapting.  I just turned 46 and am enjoying climbing regularly with my kids and am right there with them when it comes to setting goals and striving for climbing dreams though they progress much faster than I do.  

Same here wrt the splint.  I ruptured (partial or full unknown) my A2 pulley on left ring finger and my doctor splinted it with what looked like a plaster type ring (half circle) with a piece of velcro to hold it tight.  No problems after about 6-8 weeks.

I've had audible pops and swelling (double normal circumfrence) on 4 fingers. I never got them checked so no idea what I did.

I mostly immobilized them for a month. Then started light movement with no resistence. Then hobbled along with a mix of rest and taping and climbing for months or years.

I took 6 months off climbing with one of my worst until Dr. Bill Ramsey basically called me an idiot and told me to go climbing. I did 10 pitches of under 5.10 a day w it taped. I was pain free after a month. The next one I rested a month then did the easy climbing thing and was golden.

(I know the taping only reminded me that I was injured and did not provide structural support)

I thought "the studies" broke scores of cadaver fingers and didn't see much of a statistical difference between taped and untaped. That's from over a decade ago and my memory sucks.

Bill's advice was WAY better than the 4 PT's I saw.

Fehim Hasecic wrote:

When you tape, how tight do you wrap the tape? What’s the sweet spot?

My preference is the H pattern and generally just tight enough to feel some pressure on the tendon. 

And a note for those who think taping doesn’t support your pulley, I’m not really sure where you are getting your info from, but my PT definitely recommended it after my injury. Also, when I do range of motion exercises with and without tape, I can feel the tendon being restricted by a proper H tape pattern. 

I partially ruptured A2 pulleys on two separate occasions, and they both completely healed.  I took about 6-8 weeks off both on both occasions.  Both instances involved full crimping, dehydration, and multiple days of climbing in a row.

Ned Plimpton is spot-on regarding hangboarding.  I'm of the mind that pretty much everyone who's serious about climbing should try to hangboard at least once a week for basically the entirety of their climbing career.  It's simply money in the bank.

I appreciate the hangboard advice.  Nice to have a proactive strategy.  

Www.Rocknsport.com is much better than taping

Hi everyone, new climber here (and also forum newbie)! I've injured my A2/A3 pulleys on my 3rd and 4th finger some 6 months ago as a result of overcrimping and hanging on a tiny hold for way too long. Didn't hear any pop or notice any shape change apart from swelling the next days, so I assumed it wasn't a full rupture, but the consequences were quite serious enyway.

Could't hold a cup for bend fingers for more than 20 degrees for a week, and improvement has been really slow. I couldn't hold a knife to slice bread for a month, only recently started going through the day without constantly thinking about my fingers (took a long time to be able to carry grocery bags, open jars, etc. without pain or without thinking that I have to be careful to avoid pain).

I've immobilised the fingers for the first few weeks, then taped them to limit motion, did some stuff to improve blood flow, etc. Did try climbing once after approx. 3 months but realized immediately it was way too soon...

I can feel my fingers slowly getting normal again and regaining the strength. The only thing that's still bothering me now is the 'morning finger wood' that doesn't seem to go away! Fingers are slightly swollen and a bit tender when I wake up, but it goes away in a minute or two of gentle movement. I used to experience this after training even before the injury and didn't worry, but now as I guess it's injury related I think have to wait until it completely goes away before I climb again.

What do you think? I'd rather be on the safe side, as I really don't want to risk repeating the injury. And I want to climb again!

Talked to my doctor but all he said was 'just a sprain' and 'I should rest a bit and it will be fine' (that was 6 onths ago).

Welcome to climbing and crimping. Pretty much everyone I know that climbs with some regularity has the "morning finger wood' that you mention. If that's all that's left of your injury, then get back to it while being cautious. Massage of fingers is always helpful, even when you're not injured.

Reviving this thread. I have a tear (not sure if partial or full) of A2 pulley in ring finger of left hand. MRI simply says flexor tendons are displaced in the volar (palm-side) direction from the fourth proximal phalanx which is most consistent with an A2 pulley tear. PA at ortho clinic referred me to hand surgeon and says I'll need surgery. Waiting to get in with hand specialist for confirmation. But seems like there is little consensus out there about a single A2 pulley tear and how it should be treated (with/without surgery). It's been about four weeks since the injury. Finger is sometimes feeling good, sometimes not. Doesn't hurt when at rest. But when making a fist, that finger is pretty tight. And it's stiff/sore in the morning. I've tried climbing a few times and it's ok. I just don't use that finger when I do and I'm climbing a couple grades below my usual level. And taping.

first off, I'd like to apologize for being a dick in my previous post. FourT6and2, I've become a bigger and bigger fan over the last few months of very light hangboarding for tendon health. The current science has drifted away from straight up rest (this is after the acute injury has healed some) more towards rehabilitation through light use, meaning hangboarding at very low intensity. Hangboarding might sound like the worst thing to do for an injured finger, but if you take lots of weight off (like 60-70% of your BW off) it becomes a very controlled way to load the finger, with no chance of a foot slip, weird hold, etc re-injuring it. I've certainly found this to be true in my own climbing. I'd still go see the hand specialist though because I'm just some jackass on the internet. when you say "I've tried climbing a few times and it's okay" does that mean while using the finger it's okay, or while not using the finger?

Lincoln S wrote:

first off, I'd like to apologize for being a dick in my previous post. FourT6and2, I've become a bigger and bigger fan over the last few months of very light hangboarding for tendon health. The current science has drifted away from straight up rest (this is after the acute injury has healed some) more towards rehabilitation through light use, meaning hangboarding at very low intensity. Hangboarding might sound like the worst thing to do for an injured finger, but if you take lots of weight off (like 60-70% of your BW off) it becomes a very controlled way to load the finger, with no chance of a foot slip, weird hold, etc re-injuring it. I've certainly found this to be true in my own climbing. I'd still go see the hand specialist though because I'm just some jackass on the internet. when you say "I've tried climbing a few times and it's okay" does that mean while using the finger it's okay, or while not using the finger?

That means while not "really" using the finger. I H tape it and then buddy tape it to my middle finger and when I climb I try not to put weight on that finger and I'm not climbing anything overhung and I stick to easy routes. I'm usually a 5.11d - 5.12a climber and have been sticking to 5.9 - 5.10c. I don't know if it's a partial or full tear at this point. Not sure if there's any way to tell without a surgeon actually cutting me open to find out. MRI doesn't show it from what the radiologist report says.