Dupuytren's disease

Any climbers out there also have beginning stages of dupuytren's disease?

  It started as two small modules in my right hand right under my little and ring finger and now i also have it in my left.  Doesnt affect daily activities or climbing.  But they do get really sore with holds that bit into your palm.

 Looking to see if i should get it checked out and preemptively needled or wait and see if they progress.  No real curling of fingers.  Just stiffness that goes away after stretching 

I got one elongated hard spot in my left palm about 3 years ago.  It didn't really hurt unless I put direct pressure on it, but seemed to be slowly getting bigger.  I eventually went to the doctor, who confirmed that it was Dupuytren's, but did not recommend doing anything about unless it got worse.  I didn't do anything to treat it, and still climb about the same amount as I did before, and it hasn't caused any problems at all.  I can still feel it now if I think about it, but I think it's gotten smaller (or maybe I've just gotten used to it).  I have no idea if my case is typical, but at least in one case ignoring it worked fine for 3 years and counting.

Lots of posts about it on MP. Here's one

https://www.mountainproject.com/forum/topic/108056470/help-lump-in-palm-possible-pulley-injury-or-dupuytrens

I’ve literally had it for probably 20+ years. It’s never hurt or for that matter bothered me up until maybe the last year. No finger bending or stiffness - just seemed to have gotten bigger and I notice them mostly mountain biking and climbing ice. Not so much rock climbing. Will probably see a doctor soon. For reference I’m 60. 

I had something similar pop up two years ago. My hand / palm was stiff and slightly painful for three or four weeks when the bumps first appeared. Eventually the pain / stiffness went away but the bumps are still present. I got it checked out by a doctor just to be sure climbing wouldn't make it worse. The doctor said regular climbing and stretching won't negatively impact the condition. The doctor said to come back if it gets to the point where the bumps progress into elongated nodules and start the curl the fingers. I guess there are a variety of surgeries / treatments if it gets to that point. For what its worth, the doctor said that some people never progress to the point where treatment is needed. 

Hi all, saw this post from a few days ago. i put some comments from a while back on another conversation on Dupuytrens. In february i had a xiaflex surgery on my 60 deg closed little finger. I had been climbing hard with the hand, finger just stuck, but first xiaflex didnt release the little finger, bit dissolved some of the nodules and cords. Only had kn left hand showed up about 6 years ago. But the feb. treatment, quite brutal as its painful and risk of tearing tissue is high, but the finger is straight again! Took a month ir so for tear to heal. I am now returned to portland, and licensed acupuncturist here and in colo, and can offer what i did for my hand(s). In the end however, the more aggressive the disease, the xiaflex is the best option to release contractures, dont do surgery, scar tissue! thanks hope all are well!

I am 60 and had my first bout with Duputreins in my 20s and first operation in both hands in my early 30s. Yes, I am the rare case that gets affected before your 50s or 60s. I am reaching the point the contraction in my right hand has progressed to the point where I need to so somthing. It has never affected my climbing, though it takes a bit of manipulation to get my ice climbing glove on at times.

There are some new techniques that can be applied if your tissue nodules are in your fingers, but not many options if they are in the palm like mine. 

You should put off any operation till finger contraction really gets in the way of life and/or climbing.

It sucks, but it is not cancer.

Hi Michael, the xiaflex is an enzyme injection that eats through the adhesions and nodules. It really does work. Medicaid approved option over surgery.

I was diagnosed with this a few months ago. I first noticed a spot on my left palm shortly after a climbing trip. I am 40, which is relatively young to have symptoms. The hand specialist said that it may get worse or not and to just monitor it for now. So far, it has not affected my climbing, but I do notice it a little after lifting weights and gripping a barbell. I am hoping for treatment to get better in the future if I ever need it.    

plantmandan wrote:

I was diagnosed with this a few months ago. I first noticed a spot on my left palm shortly after a climbing trip. I am 40, which is relatively young to have symptoms. The hand specialist said that it may get worse or not and to just monitor it for now. So far, it has not affected my climbing, but I do notice it a little after lifting weights and gripping a barbell. I am hoping for treatment to get better in the future if I ever need it.    

I've had the contracture for a long time and tape my hands prior to lifting. It works fine--no discomfort associated with the lifting. Another possibility are gloves. I like bicycle gloves better than lifting gloves. In the picture the taping also goes around the wrist. That's because of bone chips in the wrist. The tape is Meister Tape. Good for lifting and boxing but tears too easily to be used for climbijng

Thanks for the info, Rob. I'll try that.

Julian H wrote:

There is an article in the current issue of Rock and ice on Dupuytren's . They mention the enzyme injection as one of the best options for climbers. 

I subscribe to R&I but seem to have missed that article. Anyway, it just came in my email inbox.

https://rockandice.com/climbing-injury-prevention/curse-of-the-vikings-dupuytrens/ 

I’ve had the xiaflex surgery twice, i no longer have contracture of little finger, but still have the fascia sheath thickness and tightness

I had the nodules show up in my right hand when I was about 36. No problems for quite awhile and even a number of years when nothing changed. About 2 years ago things started to deteriorate and my ring finger started to get quite fat near the palm. Short story was my crimp strength was rapidly heading south and some hand jamming was becoming very hard/painful because my ring finger was being pulled towards my palm. I’m 48 now and had the ‘release’ surgery less than 2 weeks ago on January 14th. So far incision is still healing but my fingers are all in a row now and my hand can sit flat on a table. That is encouraging, gonna just have to wait and see how it turns out but bottom line for me was that I needed the surgery whether it helps my climbing or not. I work as a machinist and I’m just not ready to ‘move on’ from being an obsessive climber.

55 and have had Dupuytren's for about 20 years in my right hand with several fingers implicated.  When it got bad enough I had needle aponeurotomy with Dr. Eaton in Jupiter FL about 10 years ago. He was the guru of NA but no longer practices medicine. He now runs a foundation for Dupuytrens's research.  It got my hand mostly flat, but he could not release all the diseased tissue in one finger because he was hitting the nerve.  Recovery was pretty quick, I was mountain biking in about 3 weeks. Unfortunately, it came back and I had orthoscopic surgery with a Doc in Pheonix about 7 years ago, it is a special technique that only this one Doc does. It did not go well. The recovery was 10 weeks or more and my hand was not flat after the surgery. It came back again and about 5 years ago I had NA again with Dr. Denkler in the Bay Area.  He was really aggressive in getting at the tissue and it took very long time to heal, 8 weeks until it started to feel normal and months until all the pain and numbness went away. My hand was not entirely flat after the procedure.  3 years ago I had surgery using the McCash open technique with Dr. Butzen in Durango, CO. For that surgery they cut across your hand in several places and remove the diseased tissue. You then leave the incisions open while they heal, soaking them in a saltwater solution 3x a day.  I was skeptical, but of everything I have had done that worked the best. Recovery was about 6 weeks and my hand is totally flat and there has been no progression in the disease. I can climb, mountain bike, etc without any issues. 

 I never had the Xiaflex.  If I had it to do all over again I would probably have gotten the surgery on the second go around.  I think that once it becomes apparent that the disease is going to continue you are better off getting the diseased tissue removed, as opposed to sticking with minimal intervention.  

Just a little follow up on my progress from surgery which was on the 14th of January. Incision was 3 weeks to heal fully, skin was trashed and peeling for about another 10 days after that. Started climbing in the gym on jugs and V0’s at 5 weeks post op. Headed outside to climb 5.10- routes beginning of March (felt weak). Slowly added to the intensity every week thereafter, last week at exactly 15 weeks post op sent my first 12d since surgery. Been noticing my hand strength coming back even more and my hand is still nice and flat. Pretty much feeling close to ready to start projecting 5.13 again shortly. Essentially everything has gone way better than I imagined and it looks like things are going to work out great for this season.

Great to hear, Jani. 

Since Dupuytrens will never go away, its not a one time fix, the disease is a wound healing adaptation, once you get surgery with scar tissue, it will be even harder to release any contractures one gets in the future. The xiaflex removes the adhesions, I was climbing 5.11-12s two weeks after the last xiaflex and still strong, hand flat. For anyone removing tissue from a hand, there will be consequences in the future to deal with, I'd do the injection therapy over surgery.

Just checking in to see how everyone’s doing. I recently found out—with my doctor’s help—that I have the same condition my mom developed in her 70s and 80s, Depuytrens Contracture. It looks like nearly two decades of climbing may have accelerated the process for me.  I’m honestly feeling pretty heartbroken at the thought of not climbing, but I’m doing what I can: loading up on magnesium and turmeric daily, using topical magnesium (salve and spray), and starting physical therapy soon to focus on the right exercises. I also read that alcohol can worsen the condition—has anyone here cut it out completely? I usually drink moderately, but I’m wondering if it’s worth giving it up altogether to support my hands.

How’s everyone’s quality of life with this? Would really love to hear how others are managing.

Nico C wrote:

Just checking in to see how everyone’s doing. I recently found out—with my doctor’s help—that I have the same condition my mom developed in her 70s and 80s, Depuytrens Contracture. It looks like nearly two decades of climbing may have accelerated the process for me.  I’m honestly feeling pretty heartbroken at the thought of not climbing, but I’m doing what I can: loading up on magnesium and turmeric daily, using topical magnesium (salve and spray), and starting physical therapy soon to focus on the right exercises. I also read that alcohol can worsen the condition—has anyone here cut it out completely? I usually drink moderately, but I’m wondering if it’s worth giving it up altogether to support my hands.

How’s everyone’s quality of life with this? Would really love to hear how others are managing.

Hey Nico! Sorry to hear about your diagnosis. Mine started 6.5 years ago. Came on suddenly as far as I noticed with on both palms 2cm long and 1cm high lesions tapering toward wrist and kind of painful at first.

quit drinking 4 months later and I have had no progression. My understanding is that a fair number never progress. My hand surgeon said not to worry unless it's progressing.

Quiting alcohol is never a bad idea. Links to cancer are impossible to ignore at this point. Booze in the 2030s will become the cigarettes of the 1960s. 

I started developing a lump in my palm under my left ring finger in my late 20s. After about 5 years I could not straighten my finger all the way and experienced soreness when supporting my weight in my palm (like push ups). I had my first kid last year and my climbing has slowed down a lot. I’d say my hand has improved by about 50% since reducing my climbing (from 3-4 times a week to about once a month). For reference my dad is 72, not a climber, and his same finger only opens about half way. So I was destined to have issues but climbing seems to speed up the symptoms.