Trigger Finger Release Surgery? Anyone?

This past summer I had a relatively sudden onset of pain and weakness in my pinky finger. Diagnosed with trigger finger (stenosing tenosynovitis). Steroid injection #1 cleared it up for about six months. Came back. Steroid injection #2 cleared it up for about two months. Came back. I've just had injection #3 - the last one I'm allowed - and again, it is clear, but at this point I'm considering surgery once it inevitably returns.

Hand surgeon says the release procedure, which basically involves cutting the A1 pulley), has minimal downtime (1 month, mainly for incisions to heal), will relieve the pain, and will not affect my strength at all. I pushed the doctor on this last point and he firmly believes the A1 pulley is not a critical one for climbing.

Has anyone out there climbed 5.13 after this procedure? I'm curious if I'll still be able to crimp or climb finger cracks the same way? Any success or failure stories?

Thank you!

Dan Daugherty wrote:

Does amputation at that joint count as a similar case? Still lost function of that pad as a worse case scenario but Mr. Caldwell has climbed pretty hard since.

I think about it occasionally. Caldwell initially had his finger reattached but when it became clear that it would neither be strong nor pain-free, he elected to have it amputated. Honestly, I know I don't need the finger to climb what I want to climb, but I need to deal with the pain and associated weakness from this condition. So if anyone has first-hand experience with the release surgery, I'd love to hear more. I guess if it doesn't work out for me I could always hit the table saw...

‘They’ say you can only have 3 steroid shots in a calandar year, not a lifetime.  Just sayin. 

Ive had trigger finger from a combination of work and climbing and was able to get back to normal after a couple months with r&r combined with some painful massage. The human body is amazing in that tight muscles from your shoulders and upper arm can affect fingers which was the case with me. Doctors love to be reactive rather than proactive, especially the surgeons.

Thanks M - and it looks like your climbing isn't suffering as a result. Can you share with me some of your massage regimen? Feel free to PM me if that's easier.

Josh Janes wrote:

Thanks M - and it looks like your climbing isn't suffering as a result. Can you share with me some of your massage regimen? Feel free to PM me if that's easier.

The first step is finding a competent sport massage person or even a good PT who actually feel you out. I was lucky for years living in a city with three massage therapy schools and a partner who was a climber PT , I couldnt name specifically what muscles were causing it or even exactly what was done but it worked and was not that uncommon. 

Based on research A2 and A4 have been shown to be most crucial pulleys to prevent bowstringing. Pretty easy procedure but if you are looking to avoid it your best bet is rest. The FDS is inflamed and having difficulty traveling through the pulley. Full fisting will cont to irritate and trigger the finger so blocking full fisting at the MP or PIP is your best option for 6 weeks (but do passive motion to maintain motion) if you haven’t tried that yet but based on research it can also depend on what grade trigger you are. The more advanced you are the less likely you are to respond to conservative management but then again the body can surprise you. 

Sydney B wrote:

Based on research A2 and A4 have been shown to be most crucial pulleys to prevent bowstringing. Pretty easy procedure but if you are looking to avoid it your best bet is rest. The FDS is inflamed and having difficulty traveling through the pulley. Full fisting will cont to irritate and trigger the finger so blocking full fisting at the MP or PIP is your best option for 6 weeks (but do passive motion to maintain motion) if you haven’t tried that yet but based on research it can also depend on what grade trigger you are. The more advanced you are the less likely you are to respond to conservative management but then again the body can surprise you. 

Pretty sound advice. If the fds tendon is inflamed it will hurt to crimp.  I’d that doesn’t hurt than it’s the tendon sheath that is irritated and treatment would focus more on mobility.  Tape the a4 when u climb and Go see an OT or hand PT before surgery is my best advice!