Ring finger tendon tear (pulley)

Today after my training session I was messing around with a few scatter wall problems I have established in my "gym" (garage) I had my headphones in full volume when I heard the POP, I instantly fell and felt the pain. I was able to move it and bend it but there is no strength to it. Can't pull at all or squeeze. I currently am icing it (as much as possible from my van) have it in a splint and am planning on taking a bunch of ibuprofen. After checking the internet I believe it to be a torn tendon.

Does anyone have any advice on care for this. Or how long it took you to recover? I recently redpointed my first 12a and am projecting and training hard for Yosemite season. Really hoping I only lose about a month... anyways any advice or stories will help. Thank you!

Ps. Sorry I can only respond to 3 people a day. But I appreciate all this support and advice! I will respond in order each day hah...! 

All I can say is good luck. It took me 6 months to fully recover from mine (ring finger also) and a significant portion of that time was spent not climbing. This is a pretty common injury and there is a lot of good info out there on how others have recovered. All I can say from my experience is don’t start back up too soon. After about a month I tried taping my finger and doing a few sessions in the gym...not a good idea.

curt86iroc wrote:

All I can say is good luck. It took me 6 months to fully recover from mine (ring finger also) and a significant portion of that time was spent not climbing. This is a pretty common injury and there is a lot of good info out there on how others have recovered. All I can say from my experience is don’t start back up too soon. After about a month I tried taping my finger and doing a few sessions in the gym...not a good idea.

Ugh. Was kind of worried of hearing these stories... thanks for the info! I'm definitely already thinking of ways to climb without this finger.. definitely need to just chill and wait it out.. thanks again for responding!

I’ve had three pulley tendon tears over the years. They have all taken 5-6 months to heal fully. Which is exactly what the hand surgeon told me it would take when I went to see him after my first one. 

I had a pulley tweak (no pop) about 2 months ago and I'm about 90% back. I still stay away from roofs and aggressive crimping and do more open hand grips. You'll find a few good physical therapy sources on the internet that all say pretty much the same thing:

Control accute pain and swelling

Rest for up to a week for major sprains

Mobility exercises until you recover full range of motion

Start loading exercises (palm crimps are good to start). It's really important to gradually increase the load.

Once you can hang a quarter of your body weight you can start very light climbing.

phylp phylp wrote:

I’ve had three pulley tendon tears over the years. They have all taken 5-6 months to heal fully. Which is exactly what the hand surgeon told me it would take when I went to see him after my first one. 

Wow. Much longer than I was expecting.. tough news. Thanks for your response, appreciate it!

Same here, about 6 months

I'm no doctor but I've looked into a lot of information on this for myself and I had repeated pulley issues for years from coming back too soon and incorrectly. After the most recent tweak I found this Article. I had always tried to rest it until I thought I was ready to climb again (often too soon) and i had never done progressive loading to help it reform properly. 

I would say give it time but once through the acute injury stage don't just rest it. I know several people who've done that only to reinjure the finger months later. Depends on how bad the tear is how soon you can start activities to recover. 

As an aside a pulley isn't a tendon it's a ligament, this means the blood flow is typically quite low and slow to heal. It might seem like a small difference but the recovery process and timeline is usually different for a ligament vs tendon.

Help it heal properly and you will thank yourself later.

Yoda Jedi Knight wrote:

I had a pulley tweak (no pop) about 2 months ago and I'm about 90% back. I still stay away from roofs and aggressive crimping and do more open hand grips. You'll find a few good physical therapy sources on the internet that all say pretty much the same thing:

Control accute pain and swelling

Rest for up to a week for major sprains

Mobility exercises until you recover full range of motion

Start loading exercises (palm crimps are good to start). It's really important to gradually increase the load.

Once you can hang a quarter of your body weight you can start very light climbing.

I'm super nervous about crimps. It's my favorite and best style of climbing.. sounds like it'll be awhile until I'm back crimping. Appreciate the exercises and response!

Climb On wrote:

Same here, about 6 months

Seems like the consensus is I'm going to be doing a TON of aid climbing for the next 6 months....

Potter Wonderland wrote:

Wow. Much longer than I was expecting.. tough news. Thanks for your response, appreciate it!

Mad hatter, I'm sorry about your injury.  But I never completely stopped climbing with these injuries, after the first month.  I just shifted my focus.  Buddy taped the injured finger really tight to the adjacent finger so I couldn't use it and did easy, lower angle crack routes, esp longer ones, slab climbs etc.  You could probably still climb all the runout easy and hard slab routes on GPA with your finger taped!

Wait until you have you first rotator cuff surgery and really can't climb for 5-6 months!  (Of course I hope you never experience this).

Mike wrote:

I'm no doctor but I've looked into a lot of information on this for myself and I had repeated pulley issues for years from coming back too soon and incorrectly. After the most recent tweak I found this Article. I had always tried to rest it until I thought I was ready to climb again (often too soon) and i had never done progressive loading to help it reform properly. 

I would say give it time but once through the acute injury stage don't just rest it. I know several people who've done that only to reinjure the finger months later. Depends on how bad the tear is how soon you can start activities to recover. 

As an aside a pulley isn't a tendon it's a ligament, this means the blood flow is typically quite low and slow to heal. It might seem like a small difference but the recovery process and timeline is usually different for a ligament vs tendon.

Help it heal properly and you will thank yourself later.

Thanks for the article. Definitely going to check that out. Been trying to find any and every piece of information on this injury!! I'm terrible at letting things heal properly, but thinking really going to have to for this. 

Here is a resource if you have not already seen it for evaluating the severity of the injury and timelines for recovery: https://theclimbingdoctor.com/pulley-injuries-explained-part-2/ 

From my personal experience with A2 pully injuries, I have found that if I follow a good rehab program and avoiding tweaking or re-injuring the finger, I have been able to get back to climbing at a decent level within 3 months while wearing a pully protection splint. It has typically taken me 6 months to be more or less back to full strength. Not following a rehab program essentially doing nothing or trying to climb too hard too early can cause these types injuries to drag on for up to a year.

Along with the other resources, here's some general finger info given in an easily digestible way: https://www.youtube.com/watch?v=h7TaPA0O1JE 

I'm about a month into my rehab for this injury, I've been roughly following the Esther Smith protocol that mike posted upthread with pretty good results. Thinking to return to easy open handed climbing in 2 weeks.

TLDR is absolute rest for only a week or two, then start progressively loading. Dial in the weight to replicate the pain in a way that doesn't last, (like you feel discomfort but it subsides within a few minutes after you stop hanging) and adding weight as time goes by and the tissues heal. 

The other thing you want to start doing right away is anything you can to encourage blood flow to the pulley, as they don't get a lot of blood perfusion on their own. Massage, rice buckets, contrast baths, blood flow restriction bands, anything that increases blood/lymph to flow through that area is going to help it heal faster.

I've also been taking collagen and vitamin c (these are the building blocks of the tissues the pulley consists of), the science is a little mixed on whether collagen is any better than any other protein, but it isn't too expensive and can't hurt. Try to stay well hydrated and get good sleep.

Sorry to hear about your injury, I known the feeling.

If you've heard the POP you most probably have a complete rupture or partial tear of the pulley.

I've had a complete rupture of two pulleys in my middle finger. Bad news is it took 4-6 months to get it healed and get back to my previous level of climbing (around V7 bouldering). Good news is that the rehabilitation left me with stronger fingers and better understanding and use of the different hand positions we use when climbing.

There's two things I recommend you to do at the moment: accept you have a bad finger injury which means you have to take time off climbing and invest in rehabilitation of the injury. And get the injury diagnosed by a proper climbing fysiotherapist (with an ultrasound) and get a rehabilitation program with help of the fysiotherapist.

From my experience your program will look something like this:

- few weeks of immobilisation phase. Taping to get rid of eventual swelling of the finger.

- rehabilitation hangboard exercises. Gently putting pressure on the finger in different positions to help the healing process. Starting something like 10 kg of pressure in openhand position slowly building up over months. In my case I didn't do a full bodyweight hang for over 4 months! I ended the hangboard program while still taking off about 10% of bodyweight.

- while doing the rehabilitation hangboard program gently start to climb on jugs. First only open hand, then pinching and after a few months gently start halfcrimp position. I was advised to only boulder since it's easier to read a boulder and make sure the grip positions are the ones you want to train on. Plus the rehabilitation is about finger strength. Endurance doesn't have anything to do with finger injury rehab.

I would strongly advise you not to think about ways of climbing around the injury (buddy taping, not using the finger in question etc.) But fully accept your condition and invest in getting the finger stronger and healthy again. This way you'll lose the least amount of time and your performance will be back to the previous level sooner than you might think. 

I took up (trail) running while doing my rehab and had some wonderful experiences in the mountains which I wouldn't have had if I didn't get the injury. Try to make something positive out of your time off climbing.

Good luck!

(The above is merely a description of my experience with my pulley injury. Yours might be different. Get it diagnosed by a professional)

nowhere wrote:

The other thing you want to start doing right away is anything you can to encourage blood flow to the pulley, as they don't get a lot of blood perfusion on their own. Massage, rice buckets, contrast baths, blood flow restriction bands, anything that increases blood/lymph to flow through that area is going to help it heal faster.

I was advised when dealing with a partial or complete tear of the pulley to NOT massage the tissue. This can damage the tissue further or cause inflammation.

Highlander wrote:

Here is a resource if you have not already seen it for evaluating the severity of the injury and timelines for recovery: https://theclimbingdoctor.com/pulley-injuries-explained-part-2/ 

From my personal experience with A2 pully injuries, I have found that if I follow a good rehab program and avoiding tweaking or re-injuring the finger, I have been able to get back to climbing at a decent level within 3 months while wearing a pully protection splint. It has typically taken me 6 months to be more or less back to full strength. Not following a rehab program essentially doing nothing or trying to climb too hard too early can cause these types injuries to drag on for up to a year.

The link you attached didn't work. Anyway you could try to resend it? Would love to see the severity as I do live out of my van with no health insurance.. going to a doctor to see how bad it is, is out of the question for me.

Ian MacDonald wrote:

Along with the other resources, here's some general finger info given in an easily digestible way: https://www.youtube.com/watch?v=h7TaPA0O1JE 

Appreciate the response!! I will check this out.

nowhere wrote:

I'm about a month into my rehab for this injury, I've been roughly following the Esther Smith protocol that mike posted upthread with pretty good results. Thinking to return to easy open handed climbing in 2 weeks.

TLDR is absolute rest for only a week or two, then start progressively loading. Dial in the weight to replicate the pain in a way that doesn't last, (like you feel discomfort but it subsides within a few minutes after you stop hanging) and adding weight as time goes by and the tissues heal. 

The other thing you want to start doing right away is anything you can to encourage blood flow to the pulley, as they don't get a lot of blood perfusion on their own. Massage, rice buckets, contrast baths, blood flow restriction bands, anything that increases blood/lymph to flow through that area is going to help it heal faster.

I've also been taking collagen and vitamin c (these are the building blocks of the tissues the pulley consists of), the science is a little mixed on whether collagen is any better than any other protein, but it isn't too expensive and can't hurt. Try to stay well hydrated and get good sleep.

Thank you for responding. This is giving me a little more hope. Although I am coming to terms with the fact I may not be able to climb my favorite style or at my limit for 6 months..

I was curious if anyone took anything supplement or vitamin wise so thank you for that as well. Going to get some.

Halbert wrote:

Sorry to hear about your injury, I known the feeling.

If you've heard the POP you most probably have a complete rupture or partial tear of the pulley.

I've had a complete rupture of two pulleys in my middle finger. Bad news is it took 4-6 months to get it healed and get back to my previous level of climbing (around V7 bouldering). Good news is that the rehabilitation left me with stronger fingers and better understanding and use of the different hand positions we use when climbing.

There's two things I recommend you to do at the moment: accept you have a bad finger injury which means you have to take time off climbing and invest in rehabilitation of the injury. And get the injury diagnosed by a proper climbing fysiotherapist (with an ultrasound) and get a rehabilitation program with help of the fysiotherapist.

From my experience your program will look something like this:

- few weeks of immobilisation phase. Taping to get rid of eventual swelling of the finger.

- rehabilitation hangboard exercises. Gently putting pressure on the finger in different positions to help the healing process. Starting something like 10 kg of pressure in openhand position slowly building up over months. In my case I didn't do a full bodyweight hang for over 4 months! I ended the hangboard program while still taking off about 10% of bodyweight.

- while doing the rehabilitation hangboard program gently start to climb on jugs. First only open hand, then pinching and after a few months gently start halfcrimp position. I was advised to only boulder since it's easier to read a boulder and make sure the grip positions are the ones you want to train on. Plus the rehabilitation is about finger strength. Endurance doesn't have anything to do with finger injury rehab.

I would strongly advise you not to think about ways of climbing around the injury (buddy taping, not using the finger in question etc.) But fully accept your condition and invest in getting the finger stronger and healthy again. This way you'll lose the least amount of time and your performance will be back to the previous level sooner than you might think. 

I took up (trail) running while doing my rehab and had some wonderful experiences in the mountains which I wouldn't have had if I didn't get the injury. Try to make something positive out of your time off climbing.

Good luck!

(The above is merely a description of my experience with my pulley injury. Yours might be different. Get it diagnosed by a professional)

Thank you for sending over what your doctor had recommended. Im also reading online that seeing a doctor would be a really good idea.. however.. I don't have health insurance and my money goes to keeping me climbing without having to work.. so doctor is kind of out of the works for me but I'm considering spending the money to see if its partial or fully torn. Today it seems much better than the first 2 days. Almost full movement but obviously haven't tried crimping or anything.