Help Diagnosing Finger Injury from Pocket Trauma (Ring and Middle Finger)

About two years ago, I experienced an injury in my right hand when leveraging (practically) all my body weight on a 2-finger pocket (used ring and middle, all others in full flexion) where I heard 3-4 pops. Afterwards, the area was a bit tingly and numb, but there were no obvious signs of large inflammation, though icing helped. I experienced, to the best of my memory, some trouble with rather “random” mundane tasks and trouble climbing for about two months. However, I was able to do some climbing better than other climbing afterwards, namely, full flexion crimps (half crimps open hand or not) were pretty much fine and now I am able to climb at my limit on everything, but splitting finger loads and pockets (I can crimp just fine).

I think I had tendons issues right away, but those healed back fast. Now, two years later, when I do pockets with slight torque (try to move up or down on them) or split my fingers in my right hand, I very easily experience pain.

When my fingers are loaded as seen below:

I experience issues here:

With issues at the area under the knuckles being the worst. I think there is pain under my ring finger knuckle too, but it is less noticeable that the tension and pain under the middle during “duo finger loading” when the other fingers are flexed down.

Moreover, the load required to feel a bit of pain with the duo configuration is orders of magnitude more than the load required to experience pain/problems when just loading my ring finger (“mono”) as shown below:

The pain experienced is show below:

Where the dark-black-filled-in part is extreme, some pain in the parts under the middle finger too, all the way down to the wrist, though not really experience in the wrist. No forearm troubles in this configuration.

These tests were done without torque, though it is important to mention that, in the duo configuration, when torquing, the load required to experience pain was much, much less, and it seemed that maybe part of the cause of the injury. I want to reiterate that the epicenter of pain (3-5/10) occurs between my ring finger and middle finger “large” (metacarpal) knuckles, and the area between my middle and index finger knuckles (3-5/10). Otherwise, some pain is felt in the A2/A3 joint area but its more weird tension stuff and slipping. Tendon tension and slipping is felt in the wrist, but no pain, really (0-1/10)

Final Notes:

Lastly, it is important to mention that, as of now, I can use all my flexor tendons; that is, I am able to move the tips of my fingers in all my fingers, when the movement to the other joints are restricted. It is no longer, if it was at all in the beginning, a flexor tendon issues, it is something more severe and deep, and something that probably has not fully healed, or healed wrong.  

Also, open hand pinches, like those used at the gym, cause me a slew of problems (in both my hands) but only cause pain in my right (screwed-up) hand in the same areas I was describing before. I attribute the trouble in my left hand dealing with these pinches to the fact that I think I have avoided them for years now and I do not have the proper muscle groups (or hand tendons/muscles) to deal with them. If anyone knows how to safely train for those as if you were coming back from an injury, please let me know!

Conclusion:

 Like I said before I can still pretty much climb in every fashion, aside from pockets and pockets that require me to split up my fingers (not even necessarily just pockets that require the duo configuration with flex index and pinky fingers.) Worth mentioning, my ring finger experiences pain pretty much ONLY when the other fingers are flexed (most notably the pink finger), though enough load will still render it useless even when the others are not flexed (aka while climbing mono ring finger).

I am really confused what kind of injury this is and why it has persisted on for so long. If anyone has any idea what it may be and the rehabilitative steps that I can got o fix it, I would be so very appreciative. Ac couple of articles that I found that were close, but not perfect, are listed below:

OP from Brendan: mountainproject.com/forum/t…

“Pocket Trauma”: http://drjuliansaunders.com/ask-dr-j-issue-172/

Thank you so much in advance! Happy climbing everyone!

-Jason

UPDATE EDIT:

I'm 95% this is a Lumbrical tear on my R 3/4 Lumbricalis (whatever the Latin name is lol)

My problem I face now is how might I break down the scar tissue in order to fully rehabilitate the muscle? It has been ~2y now so scar tissue has definitely developed and replaced the old tissue. Any thoughts help, thank you!

Sorry about your injury. Lumbrical injury sounds appropriate, esp given onset w/ pocket. https://trainingforclimbing.com/lumbrical-training-rehab/ might offer you something if you haven't already explored it.