Weird pulley injury and advice?

Hey guys, I am conflicted on this injury recovery. About 3 1/2 weeks ago I seemed to have injured my ring finger mildly (a3 pulley) and took a week off. It hurt putting pressure where my a3 pulley was but that gradually disappeared after the week I took off so I went climbing again. Everything was fine until my last climb and the finger felt funny again so I decided to make an appointment with the hand specialist the next day. Dude said yeah you injured your pulley but it’s not a full rupture so your lucky. He put me in a full forearm splint (like the kind of cast you get for breaking your arm, kinda overkill imo) and completely immobilized my fingers/hand for 2 weeks. I got that off yesterday but my finger seems to hurt more now than before I got it on?? Like it hurts/is sore to the touch as well as moving it around whereas before it was mainly just to the touch where it hurt. So he gave me a hand brace, which splints my fingers and told me to keep it on for another 2 weeks but everything online says to begin functional therapy after 2 weeks of immobilization. What do?

Edit: Also to add, it seems to hurt worse if I extend my fingers more so than bend them. It still slightly hurts to bend but extending is worse.

I would try to book another appointment, but ONLY with a physical therapist. They can often assess correctly just with a consult, but ultimately they will ideally also have an MRI or ultrasound done. Some climbing gyms have PT's that work with the gym and do ultrasounds to check the extent of damage, and that is cheaper than an MRI.  Also if you can, ask around and find a PT that has worked with climbers before, or is a climber. I've heard othro doctors say splint it for 2 months, no breaks. I've heard other people say H tape it and start using it after a month.. Either way any good physical therapist will tell you if it hurts, don't do that. Instead find areas of discomfort and gently strengthen around the injury first before loading the injury 4 weeks later or so. I'm working through an injury like this too. Popped my A3 pulley pretty loudly a few months ago. Taped it, and climbed carefully around it for a few weeks, then started splinting it, went to a PT and have been doing the prescribed therapy, and it's still barely healing because I keep tweaking it. Sometimes even falling asleep I tweak it, as my hands grip closed randomly as I fall asleep. Good luck.

I'm not a medical expert, but the advice you've been given by the doctor runs counter to virtually everything I've ever read or heard about rehabbing finger strains and sinew injuries in general. I'd recommend getting online and exploring for yourself. Tyler Nelson, Dave Macleod, Jared Vagy all offer great climbing specific resources for injury rehab. 

Personally, I've never immobilized an injured finger and never waited more than 72 hrs. To begin rehab exercises. I have successfully recovered several pulley strains. Ymmv. 

Wow, I'm going to agree and say a splint is a really unusual way to treat a pulley injury and runs counter to nearly all climbing-specific research. 

Tons of resources are available online for climbers needing to rehab injured pulleys, a google search is all you need. I completely ruptured my A2 (Grade III) and went to a hand ortho. She had me wear a pulley ring (which involves no immobilization) for 6 weeks. You don't want to lose ROM when scar tissue forms in your finger by immobilizing it. I started mobility work ASAP (pen rolling, tendon glides, massaging) and then began progressive loading on the hangboard at 5 weeks. I followed Esther Smith's protocol and was full strength in less than 4 months.

I injured a different pulley over a year later and this was a Grade II strain. I didn't take it as seriously and basically just climbed moderates and avoided crimps. It didn't start feeling better until I stopped climbing and started progressive loading. 

Feeling more pain when extending your finger might be totally normal. I felt joint pain, tendon pain, hand pain etc. all over the course of rehab...so much is interconnected. If you follow a progressive loading program, you should see your finger trend increasingly toward more strength and less pain. Start extremely conservative until you dial in an appropriate load (e.g., load two fingers with a sling and a 5 lb weight and increase from there).

Hand doctors, just like girlfriends, Marvel movies, and bowel movements run the range from absolutely spectacular to counterproductive and painful.

If you don’t trust your doc, maybe explore another option. 

Yeah, you could see six different specialists and get at least four different opinions. Find the one that tells you exactly what you figured out on the internet yesterday and you probably have a winner!

Hey guys, thanks for the advice and another question if anyone can answer. When will I know when I'm able to start easy climbing again? It will be 4 weeks since the last time I climbed on Wednesday. I don't think i'm going to go back to the hand specialist since they're essentially just taking my money without much knowledge of the situation. I've been doing tendon glides everyday and buddytaping my fingers at work and there is no more pain with everyday activity/pressure on the pulley.

I've partially torn two a3 pulleys now (both middle finger) and gone through PT and rehab for both. What I was prescribed by my hand specialist who treats lots of climbers is essentially the same as shown on these pages. In fact, she referred me to these pages in case I had any questions. Rehab gently and buddy tape.

Good luck! 

https://theclimbingdoctor.com/pulley-injuries-explained-part-1/

https://theclimbingdoctor.com/pulley-injuries-explained-part-2/