Trigger finger surgery affect on climbing?

I have trigger finger in my left thumb. It is greatly impacting my ability to climb hard. I have had 2 cortisone shots and went to finger OT for 3 months but it regresses each time the cortisone wears off. I met with a highly respected and recommended hand surgeon who conveyed a lot of confidence that a surgical fix to cut the A1 pulley would solve my problem, and that we really don’t need that pulley after all.

Willingly cutting a pulley goes against what I’ve been taught as a climber.

Has anyone been through this and have any advice?

I was reluctant but an acupuncturist permanently fixed my trigger thumb in 8 visits. No surgery. Pm me if you want more info. 

Hey Molly I've got trigger finger in both thumbs but believe its hereditary for me. There's been times when the meat of my palm (nearest to the thumb) gets inflamed and I believe it affects my grip. Like specifically type of motion opening a jar affects it most. Taking time off from climbing can help, and even got a brace to immobilize the thumb when sleeping. Seems to flare up and go away within 2-3 weeks. What kind of discomfort and impediment to climbing does it cause you?  

If you're interested, I can send articles to you.

Surgical Treatment for Trigger Thumb Using a Radial Approach.

Kosiyatrakul A, Luenam S.J Hand Microsurg. 2022 Jun 6;15(5):388-394. doi: 10.1055/s-0042-1749421. eCollection 2023 Dec.

Modified Acupotomy versus Percutaneous Release for Trigger Thumb: A Retrospective Study.

Li SM, Chen P, Yan MZ, Du WS, Guo R, Luo T.J Pain Res. 2022 Apr 19;15:1141-1148. doi: 10.2147/JPR.S339710. eCollection 2022.

Open access.

• DOI:10.18203/2349-2902.isj20232872
• Corpus ID: 262224969

Evidence in treatment of trigger finger: a review

• Ricarte-Almeida E. R., Ruiz-Berrones A., +5 authors Jaimes-Durán E. M.
• Published in International Surgery Journal 22 September 2023
• Medicine

Hi Molly - a couple considerations: 

-climbers can be difficult group to work with in that they are unlikely to follow restrictions after surgery and return to activity sooner than recommended

-if you are recreational level climber you most likely will be pleased with procedure, if you are elite level then I would discuss the demands of your thumb with surgeon more as it relates to pinch strength

-common to have stiffness and pain after surgery that improves 6 weeks to 3 months or sooner after surgery

-thumb has 3-4 pulleys; studies show bowstringing unlikely with A1 cut as is done in trigger thumb release

-grip strength typically improves following trigger finger surgery (see study below, bias being low number of participants)

-after failing conservative measures such as giving time and trying injections, most patients are very happy with surgical release 

-trigger release is simple procedure with fairly predictable, positive outcomes and minimal rehabilitation

Hope this helps and that you find some relief!

Some resources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC6026824/ - Anatomy thumb pulleys

https://theclimbingdoctor.com/finger-stiffness/ - Climbing PT education about trigger finger

https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0039-3402705.pdf - Study about bowstringing following surgery

https://pmc.ncbi.nlm.nih.gov/articles/PMC10671987/ - Study showing improvement in grip strength following trigger release