/ Finger joint injury - weakness/stiffness

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Vulgar_Monkey - on 27 Jan 2013
Hi,

So, I was hoping for a little advice on a recurrent injury that I can't shift.

First the background stuff. Been climbing for 18 months, probably 15 to 20 hours a week. Before christmas I was pushing my grades a bit and was around 6c wall climbing and maybe v4 bouldering (currently cracking on with a v5 roof section). A lot of these were pretty exclusively crimpy stuff, unsurprisingly.

Now, I did notice a lot of weakness and aching in the first and second joints of each middle finger. This was typically followed by stiffness and limited range of motion the day after, and also sensitivity to pranging it on things. In particular sideways torquing motions really hurt it, like carrying plates, picking up a laptop, things like that.

So I stop climbing for a couple of months. Truth be told, this was because of study commitments and xmas rather than the injury, but it was a good excuse to get some healing time in. However, I've just returned to climbing, having thought I felt better, and the same injury has reappeared almost immediately.

This actually concerns me more than the injury itself. Due to general inactivity lessening my fitness a little (and also my shoes desperately needing replacement)I havent even been climbing especially hard grades. Doesnt seem to matter though. As well as stiff and achey I actually cant get much power through the fingers now, and have to overlock everything with my thumb to compensate.

So, aside from strapping up with tape (which is of limited help at best), what do you suggest? If not advice with preventative measures, could anyone at least take a guess at what is going on? I'm assuming some sort of pulley or tendon injury rather than osteoarthritis, hopefully, but a bit more understanding of it would make me feel better. A bit, anyway.
In reply to Vulgar_Monkey: Sounds like a pulley injury to me. Same symptoms that I had. Have a look on Dave MacLeod's website.
Frenchfinesse - on 27 Jan 2013
In reply to Vulgar_Monkey: DO you specifically warm up your fingers before climbing? Do you stretch your fingers afterwards? DO you drink during your sessions?
David Kay - on 27 Jan 2013
In reply to Vulgar_Monkey: I don't really have too much experience with this, but the cold water therapy on Dave Macleod's website has worked whenever I've ever tweaked something. That, and some ibuprofen might put you on the road to recovery.

And stay away from those crimps!

David
Dave MacLeod - on 27 Jan 2013
In reply to Submit to Gravity: In reply to Submit to Gravity:
> (In reply to Vulgar_Monkey) Sounds like a pulley injury to me. Same symptoms that I had. Have a look on Dave MacLeod's website.

It doesn't sound like a pulley injury to me. However, speculating what it might be is not too helpful without an examination from a professional. You don't say your age but if you are teenage you absolutely must exclude the possibility of a growth plate fracture which could have been developing for some time. This is a very serious injury if untreated, you do not want to go there! If not it might just be some synovitis or capsular/ligament damage that is common when you increase the climbing load too quickly, crimp too much, climb with bad footwork or various other causes. Removing the causes, a bit of time and a change of climbing scenery generally help for finger joint pain. You mentioned trashed rock shoes - these are a fine way to cause frequent slips that shock load your finger joints.

Go and see an orthopaedic surgeon with knowledge of climbing. If you have a growth plate fracture and don't, you'll seriously regret it later. Have a look at Schoffl's papers on growth plate fractures in climbers if you want to really scare yourself. Get the full text of the paper below through your institution and take it with you to your consultation:

J Sports Med Phys Fitness. 2007 Mar;47(1):70-8.
Finger pain in rock climbers: reaching the right differential diagnosis and therapy.
Schöffl VR, Schöffl I.
philhaigh - on 28 Jan 2013
In reply to Vulgar_Monkey:
You mention sideways motions.. sounds a bit like collateral ligament. Check this out: http://blog.bethrodden.com/2012/03/collateral-ligament-injuries.html
Vulgar_Monkey - on 29 Jan 2013
Huh, I had no idea dave macleod himself posted here. How handy.
You'll be pleased to know that a lot of the other people I've asked are also pointing me directly to your site. I've had a good read.

Good news (depending on how you look at it) is that I'm 27, not a teenager. So at least I don't have to worry about plates. Since I'm still a student, though, I do have access to my institutions database of academic work in this field...havent had time to look yet, but I expect the sports science section should have something.

And yes, my old shoes saw way too much use, and were in fact down to bare leather around the toes and inner edge, so the odd slip did occur. I actually yanked the base of my ring finger when slipping on a crimpy bouldering problem - fully shock-loaded it for a quarter-second before it let go. Then did it again a couple more times. Still, that injury actually healed up just fine during my 2 months off, and doesnt seem to be coming back.

It's interesting that collateral ligaments are mentioned....when I'm poking and squeezing around my fingers to localise the pain, it does seem to be most noticeable around those points, although I don't imagine this necessarily means that much.

I have retired my old shoes today and replaced them with a fresh pair, tried taping up (didn't really get on well with it tbh, I never do), and as soon as I have time will contact my doctor. I know some are reluctant to refer patients, but he was good enough to send me to a local specialist for chronic compartment in my legs a few years ago, so hopefully he will be willing to do similar in this case if need be.

In the meantime I am probably going to continue climbing at my usual rate (15-20 hours a week over 3 or 4 days) but at a greatly reduced intensity. Aside from light bouldering, I'm thinking just lots of continuous circuits up and down easy routes to improve my general fitness....plus hopefully the cardio hit might increase bloodflow to the ligaments and such.

My main concern is that someone will tell me I have to ease right back for a while longer, as I am taking a climbing holiday abroad in a couple of months and want to be back on form by then. Also a charity climbing day I'm running at my university in a week which I sort of have a responsibility to lead by example on. That, and some of the others I've trained up equalling (or surpassing) my own grade as I get worse and worse (ego, basically)....all reasons for me to want to get back at it soon as. if for whatever reason I need to scale things back a bit, that'll be a difficult pill to swallow.

Vulgar_Monkey - on 29 Jan 2013
Oh, and in reply to the other comments (sorry guys), I do stretch and warm up, I do drink during....I havent tried cold water therapy yet, but the cold coming off the wall tends to not be particularly pleasant. Makes the acheyness a bit worse.
Lukem6 - on 29 Jan 2013
In reply to Vulgar_Monkey: rather than start my own post, I wanted to ask if anyone knew any good climbing hand surgeons near Nottingham, possibly derby and Sheffield.

And is it possible to get referral on NHS. I'm a bartender, so my hands never rest and have developed various issues from knuckles that seize up, Joints that feel bruised(I've avoided crimps for a year due to this) and one of my joints cannot bare being manipulated sideways. In general I'm screwed when it comes to pushing my self as a climber. But I would love to get a Professionals opinion. I've seen three doctors and just get told to rest, stretch and flex the joints. Ice treatment is also part of my daily routine.

Any recommendation for hand specialists would be great.

Many thanks luke
mloskot - on 29 Jan 2013
In reply to Vulgar_Monkey: Regarding stiffness of the finger joints, you may find the video I posted here with recommended osteopathic treatment for fingers helpful

http://www.ukclimbing.com/forums/t.php?t=533823
Kelcat - on 29 Jan 2013
In reply to Vulgar_Monkey: I've had similar symptoms for about 3 months now during a period when my climbing has gone from 6b to 7a. I've visited a sports physio to no avail, but on holiday at the moment & have just blasted my arm & hand for about an hour in a powerful hot tub, feels better than it has for ages, would suggest that some sort of deep tissue massage helps.
David Kay - on 29 Jan 2013
In reply to Vulgar_Monkey:
> Oh, and in reply to the other comments (sorry guys), I do stretch and warm up, I do drink during....I havent tried cold water therapy yet, but the cold coming off the wall tends to not be particularly pleasant. Makes the acheyness a bit worse.

It's not icing it straight after climbing. You can do it anytime you like, and cold water will do, not necessarily ice. Basically it improves blood flow to the fingers loads, and more blood flow means more healing. It does make your fingers feel a bit stiff straight after, but I found it to be really beneficial.

David
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Siderunner - on 29 Jan 2013
In reply to Vulgar_Monkey:
"My main concern is that someone will tell me I have to ease right back for a while longer"

Your main concern *should* be that if you f*&% up your finger permanently your ability to climb hard could be affected for many years, if not life. On a more prosaic and immediate level, you may well find yourself training harder and harder and getting worse and worse: what a waste of effort!

IMO 15-20 hours a week of climbing seems excessive on a finger injury. FWIW here's what I would do if it was me:

* focus on climbing only easy stuff, and do so open-handed; if you hate open-handed grips then even more so (read Dave's book, 9/10 climbers) (you say: "A lot of these were pretty exclusively crimpy stuff, unsurprisingly" - I don't agree this is an automatic corollary of F6c/V4, but I guess that may depend on your wall as well as your strength at open-handed climbing)

* reduce climbing to twice a week, 2hrs max per session (or 10 routes perhaps), max grade F6a and focussing on choosing juggy routes with big holds. Personally I need these firm limits otherwise the boundaries just creep gradually up over a few sessions until reinjury reminds me. If this hurts go down more grades, or stop altogether.

* do 2-3 sessions a week of strength training that doesn't use fingers, perhaps focussing on weighted pull-ups and core training; set yourself some real challenging goals here, and put the work in so you feel you'll come back ripped and much stronger than pre-injury! Personally I like L hangs and foot flyaways (http://www.youtube.com/watch?v=hxUo-6h2dA0) for abs. You could also do some antagonist work for shoulders and stretching, depending on your weaknesses. Typewriters and Frenchies are also worthwhile.

Or just keep climbing until it's so bad you HAVE to stop.
That's what I did the first 3 or 4 times :-)

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