UKC

Hi,

I recently injured my LH ring finger bouldering on a two-finger pocket and curving crimp before fully warm. I am currently seeing a phsyio - however, they noted that some of my symptoms are far from normal (perhaps linked to an historic injury to the same finger). I am therefore keen to see if anyone else has had similar symptoms?

At the time there was no audible 'tendon/ pulley pop' or pain at the time but the finger became sore around the main PIP joint and made some weird popping/ cracking noises when straightening around the middle phalanx.

The first injury has been diagnosed as routine damage to the collateral ligaments at the PIP joint. However, the second is less simple - possibly pulley injury/ some form of trigger injury. Ignoring the collateral ligament damage, four days on the finger is not sore to touch and I have almost a full range of pain free motion.

However, when at full extension their remains soreness above the middle phalanx and often a 'pop' or 'popping' when flexing after extension in the same area (weirdly the popping seems to come from the top (extensor) side of the finger?).

Apologies for the long post but the popping/ cracking noise when flexing is not too common it would seem and it would be reassuring to hear of others with similar symptoms!

In reply to tom:

Sounds like capsulitis maybe, inflammation of the joint capsule. That can be a cause of relatively pain free clicking over the top of the joint.

In reply to tom:

Are you able to achieve full extension, or is there a lag?

Put finger straight on table - can you isolate it and lift it off?

Holding finger straight (full extension) try to flex individually through each joint (DIPJ / PIPJ / MCPJ) - Any laxity?
Holding finger 50% flexed (claw position) try to extend individually through each joint - any laxity?

Sounds like you've got a bit of post traumatic inflammation around the distal insertion point of the extensor tendon / either this or there's a small # to the volar plate with mild displaeement causing the popping

If it doesn't settle with Ibuprofen after a few days - see your GP for a non urgent XR to exclude any small displaced #'s.

It's not an uncommon symptom of a soft tissue injury and I suspect it'll settle!

Good luck!

In reply to TimSter:
In reply to RupertD:


Thanks both for your replies.

I can achieve 95% extension naturally. 100% is possible although this requires me to focus on deliberately extending the finger further. I assume this is what you mean by 'lag'. However, it might, to an extent, be due to a prior injury many years ago. No problem isolating finger and lifting it off the table. No laxity in either joint in straight or claw position.

A week on from the point of injury the finger definitely feels better. However, there is still obvious pain due to the damaged collateral ligaments at the PIP joint. Making a fist and full extension is possible with no pain (except to collateral ligaments if I tighten at full flex) and in general the finger feels mobile.

However, 'popping' still occurs on occasion when flexing after full (not 95%) extension, also when extending. The noise still seems to be coming from the posterior side of the middle phalanx and towards its PIP - as opposed to DIP - end. This seems to fit with a diagnosis of either inflammation to around where the central extensor tendon inserts to the middle phalanx; to where the lateral bands pass over the collateral ligaments; or perhaps to inflammation of the ORL?

I guess in either of these cases the key to recovery is rest - cold water therapy - followed by slow return to use with hand exercisers and then climbing. But it would still be great to know what causes the popping and if causing it to reoccur irritates the tendons/ ligaments further?

In reply to tom:
I've had lots of collateral ligament and pulley issues in a finger over the last 20ish months, also a PIP joint. I don't get an audible pop but do get lots of clicking and crunching if I close the finger tight and then extend it, or just if I push it to extend it with the other hand. No idea what it is though - scar tissue stopping everything running nicely and getting moved around maybe? If you find a may to make it stop I'd be all ears!

In reply to abarro81:

How have you found the collateral ligament issues and PIP to heal OK? Previous pulley injuries have healed well for me so I am relatively optimistic!

I guess cracking is a better description (like a mini version of joint cracking) - mine may well not actually be audible as whenever it has happened people nearby have said they have not heard anything - certainly nowhere near as loud as a pulley rupture...

Have you found the cracking to get better or worse over time? Does climbing on it seem to be OK - does it make it worse?

I'l be sure to keep you posted should I find a cure!

In reply to tom:
For me the collateral ligament injury went on way longer than any pulley injury. I've found pulley issues have typically been a 1-3 month process, whilst the collateral took about 12-18 months to get fully sorted. That said, during the rehab process I did my hardest ever onsight and hardest ever redpoint - on 80% of holds I could operate with impunity, it was just crimps and twisty pockets (f2, monos - was my mid finger - also had to learn to hold 2 finger pockets differently to avoid twisting on them) that I had to be careful with. Or sidepulls as they sometimes caused excessive twisting.

That said, I know others who've had collateral issues and they could crimp ok, just couldn't do anything with twistyness, so it can depend a lot on the specifics (you'll have to go with feel for that, I don't think anyone else can tell you).

The cracky crunchyness is still there, but the injury is now 99% better (though be careful - I went back to hard crimping a bit too aggressively and tweaked a pulley, probably because they're not used to crimping after that long a period of being careful with it). I'm hoping that with time, and maybe some massage when the finger is feeling ok, that eventually the crunching will disappear!

In reply to abarro81:

I injured my collateral ligament on an indoor dyno about two years ago. It was never that bad but never really went away properly either.

I've had periods away from climbing and it always came back so complete rest doesn't help (in my case.)

In the last couple of days I tried the following method and have had close to miraculous results. I used the end of a theraband and wrapped my finger numerous times throughout the day whilst at work. Definitely worth a try:

http://www.hcrbeta.com/climbers-should-experiment-with-voodoo-flossing/

In reply to Tru:
Intriguing, will give that a go tonight, cheers!