UKC

So my GP says I've got early depuytrens in my left hand. It's at the lumpy nodule stage, not the bent finger stage. I'm only 35, so it's quite young to get it and apparently it's common in climbers... Anyone else got it? Any advice on preventing progression/treatment? Have you been advised to stop climbing? Did you?!?

Thanks, mike

In reply to minimike:

Search the forums.

In reply to minimike:

Hi,

There's a really good UKC article on this here:

http://www.ukclimbing.com/articles/page.php?id=1312

Thanks and good luck with it.

Jack

In reply to Jack Geldard - UKC Chief Editor:

Thanks Jack, looks like really helpful stuff there.. I'll have a read.

Hi minimike

I've had a Dupuytren's nodule on the palm of my hand for at least eight years. So far it has not advanced to contracture although it has changed size and shape over the years. It's now more widespread but flatter than it was.

All I have done about it is to keep stretching regularly. Sometimes it feels tighter when I stretch and I get a sharp pain either in the nodule or down in the wrist. But if I gently but firmly stretch through the pain, it dies away.

Whether this has prevented contracture, I can't say - I'm a sample of one with no control. But it does seem sensible to keep stretching regularly and, for me, so far so good. It has not impacted on my climbing at all.

One thing to note, I was taking glucosamine supplements at the time my dupuytrens appeared. On an internet search I did come across a speculative link between glucosamine and dupuytrens so I stopped taking it. Again, I don't think there is scientific evidence for a link at the moment.

In reply to El Greyo:

Well that's encouraging.. I'm not taking glucosamine, but a bit of googling reveals anecdotal and poorly studied links to whatever you can think of! It's not well understood. My GP had no experience of it in other climbers but there you go..

Stretching wax the only advice, but if it's effective then great.

Thanks

In reply to El Greyo:

Very similar story to me, re stopping taking glucosamine and the benefits of stretching and massaging the nodules.

My understanding is that it's a heriditary condition (and an indication of viking blood) and my grandfather had it.

I first noticed it about 10 years ago, but have come on quite suddenly, the nodules are not as pronounced as they once were. However another possible factor is that I have shifted focus from climbing to mountain biking in the last 5 years.

In reply to minimike:
Both hands but remained at nodule stage - now well over six years (lost track of time). Never affected my climbing. Only thing I do do is intensive stretching of the hands and fingers during and after climbing sessions. No idea if it works or I am just lucky!

In reply to minimike:

I’m currently recovering from my second operation in the same hand to overcome Dupuytren's contracture, the first operation was approximately 5 years ago, however the Dupuytren's returned very soon afterwards. The 2nd operation has also included a full skin graft as well as the removal of the cords etc, 5 weeks since the operation and the movement is improving with full extension of the fingers, the problem did cause issues with climbing as it hindered hand and finger movement. I plan to start light training and climbing again within the next few weeks. Issue’s since the operation are mainly due to how cold the fingers now get.
I also have the start of Dupuytren's in my other hand but this has not developed much (over 4 or 5 years), such is life!

In reply to Robmwatt:

This is interesting.. GP said to get it at 35 was uncommon (1-2% chance), yet here we are on a relatively small forum and there are lots of people with the same problem and relatively early onset, so much so that there's a UKC article about it and 5 people commented on their experiences within a couple of hours.. This 2005 paper

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1725323/pdf/v039p00639.pdf

suggests the same kind of correlation in climbers. I wonder if there's any way to reduce the risk? Hand warmups anyone?

In reply to minimike:


There's some evidence that trauma is a trigger. Episodes of contracture for me followed trauma caused by pulling on sharp holds / thin flakes - the trauma involved felt fairly minor and did not break the skin, but maybe excessively compressed the tendons. (I have contractures in PIP and DIP joints but not in the MCP joint, and no palmar nodules.)

In reply to minimike:

I've had nodules for the last ten years, since I was 25. Not a surprise as my dad suffered pretty badly in his 40s. It's a bit of a lottery as to how it progresses, mine has been fine.

In reply to minimike:

I got my first nodule on one hand this year and I'm 34. My Dad suffered from it as well. It was slightly painful when it first appeared but doesn't seem to bother me much now nor does it seem to be getting any worse thankfully. I do take glucosamine but don't believe that's in anyway connected.

In reply to minimike:


I also got it (in one hand only) in my early thirties, at a time when I was climbing intensively. It was a long time before I heard the actual name for the condition, and realised what it was.

It's never stopped me climbing - perhaps I'm lucky it hasn't gotten markedly worse.

In reply to minimike:

I was in my 50s before I got mine. My sister was younger I think. My dad had it too. I'm the only climber of the three. They are/were both pianists, but I don't think that's too relevant. As for climbing, the problems only start when the fingers get so bent that they lock in position, so that handjamming becomes impossible - easy to put it in, but it won't come out. I've had surgery on my left hand, but prefer NA (needle aponevrotomy) on my right. I see a surgeon who is able and happy to do this (unusual - most would reject this form of treatment) He thinks all climbers are a bit bonkers, and would never advise giving up!

In reply to minimike:

I've had mine for certainly fifteen years, possibly more. In the early stages it'll just be something you have, not something that need restrict you or about which anyone need do anything.

Over the last year mine's got to the point where the affected hand can no longer spread as wide as the normal one, one finger leans in very distinctly and the condition affects the finger next to it too, there's a big lump at the base of the finger which if massaged produces numb feelings in the finger plus another lump further down the tendon nearer the middle of the palm which is pushed causes my fingers to curl. It's only now it's got to this stage that I'm thinking I may have to talk to the GP about it.

So no need to rush into anything would be my advice. Leave it be and only seek treatment when you feel you have no other option.

T.

In reply to minimike:

I was diagnosed with it last year aged 46. Not one of my family have or had it to my knowledge.

I've only got it on one hand so far. It hasn't stopped me from climbing but I'm a real punter although grabbing an ice axe was quite painful as I have 2 nodules on my right palm.

No advice to offer really just wanted to say good luck with it and I hope it doesn't hinder your climbing too much.

cheers

Gaz

In reply to minimike:


Yes would be interesting to one day better understand. So much information on pulley injuries and shoulder injuries for example but Dupuytren's also seems very common in climbers. Very little knowledge concerning the mechanics of onset in comparison.

In reply to HB1:


Yeeeeesh - that sounds like a bad thing!

In reply to minimike:

Thanks everyone for sharing your experiences.. it's not causing me any problems so far and it sounds like progression is slow if at all in some cases. Fingers crossed (or not as the case may be.. ha ha.)

I have a friend who's a plastic surgeon and walker (not climber), so i might mention it next time i see him and see if he's keen for a little research. It would be great to get some solid understanding of how to manage this in sport, there's very little in the literature that i can see on that.

In reply to minimike:

I had a very simple 5min. procedure to cure complaint in both hands.
Involves using a syringe along the side of the affected tendon to in effect create a "tear along dotted line"; bend fingers right back..cracking noise/feeling and hey presto cure. Local anesthetic. Back at The Works the next day where one hard pull released it a bit more
If unlucky it may require repeating every 5 years or so but it,s very little hassle and no pain

In reply to rocksol:




This is the Xiaflex collagenase treatment that I have posted about on here before. I've had it, it helped a bit but the b..... thing returns after a time. I have it on a little finger and I do find that I cannot jam some finger and thin hand cracks very well anymore as I cannot get my hand in properly. After being unconvinced that its due to climbing - its very common in males of northern European origin i.e. most climbers - I do wonder if there is a link given the number of climbing friends who have it. Needs some proper research....

In reply to minimike:

My partner has an aggressive form (onset in 30s, foot as well as hand, already had surgery and radiotherapy ). She has found that supplementing with N acetyl cysteine has reversed some of the cord formation.

Damage just under the skin seems to trigger it - warming up the muscles unlikely to help much, but she has given up barefoot running and wears padded shoes, and gloves for certain physical work.