UKC

So, climbing indoors the other day and having a slightly (very) ambitious go at a 7a.  Lost balance about half way up and think I pulled too hard with my left hand trying to stay on, as a result I’ve tweaked something in my two middle fingers.

It’s not all that painful, just sore and stiff, especially when I make a fist or stretch my fingers back.

Any ideas what I might have done here and how to get them back to feeling normal?

Yeah I know, go to the doctor, blah blah blah. If it doesn’t sort itself out after a week or so I will, but in the interim any useful input?

R.I.C.E. + Ibuprofen

Also look for gentle exercises to increase blood flow to the injured fingers. Not saying this will be the correct exercise, but when I tweaked my A2 I used a soft stress ball and squeezed it while keeping my fingers and thumb straight. Eventually I got to passing an elasitc band over my fingers and thumb and then opening and closing my hand slowly, then passing it over just my injured finger and thumb. Most importantly thake it easy and don't stress it further!! 

Edit: Here's the link 

https://www.ukclimbing.com/articles/features/injury_management_and_preventi...

Best way to ice your hand is an ice bath (big bowl of water with ice cubes in). Allow it to get cold and warm back up (to air temperature) several times (as many times as you can stand). Morning and evening. 

I’m guessing this means no climbing for a while then?

Yeah I pulled an A2 once, took about 6 weeks before I was climbing again, even then it was still a little sore, hopefully your won't be as bad!  

The cold ice, leaving it in there it's room temperature is really good.  These are also really good, as they do the same thing, but are a little more convenient to use  https://www.healthandcare.co.uk/hot-cold-packs/07-030101_finger.html?gclid=... 

Also the Metolius Grip Saver worked really well in recovery for me https://www.bananafingers.co.uk/chalk-accessories/metolius/grip-saver-plus again, similar to what Mike 505 suggested...

Good luck in sorting them, don't get to down in the mouth about it, you can still train, run, do core exercises, all sorts of stuff that you always mean to get round to but are to busy climbing so that by the time you're back climbing again you're stronger than before!

Not even easy juggy routes?

i have something similar to the grip saver, don’t use it anything like as much as I should though!

It’s really not all the sore, more like an inconvenience, so hoping it won’t take long to heal.

I’ve only been climbing a year, climbing about 6c on top rope, 6b on lead. Also flashed my first 6c (on an autobelay) the same day I tweeked my fingers. Really been making some progress lately so a bit bummed about this. But deffo don’t want to do anything that will make it worse!

Maybe it's not that bad then, see how it is, it might just be a bit of a tweak rather than a full on pulley injury.  

The thing to remind yourself is that anyone leading an active lifestyle (especially climbers) is gonna pick up an injury from time to time, happens to everybody so it's not a biggie and no need to rush things.

Bear in mind that when you're (relatively) new to climbing is that your strength and technique tends to develop quicker than your tendons, which aren't used to the being put under the amount of strain that they are now, so try to avoid full crimps, and climbing successive fingery routes and putting those tendons under too much strain as they're still catching up with you.

I've had pulley injuries around 4 times in the last 7 years. They take months to heal, usually by three months they are completely recovered, but you can still climb in the meantime. Last time it happened I did no climbing for two weeks, then got back to doing very easy stuff after that. You'll get some discomfort, but avoid full-on pain. You can tape it to provide some support. After around 6 to 8 weeks I was climbing upto about my onsight level, then gradually increased things from there. Ice and ibuprofen will reduce swelling and thus pain, but if you're not getting any when not climbing I don't see why people are recommending it. If you're getting a lot of pain after climbing then you're not taking things easy enough. There aren't any short cuts, the body just needs time. Of course some people will tell you to stop climbing for three months and dunk it in ice 10 times a day, but life's too short for all that nonsense.

The icing is to increase blood flow and help the healing. I don't use Ibuprofen, but is there a benefit to reducing the swelling other than reducing the pain?

Well there is no swelling, at least that I can see it feel.

I’ll have to see how it goes. It’s really not that painful, but deffo doesn’t feel right, even more so when I put some load on. Normally I’d be climbing Monday eve, will see how it feels after the weekend with a few days rest.

Also worth taking a look at Dave MacLeod's book Make or Break. Info on taping etc but  also a lot of stuff on injury management and avoiding a recurrence.

I’ll take a look.

I already have his 9 out of 10 climbers book, not the easiest read but packed full of useful info!

From what I've read there is no proven benefit to the healing process in icing it (although I appreciate that is not what a lot of people think). I would have thought the best way to increase blood flow would be by using your hand normally without causing excessive discomfort to the finger, and that is significantly more practical than messing about with ice for something that will take a long time to heal. I have tried the icing thing previously, but I've always found the finger stays very slightly swollen (probably only noticeable because of my skinny fingers) for around 2 months whatever I do, and that swelling is part of that normal healing process anyway -- from what I understand reducing swelling only has the benefit of reducing pain within this context.

I know what you mean. This is a bit similar in that it seems a little meandering and discursive but there are some useful nuggets in there if you stick with it.

You were confused about why people are recommending icing and ibuprofen, that's all. I don't think it's about the pain even if it's not evidence based.

But I agree, there's a lot on confusion generally about the best thing to do.

I've had 3 A2 pulley strains and never had swelling. I found using a metolious gripsaver seemed to help the most, but obviously hard to say for sure what the best thing to do is.

For those who may (or may not) be interested in how my poorly finger is doing....

All seemed to work itself out. Took it easy for a couple of week and taped it after looking up some ways that might help.

In fact it might have even paid dividends. Since I have managed to flash not one, but two 6c routes, and last week managed to climb my first 6c+ followed by a second one today.

All in all feeling strong and a happy chap  

A lucky chap too, take it easy for a bit maybe just to make sure?

I have been pushing quite hard on very crimpy routes lately, which isn’t sustainable, my skin is getting battered and if I try to push on I’ll end up hurting myself properly.

Time to work on my body positioning, footwork and endurance on overhangs I think, that seems to be my biggest weakness at the moment.

Ibuprofen, and the other NSAIDS, do nothing to improve healing, in fact it’s likely the opposite. Their only benefit is pain relief, particularly if it allows you to more regularly do rehab exercises etc.

Similarly I’m not aware of any good quality evidence that ice does anything beyond short term reduction of pain and swelling, though I’m happy to be corrected on this (with links to good quality evidence that is.)

The Wurzel’s advice was actually pretty pragmatic and uncontroversial, in general, though as always in the specific case go and see a suitably qualified medical practitioner etc etc....

Have a look at this:

https://www.ukclimbing.com/articles/features/injury_management_and_preventi...

I have never fully blown a pulley but I know people who have and it can be months before normal climbing resumes. I have had numerous 'tweaks' - nearly every time it has been when I reached a new peak after a process of improvement.

Consider consolidating at 6c and below for a while before pushing on. You haven't really been climbing long and it's not worth messing up your fingers for the long run by keeping pushing it when they're injured. It won't be long before they mend.

I thought cold = lower blood supply but reduces swelling. Heat for increased blood supply.

I'm not saying they do.

Neither am I.

I can see the benefit in icing. Even if there is no gains to be made in healing time, I see no harm in the temporary relief of swelling if it causing an issue.

Pain killers in general I try to avoid though. My view being that pain is usually (but by no means always) for a reason, it’s your body telling you something isn’t quite right. To use something that blocks that hides a problem rather than helps it, and possibly even opens you up to further injury.

But not as all am I saying I don’t use pain killers. More I see them as a last resort rather than a first response.

I've had four pulley injuries of varying severity (torn pulleys to stretched tendons) throughout my climbing career and one very recently so this is fresh to me. My process for optimum recovery goes as follows:

-Complete rest (one to two weeks from personal experience - this has depended on severity of injury). Usually taking care not to load your fingers in any way throughout the day to aggravate it, at night buddy tape to adjacent finger as sometimes the injury can be aggravated during sleep.

During this time I ice once a day for up to 30 mins, and take an anti-inflammatory for the first few days. I took turmeric for my last injury which has these properties but I can't vouch for it confidently yet. I try to avoid Ibuprofen where possible. The key is complete and utter rest. This includes any form of 'rehab' exercise - of which I have not really found any to be useful. Some 'rehab' exercises have actually aggravated the original injury.

Any pain means that you have aggravated it, and from personal experience it just delays recovery overall. It's hard to lay off climbing knowing that fitness reduces but in the long run you will be stronger for it.

-Start climbing once irritation subsides at rest. Very hard to gauge this but for me a week or two of total rest has allowed me to start easy climbing again. I usually hang off a bar to see if there is any pain or irritation. Tape up. Only climb on jugs. No dynamic or hard moves. 

-After a few sessions of this (perhaps a week or two) start climbing without tape. Again, very hard to gauge when you should start doing this and unfortunately for me it took some trial and error and aggravating the original injury my first time to know how much I could push my body. I stick to jugs and positive holds for another 2 weeks.

-After the step above it's just a matter of progressive loading. Listening to the body.

This is just my personal process and has lead to what I believe to be the shortest recovery path possible for me. Which has seen me (with stretched tendons) not being able to hold a plate without pain to climbing at the level before injury within 2-3 months. My most severe injury when I tore a pulley with trial and error figuring out what works for me took about 6 months to heal.

The key for me for quick recovery was complete rest at the beginning and gradual progressive loading through actual climbing.