UKC

Managed to tear/partially tear my A2 about 10 days ago. I partially dislocated the knuckles on both the finger in question (LH ring finger) and my middle finger. I put the joints back in place while dangling on the rope, but assumed that the ring finger joints hadn't gone back properly as it was swollen and very uncomfortable. Climbed on it again this week and it was very painful when crimping, so went to get it x-rayed (luckily the student doctor's supervisor was a climber an recognised the symptoms.

Found a useful article from Dave Mac:
http://onlineclimbingcoach.blogspot.com/2010/05/pulley-injuries-article.htm... and was planning to try the following treatments suggested:

- Ice therapy
- DFM
- Stretching
- taping
- Laying off the NSAIDS until the swelling goes down
- I'm going to continue to climb, but avoid anything crimpy/ drop a grade or two

Has anyone one any tips on how to aid recovery and / or reduce the change of recurrence? Any useful physio exercises would also be appreciated.

Presumably there's no problem with me wearing my wedding ring once I can actually get it over my knuckle again?

In reply to mmmhumous: You need to rest it properly for a while - a few weeks maybe. Looking at your grades you haven't got enough spare capacity to climb enough within yourself to avoid aggravation. If you don't rest it enough you WILL regret it. I'm speaking from experience and climb similar grades to you.

In reply to mmmhumous:

cold water treatment.
I personally wouldnt avoid NSAIDS but that's just me.

In reply to mmmhumous:
When i did mine i aimed for a 6 week recovery, for me it was a week and a half of not climbing (stretching the finger daily), so there was no pain in using it in any day to day activity. Next a week of sticking to the easiest climbs the climbing centre had (4+/5). A week of less than 6a (sticking to routes that are juggy, not even getting on something that had a visible finger pocket) a second week of 6a, this time increasing the duration. Finally back to 6b, but still only on overhanging walls, avoiding crimps at pockets still.
After that it is a case of slowly building back to where you were.
The key for me was no bouldering, the temptation to jump on something just a bit harder is too big, and because they are so accessible it provides the biggest risk of re-injuring yourself and making it worse.

In summary, take it slow and you will be back to top form in no time, rush and you will prolong the recovery, and may make it a lasting condition.

In reply to mmmhumous: The problem with climbing too soon is that you find out the hard, damaging way what affects it and what doesn't. For example, I tried climbing overhanging routes on jugs but the pressure of the hold on the injured area aggravated it. It's also difficult to predict how a particular route will affect, and to account for feet slipping etc. And that's all based on you being disciplined enough to not start rushing into harder stuff too soon.

I think DM recommends returning to easy climbing once full range of motion is restored. Personally I would give it another couple of weeks.

In reply to mmmhumous:

Thanks guys!

Submit to Gravity - I hear what you're saying, but I need to climb regularly for general fitness, so somplete rest isn't an option. I will however, be taking it very slowly.

In terms of climbing, I was planning something along the linhes of what Dean177 did hopefully aiming for a 6-8 week recovery period. Although I'll probably stick to the lower grades for at least 3-4 weeksas I can manage 4-5s without weighting the finger.

I haven't got full motion back yet (either straightening or clenching), and won't be doing any climbs where I do have to use the finger until after I have got pain free motion back.(One of the reasons I want to avoid pain killers if I can).

In reply to mmmhumous: I did mine 11 months ago and it still gets a bit sore after crimping or when I'm under the weather.

In reply to mmmhumous:

All the treatment plans sound good.

In terms of climbing, there's no reason to limit yourself to a certain grade as long as you're disciplined.

The basic rule is that if you can't feel the injury, it's not doing it any harm. So if you climb 100% statically and exaggeratedly slowly, letting go the moment it starts to twinge, you'll be absolutely fine. You might even get stronger from the slow climbing! I'd stick to bouldering and top roping, so that there's nothing stopping you from just letting go as soon as you feel it.

By gently exercising it and getting the blood flowing it'll heal a lot more quickly too.

But remember with injuries it's 'pain: no gain', and it's probably best to give it a week to settle down beforehand.

In reply to mmmhumous:
Complete rest really is a good idea, just for a little while. You can gain that lost fitness back, but your finger is seriously damaged and you will make it worse if you continue to climb on it.

Mine is still sore occasionally 2 years later.

In reply to mmmhumous:

Of course complete rest is an option. Go for a run for a week or something, you're only going to make it take longer to recover and potentially create a weakness in the pulley, meaning you'll be more likely to re-injure it in the future.


I think you'll be unlikely to get a 6-8 week recovery. I can just about get a 4-6 week recovery if I spot a pulley strain very early. I mean a pulley strain which gives me no pain whilst climbing but has minor localised pain after climbing. A pulley that gives me pain whilst climbing usually takes 12 weeks but it's back to square one if you forget and crimp again..


So are you avoiding pain killers so you're able to detect any pain? Surely taking some ibuprofen would be a good idea to reduce swelling? I certainly wouldn't climb on the hand until you have ROM back in the joint and that won't return on it's own. You're going to have to perform stretches. For straightening, place your injured hand palm side down on the edge of a table with the injured joint over the edge. Place your other hand over the injured hand to prevent the finger lifting from the table and try to straighten the injured finger.

To stop these injuries occurring more frequently, avoid crimping whenever possible. Force yourself to use a more open-handed grip. I find that whilst I'm rehabilitating an A2 injury, jugs and be just as painful as crimps. Best to stick to open-hand only, if you are going to have to bend the injured joint than jump off or use a different hold.

I'm very much in favour of active recovery but it definitely sounds like you're trying to go back to soon.

In reply to cha1n:

Mix of being able to detect any pain ( to prevent me damaging it further ) and let the inflamation process take it course. That said... gentle taping over night, and 30mins in ice water last night seem to have dratically reduced the swelling.

>
>I certainly wouldn't climb on the hand until you have ROM back in the joint and that won't return on it's own. You're going to have to perform stretches. For straightening, place your injured hand palm side down on the edge of a table with the injured joint over the edge. Place your other hand over the injured hand to prevent the finger lifting from the table and try to straighten the injured finger.

Cheers. Any tips for 'clenching movement' ? Or is it just a 'squeezing-a-stress-ball-jobie.'

I generally avoid crimps like the plague ( and don't do campusing ), I'm happy to, and usually do climb open handed on larger or more positive holds, but revert to full/half crimps when I'm suffering from a lack of bottle. For instance the climb I injured myself on....pushing my lead grade on a ~10° overhang. sliped off a (higher) right-hand hold (and subsequent the smear I was stood on), and shock loaded the middle three fingers of my left hand which were in a half-crimp.


Definately! I stupidly continued to climb on it the night in question, and have probably done ~50 routes on it between injury and diagnosis.

In reply to mmmhumous: I am currently recovering from the same injury as the OP, a partial rupture of the A2 pulley,
and found this book, One Move too Many, to be useful,
http://www.amazon.co.uk/Understand-Injuries-Overuse-Syndroms-Climbing/dp/39...

and a few blogs etc,
http://onlineclimbingcoach.blogspot.com/2010/05/a2-pulley-injuries-review-r...
http://www.allclimbing.com/archive/2009/02/partial-rupture-to-a2-tendon-pul...
http://www.nicros.com/training/articles/finger-tendon-pulley-injury/

if you start climbing too soon a partial tear could become a complete rupture and could require surgery and no climbing for a year, i would let the injury dictate when and what to do, don't risk making it worse.

In reply to mmmhumous:
"Any useful physio exercises would also be appreciated."

I've been using TheraPutty to strengthen after a recent tendon pulley injury. For this I've started with the yellow putty - you'll need to find some specific advice for your injury though. (You can buy it via Amazon. BTW).

In reply to mmmhumous:

Thanks Both!

The swelling's pretty much gone and I've got full movement back (almost pain free), and ice/taping seems to be working well. (tried both H-taping and circumferential taping).


Dropping only two grades was probably a bit ambitious. But 4-5+ routes of slabs/vertical walls are doable if the Royalty grip is applied (haven't mastered the jedi yet):

http://3.bp.blogspot.com/-9u3WJdqg4uE/TwZQcCm-5bI/AAAAAAAADl8/Dh7legzBxF0/s...