/ Suspected A2 pulley rupture

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WaterMonkey 05 Nov 2019

Last night i was crimping with my left hand and heard a loud pop followed by my left ring finger gradually getting sorer.

I taped it up and carried on climbing carefully.

Today it has swollen up and is sore to straighten fully and sore-ish to bend.

I suspect it's the A2 pulley, either partial or full rupture.

My question is, is it worth bothering a doctor or walk in clinic with it? In most cases treatment is conservative so do i just tape it and try not to use it or get a proper diagnosis? 

Cheers

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GwilymR 05 Nov 2019
In reply to WaterMonkey:

As a long term sufferer of finger injuries I wouldn't bother going to see a doctor. 

I would bother going to see a physiotherapist who knows what they are talking about - 919 Clinic in Sheffield are my current default. 

If it's a full rupture of the A2 I would have thought you'd see bow-stringing. AFAIK a full rupture of the A2 needs surgery ASAP for the best chance of healing well. A partial rupture as you say the treatment is just be gentle for 6-8 weeks as you heal. Ice until the swelling has gone down (5 minutes a day or so). 

But John at 919 and others are also using targeted shock wave therapy to treat finger injuries and it is absolutely worth doing. My advice would be to see a well regarded climbing physio.  

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olddirtydoggy 05 Nov 2019
In reply to WaterMonkey:

Last season during winter I was off the indoor walls for 3 months until it healed. I didn't go to anybody. No issues now.

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WaterMonkey 05 Nov 2019
In reply to GwilymR:

Good advice about seeing physio, thanks.

He should be able to advise if I immobilise it or move it.

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WaterMonkey 05 Nov 2019
In reply to olddirtydoggy:

Did you immobilise it or just avoid using it too much?

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Street 05 Nov 2019
In reply to WaterMonkey:

I hurt mine in January this year and didn't bother going to see a doctor. I figured they'd just tell me to rest it. I took a few weeks off completely before easing back in and climbing at a much lower grade on juggy routes. If I felt anything start to pull or hurt I backed straight off.

Last time I did it I saw a physio and his advice was to keep it moving. Wait for the pain and swelling to go down and then carry on climbing, just climb well within yourself as the motion will help it heal.

Dave MacLeods injury book is worth a read too.

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olddirtydoggy 05 Nov 2019
In reply to WaterMonkey:

It popped after repeated attempts on a small side pull. I tried continuing climbing the night I did it and had to stop after about 20 mins. I took 3 months off climbing altogether until it had healed. Work didn't exactly help being in the building trade but after conciously stopping using the finger for anything from pulling the sliding door on my van shut to lifting things I noticed it got better much quickly. Total rest in my case did work.

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MischaHY 06 Nov 2019
In reply to WaterMonkey:

Visit a climbing specific physio and have the injury assessed with a scan. Stop climbing for at least 7 days, then follow the protocol in this link: 

https://eu.blackdiamondequipment.com/de_DE/experience-story?cid=esther-smith-nagging-finger-injuries 

It works exceedingly well and will help your finger return to pre-injury strength as quickly as possible. 

Be sure to tape the injury using the method found here: 

http://www.grassrootsphysicaltherapy.com/physical-therapy-treatment/2018/9/12/pulley-taping-why-the-h-tape-method

Unless you're doing any specific rehab exercises in which case leave it untaped. 

Do *NOT* do any climbing or bouldering in the first week to 'test' it. This is the no.1 way to wreck your pulley for good. 

I've found a collagen supplement taken 1hr before loading has had a significant effect on speed of healing and effectiveness of rehab. I've used this one: 

https://www.amazon.de/Laborgepr%C3%BCft-Zertifiziert-Hydrolysat-geschmacksneutral-Weidehaltung/dp/B07QJV6RCP/ 

Post edited at 10:30
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Rigid Raider 06 Nov 2019
In reply to WaterMonkey:

If you're lucky enough to live near him I would strongly recommend Alex Buckley as a physio who climbs and is based at Royal Blackburn. Fantastic physio.

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climberchristy 06 Nov 2019
In reply to WaterMonkey:

Judging by the loud noise you may well have full rupture. I did mine and the noise was very loud. If you do have full rupture you will definitely need surgery and as soon as possible. So going to a physio not going to help. My climber partner is a physio and when I did mine he told me to get to A and E at once. I did and I was scanned and referred to a hand surgeon very quickly. The surgeon confirmed that full rupture will not heal without surgical intervention. So I'd advise A and E asap. 

Good luck 

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