Author Topic: Stress fracture in a knuckle....  (Read 8892 times)

Offline Dr T

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Stress fracture in a knuckle....
« on: April 04, 2009, 11:39:50 am »
from climbing injuries dot com

Stress fractures- If your middle knuckle hurts and is swollen much of the time, you may have a stress fracture. This is especially common, and troublesome, in young climbers. I urge you to seek medical attention to confirm the diagnosis although it is often hard to see a stress fracture on x-ray. If you do have a stress fracture, you will need to take at least a month off (but as long as 3 months), especially from crimping. You can probably climb on jugs without irritating the finger, but if it hurts at all, you are just setting yourself back on the healing spectrum. You can assess your healing by noticing decreased tenderness, swelling and no pain when climbing. If it still hurts, don’t do it.

sounds spot on....  :'(
(though not always painful)
anyone else had any experience of this?
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Offline Jim

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Re: Stress fracture in a knuckle....
« Reply #1 on: April 05, 2009, 07:31:00 pm »
think i've got this in my right index finger
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Offline St Hubbins

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Re: Stress fracture in a knuckle....
« Reply #2 on: April 07, 2009, 08:44:44 pm »
I may have this.

It doesn't hurt when climbing. It only hurts if i knock on a door hard or make a tiger claw motion

Offline robertostallioni

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Re: Stress fracture in a knuckle....
« Reply #3 on: April 07, 2009, 09:14:17 pm »
Well there goes the tigger-gram career...
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Offline Dr T

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Re: Stress fracture in a knuckle....
« Reply #4 on: April 08, 2009, 06:58:57 am »
Well there goes the tigger-gram career...


Justin Hawkins career goes to the dogs following his split from the Darkness...

as for the finger - slowly improving, still itching to get on my beastmaker but am, on the behest of many, "being Sensible"  :(
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Offline sidewinder

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Re: Stress fracture in a knuckle....
« Reply #5 on: February 13, 2012, 10:17:57 am »
I have been having an issue with the ring finger of my left hand.  No pain on climbing but I am unable to touch the pad of my finger to the base of the finger, as I can with all my other fingers and the knuckle nearest the palm feels swollen and sore when I try to do this.  It is also a bit worse after climbing and then seems to get better as I don't climb, getting to the point where I can touch the base of the finger again if I haven't climbed for ~5 days (uncommon at the moment).

Does this sound at all similar to the problem you had that turned out to be a stress fracture?  Was planning on getting a bit more aggressive with post climb icing (which seems to help) and also with taping some of the time to prevent me crimping on it too much in training at least.

As a side note, does anyone know of somewhere to get a small ice pack that would be of about the right size to ice one finger, I'm tired of having to get my whole hand cold to ice one finger!

Offline stevej

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Re: Stress fracture in a knuckle....
« Reply #6 on: February 13, 2012, 02:22:45 pm »
No experience of it in fingers (trying hard not to self-diagnose and decide I've got them. Think/hope they're just a bit sore) but I really struggled with stress fracture in my shins a few years back from running.

It feels a lot like inflammation and seemed to go hand-in-hand with getting inflamed bits in places anyway so I automatically took ibuprofen. Don't take ibuprofen (or presumably other nsaids,) it apparently actively stops the bone matrix from healing (vaguely remember there's some SCIENCE in the BMJ) and also stops the pain so that you can't feel the cracks opening and closing when you load them, which makes them grow. Which hurts, so you take more pills, so they stop healing etc...

Offline duncan

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Re: Stress fracture in a knuckle....
« Reply #7 on: February 13, 2012, 05:13:11 pm »
Can't really comment on stress-fracture likelihood or otherwise.  You know the drill...

Ice-cube massage is a good way of applying local cooling to a small area like a finger.  Grip the cube in a cloth or sponge to stop the gripping fingers melting it.  Keep the cube moving.  All this assumes you have good skin-sensation: you don't want to give yourself frost-nip.

Offline Footwork

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Re: Stress fracture in a knuckle....
« Reply #8 on: February 13, 2012, 06:21:52 pm »
Maybe this is what i've got on my right middle finger? I woke up one morning and it was very swollen and painful. This is about 2 months ago. It's much better but still feels enflamed and I can sometimes feel the pressure a bit when climbing on it.

If I hold the end of the finger with my left hand and pull it towards the index finger (keeping the middle finger straight) It hurt. However it didn't hurt at all doing the same towards my right ring finger. Weird.

Offline AdamD

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Re: Stress fracture in a knuckle....
« Reply #9 on: February 14, 2012, 12:21:07 pm »
I managed to get one of these a few years back, I had an x-ray and they found that I had cracked the knuckle (Growth plate) in half. I then had to have a finger brace which held it straight for about 6 months while it healed. Even now I still have a weakness in that knuckle and the knuckle is now quite a bit larger than the other knuckles due to the bone growth when it healed.

The initial problems were a very swollen knuckle, unable to weight it when climbing and unable to bend it to touch my palm

My advice is get an x-ray if you can, you may even be given one of these funky finger braces:

http://product.handyhealthcare.co.uk/soft-stretch-dynamic-finger-extension-splint.jpg


Offline Rocksteady

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Re: Stress fracture in a knuckle....
« Reply #10 on: February 14, 2012, 01:16:32 pm »
I think this thread has just described what I have in my right ring finger. 6 months in a splint doesn't sound appealing!  :o
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Offline sidewinder

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Re: Stress fracture in a knuckle....
« Reply #11 on: February 14, 2012, 01:19:30 pm »
The initial problems were a very swollen knuckle, unable to weight it when climbing and unable to bend it to touch my palm


Think I will try and get an x-ray, to see if that tells me anything but am hopefuly mine isn't this or if it is isn't that bad, my knuckle isnt noticeably swollen, I can touch my palm, just not the base of my finger as I can with the others and I can weight it as much as any of my other fingers, plus it seems to get better pretty quickly, I would just like it to stay better/know what it is so I can ignore it.  I have ordered some of these http://www.thermosonline.co.uk/products/Thermos-Flexi-Ice-Mat-Minis-Pack-3/Cool-Bags---Ice/products/4322.htm so am hoping they will allow me to ice the individual finger more easily, which will make me actually do it!

I am presuming there is some other explanation for these swollen knuckles as it seems many climbers have some sort of similar issue, two of my friends can no longer touch any of their fingertips to the base of their fingers.  Or maybe we all just get stress fractures but most of us ignore them?
« Last Edit: February 14, 2012, 01:43:55 pm by sidewinder »

Offline Paul B

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Re: Stress fracture in a knuckle....
« Reply #12 on: February 15, 2012, 03:32:46 am »
it apparently actively stops the bone matrix from healing (vaguely remember there's some SCIENCE in the BMJ) and also stops the pain so that you can't feel the cracks opening and closing when you load them, which makes them grow. Which hurts, so you take more pills, so they stop healing etc...

You're on the money here, I was advised to avoid Ibuprofen when my leg was a 'bit' bust. However, I was prescribed Diclofenac which is supposedly an anti-inflamatory too. I was told tonight this is the active ingredient in volterol gel.
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Online fried

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Re: Stress fracture in a knuckle....
« Reply #13 on: June 29, 2012, 04:41:04 pm »
The initial problems were a very swollen knuckle, unable to weight it when climbing and unable to bend it to touch my palm


Think I will try and get an x-ray, to see if that tells me anything but am hopefuly mine isn't this or if it is isn't that bad, my knuckle isnt noticeably swollen, I can touch my palm, just not the base of my finger as I can with the others and I can weight it as much as any of my other fingers, plus it seems to get better pretty quickly, I would just like it to stay better/know what it is so I can ignore it.  I have ordered some of these http://www.thermosonline.co.uk/products/Thermos-Flexi-Ice-Mat-Minis-Pack-3/Cool-Bags---Ice/products/4322.htm so am hoping they will allow me to ice the individual finger more easily, which will make me actually do it!

I am presuming there is some other explanation for these swollen knuckles as it seems many climbers have some sort of similar issue, two of my friends can no longer touch any of their fingertips to the base of their fingers.  Or maybe we all just get stress fractures but most of us ignore them?


Did you ever get any medical feedback on the problem? I'm having exactly the same problem in both my middle fingers.
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Offline sidewinder

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Re: Stress fracture in a knuckle....
« Reply #14 on: July 02, 2012, 09:21:55 am »
Given the large number of friends who seem to have the exact same thing, I have just decided to live with it for the moment, I am pretty confident it's not a fractured knuckle.  I think just swelling of ...?

Icing after climbing, seems to help it, as does (maybe) some ibuprofen/diclofenac gel on the knuckle before bed, if I rest it it gets progressively better, but then as soon as I climb it seems to swell up.

My suspicion is that it may well be linked to swelling/tightness all the way up the biomechanical chain, so I am trying to stretch/loosen/warm up/down more in general.  Working out the tension in my forearms(see other recent threads) seems particularly helpful.  I am guessing it is no coincidence that it is the middle finger on the left hand that is having issues, as it is the left side where I also tend to get elbow/shoulder problems, due to, no doubt some sort of imbalances.

Offline B-Bird

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Re: Stress fracture in a knuckle....
« Reply #15 on: July 03, 2012, 04:57:15 pm »
I had this about a year ago, and basically just do what climbing injuries said......and it will go away.

The good news is that my finger healed stronger, don't know if thats normal though!

Offline mattwilk

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Re: Stress fracture in a knuckle....
« Reply #16 on: March 25, 2013, 08:52:29 pm »
I've been struggling for about 6 months now, and tried to lay off climbing completely for about the last 4 which seems to have made no difference.
Struggling to touch the base of my finger, tightness and pain round knuckle, getting a lot worse after climbing, and massively limiting my ability to crimp or climb hard.
I think I've finally cracked it after getting close to giving up. Pretty sure it's a stress fracture caused by climbing, but failing to recover due to typing placing constant strain on it (work in an office).
Not typed with that hand for 2 weeks and starting to improve. If it's a stress fracture it sounds like I should avoid climbing for a couple more weeks, but got a scan in about a month which I guess could give a definitive answer.

Would really appreciate any advice on coming back from this, was starting to think I could never climb seriously again!

Online Nibile

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Re: Stress fracture in a knuckle....
« Reply #17 on: March 25, 2013, 09:17:12 pm »
I got a stress fracture in both wrists. They take a lot of time to go heal, but they do heal. My second one was in May '12 and it's almost completely healed now.
Be patient. It will go.
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Offline Tombondphysio

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Re: Stress fracture in a knuckle....
« Reply #18 on: March 31, 2013, 09:35:25 am »
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259713/

recent article about NSAID's and bone healing, for those that are interested in that kind of thing

due to a lack of robust evidence, NSAID's should be treated as a risk factor for bone healing

Offline cl204

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Re: Stress fracture in a knuckle....
« Reply #19 on: January 12, 2015, 09:16:35 am »
Hi all, thought I’d reboot this thread as I have something similar. A little background:

Around Christmas 2013 I noticed some pain in my left middle finger knuckle and some swelling. I had reduced motion as described by a few of you above such that a I couldn’t bend it nearly as much as the other fingers. It wasn’t a sudden onset so I ruled out pulley damage. Since I had a climbing trip planned in March 2014, and wanted to keep up strength, I continued to climb, all the while the finger getting slightly worse – crimping seems to do most damage. Also as above, it never really hurt during climbing, just during normal life and lots of pain if I caught the finger unaware and bent to the side etc. After the trip, I saw a physio who advised me to take a few months off climbing and thought it was due to muscle/tendon tightness right up the forearm. I was told to do loads of stretching and manipulation to try and increase the flexibility, which should ease the pain and allow it to heal. By mid-June, it had become significantly better (not completely) and so I did some very easy climbing, after which the swelling came back straight away along with some of the pain, so I stopped again. The physio couldn’t understand why it hadn’t healed so asked me to just do more of the same…<sigh>. By October (7 months off), the pain had reduced to 10-20% but plateaued, so I decided to wear a splint and put NO load on it whatsoever. The pain got down to ~5% quite quickly, but stayed there and never completely healed. Yesterday (after 10 months off) I did my first climbing session and sure enough the swelling and pain have returned to about 20%.

Other points:
- Bending the finger so that the tip touches the top of the palm causes aching in the knuckle
- twisting the top of the finger so that the knuckle “clicks” (yes, I know I shouldn’t do this, but it’s only for experimentation…) hurts, but after the click, the pain is almost completely gone for about 15 minutes
- As mentioned above (@footwork), if I bend the finger toward the index finger there is much more aggravation than bending toward the ring finger
- “Pinching” certain items, such as picking up a cup/bottle could induce a sharp pain to the point that I’d drop the item

It’s reassuring to know that others are having similar issues as I was beginning to lose faith, but not looking forward to potentially MORE time off climbing. I hope to get a referral from my GP to a hand specialist soon and will keep this thread updated on progress. If anyone has any more info on this I’d be keen to hear it!

Thanks, Chris

Offline turnipturned

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Re: Stress fracture in a knuckle....
« Reply #20 on: January 12, 2015, 10:06:49 am »
Chris, I am by no means an expert or have any particular knowledge in the field except personal experience.

Are you sure its not something I refer to as a twisting ligament injury? I have this in both my ring fingers from time to time. Basically warming up its a bit painful but soon as its warm then I don't really notice it as much. Hurts when I slap for jugs and catch the lip on the back of the knuckle. When I am not climbing and push my finger straight I can feel it in the knuckle. Slight bit of swelling when its at its worse after climbing but its not huge amounts.

If this is the case, my personal experience is to just keep climbing and eventually it goes away (1-2 Months!?!).

What I do:

Tape it in a figure of 8 around the knuckle when its hurts (try and keep this to a minimum as otherwise I recon the finger will never heel).
Make sure you warm up properly, I think people (Mysef included) go to the climbing wall do 5-10 jug pulls then go try something hard. This may warm your body up but not your fingers, try and do a climb with every type of grip position before you try something more intense (i.e. half crimp, sloper, pinch, full crimp. drag etc)
After climbing, if its bad do some of that hot, cold treatment and then keep massaging it. If you can get hold of a Mr Spikey (sell them at Eden Rock) they are good for this.

My opinion is that due to the nature of our sport, you are bound to get some kind of finger injury, so I see it as injury management. I think the worst thing you can do, unless it is a serious climbing injury, is stop climbing.

Offline cl204

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Re: Stress fracture in a knuckle....
« Reply #21 on: January 13, 2015, 06:56:54 am »
@turnipturned,

Thank you for the response, I'll certainly bear this in mind as a possibility. I'm sceptical because of the length of time it has been an issue (~13-14 months now), but that's not to say it doesn't just keep recurring. Regarding warm up, I do try my best to get everything warm and flexed before attempting anything hard, but certainly at this time of year in could gyms it's not easy and takes a lot of discipline.

One other thing I forgot to mention is that massaging the finger does seem to help a lot in reducing acute pain (in the short term), should that be of importance...

Chris

Offline tomtom

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Re: Stress fracture in a knuckle....
« Reply #22 on: January 13, 2015, 09:16:55 am »
Do you ever feel any scar tissue (often clicky bits) when massaging?

Offline turnipturned

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Re: Stress fracture in a knuckle....
« Reply #23 on: January 13, 2015, 09:25:26 am »
Quote

One other thing I forgot to mention is that massaging the finger does seem to help a lot in reducing acute pain (in the short term), should that be of importance...


That's exactly what happens with me, massaging seems to make a big difference! Try these, honestly they are really good, http://www.michaelstainthorpe.co.uk/finger-massagers/

Offline Rocksteady

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Re: Stress fracture in a knuckle....
« Reply #24 on: January 13, 2015, 09:28:00 am »
I have this same thing as you cl204 in 3 of my fingers. When I had them checked out they turned out fine in a ultrasound. Hand therapist thought I had early onset arthritis and told me that I would have got it anyway eventually even if I didn't climb - but climbing made it worse. She told me that if I loved it though there was no point stopping, and to stop eating inflammatory foods and to tape up - much as turnipted's suggesting.

I accepted all this because although it wasn't great I was told what we all want to hear - keep climbing. In retrospect I wonder if I should have gone for an X Ray and 2nd opinion.

I wonder if they are twisting ligament injuries. My knuckles are quite swollen and look a bit deformed - but no more so than a lot of other climbers I see.
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