[Robsons]

SO...10 weeks of training, feeling stronger and stronger in preparation to my first time to Catalunya on Saturday.
Last night I thought I'd have a fun session on the new blocs at Reading. I was climbing well and feeling strong. Jumped on another problem which involved a two finger pocket and suddenly "POP", my finger gave way and I fell off. No pain, but as soon as I tried to apply any resistance to my left ring finger I felt pain and had NO power!!!

Off to A&E...
As I work at the wall and coach daily I told the guys my livelihood depended on it...luckily two of the Dr.s in A&E (including the head Dr. for the night) were climbers.

Today I went in again to see a hand specialist. He believes I have a full rupture of the A2 pulley, but obviously needs to see MRI to confirm.

I am off on holiday on Sat (now sunbathing), so delayed the MRI to a week Tuesday.

My question to you guys is the following:
Having read AS MUCH AS I CAN do on this forum, Dave's blog, Athlon website, Nicros etc...is leaving it the best option????

I read Adam Lincoln had these, but somehow managed to climb after it happened...absolutely cannot do this...too painful!
I've been icing/heat (Lewis reaction) and applying a little pressure for massaging...but don't know what to do?!?!

I need to get back climbing asap, but don't want recurring injuries?
When I asked the Dr his opinion, he said if it is only one pulley rupture, then probably bes to leave it. Multiple, then op!?

As well as depressed beyond belief, angry and emotional, I am now confused...

Any help would be hugely appreciated!

Thanks,


Robin

[clm]

I popped one second day in font and with heavy taping had a really good weeks climbing. Audible but doubt it was a full rupture.

[Robsons]

Was it not outrageously painful when pulling? If I put my fingertip to my thumb and press it is ridiculous!!!

[Sasquatch]

 

I would say absolutely NO to the surgery. 

Maybe someone else knows better, but I think in almost all cases surgery is truly a last resort. If in two years you still haven't recovered, then maybe think about surgery.

As far as the being able to climb on it. I've had two similar incidences one was about 12 years ago.  That one was ridiculous.  Couldn't put pressure on it for about 6 weeks, It eventually healed as strong as ever, just took time.  The other was about 3 years ago.  Turned out to be an attachment point for the tendon on the side of my index finger.  Felt brutal until I taped it, then felt fine. 

Dave recent website post about active type recovery from injury is very timely.  Good Luck.

[GCW]

 My thoughts are on the wiki.

[Nibile]

I'd say avoid surgery.
many climbers I know recovered from pulley ruptures without surgery.
I don't know if this may be of some help, but in Italy there is Dr. Parra, AKA "Doctor Laser". he developed a new type of laser, which seems to make miracles. a friend of mine went from full A2 rupture to one arm deadhangs on the good rungs of the BM in two months.
Dr. Parra has trated the likes of Alberto Tomba, Ana Ivanovic, Rafa Nadal, Roger Federer, Mario Cipollini and a few more.
a pricey last resort?
anyway good luck, and keep the fucking faith.

[Robsons]

Thanks Nibbs - like the sound of miracle treatment...Had a look at his website...wonder how much it costs??
Cheers GCW, but where on the Wiki? (Sorry, but couldn't see it?)
Good to hear Sasquatch...as soon as I can, I'll start training my front two and other hand...as well as working on my weaknesses - core and flexibility!

[andyd]

The ice treatment feels like the right thing to do, however I have been advised by a specialist that it's BS. Save yourself the bother of freezing lots of ice. Sorry about your finger mate and I hope you enjoy the sun.

[Robsons]

With reference to the icing - I am currently doing as advised by Dave Mac et al...The Lewis Reaction whereby you use cold water and a few ice cubes to cool the injury before putting it into a warmer environment (warm water), thus flooding an area which is renowned for poor circulation.
Are you talking about merely icing Andyd? As this is considered foolish as prevents blood flow?

[mrjonathanr]

Bummer, bad luck. Does DM not advise letting inflammation settle for 72 hrs before Lewis -type stuff? No NSAIs initially either, inhibits healing reactions inc prostaglandins.
I can't see what's wrong with ice, diminishes inflammation and ultimately increases blood flow although tissues are fragile when cold so look after it.

[Paul B]

With reference to the icing - I am currently doing as advised by Dave Mac et al...The Lewis Reaction whereby you use cold water and a few ice cubes to cool the injury before putting it into a warmer environment (warm water), thus flooding an area which is renowned for poor circulation.
Are you talking about merely icing Andyd? As this is considered foolish as prevents blood flow?

Surely its way too early for this? Ice, ice, ice. Buy some Voltarol gel and use that too. Speaking to a trainee physio recently, the various processes involved with tendons healing suggest that you'd be premature doing this within 6 weeks of the initial injury. At that point hot/cold treatment could be applicable but opinion seems to be split; general consensus is that climbing promotes more blood flow than this anyway.

If its a full rupture then I've got no first hand advice to offer as I've never been there. However, partial tears are a regular occurrence for me. Ice and take as little time off as you can before getting back to pain free climbing. This will be depressingly easy but stick with it. If you feel pain the day after; you've done too much, do less next time and ice until you feel you can have another session (try to get it right next time). Outside always seems to hurt less than inside.

I've actually followed my own advice with my latest injury and by careful management its improving much faster than any prior injury. Do what it takes, its much easier than the long term implications of not doing so!

Studies relating to tape don't seem overly relevant to the rehabilitation of finger injuries but from my own personal experience I've found that bending the finger at around 30' and taping from the A2 up over the knuckle helps.

[Nibile]

I've been told that after 24 hours icing does harm, because it restraints bllod flow. But ice and warm water seems fine to me. I'm no doctor though.

[GCW]

Cheers GCW, but where on the Wiki? (Sorry, but couldn't see it?)

Here.

[Barratt]

Two weeks ago I popped my A3 in quite some style. Panic, fear and regret... i'm sure you know these feelings well by now 

I went to see the guys at the Clinic in Sheff (Rick, team gb physio) and received really good advice. The point here is that you'll just get confused with the vast amount, and varrying quality, of information on the net. My suggestion would be to give Rick a call, with the medical advice you have already received i'm sure he will be able to give clear, concise information that will be of benefit not only physically, but mentally as well.

Hope this helps.

Oh, and after two weeks i can apply pressure with no pain. Bowstringing is massively reduced with the advised H taping, i'll be starting climbing again in a week, obviously easy open hand stuff... and it was a full rupture

[Snoops]

I've been told that after 24 hours icing does harm, because it restraints bllod flow. But ice and warm water seems fine to me. I'm no doctor though.

RE: THE ICING
for the first 10-14 days the area undergoes acute and then sub-acute inflammation -  a huge influx of white blood cells, increase in blood supply (angiogenesis) etc.
Doing the warm water (Lewis reaction) is a very BAD idea during this time. The injury site will become more swollen and more inflamed and the end result may be more scar tissue

Cold water/icing will help - it will help most in the first 72 hours after this the benefit is reduced, although it won't harm.
Save the LEWIS stuff for 2 weeks later.

[Nibile]

Thanks beast, hope not to need your advice though!!!
Touch wood emoticon?

[andyd]

What snoops said

[Robsons]

Awesome, thanks for the advice guys...Snoops, I will stop the Lewis then and head straight for ice...
Once initial inflammation has gone down - any knowledge of acupuncture to finger?

[andyd]

Have you tried magic beans and tarot cards to go with the acupuncture?

[Sasquatch]

I've got some snake-oil that'll work wonders too!!!!

 

[mrjonathanr]

Have you tried magic beans and tarot cards to go with the acupuncture?

The Chinese have been at this for over 4,00 years now and have parallel traditional/western hospital systems in place.

Would they not have stopped with the acupuncture after the first 1,000 years or so if it wasn't proving clinically effective?

Just a thought, although it isn't something I'd naturally consider for an injury like this.

Homeopaths, crystals, Uri Geller - all fit for 101 however.

Robsons : good luck with this, Bennett and Barratt have good advice I think.

[Nibile]

Four years isn't much though.

[Snoops]

Awesome, thanks for the advice guys...Snoops, I will stop the Lewis then and head straight for ice...
Once initial inflammation has gone down - any knowledge of acupuncture to finger?

Me no nothing about acupuncture....at least nothing informed.
Being a surgeon I'm a little sceptical, however it does work for a cohort of people with chronic problems (especially chronic pain)
Never heard of anyone doing it for acute injuries though...so no comment 

[slackline]

Awesome, thanks for the advice guys...Snoops, I will stop the Lewis then and head straight for ice...
Once initial inflammation has gone down - any knowledge of acupuncture to finger?

Google Scholar is your friend (third hit).

The Chinese have been at this for over 4,00 years now and have parallel traditional/western hospital systems in place.

Would they not have stopped with the acupuncture after the first 1,000 years or so if it wasn't proving clinically effective?

Plenty on assessing the efficacy of accupunture in general

[biscuit]

Not read the efficacy stuff of accupuncture but i can only say that having had chronic sciatica for ages; due to job consisiting of 1 hr commute in car, sitting at desk, driving in car for up to 4 hrs a day, sitting at desk and then driving home. It was crippling me and i couldn't sleep much due to it either. Dr and physio wasn't working ( anti inflammatories and stretches ) but after 1 treatment of accupuncture i felt a massive release of tension and relief of pain. After 4 treatments it was totally gone, shortly after so was the job 

She was a UK qualified Dr but had also studied Chinese medicine for 7 yrs.

Again not sure on actue injuries though.

My wife likes homeopathy, well it makes her think she is getting better quicker anyway and doesn't cost much, personally i think it's a load of