[becciesarah]

Thanks Matt,

I'd say that my trunk rotation is probably quite poor compared to my general flexibility.
My shoulders are getting stronger but my right shoulder has a history of weakness and instability after a dislocation (and immediate relocation) several years ago that was then mis-diagnosed as a rotator cuff injury. Investigative surgery was inconclusive and I then had months of physio to re-strengthen and stabilise the shoulder.
I've found climbing has helped with the strength but I still run with a base level of muscle tension and discomfort from my right shoulder.
I mention the above as I have also noticed in massaging my shoulder/arm above the elbow today that this is triggering a tingling sensation down to my hand (I've had this before due to my shoulder) and believe it is when I've pushed across a nerve.

Depending on any additional thoughts I think I'll make an appointment to see the physio at our local wall.

Thanks again!
Beccie

[DaveyDave]

Hi guys,

I've had an elbow problem now for over a year on my right arm. There's no real specific area of pain, but it hurts deep inside the elbow when locking off/doing pullups or compression moves. Also I get a really sharp pain right at the base of the tricep if I press outwards with totally a totally bent arm (like a pushup from lying down). Throwing things seems to make it worse aswell.
Everyone seems to think its an ulnar nerve thing, and I've tried eccentrics, ulnar flossing, rest, not rest etc but had no really significant improvements since I did it (brought on after a heavy day of bouldering). Seen about 5 or 6 physios aswell, all to no avail.

Any ideas what I've got, or any last ditch efforts I can make to fix it?

Cheers,
Dave

[HPclinic]

Thanks Matt,

I'd say that my trunk rotation is probably quite poor compared to my general flexibility.
My shoulders are getting stronger but my right shoulder has a history of weakness and instability after a dislocation (and immediate relocation) several years ago that was then mis-diagnosed as a rotator cuff injury. Investigative surgery was inconclusive and I then had months of physio to re-strengthen and stabilise the shoulder.
I've found climbing has helped with the strength but I still run with a base level of muscle tension and discomfort from my right shoulder.
I mention the above as I have also noticed in massaging my shoulder/arm above the elbow today that this is triggering a tingling sensation down to my hand (I've had this before due to my shoulder) and believe it is when I've pushed across a nerve.

Depending on any additional thoughts I think I'll make an appointment to see the physio at our local wall.

Thanks again!
Beccie

Hi Beccie, that sounds like a good idea particularly if there may be some nerve involvement.
regards
Matt

[HPclinic]

Hi guys,

I've had an elbow problem now for over a year on my right arm. There's no real specific area of pain, but it hurts deep inside the elbow when locking off/doing pullups or compression moves. Also I get a really sharp pain right at the base of the tricep if I press outwards with totally a totally bent arm (like a pushup from lying down). Throwing things seems to make it worse aswell.
Everyone seems to think its an ulnar nerve thing, and I've tried eccentrics, ulnar flossing, rest, not rest etc but had no really significant improvements since I did it (brought on after a heavy day of bouldering). Seen about 5 or 6 physios aswell, all to no avail.

Any ideas what I've got, or any last ditch efforts I can make to fix it?

Cheers,
Dave

Hi Dave, if the pain is deep inside your elbow it could be that you are compressing the elbow joint (more specifically the humeral ulnar part). You may also  be compressing the median nerve that runs beside your biceps and crosses the elbow joint.
I would also be interested in what you are doing further up the movement chain ie what positions your shoulder/scapular and neck are in. It is obviously difficult to fully understand your problem without looking at you. Perhaps give me a call next week on 0114 267 1223. I am in the clinic tues to fri.
regards
matt

[twoshoes]

Hi guys,

I'm having some real wrist problems. I'm getting a really sharp pain on the little finger side of my wrist. It comes on when there's any twisting force on my wrist (undercuts and sidepulls you pull up against are bad). But also when I'm pushing against my fingers, like washing my face or hair. Weirdly, it doesn't hurt on slopers. Holding a heavy saucepan or using a screwdriver aren't ideal either.

I assumed it was a TFCC injury, but I can more or less push down in a press up position pain-free. I've tried taping it, resting it, using it - all seem to work sometimes but not at others.

Any idea what's going on? Cheers!

[Pricey]

Hi,

I've been having some trouble with my left forearm for around 8 weeks now roughly. I'm vaguely pinpointing it to 3 sessions I had in quick succession on a problem and route with left hand undercut/side pull hold and a weird guppy hold (the keel hold on the keel at Almscliffe).

It's tender to touch about half way along the forearm on the anterior/palmar surface of the ulnar. Its not tender when pressed on the other side which makes me think it's what's being compressed between the bone and my finger causing the pain, rather than the bone itself. The tender area is probably 1-2 inches long.

When climbing, the pain is more like a dull throbbing and isn't obviously exacerbated by any particular orientation, it's probably a bit worse on undercutty side pulls but only marginally. After having a few days off it eases and I have a session where it's not too bad but then it just comes back. To be honest I was expecting it to sort itself out with a few enforced 4-5 day rests but it hasn't improved whatsoever.

I've just had another few days off and think I'll just do some easy climbing trying not to aggravate it.

I expect that in this case more rest might actually be the solution but I'm really not sure what's going on and wondered if you had any idea what it sounded like from my crude history?

Thanks

[HPclinic]

Hi guys,

I'm having some real wrist problems. I'm getting a really sharp pain on the little finger side of my wrist. It comes on when there's any twisting force on my wrist (undercuts and sidepulls you pull up against are bad). But also when I'm pushing against my fingers, like washing my face or hair. Weirdly, it doesn't hurt on slopers. Holding a heavy saucepan or using a screwdriver aren't ideal either.

I assumed it was a TFCC injury, but I can more or less push down in a press up position pain-free. I've tried taping it, resting it, using it - all seem to work sometimes but not at others.

Any idea what's going on? Cheers!

Hi sorry about the delayed response, I have been away.
The description you give does tend to suggest a TFCC injury and symptom reproduction isn't always consistent. There are also other structures that can give similar symptoms. Sometimes the ulnar nerve can be compressed or irritated at the wrist/hand or at the neck and can refer into this area.
If we are thinking it is more likely to be a TFCC injury then initially I would recommend a 2 week period of relative rest with the use of a wrist splint to minimise movement. Sometimes a short period of minimal movement can help as everyday movements don't always allow total rest. I am not normally an advocate of total rest but I have found for this type of problem this is sometimes necessary. You would still want to occasionally move the wrist but having a control on the amount is important.
On returning I would recommend starting on lower grade climbs and minimise side pulls and twisting actions.
If symptoms don't settle then an arthrogram may be necessary which involves injecting dye into the wrist and seeing if there is disruption to the TFCC. Even if there is it can still be managed conservatively.
Alternatively it may be worth getting a physio assessment.
regards
Matt

[HPclinic]

Hi,

I've been having some trouble with my left forearm for around 8 weeks now roughly. I'm vaguely pinpointing it to 3 sessions I had in quick succession on a problem and route with left hand undercut/side pull hold and a weird guppy hold (the keel hold on the keel at Almscliffe).

It's tender to touch about half way along the forearm on the anterior/palmar surface of the ulnar. Its not tender when pressed on the other side which makes me think it's what's being compressed between the bone and my finger causing the pain, rather than the bone itself. The tender area is probably 1-2 inches long.

When climbing, the pain is more like a dull throbbing and isn't obviously exacerbated by any particular orientation, it's probably a bit worse on undercutty side pulls but only marginally. After having a few days off it eases and I have a session where it's not too bad but then it just comes back. To be honest I was expecting it to sort itself out with a few enforced 4-5 day rests but it hasn't improved whatsoever.

I've just had another few days off and think I'll just do some easy climbing trying not to aggravate it.

I expect that in this case more rest might actually be the solution but I'm really not sure what's going on and wondered if you had any idea what it sounded like from my crude history?

Thanks

Hi sorry about the delayed response, I have been away.
From your description it sounds like it is in the area of the muscle tendon junction. The holds you mention will have put increased loading on this area and three consecutive sessions probably contributed with cumulative micro trauma leading to a strain. This type of injury would normally take 2-3 weeks to settle but needs to be managed correctly. Sometimes you can overload this area too soon. It is important to put stresses through this area as you need to strengthen it but it needs to be graded and gradual (frustrating I know!) as symptoms allow. There is also the ulnar nerve that can give similar symptoms in this area. I would still manage it by graded exposure to increased stresses.
If symptoms persist then give me a call 0114 2671223 or see a local physio.
regards Matt

[PipeSmoke]

Hello, I injured what I think is the A2 pulley in my left ring finger. I have been icing it, using a finger roller thing and climbing only on stuff that doesnt aggravate it. Whilst it doesn't hurt very much at all, even becoming unnoticable much of the time. As soon as a hold digs into the area it is extremely painful. Also the morning after climbing it is also very sore when pulling with the finger. Once I am warmed up it is also fine to climb on stuff that doesn't dig into it.

What else can I do to heal the finger? It has been a couple of months now, and whilst the injury isn't putting holding me back really, it is still painful and worrying the days after. It doesn't seem to be getting any better or worse, just stalling.

thanks

[nai]

Hi Matt

Few finger issues all on the right hand:

First up, the spot circled is very tender when pressed, Any idea what this is?  I've been avoiding crimping and can climb open-hand ok and it doesn't appear to harming it any further, I assume the answer to this is keep avoiding crimping?



Next up, bit of a trauma injury, moved my finger sideways while it was still deep in a pocket and now have lots of swelling around the PIP, two weeks on I can just about make a fist.  Been icing it and climbing at a reduced level with it heavily taped so it can't be bent.  Still quite tender around the joint though even 2 weeks on.





Last up but most long standing my finger nail (forefinger) is growing distorted, any ideas what could be causing this?



Cheers
Ian

[HPclinic]

Hello, I injured what I think is the A2 pulley in my left ring finger. I have been icing it, using a finger roller thing and climbing only on stuff that doesnt aggravate it. Whilst it doesn't hurt very much at all, even becoming unnoticable much of the time. As soon as a hold digs into the area it is extremely painful. Also the morning after climbing it is also very sore when pulling with the finger. Once I am warmed up it is also fine to climb on stuff that doesn't dig into it.

What else can I do to heal the finger? It has been a couple of months now, and whilst the injury isn't putting holding me back really, it is still painful and worrying the days after. It doesn't seem to be getting any better or worse, just stalling.

thanks

Hi the pulley would have healed by now but it is probably crumbling if a little too overloaded. Back off the grades for the next two weeks and slowly introduce crimping in a graded fashion. You could also try some massaging into this area . As you know the A2 pulley is the most common injury and both of the flexor tendons pass through it so it has to withstand a lot of stress. It will improve just keep increasing the loads as symptoms allow. Keep me posted and call the clinic on 0114 2671223 if you have any queries.
regards
Matt

[HPclinic]

Hi Matt

Few finger issues all on the right hand:

First up, the spot circled is very tender when pressed, Any idea what this is?  I've been avoiding crimping and can climb open-hand ok and it doesn't appear to harming it any further, I assume the answer to this is keep avoiding crimping?



Next up, bit of a trauma injury, moved my finger sideways while it was still deep in a pocket and now have lots of swelling around the PIP, two weeks on I can just about make a fist.  Been icing it and climbing at a reduced level with it heavily taped so it can't be bent.  Still quite tender around the joint though even 2 weeks on.





Last up but most long standing my finger nail (forefinger) is growing distorted, any ideas what could be causing this?



Cheers
Ian

Hi Ian, the first problem looks like it could be an A1 pulley injury. You are correct back off the crimping for a couple of weeks and slowly add them again.
The second problem could be trauma to the joint and/or the collateral ligaments. Keep moving it and you can be relatively aggressive with the stretches. They do take at least 3-4 weeks to settle and the swelling does tend to hang around.
The third issue it that you may have disrupted the nail bed and you may find this always grows through like this. Give me a call if these issues are not settling on 01142671223.
Regards
Matt

[lizkirk82]

Hi,

I have a hand injury sustained whilst pulling on a pocket with my hand twisted slightly. I heard something crack in my wrist/hand - no particular pain straight away but I stopped climbing and iced it.

Following this the next day I am able to do most movements pain free although clenching a fist is painful through the centre of my palm and I get an occasional pain that shoots up to my elbow when gripping things - using my middle 2 fingers especially. There is also some tightness felt if I try and stretch my fingers back. There is no swelling at all and my hand generally just feels a bit weak,

Any advice on what to do would be much appreciated, I don't feel its worthy of a doctors visit as I have nearly full range of movement, and it seems to only be aggravate by gripping in a certain way -although I know I definitely can't climb or pull with it,

Thanks

[HPclinic]

Hi,

I have a hand injury sustained whilst pulling on a pocket with my hand twisted slightly. I heard something crack in my wrist/hand - no particular pain straight away but I stopped climbing and iced it.

Following this the next day I am able to do most movements pain free although clenching a fist is painful through the centre of my palm and I get an occasional pain that shoots up to my elbow when gripping things - using my middle 2 fingers especially. There is also some tightness felt if I try and stretch my fingers back. There is no swelling at all and my hand generally just feels a bit weak,

Any advice on what to do would be much appreciated, I don't feel its worthy of a doctors visit as I have nearly full range of movement, and it seems to only be aggravate by gripping in a certain way -although I know I definitely can't climb or pull with it,

Thanks

Hi, it is a little difficult to know exactly what you have done. You could be getting weakness from a tendon strain or sometimes the median nerve in your wrist could have become compressed or irritated. I think probably the former particularly as you heard a crack (the same happens with pulley type injuries but your description of the pain seems a bit lower into the palm). It is good you have full range of wrist movement.
I would start to gently load the wrist again on much easier grades and just traverse on a bouldering wall so that you can have more control on the amount of effort. If it is not settling within the next two weeks then see a physio locally just to give you a more accurate diagnosis and be able to test your hand/wrist in different positions.
kind regards Matt

[Will Hunt]

I haven't injured myself yet but would like to avoid doing so if possible! Having searched through a few threads I couldn't match my symptoms exactly so thought to ask here. Thanks Matt for making this resource available!

I have noticed some moderate discomfort/pain at the very base of my ring finger when open handing sometimes. I don't seem to get the pain at all when crimped. It sort of feels like something is about to pull loose! Needless to say, whenever I feel this I stop doing it immediately and start crimping! This has occurred intermittently for perhaps a couple of months but the latest flare up came after a days crimping at Anston Stones (despite not feeling pain whilst crimping...)

Applying pressure to the base of the finger gives some small pain (we're only talking a 2 or a 3 out of 10 here) but the pain is never felt in the palm.

Any idea what this might be and what I can do to strengthen the weak link?

[Pako]

What is a better way to train the antagonists to prevent/rehabilitate injury? I had a period where I was doing a lot of one armers and no antagonist training, and as a result the muscles are very imbalanced, and at the moment my forearm muscles (the ones on the inside) are very tender and hurt if pushed (don't really hurt during climbing though). I have rings, and do enjoy doing weighted dips and such on them, but am not sure if going to a conventional gym to do weights for pushing exercises would be better.

So really the question is, is going to a normal gym twice a week a good way to train my antagonist muscles?

[36chambers]

Hi, I don't know whether the clinic is still going, or whether this is the sort of thing you deal with but just in case...

I injured my ring finger from crimping on a small hold about a year ago. No popping noise, just symptoms of a swollen PIP joint, pain when I pressed on my A2 pulley and pain when I fully bend the finger and forcing the fingertip to touch base. I have similar injuries on different fingers that have completely recovery.

Anyway, the injury wasn't severe enough to impact my climbing too much and I have been consistently climbing "hard" and improving since. Every 4 months or so, when I think it's fully recovered, I end up pushing it too much and "re-injuring" it (making it swell again and become slightly agitated, but never nearly bad as the original incident), when this happens I just take it easy for a week or so and continue as normal.

However, two weeks ago I have noticed that my finger now makes a very faint noise whenever I close it, which sounds very similar to slowly tearing a piece of paper. I can still pull hard and there is effectively no PIP swelling and little pain when I massage the A2 pulley, but I am concerned that the long term, reoccurring, injury has evolved into a new uglier and more serious injury.

If it doesn't appear to improve in the next few weeks I may go and see someone about it, but until then if anyone could shine some light on the injury, it would be highly appreciated.

TL;DR my long term finger injury has started making noises and I'm scared.

thanks.

[benj_d]

Hey, wouldn't mind your opinion... After I last climbed 10 days ago my shoulder felt terrible after climbing, bit of research makes me think it's a rotator cuff injury, it's been painful ever since with rest, visited the gp and he agreed likely a rotator cuff injury/micro tear based on him getting me to do a few movements and saying my shoulder still has a lot of strength in it so can't be a big tear so should heal with rest and pain killers, does that sound accurate? Got a physio appointment through work for free but earliest I could get is in 2 weeks time...

[duncan]

It's a challenge diagnosing shoulder problems with the person in front of you and practically impossible virtually. The information you give could apply to several possibilities, rotator cuff injury is a plausible one.

Try to be patient, wait to see what the physio. says, two weeks is trivial compared with the timescale of a serious shoulder problem. Relative rest for now, be gently active but any activity must be pain-free.

[shark]

Hi, I don't know whether the clinic is still going

Unfortunately Hallamshire Physiotherapy is not currently a sponsor. I have emailed them to say there are a couple of outstanding queries so they may come back with a response.

[HPclinic]

Hi, I don't know whether the clinic is still going, or whether this is the sort of thing you deal with but just in case...

I injured my ring finger from crimping on a small hold about a year ago. No popping noise, just symptoms of a swollen PIP joint, pain when I pressed on my A2 pulley and pain when I fully bend the finger and forcing the fingertip to touch base. I have similar injuries on different fingers that have completely recovery.

Anyway, the injury wasn't severe enough to impact my climbing too much and I have been consistently climbing "hard" and improving since. Every 4 months or so, when I think it's fully recovered, I end up pushing it too much and "re-injuring" it (making it swell again and become slightly agitated, but never nearly bad as the original incident), when this happens I just take it easy for a week or so and continue as normal.

However, two weeks ago I have noticed that my finger now makes a very faint noise whenever I close it, which sounds very similar to slowly tearing a piece of paper. I can still pull hard and there is effectively no PIP swelling and little pain when I massage the A2 pulley, but I am concerned that the long term, reoccurring, injury has evolved into a new uglier and more serious injury.

If it doesn't appear to improve in the next few weeks I may go and see someone about it, but until then if anyone could shine some light on the injury, it would be highly appreciated.

TL;DR my long term finger injury has started making noises and I'm scared.

thanks.

Hi sorry about the delayed response. This unfortunately is the last response as this thread has been quite. We may start again next summer.
To begin, don't alarm yourself about your injury. It sounds like the noise could be coming from the joint rather than the tendon. If the joint is not swollen then that is a good sign. If you are having intense periods of climbing then it may be that you have just overloaded the joint and it is grumbling. Certainly back off the intensity.
I would suggest you get a physiotherapy opinion as it has been going on for a prolonged period and they may be able to give you some specific exercises and perhaps look at your technique.
Regards
Matt

[HPclinic]

Hey, wouldn't mind your opinion... After I last climbed 10 days ago my shoulder felt terrible after climbing, bit of research makes me think it's a rotator cuff injury, it's been painful ever since with rest, visited the gp and he agreed likely a rotator cuff injury/micro tear based on him getting me to do a few movements and saying my shoulder still has a lot of strength in it so can't be a big tear so should heal with rest and pain killers, does that sound accurate? Got a physio appointment through work for free but earliest I could get is in 2 weeks time...

Hi sorry about the delayed response.
It is difficult to say what you may have injured. If it is a small tear then it will improve steadily with graded loading. If you are seeing a physio then they should look at possible reasons for this injury as well as checking for compensations that may be re- irritating the problem. If you have any queries and would like some advice then call me on 0114 267 1223.
regards
Matt

[36chambers]

Hi, I don't know whether the clinic is still going, or whether this is the sort of thing you deal with but just in case...

I injured my ring finger from crimping on a small hold about a year ago. No popping noise, just symptoms of a swollen PIP joint, pain when I pressed on my A2 pulley and pain when I fully bend the finger and forcing the fingertip to touch base. I have similar injuries on different fingers that have completely recovery.

Anyway, the injury wasn't severe enough to impact my climbing too much and I have been consistently climbing "hard" and improving since. Every 4 months or so, when I think it's fully recovered, I end up pushing it too much and "re-injuring" it (making it swell again and become slightly agitated, but never nearly bad as the original incident), when this happens I just take it easy for a week or so and continue as normal.

However, two weeks ago I have noticed that my finger now makes a very faint noise whenever I close it, which sounds very similar to slowly tearing a piece of paper. I can still pull hard and there is effectively no PIP swelling and little pain when I massage the A2 pulley, but I am concerned that the long term, reoccurring, injury has evolved into a new uglier and more serious injury.

If it doesn't appear to improve in the next few weeks I may go and see someone about it, but until then if anyone could shine some light on the injury, it would be highly appreciated.

TL;DR my long term finger injury has started making noises and I'm scared.

thanks.

Hi sorry about the delayed response. This unfortunately is the last response as this thread has been quite. We may start again next summer.
To begin, don't alarm yourself about your injury. It sounds like the noise could be coming from the joint rather than the tendon. If the joint is not swollen then that is a good sign. If you are having intense periods of climbing then it may be that you have just overloaded the joint and it is grumbling. Certainly back off the intensity.
I would suggest you get a physiotherapy opinion as it has been going on for a prolonged period and they may be able to give you some specific exercises and perhaps look at your technique.
Regards
Matt

Thanks for the reply Matt, much appreciated.

[Bluah]

Finger injury

I injured my middle finger whilst bouldering indoors just over three weeks ago.  I was climbing a slab problem on small holds when I lost my feet, transferring all my weight onto my middle finger, which was on a one-finger crimp directly above my head.

I did not hear any popping or cracking, but immediately felt pain in my finger just above my palm (proximal phalanx).  I tried a problem with sloper/large jugs, but this led to sharper pain.  I stopped climbing immediately.  I found that I could could not bend my finger past 90 degrees without sharper pain.  The injury didn't seem that serious, just painful and I assumed that a week or so of rest would let me start climbing again.

That evening my finger swelled at the proximal phalanx, although I had no discolouration or bruising.  I iced, elevated and put on some tape for compression.  Over the past three weeks I have continued to treat in the same way, taping my finger and using topical ibuprofen gel.

Although the swelling has gone down, my finger is still somewhat swollen and my finger and palm (at the top of the metacarpal bone) are still tender to the touch and painful when used.  I can now bend my finger without sharp pain until the fingertip is ~1cm away from my palm.  If I extend my fingers and slightly hyperextend my finger the pain is much sharper.  When applying pressure or massaging the finger the worst pain is at the base of the finger on the side and front next to my ring finger and the top of the metacarpal bone.

I would like to start building my finger up, but am really struggling to get the swelling to go down.  I haven't been to see my GP but am wondering if I should, or if there is anything else I should be doing to deal with the swelling and pain.

I would love to get your thoughts on what the injury might be and on how to treat my injury.

[Bluah]

And a photo of the injured finger: https://goo.gl/photos/PCR2XPvAM3QgqzxS8