[cjsheps]

Hi UKB, can someone help an injured brother out please? 

Over the last few weeks climbing I'd noticed a gradual soreness coming on when crimping - my hands felt almost "creaky". A few days off and it seemed OK, but a session in the Cave set me back to square one the next day.

I saw Tim from Global Therapies (highly reccomended) about this problem and got diagnosed with tendonitis in my left pinkie and right ring finger, with the advice to rest, slowly load the tendon open handed well below training loads, and avoid crimping "forever".

Does anyone have any experience with a similar issue? If so, how long did it take to heal? Is there anything I can busy myself doing except for core/bar conditioning?

Exams. Can't climb. I'm slowly going mental...

[Three Nine]

Don't fret, had this plenty over the years. Climb day on day off or similar, ice and vit I after climbing, don't crimp for a month or two.

[tomtom]

Learn to open hand everything...  I only bring the crimp out for special occasions now!

[cjsheps]

Thanks for the response. I'm a little bit wary about climbing on it and making it worse though? Three Nine, you say you've had it a few times over the years, which seems a little unusual: has it always been in the same fingers?

Out of interest, how long did it take for the symptoms (apart from weakness!) to go away entirely?

The icing's a good shout - I've been taking anti-inflammatories but will start icing as well as soon as I get something to freeze!

I'm psyched for some eventual open-hand action, as it's something missing from my strength "repertoire".

[standard]

I'm not going to 2nd guess your physio's diagnosis, but this topic seems like a good opportunity to bring this up anyway.

Tendonosis is often mis-diagnosed as tendonitus.
There have been studies to show that NSAIDs are useless (and even can inhibit recovery) of tendonosis.

disclaimer: I am not a medical professional of any sort - i've just read some research papers and stuff on the internet.

[mrjonathanr]

The suffix itis (not itus) denotes inflammation so your physio clearly thinks this is an inflammatory condition.

Ice reduces inflammation and causes a net increase in blood flow so potentially of benefit to other conditions. See D Mac's little vid for Lewis reaction in context of pulleys, principle is general of course.
http://onlineclimbingcoach.blogspot.co.uk/2007/06/finger-injury-treatment-videocast.html (not working on my iPad, but has been reposted by DMc in 2010)
Be mindful an iced tendon is fragile until warm once more.

Climbing on big jugs at the wall would be my approach to therapy, after a shortish period of total rest.

Good luck

[cjsheps]

Thank you very much! Just to clarify, the physio said that technically it was a tendonopathy rather than a tendonitis. That was sloppy nomenclature on my part.

[mrjonathanr]

You're welcome. Dave's articles (see left side bar) are worth exploring.

Julian Saunders http://www.drjuliansaunders.com/resources/ reckons tendinitis tends to fade "if you stop pissing it off" so take heart, all probably quite fixable with patience.

I gave up for 6 months this summer with injury not improving... Got bored and resumed anyway...never bouldered better. Time off doesn't always send you backwards as much as you may think.

[standard]

The suffix itis (not itus) denotes inflammation so your physio clearly thinks this is an inflammatory condition.

Cheers, sorry about that!

[Three Nine]

"Over the last few weeks climbing I'd noticed a gradual soreness coming on when crimping - my hands felt almost "creaky". A few days off and it seemed OK, but a session in the Cave set me back to square one the next day."

Creaky fingers after doing a lot of crimping is fairly standard for me. Physios like to give precise diagnoses; patients like to get them. I'd just go with your own diagnosis of creaky fingers, and do what climbing you can without pissing it off.

[mrjonathanr]

Cheers, sorry about that!

Pedantry is part of the service, there's no charge 

[cjsheps]

Just a quick update of how things are going in case anyone's interested (unlikely):

With lots of icing and resting, one finger seems to be getting a fair bit better and is looking to be ready for rehab loading within a few weeks. The left pinkie is resisting all efforts to bring it to heal - doing pull ups on a bar today set me back almost to square one (being previously at square 1.001).

[bendavison]

I injured my pinky at the end of 2012 and it took ~6 months to heal. Other people I spoke to said the same. Maybe pinkies are just slackers on that front? Sorry I can't provide any advice to speed it up, but it might be nothing to worry about in that respect.

[cjsheps]

Just a quick update in case anyone's interested, with a question bolted on:

For the last few weeks, I've been doing a fair amount of open-handed fingerboard, with some open-handed climbing too (aerocap and bouldering). While it was frustrating not to be climbing anywhere near as hard as I could before, I felt like I was making progress with my open-handing and getting better. My fingers weren't giving me any grief and I looked to be set to get back to things.

Then, a few half-crimps later and the RH ring finger especially feels like it's back to square one. NNFN. 

I'm going to try and get a clinical diagnosis from an ultrasound image, and in the meantime I think I have to stop climbing. I'm going to join a gym to help deal with stress and stay strong.

Does anyone have any advice for some good exercises to do in order to build some climbing-specific core and body strength? I'd like to get to doing a solid one-armer and I've heard that deadlifting could help strengthen the back. Are there any others that people could recommend?

[siderunner]

Obvious but weighted pull-ups and (even more weighted) negative pull-ups are worth their space in your weights programme.

Front lever progressions.

Definitely shoulder work, great time to build those to prevent injury and stabilise that area which will enable more powerful bouldering and help support your 1 armer quest. Shoulder press, lateral raise, front raise, reverse fly are what I mainly do.

[siderunner]

Also pistols (ie one leg squat) for rock overs and one leg bridge (on Ball if too easy on floor) for hammys (integral to heel hooking and good for injury prevention).

[abarro81]

What did you half crimp on? A boulder or fingerboard?  Breaking grips back in is almost always safer on the latter. Were you taping?
I would go back to open handing in the fingerboard and bouldering on f3 drags, though I have no idea what your actual injury is, never heard of tendonitis/osis of fingers before, it normally seems to be flexor units, pulleys, collaterals etc.

Also, don't climb on it pumped as you'll lost form and twist into holds.

[mctrials23]

I've found with finger injuries you can feel like you have tweaked them again very easily and think you are back to square one but thats not the case usually. I have been rehabbing an A2 injury and a few times I thought I had gone too hard on it and ruined a few weeks progress but each time it would get better quickly and continue recovering.

I'm about 1 month post injury date now and even though it may ache after a session I know that it will be better in a day or two and continue recovering. Obviously be careful but don't necessarily think you have undone any recovery simply because you have hurt it again. Mine has never regressed and I have hit it quite hard a number of times.

[blamo]

I have had a few of these types of injuries.  I haven't spent the time to diagnose what their medical name is, but I do spend a lot of time treating them and I religiously follow a few rules:

1) Stay hydrated and don't do dumb shit (no campusing, or other show-off party trick strength things).

2) Tape the finger (it might not do anything other than mentally tell you to not try hard).

3) Hangboard like crazy (get a pulley system so you can remove weight and do repeater hangs that don't hurt, but work the finger).  This may mean starting off on big holds with lots of weight removed.

4) Ice your hand like crazy and spend all your money on medical gimmicks to heal yourself (watch out for things that mask the pain, you want the hippie healing stuff).

5) Constantly remind yourself about how much of an idiot you were for getting this injury and avoid it at all costs in the future. 

Good luck and hope you heal fast!

[cjsheps]

Thanks again for all the helpful replies. The problems came back after half-crimping a little on a problem at Froggatt. After that, anything resembling a half-crimp (even when trying to strictly open-hand) was contributing to making things feel worse.

The good news is that I have an ultrasound scan on my finger in two weeks time, so I'm going to play it safe until then.

As an aside, I've found that a narrow pull up bar seems to be another aggravating thing, and a lot of pressure is being applied laterally to the region where the tendon is sore. I've widened the bar with some gaffa tape.

[thekettle]

Some really good reading on the subject of treating finger injuries in Dave MacLeods new book Make or Break. Highly recommended.

[cjsheps]

So I was misdiagnosed.

I've just got back from an ultrasound scan, and it turns out that I have some thickening (although no inflammation) of the sheath around the tendons of two fingers.

Has anyone else had this problem? I'm a bit stumped RE rehab info.

[mctrials23]

Never heard that mentioned before and I have read a fair bit of stuff about finger injuries. Might be mentioned in "one move too many" but I don't recall it being touched on.

[Boredboy]

I think you might get a thickened tendon sheath in teno-synovitis as in De quervains of the thumb tendons. Essentially your Physio was right. Tendinitis and tenosynovitis will be due to repetitive overload over time this can lead to thickening of the sheath and the end result of a badly thickened sheath would be trigger finger. All the standard finger rehab applies. I bet 90% of climbers over 30 have thickened tendon sheaths.