UKBouldering.com

Question about pulley injuries (Read 3259 times)

tommy_k

Offline
  • *
  • newbie
  • Posts: 26
  • Karma: +0/-0
Question about pulley injuries
March 01, 2015, 08:50:21 am
Hello ukb!

My finger started hurting quite a bit lately and I'm not really sure what's going on.
So I was hoping someone who has been unfortunate enough to experience a pulley injury first hand might be able to help me and answer a few questions.

If it is a pulley injury it probably is a partial tear of the A2 (no bowstring, no swelling, no hematoma).
I can feel a small knot at the side of that finger, although i think it might have been there before.

Can you feel a partial tear physically with your other hand through the skin?

Where exactly is the pain located you experience from an A2 injury?
I feel a slight pain/tenderness if I massage the A2 area but the main pain seems to be located in the PIP joint and also in the DIP joint if I load the finger in a crimped position.
Is this common for a pulley injury or would the pain be more local to the A2 pulley itself?

The overall feeling is more of an inflammation possibly through the whole finger, so hopefully it might be just that...
I trained a lot lately and also didn't notice a single event which might have caused the injury, no popping sound or footslip or anything like that.

Thanks to everyone who can help shed a little light on the issue, I appreciate it a lot!
Have a nice day! :)

tommy

Paul B

Offline
  • *****
  • forum hero
  • Posts: 9626
  • Karma: +264/-4
#1 Re: Question about pulley injuries
March 01, 2015, 12:33:47 pm
The injuries I myself think of as A2 are a source of very localised pain that I can usually find by gently pressing with the nail of a finger from my other hand (don't do this). This results in a sharp pain. I cannot physically feel a tear whilst doing this.

I've had many of these that I cannot put down to an incident as such, but usually, in retrospect, I can look back and see a pattern of overuse/lack of rest and/or a significant change in intensity (failing that I can usually think of a specific event).

The reality is that for finger issues the treatment is very much the same, rest, ice, then gentle loading etc. regardless of the specific injury. My 2p is that this doesn't sound like a classic A2 injury (remember, this is my opinion based solely on my experience).

Some people (Snr. Barros) train around pulley injuries to varying degrees of success. Some people (Stu L) think they're training around their injuries.

mrjonathanr

Offline
  • *****
  • forum hero
  • Posts: 5377
  • Karma: +242/-6
  • Getting fatter, not fitter.
#2 Re: Question about pulley injuries
March 01, 2015, 02:18:25 pm
What Paul said.

Classic mechanism is a sudden load and an audible little  'snick' sound, 'pop' if it's more severe, producing tenderness on the pad beneath the joint. Cause can be an accumulation of overuse as well as sudden injury.

Damage can be to other ligament structures around the finger, doesn't have to be just the classic A2 pad etc that sustained a bit of a tear.

Broadly speaking treatments will be the same: rest, ice and slow build up on big holds, open-hand rather than crimped is less stressful for ligaments.

I tape pretty thoroughly to immobilise finger in a banana shape when starting back. I'm not a physio though, just had a few injuries.  A physio would be best placed to advise.

Good luck.

tommy_k

Offline
  • *
  • newbie
  • Posts: 26
  • Karma: +0/-0
#3 Re: Question about pulley injuries
March 01, 2015, 03:59:06 pm
Thanks a lot Paul and Jonathan, I appreciate your feedback a lot!

Hopefully the ligaments are fine and it's "just" and overall inflammation due to overuse.
I'll see how it feels after one or two more rest days and then decide if I need to see a doctor.

Have a nice day & stay injury free! ;)

mikester

Offline
  • *
  • regular
  • Posts: 67
  • Karma: +5/-0
#4 Re: Question about pulley injuries
March 01, 2015, 05:07:31 pm
Disclaimer: I'm no expert. However, I'll still feel free to dispense some more internet-based, anonymous advice...
I'm just recovering from a suspected A2 strain and have read around the subject a bit and been to see decent physio who understands climbing injuries, which I suggest is a good idea to give you peace of mind.  I understand that bowstringing, swelling and hematoma are  unreliable diagnostic features unless you've done something properly disastrous. Going by feel and understanding how you caused it are probably your best bets. Let's face it, there aren't many things to go wrong in in a finger and, within reason, most are probably treated similarly. The swelling that you feel could be different and/or related injury: a synovial cyst. I have such a thing at the base of my finger and it's tender and so could mask, or be misinterpreted as, an A2 injury.
Regardless, I think the general advice above (rest etc.) still prevails. MacLeod's new book has some stuff about these injuries.

mikester

Offline
  • *
  • regular
  • Posts: 67
  • Karma: +5/-0
#5 Re: Question about pulley injuries
March 01, 2015, 09:55:07 pm
The swelling that you feel could be different and/or related injury: a synovial cyst tendon nodule.

Sorry, was thinking about my other finger when writing that.

tommy_k

Offline
  • *
  • newbie
  • Posts: 26
  • Karma: +0/-0
#6 Re: Question about pulley injuries
March 02, 2015, 07:09:53 am
Thank you too mikester for your input!

Thankfully the finger is already much better. All the pain around the A2 area is gone even when massaging it, and only a mild pain (maybe 3 out of 10) is left in the joints when going through the ROM in a crimped position with some load on it.

The difference between saturday and today is huge, I don't feel like possibly needing to amputate the finger any more ;)

I'll give it a few more days of rest and treatment and then see how it goes.

Thanks again for all the input, I had been really a bit worried and your experiences were a lot of help (at least placebo wise  ;D ).


J.Kydd

Offline
  • **
  • player
  • Posts: 80
  • Karma: +4/-0
#7 Re: Question about pulley injuries
March 02, 2015, 09:10:15 am
Hi Tommy,

This sounds VERY similar to what I'm currently experiencing. Topic below
http://ukbouldering.com/board/index.php/topic,25409.0.html

Some good replies in there too.
I took 10 days off, icing 2-3 times a day using the Torex finger sleeve (so I can also do it at work), and massaging it a couple times a day too
http://www.bananafingers.co.uk/torex-coldhot-finger-sleeve-p-1973.html

I'm now back climbing again, taping the finger for some support and just avoiding crimps for the time being.

Josh

tommy_k

Offline
  • *
  • newbie
  • Posts: 26
  • Karma: +0/-0
#8 Re: Question about pulley injuries
March 02, 2015, 10:44:19 am
Thanks Josh, good to know you are back climbing already!

TheTwig

Offline
  • ***
  • stalker
  • Posts: 278
  • Karma: +7/-1
#9 Re: Question about pulley injuries
March 03, 2015, 03:44:42 am
Hey Tommy,

Good to know you have experienced such a quick recovery but take it careful, my experience (and I've seen quite a few others) + some research suggests these days that pain isn't that good an indicator of the actual damage at the area and it's tempting to jump back in as soon as the pain recedes. My advice would be to try and have a bit of a phasing in approach to returning to loading the finger as before and take it real steady, even if it feels bombproof. Once you start injuring things that didn't heal properly the first time you can get stuck in a bit of a vicious cycle where it never properly heals all the way due to accumulated scar tissue (and so never returns to full strength, even with lots of rest). It will pay off in the long run!

Happy climbing

Sach

tommy_k

Offline
  • *
  • newbie
  • Posts: 26
  • Karma: +0/-0
#10 Re: Question about pulley injuries
March 03, 2015, 06:50:23 am
Wise words Sach, thanks a lot for the advice!

A friend of mine is a really good coach and has already put together a small rehab program for me.
So I'll rest till the end of the week (the fingers that is, doing lots of body tension work right now) and then start with a short pull up session on big round holds. Depending on how the finger feels doing some work and the day after I'll then decide whether to rest another two weeks or slowly start some open handed and sloper training.

If all goes well I'll be back in time for when the outdoor season starts :)

 

SimplePortal 2.3.7 © 2008-2024, SimplePortal