[mctrials23]

I have had a long standing A2 injury that was giving me some grief for just over a year so I have been religiously open handing almost everything for quite a while now. This has made me a lot stronger open handed but I think it may have also contributed to this problem.

Just below my injured finger and between that and the little finger I have a very tender and slightly swollen area. Its not really painful unless I climb hard on it or I poke it a bit. I've just been doing some DIY and that seems to have pissed it off quite a lot causing it to swell up nicely which has highlighted the area quite nicely.

Basically, what is this likely to be. From what little information I can find on the issue its likely to be tenosynovitis or inflamation of the tendon sheath in that area. Has anyone else had this issue and can give some advice on what you did to help fix it. I have been icing it quite regularly but its only been an issue for a few weeks so I don't know how effective this is proving yet.



Thats the area and shape of swelling

[Bonjoy]

Could be Dupuytrens Contracture. Common among climbers. There a big thread on it if you do a search.

[mctrials23]

Hmm, I have looked at that thread and from what I can tell this issue is in the wrong place for Dupuytrens contracture. Isn't that something that affects the tendon / tendon sheath.

The more I read, the more I think this is a lumbrical tear of some sort. If I pull with just my little finger on another finger it hurts a bit in the affected area.

[Bonjoy]

No DC affects the palmar fascia, the muscle sheath beneath the skin on the palm. You can eventually end up with cord like features but they are nothing to do with tendons.

[mctrials23]

Ok, I'm pretty sure it's not a lumbrical tear now as it doesn't hurt at all when I curl all fingers bar the ring and pull and when I do that with the little finger there isn't much pain at all. The swelling is now on both sides of the palm essentially as the picture shows but mirrored on both sides of the ring finger. Does this sound like early stage DC Bonjoy?

DC, tenosynovitisl and trigger finger all have similar/overlapping symptoms so it's very confusing.

[Bonjoy]

DC develops in line with the fingers, usually ring or little finger first. DC is very slow in its progress. You wouldn't really be able to say for sure that was what it was for some time. If it hangs around for a long time as a low level problem, that would be typical (actual pain is likely to come and go).

[mctrials23]

Are you saying that if this was my issue the problem would be along the length of the tendon rather than off to the side of it? If thats the case then its not that. In line with the tendon is fine, its just either side of it where the lubrical muscles sit. I'm going to head to a GPs and try and get a referral in the mean time.

[JWarren]

I have a bit of experience with tenosynovitis, and the symptoms do seem to match. I get pain in the same areas as well, although I would make the distinction that my pain is located on the side of the tendon sheaths, not on the lumbricals (they are very close to each other however). With my tenosynovitis I have noticed it has spread to other fingers as well, although this is not something that occurs in all cases of tenosynovitis. I also have more pain in the morning, and find that my fingers are somewhat stiff then.

For tenosynovitis, I've found that deep-friction massage and contrast baths have been incredibly helpful. Deep friction massage should go perpendicular to the tendon sheaths (up and down on your fingers, not side to side) and should be quite aggressive. For the contrast baths I do 4 minutes of hot water, 1.5 minutes of cold. Before knowing to do those things, I took 2.5 months off and it didnt really do anything. However since starting doing the deep-friction massage and contrast baths every day, I've been able to progress my climbing back to close to my max limit in the past in just over 2 months. That said, I am still refraining from really hard crimping, although hopefully I'll reintroduce that soon.

[Bonjoy]

Are you saying that if this was my issue the problem would be along the length of the tendon rather than off to the side of it? If thats the case then its not that. In line with the tendon is fine, its just either side of it where the lubrical muscles sit. I'm going to head to a GPs and try and get a referral in the mean time.

The eventual development of scar tissue etc yes, but pain can be either side, including web between fingers.