[unclesomebody]

I've just been to see a hand specialist, and walked away with a plaster in the palm of my hand.

Basically, for those who don't read my blog (what? you don't? ha ha), I've had a hard lump develop in the palm of my hand, just below where my ring finger joins the palm. The doctor who looked at it immediately said it was an irritation on the tendon sheath, which was close to the A1, so that when I move my finger (or climbed) this little irritation on the sheath was rubbing the A1 pulley and getting worse and worse. He suggested a Steroid injection, to which I baulked, but after asking him a load of questions, it seemed to have more upsides than downsides, and I went for it. Now my hand feels like it's on ecstacy and he told me not to climb for a week.

I've just been on the internet and read that steroid injections aren't actually a good idea as they can weaken the tendon or something. I'm no doctor, but have I just made a huge mistake?

Is the 1 week rest period the right amount? Is it too short? I'd really appreciate any advice from the knowledgeable folks on here as I'm feeling a bit blue about all of this. I just want to be able to pull hard again.

Cheers

[SA Chris]

Sounds suspiciously like the start of a Dupuytren's Contracture.

If so, not sure the injection was a good idea, but I hope I'm wrong.

Join the club, I think there are a few of us on here. have been a few threads about it.

[Jim]

do you think he'll give me one of those injections in the penis?

It might be a good idea to buy some marigolds, some scissors and some superglue

[Johnny Brown]

What Chris said. Have you been taking loads of Vit C?

[Stu Littlefair]

Sounds suspiciously like the start of a Dupuytren's Contracture.

Think that's probably premature. His lump appeared after a long layoff following a sustained period of training. A priori it's much more likely to be a build-up of scar tissue than anything else.

Unc - don't know much about steroid injections having never had one. Travs had a few on his elbows and if I remember correctly suggested you take it EASY getting back on the horse. Like you, I've heard the rumours about long-term damage but suspect this is more for repeat offenders than one-offs.

My sister has them regularly in her hands due to arthritis but has never snapped a tendon, or climbed 8B, so I guess it's a useless example.

[SA Chris]

Think that's probably premature. His lump appeared after a long layoff following a sustained period of training. A priori it's much more likely to be a build-up of scar tissue than anything else.

Well that's pretty much when mine appeared - halfway through a ski season, so that's not necessarily a clear indicator. And the location sounds exactly the same.

Have you got any pics Keith? And does it move about when you open and close your hand? Are there any indentations or folds in the skin of your palm anywhere about it.

[tedj234]

Hi,
It doesn't sound like Dupuytren's to me as this affects the tissue just below the skin of the palm rather than the tendon sheath itself and doesn't normally (although it can) present as a painful nodule. Trigger finger may be closer to the mark although you don't describe the typical "triggering" symptoms.

With regard to the steroid injection the weakening of the connective tissue is a cumulative rather than an immediate effect. As far as i can make out this is a good first treatment for a painful palmar nodule.

cheers, Ed

[GCW]

The doctor who looked at it immediately said it was an irritation on the tendon sheath, which was close to the A1

I believe a wise man would have said the same 

Hope you get it sorted mate.

[unclesomebody]

Thanks for the replies.

I've not been taking any vit c. Should I be overdosing on the stuff?

Here's a pic I took when I first noticed it was something rather than nothing.



There are two dots, because it does move depending on if I stretch out my hand, or if I am more claw like. There are no indentations or folds. I have had a mild case of dupuytrens in my right hand for quite a few years now, but it's located much further down in the palm of my hand. It flared up, and basically never got any worse, so I'm not worried about it these days.

[Paul B]

After my long enforced break I got a hard lump that formed just below my wrist after about two weeks back. It would move depending on wrist position by a cm or so. It went away by itself after taking it easy (easier...). My GP was fascinated with it, he kept saying he only usually saw this on testicles. I'm glad it was on my wrist the amount he wanted to play with it.

[travs]

Keith, I had 3 injections on my left elbow over a 3 year period. First thing to note is that it was an exterior tendon attachment injury, which was not climbing related. Basically I knocked my elbow hard agains the corner of an aluminium casing and it bloody hurt. The 1st injection was highly successful and I recuperated slowly over a 2 1/2 month period with everything looking really good. Then I did a comp, pulled too hard and agravated it again. The next 2 injections were less successful and I wish I hadn't had them as all it achieved was a very frustrating 3 year period of recuperating, getting strong and getting injured again. Eventually I had surgery which was a complete success - thank god.

So in conclusion I would say, take it easy, probably 3-4 months before pulling really hard, if the 1st injection doesn't work look for an alternative.

Hope it all works out for you.

[fatdoc]

After a week actively work it to stop scar tissue reforming.

minimise micro trauma, You dont need a long lay off per se. You do need to nurture it  a bit, this is a focal mechanical issue, some part of your training has caused this - reflect on what actually caused it, though this could be rather tricky.

I had a series on these on my A2s.. tendon sheath finger injections are a bit tricky, only the skilled need apply! my shoulders too have had cortisone. I need an elbow doing... though that's more MTB related.

You have not made a massive mistake mate.

[SA Chris]

There are two dots, because it does move depending on if I stretch out my hand, or if I am more claw like. There are no indentations or folds. I have had a mild case of dupuytrens in my right hand for quite a few years now, but it's located much further down in the palm of my hand. It flared up, and basically never got any worse, so I'm not worried about it these days.

based on my limited knowledge it doesn't look like DC then, and you clearly knwo what one looks like.

In this case, I'm out.

[Nibile]

unc,
sorry to hear it didn't go away. i've generally heard alot of sories of repeated cortisone injections causing long term damage, so i'd be very careful. i think only one cannot be that dangerous. the idea of built up scar tissue makes sense. maybe you could go try and remember what you did in the last months, in terms of what kind of climbing or training, and so on, to try and understand the cause.
moreover: just after a week in a plaster, your tendons get very unelastic. i broke a hand many years ago, and after 40 days in a plaster, one morning i popped a tendon just by tying my shoelaces.
and they weren't 8b shoelaces. take it super easy.
get well soon beast i need you.

[Carnage]

I had one in my long head biceps tendon before I got my torn labrum diagnosed (because I was getting localised pain there and the doc wanted to rule something else out).

Didn't and caused me any troubles so far (nearly two years on) but then I did have an enforced 6 months lay off afterwards....

[hairich]

i dont know if this is causing you grief but i have had thse for years with no pain,talking of lumps and testes after having one removed a small lump in the hand is small fry.go crush gek sit k and make sure your ass is on the floor so sd does not whine

[unclesomebody]

Everyone; Thanks for the responses. I really appreciate it. I'm basically just getting annoyed with not being able to climb, and to pull hard. It's exceptionally frustrating, especially when I don't even know if/when recovery will occur.

It's good to hear that I haven't committed a total sin by having this injection. My hand still doesn't feel right today, but perhaps that's normal. It does feel more normal than yesterday. My hope is that in another 5 days it will feel somewhat normal and I can start climbing again.

I can think of one thing which may have caused this, which was repeated attempts at a move from a strange 2 finger pocket. It involved jumping off of it, and the fingers were torqued one way then the other from the start to the end of the move. It sounds like a reasonable explanation, but I'm not foolish enough to say it is the cause. The truth is that I'll never know the cause. I've climbed for enough years to think I know when and how to listen to my body, but maybe I was wrong! I've still got much to learn.

Travs; Thanks for providing some real world experience. It's good to hear you got your problem sorted eventually!

Fatdoc; What do you mean by "actively work it"? Does that mean climbing, stretching, moving it normally? Right now I just about have full range of motion, but it's tight as hell. 

Thanks again for the advice and tips.

[fatdoc]

Unc:

as with all injuries you want to keep  yr range of motion... this does sound like an acute weird tear to an A1. If it dont hurt use it. However as you are strong as fuck and train like a demon reign it all in and go slow.

good lick with this.

GCW will ( correctly ) cite a poor evidence base, I'm a believer /user in the ultrasound machines that you can buy.

after a steroid injection the alkalinity will aggravate the lesion for about a week... 10 days in the inflammation will start to improve, it's then you need to do a load of stretching to keep the reduction in scar tissue.

to give you a glimmer of hope.. 2 weeks before I did Zoolook I had a similar lesion on my A2 on a ring finger. When I sent it ( taped up).. no pain. Its was my right hand..finger was injected with cortisone.. the one that takes all the load on the 3 hand intermediates on the crux...

with regards to this all not working out... I know a hand surgeon that I would let operate on me..

keep me informed how this pans out mate.

[GCW]

good lick with this.

That's the only bit I'd agree with 

Generally the first 48 hours make your symptoms worse, after that things gradually improve.

Ultrasound is safe, so although evidence for its efficacy is poor I can't see any harm in trying it.

Just be sensible Brad, you'll (hopefully) be out crushing soon.

[unclesomebody]

6 days have passed since the last time I had a needle inserted into me. My hand still feels pretty bad, but I have pretty much normal range of movement now. I can't pinch or hold anything heavy with my left hand, and the lump that was in my hand feels approximately 3 times bigger than it was before having the injection. Is this supposed to pan out like this?

The doc suggested I would be able to climb in a week, but unless some miracle occurs in the next 24 hours then I'm guessing he was way off. Typing even hurts my hand. Not to sound like paulb, but what could have gone wrong? Is it possible than anything could have gone so wrong?

I'm really beginning to regret this injection, but that does F.A. so I'm trying to find a solution or at least a path to getting it sorted.

Cheers

[fatdoc]

Hmmm..

I would not have expected it to be much worse at this stage... I'm not gonna b able to offer an  over the web diagnosis. I think you should go back to the dr that did it and get him to have a look at it.

[GCW]

 

[Jaspersharpe]

Just make sure you use your right hand if you want to punch him in the face.

Hope you get it sorted soon. Sounds most annoying.

[Paul B]

don't worry I didn't stay at yours long enough to pass on my bad luck.