[S Smith]

So, after fully recovering from a pulley injury last september (left hand ring A4), I managed to blow another pulley - right hand middle finger A2 this time.  2 reasons why:

1 - I haven't been climbing for that long, 3 and a half years now, and my muscles are a lot stronger than my ligaments at this stage (I hear ligaments can take years to adapt to training stresses, whereas muscles can do so in a matter of months). 
2 - I'm a fucking idiot and didn't listen to myself when it felt a bit tweaky, and just kept climbing. Bad call...

 The last time it happened I didn't do very much immediately after, just stopped climbing for a week or two.  When it didn't feel and better and was still quite bowstrung I went to a doctor who I knew had seen finger injuries before.  He gave me some good advice and said that if I wanted to know if it was a partial or a compete tear to go get an ultrasound, though the recovery path would be much the same for the two, just longer for a complete tear.  Did so, and from the degree of tendon displacement they figured it was a complete tear.

Anyway, from the last injury I have a fairly good idea of what to do this time in the longer term:

1 - Take about a month/month and a half off climbing.  Tape gently to protect from daily stresses (opening doors and shit like that...)
2 - Start climbing gradually again, on very very easy stuff, to stimulate blood flow to the fingers and increase recovery rate - "low intensity sport specific exercise"
3 - After another month or so buy a beastmaker and become insanely strong at open handing so I never have to crimp again...

What I don't know that much about is what to do on a day-to-day basis to help it recover as quickly as possible.  After it happened on saturday I put it on ice for about half an hour, then did the same again last night.  Is this a good plan?  How about Dave MacLeod's whole cold water treatment?  What have people found to be beneficial?

Any advice would be greatly appreciated as I'm going on a climbing trip to France at the end of May, and it would be pretty cool if I could actually get some climbing done while I'm there!

[tomtom]

Some people swear by the ice/cold water treatment.. I've just left mine.. I think you're doing the right thing to carry on climbing gently on them - It may well just take time....

Other stuff is pretty obious, but avoid crimping and learn to open hand everything...

[GCW]

You may find This of some use.

[fried]

I found resting for one week, then squeezing a piece of sponge helped me recover fairly quickly. I kept climbing easy stuff and was pretty much O.K within 6 weeks. I might have recovered exactly at the same rate with another/ no treatment though.

[S Smith]

Thanks for the answers guys.  I do love some good science GCW.  I have a copy of the Schöffl V, Hochholzer T, Winkelmann HP, Strecker W  paper from my last injury and I'm pretty sure this one is a grade 3 by their classification...

Think I kinda found the answer to my own question on Dave Mac's site: "If you use the treatment too early while the injury is still in the acute inflammation phase it will prolong recovery by encouraging excessive bleeding, swelling and it's associated problems".

This is definitely still in the acute inflammation phase.  It's like I've got another fat thumb in the middle of my hand...

[mrjonathanr]

Firstly, sorry to hear that. As someone recovering from A2 ring finger I know how annoying this can be.

I think most people go through similar stages in the recovery trajectory, including sadly the 'initial denial'/'I know, I'll make this a lot worse' phase. You sound pretty much in charge of your recovery tbh.

I gleaned that ice was good: initial inflammation precedes fibre remodelling phase so I wouldn't do Dave Macs water stuff till after 3 weeks which is the collagen remodelling interval I'm told. As Lagerstarfish said, try some rehab for three weeks then re-assess. Seems like a good time-scale to me.

I got green theraputty which seems really good. I guess you'd need to start with the lightest grade and progress from there. There may be cheaper options out there too.

I also climbed as much as possible whilst remaining pain free.I found climbing open-handed and with affected digit mummified in tape so that it could not bend very helpful with this.

Ultimately time is a great healer. You can however use weights long before you will be able to crimp, something that might make the wait more bearable. Good luck.

[Muenchener]

My GP - a climber - told me to keep climbing but on very easy stuff. My injury, however, was a strain/non-total tear without visible bowstringing, so probaby a quite different situation.

[Fultonius]

Do grade 3's often heal themselves without surgical intervention? 

Surely if it's fully, totally and completely busted you could climb nearly stright away as there will be no pulley left to damage?

Just throwing out thoughts, no real SCIENCE here...

[slackline]

Do grade 3's often heal themselves without surgical intervention? 

Surely if it's fully, totally and completely busted you could climb nearly stright away as there will be no pulley left to damage?

Just throwing out thoughts, no real SCIENCE here...

And that ickle new one thats trying to grow?  Won't stand much of a chance if its being stressed through climbing.

[GCW]

If it's a single pulley they tend to heal (well, not as they were) without anything needing done.  More than one pulley is a different issue.

It's better to have a pulley than not, so I certainly wouldn't advocate just climbing normally straight away.

[rodma]

I completely lost my A2 pulley in my left ring finger over a year ago. Despite it being "gone" the inflamation etc still took months to fully settle down. I can now climb with no pain at all, but absolutely have to tape that finger (which I never used to do, hate doing and don't really advocate for minor tears), or else the tendons bowstring right out.

I took it relatively easy whilst learning to adapt to the injury, but didn't stop climbing. It definately felt better with some load run through it, rather than no load.

Sorry to hear about the damage, keep your spirits up.

[SA Chris]

I completely lost my A2 pulley in my left ring finger over a year ago.

Careless of you. It's probably in the last place you will look.

[Fultonius]

And that ickle new one thats trying to grow?  Won't stand much of a chance if its being stressed through climbing.

That's why I asked:

Do grade 3's often heal themselves without surgical intervention? 

So a full tear, both ends completely detatched can re-attach and fix itself? I suppose it happens on Achilles tendons as unlikely as it sounds, so there's no reason why it couldn't. Interesting.

[GCW]

You have to remember that the pullies aren't just free floating, they do have adherence to the surrounding fibrous tissues of the palm side of the finger, so even when they go the torn surfaces aren't miles apart.  Healing happens partly with scar tissue and reorganisation, so small gaps can be bridged OK.

[ducko]

 bit of a thread hijack, but is there any way of strengthening these areas or is it just hope that it doesn't Happen to you job?

[rodma]

I completely lost my A2 pulley in my left ring finger over a year ago.

Careless of you. It's probably in the last place you will look.

I was in A2 when I lost my A2, so no danger of it having been hoovered up. It's probably down the back of the mats with the rest of the detritus.

[slackline]

bit of a thread hijack, but is there any way of strengthening these areas or is it just hope that it doesn't Happen to you job?

Climbing and training strengthens them....just don't over do it.

[Muenchener]

Another thread hijack: one always hears that tendons get strong more slowly than muscles. But do they also get weak more slowly?

I climbed - albeit never at a high standard - for around fifteen years, then didn't for ten years or so, then started again recently. Am I effectively starting again from scratch as far as tendons are concerned, or will there still be some residual extra strength/thickness from my earlier climbing days?

I suppose the fact that I suffered my first ever pulley strain last summer shortly after starting to train again rather suggests the former.

[SA Chris]

bit of a thread hijack, but is there any way of strengthening these areas or is it just hope that it doesn't Happen to you job?

I think friction massage is often recommended to prevent the scar tissue building up too. Helped me anyway.

[mrjonathanr]

Good point about massage, would like it if this were clarified: which is the best direction of massage for a pulley?

As the fibres run at 90* to the finger I've assumed that in line with the finger, across the fibres, is best. I've also been told circular motion is good. As some posters have genuine medical knowledge any comment would be much appreciated.

[Jaspersharpe]

Another thread hijack: one always hears that tendons get strong more slowly than muscles. But do they also get weak more slowly?

I climbed - albeit never at a high standard - for around fifteen years, then didn't for ten years or so, then started again recently. Am I effectively starting again from scratch as far as tendons are concerned, or will there still be some residual extra strength/thickness from my earlier climbing days?

I suppose the fact that I suffered my first ever pulley strain last summer shortly after starting to train again rather suggests the former.

Definitely not starting from scratch. I had about 12 years off but my fingers were still pretty strong (in comparison to someone who had never climbed before) when I started again. I had definitely lost muscle strength to a MUCH higher degree (in fact I still haven't recovered that but that's another story).

The injury thing is less likely to be down to the "starting from scratch" theory and more likely to just be that you are now ten years older and break more easily.

This has been my experience (loads of minor injuries that I never used to get) although *touches wood* tendons have been ok so far.

[S Smith]

Think I'm going to go ahead and stall the ice and water stuff until the inflammation dies down.  Slack-Line and GCW are definitely right about not climbing normally straight away, for a full rupture anyway, gotta give the new one a chance to grow indeed!  As far as I understand it from looking into this stuff the last time it happened, there's enough pulley action from the other pulleys, your skin, etc... that the severed ends aren't a million miles away, and can heal themselves...  Hopefully...

As for the massage, I was told by a physio who climbs that along the length of the finger (and perpendicular to the direction of the fibres) is best.

bit of a thread hijack, but is there any way of strengthening these areas or is it just hope that it doesn't Happen to you job?

Yeah, start climbing when you're 6 like all these euro wonderkids we hear about!  Don't try and train too hard too fast...

Sorry to hear about the damage, keep your spirits up.

Will do.  Left hand one-armers and deadhangs anyone?!?

[mrjonathanr]

As for the massage, I was told by a physio who climbs that along the length of the finger (and perpendicular to the direction of the fibres) is best.

 Thanks.

Will do.  Left hand one-armers and deadhangs anyone?!?

Weights won't stress the pulley so much, especially if you heavily tape the damaged finger so it cannot bend much.

[DaveyDave]

Weights won't stress the pulley so much, especially if you heavily tape the damaged finger so it cannot bend much.

 

Only thing is, be careful for a bit... when I first strained mine, any pressure I put on the joint around it (especially pullup bar and dumbells) really hurt and seemed to make the whole recovery business longer.

[mrjonathanr]

Oh yeah, me too, the pad has a very bruised feel for a while so post-training soreness is a guide to how much you can do - which at first is very little with free weights, although machines and bench-type presses stress the fingers significantly less as you don't have to grip so much.