[Concretesnail]

Not sure how I've done it but I have managed somehow to injure myself. I'm not sure what I've done or exactly what to call it so I'm looking for some advice as to what I may have done and any help advise as to stretches or exercise which could help relieve it.

Symptoms
Numbness in my hand; across the back and in in the palm.
Numbness in fingers and thumb; mostly the thumb and back two
Pain in the forearm; in the area just shy of the elbow
Pain in the upper arm; just round the outside of the elbow, though it hasn't risen higher at all.

Hi, it sounds like you have irritated a nerve in your neck. The symptoms are specific to a certain level. It has probably occured over a period of time and doesn't have to be a specific incident. It is often related to sustained sitting positions with a poor posture and a lack of movement. If you are mainly sitting in the daytime at a computer then regularly change position to break up prolonged positions particularly if they are slumped. I would reccomend you see a local physio for a thorough examination as the symptoms can hang around and you need to know how to best manage them.
Regards
Matt

Thanks Matt. If its neck related I think I might know how I've done it - stood at a pillar drill for hours cutting splinting plates.

[tresor]

Hi

Recently started to feel pain in my left elbow on the inside. Seems like a clear case of golfers elbow and the pain origins from my ring finger, only my ring finger actually. Placing my underarm flat on the table palm down the pain in the elbow comes then i press down into the table with my ring finger not the other ones. Previously had the exact same problem on the right side. Open handed and sloopers cause pain in the elbow but crimping and half crimping is fine.

What seemed to help on the right side was avoiding jugs, sloopers and just use crimp and half crimp on small holds. Not sure if it's mainly the grip or the fact that going for much smaller holds made my training sessions much shorter, never really used that grip as everyone said it was so dangerous for your fingers. Also that stretch Tom Randall recommend seems to have had positive results.

What kind of excentric exercise would be useful for my ring finger?

Any recommendations what to do to get rid of it and maybe how to prevent it from coming back?


//Tresor

[nicboarder]

Hello

Hope you can help.

I had open surgery on my elbow 3 weeks ago, to remove bone spurs in the joint which apparently are a result of wear and tear, and they also displaced the ulnar nerve (think that's what it's called). My arm had got to the point were the bone spurs were preventing me fully straightening my arm. Post-op I wasn't given any physio or exercises to do - just an appointment to see the ortho consultant in January.

The majority of the worst of the visible swelling in the forearm has gone down, but it is still tight, swollen and very tender inside and around the elbow and around the wound, however the range of movement is still very poor, in fact it seems to be getting worse. I keep trying to get my arm to straighten and bend but I would say the max range of movement I can get is 30 degrees at best. Can't bend it to a 90 degrees angle yet, and some way off straightening. It feels like there is something physically restricting movement inside - it feels like if I try to extend it or bend it past a certain point it is going to snap or something! I assume swelling and inflammation are causing this.

Can you recommend any gentle exercises that may help improve mobility. I am worried if I wait until January when I see the consultant there will be other problems occurring with muscles and tendons from lack of use.

Thanks
Nic

[HPclinic]

Hello

Hope you can help.

I had open surgery on my elbow 3 weeks ago, to remove bone spurs in the joint which apparently are a result of wear and tear, and they also displaced the ulnar nerve (think that's what it's called). My arm had got to the point were the bone spurs were preventing me fully straightening my arm. Post-op I wasn't given any physio or exercises to do - just an appointment to see the ortho consultant in January.

The majority of the worst of the visible swelling in the forearm has gone down, but it is still tight, swollen and very tender inside and around the elbow and around the wound, however the range of movement is still very poor, in fact it seems to be getting worse. I keep trying to get my arm to straighten and bend but I would say the max range of movement I can get is 30 degrees at best. Can't bend it to a 90 degrees angle yet, and some way off straightening. It feels like there is something physically restricting movement inside - it feels like if I try to extend it or bend it past a certain point it is going to snap or something! I assume swelling and inflammation are causing this.

Can you recommend any gentle exercises that may help improve mobility. I am worried if I wait until January when I see the consultant there will be other problems occurring with muscles and tendons from lack of use.

Thanks
Nic

Hi nic
I read this today and thought you needed a prompt reply.  However, it is very difficult to give specific advice about your elbow without examining it.  I would contact the hospital and ask for a review and see if they will refer you to Physio.  It sounds like you require rehabilitation given the slow progress so far.  If they won't refer you for NHS Physio ask if they will let you see a private Physio (recommended) closer to your home. 

I suspect they have moved the ulnar nerve and this might be contributing to your symptoms.  If you develop increasing weakness and/or pain in your forearm see your GP. 
With bony spurt removal there should be no reason not to start early movement but your surgeon might have a reason why they do not want to start this early.
Sorry if this sounds vague but I need further information.  If you want to ring me Monday at the clinic I would be happy to discuss progress. (0114 2671223).

[HPclinic]

Hello

Hope you can help.

I had open surgery on my elbow 3 weeks ago, to remove bone spurs in the joint which apparently are a result of wear and tear, and they also displaced the ulnar nerve (think that's what it's called). My arm had got to the point were the bone spurs were preventing me fully straightening my arm. Post-op I wasn't given any physio or exercises to do - just an appointment to see the ortho consultant in January.

The majority of the worst of the visible swelling in the forearm has gone down, but it is still tight, swollen and very tender inside and around the elbow and around the wound, however the range of movement is still very poor, in fact it seems to be getting worse. I keep trying to get my arm to straighten and bend but I would say the max range of movement I can get is 30 degrees at best. Can't bend it to a 90 degrees angle yet, and some way off straightening. It feels like there is something physically restricting movement inside - it feels like if I try to extend it or bend it past a certain point it is going to snap or something! I assume swelling and inflammation are causing this.

Can you recommend any gentle exercises that may help improve mobility. I am worried if I wait until January when I see the consultant there will be other problems occurring with muscles and tendons from lack of use.

Thanks
Nic

Hi nic
I read this today and thought you needed a prompt reply.  However, it is very difficult to give specific advice about your elbow without examining it.  I would contact the hospital and ask for a review and see if they will refer you to Physio.  It sounds like you require rehabilitation given the slow progress so far.  If they won't refer you for NHS Physio ask if they will let you see a private Physio (recommended) closer to your home. 

I suspect they have moved the ulnar nerve and this might be contributing to your symptoms.  If you develop increasing weakness and/or pain in your forearm see your GP. 
With bony spurt removal there should be no reason not to start early movement but your surgeon might have a reason why they do not want to start this early.
Sorry if this sounds vague but I need further information.  If you want to ring me Monday at the clinic I would be happy to discuss progress. (0114 2671223).

PS nic ask to speak to Steve if you ring.

[HPclinic]

Hi

Recently started to feel pain in my left elbow on the inside. Seems like a clear case of golfers elbow and the pain origins from my ring finger, only my ring finger actually. Placing my underarm flat on the table palm down the pain in the elbow comes then i press down into the table with my ring finger not the other ones. Previously had the exact same problem on the right side. Open handed and sloopers cause pain in the elbow but crimping and half crimping is fine.

What seemed to help on the right side was avoiding jugs, sloopers and just use crimp and half crimp on small holds. Not sure if it's mainly the grip or the fact that going for much smaller holds made my training sessions much shorter, never really used that grip as everyone said it was so dangerous for your fingers. Also that stretch Tom Randall recommend seems to have had positive results.

What kind of excentric exercise would be useful for my ring finger?

Any recommendations what to do to get rid of it and maybe how to prevent it from coming back?


//Tresor

Hi, i am always mildly sceptical with the term 'golfers elbow' (as i am with tennis elbow) as i know from experience as they can be more than just a tendon pathology. Eccentric exercises have mixed results and again this illustrates that it isn't always a tendon problem. I would tend to assess the neck, upper back (which is nearly always stiff in climbers) and shoulder control and stability. Sometimes proximal (shoulder and upper back)weaknesses and reduced rotation can lead to excessive stresses and overuse at the elbow. We also observe that a lot of climbers can have depressed or dropped shoulders and this can sometimes irritate the nerves through  traction as well as it being a poor mechanical position for the shoulder to work from.
There is also a nerve (ulnar) that is on the inside of the elbow and can be a source of symptoms (i have given some previous advice on this page about ulnar nerve exercises - have a look and just try!) either local at the elbow and/or the neck.
The last thing to consider is what you do at work and if it involves a lot of sitting, typing and mouse use then incorporate movements above your head throughout the day and avoid sustained poor postures, basically stand and move whenever possible.
Climbers are a specific group in that they put a lot of stresses through their forearms but depending on how efficient you are depends on how much you are using your grip.
You are right to review the holds that are causing your pain and it is wise to decrease these but continue to climb even if it means reducing yor grades. Rest isn't the best option and by restructuring your training volume and intensity you will still be able to climb. Slowly increase as symptoms allow.
The Tom Randall stretch seems more localised to the elbow as the wrist isn't fully extended. Stretches don't normally help so i wonder whether it is working the elbow joint or the neural structures, like i said there can be many origins of the symptoms.
If it helps do it. Let me know how you get on.
regards
Matt

[Sidehaas]

Hi, I have injured my tendons in my right hand.
The cause was that I was pulling on a two finger pocket through a roof with my middle two fingers, when my foot slipped heel hooking and my body swung out, overloading my hands. I tried to hold the swing but failed and came off. I think it was as my fingers came out of the pocket,  rather than when my foot slipped,  that i felt the pain.
Symptoms: the initial pain was dull rather than sharp and went after a few seconds.  However, it was deep within my wrist (perhaps 1-2 inches from my hand) rather than in my fingers.  As soon i tried to pull on to another problem, there was instant pain again, and a feeling of tenderness/fragility all along the tendon from wrist to fingers (although i cant really tell which of the middle two fi gers it is).  After 9 days it has not improved much - past tendon I juries ive had have been pains in fingers that tended to clear up quickly.
If I use all 4 fingers and load my hand in a straight direction, I feel no pain - I can hang off medium crimps on a fingerboard quite happily as normal.  On a sloper it is ok with all 4, but feelz like it would cause damage if if I slipped off.  However, anything a bit twisted or using fewer fingers - or worse both, is qhickly painful.  Some positions cause pain even at lower loads, for example yesterday i picked up a heavy book at an awkward angle and had to instantly drop it. Strangely,  I think the pain has now migrated to be more in the hand thN wrist,  although this may be position dependent.

Im really looking for help with what the injury actually is, how long it might take to heal, and importantly whether I should try to continue light training,  or rest it completely.  And also, if rest, am I ok to train straight on with 4 fingers if there is no pain?

Many thanks!
Simon

[cheque]

Hi, I’ve had an injury on the middle finger of each hand for more than a year now- it gets better with rest or climbing solely on big holds but never completely goes away. I flared it up again on my left hand just before Christmas and have decided to try and fix it for good this time so I’m most of the way through my second week of not climbing and icing every evening. It’d be good to get a professional opinion of what the injury is and whether I need to do anything different or supplementary to what I’m doing.

It’s on the back (ie the knuckle) of the PIP joint of each middle finger (slightly on the ring finger of my right too)- when I aggravate it the joint swells up noticeably and I can’t bend the finger very far due to pain on the knuckle. Even when it’s at its best neither finger will bend enough to touch the tip to the base of the palm- currently I can get my right to about 1.5cm away and my left only to 2.5-3cm away. The slightly affected right ring finger will almost touch but not quite.

Thanks!

[tresor]

Hi

Recently started to feel pain in my left elbow on the inside. Seems like a clear case of golfers elbow and the pain origins from my ring finger, only my ring finger actually. Placing my underarm flat on the table palm down the pain in the elbow comes then i press down into the table with my ring finger not the other ones. Previously had the exact same problem on the right side. Open handed and sloopers cause pain in the elbow but crimping and half crimping is fine.

What seemed to help on the right side was avoiding jugs, sloopers and just use crimp and half crimp on small holds. Not sure if it's mainly the grip or the fact that going for much smaller holds made my training sessions much shorter, never really used that grip as everyone said it was so dangerous for your fingers. Also that stretch Tom Randall recommend seems to have had positive results.

What kind of excentric exercise would be useful for my ring finger?

Any recommendations what to do to get rid of it and maybe how to prevent it from coming back?


//Tresor

Hi, i am always mildly sceptical with the term 'golfers elbow' (as i am with tennis elbow) as i know from experience as they can be more than just a tendon pathology. Eccentric exercises have mixed results and again this illustrates that it isn't always a tendon problem. I would tend to assess the neck, upper back (which is nearly always stiff in climbers) and shoulder control and stability. Sometimes proximal (shoulder and upper back)weaknesses and reduced rotation can lead to excessive stresses and overuse at the elbow. We also observe that a lot of climbers can have depressed or dropped shoulders and this can sometimes irritate the nerves through  traction as well as it being a poor mechanical position for the shoulder to work from.
There is also a nerve (ulnar) that is on the inside of the elbow and can be a source of symptoms (i have given some previous advice on this page about ulnar nerve exercises - have a look and just try!) either local at the elbow and/or the neck.
The last thing to consider is what you do at work and if it involves a lot of sitting, typing and mouse use then incorporate movements above your head throughout the day and avoid sustained poor postures, basically stand and move whenever possible.
Climbers are a specific group in that they put a lot of stresses through their forearms but depending on how efficient you are depends on how much you are using your grip.
You are right to review the holds that are causing your pain and it is wise to decrease these but continue to climb even if it means reducing yor grades. Rest isn't the best option and by restructuring your training volume and intensity you will still be able to climb. Slowly increase as symptoms allow.
The Tom Randall stretch seems more localised to the elbow as the wrist isn't fully extended. Stretches don't normally help so i wonder whether it is working the elbow joint or the neural structures, like i said there can be many origins of the symptoms.
If it helps do it. Let me know how you get on.
regards
Matt

Hi

Thanks for your input, much appreciated. Sorry for the late reply from my side but christmas stopped me from any climbing related stuff. The rest actually seemed to help to some extent this time, rest in like carrying around a 1,5 and a 2,5 year old and doing a few home improvement projects. Managed to get around to climb yesterday and got convinced by a friend to visit another local climbing gym in my town, he said the grips there were more like my moonboard and he was right and the walls were much steeper than my ordinary gym.

Feel much better in the left elbow today and still no sign of pain in my right. Can't say for sure if it is the grips themselves or the fact that steeper wall and poorer grips reduces the amount of actual climbing.

Just really happy right now as it feels I pretty much dialed in what to do and what not to do to get this sorted. Regarding the nerve thing I actually visited a chiropractor about my back as I have some "locked discs" (freely translated from swedish) I guess from years of bad posture at the desk and carrying around kids for almost 3 years now. He got more interested in the elbows as it was something he was certain he could fix but he couldn't find anything nothing wrong with the neck or shoulders.

If it is the tendoins will they become stronger with time or will I be in risk of getting these kinds of injuries all the time?

Really glad as I think I now know how to handle this.

//Tresor

[HPclinic]

Hi, I have injured my tendons in my right hand.
The cause was that I was pulling on a two finger pocket through a roof with my middle two fingers, when my foot slipped heel hooking and my body swung out, overloading my hands. I tried to hold the swing but failed and came off. I think it was as my fingers came out of the pocket,  rather than when my foot slipped,  that i felt the pain.
Symptoms: the initial pain was dull rather than sharp and went after a few seconds.  However, it was deep within my wrist (perhaps 1-2 inches from my hand) rather than in my fingers.  As soon i tried to pull on to another problem, there was instant pain again, and a feeling of tenderness/fragility all along the tendon from wrist to fingers (although i cant really tell which of the middle two fi gers it is).  After 9 days it has not improved much - past tendon I juries ive had have been pains in fingers that tended to clear up quickly.
If I use all 4 fingers and load my hand in a straight direction, I feel no pain - I can hang off medium crimps on a fingerboard quite happily as normal.  On a sloper it is ok with all 4, but feelz like it would cause damage if if I slipped off.  However, anything a bit twisted or using fewer fingers - or worse both, is qhickly painful.  Some positions cause pain even at lower loads, for example yesterday i picked up a heavy book at an awkward angle and had to instantly drop it. Strangely,  I think the pain has now migrated to be more in the hand thN wrist,  although this may be position dependent.

Im really looking for help with what the injury actually is, how long it might take to heal, and importantly whether I should try to continue light training,  or rest it completely.  And also, if rest, am I ok to train straight on with 4 fingers if there is no pain?

Many thanks!
Simon

Hi Simon, sorry about the delay in getting back to you but with xmas and holidays today is the first friday Q and A of the year. I would certainly recommend light training as opposed to total rest as you need to put some stress through the muscles and tendons for improvement to occur. It sounds like you have overloaded the tendons and rather than get a pulley injury it is further along and closer to the muscle tendon junction. The reason it is less painful when you use all fingers is that you are distributing the load through all the finger tendons and not two. It will probably take 4-6 weeks of progression back up the grades and increasing the load as well as progressing from larger holds to crimping and individual finger holds. Graded stresses will allow tissues to strengthen but too much load will not allow the tissues to adapt and strengthen. Some discomfort is acceptable but sharp pain is not.
Let me know how you are going.
regards
Matt

[HPclinic]

Hi, I've had an injury on the middle finger of each hand for more than a year now- it gets better with rest or climbing solely on big holds but never completely goes away. I flared it up again on my left hand just before Christmas and have decided to try and fix it for good this time so I'm most of the way through my second week of not climbing and icing every evening. It'd be good to get a professional opinion of what the injury is and whether I need to do anything different or supplementary to what I'm doing.

It's on the back (IE the knuckle) of the PIP joint of each middle finger (slightly on the ring finger of my right too)- when I aggravate it the joint swells up noticeably and I can't bend the finger very far due to pain on the knuckle. Even when it's at its best neither finger will bend enough to touch the tip to the base of the palm- currently I can get my right to about 1.5cm away and my left only to 2.5-3cm away. The slightly affected right ring finger will almost touch but not quite.

Thanks!

Hi, it definitely sounds like it is more of a joint problem than a tendon. As you will know climbers tend to put more load/strain through the middle and ring fingers. The joint is reacting by swelling and then the capsule (ligamentous structure surrounding the joint) is tightening up. I wouldn't advocate total rest but climb using larger holds. I think you need to regularly stretch the joint into both flexion (bending towards the palm) and extension (fingers flat on a table and push the joint straight) to try and regain full ranges. Climbers fingers can get tight and the joints can look thicker due to the continual loading etc. Try and regain the range of movement and then incorporate occasional finger holds but not too many at first. If you are local it might be worth a visit just to teach you how to self manage.
regards
Matt

[HPclinic]

Hi

Recently started to feel pain in my left elbow on the inside. Seems like a clear case of golfers elbow and the pain origins from my ring finger, only my ring finger actually. Placing my underarm flat on the table palm down the pain in the elbow comes then i press down into the table with my ring finger not the other ones. Previously had the exact same problem on the right side. Open handed and sloopers cause pain in the elbow but crimping and half crimping is fine.

What seemed to help on the right side was avoiding jugs, sloopers and just use crimp and half crimp on small holds. Not sure if it's mainly the grip or the fact that going for much smaller holds made my training sessions much shorter, never really used that grip as everyone said it was so dangerous for your fingers. Also that stretch Tom Randall recommend seems to have had positive results.

What kind of excentric exercise would be useful for my ring finger?

Any recommendations what to do to get rid of it and maybe how to prevent it from coming back?


//Tresor

Hi, i am always mildly sceptical with the term 'golfers elbow' (as i am with tennis elbow) as i know from experience as they can be more than just a tendon pathology. Eccentric exercises have mixed results and again this illustrates that it isn't always a tendon problem. I would tend to assess the neck, upper back (which is nearly always stiff in climbers) and shoulder control and stability. Sometimes proximal (shoulder and upper back)weaknesses and reduced rotation can lead to excessive stresses and overuse at the elbow. We also observe that a lot of climbers can have depressed or dropped shoulders and this can sometimes irritate the nerves through  traction as well as it being a poor mechanical position for the shoulder to work from.
There is also a nerve (ulnar) that is on the inside of the elbow and can be a source of symptoms (i have given some previous advice on this page about ulnar nerve exercises - have a look and just try!) either local at the elbow and/or the neck.
The last thing to consider is what you do at work and if it involves a lot of sitting, typing and mouse use then incorporate movements above your head throughout the day and avoid sustained poor postures, basically stand and move whenever possible.
Climbers are a specific group in that they put a lot of stresses through their forearms but depending on how efficient you are depends on how much you are using your grip.
You are right to review the holds that are causing your pain and it is wise to decrease these but continue to climb even if it means reducing yor grades. Rest isn't the best option and by restructuring your training volume and intensity you will still be able to climb. Slowly increase as symptoms allow.
The Tom Randall stretch seems more localised to the elbow as the wrist isn't fully extended. Stretches don't normally help so i wonder whether it is working the elbow joint or the neural structures, like i said there can be many origins of the symptoms.
If it helps do it. Let me know how you get on.
regards
Matt

Hi

Thanks for your input, much appreciated. Sorry for the late reply from my side but christmas stopped me from any climbing related stuff. The rest actually seemed to help to some extent this time, rest in like carrying around a 1,5 and a 2,5 year old and doing a few home improvement projects. Managed to get around to climb yesterday and got convinced by a friend to visit another local climbing gym in my town, he said the grips there were more like my moonboard and he was right and the walls were much steeper than my ordinary gym.

Feel much better in the left elbow today and still no sign of pain in my right. Can't say for sure if it is the grips themselves or the fact that steeper wall and poorer grips reduces the amount of actual climbing.

Just really happy right now as it feels I pretty much dialed in what to do and what not to do to get this sorted. Regarding the nerve thing I actually visited a chiropractor about my back as I have some "locked discs" (freely translated from swedish) I guess from years of bad posture at the desk and carrying around kids for almost 3 years now. He got more interested in the elbows as it was something he was certain he could fix but he couldn't find anything nothing wrong with the neck or shoulders.

If it is the tendoins will they become stronger with time or will I be in risk of getting these kinds of injuries all the time?

Really glad as I think I now know how to handle this.

//Tresor

Hi again, IF!! it is a tendon then it should improve as long as the load does not exceed the tissues ability to adapt. Any how you sound like you are managing better and looking at all possible contributing factors.
Regards
Matt

[nai]

Sorry to sully this thread with a lower limb problem but .....

As I mentioned when I saw you last week, while off climbing I've started running and was intending to do a marathon.
I generally run five or six times per month and cover ~50km. However when I started my training I weighed up my current distance capabilities then jumped straight into an intermediate training schedule covering over 50km in five runs over one week.

After one long run I had a sore Achilles for a day and tight calves. The Achilles soreness went quickly and reasoning that the calves would loosen up when warm I carried on with my next run, but unfortunately toward the end the Achilles suddenly started to hurt badly and I ended up limping home quite badly. I spent a week resting, icing & stretching and it felt fine, I was able to do things like: climb using small footholds; scramble with the kids climbing over and around rocks; and run up stairs, all pain free.

I then tried a short trot and it was fine for 30 minutes before it started niggling again. This was yesterday and again my calves are tightened up and legs are generally much sorer than I'd expect for such a gentle run. This despite warming down much more thoroughly than normal.

Anyway, I'm sure it's not an Achilles problem (otherwise I wouldn't be able to weight a small foothold?) but that's where it's manifesting. This point on my calf is quite tender if that helps.



I've found some stretches and yoga poses to try, anything else you could suggest? Some sites suggest massage using a tennis ball?

Cheers

Ian

[HPclinic]

Sorry to sully this thread with a lower limb problem but .....

As I mentioned when I saw you last week, while off climbing I've started running and was intending to do a marathon.
I generally run five or six times per month and cover ~50km. However when I started my training I weighed up my current distance capabilities then jumped straight into an intermediate training schedule covering over 50km in five runs over one week.

After one long run I had a sore Achilles for a day and tight calves. The Achilles soreness went quickly and reasoning that the calves would loosen up when warm I carried on with my next run, but unfortunately toward the end the Achilles suddenly started to hurt badly and I ended up limping home quite badly. I spent a week resting, icing & stretching and it felt fine, I was able to do things like: climb using small footholds; scramble with the kids climbing over and around rocks; and run up stairs, all pain free.

I then tried a short trot and it was fine for 30 minutes before it started niggling again. This was yesterday and again my calves are tightened up and legs are generally much sorer than I'd expect for such a gentle run. This despite warming down much more thoroughly than normal.

Anyway, I'm sure it's not an Achilles problem (otherwise I wouldn't be able to weight a small foothold?) but that's where it's manifesting. This point on my calf is quite tender if that helps.



I've found some stretches and yoga poses to try, anything else you could suggest? Some sites suggest massage using a tennis ball?

Cheers

Ian

Hi Ian, you most definitely have increased your running volume too soon and as a result have a cumulative strain. It would  be similar to a climber only climbing 1-2 a week and then going away for a two week period and climbing most days. You should always be cautious when increasing volume too quickly and overloading the muscle more than it can adapt (Have a look at this link and go to the quantification of stress pdf, http://www.therunningclinic.com/en/runners-information/tools-for-runners.php).
Your previous running was probably not enough and hence you would be better to run atleast 4-6 a week but start with smaller volumes and even start with walk - runs particularly as you now have an injury. Have a look at the same link as above but look at the interval programmes 1 and 2. You are better to run frequently and do not increase the volume more than 10%.
The injury could also be due to asymmetries that may need to be addressed.
I would initially reduce volume (either using the more conservative interval programme 1 or the less interval programme 2) so that you are running relatively pain free and only increase when you are comfortable. At least this way you have objective markers and you can assess the progress. Massage may relieve some tightness but the best thing is to put a degree of stress through the problem area but an amount that will strengthen the tissue and not overload it.
Hope this helps and come and see either Steve or myself if you aren't improving.
regards
Matt

[Concretesnail]

I know I have strained a finger yesterday but I would like some help trying to work out how bad it is, having not had finger stain in the past I don't rally have a frame of reference.

Pushing a roof problem yesterday I had the majority of my weight held on one hand and one foot when moving for the next hold. As I did so the was a pop/crack sound - similar to joints cracking in my finger, ring finger of my right hand. I lost grip and fell. The grip would have been a half crimp.

It isn't generally painfully but it does ache if put through a full range of motion. It ache mostly in the midsection of the finger - between the two middle joints. To flex the finger doesn't make ache increase during the movement but it does change the feeling, to a thick sausagey sensation.

In terms of movement, I can flex from the hand fine and the first joint moving up the finger. I can't curl the joint to the tip very well or far and the whole finger feels weak in general and slightly plump, and slightly numb.

So far I have treated it with:
Stopped climbing immediately.
Cold compress
Elevation
And over night, anti inflammatories and sleep.

Hope you can help

Richard

[HPclinic]

I know I have strained a finger yesterday but I would like some help trying to work out how bad it is, having not had finger stain in the past I don't rally have a frame of reference.

Pushing a roof problem yesterday I had the majority of my weight held on one hand and one foot when moving for the next hold. As I did so the was a pop/crack sound - similar to joints cracking in my finger, ring finger of my right hand. I lost grip and fell. The grip would have been a half crimp.

It isn't generally painfully but it does ache if put through a full range of motion. It ache mostly in the midsection of the finger - between the two middle joints. To flex the finger doesn't make ache increase during the movement but it does change the feeling, to a thick sausagey sensation.

In terms of movement, I can flex from the hand fine and the first joint moving up the finger. I can't curl the joint to the tip very well or far and the whole finger feels weak in general and slightly plump, and slightly numb.

So far I have treated it with:
Stopped climbing immediately.
Cold compress
Elevation
And over night, anti inflammatories and sleep.

Hope you can help

Richard

Hi Richard, sorry for the delay in response but we only answer questions on a friday each week. It sounds as if you have strained a pulley possibly your A2. Basically you have 5 ligamentous pulleys on each finger and their aim is to keep the tendons in place. Crimping puts a large load on these and more commonly the middle and ring fingers tend to be the ones that are injured.
Usually you have to have a period of rest then slowly reload the fingers in a graded way to allow the tisue to heal and then strengthen. You need to have full movement in all your fingers and it is certainly (now a week on) ok to push the stretches or movements now. You will have to start with bigger jug holds and slowly introduce crimping. Some discomfort is acceptable but not pain. Increase resistance as able.
A good exercise to regain a nice curl and uncurl of the 3 joints in your middle finger is to start with the fingers fully flexed and give a little resistance to the end of the finger and keep this pressure on throughout the movement. Then slowly uncurl the finger and check if all the joints are uncurling in an equal fashion ie none of them are flicking straight. Increase the resistance as long as they uncurl equally.
Let me know how things are going.
regards
Matt

[bagger]

Hi

I think I have tight pec muscles (major and minor), which are pulling my shoulders out of position and giving me pain. Most probably as a result of poor posture and bouldering.

I am trying to correct my posture, but my back muscles are constantly having to fight the pecs. I have tried various stretches but they are quite difficult muscles to stretch without torquing the shoulder joint.

I read that active stretching can be more effective than passive or static? Can you give some advice on the best way to get these muscles to stretch and lengthen?

Cheers

Bagger

[Concretesnail]

I know I have strained a finger yesterday but I would like some help trying to work out how bad it is, having not had finger stain in the past I don't rally have a frame of reference.

Pushing a roof problem yesterday I had the majority of my weight held on one hand and one foot when moving for the next hold. As I did so the was a pop/crack sound - similar to joints cracking in my finger, ring finger of my right hand. I lost grip and fell. The grip would have been a half crimp.

It isn't generally painfully but it does ache if put through a full range of motion. It ache mostly in the midsection of the finger - between the two middle joints. To flex the finger doesn't make ache increase during the movement but it does change the feeling, to a thick sausagey sensation.

In terms of movement, I can flex from the hand fine and the first joint moving up the finger. I can't curl the joint to the tip very well or far and the whole finger feels weak in general and slightly plump, and slightly numb.

So far I have treated it with:
Stopped climbing immediately.
Cold compress
Elevation
And over night, anti inflammatories and sleep.

Hope you can help

Richard

Hi Richard, sorry for the delay in response but we only answer questions on a friday each week. It sounds as if you have strained a pulley possibly your A2. Basically you have 5 ligamentous pulleys on each finger and their aim is to keep the tendons in place. Crimping puts a large load on these and more commonly the middle and ring fingers tend to be the ones that are injured.
Usually you have to have a period of rest then slowly reload the fingers in a graded way to allow the tisue to heal and then strengthen. You need to have full movement in all your fingers and it is certainly (now a week on) ok to push the stretches or movements now. You will have to start with bigger jug holds and slowly introduce crimping. Some discomfort is acceptable but not pain. Increase resistance as able.
A good exercise to regain a nice curl and uncurl of the 3 joints in your middle finger is to start with the fingers fully flexed and give a little resistance to the end of the finger and keep this pressure on throughout the movement. Then slowly uncurl the finger and check if all the joints are uncurling in an equal fashion ie none of them are flicking straight. Increase the resistance as long as they uncurl equally.
Let me know how things are going.
regards
Matt

Hi matt

Thanks for getting back to me. After being pested by the otherhalf and my finger going blackish and heavy bruising starting to come out I went to my local minor injuries unit. When I asked for them to look at scanning to see if it was a pulley injury the nurse looked confussed, i explained about how i had done it and that a puleyl injury was a distinct possibility. She said she didnt quiet understand and that id need to have a an xray first then see the dr. A quick xray and a brief chat l lead to a referal later that day to the hand specialist at the local hospital. The dr at the hospital looked at the xrays examined the hand and fingers and told me that tmy volar plate has torn a section of bone off and that I was going to be referred to an advanced hand therapy specialist at another hospital (lucky for me its closer to home). Ive seen the specialist there and she was really helpful and patient with my questions and with any luck im on the right track to recovery, she did say that it might take up to 12 weeks to heal but if i behave myself (no climbing, no downhill, no trackdays extremely careful with work) and do whatever is needed is could be lucky and shave a little time off. then get back to building it up. the only lucky one in this mess is my brother who is going to pinch my brand new kintaros which arrived earlier this week after i order them the thursday before the injury on the friday....

thanks again for your help and advise matt.

rich

[HPclinic]

I know I have strained a finger yesterday but I would like some help trying to work out how bad it is, having not had finger stain in the past I don't rally have a frame of reference.

Pushing a roof problem yesterday I had the majority of my weight held on one hand and one foot when moving for the next hold. As I did so the was a pop/crack sound - similar to joints cracking in my finger, ring finger of my right hand. I lost grip and fell. The grip would have been a half crimp.

It isn't generally painfully but it does ache if put through a full range of motion. It ache mostly in the midsection of the finger - between the two middle joints. To flex the finger doesn't make ache increase during the movement but it does change the feeling, to a thick sausagey sensation.

In terms of movement, I can flex from the hand fine and the first joint moving up the finger. I can't curl the joint to the tip very well or far and the whole finger feels weak in general and slightly plump, and slightly numb.

So far I have treated it with:
Stopped climbing immediately.
Cold compress
Elevation
And over night, anti inflammatories and sleep.

Hope you can help

Richard

Hi Richard, sorry for the delay in response but we only answer questions on a friday each week. It sounds as if you have strained a pulley possibly your A2. Basically you have 5 ligamentous pulleys on each finger and their aim is to keep the tendons in place. Crimping puts a large load on these and more commonly the middle and ring fingers tend to be the ones that are injured.
Usually you have to have a period of rest then slowly reload the fingers in a graded way to allow the tisue to heal and then strengthen. You need to have full movement in all your fingers and it is certainly (now a week on) ok to push the stretches or movements now. You will have to start with bigger jug holds and slowly introduce crimping. Some discomfort is acceptable but not pain. Increase resistance as able.
A good exercise to regain a nice curl and uncurl of the 3 joints in your middle finger is to start with the fingers fully flexed and give a little resistance to the end of the finger and keep this pressure on throughout the movement. Then slowly uncurl the finger and check if all the joints are uncurling in an equal fashion ie none of them are flicking straight. Increase the resistance as long as they uncurl equally.
Let me know how things are going.
regards
Matt

Hi matt

Thanks for getting back to me. After being pested by the otherhalf and my finger going blackish and heavy bruising starting to come out I went to my local minor injuries unit. When I asked for them to look at scanning to see if it was a pulley injury the nurse looked confussed, i explained about how i had done it and that a puleyl injury was a distinct possibility. She said she didnt quiet understand and that id need to have a an xray first then see the dr. A quick xray and a brief chat l lead to a referal later that day to the hand specialist at the local hospital. The dr at the hospital looked at the xrays examined the hand and fingers and told me that tmy volar plate has torn a section of bone off and that I was going to be referred to an advanced hand therapy specialist at another hospital (lucky for me its closer to home). Ive seen the specialist there and she was really helpful and patient with my questions and with any luck im on the right track to recovery, she did say that it might take up to 12 weeks to heal but if i behave myself (no climbing, no downhill, no trackdays extremely careful with work) and do whatever is needed is could be lucky and shave a little time off. then get back to building it up. the only lucky one in this mess is my brother who is going to pinch my brand new kintaros which arrived earlier this week after i order them the thursday before the injury on the friday....

thanks again for your help and advise matt.

rich

Hi Rich, thanks for the feedback. The volar plate is attached to the A1,3 and 5 at the joints so the force obviously pulled a little bit of bone off. I am glad the treatment is conservative as these type of injuries do recover and surgical outcomes are not always favourable. start to move asap and perhaps see a physio that is a hand specialist or familiar with climbing injuries.
all the best Matt

[HPclinic]

Hi

I think I have tight pec muscles (major and minor), which are pulling my shoulders out of position and giving me pain. Most probably as a result of poor posture and bouldering.

I am trying to correct my posture, but my back muscles are constantly having to fight the pecs. I have tried various stretches but they are quite difficult muscles to stretch without torquing the shoulder joint.

I read that active stretching can be more effective than passive or static? Can you give some advice on the best way to get these muscles to stretch and lengthen?

Cheers

Bagger

Hi Bagger, the issues that climbers often have with postures is that they work a lot of the muscles ie the pecs and biceps that all tend to pull us forward into a flexed (kyphotic ) position. Combine this with a sitting job and this reinforces a flexed posture. We recommend regular standing and moving when possible and walks at lunchtime, basically variety of movement and not sustained poor postures during
Be careful with excessive pec stretching as it sounds as if you are stressing the front of the shoulder joint. I would tend to do the opposite movements to what the pectoral muscles (agonist) do ie work the antagonist muscle groups. An example would be holding a light weight in your right hand, start with it infront of your left hip and move across your body and out to the right side above your head. Be careful when you do biceps exercises (elbow bends) that your pecs aren't overly contracting. The aim is do decrease overactivity of the pecs and return the balance of agonist and antagonist muscles.
A good a safe stretch to the pecs and the thoracic spine (mid/upper back - this tends to be stiff in climbers) is lying backwards over a gym ball and slowly take your arms out to the side to where you feel the pecs stretching. You should feel the mid/upper back stretching and your back will be supported by the curve of the ball.
Hope this helps
regards
Matt

[Physiotherapy]

The good news is there are many physiotherapy solutions to a frozen shoulder and relief can be obtained quickly once treatment begins. With treatment, pain will decrease and the ability to move the joint will slowly return.

[bedrock]

Hi there,
Was doing a campus board session yesterday and noticed some pain in my brachialis so stopped and have iced etc. Have one very sore point and a slight discomfort flexing elbow so hoping its not too serious.
 I did do a boulder problem the other day that required a deep lock and reach and I got a shooting pain down the side of my neck, have read that neck/shoulder probs can result in brachialis problems so could it be related? I am recovering from a strained hamstring so have increased the fingerboarding , pullups and campusing recently so guess I've overdone it which may be the cause? 
Once the initial inflammation has settled am I ok to start doing dead hangs?Will using it 'statically' inflame it? Or do I need to lay off for a while and see a physio for best results?
Many thanks!

[HPclinic]

The good news is there are many physiotherapy solutions to a frozen shoulder and relief can be obtained quickly once treatment begins. With treatment, pain will decrease and the ability to move the joint will slowly return.

Hi, this is an interesting and debatable pathology.
Adhesive capsulitis (frozen shoulder) is often missed diagnosed and hence you find a variety of shoulder pathologies can be put under this diagnosis when shoulder movements are restricted.
A true adhesive capsulitis will restrict movement in all ranges and at certain stages of the pathology patients are best to continue with exercises alone as manual techniques may only have short term benefits. There are no links to the cause of the pathology and it can last for many months and into years. In my experience there are certain stages that benefit from manual treatments particularly when the acute 'freezing' phase has stopped and stiffness is then the main problem. The good news is that the pathology will settle and full movement in most cases will return, and this is important for the patient to know.

[HPclinic]

Hi there,
Was doing a campus board session yesterday and noticed some pain in my brachialis so stopped and have iced etc. Have one very sore point and a slight discomfort flexing elbow so hoping its not too serious.
 I did do a boulder problem the other day that required a deep lock and reach and I got a shooting pain down the side of my neck, have read that neck/shoulder probs can result in brachialis problems so could it be related? I am recovering from a strained hamstring so have increased the fingerboarding , pullups and campusing recently so guess I've overdone it which may be the cause? 
Once the initial inflammation has settled am I ok to start doing dead hangs?Will using it 'statically' inflame it? Or do I need to lay off for a while and see a physio for best results?
Many thanks!

Hi, if you are also doing dyno moves on the campus board this will bring in more biceps/brachialis activity to gain the momentum. These muscles will have to contract and slow down the movement. As i am sure you know campus board exercises are intense and if you are also doing more upper body work due to your hamstring strain then i think you are right in that you have just overloaded things. You are also right in that neck pain can refer into the arm and when you were locking out that puts alot of compressive load through the elbow and tension through you neck and trunk (on that side) to basically fix/stabilise your movement. Check you have full neck movement ie rotation left and right, looking up and down aswell as a combination of the above. I would recommend decreasing the intensity of your climbing and grades, and move rather than be too static even if this involves more traversing than up. If this is too painful then have a couple of days rest from climbing but try and do some form of exercise.
If this doesn't settle go and see a physio.
regards
Matt

[Sidehaas]

Hi, I have injured my tendons in my right hand.
The cause was that I was pulling on a two finger pocket through a roof with my middle two fingers, when my foot slipped heel hooking and my body swung out, overloading my hands. I tried to hold the swing but failed and came off. I think it was as my fingers came out of the pocket,  rather than when my foot slipped,  that i felt the pain.
Symptoms: the initial pain was dull rather than sharp and went after a few seconds.  However, it was deep within my wrist (perhaps 1-2 inches from my hand) rather than in my fingers.  As soon i tried to pull on to another problem, there was instant pain again, and a feeling of tenderness/fragility all along the tendon from wrist to fingers (although i cant really tell which of the middle two fi gers it is).  After 9 days it has not improved much - past tendon I juries ive had have been pains in fingers that tended to clear up quickly.
If I use all 4 fingers and load my hand in a straight direction, I feel no pain - I can hang off medium crimps on a fingerboard quite happily as normal.  On a sloper it is ok with all 4, but feelz like it would cause damage if if I slipped off.  However, anything a bit twisted or using fewer fingers - or worse both, is qhickly painful.  Some positions cause pain even at lower loads, for example yesterday i picked up a heavy book at an awkward angle and had to instantly drop it. Strangely,  I think the pain has now migrated to be more in the hand thN wrist,  although this may be position dependent.

Im really looking for help with what the injury actually is, how long it might take to heal, and importantly whether I should try to continue light training,  or rest it completely.  And also, if rest, am I ok to train straight on with 4 fingers if there is no pain?

Many thanks!
Simon

Hi Simon, sorry about the delay in getting back to you but with xmas and holidays today is the first friday Q and A of the year. I would certainly recommend light training as opposed to total rest as you need to put some stress through the muscles and tendons for improvement to occur. It sounds like you have overloaded the tendons and rather than get a pulley injury it is further along and closer to the muscle tendon junction. The reason it is less painful when you use all fingers is that you are distributing the load through all the finger tendons and not two. It will probably take 4-6 weeks of progression back up the grades and increasing the load as well as progressing from larger holds to crimping and individual finger holds. Graded stresses will allow tissues to strengthen but too much load will not allow the tissues to adapt and strengthen. Some discomfort is acceptable but sharp pain is not.
Let me know how you are going.
regards
Matt

Hi Matt,
Thanks for getting back to me.  It's mostly developed as you predicted - I'm 6-7 weeks post-injury now and been back to full strength with 4 fingers for a few weeks.  I'm almost there with three fingers as well, as of the last fortnight or so - the only thing that causes pain is if I do max hangs on the front three on the small rung on a BM2000.  So I'm being very careful with this!  Back three is now fine and, weirdly, whether the front three hurts depends on the position of my unloaded little finger.
I started the other night weighting two fingers properly for the first time (on the better pockets) - front and back two were ok but using middle two on the decent pockets still gives a little pain (dull ache, not sharp, but obviously I don't want to do anything silly).  Overall recovery seems to be going pretty well.  I'm doing a lot of low intensity stamina training at the wall but avoiding small pockets, and just trying to develop/recover my strength on these on the finger board - although its higher load, I figure its also much more controlled, and the last thing I want to do is pop out of something unexpectedly again.
Do you have any further advice?
Thanks!
Simon