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Online Hallamshire Physio Clinic (Read 17926 times)

adrienbaudouin

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#50 Re: Online Hallamshire Physio Clinic
December 27, 2016, 05:20:51 pm
Hi
I have pain on the upper left side of  PIP joint on my left middle finger for a few years now. I found that taping the whole finger from the base to the base of the DIP joint allowed me to keep climbing with only very mild pain and without worsening the injury until now. now the pain is there even with tape and the finger is too  painful to continue with the climbing level I want.
 
the pain is mainly localized on the upper left side of the left PIP joint on the left hand. I experience the pain when releasing from a crimp grip position not so much during the crimping itself. open hand grip doesn't seem to cause pain. the joint has never been swollen or painful to touch. when extending the finger , i sometimes feel some sort of click or rubbing on the upper left side of the left PIP joint toward full extension and sometimes it is painfull to fully extent the joint.  I have full range of motion in the PIP joint
 
I have tried various hand strengthening exercises ( finger extension with elastic band, spreading and closing finger in rice bucket), self myofascial release of the forearm, massage of the joint with a spiky ring but the injury didn't get better. I saw a physiotherapist who thought that I had tight muscle in my hand and that massage and stretching would solve the problem but the stretching only made it worse. I saw an ostheopath who told me that I had a slight tear of the collateral ligament and so wear in the joint and that there was nothing to be done. I saw a hand therapist, she said that my ligament were all good but couldn't really tell me what was wrong with my finger, she thought that I had a mild hyperextension in my fingers so she gave me splint to wear for a month and told me to come back if it didn't get better. and finally i went to the doctor who told me that the splint was not going to do anything, that I didn't have hyperextension in the joint, and that I was going to have to learn to live with the injury. the doctor even told me to look on climbing forum to try to find a solution because traditional medecine was not going to help.
so I decided to reach out to Dr Volker Schöffl and he said without seeing the injury that I likely have an inflammation of the joint synovial membrane, capsulitis. I am reaching out to you guys to find out which diagnosis would confirm that and what kind of treatment option are available?





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#51 Re: Online Hallamshire Physio Clinic
December 30, 2016, 01:18:24 pm
Guessing this thread is on a winter break, but if not/anyone else has had similar.

End joint of my RH ring finger has been 'clicking' for about 6 weeks, no discomfort/pain, but the distinct feeling of something not running correctly (a tendon/similar flicking over something?). It seems worse if I move the ring finger in isolation, a little better if I move the middle finger at the same time.  I can sometimes wiggle and crack the joint and it then seems to run smoothly for a little while.

Any idea what this could be/how to resolve it? Again it doesn't hurt at all even when climbing/crimping as hard as I can, it also doesn't feel tender to the touch, hence I haven't yet tried a sustained rest period. It is possibly a little worse in the mornings, and possibly also if I have been climbing, but equally I have also had it feel worse after a rest day and a couple of days ago it seemed fine almost all day, even though I am currently in the middle of a climbing holiday.

Any help/speculation welcomed.

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#52 Re: Online Hallamshire Physio Clinic
January 10, 2017, 02:21:38 pm
My own speculation is that this is possibly trigger finger.

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#53 Re: Online Hallamshire Physio Clinic
January 17, 2017, 07:09:44 am
Hi guys,

I've got golfers elbow, or something very similar. It's at the point where it hurts to wash my hands or face. I've seen a physio who showed me a way to tape it and gave me the usual eccentric exercises but I've got a manual job which which not only caused the problem but makes it flare up every day. I can't get the taping to work, so I've stopped that and the exercises almost seem to make it worse. Should I be doing them on the same days I work? Or is that over doing it? (if I don't do them then I'm essentially doing nothing about it!)  I'm guessing I need to take a few weeks off work but that's not really an option...

Thanks for any advice.

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#54 Re: Online Hallamshire Physio Clinic
January 19, 2017, 11:23:17 am
Hi
I have pain on the upper left side of  PIP joint on my left middle finger for a few years now. I found that taping the whole finger from the base to the base of the DIP joint allowed me to keep climbing with only very mild pain and without worsening the injury until now. now the pain is there even with tape and the finger is too  painful to continue with the climbing level I want.
 
the pain is mainly localized on the upper left side of the left PIP joint on the left hand. I experience the pain when releasing from a crimp grip position not so much during the crimping itself. open hand grip doesn't seem to cause pain. the joint has never been swollen or painful to touch. when extending the finger , i sometimes feel some sort of click or rubbing on the upper left side of the left PIP joint toward full extension and sometimes it is painfull to fully extent the joint.  I have full range of motion in the PIP joint
 
I have tried various hand strengthening exercises ( finger extension with elastic band, spreading and closing finger in rice bucket), self myofascial release of the forearm, massage of the joint with a spiky ring but the injury didn't get better. I saw a physiotherapist who thought that I had tight muscle in my hand and that massage and stretching would solve the problem but the stretching only made it worse. I saw an ostheopath who told me that I had a slight tear of the collateral ligament and so wear in the joint and that there was nothing to be done. I saw a hand therapist, she said that my ligament were all good but couldn't really tell me what was wrong with my finger, she thought that I had a mild hyperextension in my fingers so she gave me splint to wear for a month and told me to come back if it didn't get better. and finally i went to the doctor who told me that the splint was not going to do anything, that I didn't have hyperextension in the joint, and that I was going to have to learn to live with the injury. the doctor even told me to look on climbing forum to try to find a solution because traditional medecine was not going to help.
so I decided to reach out to Dr Volker Schöffl and he said without seeing the injury that I likely have an inflammation of the joint synovial membrane, capsulitis. I am reaching out to you guys to find out which diagnosis would confirm that and what kind of treatment option are available?


[Hi sorry about the holiday break. Wow, you have seen a lot of people and have had varied diagnoses. Unfortunately the more medical people you see this is often the case. It is always difficult to comment precisely without looking at you but it seems very linked to specific holds i.e. Crimping.
As you know a crimping hold puts more of a load through your finger joints, ligaments (pulleys) and tendons than any other manoeuvre. In my opinion don't chase a diagnosis as I would be more interested in why you have this and how you need to go about changing it. It could be related solely to the load you are putting through this area and although it may or may not be a capsular irritation or a ligamentous injury this should settle. Often when a joint and soft tissues are loaded it is painful on the release. The fact that taping did help makes me think you were taking the load off the area slightly and helping support the joint/ tendons.
I would suggest that you back off any crimping for at least 2 weeks and stick to the holds that are pain free. Then start to add crimps that you can control i.e. Lesser grades that you can vary the load. The idea would be that you slowly add the number of crimps over  a 2 to 8 week period and start to creep back up the grades. You need to load the area in a controlled way to enable the tissues to adapt otherwise you will overload that area again. Be patient and if it becomes sore back off to the previous level. Basically control your training intensity and have easy recovery days. Let me know how you get on.
Kind regards Matt]
« Last Edit: January 19, 2017, 11:29:03 am by HPclinic »

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#55 Re: Online Hallamshire Physio Clinic
January 19, 2017, 11:27:05 am
[q
Hi
I have pain on the upper left side of  PIP joint on my left middle finger for a few years now. I found that taping the whole finger from the base to the base of the DIP joint allowed me to keep climbing with only very mild pain and without worsening the injury until now. now the pain is there even with tape and the finger is too  painful to continue with the climbing level I want.
 
the pain is mainly localized on the upper left side of the left PIP joint on the left hand. I experience the pain when releasing from a crimp grip position not so much during the crimping itself. open hand grip doesn't seem to cause pain. the joint has never been swollen or painful to touch. when extending the finger , i sometimes feel some sort of click or rubbing on the upper left side of the left PIP joint toward full extension and sometimes it is painfull to fully extent the joint.  I have full range of motion in the PIP joint
 
I have tried various hand strengthening exercises ( finger extension with elastic band, spreading and closing finger in rice bucket), self myofascial release of the forearm, massage of the joint with a spiky ring but the injury didn't get better. I saw a physiotherapist who thought that I had tight muscle in my hand and that massage and stretching would solve the problem but the stretching only made it worse. I saw an ostheopath who told me that I had a slight tear of the collateral ligament and so wear in the joint and that there was nothing to be done. I saw a hand therapist, she said that my ligament were all good but couldn't really tell me what was wrong with my finger, she thought that I had a mild hyperextension in my fingers so she gave me splint to wear for a month and told me to come back if it didn't get better. and finally i went to the doctor who told me that the splint was not going to do anything, that I didn't have hyperextension in the joint, and that I was going to have to learn to live with the injury. the doctor even told me to look on climbing forum to try to find a solution because traditional medecine was not going to help.
so I decided to reach out to Dr Volker Schöffl and he said without seeing the injury that I likely have an inflammation of the joint synovial membrane, capsulitis. I am reaching out to you guys to find out which diagnosis would confirm that and what kind of treatment option are available?


[Hi sorry about the holiday break. Wow, you have seen a lot of people and have had varied diagnoses. Unfortunately the more medical people you see this is often the case. It is always difficult to comment precisely without looking at you but it seems very linked to specific holds i.e. Crimping.
As you know a crimping hold puts more of a load through your finger joints, ligaments (pulleys) and tendons than any other manoeuvre. In my opinion don't chase a diagnosis as I would be more interested in why you have this and how you need to go about changing it. It could be related solely to the load you are putting through this area and although it may or may not be a capsular irritation or a ligamentous injury this should settle. Often when a joint and soft tissues are loaded it is painful on the release. The fact that taping did help makes me think you were taking the load off the area slightly and helping support the joint/ tendons.
I would suggest that you back off any crimping for at least 2 weeks and stick to the holds that are pain free. Then start to add crimps that you can control i.e. Lesser grades that you can vary the load. The idea would be that you slowly add the number of crimps over  a 2 to 8 week period and start to creep back up the grades. You need to load the area in a controlled way to enable the tissues to adapt otherwise you will overload that area again. Be patient and if it becomes sore back off to the previous level. Basically control your training intensity and have easy recovery days. Let me know how you get on.
Kind regards Matt]uote author=adrienbaudouin link=topic=27513.msg540717#msg540717 date=1482859251]

« Last Edit: January 19, 2017, 11:32:43 am by HPclinic »

Steve R

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#56 Re: Online Hallamshire Physio Clinic
January 19, 2017, 11:28:59 am
Sorry quick copy and paste - just started a new topic and then saw this one too....
'Find my left arm gets noticeably more pumped than my right on endurance routes and also (I think!) takes longer to recover from a similar level of pump than my right would.  No significant differences or noticeable imbalances in strength (max hangs/bouldering) or PE stuff between my arms, just longer endurance stuff.  I guess there are a lot of potential causes for it...
Intuitively, I suspect the problem might be referred from an old shoulder injury/weakness - worse posture or shoulder position on left side reducing blood flow somehow?  Can dodgy shoulders cause you to get more pumped?'
Cheers 

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#57 Re: Online Hallamshire Physio Clinic
January 19, 2017, 11:41:04 am
Guessing this thread is on a winter break, but if not/anyone else has had similar.

End joint of my RH ring finger has been 'clicking' for about 6 weeks, no discomfort/pain, but the distinct feeling of something not running correctly (a tendon/similar flicking over something?). It seems worse if I move the ring finger in isolation, a little better if I move the middle finger at the same time.  I can sometimes wiggle and crack the joint and it then seems to run smoothly for a little while.

Any idea what this could be/how to resolve it? Again it doesn't hurt at all even when climbing/crimping as hard as I can, it also doesn't feel tender to the touch, hence I haven't yet tried a sustained rest period. It is possibly a little worse in the mornings, and possibly also if I have been climbing, but equally I have also had it feel worse after a rest day and a couple of days ago it seemed fine almost all day, even though I am currently in the middle of a climbing holiday.

Any help/speculation welcomed.
Hi sorry about the holiday break. It could be a trigger finger although the finger tends to get stuck into a bit of flexion and then releases. The fact that you can still climb is good. May be try a 2 week period of lesser grades and see if this helps. If you have had an intense period of climbing or too many intense sessions in a week then you may have slightly overloaded the joint/ tendons. If it persists book in to see a Physiotherapist. Regards Matt

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#58 Re: Online Hallamshire Physio Clinic
January 19, 2017, 11:47:18 am
Hi guys,

I've got golfers elbow, or something very similar. It's at the point where it hurts to wash my hands or face. I've seen a physio who showed me a way to tape it and gave me the usual eccentric exercises but I've got a manual job which which not only caused the problem but makes it flare up every day. I can't get the taping to work, so I've stopped that and the exercises almost seem to make it worse. Should I be doing them on the same days I work? Or is that over doing it? (if I don't do them then I'm essentially doing nothing about it!)  I'm guessing I need to take a few weeks off work but that's not really an option...

Thanks for any advice.
Hi, if you have a particularly busy day then don't do the exercises. Avoid wide gripping and maybe try a tennis elbow support (I know yours is on the other side of your elbow) that you can buy from a chemist.
Sometimes the neck needs to be checked and it isn't always an easy diagnosis i.e. the pain can come from a variety of sources (neck, shoulder, nerve, elbow). May be revisit the physio or get a second opinion. What is it like when you climb?
Regards Matt

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#59 Re: Online Hallamshire Physio Clinic
January 19, 2017, 11:52:14 am
Sorry quick copy and paste - just started a new topic and then saw this one too....
'Find my left arm gets noticeably more pumped than my right on endurance routes and also (I think!) takes longer to recover from a similar level of pump than my right would.  No significant differences or noticeable imbalances in strength (max hangs/bouldering) or PE stuff between my arms, just longer endurance stuff.  I guess there are a lot of potential causes for it...
Intuitively, I suspect the problem might be referred from an old shoulder injury/weakness - worse posture or shoulder position on left side reducing blood flow somehow?  Can dodgy shoulders cause you to get more pumped?'
Cheers
Hi, if you have a 'dodgy' shoulder then most definitely this can cause you to use your lower arm more ( and get more 'pumped') or in some way you are compensating. You need a strong shoulder girdle that is stable when you are manoeuvring through a move. Basically I would suggest you book in to see a physiotherapist and they should identify any compensations.
Regards Matt

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#60 Re: Online Hallamshire Physio Clinic
January 27, 2017, 12:06:08 pm
Hi Guys,
Thanks again for your continued help.

Had a finger boo boo last night and whilst I think I might be jumping the gun seeking advice within 18 hours of this happening (as perhaps I should be following the usual protocol of PRICE with move unloaded movement for a few days?) I can't help myself...

Firstly I have noticed in the past that my left pinkie seams significantly weaker than my right and is unable to hold a crimp position (it collapses into an open position). Experimenting on the fingerboard last night it felt reasonable to hang with my left hand on a good hold and my right on just my pinkie but when I tried this the opposite way my left pinkie gave way with a shooting pain. The pain went away instantly and I could climb a bit on big holds but decided to end the session.

I am hesitant to test load and see what hurts and what doesn’t at this stage, but the little bit I have done causes pain which seems to be in the ring finger rather than the pinkie! The pain seems similar to previous mild pulley damage or ligament damage but this is not severe, my range of movement is good and I have no pain in normal movement. Also no swelling.

Perhaps in the next few days I will have more info to give you, but if there is any advice you can give based on this info I’d be keen to be doing productive recovery type stuff as soon as possible!

Many thanks,
Richard

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#61 Re: Online Hallamshire Physio Clinic
January 27, 2017, 03:27:52 pm
Hi Guys,
Thanks again for your continued help.

Had a finger boo boo last night and whilst I think I might be jumping the gun seeking advice within 18 hours of this happening (as perhaps I should be following the usual protocol of PRICE with move unloaded movement for a few days?) I can't help myself...

Firstly I have noticed in the past that my left pinkie seams significantly weaker than my right and is unable to hold a crimp position (it collapses into an open position). Experimenting on the fingerboard last night it felt reasonable to hang with my left hand on a good hold and my right on just my pinkie but when I tried this the opposite way my left pinkie gave way with a shooting pain. The pain went away instantly and I could climb a bit on big holds but decided to end the session.

I am hesitant to test load and see what hurts and what doesn’t at this stage, but the little bit I have done causes pain which seems to be in the ring finger rather than the pinkie! The pain seems similar to previous mild pulley damage or ligament damage but this is not severe, my range of movement is good and I have no pain in normal movement. Also no swelling.

Perhaps in the next few days I will have more info to give you, but if there is any advice you can give based on this info I’d be keen to be doing productive recovery type stuff as soon as possible!

Many thanks,
Richard


Hi, just do gentle range of movement exercises as pain allows, trying to get full range and don't stretch until 5 days. Certainly don't load it yet and again leave it 5 days and then do some gentle resistance exercises ie fingers to palm and back again against a resistance that allows your fingers to curl in and out equally at each joint. Let me know how it goes through the week.
reagrds Matt

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#62 Re: Online Hallamshire Physio Clinic
January 27, 2017, 04:23:47 pm
OK, thanks again, will let you know how I get on...

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#63 Re: Online Hallamshire Physio Clinic
January 27, 2017, 05:03:01 pm
hello, I've posted in this topic a few times now ;)

mainly old injuries are getting better...now I have another one, several months of pain and tightness in forearm, feels a right pain in the moerning reaching for coffee, scratching my chin, drinking a beer! For a while I thought it might be tennis elbow, but I've had doses of golfers before and it doesn't feel the same, not as tender, more sharp. Straightening the arm brings on the pain. I've been doing a lot of manual work and it is the right arm. Any thoughts greatly appreciated.

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#64 Re: Online Hallamshire Physio Clinic
February 02, 2017, 11:57:32 am
hello, I've posted in this topic a few times now ;)

mainly old injuries are getting better...now I have another one, several months of pain and tightness in forearm, feels a right pain in the moerning reaching for coffee, scratching my chin, drinking a beer! For a while I thought it might be tennis elbow, but I've had doses of golfers before and it doesn't feel the same, not as tender, more sharp. Straightening the arm brings on the pain. I've been doing a lot of manual work and it is the right arm. Any thoughts greatly appreciated.
Hi Andy, might need a few more details. Does it hurt when you climb, do you have any numbness or strange sensations in your hand/ fingers, what makes it feel easier, can you grip? Tightness in the forearm could be overuse in the muscles due to the recent excessive manual work, sometimes the neck or upper thoracic can refer into the forearm.
I would say still use your arm and hands but back off the grades and crimping if this increases the pain. Also it's probably worth seeing a physio locally to get a more accurate diagnosis and more importantly why you have it and how you can recover.
Regards
Matt

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#65 Re: Online Hallamshire Physio Clinic
February 02, 2017, 12:51:12 pm
hello, I've posted in this topic a few times now ;)

mainly old injuries are getting better...now I have another one, several months of pain and tightness in forearm, feels a right pain in the moerning reaching for coffee, scratching my chin, drinking a beer! For a while I thought it might be tennis elbow, but I've had doses of golfers before and it doesn't feel the same, not as tender, more sharp. Straightening the arm brings on the pain. I've been doing a lot of manual work and it is the right arm. Any thoughts greatly appreciated.
Hi Andy, might need a few more details. Does it hurt when you climb, do you have any numbness or strange sensations in your hand/ fingers, what makes it feel easier, can you grip? Tightness in the forearm could be overuse in the muscles due to the recent excessive manual work, sometimes the neck or upper thoracic can refer into the forearm.
I would say still use your arm and hands but back off the grades and crimping if this increases the pain. Also it's probably worth seeing a physio locally to get a more accurate diagnosis and more importantly why you have it and how you can recover.
Regards
Matt

Hi Matt thanks for your reply. It doesn't hurt when I climb, or at least not after I've stretched it out a bit on some large holds, no numbness, tingling either. Making a fist and turning it from palm down to palm up makes it hurt, not so bad gripping though.

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#66 Re: Online Hallamshire Physio Clinic
February 02, 2017, 01:37:52 pm
Hello, any help would be appreciated...

I have seen doctors/physios about this but nothing is helping so far so thought I'd see what other advice I could get!

I've been having pain in my wrists (yes, both) for about a year now - I had about 5 weeks off over summer but this didn't seem to help much, I've also restricted my climbing to one or two sessions a week for most of this time. The pain is mainly concentrated on the outside (pinky side) but it also comes over the top and on the other side fairly often. I can't do push ups due to the pain or any other motion where I am pushing with the palm of my hand with much force. Also any climbing moves that involve twisting the wrist at all tend to hurt (and I avoid) as does pulling on slopers. Advice so far has been a variety of stretches, icing, rest, taping all whilst avoiding particular climbing moves/styles that worsen the pain. I also spent a while doing lots of antagonist training on the forearm but this didn't really help and if anything made it worst. I've also had two separate weeks where I took ibuprofen which seemed to help and now use ibuprofen gel on a daily basis - this helps, but doesn't take away all the pain. Probably worth mentioning I spend most of my working day at a desk using a laptop (with a mouse though) which unsurprisingly doesn't help the issue.

One of the physios I saw referred me to someone to get steroid injections, but that person decided they weren't right for me. I'm currently trying to get referred to a orthopedic hand specialist - but unsurprisingly the NHS aren't making this easy...

Not really sure what I'm asking here, but any tips/suggestions different to what I've tried before would be great  :)


« Last Edit: February 02, 2017, 01:46:13 pm by WillRobertson »

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#67 Re: Online Hallamshire Physio Clinic
February 02, 2017, 09:26:53 pm
Hello, any help would be appreciated...

I have seen doctors/physios about this but nothing is helping so far so thought I'd see what other advice I could get!

I've been having pain in my wrists (yes, both) for about a year now - I had about 5 weeks off over summer but this didn't seem to help much, I've also restricted my climbing to one or two sessions a week for most of this time. The pain is mainly concentrated on the outside (pinky side) but it also comes over the top and on the other side fairly often. I can't do push ups due to the pain or any other motion where I am pushing with the palm of my hand with much force. Also any climbing moves that involve twisting the wrist at all tend to hurt (and I avoid) as does pulling on slopers. Advice so far has been a variety of stretches, icing, rest, taping all whilst avoiding particular climbing moves/styles that worsen the pain. I also spent a while doing lots of antagonist training on the forearm but this didn't really help and if anything made it worst. I've also had two separate weeks where I took ibuprofen which seemed to help and now use ibuprofen gel on a daily basis - this helps, but doesn't take away all the pain. Probably worth mentioning I spend most of my working day at a desk using a laptop (with a mouse though) which unsurprisingly doesn't help the issue.

One of the physios I saw referred me to someone to get steroid injections, but that person decided they weren't right for me. I'm currently trying to get referred to a orthopedic hand specialist - but unsurprisingly the NHS aren't making this easy...

Not really sure what I'm asking here, but any tips/suggestions different to what I've tried before would be great  :)
Hi Will,
Are your wrists very mobile? If so I am wondering whether you may be going onto excessive extension when you are loading them and possibly disrupting the triangular fibrocartilage disc and complex. It is difficult without looking at your wrists. Have you tried putting a wide piece of tape around your wrist at the joint to block excessive extension. Have a look at TFCC injuries and see if this sounds like your wrists. The fact it is both wrists might more towards just excessive movement and joint impingement. Let me know your thoughts.
Regards
Matt

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#68 Re: Online Hallamshire Physio Clinic
February 03, 2017, 09:26:34 am
If it persists book in to see a Physiotherapist. Regards Matt
For interest.

Saw a specific hand therapist who called in a consultant from his lunch break. Suggested diagnosis is likely some form of damage/change to the A2 ring pulley (linked to injury/scarring/early stage dupuytrens) causing catching in DIP joint (not trigger finger).

Advised to stop climbing, tape and see a consultant (likely the same one who gave me 5 mins of his lunch break) to likely get referred for an ultrasound to see the mechanism, so am now in the process of waiting for NHS appointments.

The two people I saw (though in a private setting) are both related to the nhs Pulvertaft Hand Centre in Derby, where I am now looking to go to on the nhs. For anyone who needs hand/wrist stuff it seems like a good place to consider, both for example used the word crimping, without me having said it, in the correct context.

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#69 Re: Online Hallamshire Physio Clinic
February 03, 2017, 09:33:07 am
Hello, any help would be appreciated...

I have seen doctors/physios about this but nothing is helping so far so thought I'd see what other advice I could get!

I've been having pain in my wrists (yes, both) for about a year now - I had about 5 weeks off over summer but this didn't seem to help much, I've also restricted my climbing to one or two sessions a week for most of this time. The pain is mainly concentrated on the outside (pinky side) but it also comes over the top and on the other side fairly often. I can't do push ups due to the pain or any other motion where I am pushing with the palm of my hand with much force. Also any climbing moves that involve twisting the wrist at all tend to hurt (and I avoid) as does pulling on slopers. Advice so far has been a variety of stretches, icing, rest, taping all whilst avoiding particular climbing moves/styles that worsen the pain. I also spent a while doing lots of antagonist training on the forearm but this didn't really help and if anything made it worst. I've also had two separate weeks where I took ibuprofen which seemed to help and now use ibuprofen gel on a daily basis - this helps, but doesn't take away all the pain. Probably worth mentioning I spend most of my working day at a desk using a laptop (with a mouse though) which unsurprisingly doesn't help the issue.

One of the physios I saw referred me to someone to get steroid injections, but that person decided they weren't right for me. I'm currently trying to get referred to a orthopedic hand specialist - but unsurprisingly the NHS aren't making this easy...

Not really sure what I'm asking here, but any tips/suggestions different to what I've tried before would be great  :)
Hi Will,
Are your wrists very mobile? If so I am wondering whether you may be going onto excessive extension when you are loading them and possibly disrupting the triangular fibrocartilage disc and complex. It is difficult without looking at your wrists. Have you tried putting a wide piece of tape around your wrist at the joint to block excessive extension. Have a look at TFCC injuries and see if this sounds like your wrists. The fact it is both wrists might more towards just excessive movement and joint impingement. Let me know your thoughts.
Regards
Matt

Thanks for getting back to me. I wouldn't say they're that mobile. I have tried taping them and do now tape them most of the time when climbing. I had come across TFCC injuries before and thought they fitted my symptoms, but the physios I've seen have suggested they don't think that's the problem. I'm trying to push to get a scan of some kind so that I'm not just getting differing opinions but some kind of objective test, would you advise this?

Thanks.

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#70 Re: Online Hallamshire Physio Clinic
February 03, 2017, 09:37:00 am
If it persists book in to see a Physiotherapist. Regards Matt
For interest.

Saw a specific hand therapist who called in a consultant from his lunch break...

Glad to hear you've got a diagnosis Joe.

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#71 Re: Online Hallamshire Physio Clinic
February 03, 2017, 11:39:00 am
Hi Guys,
Thanks again for your continued help.

Had a finger boo boo last night and whilst I think I might be jumping the gun seeking advice within 18 hours of this happening (as perhaps I should be following the usual protocol of PRICE with move unloaded movement for a few days?) I can't help myself...

Firstly I have noticed in the past that my left pinkie seams significantly weaker than my right and is unable to hold a crimp position (it collapses into an open position). Experimenting on the fingerboard last night it felt reasonable to hang with my left hand on a good hold and my right on just my pinkie but when I tried this the opposite way my left pinkie gave way with a shooting pain. The pain went away instantly and I could climb a bit on big holds but decided to end the session.

I am hesitant to test load and see what hurts and what doesn’t at this stage, but the little bit I have done causes pain which seems to be in the ring finger rather than the pinkie! The pain seems similar to previous mild pulley damage or ligament damage but this is not severe, my range of movement is good and I have no pain in normal movement. Also no swelling.

Perhaps in the next few days I will have more info to give you, but if there is any advice you can give based on this info I’d be keen to be doing productive recovery type stuff as soon as possible!

Many thanks,
Richard


Hi, just do gentle range of movement exercises as pain allows, trying to get full range and don't stretch until 5 days. Certainly don't load it yet and again leave it 5 days and then do some gentle resistance exercises ie fingers to palm and back again against a resistance that allows your fingers to curl in and out equally at each joint. Let me know how it goes through the week.
reagrds Matt

Hi again,
Following up on this one as I have plucked up the courage to do some loading now.
First thoughts are that it does not seem to be a bad case of something, that said symptoms are as follows...
Loading little finger, open hand position, on a "single pad depth hold" (distal phalanx only!) causes some pain in the finger; this is how the injury happened. Its hard to pinpoint a location of the pain exactly; it just feels palm side, somewhere between that distal joint and part way into my palm. Sorry I cant be more specific. (pain is relative to how much load I put on / and I cant fully load the finger as per other side)
If I use a bigger hold, 2 joints deep, the pain is less (in the same place).
If I go back to a single joint depth but put the finger in a crimp position the pain seems to go.
Finally, the prodding test! Applying pressure on the proximal phalanx / A2 pulley area causes some discomfort but not much (2-3/10)
Hope this helps for you to perhaps offer some suggestions?
Many thanks in advance!
Richard

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#72 Re: Online Hallamshire Physio Clinic
February 08, 2017, 02:07:05 am
Hey Guys -

Another shoulder question.  My left shoulder/upper arm has been having recurring discomfort.  I wouldn't call it pain, and I can't think of anything acute.  It's been something off and on for the last 6-8 months, progressing from irritating to concerning, then to nothing, and back again.  I have no pain from raising my arms overhead, no pain or discomfort while doing any rotator cuff or I, Y, T's.  If I raise my arm fully, I feel a "stretching" sensation in my lat? near the tricep.  If I hang from a bar, I feel discomfort in my upper bicep/deltoid area while warming up. Once warmed up fully, I don't notice anything really until the end of a very long session.  My gut says I may have some tendonopathy in the long head biceps tendon, but I'm not sure.  Any other thoughts? 

If it is a biceps tendonitis/osis issues, any ideas on therapy?
Cheers,
Squatch

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#73 Re: Online Hallamshire Physio Clinic
February 21, 2017, 05:51:40 pm
Hi - I'm not sure if you guys are still offering advice, but thought I'd give you a try.

About 3 weeks ago I banged my hand badly while dynoing, smacking the tip of my unbent pinkie causing immediate pain and swelling around my PIP joint. Being smarter than I look, I stopped climbing straight away and iced my hand.

3 weeks on, the swelling has substantially gone. I now have full mobility back for 'daily life' tasks - however the joint doesn't like being involved in climbing; giving me pain both underneath the PIP joint and ontop of the knuckle when I engage the pinkie in any way.

I've asked Doctor Google and am fairly sure I have acquired a Volar Plate injury from hyperextending the finger. I have a hard mass on the underside of my finger, between PIP joint and palm, which I assume is scar tissue. This is tender when pressed.

Assuming my diagnosis is right, I have two questions:
i) Should I be massaging the 'hard mass' to break down scar tissue, or am I likely to be aggravating my injury?
ii) Can you advise any exercises / stretches that will aid recovery? Google doesn't turn much up on this front. So far I've been using rubber bands / squishy balls to provide as much resistance as possible until I feel pain.

Your advice would be much appreciated!

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#74 Re: Online Hallamshire Physio Clinic
February 22, 2017, 02:53:30 pm
Jumping on the band-wagon too:

I've recurring problems with my elbows, but the pain is not isolated to the classic medial/lateral epicondylitis (golfers/tennis elbow) trigger points.

The pain I experience can be quite crippling at times (nauseating at worst) and radiates down the outside of the humerus, but when palpated is not specific to the brachialis origin.

Could the source of pain be nervous in origin? The symptoms are generally short lived (<2hrs) if i stop climbing when they start, and hence very difficult to present to a physio - what would your suggested course of action be?