[bigironhorse]

My girlfriend has been climbing on and off for around 2 years, up to around 6a+. She has been having some very persistent finger problems and I am at a loss as to what is causing the problems so thought I would consult the wisdom of UKB.

I asked her to write a summay of the problem:

“My fingers started hurting towards the end of August. After a 3 week period of very little climbing, I restarted at rather high intensity (fingerboarding, climbing for several days in a row). The pain started then, but I thought it would ease off again soon. Went on another climbing trip the following weekend, but after one day, even belaying was painful, so gave up on it. For about a month after, I did very little and very easy climbing, and for the last two months I haven´t done any climbing at all.

The pain was at first distributed across my index, middle and ring fingers on both hands, located mainly between the knuckle and the PIP but sometimes also between PIP and DIP.  There has never been any swelling. At its worst, I struggled to lift even a cup of tea without experiencing rather intense pain. The pain is far less acute now, but in the mornings my fingers feel stiff (although I don´t actually have any problems flexing them, so range of movement is not limited). The pain sometimes also spreads into the palms of my hands, but it is difficult to pinpoint. Last weekend, I lifted and carried a heavy glass table top, which seems to have worsened the symptoms again. The pain wanders between fingers, and up until last weekend, pain was mainly caused upon pressing down on that part of the finger. Forearms also feel tense but not really painful. The pain in the fingers is more of a sharp pain.

I´ve talked to a physiotherapist (not a climbing specialist), and she said that there is a lot of muscle tension in my hands and forearms. She gave me several massage balls, but using them resulted in the worsening of the pain in two of my fingers, so I stopped using them. I went to the GP last week, and they have prescribed Naproxen.”

At first I assumed there was some kind of inflammation of pulley tendons, flexor tendons or some kind of ligament damage. But the way the pain comes and goes and seems to move around the hand doesn´t fit with this. Is it possible that the pain is secondary to a trapped nerve in the elbow, shoulder or back?

Anyone have any thoughts on this. She is pretty keen to see a specialist to try and find out whats going on so any recommendations would be great. Thanks.

[crzylgs]

I'm sorry I can't help with the diagnosis, from the way you've explained it does seem a little strange. Although it seems to have started after jumping back in to 'rather high intensity (fingerboard, multi-day on) climbing' after a period of rest, which is a classic recipe for a tendon type injury. Perhaps try the often suggested: short period of rest, then careful incremental increase in intensity finger exercises. Taking a step back to re-asses if there are any serious pains, but being OK with mild discomfort.

Also, IF it is any kind of tendon/connective tissue/muscle based injury she is probably advised to not take the Naproxen or any other NSAIDs (nonsteroidal anti-inflammatory drugs) such as Ibuprofen. You can quickly Google this but there have been several research papers papers over recent years showing a negative link between NSAIDs and repair function for connective tissue type injuries. Can't (completely) fault the GP as they are under pressures to get people in and out at such a rate, but from my experience they are not fitted with the specific knowledge and tools to treat sports injuries. That isn't really their job.

Out of interest had she been taking Ibuprofen or similar to try to climb through the pain? If so this could have been disrupting the healing process.

In terms of any diagnosis/treatment I'd point you in the direction of 'Dr Jared Vagy' aka 'The climbing Doctor' he is a sports science/doctor/movement specialist (US based) who focuses on climbing based injury prevention and recovery. He undoubtedly has some exercises that'd help. I've recently listened to bits of him on a 'Power Company Training' Podcast. He also has his own website and a book out - the book could well be worth a purchase for you / your girlfriend, nice early Xmas pressie haha!

[Steve R]

sounds like a tricky one...  lateral solution - have you considered getting a new girlfriend?

[duncan]

Not an obvious one. See a different doctor or physio.

[bigironhorse]

Out of interest had she been taking Ibuprofen or similar to try to climb through the pain? If so this could have been disrupting the healing process.

Thanks. She has not been taking ibruprofen. Except for the first week or so.

Any one able to recommend a finger specialist physio based in Sheffield?

[Wood FT]

sounds like a tricky one...  lateral solution - have you considered getting a new girlfriend?

You’ll be glad to know Flo is pissing herself at that. You are such a twat

[Wood FT]

Hope you find out what’s going on, sounds bad.

[user deactivated]

I’d be asking the gp to run blood tests for inflammation. Multiple small joint pain in the fingers with stiffness of the joints worse in the morning, no specific trauma. Worth getting checked

[bigironhorse]

I’d be asking the gp to run blood tests for inflammation. Multiple small joint pain in the fingers with stiffness of the joints worse in the morning, no specific trauma. Worth getting checked

Thanks.

What exactly do you suspect here? I thought it was pretty much certain that chronic inflammation would be playing a role in this kind of problem. Unless there is a neurological component.

[nick63]

Yes I'd second Dan's advice. Some blood test looking at inflammatory markers; CRP and ESR specifically. May be an inflammatory arthritis? Psoriatic arthritis? Try getting a referral to a rheumatologist might be better than pissing about at the GPs.

[user deactivated]

Yes as Nick said exactly..... phew

[bigironhorse]

Yes we were pretty worried about some form of arthritis but the GP was pretty clear that arthritis was unlikely as the pain was mainly between the joints rather than on or in the joints. Probably not an expert though so referral probably a good next step. Thanks.

[bigironhorse]

No history of psoriasis so psoriatic arthritis unlikely I think!

[sheavi]

Hi I'm a physio - first step is blood tests as has been said. All clear then see a good physio.  Her age would be a useful bit of information and previous climbing experience.

[bigironhorse]

Thanks. Age 30. Climbing for around two years up to 6a+.

[sheavi]

Thanks yes sorry you already mentioned the climbing duration part.  Anatomically it could be a bilateral lumbrical muscle issue but as a general rule of thumb if both hands are evenly affected then possibly some systemic inflammatory issue might be a main contributory factor or it is referred pain from the lower central neck region. It can still of course just be a local tissue problem in the hands.  As mentioned have some blood tests checking for inflammatory markers.  These issues and diagnosis with appropriate treatment should be pretty straight forward if you see the right person.

[bigironhorse]

Thanks all for great replies.

Thanks yes sorry you already mentioned the climbing duration part.  Anatomically it could be a bilateral lumbrical muscle issue but as a general rule of thumb if both hands are evenly affected then possibly some systemic inflammatory issue might be a main contributory factor or it is referred pain from the lower central neck region. It can still of course just be a local tissue problem in the hands.  As mentioned have some blood tests checking for inflammatory markers.  These issues and diagnosis with appropriate treatment should be pretty straight forward if you see the right person.

I hadn't considered the lumbrical muscles but it fits quite well with the site of pain. https://trainingforclimbing.com/lumbrical-training-rehab/