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A2 News (Read 8874 times)

cofe

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A2 News
December 18, 2019, 11:21:55 am
Not about the road in Kent.

Wondered if there was any up-to-date thinking on diagnosis and treatment of A2 injuries? I appear to have done my RH ring finger, which I think I did years (15+) ago. Didn't hear or feel it go; it just became sore about 10 days ago and clearly isn't up to climbing at the moment. Happy Christmas etc.

Have read this and other similar things, which reference Volker Schoffl. Also, understand these things are almost impossible to diagnose properly without ultrasound.

Any new links/science/treatment options much appreciated.

Ru

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#1 Re: A2 News
December 18, 2019, 11:55:13 am
The following is my own take on pulley injuries formed after talking to and climbing with Volker a lot and talking to other orthopaedic surgeons and physios over the years. Unless you have completely ruptured 3 pulleys on the same finger, surgery is not recommended. You generally know if you've done that - audible cracks, swelling with visible bruising and a clearly bowstringing tendon. Anything less that that and the recovery protocol is basically initial rest, followed by gradual progressive loading to regain strength. Some think taping works, I know Volker is generally an advocate, but in my experience getting the tape tight enough to support the tendon cuts off the blood supply. It's useful to give you feedback or stop you crimping up whilst in recovery.

If yours has just become sore and it's an old injury site you may have torn some scar tissue or a some pulley fibres or something. I doubt actual diagnosis will change what you do to recover.

Distilling all this down even further into practical advice that is easy to follow, go easy on it for a bit and it will probably get better. If it hurts, stop or do something that doesn't hurt. Pain that gets better as you warm up but comes back afterwards is better than than pain that hurts as you climb. Avoid that. Science still hasn't bettered the normal healing process. Last time I mentioned an injury like yours to Volker he just said, "me too," and set off on his redpoint.

Apart from a few very expensive treatments with inconclusive or low efficacy (like plasma rich platelet injections), almost all sports injuries seem to fall into three categories - it's either completely broken and you're best having it surgically stuck back together, or it's not and you either leave it alone and it basically gets better by its self helped by gradual loading exercise, or it's somewhere in the middle and no-one can decide whether surgery will improve the outcome. There are a few exceptions like tendonosis where eccentric exercises seem to be very effective and some chronic inflammation seems to respond well to a cortisone injection.

« Last Edit: December 18, 2019, 12:05:16 pm by Ru »

tomtom

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#2 Re: A2 News
December 18, 2019, 12:02:22 pm
Since re-starting climbing in c.2008/9 I've had two A2 strains - and both have healed fairly fast with just rest for a week or two of rest then open handing things for a few weeks. What I noticed from being older (and having climbed longer) is that they healed faster than ones when I was younger.. just me and n=4 etc...

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#3 Re: A2 News
December 18, 2019, 12:04:57 pm
Ru, any mention of friction massage to break down scar tissue or is that BS?

Ru

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#4 Re: A2 News
December 18, 2019, 12:19:48 pm
Ru, any mention of friction massage to break down scar tissue or is that BS?

Don't think anyone really knows. Probably won't make it worse.

cofe

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#5 Re: A2 News
December 18, 2019, 12:20:35 pm
Thanks Ru. My last one was middle A2, same hand, in early 2016. I made it worse two weeks later by not resting properly initially and then it took a while to recover (followed by secondary injuries; joy), mainly through building up climbing. This injury doesn't feel as bad. I did wrap the finger in tape when I climbed back then, but only so it wasn't possible to crimp: I think DMC recommends this in his book. I'm not convinced you can get tape tight enough to help without affecting blood flow, and therefore recovery. I've read this elsewhere too. Volker recommends the H taping.

I have been doing the cold water (20mins) stuff to encourage blood flow. Feels good.

Ru

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#6 Re: A2 News
December 18, 2019, 12:27:46 pm
H taping is supposed to be better at taking load off the pulley, but I'm skeptical about its efficacy. Isa Schoeffl did some cadaver studies that showed it works, but cadavers don't have to pump blood through their fingers at the same time. There are also a few underground treatments with good anecdotal reports of efficacy in injury healing but with no human studies to back them up like BPC-157 injections. I've not read enough about them to comment and clearly cannot recommend.

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#7 Re: A2 News
December 18, 2019, 07:15:35 pm
Alright Cofe. I seem to get an annual dose of a pulley sprain. Usually from unleashing emergency crimp on something in bad conditions, or just generally overdoing it a bit. I often don't notice anything major at the time, but it's stiff the next day. After lots of mucking around with different things, here's what seems to work for me...

Total rest from climbing for 2.weeks to let it calm down a bit. Icing feels nice at this stage, but don't overdo it. Likewise with ibuprofen. Just be patient and go running. Keep moving it through full range lots, but carefully.

Then start doing the pen rolls (look at the Esther Smith article, rubber band stuff, and very steady climbing with absolutely no crimping whatsoever. I tape up here, purely so that my finger can't bend. No support for tendon, just to stop it crimping. Gradually build up the rubber band work and open hand climbing over 2 or 3 weeks, but mainly, keep being patient and go running. This is the key here. They often start to feel better around this time, so I'll get over excited, climb something too hard, and then quickly make my way back to square 1. Or worse. Be patient. It's only a few weeks.

After 6 weeks, start finger boarding. Really gently at first. Aim is to fix your injury, not get stronger (although there's loads you can do around it, like one arm stuff on big holds etc). I do three finger open, then half crimp. At first this hurts the injury a bit. And it feels weak as hell. Like can't actually hang bodyweight off half crimp. Every other day, a good warm up and then gentle half crimp sets (maybe 5 hangs), and every session it will feel stronger and less painful. I think at this stage you're probably OK to carefully ramp up the bouldering too. Stay open handed until its feeling lots stronger.

Usually 3 weeks of this and I start to feel condmfident using a crimp whilst climbing again. I find 9 or 10 weeks from first doing it to pretty much fully recovered. In the past it's taken months and months due to a combination of overdoing it early on, and then not doing the progressive loading.

Article...

https://eu.blackdiamondequipment.com/en_GB/experience-story?cid=esther-smith-nagging-finger-injuries

cofe

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#8 Re: A2 News
December 18, 2019, 07:36:26 pm
Cheers Ged. Sounds like I’m already doing a bit too much. Will back off a bit more and the build it back up next year.

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#9 Re: A2 News
December 18, 2019, 07:42:36 pm
One thing I found really helpful for my latest finger injury that got me back to near full strength, before the latest wrist injury... was progressive loading over sessions.

After various non-climbing rest and rehab, I started with 2-handed hangs with weight taken off by a pulley. I was on a 20mm edge with -45lb to start and every session I'd slowly decrease the weight taken off (increase once bodyweight is passed). Was really good to be able to track progress and was so psyched when I was back to bodyweight hangs. Half-crimp throughout.

I think the starting point will depend on severity of injury

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#10 Re: A2 News
December 19, 2019, 02:36:13 pm

After 6 weeks, start finger boarding.

I'd like to give a shout-out to finger boarding as a rehab method for finger injuries. I seem to have a couple of finger injuries a year. With my most recent injury it had pretty much healed, 90% of the way there, but I still found it really difficult to warm up enough to be able to crimp properly and I had to be very careful with it. It was frustrating because I always had to climb conservatively, especially coming back to the wall after a summer of climbing outdoors.

After two sessions of 5 x 10 second half crimp hangs with no added weight I could suddenly climb on all my subsequent sessions without being cautious. I suppose the fingerboarding brought my injured finger up to a similar level as my other fingers. I'm not totally sure how it worked but it has made a massive different to my recent climbing and the healing of my finger. Totally recommend it when your finger is nearly healed but not 100% there.

Nigel

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#11 Re: A2 News
December 19, 2019, 09:46:16 pm
Not about the road in Kent.

Wondered if there was any up-to-date thinking on diagnosis and treatment of A2 injuries? I appear to have done my RH ring finger, which I think I did years (15+) ago. Didn't hear or feel it go; it just became sore about 10 days ago and clearly isn't up to climbing at the moment. Happy Christmas etc.

Have read this and other similar things, which reference Volker Schoffl. Also, understand these things are almost impossible to diagnose properly without ultrasound.

Any new links/science/treatment options much appreciated.

Ay up cofe! If you didn't feel or hear it go then its not that bad, probably. I don't know any science but whenever I do this (usually with a bang to be honest) it's:

1 or 2 weeks off, occasionally rubbing / mobilising / straigtening finger as appropriate..

Easy climbing for a couple of weeks / a month (severity dependant) with mummifyingly cross taped finger. So a couple of tight turns round a2 base of finger, cross knuckle, across a4, then back down to a2. Tight enough that finger feels numb. Finger should feel locked straight, open hand. Stay in this position. Probably mainly big holds by default.

A couple of weeks / a month of same taping but allowing yourself to half crimp if needed i.e. Try to use smaller holds. Borderline impossible with tape on, especially at start if session as its tight, but it will loosen. Probably still can't do it but just try and hold on. Stop when it aches. Gradual giving in tape as you warm up gives you a natural progression of loading if you stop early.

After that then open hand fingerboarding for a week or two. Then half crimp fingerboarding for a week or two. Tape on or off, or tight or slack, depending on feeling. If you haven't gone mad by this stage then you should be nearly healed, just needing to get some load on to remind it what to do / break down scar tissue.

After that avoid full boning down for another month or two to avoid reinjury, should be healed then.

Basically doing nothing is the worst thing you can do. As is ignoring it. Take the middle way grasshopper. I've taken some fucked ring fingers to font and cone back a happy man. I can't say the same for raven tor.

tomtom

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#12 Re: A2 News
December 19, 2019, 10:11:00 pm
One of these massagers might help... I’ve one for sore / stiff post climbing fingers.

Can’t go too far wrong for £1.66 inc postage...

Finger Roller Massager Hand Handheld Blood Circulation Tool Joint Relaxing Massage Tool https://www.amazon.co.uk/dp/B07K427R6J/ref=cm_sw_r_cp_api_i_Ru.-Db6AHV2KP

Moo

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#13 Re: A2 News
December 21, 2019, 10:53:14 pm
I'll totally reiterate all the posts on here about progressive loading and trying to keep as active as possible. Something I found really useful to help with this is using progressively more difficult squeeze balls. I've got the set that metolious make.

https://www.metoliusclimbing.com/grip_saver_plus.html

I'm no advocating these ones particularly, in fact I sacked off the stretchy rubber band bits because I thought they felt a bit pointless. Something like this is good for really high volume of very light loading which can help align and strengthen scar tissue moving the finger through its full range of motion and helping increase blood flow. I found them particularly useful to have sitting on the desk at work so you can exercise with them a little and often. The main downside of the these is that they're quite expensive so I don't know if anyone knows of a cheaper alternative?

I've tried the squeeze putty in the past as well but I that didn't seem to work for me.


duncan

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#14 Re: A2 News
December 22, 2019, 10:32:45 am
For soft tissue injuries in general...

Effective:
Relative rest immediately after injury followed by progressive loading during healing
(more aggressive loading if a long-term problem).

Fingerboarding could be good way to reintroduce loading to your healing pulley: it’s easy to control the grip type (crucial, start open-hand obviously) and the load. I’ve found bathroom scales easy to use if you want to apply a low load.

Ice may promote local blood flow in very superficial tissues, eg fingers, certainly gives pain relief, is relatively harmless and cheap.

Shockwave Therapy (low quality evidence, may turn out to be a placebo).

Placebo:
Acupuncture rings and other massage devices (use your fingers).
Acupuncture.
Ultrasound.
PRP (profit-related placebo).


Unknown:
Deep friction massage.

Avoid
NSAIDs. Likely interfere with soft-tissue healing a little, probably a small effect only.
Steroid injections, unless very clear indication.

There are likely to be exceptions to all these suggestions, discuss with the person treating you.
 

« Last Edit: December 22, 2019, 10:48:57 am by duncan »

cofe

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#15 Re: A2 News
December 23, 2019, 08:31:17 am
Cheers for the extra feedback. While it's disappointing no one has found a magic cure for pulley injuries since I last did one, I'll keep chipping away.

tomtom

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#16 Re: A2 News
December 23, 2019, 09:10:16 am
Cheers for the extra feedback. While it's disappointing no one has found a magic cure for pulley injuries since I last did one, I'll keep chipping away.

Don’t chip it!

cofe

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#17 Re: A2 News
February 05, 2020, 12:28:32 pm
Coming up to 10 weeks and I can climb OK-ish (can't bone/bear down on that hand, certainly can't crimp). Still tender, not painful, but always the same. Have been taking it steady. Disciplined light/controlled fingerboarding, no hard climbing. But there is a fairly pronounced ridge/lump around the palmar side of the finger roughly at the bottom (palm) end of the A2. Starting to think it might be something else. Tenosynovitis or some other strain/thing. Any ideas? 

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#18 Re: A2 News
February 05, 2020, 12:38:46 pm
is it not scar tissue? Cross friction massage to break it down?

Bradders

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#19 Re: A2 News
February 05, 2020, 07:31:37 pm
Coming up to 10 weeks and I can But there is a fairly pronounced ridge/lump around the palmar side of the finger roughly at the bottom (palm) end of the A2. Starting to think it might be something else. Tenosynovitis or some other strain/thing. Any ideas?

I have the exact same thing on my LH middle A2. It appeared one day alongside a minor pulley issue and the two seemed like they must be linked.

Have speculated that it might be various things but never gone to get it actually diagnosed. Main theory was either some sort of synovitis or a ganglion cyst which might be a direct result of the tissue damage in the pulley.

I got the injury in late Spring 2018 and did what you're doing over summer, lots of gradual fingerboarding, building up adding weight and open handing stuff. Back to full crimping by October and set a new max hangs PB in November. Whilst the lump is very much still there it causes no issues.

cofe

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#20 Re: A2 News
February 06, 2020, 09:39:14 am
Sounds similar. Doesn't feel like a usual pulley thing or what I've experienced with scar tissue in the past. Might just take a while to settle down and I'm being impatient. Not a lot of people you can see about this kind of thing. Given it felt a minor tweak at the time I'd expected to be building it back up again soon.

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#21 Re: A2 News
February 15, 2021, 02:37:58 pm
Thread refresh:

My RH ring A2 is sometimes sore, not constant but occasionally gives me a bit of gyp. I have been prophylactically taping it for at least the last few years, can't remember when I started. This seems to help and its never stopped me climbing.

Over the summer I was consistently doing three finger drag, openhanded hangs on the RH, on the middle slot of the BM2K with a few kg of assist. I can't do that anymore and the position feels tweaky and painful. There is no pain in the finger at all when half crimping, I can fingerboard fine in that position, and I have been carefully fingerboarding in 3FD with both hands on. This is sometimes with some reasonable weight added - up to 15kg in Anderson hang sessions.

Today after climbing at the weekend it is a bit sore but suspect it won't be so painful I can't fingerboard. I have no discernible pain in palm or forearm which would seem to make a flexor strain less likely. Whats going on here, and is my current plan of just carry on doing what I'm doing carefully the right one?

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#22 Re: A2 News
February 15, 2021, 02:50:36 pm

SA Chris

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#23 Re: A2 News
November 16, 2022, 12:27:58 pm
I either strained or partially tore A2 on 22 October (sore on sides right at base of finger, and swollen after climbing wall session).

Followed most of the above, and am now climbing lightly on it once a week (big holds, no crimps)  using some squeezy putty or a hand exerciser dialled right down and taping as a precaution.

There is no pain in general use, and a bit sore after climbing, but it still looks pretty swollen, is this common?

Managed to avoid any finger injuries for quite while (15 years?) so wondering if it changes as you get older.

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#24 Re: A2 News
November 16, 2022, 01:54:41 pm
I had a probable full rupture of A2 just over a year ago.

Was swollen for quite a few weeks.

I rested for 5 weeks the started easy climbing. It was still swollen at this time. Built up very slowly. Back to hard climbing in 3 months and very hard climbing with nasty crimps in 6 months.

H-taping is the recommended taping.

I saw a physio called James at Sheffield Climbing Clinic who was very good. Saw him twice. Worth the Dosh to know I was doing the right things.

SA Chris

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#25 Re: A2 News
November 16, 2022, 02:00:57 pm
Cheers.

I'd like to go and see someone who is clued up about these things, but no climbing specialists in NE Scotland I know of.

James Malloch

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#26 Re: A2 News
November 16, 2022, 03:20:03 pm
Cheers.

I'd like to go and see someone who is clued up about these things, but no climbing specialists in NE Scotland I know of.

I’d really recommend Andy who specialises in Remote physio sessions.

I’ve not had an in-person appointment in a long time and unless I could be bothered to drive to see him I wouldn’t go anywhere else for climbing physio.

Caveat is that I do know him personally but it genuinely wouldn’t change my recommendation. He’s just great and being remote doesn’t detract from it in the slightest.

He has great after care too. Generally I’ve had one appointment which leads to some kind of write up and plan. Then any questions I have are all dealt with via email.

He makes cool splints too for climbing with pulley injuries.

https://www.processphysiotherapy.co.uk/

SA Chris

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#27 Re: A2 News
November 16, 2022, 03:45:55 pm
Excellent, doing it remotely had not crossed my mind for some reason. I'll get in touch.

James Malloch

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#28 Re: A2 News
November 16, 2022, 04:12:08 pm
Excellent, doing it remotely had not crossed my mind for some reason. I'll get in touch.

He’s been a saviour on our trip. So many sessions 😂

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#29 Re: A2 News
November 16, 2022, 04:38:49 pm
He’s a sound guy.

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#30 Re: A2 News
November 17, 2022, 08:57:18 am
Cheers.

I'd like to go and see someone who is clued up about these things, but no climbing specialists in NE Scotland I know of.

I’d really recommend Andy who specialises in Remote physio sessions.

I’ve not had an in-person appointment in a long time and unless I could be bothered to drive to see him I wouldn’t go anywhere else for climbing physio.

Caveat is that I do know him personally but it genuinely wouldn’t change my recommendation. He’s just great and being remote doesn’t detract from it in the slightest.

He has great after care too. Generally I’ve had one appointment which leads to some kind of write up and plan. Then any questions I have are all dealt with via email.

He makes cool splints too for climbing with pulley injuries.

https://www.processphysiotherapy.co.uk/

Apparently also has a book coming out?! I had no idea. Looks ace. https://www.processphysiotherapy.co.uk/the-self-rehabbed-climber

James Malloch

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#31 Re: A2 News
November 17, 2022, 09:43:58 am
Cheers.

I'd like to go and see someone who is clued up about these things, but no climbing specialists in NE Scotland I know of.

I’d really recommend Andy who specialises in Remote physio sessions.

I’ve not had an in-person appointment in a long time and unless I could be bothered to drive to see him I wouldn’t go anywhere else for climbing physio.

Caveat is that I do know him personally but it genuinely wouldn’t change my recommendation. He’s just great and being remote doesn’t detract from it in the slightest.

He has great after care too. Generally I’ve had one appointment which leads to some kind of write up and plan. Then any questions I have are all dealt with via email.

He makes cool splints too for climbing with pulley injuries.

https://www.processphysiotherapy.co.uk/

Apparently also has a book coming out?! I had no idea. Looks ace. https://www.processphysiotherapy.co.uk/the-self-rehabbed-climber

Yeah I’ve got one on order - I think it’ll be a nice thing to have to hand. He’s doing a bunch of sessions over at Kendal Wall in the next 2/3 months too - it’s a shame I’m away for most of them.

He took me on my first sport climbing session back in 2011 in El Chorro. Didn’t care that I’d not been before and was psyched to get out to Desplo despite it being September and 30+ degrees! Real nice guy.

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#32 Re: A2 News
November 17, 2022, 10:07:40 am
I also got one of those splints when I saw this James guy in Sheffield. He did explain where he was getting them from but I can't remember, perhaps it was this guy. Quite possible it was which would be a great endorsement.

Anyway, the splint seemed to really help. But this was my first pulley I jury so I've no reference point.

James Malloch

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#33 Re: A2 News
November 17, 2022, 12:47:09 pm
I also got one of those splints when I saw this James guy in Sheffield. He did explain where he was getting them from but I can't remember, perhaps it was this guy. Quite possible it was which would be a great endorsement.

Anyway, the splint seemed to really help. But this was my first pulley I jury so I've no reference point.

The type Andy makes are in his video here:

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#34 Re: A2 News
November 17, 2022, 03:15:42 pm
I've had my fair share of finger injuries including two ruptures. Best diagnosis is an ultrasound to identify whether and how much the tendon is lifting off the bone under load. For both, I've been wearing pulley ring 24/7 for min. four weeks. Pain in the ass and sore on the top of finger but helps a lot. I am actually at four weeks exactly today (seeing PT again on Monday so keeping on till then). Then wear pulley ring for min. four weeks after only when climbing.

I have a pulley ring like the one in that video for 24/7 wear but a different, thermoplastic pulley ring: https://rocknsport.square.site/  for climbing. It's lower profile so doesn't get in the way but it doesn't leave much room for your veins at the side of finger.

James Malloch

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#35 Re: A2 News
November 17, 2022, 05:24:08 pm
I've had my fair share of finger injuries including two ruptures. Best diagnosis is an ultrasound to identify whether and how much the tendon is lifting off the bone under load. For both, I've been wearing pulley ring 24/7 for min. four weeks. Pain in the ass and sore on the top of finger but helps a lot. I am actually at four weeks exactly today (seeing PT again on Monday so keeping on till then). Then wear pulley ring for min. four weeks after only when climbing.

I have a pulley ring like the one in that video for 24/7 wear but a different, thermoplastic pulley ring: https://rocknsport.square.site/  for climbing. It's lower profile so doesn't get in the way but it doesn't leave much room for your veins at the side of finger.

Not heard of those. No photos to see what they are like unfortunately.

I’m back wearing mine tomorrow after getting a tweak on a project (note to self, don’t try so hard).

Andy’s earlier versions were a bit better for me (little bit less bulky) but I also managed to snap quite a few so I think his current ones are a bit more heavy duty.

I’ve not actually used the newer ones as I bought them for our trip and haven’t needed one until now. But I used the old versions a lot last winter. Will report back on how this one is tomorrow.

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#36 Re: A2 News
November 17, 2022, 07:00:00 pm
I wear this 24/7: https://www.amazon.com/NiceClimbs-Pulley-Climbing-Finger-Splint/dp/B088MM4937

Approx. half way down the page in purple is the pulley ring (with tape) I wear while climbing: https://www.unionpt.com/climbing-finger-pulley-injury/

James Malloch

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#37 Re: A2 News
November 17, 2022, 07:07:35 pm
I wear this 24/7: https://www.amazon.com/NiceClimbs-Pulley-Climbing-Finger-Splint/dp/B088MM4937

Approx. half way down the page in purple is the pulley ring (with tape) I wear while climbing: https://www.unionpt.com/climbing-finger-pulley-injury/

Cheers. Interesting to see them 👍🏻

The one I have (whilst climbing) is similar to the one in your first link with lots of tight tape. But nothing the rest of the time (do some density hangs etc).

But My injuries have been pretty minor.

Current niggle is the A4 rather than A2. The ring should help a bit but obviously not a silver bullet.

I’m just hoping I get up my project first go tomorrow after dropping the last foot movements twice yesterday  :lol: :chair:

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#38 Re: A2 News
November 17, 2022, 07:46:27 pm
I've had my fair share of finger injuries including two ruptures. Best diagnosis is an ultrasound to identify whether and how much the tendon is lifting off the bone under load. For both, I've been wearing pulley ring 24/7 for min. four weeks. Pain in the ass and sore on the top of finger but helps a lot. I am actually at four weeks exactly today (seeing PT again on Monday so keeping on till then). Then wear pulley ring for min. four weeks after only when climbing.

I have a pulley ring like the one in that video for 24/7 wear but a different, thermoplastic pulley ring: https://rocknsport.square.site/  for climbing. It's lower profile so doesn't get in the way but it doesn't leave much room for your veins at the side of finger.

Judging by your power club posts I'd say you've had a lot more than your fair share!!

Out of interest, have you ever injured the same pulley more than once?

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#39 Re: A2 News
November 17, 2022, 07:56:41 pm
I've had my fair share of finger injuries including two ruptures. Best diagnosis is an ultrasound to identify whether and how much the tendon is lifting off the bone under load. For both, I've been wearing pulley ring 24/7 for min. four weeks. Pain in the ass and sore on the top of finger but helps a lot. I am actually at four weeks exactly today (seeing PT again on Monday so keeping on till then). Then wear pulley ring for min. four weeks after only when climbing.

I have a pulley ring like the one in that video for 24/7 wear but a different, thermoplastic pulley ring: https://rocknsport.square.site/  for climbing. It's lower profile so doesn't get in the way but it doesn't leave much room for your veins at the side of finger.

Judging by your power club posts I'd say you've had a lot more than your fair share!!

Out of interest, have you ever injured the same pulley more than once?
Maybe from a niggles standpoint but not major injuries. Injured most pulleys at some point over past 10 years so who knows. Maybe I should get a tattoo on each pulley when I injure it to keep track  ;D

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#40 Re: A2 News
November 17, 2022, 08:15:23 pm
I also got one of those splints when I saw this James guy in Sheffield. He did explain where he was getting them from but I can't remember, perhaps it was this guy. Quite possible it was which would be a great endorsement.

Anyway, the splint seemed to really help. But this was my first pulley I jury so I've no reference point.

The type Andy makes are in his video here:

Yeah that's not the same. And the way it's used looks to be very different too.

I thought voklers paper had shown that H taping was better for protecting A2 than taping over the actual pulley?

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#41 Re: A2 News
November 17, 2022, 08:27:42 pm
I also got one of those splints when I saw this James guy in Sheffield. He did explain where he was getting them from but I can't remember, perhaps it was this guy. Quite possible it was which would be a great endorsement.

Anyway, the splint seemed to really help. But this was my first pulley I jury so I've no reference point.

The type Andy makes are in his video here:

Yeah that's not the same. And the way it's used looks to be very different too.

I thought voklers paper had shown that H taping was better for protecting A2 than taping over the actual pulley?

I‘ve no idea on which is better if I‘m honest. Never looked at Volkers stuff.

I know Andy is massively into the research/papers side so I‘d assume that this product is the results of plenty of research. I know that one benefit is that you can tape really tight without restricting blood flow too much. And that means the stretch/loosening of the tape is reduced too.

He says the below but no idea which type of taping it refers to.

Quote
Flexor Pulley Splints follow the same principles of taping, but provide much more support. It is possible to wear them for hours at a time, even when climbing (at the appropriate stage of rehab). They allow for adequate blood flow to the finger whilst providing effective support.

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#42 Re: A2 News
January 26, 2024, 09:10:35 am
Damn!  First A2 in YEARS!

Very mild, ring finger on my right hand. I suspect doing a max hangs test session to "see where I'm at" plus a short but intense boulder session after (just a couple of problems, limit stuff, maybe 10 attempts in total after a couple of slightly less full on boulders).

Feels so mild/minor that I can probably take a short bit of rest and just avoid boning on it for a while but don't want to make it worse. My middle finger A2s are somewhat life-long chronically grumbly (and have a lump on the side of the RH one) but they never hurt while climbing, and generally get better with maintenance fingerboarding.

Any thoughts non rehabbing a very mild, but definitely "new" A2.

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#43 Re: A2 News
January 26, 2024, 09:15:14 am
Damn!  First A2 in YEARS!

Very mild, ring finger on my right hand. I suspect doing a max hangs test session to "see where I'm at" plus a short but intense boulder session after (just a couple of problems, limit stuff, maybe 10 attempts in total after a couple of slightly less full on boulders).

Feels so mild/minor that I can probably take a short bit of rest and just avoid boning on it for a while but don't want to make it worse. My middle finger A2s are somewhat life-long chronically grumbly (and have a lump on the side of the RH one) but they never hurt while climbing, and generally get better with maintenance fingerboarding.

Any thoughts non rehabbing a very mild, but definitely "new" A2.

6 sets of 30 second density lifts, 1 minutes rest with a 20mm edge, starting with whatever weight feels like 3/10 pain maximum and slowly build that weight up. I do these as part of my warmup now as it’s basically free prehab. I do density hangs into fingerboard hangs and then I’m ready to climb.

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#44 Re: A2 News
January 26, 2024, 09:21:33 am
Damn!  First A2 in YEARS!

Very mild, ring finger on my right hand. I suspect doing a max hangs test session to "see where I'm at" plus a short but intense boulder session after (just a couple of problems, limit stuff, maybe 10 attempts in total after a couple of slightly less full on boulders).

Feels so mild/minor that I can probably take a short bit of rest and just avoid boning on it for a while but don't want to make it worse. My middle finger A2s are somewhat life-long chronically grumbly (and have a lump on the side of the RH one) but they never hurt while climbing, and generally get better with maintenance fingerboarding.

Any thoughts non rehabbing a very mild, but definitely "new" A2.

6 sets of 30 second density lifts, 1 minutes rest with a 20mm edge, starting with whatever weight feels like 3/10 pain maximum and slowly build that weight up. I do these as part of my warmup now as it’s basically free prehab. I do density hangs into fingerboard hangs and then I’m ready to climb.

I also did this, 30 second lifts. Every day, really low intensity, slowly built up. Worked a treat.

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#45 Re: A2 News
January 26, 2024, 09:24:42 am
Damn!  First A2 in YEARS!

Very mild, ring finger on my right hand. I suspect doing a max hangs test session to "see where I'm at" plus a short but intense boulder session after (just a couple of problems, limit stuff, maybe 10 attempts in total after a couple of slightly less full on boulders).

Feels so mild/minor that I can probably take a short bit of rest and just avoid boning on it for a while but don't want to make it worse. My middle finger A2s are somewhat life-long chronically grumbly (and have a lump on the side of the RH one) but they never hurt while climbing, and generally get better with maintenance fingerboarding.

Any thoughts non rehabbing a very mild, but definitely "new" A2.

6 sets of 30 second density lifts, 1 minutes rest with a 20mm edge, starting with whatever weight feels like 3/10 pain maximum and slowly build that weight up. I do these as part of my warmup now as it’s basically free prehab. I do density hangs into fingerboard hangs and then I’m ready to climb.

I also did this, 30 second lifts. Every day, really low intensity, slowly built up. Worked a treat.

I think this is pretty much the gold standard of A2 rehab other than maybe injecting BPC-157 between your fingers  :lol:

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#46 Re: A2 News
January 26, 2024, 09:35:09 am
Damn!  First A2 in YEARS!

Very mild, ring finger on my right hand. I suspect doing a max hangs test session to "see where I'm at" plus a short but intense boulder session after (just a couple of problems, limit stuff, maybe 10 attempts in total after a couple of slightly less full on boulders).

Feels so mild/minor that I can probably take a short bit of rest and just avoid boning on it for a while but don't want to make it worse. My middle finger A2s are somewhat life-long chronically grumbly (and have a lump on the side of the RH one) but they never hurt while climbing, and generally get better with maintenance fingerboarding.

Any thoughts non rehabbing a very mild, but definitely "new" A2.

When did you notice initial symptoms?

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#47 Re: A2 News
January 26, 2024, 09:52:13 am
Damn!  First A2 in YEARS!

Very mild, ring finger on my right hand. I suspect doing a max hangs test session to "see where I'm at" plus a short but intense boulder session after (just a couple of problems, limit stuff, maybe 10 attempts in total after a couple of slightly less full on boulders).

Feels so mild/minor that I can probably take a short bit of rest and just avoid boning on it for a while but don't want to make it worse. My middle finger A2s are somewhat life-long chronically grumbly (and have a lump on the side of the RH one) but they never hurt while climbing, and generally get better with maintenance fingerboarding.

Any thoughts non rehabbing a very mild, but definitely "new" A2.

When did you notice initial symptoms?

When I woke up this morning. Got full ROM no pain but HC gives me a noticeable sensation at the A2. Probably not even a grade 1! Grade 0.4 strain  :lol:

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#48 Re: A2 News
January 26, 2024, 09:57:56 am
I had a similarly minor sprain back in June. I went to Andy (Biscuit on here) - his advice was to tape it up and "mummify" the finger so that you can't half crimp on it. Open hand only when actually climbing. Then constant stretching and periodic open hand hangs to stimulate blood flow to the finger. Still took a few months before it felt okay (but then I was and still am in a state of chronic stress, so healing was pretty slow).

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#49 Re: A2 News
January 26, 2024, 10:47:56 am
I had a similarly minor sprain back in June. I went to Andy (Biscuit on here) - his advice was to tape it up and "mummify" the finger so that you can't half crimp on it. Open hand only when actually climbing. Then constant stretching and periodic open hand hangs to stimulate blood flow to the finger. Still took a few months before it felt okay (but then I was and still am in a state of chronic stress, so healing was pretty slow).

I find this interesting and wonder if Andy/Biscuit is reading and can clarify? My understanding of A2s was that they had effectively no/very little blood supply, and that most of the repair and nutrients came from synovial fluid? And that the transport of this came through pressure cycles of loading/unloading, hence it being worth having a decent amount of protein digested in your system pre-training (something I had started doing regularly last year but come to think of it have totally slacked off on this year...)

I'm not shooting the messenger here - and it probably makes little difference to the rehab (except that I will remember to eat some mackerel pre session again!)

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#50 Re: A2 News
January 26, 2024, 10:52:38 am
Damn!  First A2 in YEARS!

Very mild, ring finger on my right hand. I suspect doing a max hangs test session to "see where I'm at" plus a short but intense boulder session after (just a couple of problems, limit stuff, maybe 10 attempts in total after a couple of slightly less full on boulders).

Feels so mild/minor that I can probably take a short bit of rest and just avoid boning on it for a while but don't want to make it worse. My middle finger A2s are somewhat life-long chronically grumbly (and have a lump on the side of the RH one) but they never hurt while climbing, and generally get better with maintenance fingerboarding.

Any thoughts non rehabbing a very mild, but definitely "new" A2.

When did you notice initial symptoms?

When I woke up this morning. Got full ROM no pain but HC gives me a noticeable sensation at the A2. Probably not even a grade 1! Grade 0.4 strain  :lol:

I'd take 3 days off to let the initial inflammation sort itself before doing anything and then go from there personally. But I always take 3 days off if something feels like I might have injured it. I'm sure I've read before that it's 48-72 hours for inflammation to settle(think inflammation peaks at 1-3 days if I recall correctly)

Ideally don't mess with it at all during those 72 hours (I personally x tape during this period just because I have adhd and it reminds me not to poke it every 5 minutes)

If you're not certain see a physio 

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#51 Re: A2 News
January 26, 2024, 10:58:19 am
Thanks. Aye, that was my rough plan. (especially the mot prodding/testing thing).

Just nipped out for a bacon roll to maximise rehab.  :lol:

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#52 Re: A2 News
February 03, 2024, 09:13:14 am
A2 update. All going well.

Took 5/6 days off completely. No taping, no massage, no ice. Just rest and avoiding any pain.

Then I built up daily with 2 sessions of half crimp, just using enough load to get to the "sensation" point, without pain. Often this meant very low load on the first couple of reps. 10 reps of 10s hangs, twice a day.

I've been doing that since around Monday /Tuesday this week and I'm already up to around 80/90% BW on the big BM2k slots, strict half crimp with NO PAIN. I'm holding myself back as I know it can be easy to overdo it in the early stages. The first rep or 2 often feels a sensation then nothing on the next reps, no pain during the day. Most mornings there's a tiny bit of increased sensation but it goes away with a few hand squeezes. No swelling, not sore to touch.

On Thursday I did a 20 minute ARC session, no pain at all.

All in, very happy with progress - just need to keep taking it easy for a bit and I think all will be well!

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#53 Re: A2 News
February 13, 2024, 01:04:14 pm
Up to solid half crimp, bodyweight (80kg) on 20mm edge.

I've had 4 or 5 decent endurance sessions, slightly above ARC level. Little bit of bouldering, avoiding crimps. Both times I could feel it a little afterwords, but fine next day. I suspect I'm treading the line of "too much too soon", so trying to keep it sensible. I feel that this is probably the critical point - moving from controlled fingerboard to more variable climbing...


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#54 Re: A2 News
February 13, 2024, 02:00:21 pm
Sounds like it’s all headed in the right direction fult, just try to not to get over excited!!

I’ve always had good luck using the metolious squeeze balls for a finger rehab. They’re not gonna fix anything on their own obviously but I definitely think they help with the alignment of scar tissue and letting you get a few for where the injury is at in a safe way.

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#55 Re: A2 News
February 17, 2024, 04:48:58 pm
Sounds like it’s all headed in the right direction fult, just try to not to get over excited!!


The inevitable...

On Thursday I warmed up at the Propstore, the usual, progressively harder half crimp hangs on the fingerboard. 20mm & BW, fine. 10mm & BW, fine.  Did some recruitment pulls on a 21mm campus edge one handed, fine. No pain, totally solid.

So, decided to have a short, carful boulder session before some gym work. All went well. Had some feeling of sensation around the A2 after one problem but it went away in 10-15 seconds and didn't notice it at all for the rest of the session. Finished early after maybe 15-20 attempts at various problems. No pain all day.

Woke up next morning, A2 a bit stiff and sore  :'(  Kinda tender and noticeable all day, to be honest, almost as much as when I first hurt it....  Had to climb 3 wind turbines, so 150m of ladder climbing. Feltnit a bit, but probably mainly just from the square metal rungs.

This morning it was ok, a bit of sensation/soreness first few fist clenches. Tentatively built up to 80%ish BW half crimp on the board, noticeable mild sensation (still not really "pain"). Feeling ok all day.

Thought I'd fucked it, but probably ok.  :devangel:


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#56 Re: A2 News
February 17, 2024, 07:37:04 pm
Based on my generalised multiple injury management learning from guru Biscuit, I would say you might be okay with the day-after-day-after having a noticable drop in pain. Obviously ease off for a bit and, errr, try not to get over excited....

 

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