the shizzle > diet, training and injuries

A2 News

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cofe:
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:
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.

tomtom:
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...

SA Chris:
Ru, any mention of friction massage to break down scar tissue or is that BS?

Ru:

--- Quote from: SA Chris on December 18, 2019, 12:04:57 pm ---Ru, any mention of friction massage to break down scar tissue or is that BS?

--- End quote ---

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

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