[slackline]

Sorry Bonjoy I think you've misunderstood me.  

I'm not dismissing the evidence that there is a correlation between intense climbing and onset of DC, its clear that climbers do get DC, perhaps at a higher rate than the general population (but no ones attempted to quantify that*).  What I am saying though is that correlation (and thats all it is until you've done the formalised research) is not the same as causation, and there are (in epidemiology) different types of causation, necessary, contributory, sufficient etc..  In this case climbing is most likely to be a contributory causation to the onset of DC, and the correlation serves as a starting point for further investigations.

I also tried to shed some light as to why the studies haven't been done yet (i.e. not life-threatening, low cost to health-care services).

As I say for people who are already showing signs of DC its more important to understand the efficacy of different treatments for which there is a body of evidence rather than worrying about what factors have invluenced the onset as nothing can be done about that.

Sorry Lagers, I don't have the wit to write a Lagerpedia^tm entry, but i'd recommend Hennekens & Buring (1987) Epidemiology in Medicine as an excellent starting point for anyone who wants to read more about epidemiology.

* When you say "well over average" how are you quantifying it against the background population rate?  I remember further back in this thread that you'd gone through your phones contacts list and compared climbers vs non climbers, but thats a relatively small sample size (so generalising to the rest of the population is dubious) and there is going to be some bias.  For example do the people you climb with tend to be older than those who you socialise with, e.g. you might have nephews & neices phone numbers in your phone, or you may have more male climbing contacts (and the ratio of male to female DC is 3:1) and more female non-climbing contacts, which in and of itself would bias your sample as older males are over-represented in your climbing group?  This is pure conjecture on my behalf, but hopefully serves to demonstrate how simple things can cloud the problem, and this is where sex and age matching start helping out.

Its relatively straightforward to do, since you simply ask people presenting with DC if they've climbed and to what level for what period of time, but to date thats not been done.  In the past though people were asked if they did "manual labour" and no correlation or association was found between this.  I'd imagine its the lumping of climbing into this ill-defined catch-all phrase that is perhaps the underlying reason why medics are dismissive of climbing as a contributory cause.  This in itself is wrong since there are very unique and specific high-stress' and no doubt micro/macro-traumas that result as a consequence of intense climbing that are never seen in "manual labour".

[stevie haston]

Bonjoy, its just homiopathic stuff, seemed to work. Stevie

[Bonjoy]

I only mentioned the number with/without on my phone list as a rough indicator to illustrate the point. Obviously it is not a representative cross section of society. However it is a list of some people who I know and is not selected with a bias for/against having DC, which is why I used it to make the point.
I'm taking population average to be roughly 10%-15% occurance within UK white males, which tends to be what I've seen quoted. Lower prevelance in females (roughly 20% of all cases of DC), so roughly 2-3% in of UK white females. Most literature seems to indicate that most cases are in people over 40. To be conservative I'd say that means at the most 30% of cases being below 40 years of age. What does that make the average for white blokes under 40, 3-5% approx? That's the kind of figures I'm thinking. This is well below the % of regular climbers age below 40 I know of with DC. As I haven't gone around asking anyone if they have DC, I only know of those who have happened to mention it, if anything my figure for the percentage of friends with DC is going to be too low.

[slackline]

Fairy-muff, hopefully I've helped answer in the last post why doctors may be dismissive about the link between climbing and DC (i.e. they wrongly lump it with 'manual labour' in their assessment of a DC patients past activities).

Nor was I trying to pick apart your phone list estimate, although you've misinterpreted what I've written.  Its not a bias for/against DC that would be the problem, thats what your aiming to assess.  Its the division between climbing and non-climbing contacts where bias may arise if, for example, you climbed predominantely with males, in which case females (who at a lower risk anyway) are over-represented in the non-climbing group (or under-represented in the climbing group if you wish) and will bias any conclusion based on the sample.

Statistics is a fickle beast (or perhaps its those who carry out statistics, i.e. me), either way I'm going to leave it there for now as I've a ton of cancer survival statistics to collate before the end of the day.

[tommytwotone]

Just re-read a lot of this - very interesting, if a little scary.

Can see Slackers' points regarding the necessity for SCIENCE, but agree with Bonjoy - putting SCIENCE aside, I don't feel like it's a massive leap of logic to say "doing loads of serious, finger thrashing climbing is pretty likely to result in a higher risk of developing a condition that knackers up your fingers" is it?

Think the only thing I could add to this discussion is to say don't read that UKC article while eating your lunch...those pics made me feel a bit queasy for sure.

[Johnny Brown]

A possible 'confounder' might be the higher level of awareness of DC in the climbing community. I recognised mine in the very early stages whereas I've met a few non-climbers since who have far more advanced DC without a clue what it is.

[GCW]

I just don’t understand why many medical types are so adamant there is no link.

I'm not sure that's the case, is it?  As far as I recall (I may be wrong) noone here has said climbing does not increase the risk of Dupuytren's, only that there's no study proving it.

Before now, various causes and effects were taken as fact:  Drinking port gives you gout.  Alcoholism and using vibrating tools gives you Dupuytren's etc etc.  Most have never been proven, and many have been disproven.  Just because it seems anecdotally correct or logical, it doesn't make it fact.

I can quite believe climbing increases the risk of Dupuytren's but it's never been proven in SCIENCE.  Yeah, it is logical.  Yeah, a lot of climbers have it.  But (as a daft example) the Viking genes are associated with an increased risk of Dupuytren's, so Viking genes predispose people to become boulderers.  Thus it isn't a direct link between bouldering and Dupuytren's.  Assumption is the mother of all fuck ups.

But, at the end of the day, I expect you'll be proved right, Jon, and a link will be found once someone does a decent sized study.  If that ever happens.

[GCW]

A possible 'confounder' might be the higher level of awareness of DC in the climbing community. I recognised mine in the very early stages whereas I've met a few non-climbers since who have far more advanced DC without a clue what it is.

Or people are more symptomatic because they climb and report it, whereas Joe public doesn't get tenderness and lives with it so rates seem lower.   

[Bonjoy]

I'm not sure that's the case, is it?  As far as I recall (I may be wrong) noone here has said climbing does not increase the risk of Dupuytren's, only that there's no study proving it.

I wasn't really referring to comments made on here, more the reactions by medical practitioners out in the real world.




Here's an out of the box confounder. Maybe people of viking origin are pre-disposed to go rock climbing 

[GCW]

Here's an out of the box confounder. Maybe people of viking origin are pre-disposed to go rock climbing 

Fuck me, that's genius.  Good work

Anyone that dismisses the possibility outright is a moron and I suggest you change your medical practitioner.

[stevie haston]

hello I must apologise for getting something wrong, laurence corrected me as DC is affecting her badly again. I took daisey oil which is flowers disolved in alcahol and  rubbed it in to the 'cord', she took some kind of homiopathic pill which can  be (in france) recomended for this kind of thing. Another friend (female) has just had the needle treetment rather than the operation and is totally satisfied and very happy with this treetment. It really looks to me, that simple on down time from the invasive surgery, the needle way is far better (quicker to heal, quicker to go back to using your hands). I love the stats thing with Vikings , as being of Viking stock seems to predispose you to nearly everything except sickle cell. Lots of these statistics,  are drawn from the wealthier part of the population in northern europe and north america where you guessed it, lots of people have Viking stock. Not saying its wrong, my dad was pure Viking and he had DC (hard labour), I am not 100% viking but havemild DC  (lots of climbing particularly with axes. Laurence is pure viking and she has DC (climbing), her dad is pure Viking and has DC , he put it down to holding onto cycling bars. I do think mine would be much worse if I hadnt been stretching my fingers for all these years. Anyway goodluck to everybody. Stevie   

[Scouse D]

Bonjoy,
If my number is on yor phone you can now add me to your lump buddies list. Mine has come on over the last few weeks really.

[Paul B]

Bonjoy,
If my number is on yor phone you can now add me to your lump buddies list. Mine has come on over the last few weeks really.

add me to that club. RH palm, between ring and little finger. Pronounced looking tendon and hardness on the palm. Came on during my trip, thought it was just a spikey jug had stuck me, obviously not. Guppying will never be the same again.
(24 years old!)

[SA Chris]

Is that the same as the lump that you thought was scar tissue a few weeks ago or another one?

[Paul B]

the very one. I checked back through my blog and it isn't in the right place to be my prior injury.

[SA Chris]

So jfw was right? You beter wad him.

[Paul B]

So jfw was right? You beter wad him.

or else? 

[SA Chris]

...or else karma may once again seek you out.

[Plattsy]

So jfw was right? You beter wad him.

[SA Chris]

her? Never noticed that the initials were gender specific.

[GCW]

You not see that photo then?

[SA Chris]

NSFW. Never bothered at home.

[Duma]

this one's SFW: jfw:

was a while ago tho, and if you don't run...

[jfw]

  blushing

On another statistical note - I know of a fair few climbing lasses (me included) who have dupuytrens. My cursory literary review indicates that Dupuytrens is even rarer in wimmin than in blokes.

My own hypothesis is that personally

1) I have a genetic disposition (dad had the normal op)

2) This has presented much earlier (in age terms mid 20s cf to dad 60s) due to the stresses on the hand of climbing

I have got some pretty pronounced bumps/cords going on.

On a plus note My dad had a successful op.

More  pertinently to climbers - Pod has also had the full op (maybe twice?) successfully.

[SA Chris]

There were some pics on UKC of PODs op. Hope it won't get that far, looked grim!