[Paul B]

Right before I start, i've had a good read of past threads and climbinginjuries.com but i'm still very confused:

About 3 weeks ago my LH middle finger started feeling a bit odd, nothing hurt just the joints ached a bit after stepping off problems. I stopped training at the board and had a couple of easier sessions to try and see if it would go away. So after a few easy sessions and a 5 day rest period I went back to the wall and had a light ish session again, this time there was a lot of soreness in the side of my finger on the lowest pad. I had a week off and that disappeared early on in this week so I thought last night I should be ok to start again and that maybe it was just some kind of a crush injury, I taped but even after the warm up the pain was there. Now i've never actually felt it hurting when i'm doing anything open handed or crimped. If I push my nail in about mid way down the side of the pad I can feel a sore place (I know this isnt a great idea I just need to know wtf it is), how high does the A2 pulley go? more and more i'm beginning to think its a small A2 tear but like I said, it doesn't hurt to pull on it.

Any thoughts/suggestions? Tape and carry on climbing? Take yet more time off (i'm a bit unwilling due to 5 months off already!)? On the one hand I don't want to uncessarily take time off but then again I REALLY don't want it to get worse.

 

Thanks in advance...

[GCW]

Paul, I'm not 100% clear here.  Can you post a pic with the sore area illustrated?
It sounds like you mean an area between the PIPJ and MCPJ, which is A2 area, so I am assuming this is what you mean.
Pain in the joint area can be various things from partial collateral injuries to joint problems.
It is virtually impossible to diagnose over t'internet, and if it continues you should see someone that knows about this stuff.
Generally the treatment is the same............ Rest etc  Going back too quick is a common problem.  It'll cost you more in the long term.

[Paul B]

Red arrow is about where it hurts with a nail ground in to it (i'm going to stop doing that now)

Green arrow is where i've previously had pulley injuries, this new one is further round and half a pad higher...(and on a different finger)...

I would of had more time off etc. but it wasnt behaving like any injury i'd had before and faded very quckly during the rest I did take therefore i'd kind of deemed it to be a crush injury. Its looking like i'm wrong.

[GCW]

Aye, could be a pulley from your red arrow.  A2 is usually around 1cm wide.
Advice as above.

[Paul B]

it just seems odd, its ALWAYS been the ring finger that goes first. Can you feel where the A2 ends in your own finger? feels like theres a bit of a lip where the pain is.

[GCW]

Can you feel where the A2 ends in your own finger?

At the proximal end, maybe.  Not really towards the finger tip.

if it continues you should see someone that knows about this stuff.
Generally the treatment is the same............ Rest etc  Going back too quick is a common problem.  It'll cost you more in the long term.

[Paul B]

hmmm there's a definate lip there...

if it continues you should see someone that knows about this stuff.

Like who, climbing physiotherapist?

[GCW]

Decent upper limb physio, hand surgeon etc.
Do you top end guys not have someone to turn to?  [not being facetious, just surprised].

I expect if you rest it and rehab it correctly you'll be fine.  I can understand the frustration (esp with recent events) but don't rush it.
Good luck, hope it all settles soon.

[etjoset]

Paul,

The symptoms that you describe and the position of the red arrow on your photo are exactly like an injury I had earlier this year and as described here:
http://ukbouldering.com/board/index.php/topic,7468.0.html

feels like theres a bit of a lip where the pain is.

The pain I had was right where the lip is too. I felt little pain when climbing but quite bad soreness after climbing and especially the morning after. In my case I tried to climb through it by doing very light sessions and easy routes but it just got worse. In the end I stopped altogether for just over a month and did the icing and massage treatments recommended on various web sites. I'm pretty sure that by the end of a months rest the tear had healed and that any residual soreness was from the breakdown of scar tissue. That said, by then (mid August) I was in one of my climbing lulls so wasn't too bothered about starting to pull hard again. I'm only now just starting to get back to it seriously but that's more to do with motivational issues rather than the injury.

[Paul B]

Its not as if its the first finger injury i've had, far from it; when I first came to sheffield I decided that quantity was far better than quality, and that achey fingers after training was a good thing. I wrecked most of my A2's at that point and had a while off, since then i've had a couple more and each time had two weeks off, followed by two weeks of easy stuff then an extra overly sensible warm up tagged on to the front of my session, after this the injuries always faded. Just this one wasn't behaving the same, the pain usually took about a week maybe more to go down where as with this injury it faded in about 3 days and it was in a slightly different place, plus I usually have a fair idea of what caused my previous injuries, apart from one suspicious pinch I can't think what on earth has caused this....Maybe its the come back, 5 months off then a pretty harsh re-introduction to things.
Anyway cheers for your advice, i'm sure I heard someone (johnny brown maybe?) saying good things about John from the Clinic.

[Paul B]

Paul,

The symptoms that you describe and the position of the red arrow on your photo are exactly like an injury I had earlier this year and as described here:
http://ukbouldering.com/board/index.php/topic,7468.0.html
...........

Cheers for the info and link, its just this is extremely different to any other A2 injuries i've had and i was very dubious as to whether it was indeed an A2 injury.

[GCW]

I've had similarly postioned pains before that have been due to bruising or "strain" and settled with the usual.
I'm reluctant to offer formal advice without seeing the offending finger.
Go see someone if you're worried (which it sounds like you are).  And no, it doesn't sound like a typical A2 injury.  Doesn't mean it isn't an A2 though.   

[Paul B]

I've chatted to a fair few people now who have had their fair share of finger injuries, it sounded very different to most.
Thanks for your advice anyway (formal or non). Rest/Ice/Jugs it is!

[GCW]

Nae probs.
You can never get hold of too many jugs anyway   
Get well soon.

[Monolith]

Paul, I have exactly the same injury as your symptoms describe at the moment. Tried a session at the board last night and it hurt the whole way through. Never get injuries so grateful for the info within the thread.

[fatdoc]

I'm seconding GCWs advice Paul.

regarding physios / hand specialists...

bit of ice frictioning and stretching out + / - ultrasound is the regieme i'd use for this.... lots of upper limb general stretching +/- some yoga.... neck and imbalanced limb tension can predispose you to injury...

see john at the clinic, i rate him.

there are very few soft tissue experts in upper limb that are drs as far as I know. the best sports doc i've ever met now works for Chelsea FC, but if i ever needed another streiod injection into my fingers (long story..) i'd go to london to have it done!

[Paul B]

Right. Just got back from the works where the clinic run a question and answer session between 8 and 10 on a thursday. After various squeezing, pulling, twisting, jabbing tests the conclusion is that it is NOT a pulley tear!

 

and is some kind of ligament strain!

Course of treatment: As much climbing as I like but bearing in mind that if its going to hurt its probably not going to until the next day, hence take it easy and see whats does and doesnt hurt, crimping/pulling hard not ruled out, dodgy incut jugs and twisting to be avoided. Lots of tape, rings and cross. Deep friction massage every two days. Ice after climbing.

[GCW]

Good news.

[Nigel]

and is some kind of ligament strain!

Thats what I told you in the Porters last week. Always listen to your uncle Nigel! Good news (relatively!) Second the lots of taping too, cross over the knuckle like I said, it'll get better while you bone down. Winner. 

[Johnny Brown]

When are you going to write Kershaw on Rock? Its time your wisdom was more widely available.

[Somebody's Fool]

When are you going to write Kershaw on Rock? Its time your wisdom was more widely available.

Preposterous Ails?

[chappers]

cross over the knuckle like I said.

i have what i think is a similar injury that is ongoing... here are you talking about crossing over the knuckle on the back of the hand, or on the palm side, or both? (i cross over on palm side at the min, should i cross the other way too, so to speak?).
nice one.

[Jim]

I think the book should be called 'Kershaw on injuring yourself'

[dave]

remember kids, guns aren't all fun & games, they can actually be dangerous.

[Paul B]

cross over the knuckle like I said.

i have what i think is a similar injury that is ongoing... here are you talking about crossing over the knuckle on the back of the hand, or on the palm side, or both? (i cross over on palm side at the min, should i cross the other way too, so to speak?).
nice one.

I was suggested to have the cross on the side that hurts, not on the back or front of the finger.

Nige, well what can I say