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the shizzle => diet, training and injuries => Topic started by: abarro81 on January 06, 2014, 08:14:27 pm
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Background
Near the end of October I tweaked something in one of my knuckles whilst twisting on a sidepull mono, (probably a collateral ligament? It hurts a lot to try to put into extension at that joint). I carried on climbing on it for the next week since I was on a trip. In general it was fine and I could climb at my max without feeling it at all, however I did feel it a bit on certain holds and in the evenings it would be slightly swollen.When I came back I rested for a week, then went out on the grit and promptly retweaked it on a crimp. Since then it has been up and down. I thought it was a lot better, but due to my own stupidity it's got worse again. I've now realised that even when it feels ok - e.g. right now it doesn't feel sore and stiff - it's actually still swollen. Realistically I suspect it's actually been swollen the whole last 2 months. I'm icing multiple times per day and currently using ibuprofen gel, have also taken orally.
Question
How important an indicator is swelling, as compared to soreness and stiffness during/after climbing? Now that I've actually accepted I'm a douche and need to sort this out properly, how important is it to let the swelling go down fully before commencing rehab?
100 8a.nu points to anyone providing an answer :)
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A physio did an examination of your duff finger the other day and told you that it needed rest (his exam seemed to cause you notable amounts of pain). I'm sure someone will tell you it's all OK if that's what you really want to hear? Three Nine perhaps?
:fishing:
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Motto of the story- it's never worth pulling on monos, unless you're a Frankenjura local. Not worth the risk especially if you're a fatty. Hope it heals up soon
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Question
how important is it to let the swelling go down fully before commencing rehab?
the importance correlates directly to the value you place on your finger functioning properly, so only you can answer that.
(I'd follow the physio's advice, or get some if you haven't already. My right knee became very swollen at one point when preparing for a marathon though it only hurt when I compressed it by squatting down. Just because I could walk without pain didn't mean I didn't have a real problem to take immediate notice of tho. Ultimately I followed advice, it got better and I enjoyed the run. )
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Motto of the story- it's never worth pulling on monos, unless you're a Frankenjura local. Not worth the risk especially if you're a fatty. Hope it heals up soon
I know, we decided afterwards that all routes with monos should come with an appropriate warning in the guide. Must have been about the only mono in the whole region too.
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Alex,
You already know the answer to this, especially as your first Aim for 2014 was "stop getting so damn injured".
- See a reputable physio
- Follow his / her treatment advice
I appreciate this probably isn't what you want to hear, otherwise you wouldn't have bothered asking.
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Climbing finger injuries are funny things to treat partially because the anatomy is quite complex it can sometimes be really difficult to tell exactly what's going on. Joint swelling may be stopping you extending the finger properly but doesn't always mean complete rest is needed. A reasonable thing during climbing would be to strap the finger with that X shape, and make sure you don't cause further pain while training i.e. using holds that don't hurt.
A swollen joint does suggest some local joint or supportive structure injury e.g. collateral ligament, but may also involve a Volar Plate injury if the joint is effused and painful in extension. That means a healing time of 3-6 months as long as you're not re-tweaking all the time. Local inflammation is suggestive of an on going healing process but can also be due to a chronically irritable joint (think of it like a knee with a mild ligament / cartilage injury, it takes months for effusion to settle) or a mixture of both. There is an argument to say that taking lots of NSAIDS can delay healing process if it's acute still, and even icing it loads might not even be that beneficial.
One option is to keep it moving, strap it when doing suitably modified training, don't be tempted to do local massage or 'test' the finger all the time with prodding it or pulling on it as this probably wont help. Give it a few months.
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A reasonable thing during climbing would be to strap the finger with that X shape, and make sure you don't cause further pain while training i.e. using holds that don't hurt.
That's what I've done in the past with pulley injuries, and has for example meant I could train pockets hard even when injured. Part of the problem I've been having this time is that I'll have a session on, say, back 2 and campusing on jugs (middle is the injured one), I'll think the finger has been fine with it and then it will get sore and swollen after the session.
I suspect the others are probably right, I know the answer but need it beating into my head so that I don't keep trying to convince myself it's ok to keep pushing it.
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Motto of the story- it's never worth pulling on monos, unless you're a Frankenjura local.
Not even then if it's three weeks before your big trip of the year, and you then can't train for those last three weeks. And you've accidentally stumbled across probably the only 6b in the 'jura that has a mono crux. :furious:
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It's desperate to make yourself stop when you're psyched.
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BoredBoy, thats four, possibly five suggested diagnoses. Glad we are clear.
Alex, why not just train harder on it, perhaps that will work... :wall:
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I fear the answer you're really dreading may be the only solution in this case. Desperate circumstances an' all that ....
climb on grit.
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Very generally, pain, particularly pain whilst climbing, is not a particularly good indicator of the severity of pathology for various reasons. There is a 75% complete post-going-on-essay sitting waiting to be completed to justify that statement but, briefly, adrenaline, endorphins, movement, and social context can all moderate pain (and low mood, anxiety, beliefs about pain and injury, and social context again can amplify pain). This is evolutionarily useful if you're running away from a sabre-tooth tiger but means it is quite easy to inadvertently damage yourself climbing. Soreness after climbing is a better guide. Swelling is more useful still: I'd definitely take notice of persistent swelling. That doesn't necessarily mean that you should stop completely but it sounds like you need to modify what you're currently doing.
Usual disclaimers regarding internet advice apply...
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BoredBoy, thats four, possibly five suggested diagnoses. Glad we are clear.
Alex, why not just train harder on it, perhaps that will work... :wall:
Haha, whatever.
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Thanks duncan, very useful post.
climb on grit.
Even climbing big blobby slopers at the works aggravated it last session. I think a week of rest and then some VSs and 5+ plodding might be in order. And a million sit-ups.
It's desperate to make yourself stop when you're psyched.
Aint that the truth. I hate wanting to train my ass off and not being able to. Training is easy, not training is the killer. I'm gonna get me the core and biceps of doom.
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Very generally, pain, particularly pain whilst climbing, is not a particularly good indicator of the severity of pathology for various reasons. There is a 75% complete post-going-on-essay sitting waiting to be completed
Would be interested to see that post/essay :)
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climb on grit.
Even climbing big blobby slopers at the works aggravated it last session. I think a week of rest and then some VSs and 5+ plodding might be in order. And a million sit-ups.
Why not follow Tommy's example, take up crack & off-width climbing and become an honoury Wideboy :D
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The gunshow is steep drytooling, no finger strength required! And it keeps you route fit and strong as fuck in the back, shoulders and arms.
Heelspurs are cheating... ;D
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A few years a go I did my collateral in my middle finger twisting on a pocket. I had three/ four days off afterwards but then carried on climbing. After that It was slightly sore warming up but when warm it didn't really hurt, except believe it or not on pulling Jugs and big indoor slopers. However afterwards as you mentioned it would swell up and hurt again, especially when straightening said finger. Same symptoms carried on for a bout 4-5 months but gradually disappeared and is fine now. It didn't really effect my climbing a great deal.
This summer I also did the same injury on my ring finger (it turned out the two others who were both trying the same problem with me both had the exact same injury from the exact same hold- a weird vertical sidepull that you load quite dramatically). Again the same situation, sore and swollen after climbing, but once warmed up feels fine except on jugs and big indoor slopers. The finger is now gradually getting better and pain is near enough gone 4 months later. The only thing I changed was try to warm my fingers up really well before climbing mainly using a sponge ball and a portable finger board. (maybe get a portable fingerboard to take to the crag), when it was really sore I would tape it, the best method I found was to tape it above the knuckle and then figure of 8 below the knuckle making sure the finger was always slightly bent and never went straight! However I would avoid tape if I could. I also made sure I didn't really pull on weird holds, just pulled on straight uniform crimps mainly.
Well I guess that pretty poor advice from someone who has no idea about injuries and has even less idea how to rest! Anyway seems to have worked and hasn't really effected how hard I can climb and its kind of sorted itself out. One thing I would say is don't just stop climbing and rest the finger, I would always found that way the finger just got really stiff and even more sore when I started climbing again.
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Yeah, someone else mentioned they could crimp straight down when they hurt a collateral, but mine hurts to crimp, in fact crimping is possibly the worst of all grip types, rivalled only by monos on that finger, though any aggravation/pain feels to be in the knuckle not the pulley. I guess it may be that the original injury on the mono was collateral (I could crimp hard with no obvious issues 2 days later that trip) and subsequent retweaking on grit caused both an issue with that injury and some extra new crimp related injury (the retweak was on a crimp) so there's now a few things going on.
Booked to see physio on Friday for non-internet advice, but thanks to everyone for the input.
Got one of these the other day too which makes icing it easier http://www.bananafingers.co.uk/torex-coldhot-finger-sleeve-p-1973.html (http://www.bananafingers.co.uk/torex-coldhot-finger-sleeve-p-1973.html)
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have you read http://www.mobilitywod.com/2013/07/community-video-peoples-weve-got-to-stop-icing-a-year-later/ (http://www.mobilitywod.com/2013/07/community-video-peoples-weve-got-to-stop-icing-a-year-later/)
or the original article here? http://www.mobilitywod.com/2012/08/people-weve-got-to-stop-icing-we-were-wrong-sooo-wrong/ (http://www.mobilitywod.com/2012/08/people-weve-got-to-stop-icing-we-were-wrong-sooo-wrong/)
It might influence how you choose to treat the inflammation, it certainly rocked my little world.
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Got one of these the other day too which makes icing it easier http://www.bananafingers.co.uk/torex-coldhot-finger-sleeve-p-1973.html (http://www.bananafingers.co.uk/torex-coldhot-finger-sleeve-p-1973.html)
Nice find.
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May have been mentioned before but based on personal experience of a couple of tweaked collaterals over the years I found that easy traversing during the rehab phase could be unexpectedly hazardous. This applied especially when doing long moves off horizontal-ish edges either when reaching to the next handhold or when moving your weight from one foot to the other once the distant handhold had been reached - basically its rather easy to accidentally put a sideways load on the joint even on large-ish holds - shit explanation but hopefully you get what I mean.
The above may be entirely due to the fact I am a fat weak old punter but could be worth considering to avoid any accidental delays to full recovery, best of luck!
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(https://pbs.twimg.com/media/BdYOUH0CMAAHRn1.jpg:large)
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Turnip I think all that's happened is your finger has healed over time, regardless of whether you've climbed or not. 4 mths is about the same length of time it took me to heal, on 2 separate occasions in the same yr, for what sounds like pretty much the same injury. Coincidence or merely chance?
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Slaclkline that graph is amazing.
I had no idea climbing injuries caused time to flow backwards. Who needs a Black Hole, eh?
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That graph should be used for training effects, dieting, and pretty much everything on the forum :)
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So, I am not sure, but I might have given myself a similar injury to yours today.
I loaded a pocket at an odd angle at the works, and my ring finger made two very distinct crunching sounds.
There appears to be pain and mild swelling around the joint, more so then the pully positions currently.
Strangely the pain is when I straiten the finger.
Have you gotten any further in figuring out exactly what your injury is?
Everyone seems to talk about a pop, but mine was definitely a crunch, so not sure of diagnosis.
My game plan is the Dave Macleod thing from yester-year; rest and slow recovery with plenty of stretching/ice.
Will avoid NSAIDS, on the basis that the swelling provides a function, and I don't want to inhibit that.
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Alex, I think I did something very similar (twisty collateral damage to index finger, then aggravated on a crimp) about 4 years ago. For about 6 months I just taped it and avoided crimps, then another 6 months of taping it but otherwise ignoring it. After all that it was still swollen. Then I broke my foot and had 4 months total layoff. This seemed to make it considerably worse and it audibly creaked when I flexed it. After that I tried to rehab it properly for a year or so, after which I gave up and just went climbing as it seemed to be totally fine apart from being swollen. Sadly it's still a weakness and it complained really badly when I tried Baboo Baboo last year. At no point in the last four years has the swelling gone down completely. I just had a month of just doing core, pullups and non tweaky deadhanging and it feels fine and stronger than ever but is STILL swollen.
Moral: monos and crimps suck? Oh and obviously don't break your foot and have 4 months off, so be careful on the grit!
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I used to climb a bit with a talented lad (French Junior Indoor Champion) who had knackered his middle finger PIP joint...as in....could not resist force. You could forcibly open the finger without effort.
He took monos with his ring finger and still climbed 7c+ onsight/8b+ rp. It was amazing how the other fingers compensated.
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It was amazing how the other fingers compensated.
Look at Caldwell!
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Have you gotten any further in figuring out exactly what your injury is?
It's to do with the collateral ligaments (/joint capsule). Got some advice from the physio but the main parts are unlikely to be useful to you since yours is a much newer injury than mine.
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so not sure of diagnosis.
My game plan is the Dave Macleod thing from yester-year; rest and slow recovery with plenty of stretching/ice.
Will avoid NSAIDS, on the basis that the swelling provides a function, and I don't want to inhibit that.
diagnosis of finger injury is overrated, in my opinion. If you are sensible and treat it symptomatically, exact pathology isn't that important... (though someone may well prove me wrong shortly...) if it hurts or swells you shouldn't be climbing on it really. climb as much as you can, pain free. Which essentially is what Duncan was saying (i think) sorry if it wasn't D!
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Have been meaning to post this but had to wait ages for it to download to my dropbox:
www.dropbox.com/s/ussortph9ccg4iw/Inflammation%20paper.pdf (http://www.dropbox.com/s/ussortph9ccg4iw/Inflammation%20paper.pdf)
The take away is DHA/EPA help the body produce it's own powerful anti-inflammatory's, via a different mechanism than NSAID's. Low-dosage aspirin amplifies the effect of DHA/EPA further.