[Paul B]

Sorry to post (yet) another finger injury thread but I just don't have a clue whats going on with this latest one.

I've been fairly lucky over the last 2 years, with no real finger injuries to speak of (having said that I avoided doing anything that looked like training too). This winter, with a few goals in mind I had a tentative return to training but I've been very careful, avoiding board climbing up until recently and spending a lot of time on routes (so less high intensity work).

About 2 1/2 weeks ago I had a great session, climbing well and didn't do anything stupid (it was cold, I warmed up thoroughly, no dodgy footwork, no flailing at the same dirty crimp for 3 hours etc.) and yet the day after, picking something up in the kitchen I could feel soreness (a dull ache, nothing sharp) in my RH ring finger A2. I immediately backed off, avoided the board and begun icing but the day after the next two sessions (even an easy one on routes) and it was more sore in the morning.

Due to work I took a week off reasoning that I'd just irritated it a bit further (one session was a bit overly hard) and the initial swelling needed to go down but through the week I became more conscious of the injury day to day (without constantly fiddling etc.). Last night was my first session back and I stuck to 4+ jugs and yet today it feels like I might as well have been doing some form of weighted campussing, the injury feels a lot worse.

Accepting the commonly given advice on these injuries, and that you can't really get lower intensity than yesterday, would people suggest that this is still the initial inflammation (and more time away is a good thing) or is there something else at work (scar tissue)?

Its quite depressing to think my finger can't handle even the easiest of easy stuff.

[rodma]

Have you checked your forearm for tension etc?

Often overlooked and can make the smallest amount of inflammation pretty hard to get rid of and make the pain much much worse, because the pulley is almost under a constant load. Doing the ususl climbers favourite bend-the-hand-back at 90 degrees to the forearm stretch tends to load the most affected area too, if tightness is the underlying problem. If so, then massaging the forearm ought to help.

[Paul B]

Have you checked your forearm for tension etc?

I hadn't but I have now, I just get a stretch feeling in the center of my forearm, nothing more. Thanks though.

[rodma]

when I had bad pulleys in the past I could generate a lot of pain by simply pressing gently into the related muscles in my forearm.

From a rehab point of view, I do quite like working from quite a loose starting point (little discomfort) but this does mean feeling like you couldn't crush a........ erm......... grape  sorry

I think most of us are super tight almost all of the time and there is definitely a happy balance to be struck, but it is very hard to rehabilitate without easing things off a bit first.

[John Gillott]

Sorry to say this, though it might be useful if something can be done, but from my own experience it does sound like scar tissue. If I remember right from previous posts you had a mad keen get strong phase during which you did perhaps even more damage to your pulleys than the average strong, keen, climber? And what's more you managed to carry on like this for some time?

I only did them once, but made the mistake of stopping altogether for a few months rather than getting on with rehab much more quickly. I've tried most of the ideas, short of surgery, to get rid of the scar tissue over the years since and unfortunately they haven't worked. I've not gone down the surgery route; I've accepted that I just can't crimp as hard or in general pull as hard as I might like to. However, being younger, stronger and keener you might want to investigate it?

[Paul B]

If I remember right from previous posts you had a mad keen get strong phase during which you did perhaps even more damage to your pulleys than the average strong, keen, climber? And what's more you managed to carry on like this for some time?

My finger issues began pretty much 3 months after I first landed in Sheffield and I was plagued by A2 injuries and various other problems (I was also naive about the warning signs). Strangely enough the time I saw the biggest increase in almost every aspect of my climbing (sans technique) was a 6 month window in which I trained religously 1 day on 1 day off without injury. When it did come it was in the shape of a broken leg (although my fingers were starting to feel dodgy), followed by 6-8 months off. I then had just about got back to what I considered a similar level and was involved in a car crash (my lucky streak). I took another long break from climbing following this basically as everything hurt (not my finger, the broken bits)..

Since then I fairly much avoided training as I did and just concentrated on going climbing (which included a 6 month injury free tour of europe) and a quite radical change in direction (i.e. Trad and Big(ger) stuff).

[groovedog]

Perhaps it could be the tendon sheath? I had a finger injury in May last year. Thought it was typical A2 pulley tear. After months it hadn't improved, tried icing, massage,  steady climbing etc. Went to the a physio and he suggested it was chronic tissue damage to the sheath of flascher (sp)

After a course of quite harsh massage with a special metal tool he had, Ultrasound and acupunture it started to improve and has pretty much gone. The symptoms I had was I could climb and crimp and it wouldn't hurt just a discomfort in the base of my finger in A2 area. Quite frustrating as finger injuries are. The physio was adament that no ammount of ice treatment would have fixed it. Maybe soemthing to consider, I should have gone to the physio sooner but you always think it will improve and remedy itself in time. Not in  this case, 6 months no improvement! I guess you get it in your head that its the old A2 problem but there are so many other facets to what can go wrong in the finger, wrist, shoulder elbow etc through over use that unless your on the sharp end of anatomy knowledge its often a shot in the dark as to what problems you think you have.

[Paul B]

Well, interestingly I just had a pain free session making sure to open hand jugs (rather than risking the edge pressing into the affected region), well it was mind numbingly dull but there was no pain in my finger.

Maybe it was simply down to the over zealous sessions the week before and some extra damage / inflammation caused?

I'm also finding that Volterol gel (diclofenac) seems much better at reducing any pain and inflammation than ibuprofen gels (even double strength [10%]).

I've had tendon sheath issues before and that (to me) seemed absolutely fine and then all of a sudden I'd get a very sharp "don't do that" pain.

[TobyD]

Well, interestingly I just had a pain free session making sure to open hand jugs (rather than risking the edge pressing into the affected region), well it was mind numbingly dull but there was no pain in my finger.
I've had tendon sheath issues before and that (to me) seemed absolutely fine and then all of a sudden I'd get a very sharp "don't do that" pain.

Hi Paul only just seen this thread, this actually sounds quite similar to some finger niggles i have had in the past. I frankly have no idea about the exact involved structures (A2; collaterals; sheath; blah; blah) but am rather dubious about the value of fixating on diagnosis of a particular structure anyway. I suspect most finger injuries are compound of several things anyway, as the bits of connective tissue are so tiny and complex that if you've duffed one bit, chances are, it has taken a few other nearby bits with it too. Even MRI scans have a deeply imperfect record of pinpointing involved structures in the studies i have seen

Generally, I strongly feel that the optimium course of action with finger injuries pretty much watever they are is to return to climbing as soon as it feels like you can manage pain free (or VERY pain limited) sessions. Then to basically do as much as you can within this range in order to promote local blood flow (and keep you sane  ) stepping up your volume / intensity in TINY increments (say a 5% increase as an absolute maximum).
For me the best / most enjoyable way of doing this was to switch to trad or indoor routes, and when outside stick to routes with sufficient gear for anything remotely tricky that i would be willing to jump off at the slightest niggle. Result: tick lots of brilliant routes, and rehab finger in a progressive and specific manner, including gradual exposure to the full variety of hold types and shapes. That's my tuppence anyway.... hope it is getting better! T

[Paul B]

I had a pain free session on 4+ jugs so I think it was still inflammation so 4.2+ jugs next session 

[TobyD]

I had a pain free session on 4+ jugs so I think it was still inflammation so 4.2+ jugs next session 

precision grading, i like it. Stick with the tedium though, your fingers will thank you for it!

[slackline]

Cross reference