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Swollen PIP joint / hand specialist? (Read 28307 times)

petejh

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Swollen PIP joint / hand specialist?
April 10, 2012, 05:08:48 pm
I've had a swollen pip joint on the middle finger of my LH for the last 2- 3 years without it ever hindering me, but just recently it's started hurting and holding me back a little - I did quite a lot of crimpy bouldering earleir this year which might have tipped the balance. The pip joint is now achey, a bit stiff and it clicks and 'catches' in the joint if I hyperextend the finger it and then return to normal position. I've also lost a little bit of range of motion when making a fist - can only just make my middle finger touch my palm with a little pain/stiffness.

I'm worried about the longer term - arthritus etc... and wondered if anyone's experienced similar problems with chronically swollen pip joints?

Am going to go back on the glucosamine/chrondroitin after laying off it for the last 18 months and see if anything improves over the next 6 weeks (apart from my piss becoming more valuable).

Also does anyone know a good ortho hand specialist in case I need to get it checked out properly?

Pebblespanker

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Have a similar issue on my left ring finger and what you describe sounds all too familar apart from the catching/clicking. The inability to make a full fist when the fingers have been boning crimps too much is exactly what I get  :(  I have slight soreness just below the joint to boot, recently found that Voltarol gel helps a lot to reduce soreness and flexibility after a heavy session.

In practical management terms I ensure I avoid over using the crimp holds on the board or crag - nothing cleverer than that, balanced training/climbing - not easy when crimps are my thing lol. It does mean however that I suspect long endurance sessions on crimps may always be beyond me - no change there then! One last comment beware plastic, I find certain types of wall holds very tweaky and they can make the issue much worse than natural holds especially crimping curved holds - unequal pressure at the joint???

Be intersted to hear anything you find out  :)

cheque

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...beware plastic, I find certain types of wall holds very tweaky and they can make the issue much worse than natural holds especially crimping curved holds - unequal pressure at the joint???

 :agree: I find plastic knackers my fingers like nothing else- a combination of using the holds and the way your joints are shocked when you fall off them, possibly also the volume of climbing that the indoor environment allows in a short period too. Nottingham wall seems particularly bad for it.

Pebblespanker

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Nottingham wall seems particularly bad for it.

 :agree:  its my local wall when down south, training on Trent Bridge however is fine!

pete b

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I thought I'd add this here rather than making a new thread. If I don't bend my finger at the base of the finger but bend it at the first joint from the base, then I can feel it tighten and slight paint. I have this in 3 of my fingers. Worst for a couple of days after climbing. Is this a swollen PIP joint?

i_a_coops

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I've had a swollen pip joint on the middle finger of my LH for the last 2- 3 years without it ever hindering me, but just recently it's started hurting and holding me back a little - I did quite a lot of crimpy bouldering earleir this year which might have tipped the balance. The pip joint is now achey, a bit stiff and it clicks and 'catches' in the joint if I hyperextend the finger it and then return to normal position. I've also lost a little bit of range of motion when making a fist - can only just make my middle finger touch my palm with a little pain/stiffness.

This sounds exactly like the index finger trouble I had last year, which turned out to be a damaged collateral (which doesn't affect crimping THAT much, but does a bit if you crimp a lot) and a ton of scar tissue. A physio told me to grab the finger and pull it with my other hand to stretch it, just hard enough to make it kind of pop out of its joint..... I did that a lot and climbed on jugs a lot and it went away after about a year.

if it's a collateral you can feel it twinge when you try and bend your finger sideways at the joint with the other hand, I believe.

No real science or knowledge here I'm afraid, strictly anecdotal.....  :-\

chris j

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Good anecdotal evidence! (is that a contradiction in terms?) ;)

Were you pulling straight out or bending the finger back at all? (which seems to put marginally more stretch on the injured bit but probably stresses the joint the wrong way...)

i_a_coops

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Straight out, and holding for about 30 seconds..... I also noticed that immediately after stretching, it didn't catch as badly when I moved it.

Finger injuries are totally pants  :'( (I got a new one to rehab a few weeks ago!)

slackline

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Good anecdotal evidence! (is that a contradiction in terms?) ;)

No it just means its anecdotal evidence that fits with what you want to hear  ;)

chris j

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I want to hear anything that might help cure the damn thing. Since I hit 36 all my various injuries and ailments (1 collateral PIP, one pulley, 1 crocked knee, buggered neck and my rotator cuff's started playing up again after 4 years relief) seem to have stopped getting better  ( :wall: ) so anything remotely plausible that might help one clear up is welcome!

petejh

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PIP joint seems to have settled down by itself over about 4 weeks with minimal input from me - enough to keep on climbing at my usual level whilst being aware of of it lurking in the background along with my Dupuytren's, tweaky elbow tendon and scar-tissue ravaged rotator cuff scheming how to trip me up in the future.

Interesting to read IA's physio recommended pulling the finger outwards - that's exactly what I do but without anyone ever having told me it does anything - just feels like the right thing.

Chrisj - managment rather than cure I think is the most realistic approach - or is that a sign of getting old?



tim palmer

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Chrisj - managment rather than cure I think is the most realistic approach - or is that a sign of getting old?
It is the correct approach I think, really all that physio does is pass the time whilst a soft tissue injury heals itself.  Once it does so and coincidentally you have been to a physio everyone says physio sorted me out whilst it was actually just the passage of time. 

chris j

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Chrisj - managment rather than cure I think is the most realistic approach - or is that a sign of getting old?

I'd settle for any easing - it gets regular month long breaks from climbing while I'm away offshore, during which it settles down after 3 - 4 days to no pain, just swelling at the joint side and being able to push things around while massaging it with the other finger. Then after the first climbing session back home it's right back as bad as ever.

But I am slightly shocked how I just seem to have stopped healing in the last year. Cuts and bruises seem to take forever to go away and leave scars where they wouldn't before, tweaked muscles might feel better after a while but they all seem to be lurking ready to jump out again at the slightest provocation. Tweaked the back of my knee last year landing badly running downhill and it went away after 2 months, did the other one this winter the same way and it hasn't improved at all in the same time. And as for my bloody neck since I fell on it, just feels like the muscles keep stiffening up so I have to stretch it all the time (I mean all the time) but no change since I did it at the start of January?! F*ck I feel old just thinking about it all.

Sorry, just a bit frustrated.

chris j

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Just read that & I should probably be off out to buy a motorbike & some gay leathers as I've obviously just hit the mid-life crisis...  ::)

SA Chris

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along with my Dupuytren's

Are you aware that there is a possible link between Dupuytrens and taking glucosamine? Just something else to keep an eye on.

petejh

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Interesting... I had heard that before but then completely forgotten about it. I've got some pretty major lumps on the tendons of my palms which don't stop me doing anything at present.  I 've been regularly taking strong glucosamine/chrndroitin tablets on and off for years, just started again recently.
Fuck it, I'm climbing better than I was ten years ago and I don't see myself slowing down anytime in the next 10 years either.

jmews

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Chrisj - managment rather than cure I think is the most realistic approach - or is that a sign of getting old?

I'd settle for any easing - it gets regular month long breaks from climbing while I'm away offshore, during which it settles down after 3 - 4 days to no pain, just swelling at the joint side and being able to push things around while massaging it with the other finger. Then after the first climbing session back home it's right back as bad as ever.

But I am slightly shocked how I just seem to have stopped healing in the last year. Cuts and bruises seem to take forever to go away and leave scars where they wouldn't before, tweaked muscles might feel better after a while but they all seem to be lurking ready to jump out again at the slightest provocation. Tweaked the back of my knee last year landing badly running downhill and it went away after 2 months, did the other one this winter the same way and it hasn't improved at all in the same time. And as for my bloody neck since I fell on it, just feels like the muscles keep stiffening up so I have to stretch it all the time (I mean all the time) but no change since I did it at the start of January?! F*ck I feel old just thinking about it all.

Sorry, just a bit frustrated.

The month long breaks might not be helping things much, either. Sometimes I find that taking too long off has made my fingers more creaky and they become tender either. I remember somebody attributing this to regular loading helping to break down/inhibit scar tissue. If this is the case (maybe someone can cast some light on this), then perhaps gentle sessions on an edge or whatever is available may help to keep them in better condition?

chris j

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Tis a tricky one. I'd always thought in the past it helped me stay injury-free with time to rest up and heal but obviously that views changing given the state I'm in...

Most boats the gym is limited to rowing machines and bikes and treadmills and they inconveniently make the doorways without lintels so I'm reduced to hanging off the undersides of stairways & the like (which always gets strange looks from safety reps...). One boat last year I did take a set of rock rings and found somewhere to hang them up - promptly discovered too many pull-ups can put my back out (got to consciously not arch my back while doing them).   :slap:

Anyway, OT, back to trying to (almost) pull my finger out of its socket...

Pebblespanker

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Interesting to read IA's physio recommended pulling the finger outwards - that's exactly what I do but without anyone ever having told me it does anything - just feels like the right thing.

Chrisj - managment rather than cure I think is the most realistic approach - or is that a sign of getting old?

Have been trying the pulling approach for since the above was posted and I have some minor improvements, I have had the odd funny look on the bus/train though, also had far less grief after a session at Burbage on Sunday that I would have expected  :) Finger now sits flatter and less tenderness below the joint so happy to pursue this line of therapy - its what to about the state of the rest of my almost 50 year old body now lol

Thanks for sharing, waddage administered   :2thumbsup:

Robsons

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Was referred to a Mike Hayton (based in Manchester) from John Dunne for my snapped A2 - said he's the best hand specialist in the UK...google him and see what you think?
I am yet to get up there and see him myself, so only passing on the good word...

Lot of people are getting PIP joint problems at the moment. Friend of mine had an X-Ray and MRI on his and it turned out that he had a floating chipped bone in there...just had the op to get it out...(I would assume very rare however?)

Good luck

jayuu

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It is worth knowing that you do not have to travel to London, Harley Street or Manchester to see the best Hand Specialist - just check on the website of the BSSH (British Society for Surgery of the Hand) to find a Hand Specialist near you.  The best specialists do not necessarily have the most flash websites and may not have their own website at all.
I have never heard about a link between Glucosamine and Dupuytren's disease.  Dupuytren's is a genetic condition and may be made worse by smoking and diabetes - it is not made worse by use.
The best recognized hand injury in climbing is tendon pulley rupture.  It is possible to repair the pulleys but it is probably safest just to strap the affected finger/s.
I will try and give useful advice as and when - I have done some bouldering (on a wall) and I am a Hand Specialist.

Peanuts

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#21 Re: Swollen PIP joint / hand specialist?
November 02, 2015, 11:25:31 am
Hi all, i am resurecting this topic again as i think I need some proffesional advise about a couple of finger related injuries, specifically swollen painful pip joints. I dont think it is tendon related but could be proven wrong, I suspect a scan is the only way to get to the bottom of this. I would be interested to hear if anyone has any personal recommendations for Hand specialists preferably with experience of climbing injuries, I have been to the BSSH (British Society for Surgery of the Hand) website but a personal recomendation would be a little more reassurimg than just dropping a pin on their list of members.

Cheers

petejh

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#22 Re: Swollen PIP joint / hand specialist?
November 02, 2015, 04:16:29 pm
You don't say where you're based but I saw this guy in Manchester last year when I was concerned that I'd majorly fucked my dip joint. (Turns out it wasn't)


I can't say whether or not he's the shit. Saw him once, got an xray and an mri which didn't show anything major, then it healed within 6 -8 weeks as these things often do.

benno

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#23 Re: Swollen PIP joint / hand specialist?
November 02, 2015, 06:08:26 pm
I saw a physio a few times about a particularly sore PIP joint that became very swollen, stiff, locky and painful after hard crimping. He prescribed finger extensor exercises which did seem to help (search "powerfingers" to get the idea). I started to have to do the "pull your finger apart again" thing less frequently and now I never need to and the pain has gone. His theory was that you need the extensors to support the joint at higher angles of flexion, or they don't hinge properly and pinch slightly on the palm side and get inflamed. Make sense to me. Even if all the extensor exercises do is get your joint moving again throughout its whole ROM then it's worth a go, I'd say.

Peanuts

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#24 Re: Swollen PIP joint / hand specialist?
November 03, 2015, 10:57:18 am
You don't say where you're based but I saw this guy in Manchester last year when I was concerned that I'd majorly fucked my dip joint. (Turns out it wasn't)

Hi, I should have mentioned that I am based in Sheffield so Manchester is not out of the question. Just didn't want to try explaining rock climbing to someone who's idea of 'crimping' is applying a decorative finish to a pie  8)   ...... Mmmmmm Pies !

 

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