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Meva
Jun 21, 2011, 4:17 AM
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Hi everyone,
I think I screwed up a pulley about an hour ago and I would really appreciate some advice.
I was about 5 problems into warming up today (gym bouldering) when I heard a distinct *pop* sound come from my right hand. It was audible from maybe a few feet away. I then made a last move to the finish rail and fell to the ground before realizing my right pinky felt a bit sore and bruised.
I remember a little hand anatomy so I'll try to describe: The pain is on the palmar side of the middle phalange of my right pinky finger (between the last two finger joints). From googling, I think this seems like the A4 pulley. the joints themselves feel great. I can move my pinky through ~90% ROM passively (with my other hand) with no pain, but when I try to flex the pinky actively it feels quite sore toward the end. There is no pain when I'm at rest. There is slight visible inflammation right now.
I taped up the finger to limit ROM and compress slightly, and I iced for ~15 minutes, and then decided to seek help.
Some more info about me:
- 150lbs, 6'1", 24 y/o male.
- No previous finger injuries, but I have very skinny, long fingers...
- I climb around V8/V9 consistently.
- Started bouldering June 2009, with few breaks since.
The problem I hurt myself on was probably V4-V5 and had a series of comfortable medium crimps on a very steep incline, followed by a smallish flat jug on the headwall (2 pads deep) just before the top. I was moving quite statically, and the (open-hand) crimps felt great (no pain or anything weird), and then somehow the acute injury occured right when I grabbed the jug (again, this was a short, controlled move). I supposed I'm lucky that this didn't occur on a difficult move.
Thanks for reading this and for any advice or information! I'm googling stuff about pulley injuries but having a hard time determing what is important and how bad my injury actually is. I'm hoping this was just a partial tear, but I have no experience with this sort of thing.
-Steve
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mr.tastycakes
Jun 21, 2011, 1:27 PM
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I'm no doctor, but I think generally...
If the injury occurred while crimping + pain when you crimp = pulley tendon.
If the injury occurred while open handing (usually a 2 or 1 finger pocket) + pain when trying resist forces open handed = flexor tendon.
If the injury occured while pulling at a funny angle + pain when wiggling the finger side to side = collateral ligament.
You can injure more than one structure at once.
Search around this forum, especially for posts by onceahardman.
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marc801
Jun 21, 2011, 2:51 PM
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mr.tastycakes wrote: Search around this forum, especially for posts by onceahardman.
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cracklover
Jun 21, 2011, 3:43 PM
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Meva wrote: Hi everyone, I think I screwed up a pulley about an hour ago and I would really appreciate some advice. I was about 5 problems into warming up today (gym bouldering) when I heard a distinct *pop* sound come from my right hand. It was audible from maybe a few feet away. I then made a last move to the finish rail and fell to the ground before realizing my right pinky felt a bit sore and bruised. I remember a little hand anatomy so I'll try to describe: The pain is on the palmar side of the middle phalange of my right pinky finger (between the last two finger joints). From googling, I think this seems like the A4 pulley. the joints themselves feel great. I can move my pinky through ~90% ROM passively (with my other hand) with no pain, but when I try to flex the pinky actively it feels quite sore toward the end. There is no pain when I'm at rest. There is slight visible inflammation right now. I taped up the finger to limit ROM and compress slightly, and I iced for ~15 minutes, and then decided to seek help. Some more info about me: - 150lbs, 6'1", 24 y/o male. - No previous finger injuries, but I have very skinny, long fingers... - I climb around V8/V9 consistently. - Started bouldering June 2009, with few breaks since. The problem I hurt myself on was probably V4-V5 and had a series of comfortable medium crimps on a very steep incline, followed by a smallish flat jug on the headwall (2 pads deep) just before the top. I was moving quite statically, and the (open-hand) crimps felt great (no pain or anything weird), and then somehow the acute injury occured right when I grabbed the jug (again, this was a short, controlled move). I supposed I'm lucky that this didn't occur on a difficult move. Thanks for reading this and for any advice or information! I'm googling stuff about pulley injuries but having a hard time determing what is important and how bad my injury actually is. I'm hoping this was just a partial tear, but I have no experience with this sort of thing. -Steve
Yep, sounds like a pulley injury to me, too. See a doctor (who, most likely will be useless, but will rule out other possible problems) and check out the book "One Move Too Many".
Good luck.
GO
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Meva
Jun 21, 2011, 6:51 PM
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marc801 wrote: And gosh, just maybe, see a doctor.
Finger feels about the same today. I made a small splint to keep the DIP joint straight overnight. I've been taking this off to move the finger a bit every once in awhile. Do you guys think this is a good idea to keep doing until I see the md?
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mattmaxwell
Jun 21, 2011, 8:38 PM
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Close to the same happened to me recently...well, early January...and it was my middle finger.
Any swelling? Probably better in the long run if you don't have any.
A week's wait for an ortho surgeon? Not too bad, actually. More than likely he'll tell to perform normal, daily activities--that don't include climbing--for about 4-6 weeks. Then return for a follow-up appointment.
I think most experienced climbers will tell you to take it easy and not rush back. Err waaaayyyy on the side of caution, no matter how desperate you are to climb.
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Meva
Jun 22, 2011, 6:46 AM
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It is not obvious unless you look at my pinkies side by side, but the injured one is slightly swollen throughout the middle bone area. I've been taking ibuprofen. Hopefully I can keep the swelling down for the appointment so it's easier for the ortho to diagnose.
What happened with your finger mattmaxwell? How long until you started to climb and how is it feeling now? Do you climb hard on it?
Minus the injury, I'm feeling stronger than ever and my skin is great right now.It's really really going to suck to not climb... In a couple weeks I'm going to be tempted to splint the pinky up and try to climb a bit (using only thumb and 3 fingers)... Is this a horrible idea?
(This post was edited by Meva on Jun 22, 2011, 7:03 AM)
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mattmaxwell
Jun 22, 2011, 1:02 PM
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My tendon sheath popped in two different places--almost a bowstring. I had massive swelling, blood draining into my palm; pain and limited movement for several weeks.
"Hard" is a relative term. I don't climb V8, but when it happened I was climbing near my limit. Just a freak injury.
Injury happened January 7. I've done very little since then, and just recently started climbing again, just jug-haul rope routes. I also do limited work on my hangboard. My finger is still only about 60%...and sometimes I can't tell if the sore/pain is the "good pain" or "bad pain."
But with yours being the pinky, and based on what I'm guessing for the severity of the injury, you should be in decent shape to resume climbing soon, without much issue. Of course, I'm not in any way qualified to diagnose.
But, yes, a few weeks. And definitely splint the finger.
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rtwilli4
Jun 23, 2011, 11:52 PM
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Meva wrote: Minus the injury, I'm feeling stronger than ever and my skin is great right now.It's really really going to suck to not climb... In a couple weeks I'm going to be tempted to splint the pinky up and try to climb a bit (using only thumb and 3 fingers)... Is this a horrible idea?
HA! I wouldn't wait three weeks.
Just tape it up so much that you can't bend it, then there will be no way to use it. As long as there is no pain in the palm or forearm, and only in the finger, then it doesn't really matter what it is. Pulling with the other three fingers shouldn't hurt it a bit, but you have to be disciplined and careful.
A4 injury in your pinky finger? I wish! Just wait 'til you get one on your ring finger (and you probably will at some point in your life)... then you HAVE to cut back on the climbing.
Disclaimer, I could be wrong about climbing now not hurting your finger, but I don't think that I am.
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Meva
Jun 24, 2011, 7:13 PM
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Registered: Jun 21, 2011
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*update*
I had x-rays taken and visited the Ortho yesterday. She said said there didn't seem to be any bowstringing and that I probably partially ruptured the A4 pulley. She recommended an MRI but said it would be ok to hold off and see what happens. She said to climb carefully starting in 4 weeks, more aggressively in 8, and to tape the finger for at least 12 weeks.
Do any of you have experience with flexor tendon rupture? I was just thinking that the pain is exactly where the A4 pulley is, as well as where the FDS tendon inserts on both sides of the finger. Too bad I didn't think about this before I saw the doc.
In reply to: HA! I wouldn't wait three weeks. Just tape it up so much that you can't bend it, then there will be no way to use it. As long as there is no pain in the palm or forearm, and only in the finger, then it doesn't really matter what it is. Pulling with the other three fingers shouldn't hurt it a bit, but you have to be disciplined and careful. A4 injury in your pinky finger? I wish! Just wait 'til you get one on your ring finger (and you probably will at some point in your life)... then you HAVE to cut back on the climbing. Disclaimer, I could be wrong about climbing now not hurting your finger, but I don't think that I am.
This sounds extremely tempting  Seems like climbing without a pinky would put extra strain on the ring finger, but maybe that would be fine.
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Meva
Jul 20, 2011, 8:03 AM
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I really appreciate all the help I received in this thread and thought I should give an update on my finger.
I began climbing very carefully starting a week post-injury (probably NOT smart since I was putting unusual strain on my ring finger by not using my pinky.) A month later (today) I've been able to climb fairly strong in the gym as long as I skip certain holds and am careful. I have also spent time outside on granite and limestone (bouldering and routes). As long as the last IP joint of my pinky is fairly straight I do not feel much discomfort; Ironically, it feels much safer to crimp or half-crimp than to grab many types of pinches or slopers... Had I injured my A2 pulley I'm sure this would not be the case.
One interesting thing I've noticed is that both IP joints in my pinky seem slightly 'looser' than they did before. I find myself popping the joints accidentally just by massaging the damaged pulley, or doing everyday things that put lateral strain on my fingers.
After talking to several people who have had pulley injuries (often very severe) I feel *extremely* lucky. It seems like most pulley injuries happen due to shock-loading (e.g. foot slip while holding tweaky holds) or flexing/extending of fingers while they are bearing weight.
I am much more aware the holds I'm grabbing and am trying valiantly to half-crimp/openhand whenever I can. It is still very disconcerting to me that this injury occured while half-crimping a jug, but I'm hoping these changes will help prevent future injury. It could be months before I can safely pull as hard as I did before, but I'm very grateful that things are not worse.
My injury seems a little unusual, but I would ge glad to share more or try to help anyone that has questions.
(This post was edited by Meva on Jul 20, 2011, 8:08 AM)
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