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surfergirl
Jan 14, 2009, 6:17 PM
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hi, i'm a beginner so i don't know if this is a very common injury, if so maybe you can help...
my finger is swollen in the middle segment (sorry, i have no idea what that is called, it looks like the finger has three segments and i'm referring to the middle one). i wasn't really that concerned about it but it's been over a week and it's getting slightly worse. weird thing is, i've never noticed any pain when climbing...but the next morning it's always swollen, and it stays swollen.
what should i do--anything?
this is the ring finger
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GeneralZon
Jan 14, 2009, 7:02 PM
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You should see a doctor, RC.com medical advice is not the way to go.
On that note, I would Ice it and keep its use to low impact stretching exercises for a while to see if it improves if you didn't want to proceed with a medical consult first.
Good luck.
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onceahardman
Jan 14, 2009, 7:41 PM
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Hi surfergirl...
First off, let me say it's really weird someone (poster #2) would say, "see a doctor, don't get advice here...", and then the same poster proceeds to give you advice that is exactly wrong.
Your finger injury is at the most common joint, in the most frequently injured finger.
Can I bore you with a couple principles?
Joints have active restraints, (muscle/tendon), which cross the joint, and move it in one direction or another. They also have passive restraints, including ligaments, joint capsule, meniscus, labrum, etc. These structures keep a joint tracking in the direction it should, and also keep the joint from going too far in any given direction.
A pulley is a specialized restraint which keeps a flexor tendon in the correct place, and improves it's mechanical advantage.
When you climb, you put a traction force on your finger joints. That is, you are pulling them apart. The resultant injuries tend to be tears of restraints, either passive or active. To recommend stretching of a torn structure is really indicative of very poor mechanical understanding of the nature of the injury (REGARDLESS of which individual anatomic structure is damaged). It's like telling you to stretch a broken arm, instead of getting a cast put on.
STRETCHING has a meaning. Its purpose is to move a joint beyond the existing active range of motion, in order to increase that range.
So, for an injury like yours: Keep the joint moving, (active range of motion exercise-AROM) but DO NOT STRETCH. Stretching a torn structure serves only to tear it farther apart.
Finger injuries can be stubborn and frustrating. Don't climb on it for at least two weeks, then re-assess. Depending on severity, you could be out of commission for a year. But probably not in your case.
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surfergirl
Jan 14, 2009, 8:05 PM
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when you say don't climb on it for two weeks, you mean climb but just don't use that finger...right???? maybe i will try taping it so that i don't use it to climb...might be difficult to climb like that though
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mike_devildog
Jan 14, 2009, 8:13 PM
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This is a continuous problem that I get with the tendon in my left ring finger every once in awhile. Mostly occurs when I overwork a crimpy boulder problem, or do my workout on the crimp holds on my fingerboard! The advice above is great..absolutely do not stretch! Give the finger a few days to rest, and then assess! Also learn proper tendon tapping techniques to reinforce the finger! Good luck..have fun!
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onceahardman
Jan 14, 2009, 8:50 PM
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Surfergirl, I HATE telling people not to climb...but that's what I meant.
If you can't do that, taping can be helpful. It probably WILL be helpful for long-term management. Do pretty snug wraps around the "segment" where you would wear a ring, not so much right over the joint, but proximal to it. Tape stretches pretty quickly, so replace it often.
Chronic inflammation (pain, swelling, redness, heat) generally has a deleterious effect on things. Don't keep pulling it apart.
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rockforlife
Jan 14, 2009, 9:24 PM
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surfergirl wrote: when you say don't climb on it for two weeks, you mean climb but just don't use that finger...right???? maybe i will try taping it so that i don't use it to climb...might be difficult to climb like that though
DON"T CLIMB yes you could, but you are a climber and you will take it to far, just take the time off it will be good for you.
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GeneralZon
Jan 14, 2009, 9:39 PM
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Perhaps you didn't see the low impact or the that being said part. I in no way suggested that she hyperextend her joint and injure herself more. You can stretch without moving beyond normal range of motion. "Stretching" in my terms "low impact" was to keep it moving and not let it lock up, essentially the AROM part. My bad for not being a uber cool PT guru like yourself.
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surfergirl
Jan 14, 2009, 10:04 PM
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oh crap it seems to be getting worse by the hour! ugh i guess maybe i really do need to not climb for a few days. when i woke up this morning it wasn't that bad, but now i can't press down on it at all...i can move it the other direction (like i'm making a fist) but that direction is getting worse too
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onceahardman
Jan 14, 2009, 10:51 PM
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Relax, surfergirl...stop poking it, put some ice on it, and rest.
Tomorrow, start an AROM program, make a fist, spread the fingers, make a fist...3 sets of 50, minimum. Re-assess a bit after every set (but don't keep poking at it!) You'll almost certainly be much better in a few days.
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onceahardman
Jan 14, 2009, 10:59 PM
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Sorry to come off as a dick...I'm sometimes too gruff when I write.
In reply to: You can stretch without moving beyond normal range of motion.
Unless the "normal" ROM is restricted or obstructed, that statement is false. Movement beyond the available ROM is stretching. AROM is one thing, and stretching is another. It's OK, you didn't know the definition, but now you do.
I think your instincts were right, keep it moving. But your definitions were wrong.
I'm just trying to be helpful. I'm not trying to be "uber cool".
Anyway, I didn't intend to be offensive. I hope you are not offended.
Be well.
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pinkarm
Jan 14, 2009, 11:20 PM
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I'm not offering any advice; just my experience with finger injury. Make of it what you will.
I hurt my middle finger; pain in right middle knuckle noticed in July sometime (after a climbing trip so maybe injury happened then). I notice that you don't mention any pain in addition to the swelling. I had pain and swelling. The pain/swelling didn't improve dramatically over time because I just kept climbing, albeit I cut back on number of days and difficulty of climbs.
I knew (from previous rotator cuff sprain) that the first thing to do should have been complete rest of a duration commensurate with injury severity. I rationalized to myself that I was avoiding crimping moves (cause that really hurt)...Using that same argument, I added a new physical activity that involves climbing positions which I deemed less "stressful". [Holding a trapeze bar or climbing a fat rope requires gentler curving of my fingers.] Eventually, I hardly did any climbing.
Five months later, the worst pain was gone but my right knuckle is still noticably larger than the left hand's and still not 100%. I finally saw my doctor in December really to get the okay that I could resume climbing as normal because I figured the finger was as good as it was going to get. Doctor told me to take 4 weeks off from any weight bearing activity. [Which actually got the residual pain/clicking to go away.]
The hand specialist whom I saw 3 weeks after doctor visit told me to try climbing and if it hurts again to come back and see him (and an MRI to check what the X-rays can't reveal). Oh, and he said that the swelling could take a year to go away (if ever). I climbed, well bouldered, for the first time yesterday. Finger seems okay.
Good luck.
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surfergirl
Jan 15, 2009, 12:38 AM
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it didn't hurt until today. for the last week i just couldn't bend it that far. today it's starting to hurt. i'll try icing it. i can see why the ring finger is the most injured--on my hand at least, it is least able to move independently of the other fingers
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