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johnr9q
Jan 17, 2009, 5:50 PM
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Further information. On 1/15/09 saw Dr Curtain at Stanford the second time. Had an MRI by RAS. It didn’t show any problem with index finger but commented on middle finger and thumb issues. She thought surgery should be last resort. She gave me another steroid shot which did nothing. (Dr Curtin first tried to get the Lidocaine to find the pain by deadening it before injecting the steroid, but couldn’t get the Lidocaine to relieve the pain. She injected the steroid anyway) Said buddy tape it for 2 more weeks then use it.
(This post was edited by johnr9q on Jan 27, 2009, 3:28 PM)
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johnr9q
Jan 27, 2009, 3:30 PM
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1/27/09 I have taken 32 mg of Ibuprofen a day for the last 6 days and have immobilized the joint by buddy taping constantly since 1/15 but still significant pain when adducting the finger with the thumb.
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onceahardman
Jan 27, 2009, 6:04 PM
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John, if this was my finger, I'd:
1) Stop taking ibu unless the pain is unbearable. Ibu and other NSAIDS can interfere with scar tissue formation.
2) I'd be doing tons of AROM. If you need to immobilize, do that in between AROM sessions. OR>>>specifically when you are doing something which could cause re-injury, like manual work or playing with the kids.
3) Stop torquing on the joint by testing that adduction. You already know it hurts, stop testing it.
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johnr9q
Jan 27, 2009, 6:39 PM
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once: Thanks again. I hadn't tested it since the visit on the 15th of Jan. But, after taking Ibu and total rest I wanted to see if it still hurt. I didn't take the Ibu because the pain was unbearable but I thought that it didn't seem that the doctors were injecting the steroids in the right spot because the Lidocaine didn't immediately take the pain away so I was attempting to see if IBU applied thruout my body would get all of my MCP joint and do something that the steroid injection failed to do. Just a laymans way of thinking. what do you mean by "tons of AROM" More that 50 reps 3x per day? Any other AROM than going from a straight finger to complete fist?
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onceahardman
Jan 27, 2009, 7:13 PM
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In reply to: Any other AROM than going from a straight finger to complete fist?
Yeah, there are a couple more ranges you can do.
- Abduct and adduct the fingers and thumb.
- Flex the MCPs, while keeping the PIPs and DIPs extended...mix that up with, extending the MCPs while flexing the PIPs and DIPs (kind of a "claw hand" position.)
3 X 50 is not a magic number. If it's not getting worse, try adding more. If it IS getting worse, back off.
As I'm sure you've figured out, this is going to take a while, but motion is a good thing for joints. It's what they do.
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johnr9q
Jan 27, 2009, 8:20 PM
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Just had a phone conversation with a long time hardman rock climber and Orthopedic Surgeon. He said something very similar to Once that motion is what the joints like. He said a little pain is okay but don't overdo it. He said I should go ahead and climb with the injury starting easy and progressing. He said often crack climbing injuries are difficult to diagnose because there is no specific injury location just a generalized area. MRI’s may show nothing and steroid shots are too specific in location to affect a generalized problem. He said nonuse was not a good thing as the healing process is encouraged by use and AROM. He said many times Orthopedic Surgeons don’t understand this but Physical Therapists do. He said the idea of “building on healing by avoiding pain” was not appropriate. Some pain is okay. He said when I climb I should not buddy tape it as buddy taping may actually stress it more.
(This post was edited by johnr9q on Jan 29, 2009, 10:13 PM)
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ubu
Jan 27, 2009, 10:51 PM
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onceahardman wrote: 1) Stop taking ibu unless the pain is unbearable. Ibu and other NSAIDS can interfere with scar tissue formation.
Really? I hadn't heard this before. Hmmmm. I've been leery of NSAIDS just because of the potential heart issues, but figured that unless hypertension is a problem one shouldn't worry too much. Is it your position that NSAIDS should *always* be avoided for these kinds of injuries except for cases where pain is extreme, i.e. is it not true that reducing inflammation also aids tissue repair?
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onceahardman
Jan 28, 2009, 12:29 AM
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ubu wrote: onceahardman wrote: 1) Stop taking ibu unless the pain is unbearable. Ibu and other NSAIDS can interfere with scar tissue formation. Really? I hadn't heard this before. Hmmmm. I've been leery of NSAIDS just because of the potential heart issues, but figured that unless hypertension is a problem one shouldn't worry too much. Is it your position that NSAIDS should *always* be avoided for these kinds of injuries except for cases where pain is extreme, i.e. is it not true that reducing inflammation also aids tissue repair?
There are other, better sources, but I found this one with a quick search:
http://www.raysahelian.com/nsaid.html
I use ibu personally for my own knee pain. I take it before and after skiing and hiking. My old knees aren't doing much healing these days, anyway. 
So I just treat the symptoms.
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johnr9q
Mar 31, 2009, 9:16 PM
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Well it is now March 31, 09 and the injury occured about 7 months ago. I have been back climbing now for a couple of months and the injury doesn't slow me down at all. It isn't totally healed cause there is slight pain when I do adduction. Much of the stuff I posted here is to help others with similar problems. Do people actually read all this info and if so do you find it helpful? Post answers. Many people post their problems here but never get back to tell how they resolved the problem or if it ever did heal. I've made it a point not to do that.
(This post was edited by johnr9q on Apr 2, 2009, 3:59 AM)
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onceahardman
Apr 1, 2009, 2:01 PM
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Thanks John...
Your recovery to full function should serve as an inspiration to many of the injured here. The road back is long, but has an end. Congratulations.
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