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Approach inquiry, ongoing pain in finger pulley

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  • Approach inquiry, ongoing pain in finger pulley

    History:
    In the last 2 months I have been experiencing chronic pain in my right ring finger. I am quite certain it is the A2 pulley but it could be the A3, the sensation radiates a little too much to be sure. Outside of barbell training(3-4 days a week), I am an avid rock climber(2-3 days per week) which is where the injury developed. I have been able to continue both activities unaffected through quarantine because of location and garage gym. There was not an acute trauma from a high momentary load with an associated pop like many climbers experience with this injury, rather just dull pain that started after a pretty intense 3 day trip that has persisted since, which gives me hope its not a partial tear.
    -30y/o male, 6'3'', 210lb
    -Never had this injury before
    -Not on regular NSAID schedule or icing
    -Acute pain never really gets above a 6/10 and postacute aching above a 4/10, maybe i am too hyper vigilant about avoiding pain/compensating. My understanding of acute tendon issues is that pushing through pain should be avoided wherever possible.
    -Not sure what else would be helpful here sorry


    Symptoms and attempted rehab:
    I do not feel typically feel pain when my finger is relaxed but putting any stress on it creates pain, even a very low stress crimp using my other hand, or sometimes after activity where its loaded. Pulling it backwards feels okay, if i pull past range of motion with force probably max 2/10 pain local to the same area. First it was just climbing and so i started to climb less intensely(5.11 to 5.9/5.8) then additionally less often( first down to 2 days then 1 day a week the last month to Im not climbing this week) . I am starting to feel pain from more varied stimuli now, including while barbell training, anything with a supinated or overhand grip essentially(3-5/10). Ive started to hook grip everything I can as a result that helps some(other compensating measures include only using thumb pointer and middle fingers to flip a tire or grab a sandbag, using neutral grip pullups), I should probably use straps for deadlifts/rows, etc but i dont have any, could probably make some out of tubular webbing. Even outside of training its affected, for instance this morning i was using wire cutters(to cut plastic no less)and i couldnt cut the work without causing what i deemed to be excessive pain(6/10) cut no problem with my left hand.

    Thoughts:
    At this point im thinking i need to just dial back intensity of everything to the point where I can do the exercise/activity pain free and then start working my way back up, like you all discuss for back pain, knee pain, etc. I am uncertain if a tendon is able to do active recovery like that, or should i just not climb/put high load on my finger period until i can for instance put a very light crimp on it with my left hand. The other struggle with the active recovery piece could be sometimes I dont feel pain during the activity but then it will ache after(particularly climbing, but barbell/gpp as well). I should probably stop climbing for a while at the very least, i have tried to pick routes that dont have much crimping but I think its impossible to fully avoid it.

    Any rehab advice in the climbing community seems to be anecdotal. The common denomonators are rest, tape it, improve wrist mobility, and do finger curls. I can do up to a 10lb finger curl without having acute pain, anything higher and it begins to hurt(even though i could do a few dozen reps). Wrist flexibilty and finger curls also sound like they could potentially be silly bs, i dont know. Couldnt find any studies on the matter that were in free databases. Any useful methods or suggestions for dealing with this without cutting out everything I do for fitness currently? I could just mountain bike/cycle for the forseeable future but i would prefer not to. Losing weight would probably be helpful for climbing purposes as well, thick legs and a good squat are just extra weight to carry around while climbing stressing my fingers more with negligible benefit. But this injury also happens to plenty of climbers who are toothpicks.

    Tldr: experiencing inevitable climber injury, pulled a2 pulley in right ring finger, what do?

    Thanks for taking the time to read

  • #2
    Fred clause Hey, sorry to hear about the recent finger issue. Based on what you've said in the post, I would likely approach this similarly to other training related symptoms (outlined here: https://www.barbellmedicine.com/blog...ining-what-do/). You may also want to consult with Natasha Barnes, she is very familiar with the climbing community and approaches pain and rehab similar to us.

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