Sudden hard, tender lump in palm during heavy deadlift?

Medical Q&A [Moderated]
1

Hi all, posting here at the advice of my coach—she says y’all are the experts when it comes to powerlifting injuries.

I’ve got two questions I’m hoping you can help with:

  1. What are potential diagnoses for my underlying hand injury?
  2. How can I reduce the risk of recurrence of this injury during future deadlifts?

Thank you for any insight you can offer!

Background:

About a month ago I was pulling a heavy single (375lbs at RPE ~7) with an alternating grip (left hand overhand, right hand underhand), and as the bar came off the floor I felt a sudden “squirting” sensation (for lack of a better term) in the palm of my left hand. I dropped the weight and noticed that a hard lump had suddenly appeared in my left palm as shown in the attached photo. The lump wasn’t painful, but was tender.

I stopped deadlifting, finished up my workout, and went to urgent care immediately after the gym where I was evaluated for potential fractures or tendon/ligament damage. Finding no apparent injuries, the urgent care provider suggested waiting for a couple of weeks for it to go away on its own.

Two weeks later I followed up with the provider as there wasn’t much improvement in the lump—it had perhaps softened very slightly, and wasn’t really tender anymore, but was it was still prominent and made barbell pressing movements uncomfortable. They evaluated again for potential fractures or tendon/ligament damage, and then ordered X-rays, which indicated no fractures and no abnormal soft tissues. They have since ordered PT.

I’ve since been using straps to deadlift while I heal and try and figure out what’s happening with my hand.

Images

Immediately after injury (Feb 21)

IMG_2229
IMG_22291500×2000 177 KB

IMG_2230
IMG_22301920×1440 167 KB

Today (March 18)

IMG_2717
IMG_27171500×2000 206 KB

IMG_2718
IMG_27181920×1440 168 KB

2

Hi there!

Thanks for joining the forum and submitting your question. Sorry to hear about your incident. Unfortunately, we cannot provide a medical diagnosis from here, though you may benefit from a consultation with one of our professionals. We can be reached at support@barbellmedicine.com.

I can’t comment too much on reducing the risk of this happening again prior to diagnosis. However, given the mechanism (forceful extension of a flexed finger), the location (ring finger), and appearance, I have concerns about a soft tissue injury related to the flexor tendon. X-rays could potentially miss this unless there was a prominent avulsion fragment. I’m not sure about the rest of the workup, but there’s no mention of seeing an ortho hand specialist, which would be reasonable. I suspect their exam and subsequent workup could be valuable.

Of course, there are other possibilities. However, with the time course from injury to now, and failure of resolution, those would be my concerns.

-Jordan

1 Like