Disclaimer: The following information is not official medical advice. If you have severe pain or are concerned about a significant injury, seek out treatment from a certified medical professional.
As a rock climber, finger injuries are possible and quite common. However, even the most diligent individual, who does finger prehab and warms up for an hour, can suffer from some form of finger injury. While no one wants to go to the climbing gym or crag only to leave unable to climb, the reassuring news is that because finger injuries are so prevalent among climbers, there’s a wealth of information to help identify the type of injury and implement proper rehab.
If you suspect a finger injury while climbing, your first step should be to halt and self-assess. Different types of finger injuries have unique identifying characteristics. The most common finger injuries climbers encounter include pulley strains or ruptures, flexor tendon tears/strains, collateral ligament injuries, tenosynovitis, lumbrical strains, and joint injuries. Here is a breakdown of things to assess and what each may indicate about your potential finger injury. Then, delve into the guide on creating a plan of action for rehabbing your injury and whether or not you can continue to climb (yes, we understand that is the most pressing question on your mind).
Self-Assessing a Potential Finger Injury
When assessing an injury, you want to collect a variety of information:
● Location of pain
● Was there an audible “pop?”
● What move/hold type did you hurt it on (if identifiable)?
● Is the pain sharp, like a sudden stab, or is it more of a dull soreness, like a persistent ache? Understanding the nature of your pain can give you clues about the severity and type of your injury.
● Does the affected area hurt when you touch it? This is what we mean by ‘palpitation ‘. If you feel pain upon touching the area, it could indicate a more severe injury.
After you’ve answered the above questions, you can use these general descriptions of the most common climber finger injuries to see if your symptoms match one. Remember, these generalizations may not directly mirror your injury but can point you in the right direction.
Pulley Injuries: Strains and Ruptures
Pulleys in the hand are crucial structures of connective tissue that maintain the connection between the flexor tendon and the bone on the palm side of the finger. The A2 and A4 pulleys are the most commonly affected when it comes to injuries involving these pulleys. The spectrum of pulley injuries ranges from mere strains to partial tears and even complete ruptures. If you experience a distinct “pop” sound while executing a climbing maneuver, it is highly probable that you have sustained a partial tear or a complete rupture of the pulley.
Following such an injury, the affected area may exhibit a gradual onset of soreness or tenderness, especially after engaging in a climbing session. Pain typically manifests around the base of the finger in the case of most pulley injuries, while an A4 pulley injury tends to elicit pain in the middle section of the finger. It is essential to be mindful of these symptoms and seek appropriate medical attention to accurately diagnose and address the issue to ensure proper healing and recovery. Remember, early intervention and proper management are critical in effectively treating pulley injuries and preventing potential complications that may arise from such trauma.
Flexor Tendon: Tears and Strains
The flexor tendons play a crucial role in the intricate movements of your fingers and forearm, forming a vital connection with the flexor digitorum profundus (FDP) muscle that extends up to your elbow. These flexor muscles and tendons are constantly engaged in climbing, facilitating your grip and control on various surfaces. A tear in these tendons can lead to debilitating pain, particularly hindering your ability to exert downward force in an open-hand position. Furthermore, palpation of the forearm may reveal tenderness, indicating potential damage to the flexor tendons.
When dealing with a flexor strain, climbers may find they can still perform basic climbing movements. However, the discomfort becomes more apparent when pressure is applied to specific hand positions, such as open and crimp grips. This discomfort typically manifests as a mild to moderate sensation that radiates from the injured finger through the forearm, highlighting the interconnectedness and impact of flexor tendon injuries on climbing performance. Be mindful of these symptoms and seek appropriate medical attention to prevent further complications and ensure proper rehabilitation to regain full function and strength in the affected area.
Collateral Ligament Injury
The collateral ligaments of the finger play a crucial role in stabilizing the joint and supporting its range of motion. When the finger rotates, these ligaments come into play, ensuring the movement is controlled and within the normal range. However, engaging these ligaments excessively or in an unnatural way can lead to injury, a common occurrence among climbers who frequently put stress on their fingers by gripping small pockets and concave hold on challenging routes, especially steep or overhanging ones.
The specific mechanism of injury in such cases often involves the collateral ligaments being strained or even torn due to the repetitive and demanding nature of climbing movements. This can result in significant pain along the sides of the affected finger, accompanied by tenderness upon touch. The discomfort experienced is usually a result of inflammation and damage to the ligaments, which can impact the overall stability and functionality of the finger joint.
Climbers and individuals engaging in activities that stress the fingers must be mindful of proper technique, warm-up routines, and adequate rest periods to prevent such injuries. Understanding the biomechanics of finger movement and the role of ligaments in supporting these actions can help develop strategies to minimize the risk of collateral ligament damage and maintain finger health and performance over time.
Tenosynovitis
Tenosynovitis is a common condition characterized by chronic inflammation of the protective sheath surrounding a tendon. While a traumatic event can trigger it, it most often develops gradually due to overuse of the affected tendon. Unlike other tendon injuries, tenosynovitis does not involve damage to the tendon itself but instead results in inflammation of the synovium, the protective tissue surrounding the tendon. This inflammation can lead to swelling, stiffness, and soreness in the affected area, making it uncomfortable for the individual to move the affected joint. It is vital to address tenosynovitis promptly to prevent further complications and to promote healing. Treatment usually involves rest, ice, compression, elevation, anti-inflammatory medications, and physical therapy to help reduce inflammation and improve flexibility and strength in the affected tendon. In severe cases, a healthcare provider may recommend more advanced treatments, such as corticosteroid injections or surgical intervention, to alleviate symptoms and restore normal function.
Lumbrical Strains
This type of injury, known for its relatively lower frequency and increased complexity in identification, often poses a challenge for individuals experiencing it. The primary cause typically stems from exerting excessive force while reaching into a pocket with the middle and ring fingers while tucking in the pointer and pinky fingers. As a result, individuals may notice discomfort and pain manifesting in the webbing region between the affected and unaffected fingers, extending towards the palm. It is worth noting that this particular injury differs from others in that it primarily involves a muscle rather than the connective tissue. This unique characteristic can be advantageous for the healing process, as a robust blood supply to the muscle can potentially expedite recovery and alleviate symptoms more efficiently. Therefore, while this injury may present challenges in identification and management, the inherent nature of muscle involvement offers a silver lining by potentially facilitating a quicker healing trajectory.
Joint Injuries
In the long term, the physical demands of climbing can lead to various adaptations in the body, particularly in climbers’ joints. As climbers continually put stress on their joints while ascending challenging routes, the connective tissue surrounding these joints may gradually thicken and swell over time. This thickening process is how the body adapts to the repeated force and pressure exerted during climbing activities.
While some climbers may not experience any pain or discomfort due to this thickening of connective tissue, others may deal with symptoms such as soreness, stiffness, and occasional swelling in the affected joints. These symptoms can be attributed to the restricted range of motion caused by the thickened connective tissue. Rather than a specific injury, this limitation in joint mobility is a natural response to the ongoing physical demands placed on the body during climbing.
Climbers must be mindful of these potential joint changes and take proactive measures to maintain joint health. This may include incorporating regular stretching and mobility exercises into their training routine and ensuring proper rest and recovery to allow the body to adapt and repair itself. By understanding and addressing these long-term effects of climbing on the joints, climbers can better support their overall physical well-being and continue to enjoy their passion for the sport for years.
Create a Plan of Action
Thoroughly assess and identify the potential type of finger injury. That is the crucial first step in creating a plan of action to heal and return to climbing. Remember, the recovery timelines and process will look slightly different based on the injury identified in the Self-assessing A Potential Finger Injury section. The golden rule should always be to listen to your body. If you feel a sharp, sudden pain while climbing, it’s a sign to stop immediately and rest. Continuing to climb in such cases can worsen your injury. Seek out appropriate medical attention if needed.
If you’ve entirely ruptured a pulley or torn a tendon, taking adequate time off of climbing may be necessary, along with scaled re-entry and physical therapy exercises. These exercises may include finger stretches, grip strengthening, and range of motion exercises for the affected finger. For strains and tenosynovitis, climbing may still be manageable by avoiding the specific grip position(s) that cause pain. If you continue to climb, climb smart. Don’t throw yourself at risky moves where your foot may slip, and you could unexpectedly load the injured finger.
If you’re looking for a more in-depth discussion of the finger, hand, forearm anatomy and common climber finger injuries, check out this two-part series from Lattice Training with the Sheffield Climbing Clinic:
Finger injuries are the last thing a climber wants, but it’s essential to stop and assess if you are feeling the onset of soreness and pain. Catching a pulley or tendon injury in the early stages can prevent worse damage and can mean the difference between continuing to climb and train or being sidelined for months. If you can speak to a professional, ideally with experience dealing with injured climbers, listen to their diagnosis and advice! If your injury will take you out of climbing for a little bit, don’t fret! The rocks will be patiently waiting when you are ready to come back. To find a qualified healthcare professional, ask your local climbing gym or community for recommendations or consult with a sports medicine specialist.
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