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So You Think You Have a Finger Injury?

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 not only possible but also 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).

hands and climbing holds

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 serious 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 are bands of connective tissue that run along the palm side of your finger and keep the flexor tendon connected to the bone. The most common pulley injuries are the A2 or A4 pulleys. You can strain, partially tear, or fully rupture a pulley. If you heard an audible "pop" when performing a climbing move, you have most likely partially torn or fully ruptured the pulley. The area may become progressively sore or tender to the touch with a strain after a climbing session. Pain around the finger's base is most common, whereas an A4 pulley injury leads to pain in the middle of the finger.

●     Flexor Tendon: Tears and Strains

The flexor tendons run from your fingers to your forearm, connecting to the flexor digitorum profundus (FDP) muscle that extends to your elbow. You use your flexor muscles and tendons with every move in climbing. If torn, you will have pain that prevents you from down-pulling in an open-hand position. The forearm may also be tender when palpitated. With a flexor strain, you may be able to climb normally. However, when applying pressure in certain open-hand and crimp positions, you may experience mild to moderate discomfort along the injured finger and into the forearm.

●     Collateral Ligament Injury

The collateral ligaments engage when the finger rotates. This injury most commonly occurs from climbing on pockets, which are small, concave holds often found on steep or overhanging routes. You will typically feel pain along the sides of your finger. It may be tender to the touch.

●     Tenosynovitis

Tenosynovitis is a chronic injury that develops gradually. A traumatic event may trigger it but it is typically associated with overuse. There is no damage to the tendons; inflammation occurs in the protective sheath surrounding the tendon. The affected area will likely show signs of swelling and feel stiff/sore.

●     Lumbrical Strains

This type of injury is less common and more complicated to identify. The most common cause is pulling too hard in a pocket with your middle and ring finger while tucking in the pointer and pinky finger. Pain occurs in the webbing between the affected and non-affected fingers and the palm. However, this is the only injury that impacts a muscle, not connective tissue, which means the blood supply will quicken the healing process.

●     Joint Injuries

In the long term, some climbers may develop thickened and swollen joints as the connective tissue thickens to accommodate the force loaded when climbing. That may not be painful for some, but it may bring about sore, stiff, and sometimes swollen joints for others. Rather than an injury, the thickened connective tissue around the joint is likely limiting the range of motion.

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 exercises, 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, you can start by asking your local climbing gym or community for recommendations or consult with a sports medicine specialist.

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