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Think Your Finger Injury is a Pulley Injury? THINK AGAIN…

Jul 08, 2021

 Oftentimes, climbers will mistake more serious injuries for the common “pully injuries”, and that might cost them some serious time away from climbing. Being able to recognize an injury… and finding a physical therapist who actually specializes in rock climbing injuries is KEY to improving your performance and time climbing! 

There are a lot of finger injuries, yet not every finger injury is a pulley injury. I say that because every time a climber injures their finger they automatically assume it's a pulley injury. According to Google or some kind of internet search, pulley injuries are one of the top things that come up, specifically, A2 pulley ruptures.

Today, I want to help you learn that there are multiple finger injuries. Just because you have a finger injury, doesn't always mean it's a pulley injury.  This can potentially be dangerous if you always assume a pulley injury, then treat it as such, and it is in fact NOT a pulley injury, you're going to be more frustrated because your fingers are not getting better and you're unable to climb. 

Here are a few examples of other kinds of finger injuries:

  1. Shift Lock Syndrome: Occurs during a thin hold, typically in a crimp holding position, when you are in the action of pulling your fingers out and then damage them. This type of injury typically occurs in the DIP joint on the finger. During this, the DIP is usually more frequently injured than the PIP. 

    2. Side Ligament Strain: Occurs when the ligaments on the side of your finger become strained. There are many causes for this such as power-loaded fingers, rotation, and gaping can irritate the PIP joint, causing inflammation, affecting 3 ligaments ( proper collateral ligament, accessory collateral ligament, and phalangeal glenoid ligament). Injury to one or more of these ligaments affects the PIP.

    3. Tendon Locking ( Rubbing): This usually happens after 1 or multiple traumas, pulley tears, partial pulley tears, smaller damages, and even inflammation. This hinders the normal glide system between fingers and tendons. This can trigger irritation, causing tendon lock/ rubbing. It also usually occurs towards the base of the finer, closest to the hand. It is important to treat this early, as the friction can hurt the finger, and ultimately the palm, negatively affecting your climbing performance. 

    4. Tendon Insertion Pain: Occurs in 2 tendons ( flexor digitorum superficialis, and flexor digitorum profundus). These originate from your forearm and turn into the tendon in your hand. The insertion point is at the tips of your fingers and overuse/ eccentric peak loading can cause pain at the end of your fingertips. 

    5. Flexor Muscle Strain: This can occur when the muscle belly becomes injured. It can also occur when people hear a “pop” but feel it in their forearm. There are also multiple causes, but eccentric loading on the forearm or overuse is the main cause. This also can cause the “flexor” side to become irritated. During a pull, extension and flexion are used in the wrist to grip. 

A test you can try is to try and feel the “pull” by flexing the wrist and try to pull on something with your fingers. If you extend your wrist and pull, you can hang on harder. 

    6. Pully Rupture: Usually caused by eccentric overload and usually affects A2 and A4 regions on your finger. If you were to crimp/ pull and allow your wrist to slip upwards, that would cause the finger flexors to shorten, creating a concentric load, although this is rare. 

    7. Interosseous “In between the bone” Muscle injury. These muscles will actually insert into the base region of the finger, mimicking an A2 pulley injury. Occurs during a lock or twisting of the fingers that can cause the muscles in the palm to become irritated, but is most commonly irritated at the finger insertion point towards the hand. 

    8. Axial distortions of the finger joints. A jammed and crooked finger can be caused by repetitive finger strain or singular traumas, usually affecting the DIP, where it can usually get more lodged in the holds than the PIP. 

 Let me ask you a question…

 Why is it important to work with a PT that specializes in rock climbing injuries?

1. You will save time and headaches as fingers and hands are very complex. They will be able to decipher the difference between one of these injuries listed above, and a pulley injury. They can also provide more rock climbing-specific evaluations and exercises. 

2. You’ll also have a professional to guide you through the process. 

3. Your recovery will be MUCH quicker, so you can enjoy climbing. Putting off getting an injury checked can lead it to get worse, or further and more serious injuries could occur. 

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