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What is PIP Synovitis? Plus, Helpful Techniques You Can Use to Rehab this Finger Injury

Sep 25, 2022

As mentioned in the previous blogs, PIP refers to the Proximal Interphalangeal joint. Usually, the PIP is the one that gets injured, but it does not mean that your Distal Interphalangeal Joint (DIP) will never get any injuries. The reason why the PIP generally takes the brunt of the stress is that when you crimp on something, your fingers bend the PIP at a sharp angle. 

So if you're crimping hard too often, not giving your body adequate rest, and overgripping with your fingers, then you can create problems with your PIP joint. But it does not mean that you're immune from getting DIP problems. In fact, I've treated climbers with both PIP and DIP problems at the same time.

In this blog, we’ll go over what PIP synovitis is and learn some helpful techniques you can use to rehab this particular finger injury.

PIP Synovitis Explained

By definition, PIP synovitis is the swelling of the joint lining membrane of the Proximal Interphalangeal Joint. If this condition continues for years, then enzymes may gradually digest the cartilage and bone of the joint which can lead to chronic pain and degenerative changes. Again, as mentioned in my previous blog, it's always important to get your injuries treated as soon as possible because you will prevent many of these chronic problems from happening in the long run. 

What Does PIP Synovitis Feel Like?

When you’ve got PIP Synovitis, there’s usually pain with motion, swelling due to joint effusion (fluid collection in the joint), puffy to the touch, and warmth. You will usually feel pain and experience irritation when you move or use your fingers from time to time. 

Rehabbing PIP Synovitis 

Here are some of the important things you can do to rehab your PIP synovitis:

  • Warming Up Your Fingers

One of the best things you can do is warm up your fingers properly. Too often I just see and hear climbers warming up by climbing lower grades and “stretching” while climbing up the wall. Now let me ask you a question, in every other sport (i.e. soccer, football, basketball, volleyball, etc.) do athlete’s just scrimmage to warm up?

No, they do smaller activities to warm up their bodies before participating in the sport. In climbing this fundamental practice is missed by most climbers, but it will do wonders for your climbing and keeping your fingers healthy. Need a finger warm up designed specifically for climbers? Just click this link and get the exact finger warm up I give to all of my climbers for FREE.

  • Isele-Method

The second thing I recommend to rehab PIP synovitis is finding an Isele-Method trained therapist. I got to travel to Austria to learn how to treat finger injuries from Klaus Isele. He developed his own way of treating finger injuries specifically for rock climbers, and it’s a big part of how I’ve been able to help so many climbers recover from finger injuries. The Isele-Method uses 4 different techniques for treatment:

The Claw Technique - It works on the tight tissues in your hand. 

Chopstick Technique - Warning, this is often very painful. However, in my experience, climbers will gladly endure 10-15 minutes of intense pain if it gets them back to climbing again.

Mädchenthrust - Doing a popping or cavitation that could feel good and create a little bit more joint space for the fluids to move in your fingers.

Flexor-lift - Mobilizing the flexor tendons so they move and glide easier.

  • Myofascial Release

This is a more subtle and gentle technique than dealing with a lot of pressure and pain. This way of rehabbing your PIP synovitis includes gentle compression and rotation that will only take a few minutes for each of your fingers. To know more about this technique, please watch the video above for a demonstration.

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