Pully Problems.

Someone recently told me that the fastest way to get better at climbing is to not get injured. Finger injuries are the most common injury in rock climbing. Let’s face it: the ability to land a quarter-pad crimp on a 45 is not inherent within human physiology. For a lot of climbers, finger injuries become an annual (annular?!) thing. Lately for me it’s been more like a bi-monthly thing (RIP: Some Part of My Pinky). These injuries can mess up your training schedule and, in serious cases, even go as far as permanently wrecking your ability to stick tough holds. I’ve been getting pretty tired of these pesky twinges and strains. So, in lieu of my recent run-ins with painful finger problems, I’ve started looking further into fingers, injuries, and treatment.

When it comes down to it, it’s all about your tendons and the muscles that support them. Climbing puts a lot of stress on your tendons, and most injuries come from overusing them. I’m sure we’ve heard this word “tendons” nearly a thousand times at the gym. But, do you really know what’s going on underneath the skin when you hear that snap-crackle-pop?

Painful Tendoncies

The most frequent type of finger injury manifests as a damaged flexor tendon pulley, usually as a result of supporting your bodyweight with just a finger or two. Pulleys are fibrous tissues that support your tendons by forming tunnels for them to go through. The tendons are a connective tissue, which extend and contract by way of the flexor mucles deep in your forearm. Tendons and pulleys develop at a much different rate than, say, the muscles we use for climbing. It can take up to 100 days or more for these parts of your finger to heal fully. One of the things that gives climbing its steep learning curve is the difficulty of developing these finger tendons.

Of course not all pulley pains are created equally, and so that sudden pain can mean different things. An instance of injury can vary between three grades of severity:

Grade I – Sprain of your finger ligaments (collateral ligaments) in pulley, pain manifests in the pulley when squeezing or climbing.

Grade II – Partial rupture of the pulley tendon. Pain locally at the pulley, pain when squeezing or climbing, also pain is possible when extending your finger.

Grade III – Complete rupture of the pulley causing bowstringing of the tendon (“bowstringing” is the effect created when your tendon is no longer being held against the bone). Symptoms of such a rupture include pain locally at the pulley (usually sharp), a “pop” or “crack” may be heard/felt, swelling and bruising, pain when squeezing or climbing, pain when extending your finger, pain with resisted flexion of the finger.

Three Phases to Healthy Hands

Phase 1: Keep Calm and Leave the Gym - If you do feel that sharp twinge or crack in your finger, you should immediately stop climbing and any other activity that puts stress on the injured finger. This means no crimping your coffee cup, no aggressive tapping on the shoulder, and most importantly - no climbing. Yes, this first step toward recovery, not climbing, is the toughest yet the most important. A couple weeks ago I got a grade one strain instantly upon my arrival to the gym. It was a tough battle of will especially with my climbing buddy encouraging me to continue. The upside is that I still had time on my CTA transfer, so I excused myself before the temptation to climb became too overwhelming.

After you’ve ceased all finger-stressing activities, go to a doctor and see if there is any bowstringing on the tendon. Even if you think you’re in the clear, a doctor will at least verify that you have nothing to worry about – which can help keep your cool. Give yourself at least one week before trying any finger-heavy activity.

Phase 2: On the Mend - When the pain and swelling is gone which, depending of the grade of the injury may take one to four weeks, begin rehabilitating the finger. Go pick up some TheraPutty or a stress ball and begin to slowly exercise the finger muscle. By taking these exercises slowly and combing them with light massages and stretches, you can ensure a proper healing process to prevent future mega-ouchies. Alternating heat and cold and taking an NSAID like Aleve can help reduce inflammation and improve the blood flow necessary to begin healing. Continue the rehab for about twice as long as the resting period (two to eight weeks) before returning, and with the highest caution, to climbing. 

Phase 3: Slow ‘n Steady Sends the Route - When you do begin climbing again, stick to easy routes with big holds and good footholds. That is to say, don’t jump right back on the route that blew your finger out in the first place. I foolishly tried this once, and now look at me – I’ve had so many finger problems I could write an article on them. Keep your sessions short, stay away from overhangs, and remember to tape up that finger. Studies have actually shown that the H-Tape Technique is a good prevention method for previously injured fingers. Check out this video to learn how to H-Tape.

The H-Tape Technique supports the damaged pulley in bearing the stress of the tendon.

Once you’ve gotten back into the groove of things and easier climbing yields no pain, you may return to full-force crushing. Continue taping (it will also serve a little reminder to go easy on the finger) and avoid tiny crimps and finger pockets for a while longer, since, as mentioned earlier, tendon healing can take 100 days or more.

Prevention

You can avoid pulley injuries by climbing smart and taking precautions. Change your training and follow some simple rules to stay injury free:

            • Always warm-up. This one took me awhile to figure out.

            • Vary the types of hold you climb on – slopers need love, too.
            • Don’t always use finger-heavy training tools (hang board, campus routes).
            • Utilize good technique to minimize finger stress.
            • If something feels weird, don’t try it.

Adding foods to your diet that contain omega-3 fatty acids can reduce tendon inflammation. Eating foods like salmon, tuna, flax seed, or the super trendy chia seed are good for every climber’s diet.

Remember to always take the advice of your doctor. If he/she should say anything that conflicts with what you see written here, take his/her word over mine. Be careful out there.

Sources & Further Reading:

Finger Pulley Injuries
ClimbingInjuries.com Section on Fingers and Pulleys
Rock Climbing - Reaching New Heights
Wikipedia: Climber's Finger
Tendon Health & Nutrition