Forums: Climbing Information: Injury Treatment and Prevention: Re: [Agilis] Need advice - Injured right ring finger - Full ROM: Edit Log




onceahardman


Jun 3, 2011, 3:02 PM

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Registered: Aug 3, 2007
Posts: 2469

Re: [Agilis] Need advice - Injured right ring finger - Full ROM
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Agilis wrote:
Thanks for the information Onceahardman & qtrollip.

First, the tests you both mentioned was exactly what he did. The link you linked me to Onceahardman was exactly what he did. I'm impressed I explained that so well :) Anyways, really appreciate both your input and insight.

Now I thought I mentioned the pulley test but I can see that I didn't touch on it like I should have and I apologize for that.

The test, now that I think of it, perhaps it was 2, that the specialist did to test my pulleys was first, he used firm pressure on the bottom of my fingers where the pulley locations were to see if I felt any pain. I told him I felt slight pain, located right where my finger meets the palm, but it was barely there, and from a scale 1 to 10, I told him it was like a 1.

He then had me hold my right hand in a crimp like position and had me pull against his fingers which didn't result in any pain from the pulleys, but I was able to pin-point the joint as the location of the pain. This is exactly what qtrollip suggested I do, only instead of me opening my hand, the specialist was the resistance.

Another test he did was he took my fingers and checked for side to side movement in the joint. I believe that was to test for the integrity of the collateral ligaments.

With that added information, any change of opinion? I really am sorry I forgot that information.


Here's what I think:

If crimping duplicates (or duplicated) your symptoms, then a pulley injury is certainly "in play". The doc put you in a crimping position, but only loaded the joints up to the amount of force that his fingers could apply, rather than your entire bodyweight.

You need to load the position sufficiently to duplicate symptoms. A pulley strain is thus not ruled out.

Now, also still in play is this "stiff" DIP joint. If extending the DIP under load (as in crimping) duplicates your symptoms, then that would lend credence to the specialist's opinion. But, if the problem is purely the stiffness of the DIP, then (follow me here), the position of the PIP should be irrelevant.

That is, you should be able to duplicate symptoms by moving the DIP whether the PIP is flexed or not.

In crimping, the PIP is very flexed, while the DIP is extended, which puts maximal outward force on the pulleys, and would be expected to reproduce symptoms for a pulley injury.

Things that cause pain:

-normal force on abnormal tissue
-abnormal force on normal tissue
-abnormal force on abnormal tissue.

If we assume that crimping forces are "normal", (which is arguable), then painful crimping would result from loading damaged (abnormal) structures by crimping. But the end-range extension of the DIP would also not rule out a stiff DIP...UNLESS, the pain of extension goes away when you remove the flexion on the PIP.

I hope that makes sense.


(This post was edited by onceahardman on Jun 3, 2011, 3:03 PM)



Edit Log:
Post edited by onceahardman () on Jun 3, 2011, 3:03 PM


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