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euthanasia
Oct 9, 2005, 7:21 PM
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Registered: May 2, 2004
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Could somebody please help me! I've been out of climbing for sooo long with a finger injury from last year. It's not getting better. It's on my middle finger at the base and when press down on it I can feel a dull pain. I've imobilized it for weeks, taped it up for weeks, and have soaked it in warm water every evening for weeks, but nothing is working. Does anybody have any ideas or tips to help me get back on the rocks?
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vegastradguy
Oct 9, 2005, 7:29 PM
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yeah...go see a doctor. that's what they're there for.
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euthanasia
Oct 9, 2005, 7:36 PM
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I've already been. They couldn't find any thing wrong. He did x-rays and nothing showed up. He just told me to take ibprofen. It seems liked he should have done an MRI though so that the soft tissue showed up.
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euthanasia
Oct 9, 2005, 7:37 PM
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I've already been. They couldn't find any thing wrong. He did x-rays and nothing showed up. It seems liked he should have done an MRI though so that the soft tissue showed up.
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euthanasia
Oct 9, 2005, 7:40 PM
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I've already been. They couldn't find anything wrong in the x-rays and just told me to take ibprofen. It seems like they should have taken an MRI so that the soft tissue showed up.
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stardrivin
Oct 9, 2005, 9:36 PM
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sounds like an a2 pulley rupture (fairly common among climbers). part of the reason it is not healing is that you've immobilized it. connective tissue (your pulley) heals in response to the stresses that you put on it. you need to use it to stimulate growth/repair. but, don't over do it. if it hurts don't do it. start back climbing on jugs in a few weeks. do some stretching with it. i have a pulley that healed itself in about 6 wks (with scarring). lay off the ibuprofen once you've gotten ahead of the inflammation. try ice.
good luck, hope this helps.
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bensnyder
Oct 9, 2005, 9:36 PM
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Sorry to hear it, but if you still have a problem after months, not weeks, thats when you need to really start worrying. Until then take the ibuprofen (to reduce swelling if nothing else), and get a second opinion. Chances are it's nothing big, but don't take my word for it - I'm not an MD.
In reply to: sounds like an a2 pulley rupture (fairly common among climbers). part of the reason it is not healing is that you've immobilized it. connective tissue (your pulley) heals in response to the stresses that you put on it. you need to use it to stimulate growth/repair. but, don't over do it. if it hurts don't do it. start back climbing on jugs in a few weeks. do some stretching with it. i have a pulley that healed itself in about 6 wks (with scarring). lay off the ibuprofen once you've gotten ahead of the inflammation. try ice.
Your armchair doctor privaleges have been revoked...
I know you are just trying to help, but unless you are sure of whats going on don't post. If it were an A2 pulley rupture, he would be in excruciating pain to the point where he couldnt pick up a 1/4 full milk jug. And tendon injuries definitly need to be isolated and immobilized, not stimulated. You don't stimulate something when it needs to heal, you stimulate it when you are trying to induce hypertrophy - you don't "stimulate" a torn muscle, and you shouldn't "stimulate" a torn tendon - the body doesn't need any more stress to recognize its injured. As for healing time, it takes months (6 or more for a full rupture), not weeks for a tendon injury to recover. To even go jug hauling after 2 weeks would be increadibly painful and injure him even more. Anyways - don't worry OP, you don't have an A2 pulley tear - the doc would have caught something that big. Good luck with your injury.
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stardrivin
Oct 9, 2005, 10:39 PM
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In reply to: Your armchair doctor privaleges have been revoked... I know you are just trying to help, but unless you are sure of whats going on don't post. If it were an A2 pulley rupture, he would be in excruciating pain to the point where he couldnt pick up a 1/4 full milk jug. And tendon injuries definitly need to be isolated and immobilized, not stimulated. You don't stimulate something when it needs to heal, you stimulate it when you are trying to induce hypertrophy - you don't "stimulate" a torn muscle, and you shouldn't "stimulate" a torn tendon - the body doesn't need any more stress to recognize its injured. As for healing time, it takes months (6 or more for a full rupture), not weeks for a tendon injury to recover. To even go jug hauling after 2 weeks would be increadibly painful and injure him even more. Anyways - don't worry OP, you don't have an A2 pulley tear - the doc would have caught something that big. Good luck with your injury.
hmmm......
1- "degree of pain" is often a subjective assessment and as such is rarely diagnostic. connective tissue has no nerve endings. "pain" is often the result of your body's response (inflammation). this makes drugs like ibuprofen work so well at relieving these symptoms (anti-inflammatories). (note: some inflam at first is a good thing (brings growth factors, etc), chronically it can actually inhibit healing). i ruptured an a2 with little to no pain.
2.- "healing time" for connective tissue is 6 wks minimum. besides lacking nerve endings, ct is largely avascular and thus takes a long time to heal. your're body starts laying down collagen around day 8. fibroblasts are stimulated in part by the stresses put on the tissue (also, cytokines, gf's, etc). it is in this way that collagen is layed down in an orderly fashion (strong). mobilization is but one factor of many that promote regeneration
3- "not puley rupture?" may no be. however, a2 pulley ruptures of the 3rd and 4th digits are common climbing injuries; much more common than a pure tendon rupture. his description (dull pain to pressing down at base of 3rd right on top of the pulley, missed by doctor, etc) is classic. however, it could be a number of other things. a better history would probably suffice (did you injure it crimping? was there an audible pop? etc). an mri would have been more diagnostic but expensive (health insurance often won't cover).
4- "doctor wouldn't have missed it" not so. often pulleys rupture partially with no signs of bowstringing. no mri was done. how many doctors specialize in climbing injuries? how many people do you know that have ruptured pulleys did it doing something other than climbing?
5- a few weeks out, looks like you might be dealing with more of a chronic injury (increased scarring, inflammation persisting). get ahead of the inflammation (ice, nsaids, whatever). get a second opinion and hopefully a bit more of a work up. good luck. also, as you ease back into climbing, you might try supporting the area with tape (assumming pulley injury is confirmed). the jury is still out on wether this actually does anything. moreover, get rid of the tape wants it's been symptom free for awhile (b/c of the response to stress hypothesis in 2)
hope this helps clarify a bit
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flatlander
Oct 9, 2005, 11:26 PM
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I'm sure a doctor would have certainly caught a pulley tear...they never miss a thing. Except occasionally leaving instruments or sponges inside a body cavity after surgery.
Regarding stimulation: The idea here is light stimulation...take more time off begfore climbing, but light day to day stimulation will encourage tissue growth.
Ben
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euthanasia
Oct 9, 2005, 11:27 PM
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I first noticed my injury after I lowered to the ground and began to untie my knot. It wasn't a sudden pain at all like an a2 pulley tear and I heard no sound. It just began to be tender and sore when I put pressure on the base of the finger. Being that I was only half way through a trip at the Red River Gorge I climbed again the next day. I was performing fine and had no pain as I climbed,although the pain was increasing when I pressed on the base of my finger. I stopped all training at home. After I was pretty sure that my finger was healed I returned to the Red where on my warm up route my finger totally gave out on me and the pain at the base of my finger returned. Ever since then I havn't put any stress on my finger.
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fluxus
Oct 10, 2005, 9:19 PM
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You should go see a different doctor, you need a hand specialist, don't bother with anyone else.
When you say the pain is at the base of your finger it could be a problem with the A2 pulley or maybe you somehow damaged the joint capsule of the metacarpophalangeal joint, or maybe there is a problem with the tendon of either the flexor digitorum superficialis or profundus muscles.
or maybe there is a different problem all together.
you have not provided us with enough information to help you and even if you did you are posting on the internet and who know what kind of nutty advice you'll get (have already gotten).
try the following to learn more about your injury:
1) If you had a full A2 rupture you would be able to see it. Does your finger "buldge" out at the Proximal phalanx when you bend your finger and then get "thin" again when you straighten your finger? if not then its not a complete rupture, but it could still be damaged. Often times pulleys hurt on the side of the fingers as well.
2) Hold your finger straight and just bend the last digit (the distal interphalangeal joint) of your finger against resistance. If this hurts then the problem involves the tendon of the flexor digitorum profundus.
3) Hold your finger straight and then bend your finger only at the "middle joint" (the proximal interphalangeal joint). If this hurts the problem involves the tendon of the flexor digitorum superficialis muscle.
If your finger hurts when you do both these tests your injury may involve the A2 pulley.
If these simple tests don't reveal anything then you need to look at other possibilities, such as some sort of damage to the joint capsule of the metacarpophalangeal joint.
hope this helps.
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