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difdclimber
Jul 14, 2008, 11:25 PM
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Registered: Feb 13, 2007
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I was climbing about 6 weeks ago and fell of while my left hand was in a weird angled pocket. I felt it as i got to the ground that my hand really began to hurt between/on my ring and pinky finger. It felt like it hurt in the upper palm area between them when i grabbed something with them. It is much better now (haven't climbed since) but don't know how to test it out to make sure it won't hurt again if i climb. How long is the approximate time for a tendon injury like this? Also should i be doing any sort of excercises for it? Thanks
-Doug
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scotchie
Jul 15, 2008, 5:22 PM
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First of all IANAD and I have no qualifications to help you whatsoever. But that said you are asking on the Internet, where eveyone has an opinion, so... Upper palm sounds like the A1 pulley. The pain was behind the knuckles, except on the palm side of the hand, right?
I'd say take it easy. A little extra rest wouldn't hurt, considering climbing puts a lot more stress on your body then ordinary life. Then take it one step at a time, starting with very easy grades and slowly progressing toward where you were pre-injury. If it hurts, stop climbing or go back to easier grades.
Also, taping your hand might help protect it when you come back to climbing.
Good luck!
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coolcat83
Jul 15, 2008, 5:48 PM
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Registered: Jan 27, 2007
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I did that about 3 months ago, It's pretty much 100% now but i tape as a precaution, i took a couple weeks off. then took it slow NO CRIMPING, on the positive side, because I had to not crimp my open hand strength has greatly improved and i went up a whole number grade.
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aerili
Jul 15, 2008, 8:00 PM
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It sounds like an injury to your metacarpophalangeal (MCP) joint. This could be the A1 pulley, like scotchie said, or it could easily be a ligament issue as well. It could also be a tendon, like you thought, but your mechanism of injury (falling off while your hand probably got wrenched out of a weirdly angled pocket) sounds more like a good recipe for a ligament injury. (Although this is really impossible to know unless a doc/therapist examined you.)
Regardless, both ligaments and tendons heal VERY SLOWLY. Mainly b/c their blood supply isn't that great. It can take up to a year for these kinds of tissues to fully heal (this doesn't mean you can't climb for that long, however, it just means you will have to be careful for quite some time).
I don't know the best treatment for you, but buddy taping your fingers is commonly advised for sprains. The problem is that without a true correct diagnosis, it's hard to give you the right treatment answer. Perhaps one of the PTs or MDs on here can chime in with more specific questions and insight.
(This post was edited by aerili on Jul 15, 2008, 8:01 PM)
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onceahardman
Jul 15, 2008, 10:06 PM
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Registered: Aug 3, 2007
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I've kind of been in lurk mode for a little while here, but since my buddy aerili asked so nicely...
First off, assessing an injury like this can be pretty challenging, even if you were right in my office. There are lots of little pulleys/volar plates/tendons/ligaments, as well as the intrinsic musculature of the hand (interossei, lumbricals), and carpals/metacarpals, joints, nerves.
Next, many of the injuries which are fairly common in climbers (see pulley injuries) are virtually unknown in the rest of the human population, so many doctors/PTs/OTs will have a tough time really making the call. MRI is great, but it only shows anatomy, it does not necessarily identify pain generators (see false positive/false negative)
With those problems identified, though, all is not lost. Often, you don't need a really firm diagnosis to get things better. A quick example is headache, which might be a stroke, traumatic brain injury, subdural hematoma, cancer, influenza, meningitis, etc....but is probably not. Take two aspirin, and call me in the morning.
you have made perhaps the most insightful "assessment" already. It is much better. The natural state of a healthy body is healing. Most things get better. Now that is is feeling better, start moving the injured area more. NOT stretching, but range of motion (ROM). If (and only if) you have limited ROM in any direction, you can start gently stretching, just far enough to restore the affected motion. Use the opposite appendage to assess normal motion.
Once you have full, pain free ROM, start strengthening. Things like regular rubber bands, like you'd find at your desk, have a place in finger rehab. Also, theraputty, silly putty, modeling clay, etc., have a place. After a couple weeks, start back on easy routes, on top-rope. Take several weeks to re-train your connective tissue. Stop if you have lasting pain. Do not re-injure.
You are getting better. That is the best possible sign.
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onceahardman
Jul 15, 2008, 10:44 PM
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One additional point. Could have been an edit, but probably deserves it's own post. Know the difference between ROM and stretching.
ROM-has two types, active ROM (AROM), and passive ROM (PROM).
AROM-Consciously moving the joint within it's available range. Fingers, for example, flex and extend. In addition, the metacarpophalangeal joints (MCPs) abduct and adduct. Making a fist, then spreading your fingers would provide pretty full AROM exercise.
Rehab benefits of AROM- keeps joint surfaces healthy, retards muscle atrophy, prevents contractures.
PROM-using your opposite hand (or therapist-applied force) to move your joint(s) within the available range. Typically, PROM will measure greater than AROM.
Rehab advantages- keep joint surfaces healthy, avoid contractures, can be performed on neurologically affected joints which can't be moved actively.
Contraindications of ROM exercise-acute fracture, active joint infection, acute flareup of rheumatoid arthritis, cancer within a joint, or during acute recovery from a stabilization surgery.
Note: The purpose of ROM exercise is NOT to increase the ROM of the joint. It is only to move the joint within it's available range.
STRETCHING-is moving a joint BEYOND it's existing range. It is used to increase ROM in joints whose ROM has decreased secondary to injury or disuse. It is contraindicated in all of the ROM cases, as well as most acute/subacute soft tissue injuries (muscle strain, ligament sprain, capsule injuries, articular surface injuries.).
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