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ACJ
Jan 5, 2009, 8:37 PM
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So I am wondering if anyone has any experience with this.
I woke up the day after climbing and when I started to use my hands the pointer, middle, and ring finger on both were in excrutiating pain whenever I used them (think yelping when you pull your wallet out of your pants).
I've been climbing for 2.5 years and have recently had sore hands after bouldering days. 2 days before the injury I climbed 4 steep 5.11 limestone routes on TR. Normally I am a 5.10 trad climber. The day after I went trad climbing and did a few moderates with one 5.10 route. The next day the pain set in.
I have been resting for over a week now and can't tell if they are getting better or not. The right hand seems 100% after a day of rest but the left hand doesn't seem to be getting better. Some days I think so, others no.
I'm a bit baffled as to what happened since it is 3 fingers all at once, not just one.
Any thoughts?
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onceahardman
Jan 5, 2009, 9:02 PM
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In reply to: I woke up the day after climbing and when I started to use my hands the pointer, middle, and ring finger on both were in excrutiating pain whenever I used them (think yelping when you pull your wallet out of your pants).
Digits 2,3, and 4 (more professional-sounding than "pointer...") are used the most, along with thumb (digit 1). So they are more prone to injury.
Using the opposite hand, resist flexion of each finger individually.
-do any feel worse than the others?
- WHERE do you feel the pain? (right in the finger, in the hand, or forearm?)
Your post sounds like the pain is right in the fingers. That makes it sound like a tenosynovitis, or inflammation of a tendon sheath. Keep it moving, gentle range of motion (ROM). Anti-inflammatories if it's super painful. A few days of icing, on and off, won't hurt.
It shouldn't take more than two weeks to be close to normal. Don't just try to train through it.
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ACJ
Jan 6, 2009, 2:54 AM
Post #3 of 10
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Resisting flexion results:
Digits 2 and 3 feel the same. Digit 4 feels weak. I did this a few days ago and it felt like the tendon shifted over something in digit 4 and had a brief moment of pain. I don't know if saying it popped is correct but it was a similar sensation.
The pain only comes when I use my fingers now, otherwise they feel tight but do not appear swollen. The tightness and pain when it does occur is between the two knuckles closest to the finger tip (second metacarpals?).
I have been off of them (not climbing) for 10 days now. Is this the type of injury that I shouldn't use the fingers at all (no typing...) or just don't climb. Also, I'd be hesitant to just jump back onto using them again once they feel better. Would resting longer be beneficial? I am okay with resting for a while in order to heal well and hopefully avoid future injury.
Thanks for the help.
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onceahardman
Jan 6, 2009, 5:29 PM
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ACJ wrote: Resisting flexion results: Digits 2 and 3 feel the same. Digit 4 feels weak. I did this a few days ago and it felt like the tendon shifted over something in digit 4 and had a brief moment of pain. I don't know if saying it popped is correct but it was a similar sensation. The pain only comes when I use my fingers now, otherwise they feel tight but do not appear swollen. The tightness and pain when it does occur is between the two knuckles closest to the finger tip (second metacarpals?). I have been off of them (not climbing) for 10 days now. Is this the type of injury that I shouldn't use the fingers at all (no typing...) or just don't climb. Also, I'd be hesitant to just jump back onto using them again once they feel better. Would resting longer be beneficial? I am okay with resting for a while in order to heal well and hopefully avoid future injury. Thanks for the help.
When digits 2 & 3 "feel the same", does that mean they both have the same increased pain with resistance? Or does it mean they feel the same, whether you resist flexion or not?
The digit 4 weakness is perhaps troubling...but it's also the weakest finger, so maybe it's just the normal weakness.
A couple anatomic definitions for your viewing pleasure, and to make this process easier:
The bone "between the two knuckles (joints is a better word) closest to the finger tip", is the middle phalanx. The metacarpals are inside the hand, in line with the fingers.
The joint closest to the finger tip is the distal interphalangeal joint, or DIP.
The next joint down is the proximal interphalangeal joint, or PIP.
The joint where your finger enters your hand is the metacarpophalangeal joint, or MCP.
Thumb has only a single IP joint.
Joints are built to move. There are few contraindications to keeping them moving, and many reasons to keep them moving. Move them a lot, make a fist, spread the fingers, make another fist, etc. Min. 3 sets of 50 daily. Since you are (apparently) improving, go ahead and start some very gentle strengthening, using putty, modeling clay, play-doh, or a very soft rubber ball. Isolate each finger. Start slowly, make sure you are not re-inflaming it. You can always add more exercise, but once you do too much, you can't take it away.
Stay in touch.
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ACJ
Jan 20, 2009, 10:44 AM
Post #5 of 10
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Fingers update and question.
It has been 25 days since the onset of pain and 27 since I believe the injury actually occurred.
I immediately stopped all climbing.
I injured digits 2,3,4 on my left and right hand. I felt no symptoms until two days after the climbing that I believe injured it. I woke up and experienced severe pain when I used those digits. The pain seemed to originate from the DIP joint on all 3 digits and continued down the middle phalanx of all 3 digits.
After 7 days I was lightly resisting flexion and felt a small pop/shift accompanied with a sharp pain coming from the DIP joint of digit 4 on my left hand. My right hand felt completely normal and has not bothered me since.
After 10 days I started ROM exercises and ibuprofen.
After 17 days my hand felt normal again, I attribute this to the ROM and not climbing. I stopped taking ibuprofen and continued ROM exercises
After 20 days I tried a light day of ice climbing (200 ft. of WI3). I felt no pain or problems while climbing. The next day I had slight aching pains in my hands and decided not to do anymore ice climbing.
After 25 days digits 2 and 3 seem normal but there is occasional glancing pain. I haven't been able to identify what instigates that pain. When I resist flexion with those digits they don't hurt. If I am carrying a book, the pain sometimes hits me in a sharp burst that stops right away.
Digit 4 however seems to be more troublesome. It appears to be very slightly swollen, hard to notice without close inspection. It is in a constant dull aching pain. During flexion it feels tight. When resisting flexion there is increased pain through the whole ROM. ROM exercises also increase the aching pain during the exercises, mainly during extension.
I also occasionally feel an increase in pain after I run. I figure this is my hands being jared around during the exercise.
Assuming I'm not holding anything my finger feels more relaxed when my hand is in a lightly formed fist, digits not touching palm. Tighter if my hand is open flat (almost like a stretch, which from other posts I have read is a not what I am going for here).
So my question is where can I go from here. Is this simply a super slow process? I'm on top of nutrition and working cardio to stay in general shape. I still do the ROM exercises daily in both hands. I do believe that for the most part I have been healing. Digit 4 just doesn't seem to be coming along like the others. Again I am willing to commit to whatever process I need to in order to heal this injury correctly and in whatever the shortest time possible is (3 months is better than 6 kind of thinking).
Thanks again for all the help.
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onceahardman
Jan 20, 2009, 6:49 PM
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Well, 5 out of 6 affected joints are significantly better- that's good.
There are several possibilities, but generically speaking, either:
-The same injury was more severe in digit 4;
-The injury to digit 4 was a different injury which happened concurrently.
I'd like you to try something, but I'd like to specifically note that this technique is for ONLY YOU to try, not someone else who also has a sore finger.
Rules: Do the technique once. If the pain is notably worse, stop immediately. If it makes no difference, stop immediately. If better (or especially if the formerly offending motion is now pain free) do 5 repetitions ONLY, for today.
Using the thumb and forefinger of the opposite hand, grasp the middle phalanx (middle of the 3 bones of the finger), and apply a compressive force to the PIP, using the middle phalanx to apply this compression to a nearly fully extended PIP of the injured finger.
While applying this compression, actively flex the injured finger, continuing to apply the compression throughout the motion. You may hear some cracking or grinding. If it's painful, stop.
If it's not painful, do 5 reps. Tell me what happens, and we'll progress if appropriate.
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ACJ
Jan 20, 2009, 7:26 PM
Post #7 of 10
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onceahardman wrote: Using the thumb and forefinger of the opposite hand, grasp the middle phalanx (middle of the 3 bones of the finger), and apply a compressive force to the PIP, using the middle phalanx to apply this compression to a nearly fully extended PIP of the injured finger. While applying this compression, actively flex the injured finger, continuing to apply the compression throughout the motion. You may hear some cracking or grinding. If it's painful, stop. If it's not painful, do 5 reps. Tell me what happens, and we'll progress if appropriate.
Results after 5 reps:
No pain, cracking, or grinding during reps. I was very careful to ensure I wasn't resisting flexion while doing the reps. What I did feel was something flopping back and forth across the middle phalanx. Once I completed the reps there was a dull throbbing (not painful) for about 15 seconds. After that the digit returned to it's normal (injured) state that I described before.
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onceahardman
Jan 20, 2009, 7:42 PM
Post #8 of 10
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In reply to: What I did feel was something flopping back and forth across the middle phalanx.
Sorry, man, in this format, it's really impossible to tell what that "something" is.
If your sense is, the injury is healing, I'd just keep up the AROM, and gentle strengthening with putty.
If your sense is, it's just not improving at all, I'd go find a specialist/hand surgeon.
I wish I could have been more helpful. Stay in touch anyway.
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ACJ
Jan 20, 2009, 8:03 PM
Post #9 of 10
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Well bummer. Thanks for your time and help though. Is there any chance this could get worse with time? In other words can I give it a few more weeks before deciding to go to a specialist or could that be detrimental?
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onceahardman
Jan 20, 2009, 8:18 PM
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The decision is entirely yours.
The normal, healthy state if the human body, though, is healing. I don't know exactly what you are feeling, but from what you described, if it was me, and it is not clearly worsening, I'd keep up the AROM and gentle strengthening, and hope for the best.
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