Collateral ligament finger injury

I think I have done some damage to my collateral ligament on the 2nd knuckle (proximal interphalangeal joint). It is often swollen and it is painful to the touch on the top interior of the index finger (top left of the right hand if looking at the top of the hand). Taping the crap out of it helps and buddy taping to helps too. Torsion hurts and crimping makes it bad too. It often does not hurt while I climb but swells and hurts the day after. I have stopped gym climbing for the last 3 or so weeks. Oddly enough, I can climb cracks ok, especially if I avoid torquing my index finger, but any real crimping sets it off bad.

I've had pulley injuries, so I am (pretty) sure this is different. Pulleys were annoying enough and this seems like it may take even longer to heal! Anyone have any experience with this?

Dana Bartlett wrote:Was the onset of the pain sudden?

No, not really. I thought its was arthritis at first, as there was swelling and minor non-localized pain. But as it went on, over a couple of months, the pain has become more focal and intense, and I have noticed that torsion sets it off.

I've had a couple bouts with it. In my case, it was very difficult to get rid of, lasted much longer than any of the many pulley injuries I've had. Had to basically stop climbing finger cracks for about a year for one of them to finally settle down. One of mine was index finger, one in the middle finger of the other hand. Hard thumbs down finger lock while cold, first route of the day, was the culprit for the index, training on some less than ideal two-finger pockets is what I think did the other one. Middle finger one recovered quicker, but it was still about 6mo.

Both these were in my mid 30s, so take that into account for my healing time.

I also all but stopped playing guitar because the extra irritation was just too much to recover from and seemed to really be concentrated in that collateral area. Went from playing many hours per week to maybe one or two short sessions per week, and almost totally on the electric. Even now, if I start playing more often, inflammation starts to creep in around the collaterals on my fretting hand, index finger in particular.

Volar plate injury is another possibility. Collateral ligament injury should hurt like hell if you apply force laterally to the joint. Your knuckle doesn't move in this direction but there should be some play.

jeff lebowski wrote:Volar plate injury is another possibility. Collateral ligament injury should hurt like hell if you apply force laterally to the joint. Your knuckle doesn't move in this direction but there should be some play.

I'll have to research that more. It takes a significant amount of lateral force for it to hurt, and even then it is not all that bad. Not as bad as just pushing on the area and not as bad as it hurts after a day of crimping. So maybe it is not a collateral ligament or if it is, it is more minor. I have also read that stress fractures can cause pain in the same area.

Hi csproul,

I am facing very similar problem at the moment. In my case its a pinkie. It came slowly ... I realised it once when I saw the joint is a bit swollen and red (not because of any pain). I have seen a doctor (hands specialist + climber ) a few months ago at a climbing gym. He said it was a joint inflammation and advised me to take a rest and take some anti-inflammatory drugs(NSAIDS) and ointment. The problem was it did not really hurt while climbing and even the day after it was not that bad so I still climbed 1,5 month. Since it was not getting better ("surprisingly") I decided to stop completely two weeks ago. Since then I use the ointment (Voltaren), cold water therapy (Lewis reaction) and I tape it for almost the whole day to immobilize it a bit.

I will see him again in about two weeks if it does not get better. Now it almost does not hurt...on the other hand the swelling is the same as before, as well as the colour.

How about you...is it getting any better/worse?

...wish you a strong and patient mind:)

adam

Adam Shanti wrote:Hi csproul, I am facing very similar problem at the moment. In my case its a pinkie. It came slowly ... I realised it once when I saw the joint is a bit swollen and red (not because of any pain). I have seen a doctor (hands specialist + climber ) a few months ago at a climbing gym. He said it was a joint inflammation and advised me to take a rest and take some anti-inflammatory drugs(NSAIDS) and ointment. The problem was it did not really hurt while climbing and even the day after it was not that bad so I still climbed 1,5 month. Since it was not getting better ("surprisingly") I decided to stop completely two weeks ago. Since then I use the ointment (Voltaren), cold water therapy (Lewis reaction) and I tape it for almost the whole day to immobilize it a bit. I will see him again in about two weeks if it does not get better. Now it almost does not hurt...on the other hand the swelling is the same as before, as well as the colour. How about you...is it getting any better/worse? ...wish you a strong and patient mind:) adam

I stopped climbing completely for about 3 weeks. I am going to the gym about once a week and climbing outside every other week or so. I tape it whenever I am climbing, and that helps. It is now fine when I am not climbing, which is better than before. However, it does not take much to get it hurting again and I have to be careful to climb easy. I stay away from crimping, but cracks are pretty kind to it. It is frustrating though, it has been at least 3 months now and it still seems like it is not really healing to the point that I can climb on it.

I have the same problem on my middle finger. Happened about 4 years on a gaston at a off-angle. I climbed on it the day after and aggravated it even more. Since then I've taken two separate 6 months from climbing. Each time I feel great for the first couple of months back, but then the pain and swelling come back again especially on crimps the evening and days after climbing. The only thing that really helps is ice and ibuprofen. I use my fingers for work so I try to be really careful. Sucks though.

Hi again,

so today I have been to see the doctor (specialist for hand).

The diagnosis in my case according to him is quite ordinary bursitis (eg. here en.wikipedia.org/wiki/Bursitis, plenty other information on the web)

He told me it should get away pretty quickly. I responded I got it already for almost 3 months and he "responded" with an injection of kortikoids and told me it should have immediate effect and that I can go climbing on Saturday (in 2 days). Well, I will definitely wait longer since I already took a month off climbing which I have not done for years, so I will give it time to heal properly...if it is this bursitis. I will know I hope after a week or so...

Do you guys have any possibility to see a hands specialist? (hands surgeon or specialized orthoped)?

Adam

Fellow Crimples,

I recently developed some pretty gnarly swelling in my index finger around the middle joint. About 6 weeks ago I was crimping the crap out of some pebbles in Bishop and noticed that it was swollen the next day, however I proceeded to climb on it. On my next day (rest day) I knew something was up, and it seems to fit the description provided by you guys very well. I attribute the injury to sustained crimping and cold temps, as well as a bad warm up.

I took 4 weeks off of it and rehab'd it like a strained A2 which involved icing (in ice water), ibuprofen, buddy taping, and rehabilitation exercises (extending fingers w/ a rubber band, and grip ball). I saw slight improvement but not much, so I went and saw a hand specialist. He took x-rays to rule out a stress fracture, and identified collateral ligament injuries on both sides of the joint rather than a tendon injury by virtue of the fact that there was no pain at the A2 or A3 but on the sides of the joint.

Next he told me to splint it (no other motion... or rehab which I had been doing for weeks -.-) for the next 2 weeks and then start climbing as hard as I want and it will be fine (which I am very suspicious of). As of now I plan on starting to climb high volume, very low intensity (5.7-5.9) for the next month in the gym, and hang board (slowly) to rebuild strength. For those of you who have suffered this injury, what sort of rehabilitation measures did you take or get recommended to get back to full strength following immobilization of the joint?

Thanks,
Kyle

Hey Kyle,

thanks for writing this down. I guess it might help somebody with the same problem. In my case it was (unfortunately still IS) bursitis (from wiki: Bursitis is the inflammation of one or more bursae (small sacs) of synovial fluid in the body.) Which is not the problem of the joint itself but rather the "staff" around it. Injection of corticoids helped a lot, however it has not healed the thing completey and its slowly getting worse again. I tried splinting/resting/icing...basically nothing has helped significantly. I am quite curious if you will succeed with splinting...let us know please:)

adam

I’ve been dealing with this for 7 months now. Swelling to the pip joint in my middle finger. Fairly sudden onset after a session on small side pull crimps with poor warm up. I waited about 2 weeks to Climb again to allow the initial swelling to subside but since then have been Climbing at 100% and haven’t been really limited aside from avoiding hard ring locking. I have noticed no improvement aside from the initial swelling and pain to subside. Hasn’t really gotten worse either though. Stays swollen for a day or 2 after hard sessions. 

What works best for me is consistent compression taping of the joint with kt tape, as well  as buddy taping ( it’s literally always buddy taped and compression taped, even when not Climbing ) it usually starts hurting when not taped due to being allowed to move laterally and swell. I also use an accupressure ring (google it if you don’t know what I’m talking about) and ice occasionally and that seems to help maybe. 

Annoying little injury that is taking forever to go away. Maybe it would heal if I stopped Climbing? But from what I’ve read it sounds like that’s no guarantee. Considering I haven’t observed a worsening of my condition or decrease in performance, I think I’ll keep doing what I’m doing. I’m very interested in hearing others experiences with this injury. 

Wondering if anyone has had success using a hang board to recover from strained collaterals. Seems like hanging on jugs and slopers could strengthen the fingers and get a lot of blood to the area without directly stressing the ligaments.

Anyone have updates on their injury?

Still the same and now I’ve also torn a pulley too :(

csproul wrote: Still the same and now I’ve also torn a pulley too :(

sorry to hear that, csproul! Your first post was five years ago-- is it the same collateral ligament you're having trouble with? And a pulley on that finger too? Did you take any extended time off (~3 months or so) since the initial injury or have you climbed pretty regularly? Was your collateral ligament completely torn or just partially? I have a strained collateral ligament (pretty sure it's just a partial tear) on my DIP of my right middle finger. Any advice? Things you wish you would have known or done differently? I don't want this to go on forever! Wishing you healing.

Christian Cota wrote:

I’ve been dealing with this for 7 months now. Swelling to the pip joint in my middle finger. Fairly sudden onset after a session on small side pull crimps with poor warm up. I waited about 2 weeks to Climb again to allow the initial swelling to subside but since then have been Climbing at 100% and haven’t been really limited aside from avoiding hard ring locking. I have noticed no improvement aside from the initial swelling and pain to subside. Hasn’t really gotten worse either though. Stays swollen for a day or 2 after hard sessions. 

What works best for me is consistent compression taping of the joint with kt tape, as well  as buddy taping ( it’s literally always buddy taped and compression taped, even when not Climbing ) it usually starts hurting when not taped due to being allowed to move laterally and swell. I also use an accupressure ring (google it if you don’t know what I’m talking about) and ice occasionally and that seems to help maybe. 

Annoying little injury that is taking forever to go away. Maybe it would heal if I stopped Climbing? But from what I’ve read it sounds like that’s no guarantee. Considering I haven’t observed a worsening of my condition or decrease in performance, I think I’ll keep doing what I’m doing. I’m very interested in hearing others experiences with this injury. 

Christian-- is the join unstable (does it move side to side more than it should)? Have you had imaging? Considered prolotherapy?

Will S wrote: I've had a couple bouts with it. In my case, it was very difficult to get rid of, lasted much longer than any of the many pulley injuries I've had. Had to basically stop climbing finger cracks for about a year for one of them to finally settle down. One of mine was index finger, one in the middle finger of the other hand. Hard thumbs down finger lock while cold, first route of the day, was the culprit for the index, training on some less than ideal two-finger pockets is what I think did the other one. Middle finger one recovered quicker, but it was still about 6mo. Both these were in my mid 30s, so take that into account for my healing time. I also all but stopped playing guitar because the extra irritation was just too much to recover from and seemed to really be concentrated in that collateral area. Went from playing many hours per week to maybe one or two short sessions per week, and almost totally on the electric. Even now, if I start playing more often, inflammation starts to creep in around the collaterals on my fretting hand, index finger in particular.

This just about exactly describes my case. .11 thumbs down finger crack crank straight from car, cold, and now I wake up and its sore and playing guitar aggravates it. Can this be mended by a surgeon, or better yet, is there a youtube video where I can learn how to do self-surgery? I miss finger cranking! #nohealthinsurance

Mine gradually healed. I think taping them and climbing hard is worse than leaving the tape in the bag and building up from a lower intensity, at least that was the ticket for me. 

I think you all have synovitis in your fingers. Google "julian saunders finger stretching" and there's a youtube video that shows how to alleviate this condition. It's the only real/permanent cure for it afaik. 

Will S wrote: I've had a couple bouts with it. In my case, it was very difficult to get rid of, lasted much longer than any of the many pulley injuries I've had. Had to basically stop climbing finger cracks for about a year for one of them to finally settle down. One of mine was index finger, one in the middle finger of the other hand. Hard thumbs down finger lock while cold, first route of the day, was the culprit for the index, training on some less than ideal two-finger pockets is what I think did the other one. Middle finger one recovered quicker, but it was still about 6mo. Both these were in my mid 30s, so take that into account for my healing time. I also all but stopped playing guitar because the extra irritation was just too much to recover from and seemed to really be concentrated in that collateral area. Went from playing many hours per week to maybe one or two short sessions per week, and almost totally on the electric. Even now, if I start playing more often, inflammation starts to creep in around the collaterals on my fretting hand, index finger in particular.

Will, when you say your middle finger took six months to heal, do you mean six months no climbing... what did you do during the healing process? How is it now?