A3 pulley injury, recovery

So I believe that i have a minor tear in the A3 pulley in my right middle finger. I can still easily make a fist with mild discomfort but a crimp under light pressure hurts a little. Sadly I am a recent college grad job hunting and so I don't have health insurance or the money to get professional help. I have read several threads about the recovery process and I am hoping to be sidelined for no more then 6 weeks, but I will take as long as needed to heal it properly. I plan to follow the recommendations in these two articles.
onlineclimbingcoach.blogspo…
nicros.com/training/article…

its goes
1. rest
2. ice therapy and heating pads
3. Deep friction massage
4. gentle exercise and stretching

My real question is how to keep strong well i let my finger heal. I obviously can't try to train that finger. I was thinking that maybe i could splint my finger and still train pull ups on a hang board, and even do climbs 2 or 3 grades below my normal with the splint on. Is this just a bad idea? Should I rather focus on aerobic fitness and just stop climbing until my finger has healed?

I don't want to loose to much strength I was just starting to project my first 5.12a and was hoping to get in done in the next month, I know that is not happening now but I would like to see that go down before Jan 1st, 2016

Any advice or your own experiences would be most appreciated.

its hard to quit climbing to heal, but in my personal experience, climbing while splinted doesnt work. doing pullups however with a sling around the wrist to minimize finger usage does. my pulley was sore for a few weeks before it popped. then the down time was major. jugs are better but the pressure of the lip of the jug on the sore tissue will keep it inflamed and slow the healing. my advice is take whatever time is necessary and learn to chill. youve got years to climb and will have many injuries. poorly healed injuries will haunt you for years. best, k

The good thing, based on what your pain intensity sounds like, is that it appears to be a relatively minor injury. Both times I have torn pulleys I could not even come close to closing my finger into a fist for at least a week probably longer. I am just about to come off an almost 7 week break from my most recent one.

If you are sure it is a pulley, do not crimp and do not climb on it at all for at least a couple of weeks. Especially hangboard, that is way too high impact. The first time I tore a pulley I tried to keep climbing and it in turn led to a tendonitis flare up because of the way I was trying to compensate and my finger swelled up so much I could have cooked it on a grill.

Take it easy for a couple of weeks. Find something to do that still challenges you without putting any strain on the finger. Intense aerobic or just a hard workout. I have been running laps on the 2nd Flatiron just to say I have been on the rock and hitting the gym much harder than normal on other days just to make myself feel like I am not a lazy ass.

Your project is still well within reach, even by the end of the summer. Test out how it feels after a couple of weeks. If it isn't too bad, ease back into it. Most importantly, TAPE THE FINGER in the affected area when you start climbing again. I taped for almost 4 months while rehabbing last time. It probably will still ache a little bit when you start to climb again. If the pain starts to get worse again, stop. For better or worse, time is the only thing that really helps heal an injury like this. A tiny bit of pain may linger for quite some time afterwards, but if you know your body and your hands well you can recover pretty quickly and safely without doing any lasting damage or losing too much strength.

Good luck man, and good looks on immediately considering taking a break. Too many people try to climb through the pain and it just complicates the process and makes it longer than it needs to be.

I took some time off. Had a MRI they didn't see anything they said ti could have been a2/a3 and to rest. I did caoe back slowly after a few months off. maybe waited a little long but till this day i tape it. It still feels a little sore after climbing im still not pushing it. its been about a year. but I never feel the stiffness and soreness longer than 5-10 minutes after a climb so i am assuming its still just healing and i try not push it. ( I never feel it during a climb like when i first injured it just after for a few mins) I would rest ice and like others said work on aerobics and other general strenghtening. its a good time to focus on balancing out muscles that might have been nelected like forearm extensors if finger allows it and rotator cuff work.

If anyone can comment on soreness for along time after i would appreciate it. I have heard people feel sore for sometime after like me but if anyone can confirm it personally i would appreciate it and maybe put my mind at ease about my recovery.

Mike,

Soreness can linger for quite a bit depending on how your body heals. My first one was sore for a very long time afterwards, months after I eased back into climbing. A year or more seems quite long though. Maybe try to push it hard a couple of times and see how it responds. I found that even though I was sore some months after I was able to climb full strength and that climbing hard may have actually helped the very last stages of recovery.

Are you still getting the stiff / swollen finger feeling when you wake up in the morning? That was a sign to me that I was still in the recovery process in some form. Maybe you had a complete tear and the MRI didn't pick it up. A complete tear will take a lot longer to heal than a partial. Was your tendon bowstringing out at all when the injury occurred? Sometimes that can be the only way to tell the severity of the injury. Hope you get back to climbing hard soon man.

after mine was healed to the point where i trusted it and could climb reasonably well, i found jugs pressing on the tissue irritated it more than crimps. it took well over a year for the soreness to go away, but climbing outdoors was certainly preferable to pulling the plastic. outdoor days would cause little irritation whereas indoor work with many more routes and more intensity made it hurt again, although not swell much. i made a metal ring out of a piece of 3/4 inch copper pipe about 3/8 of an inch long which was split down the side so it was somewhat adjustable. would slide this on, pinch it tight, and tape it. gave good support and probably prevented other injury on the occasions where i tended to catch myself in a fall and overload the finger again. climbing without the "ring" was a big deal and hard to do as i had really come to trust and rely on it. still have it in the bag. best, k

Hey!

I just had this exact injury and I managed to go from a major tear to full strength of climbing in 4 months. I know what you're going through. I'm also a recent college grad working into the 5.12 range. Lots of similarities...

One thing I had going for me was that I was injured in winter so staying off the rock wasn't as hard. That being said...

First, REST THE FINGER.

It is the hardest thing in the world but whatever you do, rest, rest, rest. Lift free weights, do chinups with a taped finger making sure to not let that joint take any extra work.

NO CLIMBING until you can make a fist without any discomfort and crimping is pain free. You'll still notice the joint but it shouldn't hurt. Once you are at no pain at all, start working in easy climbing and continuing other workouts.

After that, continue to tape the finger as you progress in climbing. Just something that limits the bending, but not super tight.

Lastly, for some prevention and comfort...

Take a spoon or butter knife and roll it over your joints with your fingers sideways on a table. Not super hard, just enough to feel like a heavy massage. This works calcium deposits out and massages the mechanisms in your joints.

All of this advice is second hand but came at the recommendation of my orthopedist and like I said, 4 months later and I was back on 5.12s.

I would ditch the icing, you want inflammation that is what brings the nutrients and speeds the healing process. Studies have shown that injuries that were allowed to run through the inflammation process healed much stronger in the end versus injuries that were treated with icing and ant-inflammatories.
I just came off a major finger injury, ring finger flexor tendon, and I found that once I dropped the icing routine, I started to heal faster and make progress.

Gently exercise the finger this could be as simple as just flexing the finger, movement is a good thing and help it heal stronger. Lots of good finger exercises using thera putty, start conservative.
Anything you can do increase blood flow is good, cardio, etc.

Lessons I learned: Don't ice and don't take anti inflammatories, those are antiquated forms of therapy.

I completely agree with everything said above. I was in same boat, middle finger on right hand. I could make a soft fist with pain and even doing nothin, pain referred to my elbow and forearm. Ultrasound showed "nothing" was wrong.

I rested six weeks, no climbing. Would do lots of core work, which we all need all the time in climbing, and TRX stuff was good too, because the handles didn't seem to bother my hand, like jugs did, as Kurt mentioned. I teach yoga, so was constantly working all the shoulder alignment and arm opening stuff I knew, and that always helped relieve my elbow and hand pain.

Then, when I'd come back to climbing I could climb as long as I didn't crimp, and, yes, I taped. Problem was I'd be so psyched to be outside that I'd overdo it, and be right back at 6 weeks off. :-/

What seemed to snap me back to "normal" after a year of that cycle, was adding MELT method every night before bed. It is targeted at rehydrating connective tissue, and getting muscles and tendons to glide along each other instead of being stuck. I wrote about it here: theinspiredclimber.com/2015…

I also added in open-hand work on the hang board once a week with weight off. I'd stand on a chair and gently load my hands by bending my knees. This was after the six weeks rest, of course. After a few months of that (I started in February) I was back to being able to crimp, as long as I warmed up. I am easily climbing 5.11 now and projecting 5.12 and no taping required!!

Good luck and be patient with your body!

Hey everybody I really appreciate what you have said about your recovery processes. I have some questions about some of your methods?

At KrisFiore are you saying like the broad side of a knife or the thin side edge?

Highlander do you have any references about letting the inflammation be? I would really be interested in reading about this? The ice therapy i plan on using is know to significantly increase blood flow as the body tried to keep and extremity warm.

Paisley Close, can you say that the MELT method is something beyond just another deep tissue massage?

Also I have been experimenting with methods of working individual fingers did any body every try something like that? I have reversed my metolius rock rings and using a pully some rope and free wights have a system that lets me do pull downs with a single finger with adjustable weight, it feels like a great way to keep trying my hurt hand that lets me completely avoid the injured finger.

jacob m s wrote:At KrisFiore are you saying like the broad side of a knife or the thin side edge?

The thin side although I've found the back of a spoon works much better as it rolls easier on the joint.

Yes. It's completely different. It's a "less pain, more gain" system. You actually often work around tight spots rather than dig in in them. The analogy I've heard is like when you stand in wet sand, then you move and your footprints fill in with water from the surrounding sand. You can press an area and then it rehydrates more than just that area. So it's not like deep, sports massage where they dig and dig and dig on knots. It works with the connective tissue which communicates over a vast network (I.e. I release my feet and my neck will often pop and lengthen!)

Also, it's a self-care method so you learn your own body and healing better than putting it in someone else's hands and it's free once you buy the MELT balls. I'd suggest looking for a class in a gym or yoga studio (they're popping up in more and more places) because the guidance of a teacher can get you a base understanding to really help you at home.

handon broward wrote:Mike, Soreness can linger for quite a bit depending on how your body heals. My first one was sore for a very long time afterwards, months after I eased back into climbing. A year or more seems quite long though. Maybe try to push it hard a couple of times and see how it responds. I found that even though I was sore some months after I was able to climb full strength and that climbing hard may have actually helped the very last stages of recovery. Are you still getting the stiff / swollen finger feeling when you wake up in the morning? That was a sign to me that I was still in the recovery process in some form. Maybe you had a complete tear and the MRI didn't pick it up. A complete tear will take a lot longer to heal than a partial. Was your tendon bowstringing out at all when the injury occurred? Sometimes that can be the only way to tell the severity of the injury. Hope you get back to climbing hard soon man.

No bowstringing. hasnt been sore longer than 15 minutes after a climb in months. I do not feel any soreness or stiffness the next morning just a soreness after the climb. depending on how fingery it is it can be 10 minutes of sorness to the touch or less. push here and there but i always lay off if I feel a little bit of soreness.

kurt hoelter wrote:after mine was healed to the point where i trusted it and could climb reasonably well, i found jugs pressing on the tissue irritated it more than crimps. it took well over a year for the soreness to go away, but climbing outdoors was certainly preferable to pulling the plastic. outdoor days would cause little irritation whereas indoor work with many more routes and more intensity made it hurt again, although not swell much. i made a metal ring out of a piece of 3/4 inch copper pipe about 3/8 of an inch long which was split down the side so it was somewhat adjustable. would slide this on, pinch it tight, and tape it. gave good support and probably prevented other injury on the occasions where i tended to catch myself in a fall and overload the finger again. climbing without the "ring" was a big deal and hard to do as i had really come to trust and rely on it. still have it in the bag. best, k

Yes i find a day outside i barelt feel it. most likely the grades i am climbing a re a bit lower and mroe rest in between climbs. Living in michigan its hard to get outside I try to get down to the red every 3 weeks so in that time i need to get some climbing in.

I've had 12 pulley injuries, 10 A2, 2 at A3 in a 25 year climbing career.

From date of injury to pain-free has been as short as 4 weeks to as long as 15 months. A3 is pretty easy to work around. The last A3 I did, I didn't stop climbing at all and barely ratcheted back the intensity and volume. It healed faster than any of the others...not that I recommend that approach.

I would recommend against pure rest after the initial trauma period (say ~3weeks). People taking 6-8 weeks off is counterproductive in my experience. You need to move it, exercise it, IMO.

People tend to say "12?!!! pulley injuries, WTF?!!". In my 20s I drank a lot, didn't sleep well, bad diet, and crimped a lot. Would "load-up" and crank off crimps (like sag into the move and explode off the crimp).

But I went a good 8 year period with any injuries. I attribute that to getting strong on the hangboard, and cutting slightly back on the volume of dynamic bouldering (I still boulder, a lot and dynamically, just am really choosy about what and how I climb, I walk away from many, many gym problems that are set with high injury potential...all too common unfortunately, especially in the higher grades...probably because most setters are in their early 20s and not the sharpest tools in the shed either).

I also stopped crimping anything that didn't absolutely require it. I open-hand almost everything. If a route has manadatory tweaky crimping, I will prophylactic tape it, make sure I am totally fresh on the attempts, and quickly move to something else when I start to tire.

The ice-water submersion treatment has seemed to work well for me. Dave MacCleod has pretty good info in that regard on his site. Basically 20min submersion in slighly icy water. I would use about a tray of ice in a large coffee can, the first 5 minutes will hurt and be a test of will power to stay submerged, after that blood flow will reverse from shunting to your core to flooding the tissue of the hand. By the end of 20, the ice will all be melted and your hand will be full of blood and not feel that cold. If your hand is going numb and still white (assuming your not a person of color) after about 10min, it's too cold. I did this 2x/day, everyday for a few weeks and it seemed to speed recovery. Probably due to the massive increase in blood flow.

https://www.trainingbeta.com/media/esther-fingers/

Listen to WIll S.  I agree that you should rest you should rest your finger but only until the swelling goes down and you can make a loose fist without discomfort.  no amount of rest will fully heal your pulley injury.  If its still sore after climbing, follow the protocol described in the above link.  Note Paisley's story above, her finger remained sore until rehabed it properly with the hang board.  the hang board is key to developing pulley strength for both healing and preventing a pulley/flexor tendon injury.