Weird Finger Pain - Only on Good Holds

Hi Mountainproject,
I've got a puzzling finger injury for the armchair doctors. So far searching hasn't been very productive. I've had the same problem several times over the past three years (always on the RH side, and always either the ring finger or middle finger) and have never managed to figure out the root cause. It's gotten quite bad now (and I've got a trip planned) so I figured it was worthwhile to post now.
Here are the symptoms:

• Pain in PIP (1st) joint of middle finger
• Pain on the sides of the joint
• Worst when pressing with uneven distribution on joints (eg: more weight on 2nd pad than the fingertip pad, putting hands flat on floor in a pushup position - this one in particular hurts the worst)
• Also bad with sideways movement (sidepulls, drive-by's and cross-throughs in particular. Gaston's aren't an issue).
• Also feel pain when pressing below base of finger in palm (towards the palm past the big lump of the metacarpal where it meets the finger's base)
• Aggravating climbing holds: uneven slopers, big edges, pinches, awkwardly positive crimps (where you have to slot your fingertip down towards the ground rather than crimping on the lip)
• Totally fine climbing holds: small crimps, even-radius slopers and edges (except when moving laterally). Really, the comfiest holds are things like the small/medium metolius campus rungs.
• Feels better when I tape the sides of my entire finger (in kind of a U shape)
• Worse with big lateral movements, even on otherwise OK holds

My current guess is a volar plate injury combined with a collateral ligament strain, but I'm interested to hear others' thoughts, especially if they've had similar symptoms. I find it strange that I've never had a pulley injury (to my knowledge) but have had this same injury three times now roughly a year apart from each other. Interestingly, for the first time, I've also had on-and-off symptoms of trigger finger with this round of the injury (wake up and finger will snap alarmingly before moving freely). Thankfully, that aspect has subsided but the joint pain remains.

Let me know your thoughts on what it could be and possible treatment avenues. Taping suggestions would be great - I've tried buddy taping without success and figure-8 taping as well. The best so far has been the weird U-taping with loose "railroad" tape on each phalange to keep the U in place.
Thanks!
-Matt

MattH wrote:It's gotten quite bad now (and I've got a trip planned) -Matt

But not bad enough to see a real doctor? Do you have health insurance?

I have seen very similiar pain several times(maybe not quite as severe though) but I have always treated it as immediately skip a couple of climbing workouts and gradually work back in. After skipping a workout or two it usually is lessened in intensity and as long as I continues to lessen I continue with easy climbing till pain is gone. Once pain is gone I feel free to go nuts again.

sorry I don't have more information, I am curious if anyone else knows more.

FrankPS wrote: But not bad enough to see a real doctor? Do you have health insurance?

Yeah, I do. I can still climb, but well below my normal ability on anything that aggravates it (and with a good deal of pain when it is aggravated), so I tried to push through without success. Mostly, I know the doctor's response is going to be to rest it, which I don't want to do for more than a week given the impending trip, and it's been a slow realization that active recovery isn't cutting it. I guess I'm looking to see whether other people have had this problem before and what it took for them to recover, as well as any suggestions for improving recovery rate.

Ice rest anti inflamitories and tape two fingers together for support. Rest is very powerful treatment

It could be a sprained ankle. Have you checked your ankles for sprains?

MattH wrote:Hi Mountainproject, I've got a puzzling finger injury for the armchair doctors. So far searching hasn't been very productive. I've had the same problem several times over the past three years (always on the RH side, and always either the ring finger or middle finger) and have never managed to figure out the root cause. It's gotten quite bad now (and I've got a trip planned) so I figured it was worthwhile to post now. Here are the symptoms: *Pain in PIP (1st) joint of middle finger *Pain on the sides of the joint *Worst when pressing with uneven distribution on joints (eg: more weight on 2nd pad than the fingertip pad, putting hands flat on floor in a pushup position - this one in particular hurts the worst) *Also bad with sideways movement (sidepulls, drive-by's and cross-throughs in particular. Gaston's aren't an issue). *Also feel pain when pressing below base of finger in palm (towards the palm past the big lump of the metacarpal where it meets the finger's base) *Aggravating climbing holds: uneven slopers, big edges, pinches, awkwardly positive crimps (where you have to slot your fingertip down towards the ground rather than crimping on the lip) *Totally fine climbing holds: small crimps, even-radius slopers and edges (except when moving laterally). Really, the comfiest holds are things like the small/medium metolius campus rungs. *Feels better when I tape the sides of my entire finger (in kind of a U shape) *Worse with big lateral movements, even on otherwise OK holds My current guess is a volar plate injury combined with a collateral ligament strain, but I'm interested to hear others' thoughts, especially if they've had similar symptoms. I find it strange that I've never had a pulley injury (to my knowledge) but have had this same injury three times now roughly a year apart from each other. Interestingly, for the first time, I've also had on-and-off symptoms of trigger finger with this round of the injury (wake up and finger will snap alarmingly before moving freely). Thankfully, that aspect has subsided but the joint pain remains. Let me know your thoughts on what it could be and possible treatment avenues. Taping suggestions would be great - I've tried buddy taping without success and figure-8 taping as well. The best so far has been the weird U-taping with loose "railroad" tape on each phalange to keep the U in place. Thanks! -Matt

Climbing friend,

Perhaps you may not be touching yourself so much.

You have two paired flexor muscles/tendons running to the digits. The flexor digitorum superficialis inserts just beyond the PIP joint and whereas the flexor digitorum profundus runs all the way to the end of the finger and inserts on your distal phalanx.

FDS flexes at the DIP whereas the FDP flexes more at the PIP joint

Could be FDS tendonitis with an unaffected FDP tendon?