Anyone know a good physiotherapist for climbers hands? Seemingly bad injury underway :/

I injured my right hand two days ago and I'm hoping that someone has the name of a physiotherapist or other specialist with climber specific hand knowledge. Obviously given these times I would be open to a zoom consultation. I live in the Gunks in NY and would also be willing to drive for an in person consultation in available.

For reference, I was cranking on a vertical two fingerlock pocket and felt some intense pain (general in my ring finger) afterward. The pain felt bad and I was worried but it went away pretty quickly. But I woke up in the middle of the night with terrible aching in my hand. Now my pinky and ring fingers are sore, my palm is sensitive, the meat of my thumb is sore and feels bruised, and the muscle on my forearm on either side of my elbow are very sore. I injured the lumbrical on my right hand from pinky dropping about 18 months ago and it recovered with buddy taping and continued climbing in about 3 months. This feels a good bit worse.

Thanks for taking the time. I'm hoping to get some answers and move past this injury as soon as possible.

• Hand therapist here but on the west coast. You can easily look up a local hand therapist if they are member of ASHT. https://www.asht.org/find-a-therapist That is the link! Hope that helps. You can also look up a certified hand therapist here: https://www.htcc.org/find-a-cht 

Sydney F wrote:

• Hand therapist here but on the west coast. You can easily look up a local hand therapist if they are member of ASHT. https://www.asht.org/find-a-therapist That is the link! Hope that helps. You can also look up a certified hand therapist here: https://www.htcc.org/find-a-cht 

Thank you so much, Sydney. Definitely a resource worth having as a climber. The injury actually seems to have improved dramatically with some rest, collagen, and tons of massage.  

Awesome! Glad to hear that! Soft tissue work is the best thing you can do! The flexor tendons (FDS and FDP) all attach at the medial epicondyle so i was wondering if you overworked the area. If it was nerve usually you have some numbness/tingling (but not always). You can always stretch out that area by straightening the elbow and bending the wrist up and down for a stretch. Happy healing!

Sydney F wrote: Awesome! Glad to hear that! Soft tissue work is the best thing you can do! The flexor tendons (FDS and FDP) all attach at the medial epicondyle so i was wondering if you overworked the area. If it was nerve usually you have some numbness/tingling (but not always). You can always stretch out that area by straightening the elbow and bending the wrist up and down for a stretch. Happy healing!

Sydney! I think you are correct! 

I realized today that I'm experiencing a dull ache in the medial epicondyle area when I do pull ups, no matter the hold size. This seems to be my only remaining symptom and I only experience this ache when at the peak of the pull-up. Do you think climbing would be a terrible idea at this point, 10 days out from injury? I certainly don't want to make it worse. Seems like Nicros ( nicros.com/training/treatin…) recommends a lot of rest for this injury but mine didn't swell or bruise and was only sore to the touch for a couple of days. Bummer! I wish I had just torn my lumbrical, could buddy tape and be done with it!

Stephen Bittner wrote:

Sydney! I think you are correct! 

I realized today that I'm experiencing a dull ache in the medial epicondyle area when I do pull ups, no matter the hold size. This seems to be my only remaining symptom and I only experience this ache when at the peak of the pull-up. Do you think climbing would be a terrible idea at this point, 10 days out from injury? I certainly don't want to make it worse. Seems like Nicros ( nicros.com/training/treatin…) recommends a lot of rest for this injury but mine didn't swell or bruise and was only sore to the touch for a couple of days. Bummer! I wish I had just torn my lumbrical, could buddy tape and be done with it!

Honestly if you have an ache with pull ups then i would give it another week off. You can challenge the area with some wrist weights for strengthening (three directions palm up, palm down, and thumb up). Definitely rub the forearm out and that area at the inside of the elbow. I usually will do astym (use of tools) over both sides of the forearm. Plenty of stretching too (elbow extended with palm down use your other hand to pull wrist back for stretch). Other things to consider is strengthening the middle/lower traps and shoulder stability just in case you are compensating and putting more load on the flexor tendons/pronaters. Hope that helps!

Sydney F wrote:

Honestly if you have an ache with pull ups then i would give it another week off. You can challenge the area with some wrist weights for strengthening (three directions palm up, palm down, and thumb up). Definitely rub the forearm out and that area at the inside of the elbow. I usually will do astym (use of tools) over both sides of the forearm. Plenty of stretching too (elbow extended with palm down use your other hand to pull wrist back for stretch). Other things to consider is strengthening the middle/lower traps and shoulder stability just in case you are compensating and putting more load on the flexor tendons/pronaters. Hope that helps!

Wow, Sydney thank you so much for the advice. Very kind of you to offer it; know that it is gratefully received. I think pretty much everything you've said is accurate. I recently saw some large improvements in my bouldering and now my muscles are super out of whack, so I'm sure the imbalances are severe. I'm going to start the strengthening tonight and see how it feels after a week.

Stephen Bittner wrote:

Wow, Sydney thank you so much for the advice. Very kind of you to offer it; know that it is gratefully received. I think pretty much everything you've said is accurate. I recently saw some large improvements in my bouldering and now my muscles are super out of whack, so I'm sure the imbalances are severe. I'm going to start the strengthening tonight and see how it feels after a week.

Awesome best of luck! The body is a mystery so it’s fun to problem solve! Happy climbing! 

Even I am a 35-year rock climber with a naturally athletic build. But a few months before my left wrist was popping and grinding, and my fingers were so painful that I had to put a brace on it. Even opening and closing my hand caused a lot of pain in my tendons; the pain increases if I overextend my fingers. Icing the wrist helped for some time, but it didn't help my forearm in the slightest bit. My physiotherapist diagnosed it as the carpal tunnel syndrome, which is a repetitive sports injury. I used the BFST wrap, which promotes blood flow that, in turn, heals damaged tendons; I also used a compression bandage. Later, my therapist recommended ultrasound therapy and carpal manipulation, which treated me. I don't know if these would work for you, but perhaps you should try finger wrapping and bandages for the meantime. Maybe you should go through a list of the best-certified therapists in NY(https://www.yelp.ca/search?find_desc=Certified+Hand+Therapist&find_loc=New+York%2C+NY), hope it helps!

Dr. James Lee PT, DPT, FAAOMPT
Doctor of Physical Therapy
Fellow, American Academy Orthopaedic Manual Physical Therapists

Fax (866) 722-3137

james@leeptchicago.comwww.leedpt.com
Follow me on Facebook  Instagram

Josh Rappoportwrote: Dr. James Lee PT, DPT, FAAOMPT
Doctor of Physical Therapy
Fellow, American Academy Orthopaedic Manual Physical Therapists

1925 N Clybourn Ave #302, Chicago, IL 60614
Work (847) 957-3137Fax (866) 722-3137

james@leeptchicago.comwww.leedpt.com
Follow me on Facebook  Instagram

He is a great physio and SUPER strong climber as well

Helped me in person and remotely with several issues

revans wrote: Can you hold a water bottle in that hand? If not get help or prepare for several month recovery 

Now, I can use my hand without issue, but in a few very specific positions the pain is severe and triggered with very little force. When climbing with my pinky and ring finger buddy taped, there is a general sensation of discomfort and it feels very "off". Really hoping that I'm not looking at a several month recovery. But i guess summer is the best time for one if it were necessary,

Josh Rappoportwrote:

He is a great physio and SUPER strong climber as well

Helped me in person and remotely with several issues

Thanks Josh! I actually made a remote appointment with him for Monday, It will be nice to speak with someone with such climber specific knowledge.

Steve Clarkwrote: Even I am a 35-year rock climber with a naturally athletic build. But a few months before my left wrist was popping and grinding, and my fingers were so painful that I had to put a brace on it. Even opening and closing my hand caused a lot of pain in my tendons; the pain increases if I overextend my fingers. Icing the wrist helped for some time, but it didn't help my forearm in the slightest bit. My physiotherapist diagnosed it as the carpal tunnel syndrome, which is a repetitive sports injury. I used the BFST wrap, which promotes blood flow that, in turn, heals damaged tendons; I also used a compression bandage. Later, my therapist recommended ultrasound therapy and carpal manipulation, which treated me. I don't know if these would work for you, but perhaps you should try finger wrapping and bandages for the meantime. Maybe you should go through a list of the best-certified therapists in NY(https://www.yelp.ca/search?find_desc=Certified+Hand+Therapist&find_loc=New+York%2C+NY), hope it helps!

Interesting! I am definitely dealing with a more acute injury that happened at a very specific point in time, but my wrist actually has been grinding and uncomfortable for a little less than a year at this point.