Help!!!!! Lump in palm, possible pulley injury? or Dupuytren's?

The lump in my hand never went away completely, but it shrunk somewhat, and I no longer have pain from holds that press into it. It gradually got better for me over a few months. Doesn't seem to be Dupuytren's, probably was a muscle strain/sprain. Collagen supplements may have contributed? I'm still not sure, but I think it may thicken when I take collagen supplements (I take them for finger injuries). I do have a permanent hand taco that I'm fairly confident did not exist prior to the acute injury. I've stayed away from the climb that caused the injury, and I have not had a reinjury from other climbs. Overall, seems more minor than finger injuries except the permanent lump is kind of a cosmetic bummer. 

Currently, nursing a partial hamstring tendon tear from heel hooking. Low on the pain scale but by far my worst climbing injury (over 3 mos out and still can't lead climb or hike uphill).

Anja wrote: I have something similar going on, it started about a month ago from pulling on a pocketed 12c. I came down and my palm hurt and there was a lump in line with my ring finger. I thought it was a lumbrical muscle strain, but it hasn't gone away. It swells up from climbing, but after a few days of rest the swelling mostly dissipates, but the smaller thick tissue lump remains. It hurts on sharp holds that press into it, but otherwise seems ok.

It seems like there's a thickening of the cords in my hand, consistent with dupetryns, but the sudden onset and swelling associated with climbing suggest something else. Had it looked at by a hand surgeon and a PT, the surgeon said lumbrical muscle strain the PT said dupetryns. I stopped taking collagen supplements in case it's dupetryns and in case that helps?

I did some gentle loading of the lumbrical muscle by raising and lowering a light weight with my ring finger and that caused it to swell extensively, far more than a day of climbing. (The PT said not to do that). Buddy taping of ring and pinky while Climbing was another thing that I tried, but it didn't seem to have much effect. Curious what the long term state of this injury is like.

The picture below is when it's in the not so swollen state.

Mine looks identical to yours. Mine popped up overnight after a day of lifting rice bags full of rocks, grabbing the heavy bags by the scruff with my fingers (I don't just climb rocks, I study them as well :p). Seems a similar kind of heavy loading on the fingers that you'd experience pulling pockets. Just had an ultrasound yesterday and the Dr suggests it's Dupuytren's, but similar to your story, the onset was incredibly rapid, which doesn't make a lot of sense. No limitations in use or pain associated, but the lump also hasn't changed in 2 months. Has anything changed in your case?

This thread was super helpful, all. I used to climb more often (just an indoor gym) and have been rowing this past year. I thought it might have been related to it, and do think it is, but finding a name for it and seeing your descriptions is really helpful! Seems to be exactly what’s going on for me. Thank you! 

Same exact thing for me in both hands. Doctors say its Dupuytren's but onset was acute and happened almost overnight after hard climbing. Been that way for a few years now with no progression or regression. No pain or range of motion issues. It's a mystery for now.

Looks like I have the exact same lump develop on my left hand after a hard gym bouldering session. Mine is less pronounced than in the picture and seems to soften with a firm massage. Has anyone had a definitive diagnosis and remedy?

Never had a definitive diagnosis, my doctor said to massage it, and that it wasn't a cause for worry. I also did a lot of hand physical therapy for a different reason. I have climbed quite a bit more since this happened and the bump I had gradually got smaller and seems to be entirely gone now. 

Noah Balmer wrote:

Never had a definitive diagnosis, my doctor said to massage it, and that it wasn't a cause for worry. I also did a lot of hand physical therapy for a different reason. I have climbed quite a bit more since this happened and the bump I had gradually got smaller and seems to be entirely gone now. 

Thanks for getting back with a response, it's honestly quite reassuring. I climbed yesterday and it wasn't noticeable and I have full power so I'm just going to carry on climbing massage regular as I suspect it's scar tissue.

Thrillington wrote:

Mine looks identical to yours. Mine popped up overnight after a day of lifting rice bags full of rocks, grabbing the heavy bags by the scruff with my fingers (I don't just climb rocks, I study them as well :p). Seems a similar kind of heavy loading on the fingers that you'd experience pulling pockets. Just had an ultrasound yesterday and the Dr suggests it's Dupuytren's, but similar to your story, the onset was incredibly rapid, which doesn't make a lot of sense. No limitations in use or pain associated, but the lump also hasn't changed in 2 months. Has anything changed in your case?

Sorry for the late response, I only had "notify me on the site" checked, and I don't access mtn project often from my computer. 

The lump in my hand has shrunk a lot from when I first injured it, but it's still there.  Never did find out exactly what it is, but I doubt it's dupuytren's since it has only improved. I'm wondering if taking a lot of collagen supplements could've contributed?  I was taking 2-3 scoops/day around the time of this injury. But I'm not sure. Stayed off the original injury provoking climb, and haven't had a re-injury. It is no longer bothered by sharp holds poking into it either, so pretty much no symptoms at this point. But it's easy to feel the extra thick band there with my other hand, and it's still visually noticeable, just less pronounced. 

How has your recovery been going?

Since this is another thread about Dupuytren's - saw this reasearch -

https://www.medpagetoday.com/rheumatology/generalrheumatology/98527 

A drug already on the market for 20 years effectively reduced nodules associated with Dupuytren's disease in a mid-stage trial, researchers said.

Patients receiving intranodular injections of adalimumab (Humira) showed significant declines in nodule hardness and volume over 18 months, whereas these remained stable or increased in a saline-treated control group, reported Jagdeep Nanchahal, MBBS, PhD, of the University of Oxford in England, and colleagues.

Nodule hardness as measured with a standard durometer decreased from 63 to 55 AU in the 70-patient adalimumab group, versus almost no change among the 70 controls (61 AU at baseline and 60 at 18 months), according to the researchers' paper in Lancet Rheumatology.

Adalimumab-treated nodules shrank in area from 28 to 18 mm3, while those injected with saline grew from 32 to 34 mm3. Nodule height also decreased with adalimumab by 0.9 mm; there was no change on average in controls.

Ernie Port wrote:

My advice to anyone noticing lumps, cords or both is to see a hand specialist immediately.  When caught early, lesser invasive procedures can correct the condition.  And potentially prevent what I went thru.

amarius wrote:

Since this is another thread about Dupuytren's - saw this reasearch -

https://www.medpagetoday.com/rheumatology/generalrheumatology/98527 

I'd say yes... go see a specialist. But... I've seen three of the "best" in the SF Bay Area and they all told me the same thing: Don't do anything. Treatment will make it worse. If you aren't experiencing any contracture of your fingers, then surgery will make it worse. And injections will make it worse. So really... forget about the bumps and just get on with your life until your fingers start to curl. And then you can do something about it. Because again... if there's no curling, then treatment will exacerbate things (including those injections).

I suffer from the exact same thing described in this long thread— a small nodule on the tendon about 3cm below the webbing between my pinky and ring fingers! It came on acutely after I followed the first pitch of Serenity Sons about 4 months ago, and I noticed it immediately as I got to the belay. Since then, I've been climbing on it and it hasn't gotten any worse or any better, except for juggy dynos that cause the palm of my hand to grind against the hold right where this nodule is located. It's nice to know that this seems to not be a terrible issue for many of us who suffer from it, but it certainly is a mystery! Is it really Dupuytren's?

Thomas Dietert wrote:

I suffer from the exact same thing described in this long thread— a small nodule on the tendon about 3cm below the webbing between my pinky and ring fingers! It came on acutely after I followed the first pitch of Serenity Sons about 4 months ago, and I noticed it immediately as I got to the belay. Since then, I've been climbing on it and it hasn't gotten any worse or any better, except for juggy dynos that cause the palm of my hand to grind against the hold right where this nodule is located. It's nice to know that this seems to not be a terrible issue for many of us who suffer from it, but it certainly is a mystery! Is it really Dupuytren's?

I have my doubts about it being Dupuytren's because like your situation, onset was rapid (almost instantaneous). For me, one minute it wasn't there, and then suddenly it is. The first time it happened in my right hand, I did a bouldering session after work one night and two hours later it was there. Same thing in left hand. Appeared over night. And then another bump in my right hand years later appeared almost instantly. I've seen a number of hand specialists and two say Dupuytren's. But a third initially said it was, but then after I pressed him about how rapid onset was and got an MRI, he said doesn't actually think it is Dupuytren's but has no other ideas.

FourT6and2 ... wrote:

I have my doubts about it being Dupuytren's because like your situation, onset was rapid (almost instantaneous). For me, one minute it wasn't there, and then suddenly it is. The first time it happened in my right hand, I did a bouldering session after work one night and two hours later it was there. Same thing in left hand. Appeared over night. And then another bump in my right hand years later appeared almost instantly. I've seen a number of hand specialists and two say Dupuytren's. But a third initially said it was, but then after I pressed him about how rapid onset was and got an MRI, he said doesn't actually think it is Dupuytren's but has no other ideas.

Go see a specialist!  I waited years before seeing a specialist.  Then when I did the specialist did full on double hand surgery requiring 60 stitches and major rehab!

It's a clinical diagnosis, based on the history of dysfunction and certain findings noted, on the physical examination. 

I have Dupuytren's nodules in both hands. Only one has contracted so far (left pinky) and I had surgery to fix it a couple years ago. One way to tell the if it is Dupuytren's rather than ligament damage is if the lump moves or is attached to the skin. Dupuytren's does not effect the finger ligaments but rather the palmer fascia. The palmer facia ancors the skin of your palm to the bones and keeps it from moving around. You can see this by putting a finger in the palm of your hand and push the skin around, it doesn't move very much. Try the same thing with the skin on your forearm and it will move a lot. So, if the lump seems to be attached to the skin, it is likely Dupuytren's.

My surgery seems to have fixed the one contracted finger and the condition seems stable. The scar tissue in my palm from the surgery can be bothersome and is irritated easily by even simple things like holding a steering wheel on a long drive. Not great for climbing but better than having the finger folded into my palm. Folded fingers don't work in hand cracks.

The cause of Dupuytren's is not clearly understood but my nodules have been unchanged since I gave up alcohol. Stretching may or may not help, I frankly don't know. Some say stretching irritates the problem making it worse. I do know that the only cord I tried to stretch is the only one that has contracted. My impression is that stretching amplified the contraction.

I came to this post a year ago with the same symptoms... sudden onset, lump, looks like Dupuytrens (even moves relative to skin/fascia in a similar way). However, it has seen gone down and doesn't bother me any more. I can still feel a tight tendon and some small 'lumps' but I haven't thought about it for a few months until I saw this post again.

I think a lot of these 'lumps' are small strains that heal themselves and a lot of the doctors Dupuytrens diagnoses are based on differential diagnoses with no knowledge of casual climbing injuries (strains in this part of the hand are probably extremely uncommon outside of climbing)

I've had a couple pea-sized growths pop up recently (in the last year or so) in my right hand. They're kind of annoying. Don't really hurt or anything, but they get in the way if I'm doing pull ups. No contraction (yet). knock on wood.