Climbing hard with degenerative arthritis (fingers)

I've already read through this thread on Osteo arthritis, but I wanted to feel out opinions on my doctor's advise, and if it's possible/reasonable to keep climbing hard with it.

I'm 38, been climbing for 12 years and was just diagnosed with degenerative arthritis in my fingers.  I had some mild pain in my left ring finger, second knuckle that had persisted for 3~4 months.  Got an X-ray and that was that.  Arthritis in multiple joints, although so far pain in only the one.  I'm sure the others aren't far behind.

My fingers have taken a lot of abuse from climbing - lots of bouldering in the gym, campus board, climbing ~V7 and 5.13- outside.  My concern is the advise I was given by the doctor (hand specialist): he told me that the progression is slow, and that I could just keep climbing at my current level.  Aside from the usual pain management suggestions, all he offered was to consider reducing the duration of my climbing sessions. Does continuing to climb without modification seem like reasonable advise?  Should I be seeking a second opinion?

I know what's done is done  and there's no fixing it.  Right now I am less interested in managing pain, what I want is to do everything I can to slow the progression while still climbing as hard as is reasonable, maybe even get stronger.  What I don't want is to overdo it and not realize it until it's too late and I basically have to quit climbing or have a crippled hand.  Does regularly gym bouldering and campusing seem reasonable or is that insanity?  How much pain is a red flag?  Climbing at my limit brings me so much joy, I want to have that in my life for as long as possible...

Many climbers at that level would get the same diagnosis. But climbers often just have osteophytes and not much joint space narrowing (cartilage loss). So maybe not as scary as it sounds.

Maybe crimp less and progress more on strength/coordination problems?

Have you tried anti-inflammatory diets?

Cocoapuffs:  I think I’m in a fairly similar situation (similar age, climbing interests, diagnosis, etc.).  I have osteoarthritis and pain in the PIP joints of my two middle fingers.  I was bummed about the diagnosis but it hasn’t been as big a problem as I feared.  (The shoulders, elbows, tendons, pulleys, mental game, etc still feel like the factors that really limit progression . . . )  

Anyway, I haven’t had a big issue trying push my level, and I haven’t noticed any progressive degeneration or additional pain since the diagnosis.  But the following have been helpful:

• Less closed crimping, especially on indoor boulders, and more finger-strength training on the hangboard.  Max hangs in half/open crimp on the hangboard, even with a bunch of added weight, do not bother my knuckles.  More generally, I now try to climb open-handed has much as possible.  
• I climb less when it’s super cold out.  If I’m bouldering outside below freezing, I try to make sure it’s on slopers.
• In my experience, taping the knuckles helps.  

Hope that’s useful!  I think you should still try hard and push yourself.

I take natural anti-inflammatories every day.... have similar issues.   Since taking ( religiously ) for years.... the latest x-rays show no worsening !!    And I climb crack alot more.    So... glucosimine
 with chondroitin ..... fish oil.... turmeric ....  lots of virign olive oil....     Pain is not good... and try not to ignore it!!!     You can be really tough.. then crippled.    And whatever you can ice afterwards is awesome.
 
rock on

Yeah why me too? I have had it since mid 30’s and now I am 50 :( So it steadily gets worse as all knuckles enlarge. Open hands is essential. Glucosamine and anti inflammatory medications. I am now getting PRP injections into worst knuckles and helps a lot. Ps climbing at my limit for all of 27 years now 

Every case may be different, but I've been told that in general arthritis does not mean inflammation.
I have osteo-arthritis, and the doctor detected no indication of inflammation in a blood test. An anti-inflammatory pain killer helps me, but that is probably due to its effect on pain, not inflammation. Have you asked your doctor if there is any sign of inflammation?

I may be lucky in that my case is with my hips, in which effective surgery is possible. Sorry to hear that you have it in your fingers. Keep working with your doctor and trying new things. I tried a few things suggested by my doctor without luck, so I have settled on surgery. None of the doctors I talked to said anything about diet, instead suggesting that genetics play the greatest role.

Good luck-

I'm quite a bit older, but have been dealing with osteoarthritis in my hands, back, knees and ankles for decades.

My advice: crimp less, jam more.  Except for stuff like rattley finger cracks, cracks keep me climbing. Crimps make me cry :( 

If somebody should still be following the thread, I just found this blog from another climber:

http://ronnybirchler.blogspot.com/2013/03/
http://ronnybirchler.blogspot.com/2013/04/

His also had arthritis, but the outcome sounds pretty optimistic.

Thanks for the feedback guys, and the blog (maybe I will email him and see how he is doing...)  I will obviously be trying things to minimize damage and pain.  It might just be placebo but finger massager seems to help when it is a little stiff.  I just got through a 2week trip of climbing hard and it feels better than when I was diagnosed.

One thing I will probably ratchet back a bit is gym bouldering, which is probably the worst.  Shorter sessions and replace one day a week with hangboarding.  It sucks because the hangboard is so boring but I agree it is lower impact.

late to the party, but the same thing just happened to me... dr told me today that i have joint space narrowing in my middle fingers (cartilage loss?).I would love to hear an update Cocoapuffs and/or Conor Clark if you guys still climb and what your experiences have been in the last couple of years?

Hi Ben,

I am still climbing.  The biggest changes I made were to shorten my gym sessions (which were way too long) and work on my technique, especially campusing so that I am not repeatedly smashing my fingers into the wall.  Once I did that I saw immediate improvement.  I try to warm up my fingers well before climbing (portable hangboard outside is great).  Another thing I stumbled on when rehabbing an unrelated finger tweak is to do very light hangboarding on 'rest' days.  Just enough to get the blood flowing (again, portable hangboard very useful).  I do take glucosamine but no idea if it does anything.  There is a chance that it slows further degeneration.

If you have the option I highly recommend seeing a doctor familiar with climbing.  Non climbing doctors tend to be completely useless beyond answering yes/no to if there is joint degeneration.  (Unfortunately not an option for me in Ohio).

Thanks for the update Cocoapuffs, that's given me hope for the future ... and youre still able to campus board?!? that's amazing. 

does that mean you no longer have any pain in your joints so long as you keep up with the rehab/prehab and limit the volume? i.e. if there is any pain or stiffness the day after a session, that means the session was too much? 

I booked an appointment with a climbing doctor... while i wait for that I guess I'm gonna work on my slab technique...

Benjamin Twistwrote:

Thanks for the update Cocoapuffs, that's given me hope for the future ... and youre still able to campus board?!? that's amazing. 

does that mean you no longer have any pain in your joints so long as you keep up with the rehab/prehab and limit the volume? i.e. if there is any pain or stiffness the day after a session, that means the session was too much? 

I booked an appointment with a climbing doctor... while i wait for that I guess I'm gonna work on my slab technique...

I did quit campus board for awhile but this past year I started to try it again as part of a finger rehab program I was given (unrelated to arthritis, at least I think).  I started with feet on foot chips to work on my technique.  I am not throwing as far as before and trying to have more control so I don't just slam my fingers into the board.  I am using the small rungs and so far so good.  Soon I am going to try full campus (no feet), we will see how it goes.

As far as actual climbing, If I push hard I may feel more stiff the day after but there is rarely any pain, and it is less than 1/10 if there is any.  But I try to stay aware and be careful.  If my joints start feeling hammered during a gym session, I stop.  If my fingers feel persistently really stiff even on days off I will end sessions earlier and/or not push as hard.  I also follow the usual mantra that if I get tired to the point that my technique starts getting sloppy, I stop.  Just as a snapshot I just finished a 3 week climbing trip with a lot of time spent on 5.12 to 5.13- which is pretty much my limit right now. My last climbing day was 2 days ago, and yesterday and today my fingers fell a little stiff but very minor, and zero pain.,

But again this is all without a doctor's advice or feedback - I am kind of winging it.  Am I doing enough?  Am I being too conservative?  It's hard to say.  It's possible I was overreacting and there was never much damage to start - my doctor was very vague on how acute my situation was and could not give any advice on how quickly it might progress.  At some point if I find myself in Boulder or SLC with time to spare, I may try to see a climbing doctor.  Maybe post how your appointment goes.

hi cocoapuffs,
I wanted to give an update since i have now been to a climbing/hand specialist doctor.

he took one look at my x-ray and ultrasound and immediately pronounced i don't have arthritus. in fact he says i have nothing wrong except for some "over-use" of the fingers, whatever that means. That is super good news for me, but should also give hope to other people in a similar situation because my first doctor (hand specialist but didnt know anything about climbing) was sooo clear that it was arthritus. i even asked him if there was any doubt to the diagnoses and he said he was "100% sure". Additionally my own observations of my symptoms, e.g. stiffness and pain in the morning, kind of fit with everything i read about arthritus so the diagnosis seemed plausible. Moral of the story: If it looks like a duck, swims like a duck, and quacks like a duck, then it maybe is a duck, but also go see a specialist just to be sure!

the specialist said it should clear up with 6-12 months of "not climbing too hard", collagen suppliment should help, warming up the fingers thoroughly should help, and open-hand grip should be better

Benjamin Twistwrote:

first doctor (hand specialist but didnt know anything about climbing) was sooo clear that it was arthritus.

What kind of arthritis?

• Osteoarthritis.
• Rheumatoid Arthritis.
• Psoriatic Arthritis.
• Gout.
• Lupus
• Something else?

I suspect that "some over-use of the fingers" can also be called arthritis.

Do you drink/smoke(including weed, amazing how many people consider weed a health-food product) and otherwise eat an unhealthy diet? You can slow the process dramatically if you make lifestyle changes.

I've been climbing for 12 years also, I'm 30, I boulder V10 and climb 5.13, campus, hangboard, train constantly. I've injured every single finger on both hands probably multiple times. I recently had an MRI on my left hand and the doctor commented that I had much higher bone density then the average person and "very healthy" joints. I am 8 years younger than you, but there are many strong climbers who are many years older(and much stronger) than you without similar problems. Unless you're genetically pre-disposed, the only reason you'd have arthritis from climbing at such a young age is due to an improper diet/nutrition for your amount of training/climbing. 

If your diet really is squared away, and you're not genetically pre-disposed, get a second opinion. 

Eric, can you elaborate on diet?

Dragging this thread back up for an update:  I have been climbing for a few years now since my OP and haven't had much issue, except the finger joint in question does occasionally feel a little stiff.  Then I got Covid this past August.  A few days after I first got sick the same joint started aching again - and I had not been climbing or doing much besides sitting on my ass at home.  After I more or less recovered (although still feeling a little weak) I started cautiously climbing in the gym.  The joint still had some nagging pain (like 0.5 out of 10) but less than when I was sick and doing nothing.  I thought that moderate activity was helping it.  After a few weeks there was almost no pain and at this point I wasn't taking any Aleve, etc

A couple weeks later I went to the Red and tried a hard route that I have been gunning for - lots of sloping pinchy holds - and that immediately sent my finger downhill - after the second attempt pain was up and I called it quits for the weekend.   At this point Fall was getting close and I went into emergency rehab mode - very low volume of climbing, cautious hangboarding, the ice bath/heat thing... and what climbing I did was quasi-static and very controlled.  Again it seemed to slowly improve but still still a little flared up.  I did my planned week-long trip at the Red this past week, but only climbed every other day and limited hard climbing to only 1-2 burns per climbing day.  Despite this, by the end of the week it again seemed to be going downhill.  Now yesterday at the gym I tried a couple hard moves and it hurts.

I mentioned it to a (non-climber) doctor on a routine checkup and they said Covid can cause inflammatory response in seemingly random and very specific places.  But they cautioned me that there was probably an underlying issue and not to blow it off as phantom pain.

Anyway, I have one more trip coming up over Thanksgiving and at this point I am beyond frustrated.  After several years of battling other injuries that partially hosed my climbing goals, to have this happen now is super discouraging.  And while the acute inflammation will (hopefully) go away eventually, I doubt it will be in the next 2 weeks. And it's a reminder that I am likely to have more trouble in the future - on a longer term/permanent basis.  Not sure if I should just say screw it and climb my ass off of the rest of fall.

Anyway, I am more venting frustration than asking for advice.  Perhaps will see if there is a hand doctor in Lexington that knows climbing, that I could visit on a rest day (no one like that in Columbus where I reside), which would at least be a good reality check.

Cocoapuffs 1000wrote:

Dragging this thread back up for an update:  I have been climbing for a few years now since my OP and haven't had much issue, except the finger joint in question does occasionally feel a little stiff.  Then I got Covid this past August.  A few days after I first got sick the same joint started aching again - and I had not been climbing or doing much besides sitting on my ass at home.  After I more or less recovered (although still feeling a little weak) I started cautiously climbing in the gym.  The joint still had some nagging pain (like 0.5 out of 10) but less than when I was sick and doing nothing.  I thought that moderate activity was helping it.  After a few weeks there was almost no pain and at this point I wasn't taking any Aleve, etc

A couple weeks later I went to the Red and tried a hard route that I have been gunning for - lots of sloping pinchy holds - and that immediately sent my finger downhill - after the second attempt pain was up and I called it quits for the weekend.   At this point Fall was getting close and I went into emergency rehab mode - very low volume of climbing, cautious hangboarding, the ice bath/heat thing... and what climbing I did was quasi-static and very controlled.  Again it seemed to slowly improve but still still a little flared up.  I did my planned week-long trip at the Red this past week, but only climbed every other day and limited hard climbing to only 1-2 burns per climbing day.  Despite this, by the end of the week it again seemed to be going downhill.  Now yesterday at the gym I tried a couple hard moves and it hurts.

I mentioned it to a (non-climber) doctor on a routine checkup and they said Covid can cause inflammatory response in seemingly random and very specific places.  But they cautioned me that there was probably an underlying issue and not to blow it off as phantom pain.

Anyway, I have one more trip coming up over Thanksgiving and at this point I am beyond frustrated.  After several years of battling other injuries that partially hosed my climbing goals, to have this happen now is super discouraging.  And while the acute inflammation will (hopefully) go away eventually, I doubt it will be in the next 2 weeks. And it's a reminder that I am likely to have more trouble in the future - on a longer term/permanent basis.  Not sure if I should just say screw it and climb my ass off of the rest of fall.

Anyway, I am more venting frustration than asking for advice.  Perhaps will see if there is a hand doctor in Lexington that knows climbing, that I could visit on a rest day (no one like that in Columbus where I reside), which would at least be a good reality check.

Hey C,

I'm your age and started climbing at 22. I too have had numerous finger tweaks and had the same arthritis diagnosis (in multiple fingers) after getting imaging done for an unrelated tear of a collateral ligament in one of my fingers. I know many others with the same arthritis diagnosis. Everyone just climbs/trains through the pain. If you're trying to get near your potential/limit, you're going to feel ache. I say I normally have pretty stiff fingers. I try to incorporate a deload week when things feel extra stiff/tweaky. I dont really take extended time away from climbing though and I'm still able to climb at near my personal bests. Obviously everyone is different and I dont want to minimize what you're going through but if it's mild pain, I dont think it means you should stop climbing. I know plenty of older crusty dudes that climb through pain/hideous looking fingers and they're still getting after it despite some mild pain. I've noticed taking turmeric helps when I'm training a lot. Never noticed much when taking glucosamine/chondroitin. Good luck! If you push through let us know how it goes.

Cocoapuffs 1000wrote:

Eric, can you elaborate on diet?

I can.

I was diagnosed with arthritis in both knees in my late 20’s (I’m almost 50 now), and then my ankle after a bad fracture. Somewhere along the line it showed up in my fingers.

A few years ago I really though my climbing was coming to an end with all the joint pain I had. I was really desperate and did a lot of research (I’m a master’s-prepared nurse).

I found out that everything I knew about osteoarthritis, even as a nurse, was all wrong. A lot of health care providers still believe in old, outdated science when it comes to osteoarthritis. The word is starting to get out and things are changing but we still have a way to go. Even the term 'degenerative arthritis' is an archaic one.  

The key driver of osteoarthritis, and most of the pain of osteoarthritis, comes from inflammation. Our lifestyle choices can either fight or fuel this inflammation. Diet is a big part of it. Certain foods like sugar, flour, meat – and especially processed meat, excessive alcohol, trans fat, too much saturated fat – can all increase inflammation systemically in the body which then increases inflammation at the joint level and can increase pain and aggravate other symptoms. Other foods, like vegetables, fruits, fatty fish, olive oil, whole, intact grains can lower inflammation.

Other ways to manage inflammation are getting daily exercise, managing stress, getting sufficient sleep, and maintaining a healthy weight (excess body fat increases inflammation).

 All this made a huge difference for me. I don’t even notice my fingers anymore and my knees and ankle are greatly improved – better than I ever thought they would be again.

Supplements and NSAIDs can also help but work much better if you are living (what I call), an inflammation-fighting lifestyle. I take a daily NSAID mainly for my ankle. The over-the-counter stuff is useless – prescriptions NSAIDS like Celecoxib, Meloxicam, and Diclofenac have been shown to be much more effective for OA pain than any oral meds available over the counter. However, for a finger it may be better to try diclofenac gel which is available over the counter. It works much better when applied consistently as directed and can take a few days until you notice any effect.

This was so enlightening for me and there is such a need out there that spreading the word and educating others with osteoarthritis had become my passion. I share a lot on my Instagram profile @arthritishealthcoach. I also have a course coming out soon. Happy to answer any questions.