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A4 Pulley Tear

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Orphaned · · Unknown Hometown · Joined Jul 2007 · Points: 12,060

Alright, I know there are a bunch of these up right now, but here's another.

I have been seeing a hand therapist for 2 weeks for what I have been told is a "partial" tear of my A4 pulley. I haven't been climbing since March 6th (aside for 1 squeeze chimney and 1 easy boulder problem). When the pulley tore, it made a very loud popping sound. It echoed and was picked up clearly by a camera 100ft away. There is no visual bow stringing (1 study reported that visible bowstringing not obvious until 2 or more pulleys fully rupture). I had an MRI that showed a lot of inflammation suggesting a possible partial tear, but was fairly inconclusive.

I am doing all I can so I am not looking for tips on how to heal (unless you have a magic cure). What I want to hear are some other people's healing timelines. I have guiding work lined up for the whole month of June and I need to start figuring out if I am going to be able to work.



James Glover · · Boulder, CO · Joined Apr 2008 · Points: 5

I am an advocate of more rest than you may hear otherwise.

Anecdotal observation of my climbing partners rushing back to climbing and re injuring their finger or often injuring other fingers makes me glad I rested longer.

In April of 1996 I had a similar injury, ring finger of my left hand. I did not climb for 90 days. I did hit the weight room that entire time and when I started climbing again I picked up essentially right where I left off. More importantly I have not had any problem with that finger since.

I know that doesn't sound very good for your work schedule and 90 days is a long time. That's just my experience; I for one am glad I rested that long and have never worried about that injury again.

Good luck

Will S · · Joshua Tree · Joined Nov 2006 · Points: 1,053

Only had one A4, but have had a total of 11 A2s over a 20 year climbing career.

Longest time to full strength and no pain ~ 18mo
Shortest ~ 3mo.
Avg ~ 5-6mo
A4 was in my pinky and also did A2 at the same time. ~4mo

JJNS · · Unknown Hometown · Joined Sep 2008 · Points: 455

The camera picked up the pop from 100ft away? No way.

Kevin Landolt · · Fort Collins, Wyoming · Joined Jun 2009 · Points: 585

Don't be a pussy, climb through that shit!

Charles Kinbote · · Brooklyn, NY · Joined Jan 2012 · Points: 5

Tomorrow will be exactly 10 weeks since I strained my left ring finger A2 pulley. It sounds like your injury was much more severe than mine. When I hurt my finger, there was no audible pop, I just felt something "give" a little, followed by a twang of pain near my knuckle. Anyway, I followed the Dave MacLeod guidance (he advocates a short layoff) and here's my timeline/advice:

1 week of complete rest for the finger. I didn't even do the dishes (begged and bribed my girlfriend).

Weeks 2-3: I did active range of motion exercises, and after doing them without any pain for a week started squeezing the putty.

Weeks 4-6: I started climbing again, but climbing basically sucked. You definitely can't crimp anything. Hell, you can't even open-hand holds aggressively, and you need to be careful you don't apply direct pressure to the pulley when climbing jugs. Much restraint is needed...if you try anything hard you WILL get re-injured. Be precise with your hand placements and carefully load them. We're talking 2+ number grades, or 3+ V grades under your limit.

Weeks 7-8: You can do a bit of 1/4 crimping (pointer and pinky finger in open position, middle and ring finger in a wide open crimp), and eventually open or 1/2 crimping on easy routes and boulder problems. Still, no hard stuff and my climbing was quite limited.

Weeks 9-10: Open crimping is slowly becoming more comfortable, especially on routes near vertical where much weight can be supported by the feet, but the finger will still feel weak on overhanging terrain. Hard-ish climbing is possible so long as the rock doesn't require hard crimping with the injured finger. Last weekend I did my hardest route so far this year (on a TR, lol), and last night I flashed my hardest indoor boulder problem to date...but neither of these climbs required hard crimping with my left hand.

Right now I feel like it could easily take another 6-8 weeks, maybe more, until I'm able to crimp hard with my injured finger (and put it out of mind). I'm quite happy with my recovery so far, and believe I've been able to come back faster from this pulley injury than from others by stimulating the injured tissue with easy climbing throughout the rehab process. Of course, I don't have a clone who approached the injury with a 2-3 month layoff, so we'll never know for sure.

Good luck! Sorry this post got so long, lots of coffee this morning!

Guideline #1: Don't be a jerk.

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