A2 Pulley Soreness

Hi All,

I've been having a constant soreness in the A2 pulley of my left middle finger. There was no particular moment when I remember injuring it. It isn't painful enough to stop climbing, but the following day after climbing at my limit I can feel a sharp pain when applying pressure to the area (but almost nothing while I'm actually climbing except for a full crimp).

I'm sure many have had a similar issue and wondering how you dealt with it. I climb about V6/7ish, 5.12ish on lead, and have yet to try any hangboarding routines.

I understand these things can quickly turn into a much worse injury so any advice is appreciated.

Thanks!

Rest is probably best but if you’re going to climb anyway try taping below and above the knuckle to stabilize the tendon.

I’m def no expert but that sounds like a partial tear, I’ve had similar issues intermittently. Avoid the hard crimping and slapping the middle of the digit against rock/plastic. Rest obviously wouldn’t hurt. Continuing to stress it could make for a longer recovery. I avoid ibuprofen generally but it helps with pain, not so much with recovery time, in my experience. Hope it heals up :3!

Dan Knisell wrote: Rest is probably best but if you’re going to climb anyway try taping below and above the knuckle to stabilize the tendon.

Not to be a Naysayer, but taping has been proven to be ineffective for pulley injuries, plus false confidence might cause you to push it too far.

Meow Sherwood wrote:

Not to be a Naysayer, but taping has been proven to be ineffective for pulley injuries, plus false confidence might cause you to push it too far.

Helps for me. Is there a study that has been done?

Ice and hot baths.   Fill a bowl with ice water and stand by your sink with warm/hot water running.  Do 30 seconds ice, 30 seconds hot, but after your 4th ice do only about 10 sec hot to end at closer to an ambient temperature.  Might as well do both hands because it will be good for the non-sore fingers also.  Plus it is more tolerable when your left is in ice and your right is in hot.  Also be opening and closing your fingers the whole time to help promote the blood flow.    THIS WORKS WONDERS AND IS GREAT NEARLY YEAR ROUND.

Dan Knisell wrote:

Helps for me. Is there a study that has been done?

Yes.  It is mostly shown to be a great placebo and it helps with proprioception.   To have the tape tight enough to actually support the tendons would cut off all blood circulation and do more harm than good.

Eric Carlos wrote:

Yes.  It is mostly shown to be a great placebo and it helps with proprioception.   To have the tape tight enough to actually support the tendons would cut off all blood circulation and do more harm than good.

The power of the mind I guess. I’ll take any edge I can get.

I'd be interested in reading that study if you know where one could find it! 

Eric Carlos wrote:

Yes.  It is mostly shown to be a great placebo and it helps with proprioception.   To have the tape tight enough to actually support the tendons would cut off all blood circulation and do more harm than good.

That's not quite true, here's a link to an expository summary of the findings. They found some efficacy depending on the taping method, but it also quickly reduced once the tape stretched out. However, in moral, you're correct. 

Thanks for the input ya'll. Has anyone had any experience with the following hangboarding rehab?

https://www.blackdiamondequipment.com/en_US/esther-smith-nagging-finger-injuries/esther-smith-nagging-finger-injuries.html

From their descriptions of the injury, I would fall into the "PHASE 2: Grassroots Finger Remodeling Program" section. They make it seem like you can keep climbing while doing it, which I have a hard time believing. But I'm not opposed to taking a couple weeks off and testing it out, combined with the hot/cold baths. 

Austin Martin wrote: I'd be interested in reading that study if you know where one could find it! 

Schweizer A. Biomechanical effectiveness of taping the A2 pulley in rock climbers. J Hand Surg. 1999;25(1):102–107.

https://www.ncbi.nlm.nih.gov/pubmed/10763736

 Warme WJ. The effect of circumferential taping on flexor tendon pulley failure in rock climbers. Am J Sports Med. 2000;28:674–678.

https://www.ncbi.nlm.nih.gov/pubmed/11032223

Zac Hummel wrote: Hi All,

I've been having a constant soreness in the A2 pulley of my left middle finger. There was no particular moment when I remember injuring it. It isn't painful enough to stop climbing, but the following day after climbing at my limit I can feel a sharp pain when applying pressure to the area (but almost nothing while I'm actually climbing except for a full crimp).

I'm sure many have had a similar issue and wondering how you dealt with it. I climb about V6/7ish, 5.12ish on lead, and have yet to try any hangboarding routines.

I understand these things can quickly turn into a much worse injury so any advice is appreciated.

Thanks!

Your best bet is to rest for a bit and then to do some hang boarding to try to remodel and strengthen the pulley. Plenty of stuff online for this kind of thing. See the Training Beta Podcast 76 for a nice explanation, although, that's in response to acute injury (a POP). 

Zac Hummel wrote: Thanks for the input ya'll. Has anyone had any experience with the following hangboarding rehab?

https://www.blackdiamondequipment.com/en_US/esther-smith-nagging-finger-injuries/esther-smith-nagging-finger-injuries.html

From their descriptions of the injury, I would fall into the "PHASE 2: Grassroots Finger Remodeling Program" section. They make it seem like you can keep climbing while doing it, which I have a hard time believing. But I'm not opposed to taking a couple weeks off and testing it out, combined with the hot/cold baths. 

Yes, this is correct. If you don't want to reference just a single source, see also Dave's outdated blog post or his book Make or Break.

Thanks for the help I'll give this a go!

http://onlineclimbingcoach.blogspot.com/2010/05/pulley-injuries-article.html?m=1