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

A few weeks ago I was bouldering in the gym and pulled pretty hard through a few crimps. My hand/fingers felt super strained when i came down, and i noticed that there was a small lump in the palm of my hand, about 3/4" below my ring & pinky finger. The pain went away within a few minutes, but the lump has been there for a few weeks now and the tendons in the palm of my hand where the lump is are slightly more visible than normal. I have full mobility and no pain at all, however my pinky finger feels really weak and shakes a bit..help! Can anyone tell me what i might have done? I've been researching for countless hours and all i can come up with is it might be a partial pulley tear, or Dupuytren's, but i'm a 30yr old female so i don't really fit that profile...Can i keep climbing if it doesn't hurt at all? I went to Red Rocks and bouldered hard the weekend after it happened and it didn't bother me, might have gotten slightly more swollen but thats it..

That looks exactly like Depuytren's Contracture, but your story leading up to it is puzzling. Depuytren's is chronic, not acute. Could it be that the lump has been there for a while but you only noticed it after straining your pinky flexor tendon?

Anyway, my left palm looks exactly like yours. I recommend stretching your pinky and ring fingers regularly. I tried massaging the lump for a few weeks but it only made it hurt and did nothing to reduce its size. The key is to maintain flexibility. With lots of stretching the bump will gradually get smaller. FWIW, this hasn't impacted my climbing at all, and it gives me something to do during staff meetings.

Thanks for getting back to me! It's possible the lump was there for awhile and i didn't notice it..although it seems to have just appeared after i strained it on the wall..
How long have you had Dupuytren's? Has it gotten any worse? Thats such a relief to hear it hasn't affected your climbing at all!
Maybe my pinky flexor tendon was strained and that's why it feels weak?

Go see your doctor!

Dupuytren - Your hand looks exactly like my hand. My incident happened a year ago on a relatively mild sports (10.b, big hold) climb at 40 years old. The key is to reduce the swelling, massage and stretching. The classic example is the finger is stuck in an odd position. Some people got surgery. I did not and finger is fine with only slightly perceptible stiffness.

I still can't wear my wedding ring.

youtube.com/watch?v=OaTO8_K…

Do you think it could be synovial fluid in my tendon sheath from too much stress on my fingers? It might very well be Dupuytren's, but since it came on acutely, and i'm a 30 year old female of italian descent, i don't really fit the profile at all..

kristenu wrote:It might very well be Dupuytren's, but i'm a 30 year old female of italian descent, i don't really fit the profile at all..

Dupuytrens can come on early. I was 22 when I first had a dupuytrens knot show up (although I am male and Norwegian, so other than age I definately fit the profile). Still age doens't exclude you from consideration.

That said, Dupytrens does go "pop" on a move and sudeenly show up; it is a slow onset thing, over the course of years, so the sudden arrival is a vote against. Also, there really should be zero pain associated with Dupuytrens.

Fortunately, if it is Dupuytrens, there is no hurry to do anything about it. Mine hasn't changed whatsoever since it first showed up.

Overall, altough the picture looks a lot like Dupuytrens, all of your descriptions point to something else. My guess is that it is something else.

Could be a lumbrical tear. Does it hurt when you load your ring finger in an open position w/ your pinky curled up?

Kristen, I had the exact same thing happen to the same place yesterday on my left hand, after I had read your post by chance. My hand looks identical to yours. I am not feeling any pain nor have I noticed any shaking of my pinky finger. I am positive that the lump was not there prior to my acute injury.

I think it is a lumbrial tear like Charles suggested. My hand is bothering me enough 36 hours later that I am going to see a specialist. I am at physical therapy all of the time for a torn bicep anyways. I have been icing the area with no decrease in swelling or pain. I was not climbing at the time of the injury. I felt a very sharp pain that came in two or three decreasing bursts and I knew I had really messed something up. I do not dare hanging with an open grip even on a bar with the pinky curled because I can already feel that maneuver will really hurt. I will post my results after I see a surgeon.

Sign me up too. I pulled on a stupid juggy/edge with a pointed corner at the gym on Sunday. The corner dug into my palm and when I came down I had a rather angry looking tendon extending from between my first and middle finger to the palm on my left hand--exactly like yours just a different spot. It had a bruised look to it and pulsed kinda like a bruise. After I stopped climbing the swelling mostly went down. I still have a slight nervy feeling in my hand and wrist, though. And it hurts to press on the area. I'm hoping it's just a bruise (like I thought initially) or a strain. I don't have any pain when loading any of my fingers or any decrease in range of motion.

Wishing speedy recoveries to all.

It's kinda strange that this happened to me too last week while bouldering on my home wall. I happened to look at my palm and noticed a small lump in my palm about an inch below the base of my right ring finger. It didn't hurt then or now, hasn't changed size, and I have full range of motion of my hand/fingers. I was going to research it last weekend but I basically forgot it was there.

I hope everything works out for you. You should see a doctor if it continues to bother you.

That is most likely a tendon injury. Dupuytrens doesn't swell. My dad had a pretty severe case. The tendon feels like a hard cable basically. That looks more like an overuse injury. The fact you can fully extend your finger leads away from Dupuytrens as well, though in the early stages that is less of an issue.

As someone else mentioned, climb enough, and your hands will get thrashed. Just part of it...

One more oldish man joining the club. Lump below my pinky and ring finger that came on suddenly in the gym. No noticeable impact to strength, flexibility or feeling. It does become sore to the touch after climbing though. Has anyone pursued treatment for this? Seems like there wouldn't be much more to do than rest and maybe ice?

Experience with Dupuytren's contracture

Profile: Eastern European Jewish descent. Onset: age 78. (Anyway, recent research suggests that disease is not especially confined to old Scandinavian men. Bit of a medical myth and the first question both orthopedists asked me was I of Scandinavian desecent. )

Location of lumps: On palmer side of L hand, below L ring finger.

Hand surgeon opinions (2 doctors; one a climber): If it can be treated non-surgically good, since the surgery is delicate. However if it starts getting to the point, where the finger is difficult to move, it’s best to get the surgery done early rather than later as the surgery is more difficult if it has progressed to the point where the finger is immobile.

My experience: Since the condition developed, I tape around the hand so the lumps are covered. I do this before climbing or other activities such as working hard in the yard. If I don’t do this, the lumps get irritated. No further progression over the past 5 years. The lumps are there, but they don’t hurt and the finger is mobile.

My advice: See a hand specialist.

Gratias et valete bene!
RobertusPunctumPacificus

I'm 31 years old and I've had Dupuyton's since I was about 21 (I'm mostly German descent). The worst season I've had with the condition was my first summer at Rifle -- did too much closed crimping. Since then, I've gotten much better at using an open-handed grip as much as possible. Hasn't bothered me too much in the last 9 years or so, but the bumps do get irritated when I'm climbing a ton on limestone jugs.

D-Storm wrote: Hasn't bothered me too much in the last 9 years or so, but the bumps do get irritated when I'm climbing a ton on limestone jugs.

That's exactly the situation in which I find taping around the hand and covering the bumps is a big help.

r.c

I have something that looks very similar, sudden onset, etc. Did you ever find out if it was Dupuytren's or a partial pulley tear?

I have the same symptoms as were described in the initial post...an elongated ridge/lump in the palm of my left hand connecting from my pinky finger to the center of my palm. My pinky finger shakes when I extend it and feels weak. I also have a tear in the ulnar side of my wrist (got an MRI finally). The hand doctor I saw thinks it's Dupuytren's but I have pain and a slight indentation where the lump starts below my pinky, and it started after bouldering hard a while ago. The MRI showed my tendon is normal in my pinky. Has anyone resolved this issue?

I was also diagnosed with Dupuytrens and visited my dr, two hand surgeons and two radiologists.  I have been climbing for 30 or so years and it showed up and progressed a little for a period of year.  I noted the association with joint related supplements (Glucosamine, Chondroitin, MSM, collagen, etc.)   I cut out all those supplements and noticed no further progressions in 1 years time.  During that time I also have been taping my hand for support.  From what I have been told Dupuytrens can progress at various paces, stop progression then start again.  The approach I will take is once my hand reaches the 30 degree table top exercise (lay hand flat on table), I will get the Needle Aponeurotom or what ever my hand dr recommends at the time.  

Dupuytrens is genetically related and there is no clinical linkage to climbing.   It can be brought on by hand trama.  It does seem to me climbing is repeated hand traumas.  Also there seems to be an unusually higher number of climbers that have this ealier in life.   Neither my mothers or fathers family line ever had duputryens but none of them were climbers either.    I would highly going and getting professional advice from a hand specialist with some experience.  

I have the same thing in my right hand. I'm 41, been climbing for 11 months. Happened on a really crimpy route about 2 months ago and I was straining harder than I should have but I really wanted to send it. I felt a little pop in the center of my right hand while pulling on a hard crimp - with almost zero pain - it hurt maybe a tiny bit for a minute or so. Now I have a lump very similar to the picture - between my pinky and ring finger, about 1-1/4" below the edge of skin between the pinky and the ring finger. It very little to no pain normally. It can get a little agitated by climbing but stops being agitated an hour or so after I stop climbing. I'm taking a 2 week break right now and ibuprofen to see if it will heal at all.