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How hard can I push it while rehabbing an a2 pulley injury?

Original Post
ckersch · · Unknown Hometown · Joined Apr 2013 · Points: 161

A month or so ago I picked up a fairly minor a2 pulley injury. Nothing popped or ruptured, but the pulley was fairly painful the day after working on a hard, crimpy bouldering project. I took the rest of the month off aside from a few easy outdoor outings (probably not the wisest choice to go ahead with those) and am now getting back into the gym to do some rehab for the injury.

I've read that some light climbing is ideal for healing pulley injuries, so long as you don't push things to hard. My question is, how hard is too hard? I normally boulder around V9, so I've been restricting myself to problems V4 and below, and avoiding crimps, as well as climbing routes up to 5.10. Essentially, anything that I can do where I'm completely controlled and static and where I can climb with only open hand grips.

So far, this doesn't seem to be making things any worse, but I'm not sure if it's the ideal way to heal up quickly and get back to pulling hard. Does anyone have experience or expertise as to how hard I should be pushing myself while rehabbing a pulley injury?

Bapgar 1 · · Out of the Loop · Joined Oct 2007 · Points: 90

There is no "right" answer to this. The long and short of it is, you're an experiment of n=1. If what you're doing isn't making it worse then awesome, you're headed in the right direction. If you're losing function (can be a little vague figuring this one out) or having more pain (can be a lot vague since pain is a terrible indicator) then you're overstressing the system (physical tissue and/or CNS) and need to make changes to your rehab/training plan. (This is where a professional comes in handy.)

Unfortunately folks like to think in terms of either a) I'm hurt and need to rehab OR b) I'm healthy and training. The truth is that human performance gains are a spectrum. Someone coming out of knee surgery (or pick your favorite injury) and an olympic athlete are on the same spectrum, just at opposite ends.

I'm not saying that the post op athlete will be able to achieve the same performance levels as the olympic hopeful but the same basic principles of tissue healing, motor learning and adaptation to stress apply equally to both athletes.

The main difference in getting back up to speed after/during injury and pushing your personal performance limits are which variables you focus on most.

Good luck w/ getting back to full speed.

Dan Austin · · San Francisco, CA · Joined Oct 2010 · Points: 0

Do you hangboard at all? IMO the best rehab for a pulley injury is some very light hangboarding, provided that you have access to a hangboard with a pulley system to remove weight.

E.g. if you normally do a hangboard workout using an open hand grip on a 1-pad edge at bodyweight, for rehabbing you may want to consider doing the same workout with 40 lbs. removed using the pulley.

The advantage of rehabbing using a hangboard and pulley is that you can fairly precisely control the loads you place on your fingers, which makes it easier to avoid accidentally overloading and re-injuring your afflicted finger.

If this is not an option, I think you basically have the right idea. Keep climbing, but scale back the difficulty and avoid any routes/moves where you might shockload your finger and aggravate the pulley. Hard to describe, but I think the sweet spot is having your injured finger feel warm and maybe a little tingly while you're in a rehabbing workout -- you can feel it, but you're not pushing it so hard that it's painful. The tricky thing is that this requires a lot of self-awareness, constant self monitoring, and a lot of discipline to back off anything that seems remotely tweaky.

Also, and I have no idea of this has any scientific merit, but I like doing a lot of ARCing for rehab. Partly because it's a good way to avoid tweaky moves or the temptation of hopping on a too-hard problem, but also because it seems to get the blood flowing to the forearms quite well, and I like to imagine there may be some residual therapeutic benefit for the injured fingers.

pkeds · · Broomfield, CO · Joined Feb 2006 · Points: 30

IMHO, i normally take up to 2 months off for a bad A2 injury (pop). I do a lot of massage therapy and cold water therapy, both to promote blood flow and healing. After a few weeks when the swelling goes down, its probably not a bad idea to work in some light intensity climbing (jugs only, nothing crimpy/tweaky) slowly upping the volume over time. After 1-1.5 months of this, i normally slowly start introducing higher intensity holds/movements, always conscious on tenderness/inflammation of the hurt location.

Guideline #1: Don't be a jerk.

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