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Finger Injury: C2, possibly A4
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Aug 21, 2013
So here we go again.

I'm experiencing a dull pain after working on my endurance (lots of laps on 11s) 2 to 3 times a week.
The pain is dull and only felt when I press or massage the area right above the second knuckle on my ring finger. The pain can be felt from one side of the finger to the other. I climbed yesterday and noticed this today so I haven't tried to put an weight on it and won't for a couple days unless the finger feels better. No popping, no swelling and still have full ROM.

After looking at a few pictures on the anatomy of the finger I'm assuming that it's the C2 that is irritated/strained and not the more common A3 or A4 pulleys. If i'm right in thinking it's the C2 then what is the best course of action? Common sense would dictate to treat it similarly to an A3 strain but I just want to hear what people's experiences are with this sort of 'injury'. I can't seem to find much literature on C2 or C1 injuries anywhere.

Rock Climbing Photo: Pain area
Pain area

Lorenzo de Amicis
Joined Feb 1, 2011
5 points
Aug 22, 2013
So, it has been a couple days now and the tenderness has increased significantly when my hand is in crimp position with little resistance. Looks like I'll have to put climbing on hold until the inflammation goes down.

I've looked around for information on my particular injury but I can't seem to find anything with much detail on diagnosis or treatment of the C2 pulley. Whenever I find something promising the author just grazes over the Cruciate pulleys and instead goes into explaining everything regarding Annular pulley injuries.

Does anyone have any links or info worth sharing on the matter? It's hard to believe that this is an uncommon issue with climbers.
Lorenzo de Amicis
Joined Feb 1, 2011
5 points
Sep 17, 2013
Hi Lorenzo,

Any update on your injury?

I too believe I may have injured my C2 in my ring finger on the left hand.

I have a very similar experience to you. I can use certain holds, but there are definitely some holds I can't use.

Let me know how your road to recovery is.

Vu L.
Joined Jan 8, 2012
65 points
Oct 21, 2013
I am dealing with a similar injury right now - same exact spot. I came to the conclusion that it was probably A3, but the area of pain is exactly the same.

I first felt the tweak from climbing a crimpy problem before I was fully warmed up. I've probably climbed 4 or 5 times since, taping the finger, and it has continued to give me trouble. It is pretty mild but I figure I should just take some time off.

Anybody got any advice on this? Lorenzo, how is yours shaping up? Should treatment be the same as an A2 injury?
From Raleigh, NC
Joined Nov 7, 2011
185 points
Dec 23, 2013
I have also been experiencing the same pain in my left ring finger. At first I thought it was an A4 injury but after closer examination it seems to be the C2. Any advice from any of you experiencing this. I took 2 weeks off when it first began to hurt. Lately I have only been climbing on big holds. The pain has never been very intense really it only hurts when I touch the injured area, and it feels a little sore after climbing but my finger strength is no where near 100%. Now its been about 5 weeks since I injured it and I have not noticed any improvement nor has it gotten any worse.

My finger hurts in the exact area Lorenzo circled in his picture.

Any info or advice from anyone would be much appreciated,

Willie Wilson
From America
Joined Aug 1, 2010
5 points
Dec 23, 2013
rest is the best for it, but if you don't want to stop climbing, i suggest using the ice and heat method to increase blood flow. ice the area, then submerge in warm water bath, and continue. also, do rubber band exercises to work the opposing muscles and tendons. make sure to warm up your fingers before. i had both middle finger a3 tendon strains and it took approximately 2 weeks of rest and opposition exercises to get it to 80-90% normal. cachu
Joined Apr 27, 2011
10 points
Dec 23, 2013
Climbing this weekend, my ring finger went *pop* (like a single knuckle cracking) after taking a lot of weight on a crimp and I've had the same symptoms as you since. I've had similar experiences on my left middle finger and right index finger, but closer to the base of the hand (my guess A2 injuries for both), but I think this current injury is damage to the A5.
Rock Climbing Photo: Messed up finger (most bent)
Messed up finger (most bent)

Above is what my finger looks like when i try to curl it as much as possible by itself. When using my entire hand, it nearly closes completely, without... not so much.
For the two previous finger injuries, I was unable to climb comfortably (even on jugs) for about 2 months. It's a bummer.
Ben Huber
Joined Dec 19, 2013
0 points
Dec 24, 2013
So here is my injury update:

It's been over 4 months since I posted and things were not looking good the first couple months. I would rest for a couple weeks and try and climb easier routes/problems and within a couple sessions the soreness/ache would come back. Even though I completely abstained from using full crimps, (which I try to not do anyways) it still hurt in half crimp. Nothing too painful but more of a mild ache whenever I massage the injured area or if I did anything harder than a v3 (i climbed v6-v9 before said injury).

I then stopped climbing all together for a month but kept doing pull ups and eventually bought some theraputty (firm blue) and it was still too much for my finger. I then bought a squeeze ball at Dick's sporting goods (much less firm than the theraputty) and it would also irritate my finger if I squeezed it too hard.

I then stopped doing pull ups all together and decided to actually take a couple weeks off which helped and started doing laps on 5.9s once the pain was completely gone. I have yet to climb anything harder than a 5.10 but so far so good after 3 weeks of easy laps.

Honestly, I think this is just an overuse injury that has become chronic. Because of this, the healing process is hindered and the collagens produced and used by the body to treat these injuries become unbalanced and has a difficult time healing healthily. Now, i know this is true of tendons but not certain it applies exactly the same with ligaments though I feel ligaments may react similarly to overuse injuries.

I think what I'm going to try and do is what others have already said in this thread. Massaging forearm and finger, work on opposing muscles in forearm (rubber bands) and very light climbing that doesn't cause any pain. Hopefully, this will cause the healing process to go back to its normal and optimal state.

Hope this helps.
Lorenzo de Amicis
Joined Feb 1, 2011
5 points
Jun 1, 2014
Any update on your progress? Are you back to full strength? Its been about four weeks since I thought I strained my A4, but after no progress, actually it hurts more now, I decided to look more into it and found this thread and when I hear four months to maybe feel comfortable on 5.10s, I'm getting very depressed haha. So I would like to know how you're doing after about 9 months. Thanks! Andrew Lewis
Joined Jun 1, 2014
0 points

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