Finger Injuries in Sport Climbing

Finger Injuries SUMMIT MAGAZINE Humphrey Bacchus CMT Overview As most of you reading this have probably experienced, finger injuries are the most common affliction of the climber. They can range from being acute and devastatingly debilitating through to frustrating chronic long-term injuries. Each stage of a climber’s technical ability or battle with different rock formations brings separate challenges to the hands and it is these that place the heavy strain on the tendons, ligaments and musculature of the climber. It is important that we determine what type of injury has occurred, what severity and how to rehabilitate the affected area. Here is a very brief overview of some of the injuries that we should be aware of in climbing. Joints There are three main joints that we are concerned with when considering finger injuries. Firstly we have the MCP joint [metacarpophalangeal] which is the knuckle. Then next along is the main flexion PIP joint, proximal interphalangeal, in the middle of the finger. Finally we have the DIP joint, distal interphalangeal, which is last joint before the fingertip. Different grips exert varying pressure on the joints and these can determine the type of injury or strain that occurs at each of the junctions. [Insert anatomy picture of hand with reference to the joints above]. The joints are joined by ligaments and mobilised by the tendons and muscles. Tendons, Ligaments & Muscles The tendons, ligaments and muscles make up a complex system of support and movement thorough the fingers. The most important to consider are: the collateral ligaments which are key in maintaining structural integrity; they literally hold the joints together whilst the tendons attach the muscles in the forearms; Tendons that are held in place by a pulley system. These are ligament structures, like rings, that run the through the whole finger. These pulleys take huge amounts of force when we consider some of the moves accomplished when climbing; and the muscle finger flexors that are of primary importance in climbing; include flexor digitorum superficialis, flexor Digitorum profundus, palmaris longus and flexor pollicis longus; and the tendons which bring movement to the joints. Each of these tendons, which attach the muscles, runs through

a lubricated sheath, which keeps it moving smoothly and consistently. These all work simultaneously to provide fine and controlled movement. Common Injuries Any or all of these joints, ligaments, tendons or muscles can be damaged during climbing. Some injuries are much more common than others and as was mentioned above, it is paramount that the injury is determined so that a route to recovery is mapped quickly. In one major study of climbers it was found that three quarters of the most frequent injuries occurred in the fingers; Pulley injuries being the most common. These pulleys injuries can be graded from 1 to 3. Grade one is a simple strain; Grade 2 is a serious sprain or partial tear and Grade 3 a complete rupture. Symptoms can include hearing a snapping sound, swelling round a joint, pain with flexion of the fingers, inability to maintain a pinch grip and localised pain. The severity of the injury is often made clear by the number of accompanying symptoms following the injury. Other common injuries that require attention are what some might call trigger finger as well as damage to the collateral ligaments. Trigger finger is known as stenosing tenosynovitis. This type of injury occurs when a hard nodule appears on the tendon that travels through the tendon sheath. This causes the tendon to move less freely through the sheath and is sometimes accompanied by a feeling of the finger getting trapped in movement or the tendon catching during movement. This can be a cause of both pain and inflammation. Collateral ligaments can also be damaged around the PIP and MCP joints of the hand. These like pulley injuries can be anywhere from a mild sprain through to complete rupture. Other injuries include stress fractures (thought less common) and arthritis that can develop due to the frequency of ligament strains. Rehabilitation Like any other athlete climbers want to return to climbing as soon as possible we need to know what’s happened as soon as possible. As climbing is such a specific sport its unlikely that the local GP is going to be able to deduce exactly the type of injury that has occurred in a finger. Mild strains of the tendons, ligaments or pulleys seem to respond well to conservative treatment. Decreasing the inflammation immediately with ice, taping damaged finger to a fully working one (often the ring and middle fingers) and going easy on the climbing. This means doing routes well below your level for a couple of weeks. There might be low-level discomfort, but no aggravation to the injury should be noted and no increase in pain. Be sensible and your will recover fast. Grade 2 strains require more care. If a grade 2 strain is suspected, stop climbing immediately. Stopping inflammation in the initial phase is important, before starting on rehabilitation after 10-14 days. This can include theraband hand exercises or theraputty. In each instance “going slow” is the order of the day. If you suffer grade 3 injuries, then you’ll know it! This type of severity often needs local surgery to repair and can take a slow going possible 3 months before returning to full climbing again. Trying to get too far too quick will result in going backwards and a compromise of the joints and soft tissue again.

Trigger finger needs to be treated on a case-by-case basis, sometimes requiring surgical intervention but can also respond well to conservative therapy treatment. Most climbers I know seem to want to run before they can walk on when recovering from finger injuries; not able to be patient with the knowledge that slow and steady recovery will in fact make them stronger. If you damage your hands, seek professional help. It’s pretty hard to climb without them and long-term damage can cause long-term pain. Don’t second guess what you’ve done to your fingers, rest up take a few days off climber and get a plan in place for getting you back fit and strong. You’ll thank yourself for it.

Finger Injuries in Sport Climbing

by somahealthcare on Dec 28, 2009

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Finger Injuries in Sport Climbing — Document Transcript