Finger Injuries in Climbing

The hangboard.

It sits above the doorway in the office, taunting me. It sits above the doorway, daring me to train. It sits above the doorway, and stares me down. It sits above the doorway...

I can't help it. I'm a climber. It's in my genes. I have to hang on it. I have to do pull-ups on it. I have to climb.

But the reality is that hanging on a hangboard is not climbing. Hangboards are supposed to be for training. In truth hangboards are one of the best ways climbers have devised to obtain sports injuries.

I know only too well. One day I succumbed to the devious taunts of the board and began to train on it. I succumbed and pulled something in my ring finger.

A climber on the Boy Scout Wall in Red Rock Canyon
Photo by Jason Martin

After doing a little research I discovered that I probably injured one of the pulleys in my finger. A great website called climbinginjuries.com provided me with everything that I needed to know in order to get better. They indicated that I had a pulley injury in my finger and they identified three levels of pulley injury.

• Grade III: A grade three injury usually involves a complete rupture of the pulley creating bowstringing of the tendon. Symptoms of this severe soft tissue injury includes local pain in the pulley, swelling or even bruising, pain when squeezing, pain when extending the finger, and most disturbingly those who get this injury often hear a pop inside their finger.

• Grade II: A grade two injury is identified by a partial rupture of the pulley tendon. This injury is characterized by local pain at the pulley, pain when squeezing and occasionally pain when extending a finger.

• Grade I: A grade one injury is characterized by local pain at the pulley, pain when squeezing and a sprain of the finger ligaments (collateral ligaments).

Treatment:

These injuries can be quite serious. Some people may require months to recover from a Grade III pulley rupture. Climbinginjuries.com has a prescribed method for treatment:

Go buy some TheraPutty! All orthopedic doctors and physical therapists will recommend putty as a tool for successful recovery. (2) The fingers generally receive poor blood flow so getting blood to the injured area is important. Contrast baths have had mixed results in the literature, but it wouldn't hurt to try. To do a contrast bath, get a bowl of warm water, and cold water. Put injured finger in cold water for a few minutes, then place it immediately in the warm water for a few minutes. Repeat 3-5 times. Finish with the cold water. This could be done after squeezing the putty ball to "flush out" the injured joint. Massaging the effected area can be effective as well. Start out lightly and gradually increase the pressure.

Pulleys

• Grade III: - Immediately- Stop climbing Apply ice or cold immediately, no more than 15 minutes at a time (1-2 days) Take ibuprofen for 1- 2 day Keep the hand elevated Week 1-2 Don't climb! Don't immobilize the finger. Unless there is a lot of pain, open and close your hand often VERY light massage at the site of the injury. Concentrate on other aspects of your life. Week 4-8 Warm the hands by use of a bath or an electric blanket, then squeeze the yellow (softest) putty. Don't push it, if there's pain…stop. Repeat a few times per day. Go to Grade II Treatment.

• Grade II: (Week 1-2) No climbing Warm the hands by use of a bath or an electric blanket, then squeeze the red putty. Don't push it, if there's pain…stop. Repeat a few times per day. Lubricate and lightly massage at the site of the injury. (Week 3-6) Tape the injured finger, stretch your forearms (this relieves the stress on the finger tendons) and climb the biggest holds you can find. Start easy, this will be the quickest way to recovery. If you climb too hard, too fast, then return to the start of Grade 2 and do not collect $200. Always stretch your forearms after warming up and prior to climbing. Start squeezing the medium to firm putty. Lubricate and massage the finger at the site of the injury a couple of times/day. Start lightly and gradually increase the intensity using very short strokes on the injured site. Go to Grade I Treatment

• Grade I (Week 1) Tape the injured finger and continue to climb at a level well below your normal level. Gradually increase the stresses on the fingers. Stretch your forearms after warming up and prior to climbing. This relieves the stress on the finger tendons. Squeeze the medium to firm putty a few times per day. Lubricate and massage the finger at the site of the injury. Start light and gradually increase intensity. Very short strokes on the injured site. Expected outcome Take advice from a practitioner who specializes in climbing. However, if treated early and effectively, with an appropriately graded return to activity, recovery will usually take 3-8 weeks. However, if the injury is pushed beyond its stage of recovery, re-injury will occur and may result in a chronic injury that will require a much more protracted rehabilitation period.

The best way to recover from a finger injury is to avoid getting hurt in the first place. Here are a few rules to live by:

1. Always warm up on easy climbs. Don't jump straight onto the hardest thing you can get up.
2. Stretch your fingers.
3. Don't overtrain. If you are climbing hard then you should probably avoid climbing every day. Strong sport climbers will often climb every other day.
4. Stretch your fingers again.
5. Massage your forearms between burns.
6. Stretch your fingers more.

Sooner or later my finger will heal up and when it does I'll train more consciously. The hangboard definitely requires a bit more care. The last thing I need is another finger injury to crimp my crimping style!

--Jason D. Martin