Finger Pulley Injuries in Rock Climbers
One question to ask is why did I get injured in the first place and how can I prevent that from happening in the future. Trying to find your specific weaknesses is key. Once you find them, they are easy to train. Your fingers each have 3 joints (thumb is exception) and different muscles or parts of muscles that bend each joint. Being strong and stable at all of the finger joints and muscles is a key to preventing injury and looking at the bigger muscles of the arm, shoulder and body are other key players. Technique and training style are also worth looking at. Here are the wrist and hand muscles of importance to us.
The main 3 are flexor digitorum superficialis, flexor digitorum profundus and lumbricals.
The big muscles of the arm, body and core should not be overlooked as well. If they aren’t functioning well there is way more work happening at our hand and forearm than there should be. If we look at the pulling muscles:
Elbow = bicep, brachioradialis
exercises: bicep curls and reverse curls
Shoulder = latissimus, rear deltoid and posterior rotator cuff
exercises: pull downs, shoulder extension and adduction, pullovers, reverse flyes, shoulder external rotation in abduction
Shoulder blade = rhomboid, mid and lower trap
exercises: prone T,s and Y,s
Core = abs, side abs and low back muscles
exercises: planks, side planks, superman’s
There are 6 basic grips in climbing: open hand, full crimp, half crimp, pinch, pocket and friction
Open hand – jug + sloper, deep flexors, slight bend at all knuckles, least prone to injury
Half crimp – superficial flexors, fingers bent at middle finger joint no thumb wrap
Full crimp – superficial flexors, fingers bent at middle finger joint thumb wrapped, most prone to injury
Pinching – lumbricals and deep flexors, fingers bent at first joint thumb on opposite edge
Pocket – lumbricals, one or more fingers in a pocket hole, middle finger is strongest
Friction – deep flexors, open hand palm is on wall/surface
Each grip works different muscles in the system and therefore all need to be strong to be able to climb varied terrain/routes.
Flexor digitorum profundus: jugs, slopers and friction – least prone to injury
Lumbricals: pinching and pockets – single and double finger pockets can be dangerous
Flexor digitorum superficialis: half and full crimp – most prone to injury
Due to anatomy the lumbricals and flexor digitorum profundus work together when the fingers are in an extended position (open handed positions and pinching)
Begin with routes that have more jugs, slopers and friction holds then progress to pinching and pocket holds and climb the least number of routes with crimp holds. Take longer breaks between climbs when on routes with a lot of crimping.
The muscles in our forearms attach to long, narrow tendons as they reach into the fingers. These tendons run through sheaths and are anchored by pulleys that keep the tendons gliding flush to the bones. Pulley injuries happen when trying difficult moves when tired. Particularly crimping and during the lengthening or eccentric motion. So when you fall off and you are tired your hand slowly opens while trying to continue to hold on and tears the pulley. The most common is the A2 pulley of the ring finger. As you fatigue your elbows will tend to flare which puts more stress on the hands and pulleys.
Things that increase the risk of a pulley injury
Being aggressive – don’t climb way above your abilities, also don’t try big moves off of a crimp keep the movements static instead of dynamic.
Not having smooth, precise and controlled motion – the more control you have and the more you use your legs and feet the less likely of injuring a pulley
Being new to the sport – don’t progress too fast and be sure to take frequent and long enough breaks between climbs. Your tissues will take some time to adapt to climbing.
Overtraining crimping – self explanatory, this is the grip that puts the most stress on your pulleys, train this sparingly and progressively, your tolerance will build over time as your hands, arms and tissues strengthen.
Being dehydrated – tissues without water are more easily injured
Being tired – if your other muscles are fatigued you will likely compensate by putting more pressure on your finger tendons as there is nothing to help stabilize
How to rehab a pulley injury
Step 1. Take time off from climbing and use ice or contrast baths to reduce swelling and start gentle stretching and self massage until you have full, pain-free range of motion (usually one to two weeks after injury). Tendon glide exercises can also help.
Step 2. You can begin gentle re-strengthening. Putty exercises for gripping, or hand strengthening devices are gentle ways to start strengthening. Finger extension exercises are also very helpful. You can push hard enough to create mild discomfort. We want progressive loading to the tissues.
Step 3. You can start to climb easy routes with lots of jugs for endurance. You can also start to use a hang board. While hang boarding, use your feet to offload or use offset handholds. Avoid crimping and painful movements for four to six weeks post-injury. H-taping can be helpful though opinions vary on effectiveness.
Step 4. Full return to climbing will take six weeks for grade 1 and 2 injuries, and six to eight weeks for grade 3 injuries, with a full functional return by three to six months minimum.
If you have a climbing injury and would like to learn more about how we can help please send us an email at firstname.lastname@example.org or call 203-557-9111. Thanks - Dave