Possible lumbrical tear [was: Tendon strain...] in Climbing Injuries Forum

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Possible lumbrical tear [was: Tendon strain...]

Author	Comment
sgodwin	Possible lumbrical tear [was: Tendon strain...]	Lead	[-]
Tomáš Mrázek 3 years Jun 10 11 7:06 AM Reply Quote More My Recent Posts	Tags : None Last night I walked into Urban and decided to warm up on an easy overhung purple. Apparently it wasn't easy enough. I was feeling pretty cold before I started and somehow I managed to strain/tear the flexor tendon of my right ring finger where it runs through my palm. I've done this before, years ago when I first started climbing, and it took months to heal. This time it doesn't feel quite as bad, but with an Arapiles trip coming up in two weeks I'm feeling quite devastated. Looks like I'll have to forget about trying to get strong in the meantime and just try to heal enough to be able to climb some 12s when I get there. I don't suppose anyone knows any magic tricks to speed up tendon repair? Scott Last Edited By: manacubus Jun 14 11 10:50 PM. Edited 1 time.
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manacubus		#1	[-]
Jun 10 11 9:01 AM Shhh! Reply Quote More My Recent Posts	It's a tendon pulley. Tendons themselves are strong, like fishing line. The pulleys are where the force is concentrated, like runners on a fishing rod. Healing is about bloodflow. Listen to our good friend Davie Mac:
sgodwin		#2	[-]
Tomáš Mrázek 3 years Jun 10 11 5:51 PM Reply Quote More My Recent Posts	So using the interwebs I have diagnosed myself as having a strain or partial tear of the A1 pulley of the ring finger on my right hand. It is exactly the same spot that I injured three or four years ago. I had thought that it was 100% recovered, but apparently I was wrong, because what I was pulling on last night was scarcely smaller than a jug, but something about the way I pulled on it was enough to damage my very cold pulley. This article is quite helpful: http://www.nicros.com/archive/A2_pulley_injury.cfm Except for the part where it says it typically takes 2-10 weeks for the pain to subside, and that you should wait at least 2 more weeks before resuming easy climbing. It then rubs salt into the wounded pulley by saying that a modest pulley injury typically means about 45 days of climbing downtime! I'm going to Arapiles in 2 weeks from today. That's 14 days, and my hand is f@%#ed Scott
sgodwin		#3	[-]
Tomáš Mrázek 3 years Jun 11 11 7:13 AM Reply Quote More My Recent Posts	After doing some more reading I have revised my diagnosis. The symptoms fit the bill for a flexor unit strain. The pain and swelling is in the palm of my hand. It doesn't hurt at all to crimp, but any load at all on the ring finger in an open handed position sends immediate jolts of pain through my hand. I'm hoping that ice and celebrex will help the swelling to go down. Once that happens I'll try Dave Macleod's cold water trick. I've already resigned myself to having to settle for very easy climbing at Arapiles. No trying Kachoong this time. . . . Scott
ross ferguson		#4	[-]
Steve McClure 9 years Jun 11 11 11:07 AM Reply Quote More My Recent Posts	I'm sure Gareth had a similar thing. He took 6 months off. Then did the same to the other hand! Go and see some one (a hand specialist) before you decide it will be ok! Ross..
manacubus		#5	[-]
Jun 14 11 11:56 AM Shhh! Reply Quote More My Recent Posts	Gareth's was a lumbrical tear (a muscle in the palm). Duncan did the same. Can occur when you drop your pinky and pull really hard with the other three fingers (creates a shearing force in the muscles).
sgodwin		#6	[-]
Tomáš Mrázek 3 years Jun 14 11 5:48 PM Reply Quote More My Recent Posts	Hi Lee - The hand position you describe sounds about right. Actually I'm not sure what position my hand was in this time, but the symptoms are exactly the same as what happened last time I did this. On that occasion I was pulling hard on a three finger pocket, without the pinky. I felt a sudden 'ping' in my hand, and by the time I got home that night I couldn't even lift a carton of milk with it. It took a couple of months for all the pain to go away, and several more months, probably over a year, before I felt comfortable pulling on pockets again. Two weeks after I did it the pain was just as bad as the first night, so I saw an orthopaedic surgeon about it and his opinion was that it was partial tear of the tendon, and that there was nothing that could be done about it except wait for it to heal. I'm not convinced that his diagnosis was correct, because it is also my understanding that the tendon itself rarely tears, but whatever it was took a long, long time to heal. This time I don't think its quite as severe, the pain and swelling have reduced a fair bit already, but I doubt that it will be fully recovered before the end of this season, which really sucks There seem to be a lot of discussions on various forums about 'flexor unit strains' which result in pain in the palm of the hand when flexing the ring finger in an open handed position, especially if the pinky finger is already curled downward when flexing, but as yet I've been unable to find a diagram that illustrates exactly what the 'flexor unit' is. Scott
sgodwin		#7	[-]
Tomáš Mrázek 3 years Jun 14 11 5:58 PM Reply Quote More My Recent Posts	Here is a nice article on lumbrical tears http://www.klatring.no/LinkClick.aspx?fileticket=LG2ASlI1haM%3D&tabid=5929 Having read it, and having not been able to find any reference to the mythical 'flexor unit' anywhere other than on climbing forums, I'm starting to think that this makes the most sense. I wonder if similar shearing forces to what the article describes would be generated between the tendons of the ring and pinky fingers when pulling on a pocket with the pinky flexed. Interestingly the three climbers that were studied were advised to keep climbing and training, but to avoid pulling on anything with the ring finger alone. They were told to 'buddy tape' the ring finger to the second finger. Scott Last Edited By: sgodwin Jun 14 11 6:09 PM. Edited 3 times.
jjobrien		#8	[-]
Steve McClure 10 years Jun 14 11 7:50 PM Mr Kneebar Reply Quote More My Recent Posts	I believe I have had this same injury. Same cause. Mine was taking forever to heal, until I started treating it. The treatment: Get a bucket of hot water, and a bucket of cold water. Hot - as hot as can be bore Cold - use some frozen drink bottles to pre-chill the water, then re-freeze and re-use. Start with the cold - immerse the hand for 10-15 seconds then hot - immerse the hand for 40 - 50 secs (if it's too hot just dip in and out) back to the cold, 10-15 secs hot 40-50 secs Do 10 reps start and finish with the cold. Do 3 or 4 sets a day. You can feel the blood vessels contract and dilate as you go from cold to hot. You will notice a big difference in days. Harder ~ Steeper ~ Higher
manacubus		#9	[-]
Jun 14 11 11:04 PM Shhh! Reply Quote More My Recent Posts	That is some sweet Googling with that article find Scott. I am very interested to surmise that quite possibly, many of the "tendon" injuries (actually tendon pulley injuries) people are having or have had in the past may actually be lumbrical tears. Prevention: a) As it's now winter, warm up lots on easy routes and problems before unleashing the beast. b) Try to not drop the pinky. c) Try to avoid grips where one finger is doing something markedly different to the one beside it (in terms of joint angle and force applied). Here's a nice picture of the lumbrical muscle from the above article which gives an idea of the shearing forces which happen when two adjacent fingers aren't playing nice:
rightarmbad		#10	[-]
Steve McClure 9 years Jun 14 11 11:17 PM Reply Quote More My Recent Posts	This is what I have. I did it while sort off laying away on three fingers with really high feet. It has pretty much taken since end of last season to repair and I believe it is only now responding because I have only climbed a couple of times in the last few months and then all I did was jamb crack at Frog. I found it quite easy to knock the finger from the side in every day life and just keep annoying it. Follow the path of the independent thinker. Expose your ideas to the dangers of controversy. Speak your mind and fear less the label of 'crackpot' than the stigma of conformity. And on issues that are important to you, stand up and be counted at any cost.--- Thomas J. Watson
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sgodwin		#11	[-]
Tomáš Mrázek 3 years Jun 15 11 7:39 AM Reply Quote More My Recent Posts	This image of the lumbrical muscles comes from wikipedia. The article above talks about tears of the third lumbrical that happen when the ring finger is extended and the middle finger is flexed. I'm thinking that maybe I have torn the fourth lumbrical, which according to wikipedia, spans the gap between the tendons of the ring and pinky finger in a similar way to the way the third lumbrical connects the tendons of the ring finger and middle finger. That would explain why it only hurts when I pull on my extended ring finger with the pinky flexed. Scott
sgodwin		#12	[-]
Tomáš Mrázek 3 years Jun 15 11 7:41 AM Reply Quote More My Recent Posts	So, the question is how to fix it? I thought the aim of the hot/cold treatment was to create a fluid pump to shift fluid out of inflamed finger joints. If this is really a muscle tear, is hot/cold (or just cold) therapy still appropriate? In any case I think I'll tape my ring and pinky fingers together at Araps to prevent them from doing anything independently. Scott Last Edited By: sgodwin Jun 15 11 7:50 AM. Edited 1 times.
jjobrien		#13	[-]
Steve McClure 10 years Jun 15 11 8:04 AM Mr Kneebar Reply Quote More My Recent Posts	As explained to me, in very simplified terms, the hot/cold treatment sort of force feeds blood and nutrients to the affected parts, therefore speeding recovery. It feels good, and it works. Harder ~ Steeper ~ Higher
manacubus		#14	[-]
Jun 15 11 8:53 AM Shhh! Reply Quote More My Recent Posts	Yes, it sounds like for this injury, buddy taping is the go. Do that for sure, just to limit movement and reduce possible shearing. I would do the hot-cold therapy JJ describes like a fiend. And I would continue to climb easy routes with the finger buddy taped. Reassess in a month.
willmonks		#15	[-]
Sketchy leader 5 years Jun 15 11 3:43 PM Reply Quote More My Recent Posts	In the same hand position (pulling with three fingers, pinky curled up) I tore the frenulum of my flexor digitorum profundus last year. I probably also did something to the lumbricals but the pain in my palm disappeared within a week or so, before I got home, so was not diagnosed. The FDP is deep in the belly of your forearm muscles so you might like to probe around in there to see if it's injured too. The bad news is the FDP took months to heal, the good news is that Julian took one look at it and said I could climb anyway, so long as I didn't let my pinky drop off and curl up (which pain stopped me from doing anyway). I buddy taped and climbed to my heart's content, and in fact recuperation seemed faster once I started climbing again. The reason I write this is because Julian Saunders diagnosed it in 30 seconds after Brisbane's finest had frankly not had a clue for 10 weeks. So, if I wanted a roadtrip 2 weeks after this injury, I'd be doing a Skype with Julian... PS: in a recent US climbing mag Julian was scathing about the mythical "flexor unit" ... Last Edited By: willmonks Jun 15 11 3:47 PM. Edited 1 times.
sgodwin		#16	[-]
Tomáš Mrázek 3 years Jun 15 11 9:49 PM Reply Quote More My Recent Posts	Ok, buddy taping and hot/cold therapy it is. Will let you know how it goes. Thanks team. Who needs a doctor when you can get top notch advice from a panel of medical professionals on the internet? Scott
sgodwin		#17	[-]
Tomáš Mrázek 3 years Jul 6 11 10:07 PM Reply Quote More My Recent Posts	An update on this injury if anyone is interested - I didn't climb at all for two weeks after doing it. The first week or so I couldn't have climbed anyway, there was too much pain and swelling. I started JJ's hot/cold therapy near the end of the first week, and did it once or twice a day, everyday up until we left for Arapiles. I kept my ring and pinky fingers firmly taped together the whole time at Araps, and was able to climb pretty well normally without any trouble, except for occasionally fumbling with gear because my fingers were taped together. The injury is still there, but keeping the fingers buddy taped seems to protect it well enough to still climb. We had a great time down there, and I'm already itching to go back. Scott
manacubus		#18	[-]
Jul 7 11 8:17 AM Shhh! Reply Quote More My Recent Posts	If it is a lumbrical tear, I'm told from two people who had it that the total rehabilitation time was 6 months.
rightarmbad		#19	[-]
Steve McClure 9 years Jul 7 11 12:32 PM Reply Quote More My Recent Posts	As long as you don't keep annoying it like I do. Follow the path of the independent thinker. Expose your ideas to the dangers of controversy. Speak your mind and fear less the label of 'crackpot' than the stigma of conformity. And on issues that are important to you, stand up and be counted at any cost.--- Thomas J. Watson
sgodwin		#20	[-]
Tomáš Mrázek 3 years Jul 7 11 5:13 PM Reply Quote More My Recent Posts	manacubus wrote: If it is a lumbrical tear, I'm told from two people who had it that the total rehabilitation time was 6 months. Sounds about right. Last time I had this same injury it took at least six months before I was completely pain free, and probably 12 months before it really felt 'normal' again. The good news is that buddy taping seems to pretty much eliminate the possibility of aggravating it, while still allowing me to climb. I didn't notice any pain at all while climbing every day at Arapiles Admittedly I mostly stuck to easy stuff - the hardest thing I did all week was second a 21 (pretty hard for me), and I deliberately avoided bouldering. Without the tape I can definitely tell that the injury is still there. The best news of all is that I can still jam! So my frog season isn't ruined after all. Hooray! Scott
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Possible lumbrical tear [was: Tendon strain...]

Possible lumbrical tear [was: Tendon strain...]