Finger pulley injuries - page 2 Climbers who don’t get injured often tend to have a good balance of gripping styles. Before my first pulley injury, I was one of the many climbers who crimped everything, even pockets. Once I was forced (by injury) to train using open handed, I realised that this grip is much stronger and less tiring on certain holds. You don’t have to learn the hard way! Some climbers use finger tape on healthy fingers or old injuries to try and prevent pulley tears. The consensus of a few scientific studies is that tape is not strong enough to absorb injury causing forces. Tape appears to be useful only in the early stages of repair when the pulley is weak and you are not climbing hard. It’s also important to consider your general health, diet and lifestyle. Good sleep is essential for tissue repair during training and if you are tired, your sloppy technique will predispose you to tweaking your fingers. Don’t underestimate the importance off gentle and progressive warm up during a session. Treating pulley tears In this article I have focused on the self administered treatment/prevention of minor pulley injuries (where hand function is not severely limited). If you suspect a pulley rupture you should see your doctor/specialist straight away. For less serious tears, long lay-offs and surgery are thankfully not necessary and with prudent care, the injury should heal very well. It is crucial to understand that the extent and speed of your healing is down to what YOU do during the recovery. The outcome is dependent largely on the effort and diligence you contribute to the process. Rest Contrary to popular belief, months of complete lay-off from climbing is not required and is likely to stunt the healing process! All injuries follow a well defined and staged healing process. The first stage is inflammation and this usually lasts a few days to a week. Inflammation is a good thing as it triggers the later stages of tissue repair. However, chronic inflammation (from climbing too hard, too soon) can cause further tissue damage. It’s important to stop climbing completely until the inflammatory phase is past. It’s hard to know exactly how long the lay-off should be, but in general it should be 1-3 weeks. Too short and you risk chronic inflammation and too long and the tissues become naturally weaker and scarred. Once you can move the finger through its normal range of movement without pain, its time to start using it again gently. Using the injured part encourages healing in the same way that training makes your body stronger. Build up carefully over weeks and back off if the pain and tenderness increases. Climbing with a completely open handed grip produces little strain on the pulleys and thus you may be able to climb harder by using strictly only this grip until you can crimp again. Such discipline and change to your climbing style is extremely hard to maintain and it might only take one lapse of concentration to crimp again and risk further injury! It follows that this approach may be best confined to careful use of a fingerboard and certainly not where any dangerous climbing is involved. Ice therapy Increasing the blood flow to the area helps to speed healing greatly. Gentle climbing or exercise is an obvious way of achieving this. A little used, but massively effective method of increasing blood flow is ice therapy. If significant cold is applied to the skin, the blood vessels in the nearby area (in this case the hand) constrict to reduce blood flow and prevent cooling of the blood. However, when moderate cold is applied there is an initial reduction in blood flow followed by significant dilation of the blood vessels and subsequent increase in blood flow of up to 500%. This is called the ‘Lewis reaction’. The cycle of blood vessel constriction and dilation takes around 30 minutes and thus the cold application should last this long. Place your injured hand in a pot or small bucket of cold water with a few (roughly 5) ice cubes added. Leave your hand in the water for the length of the treatment. If your hand hasn’t gone pink and feels flushed with blood after ten minutes, the water is too icy. Try to use the ice at least once or twice a day. Don’t use this treatment on a freshly injured finger where there is significant inflammation!
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