Rock Climbing Finger Injuries
Climbing injury treatment Sydney
Rock climbing has been increasing in popularity in recent years, and many more people are discovering this exciting and rewarding sport. Although it’s a lot of fun, climbing is also a sport that carries some risk of injury. Climbing involves the whole body, but the fingers make the most contact with the rock, and they can take a lot of force. This is why the fingers are particularly prone to climbing injury.
What types of finger injuries are common in rock climbing? How can we treat these injuries? To understand climbing injuries, we first need to look at certain details of the anatomy of the hand.
Climbing-related anatomy
The flexor digitorum profundus (FDP) is a muscle in the forearm that creates flexion of the fingers – the motion that happens when you make a fist. The tendons of the muscle run along the inside of the wrist, along the palm, and then along the palmar side of each finger. (If you place one hand on the opposite forearm and gently clench and release your fist, you’ll be able to feel the FDP working.) These tendons are known as A1 through A5; there’s one for each finger, numbered from A1 for the thumb to A5 for the little finger. The tendons are encased in tendon sheaths, which help to lubricate the tendons and also to protect them during their relatively long course.
In order to keep the tendons close up against the bones of the fingers, each tendon is held in place by a band of connective tissue known as a pulley. This is located at the carpometacarpal joint – where the finger meets the hand. The pulley runs horizontally across the hand, and keeps the tendon snug against the joint, so that it will be able to work well. Without the pulley, the tendon would tend to move away from the joint as the finger flexes.
In order to keep the fingers in good alignment, there are collateral ligaments that run along the sides of the fingers. These help to keep the small finger bones from moving sideways relative to each other.
A2 pulley injury
Sudden force on the tendon can cause a partial or complete rupture of a pulley. This often happens when you’re gripping with the hand, and then a foot slips, so there’s suddenly a lot of extra force on the hand while the fingers are flexed. The force can easily be too much for the pulley and can rupture it.
The A2 pulley, at the base of the index finger, is by far the most commonly injured during climbing. The climber feels pain localized around the base of the affected finger, and there is often some swelling around the area as well.
Usually, surgery for an A2 pulley rupture is not recommended. Once it heals, you can start climbing again, and your strength won’t be significantly affected. However, you will need to tape up the finger to help support the tendon. Without the pulley, the tendon may experience “bowstringing” when the finger flexes – think of the shape of a violin bowstring. External support via taping can help with this issue. A hand therapist can help you learn the right technique for taping after an A2 pulley injury.
Flexor tendon injuries
When the pulley is injured, then the tendon remains intact. However, it’s also possible to tear the tendon itself. When this happens, you’ll usually feel pain between the palm and the wrist, where the flexor tendons cross over into the hand. In addition to pain, you’ll also have difficulty bending one or more of your fingers.
Tendon ruptures generally don’t heal without surgery. If you have a complete rupture of a tendon, then surgery is generally recommended in order to regain your hand function. If the tendon is only partially ruptured, then the remaining function may or may not be enough for you to be able to function well. Surgery may or may not offer enough benefit to be worth the risk. The decision about whether or not to have surgery is made in consultation with a surgeon, based on your current situation and your needs and goals.
Collateral ligament injuries
Certain types of sideways forces on a finger can injure the collateral ligaments. Certain types of climbing movements tend to produce these types of forces – when you’re gripping the rock with a hand while moving sideways to reach for another hold. The climber will usually feel pain along the side of the finger, often along with swelling.
As with tendon ruptures, collateral ligament ruptures may not heal without surgery. Without intact collateral ligaments, the finger will tend to remain unstable and may be much easier to injure again. If it’s a partial tear, then surgery is usually not recommended. More conservative measures, such as splinting for a few weeks followed by hand therapy, may be sufficient. For a complete tear, especially if the finger is dislocated or there is other damage, then surgical repair may be worthwhile. Whether or not surgery is recommended depends on how severe the ligament strain is, and whether you and your surgeon believe that the increase in hand function from repairing it would be worth the risks of surgery.
Climbing injury treatment Sydney
There are certainly many different types of injuries that can be caused by climbing. These are the most common finger injuries that we see, but there are many types of injuries to the hand and wrist that could occur in climbers.
If you’ve experienced a finger injury while climbing, then you may want to have it evaluated to determine what type of injury it is. In some cases, the injury will be treated using conservative measures, and a hand therapist can help you to learn how best to protect your hand after it heals. For certain more severe injuries, hand surgery may be necessary in order to regain your full hand function.
If you have a finger injury that you’re concerned about, then we invite you to schedule an appointment with Dr. Sungaran. He’ll use his many years of training and experience to evaluate the injury and determine what the best treatment would be. Dr. Sungaran is a widely recognised expert in the field of microsurgery, which allows him to complete very delicate repair procedures with an extremely high level of skill.
Your future in climbing, as well as so much of your life, depends on your hands, so it’s worth choosing an expert to help you take care of them. To book your appointment, simply contact our front desk.
