One can safely assume that veteran climbers have experienced a finger pulley injury or two (maybe more) at some point in their climbing careers. Aside from scrapes and bruises, pulley injuries are some of the most common climbing finger injuries. Unlike the first two, however, pulley injuries are painful at the least and can require surgery at the worst. Regardless of the severity, pulley injuries can set your climbing adventures back by a few weeks or even several months. If you don’t want that to happen to you, then be sure to take some time to read the following paragraphs. We’ll take a look at the causes, treatment, and what you can do to avoid them.
Causes of Pulley Injuries
While gripping and pulling yourself up over different climbing holds, you are exerting a significant amount of pressure on your fingers. Under normal circumstances, you shouldn’t have to worry about getting a pulley injury or any climbing finger injuries. However, there will be times when you accidentally shock-load your fingers, which can cause finger pulleys to rupture or break.
For example, when you suddenly lose your foothold and slip while climbing, your fingers will be responsible for carrying your weight. The sudden increase in pressure and strain is what leads to a finger pulley injury.
Treatment for Finger Pulley Injuries
Unlike finger scrapes and bruises, you cannot treat pulley injuries using climbing salves and balms. They may help alleviate the pain associated with the injury, but that’s about it. So how do you treat a finger pulley injury, and how soon can you get back to climbing after the treatment?
That will depend on several factors like the severity of the injury, how well your body responds to the treatment, and others. Below is a general guideline regarding the matter.
Grade I Injury: Pulley Strain
Like most types of climbing finger injuries, this type of injury requires no immobilization and surgery. Therapy should include functional and passive motion (ROM) exercises. Taping the injured finger is also recommended to protect it from further damage.
You should be able to get back into climbing after four weeks of treatment. Experts recommend wearing a climbing tape for the first three months after returning to climbing.
Grade II Injury: Partial A2 or A3 or Complete A4 Rupture
Doctors recommend at least ten days of immobilization when treating this type of pulley injury to protect the damaged tissues. After the immobilization stage, patients undergo passive ROM exercises. After two to four weeks, patients can do functional exercises while wearing tape to prevent further injury.
Climbers can start doing novice level climbs to regain strength and coordination after four weeks. Wait until six to eight weeks before doing any strenuous climbing. Remember to wear tape during these times.
Grade III Injury: Complete A2 or A3 Rupture
This type of finger pulley injury is the most common and makes up the majority of the pulley injuries treated in hospitals. It requires extensive treatment and longer recovery. Doctors suggest an immobilization stage of 10-14 days followed by passive ROM exercises. Functional exercises usually start at the four-week mark. Patients wear a thermoplastic ring instead of tape during these times.
Climbers can start doing easy climbs after six to eight weeks but should refrain from doing full climbs until after three months. Climbers should wear a thermoplastic ring or tape while climbing for at least six months.
Grade IV Injury: Multiple Ruptures or Single A2/A3 Rupture with Trauma
Like other severe cases of climbing finger injuries, surgery will be required for this kind of pulley injury, followed by 14 days of immobilization post-operation. Patients perform passive ROM leading to 4 weeks, which is when they can start doing functional exercises. Patients will be required to wear a thermoplastic ring throughout these times.
Patients can start doing easy climbs after four full months after the operation. Only after six full months should they attempt full climbs. They will still be required to wear a thermoplastic ring for a year after surgery while climbing.
Q: How do you know if you have a pulley injury?
Most climbers report hearing a "pop" at the time of the injury. Also, most common symptoms of a pulley injury include pain and tenderness on the palm-end of the finger when pressure is applied, swelling of the injured finger, and inability to roll their fingers to form a fist.
Q: How do you treat a strained finger pulley?
A strained finger pulley falls under a Grade I type of finger injury and treated by therapy that includes passive ROM and functional exercises. Wearing a tape is also recommended to prevent further damage to the tissue.
Q: How do you know if you tore a tendon in your finger?
Different types of tendons show different symptoms when damaged. For instance, if the extensor tendons are damaged, you won't be able to straighten your fingers or thumb. If the flexor tendons are damaged, you won't be able to bend your fingers or thumb. Tendon damage (regardless of the type) can also result in swelling.
Q: How do you treat A2 pulley strain?
The standard treatment for a singly pulley injury applies but will require longer immobilization and recovery. Doctors will recommend wearing tapes or thermoplastic rings as well. Postpone any climbing plans for at least two months after the injury.
Q: Where is the A1 pulley located?
The first annular pulley or A1 pulley, located near the head of the metacarpal bone, is found in the flexor groove in the deep transverse metacarpal. The A1 pulley originates from the volar plate on the volar aspect of the metacarpophalangeal joints.
Q: How do you tape a pulley injury?
There are several ways to tape a pulley injury and the most common is by using the "H" tape method.
- Take a piece of tape about eight to ten centimeters long.
- Tear one end of the tape lengthwise up to the middle portion of the tape. Do the same with the other end. Don't tear the tape completely. Leave a "bridge" of at least one centimeter between the inner ends of the tears. The tape should form an "H" or "X" shape after this.
- Position the "bridge" on your inner joint.
- Wrap the straps around your finger. The upper straps should wrap around just above the knuckle behind the middle joint of your finger, while the lower straps should wrap around just below the said knuckle. Again, the knuckle should be left exposed with the straps wrapping above and below it. Turn your palm towards you, and you'll notice that the tape formed an "X" over the middle joint of your finger.
- Take another piece of tape. The second tape should be a bit longer than the first one. Do not tear it up like the first tape; leave it whole and intact.
- Take one end of the second tape and attach it onto the "bridge" on the first tape. Press it down firmly to prevent it from coming off. Then, wrap the second tape around your finger by following the "X" pattern made by the first tape. The knuckle behind the middle joint of your finger should remain exposed after this.
Globo Surf Overview
Despite the many health benefits of rock climbing, it does have its own set of risks and hazards. Climbing finger injuries is one of them. If you have been climbing for years, then you’ve probably experienced a finger pulley injury. If you’re new to climbing, it will only be a matter of time before you get to experience it. Fortunately, there are things you can do to avoid it like doing climbing warm-up exercises, using climber’s tape, and others. These will