Finger Injury? Don't Sweat
Unfortunately, over the past several years, I’ve become quite familiar with finger injuries. I’ve suffered it all—from classic crimping injuries to bizarre accidents like falling with a finger stuck in a crack, or having a block shift and hyperextending a finger. Nonetheless, the results have been the same: time away from climbing and lots of rehab. I’ve had MRIs, seen physiotherapists and consulted with finger specialists. And while I’m no MD, through my own misfortune, I’ve amassed some knowledge and practical experience for dealing with these annoying injuries. Here are a few tips to help prevent these pesky injuries, and deal with them if they arise.
Of course, the best way to deal with a finger injury is to avoid getting one from the start! We all know that a good warm-up is essential—but what exactly does that mean? When dealing with tendons, a warm-up lengthens the fibers, thus putting less stress on the pullies and requiring less force to hold a grip. To achieve a proper warm-up, research has found you need to do between 100 and 120 moves while increasing the difficulty (Schweitzer MD, 2016). This means doing about 3 routes at the crag. But it’s essential that you increase the difficulty during the warm-up. You’re not going to get your fingers ready for a 5.12 route by simply climbing 5.9s. I also employ finger stretches while driving or walking to the crag, and use a finger-strengthening tool (like hand putty or a donut), to get blood to the digits.
Another way to help prevent injury is to train the fingers by doing regular strengthening exercise. This means hang board routines, bouldering or trying sport climbs at or above your limit. If the fingers are not regularly exposed to the stresses of climbing, there’s no way to develop the strength. I attribute some of my injures to the fact that I grew up predominately trad climbing and in recent years find myself doing a lot of sport climbing on limestone. I’ve never been great at training, and I feel I didn’t develop a lot of finger strength as a young climber. So, while it’s important not to overdo it, a regular program of finger strengthening is a good way to not only improve your climbing, but also prevent injury. Pay attention to keeping the forearm and fingers balanced by doing opposition or extensor exercises along with regular stretches and massage.
Throughout all my finger injures, at least the ones resulting from normal circumstances, I have noticed one common denominator: Climbing while run down, sick, or dehydrated is a sure recipe for injury. Most of my injuries have come during the middle of the guiding season where my body is already under a lot of stress. Despite being motivated to climb for myself, my tendons seem to be unable to deal with the added stress. Climbing may help to rejuvenate your mind when you are run down, but pushing it too hard is a bad idea. It’s better to take is easy on a session if you’re feeling low on energy than to force too much and risk a few months of rehab.
If you do suffer a finger injury, it’s important to diagnose the injury properly. This might mean seeing a doctor or having an MRI. Hands and fingers have a complex anatomy, and it’s vital to understand what you did. The most common injuries include pulley tears, collateral ligament strains, flexor tendon strains and PIP joint tears; sadly, I have done them all. Today, most injuries are treated noninvasively, meaning no surgery, but that’s not true for every case. Personally, despite more than a dozen finger injuries including two complete pulley tears, I’ve never gone down the surgery road. Most treatment recommends not climbing for six weeks, but that does not mean “no movement.” It’s essential that you keep the finger mobile by doing stretches and massage during recovery. Depending on the severity of the injury, it may be possible to start climbing in as little as two weeks or less. What I’ve been told from several physios is that a little pain is ok, but swelling or bruising is bad. You need to wait to start climbing until any swelling or bruising has disappeared, and stay mindful of this when you recommence. It’s normal for the injury to hurt while you recover, but if it swells you’re pushing too hard. Furthermore, you need to be realistic in managing your injury. While you may start climbing in a couple weeks, full recovery will normally take around three to four months or maybe up to a year.
Contrary to popular thought, applying tape to a finger will not help prevent a finger injury and is not a substitute for a good warm up. Tape, however, is a useful tool in helping with recovering from a finger injury. For injuries to pullies, joints or collateral ligament, tape is very useful for helping to stabilize the injury when you begin to climb again. For pulley injuries, it’s becoming common to use a custom-formed plastic ring for the first two to six weeks after the injury. This ring, which goes over the injury, helps support the injury and promotes proper alignment of the pulley during recovery. After this initial period, tape is applied to the pulley when climbing, and then you slowly wean yourself off the tape over time.
The main problem with injures to the tendons is that it’s difficult to get blood flow to the injuries, and therefore the healing process takes a long time. One way to help increase this blood flow is to do self-massage on the fingers. There are a few tools on the market to help with finger massages, but the main goal is to promote blood flow and break up scar tissue. Another way to increase blood flow is to do regular ice baths. The idea here is to cool the water enough to leave the hand in for 20 minutes, which promotes blood flow once the hand is removed.
Perhaps the crux in dealing with finger injuries, or any injuries for that matter, is staying in a good head space and maintaining a positive attitude. A finger injury is not the end of the world—you’re still mobile and can still do just about everything except climb at your limit. Use the recovery to work on other aspects that will improve your game once your injuries are healed: Increasing your cardio base, working on core strength and doing balance exercises are great ways to improve your overall fitness while you wait for a finger injury to heal. I’ve found that if I stay active and remain diligent about rehab, I return to climbing not very far below where I left off. Climbing is a very consumptive pursuit, and while it feels like the world may have ended when you hear that dreaded “pop” from a tendon injury, it is, in fact, just a minor stumble in anyone’s climbing career.
Photos by Erik Gordon and Adam George.