Houston Methodist. Leading Medicine

Hand FAQ

Question:

I'm a fairly good rock climber with a slight problem. Last week my foot slipped while I was climbing a short, steep section. My hand was in a crimping finger position and I heard a loud pop. Now there's swelling in my index and middle finger. Should I see a doctor? I'm really afraid of something serious like surgery. I'd rather not go there.

Answer:

In the hand there is a flexor tendon pulley system that allows rock climbers to grip with the fingertips while keeping the hand flexed. When a bent finger is forcibly extended during a foot slip like you had, the tendon pulley system can get torn or ruptured.

With serious injury bowstringing can occur. The flexor tendon actually protrudes into the palm every time you bend it. This is a sign that surgery may be needed. Otherwise, in less serious strains conservative care is all that's needed.

First the fingers will be immobilized. Taping or splinting is used for 10 to 14 days. Antiinflammatory drugs are also used to keep the swelling down. Early hand therapy is often advised for the rock climber who wants to get back to rock climbing. The soft tissues of the hand must be protected while you do sport-specific exercises.

Usually after two months you can start some easy climbs using tape or a soft finger cast. Full climbing activities are resumed after three months. The fingers will have to be taped for a full six months.

It's probably best to take a deep breath and make an appointment. Find out what's really wrong. Get a game plan going. The sooner you heal properly, the faster you'll get back to safe rock climbing!

Mark Ryzewicz, MD, and Jennifer Moriatis Wolf, MD. Trigger Digits: Principles, Management, and Complications. In The Journal of Hand Surgery. January 2006. Vol. 31A. No. 1. Pp. 135-146.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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