January 31, 2018
Finger injuries. The bane of many climbers at some point in their climbing journey. As a Registered Massage Therapist who climbs and treats climbers, I have had a fair share of people coming into the clinic with finger injuries, along with my own woes. After having my own finger “tweak” recently (and the process is fresh in my mind), I decided to write a blog on how to properly rehab and load your fingers to get you back to climbing your projects as quickly as possible. This post isn’t going to address diagnosing specific injuries -ligament, tendon, fractures or dislocations. The injury should be assessed by a professional who knows climbing injuries since your elbow and/or neck may also be involved. Which brings me to my disclaimer, this blog should in no way take the place of seeing said professional who understands treating climbing injuries, especially if you heard a pop or felt tearing in your finger, hand, or forearm.
First of all, mechanics are important in terms of how the load is transferred through your fingers. If you look at your finger with it straight and then bend it (finger flexion) so your finger touches your palm, it should track straight. Every person who has come in to my office with a finger injury always has their finger deviating to a side.
Once you have that finger tweak from climbing, or if you wake up the next day with a swollen and sore finger but you don’t remember hurting it during your last session, you need to rest from climbing. Having done everything from dislocating my finger, to waking up with a swollen finger without feeling a snap or pop, I have learned the hard way that resting from climbing for at least a few days or maybe a week or two, depending on the severity of the injury, will let you heal and return to climbing at full strength, faster than trying to climb through it. However, you do need to load the muscles/tendons/ligaments an appropriate amount so that they get blood flow and repair. Just so you know that I’m not making up this idea of loading soft tissues -especially tendons with long standing pain aka tendonosis- to promote healing, Dr. Julian Saunders is a climber, who treats climbers as an Osteopath, recommends this in his article on Dodgy Elbows http://drjuliansaunders.com/ask-dr-j-issue-223-dodgy-elbows-revisited/. Another climbing resource that states loading soft tissue injuries within reasonable amounts is necessary for the healing process is Dave MacLeod in the book Make or Break: Don’t let climbing injuries dictate your success.
So let’s go back to concept involving finger mechanics while adding load aka resistance. You need to load your finger in conjunction with fixing the tracking problem. As long as your finger continues to deviate, you will keep putting extra force on the surrounding ligaments and tendons. So, the first few exercises revolve around fixing your finger tracking and balancing out the intrinsic muscles of the hand. You can do them daily to encourage blood flow to the injured tissues as long as you aren’t MORE SORE the next day. If you find you are more sore the next day, back off on the reps or resistance level. There are a few tools you can use to do this. Some people will use elastic broccoli bands. I personally like Power Fingers. Here’s a link to the website: https://thepowerfingers.com/product/climbing/. Boulderhouse also sells them.
Power Fingers are great for a few reasons: there are 5 different levels of difficulty with various spots to put your fingers for straightening your fingers (extension) and spreading your fingers apart (abduction). I usually do these exercises in 3 sets of 20-30, but you can play around with the reps to see what feels the best for you. You can also use them for isolated finger flexion while working on getting your finger to track straight. Finger extension and abduction are where climbers generally have the most significant strength deficit. Another exercise that is helpful involves moving between pronation (palm down)/supination (palm up) that will help balance out your elbow. You can use a stick clip, a frying pan, or a dowel for this exercise (3 sets of 10/15). Check out this video to see one elbow exercise and three exercises to correct finger tracking and imbalance that lead to poor finger tracking here!
For the people who are still reading this article even after I used the dreaded R word, “rest”, fear not. You don’t have to be 100% to return to some level of climbing. I have a few basic tests that let me know when I can start climbing easy open handed climbs. The first one is being able to hang with body weight for 10 seconds for 5 sets on a one pad edge without pain during the exercise or the next day. Or I should be able to use a half crimp grip on my steering wheel using a decent amount of force without pain. Once I am able to do these 2 things, I can go back to very easy climbing (2 to 3 number grades below your redpoint ability if you are on a rope) focusing on only climbing with an open hand WHILE using good finger tracking and no chicken winging with your elbow. Then, if you are able to wake up the next day without an increase in pain, you slowly, I repeat SLOWLY start climbing a little harder (a letter grade or two harder). At the re-entry to climbing phase, I would limit climbing to 3 times a week, always having a rest day in between. The biggest mistake people make when returning to climbing is feeling better and then jumping right back to trying hard without building the injured tissue back up. If you do this, you will wake up a very grumpy climber with a sore finger the next day. Last of all, you need to continue doing these exercises when you start climbing. If you return to climbing and aren’t experiencing pain during your session or anymore pain the next morning when you wake up, you know you are loading your finger the proper amount! Congrats!! Self control is one of the hardest things for climbers to manage.
And just to give you a glimmer of hope, after dislocating my finger and having 5 weeks of the most excruciating finger pain -couldn’t hold a knife type of pain- after seeing 3 therapists who had no idea what was wrong with me, I saw a Physiotherapist in Vancouver who understands climbing injuries. After one session with him, I was able to return to climbing 2 weeks later and sent my long term project, rated 13a, two months after having my finger adjusted. In my next post, I’ll go over more advanced ways to load your fingers so that you can get back to pulling hard and use these methods to help prevent injury in the future.
Christy Mader BSc. RMT and avid climber.