Due to lockdown, bouldering and climbing centres across Victoria are closed causing a lot of disappointment for avid climbers. We can expect that once restrictions ease there will be a rush of climbers returning to the centres and due to their limited opportunity to climb, they may be at increased risk of injury due to deconditioning.
Approximately three quarters of total rock climbing injuries are related to the hand/wrist and almost half of those injuries are due to flexor tendon pulley injuries. Within your fingers, these flexor tendon pulleys keep the tendons supported close to the bone, acting like supportive loops – similar to the action of eyelets of fishing rod. These structures can be overloaded, causing them to tear partially or fully. There are five main flexor pulley injuries and multiple pulleys can be injured at one time. In climbing, these injuries can be caused from a sudden force through the fingers, such as when your foot slips from a foot hold or when trying to apply pressure through the fingers on a dynamic movement between grips. Due to the exaggerated positions of the finger joints in a crimping hold and the associated stress on the pulleys, this position can often be the culprit of causing a pulley injury.
These injuries will often present with a “popping” sensation when injured as well as pain, tenderness and swelling over the underside of the finger. In more serious pulley injuries, “bowstringing” (i.e. pulling away of the tendon from the bone when bending) can be seen, with reduced ability to bend and straighten the fingers.
If you suspect that you may have injured your hand whilst climbing, it is important to see a hand therapist for a comprehensive assessment of your injury to determine the likely diagnosis and best treatment plan. Although pulley injuries are common with climbers, it is important to see a specially trained therapist to determine the most likely cause of your pain, determine if imaging (x-ray/ultrasound) is required, as well as provide splinting, taping or exercises as appropriate. Your therapist can also help develop a plan to get you safely back to climbing as well as managing your injury in daily life.