Finger Flexor Pulley : the most common climber finger injury

pulley-injury-finger-climber
How to Prevent and Treat Finger Flexor Pulley Injuries ? Pulley injuries are the most common climber finger injury. To climb longer and stronger, it’s important to understand our hand anatomy. And also how pulley injuries happen, as well as how to prevent and treat them, and to restrengthen an injured digit.

Anatomy

Three bones and three hinged joints make up the finger. Ligaments connect and stabilize the bones. Tendons connect muscle to bone, transferring to the bone any forces created by the muscles. Flexor tendons in the fingers attach to muscles in the forearms that pull on the tendons, bend the fingers. And allow us to crimp.

Connective tissue encases the tendons, forming a sheath with five thickened areas that create the annular pulleys (A1, A2, A3, A4, and A5). They keep the tendon close to the bone when bending the fingers.

Finger-Pulley-injury-climbing-crimp

Causes

A loud “pop” and then significant swelling and pain often indicate damage to the flexor-tendon pulleys. For A2 pulley injuries, the most common pulley finger injury for climbers, the pain usually arises at the base of the finger. And it is noticeable when trying to straighten or bend the finger.

For A2–A4 ruptures, there may be bowstringing—bulging at the base of the finger—which can be detected by resisting fingers bending at the fingertip. In this latter case, consult an orthopedic surgeon. As it can indicate a serious, grade 4 tear.

finger-flexor-pulley-injury-risk-crimping-climbing

You know what ? Crimping increases the risk of injury. Just because of the increased forces exerted on the pulleys, especially the A2. A fully closed crimp grip, with the thumb over the index finger, exerts even more force. Typically, this injury stems from either warming up poorly or a desperate, dynamic move to a tiny crimp, often with poor footwork and body positioning.

Prevention

The best way to deal with finger injuries is to not get them in the first place. And so what ? Prevention requires warming up well, climbing with proper technique. And also stretching.

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1 Response

  1. Charly Begood says:

    Pulley injuries are often describe as a “loud pop”.
    But this is for a clean pulley rupture. And in my case, it never happened.
    This is more of a swelling Pain localized in the joint of the finger.
    At this point, I know I have to stop climbing for a month… But no surgery
    Maybe I am wrong, but according to the book “Escalade : Pathologies de la main et des doigts” from S Gnecchi, my injury is also a pulley injury. And no “pop” was heard…
    Is it…?
    Anyway, finger are really exposed in our sport, and every climber should listen its body with attention to avoid injuries.

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