Today when bouldering, I went up for a two-finger crimp with the middle and ring finger of my left hand. I'm pretty sure I heard the tiniest pop, then my ring finger went out and I felt pain in very specific spots: A) mild discomfort between the knuckle at the base of the ring finger, and the next knuckle up the finger, B) pain in the palm and C), for the first hour or so there was pain about midway down the forearm that I actually can't duplicate right now.
Alex | rockandice.com Forum
I have been documenting this injury for many years and really, I should get off my lazy ass and do some research into what exactly is torn.
The mechanism is virtually always a training condition known as hyperzealopathy, whereby the climber is unable to recognize imminent injury. The two most common situations are carrying your over-laden shopping bags with one finger or pulling on a hold with one (or two) fingers with the little and/or ring finger tightly curled into the palm.
SHIZZLE! Not only did it F#%* hurt, but now you can't get it to hurt again. Wassup with that? It won't hurt unless you replicate the tightly curled finger. Try the Dr J Test described in Ask Dr. J issue 172 (archived at www.drjuliansaunders.com.)
I recently saw a research paper written by a less lazy practitioner who suggested the pain might be arising from a tear at the insertion of one of a group of small muscles in your palm called lumbricals. Unlike other muscles they attach to corresponding tendons that control flexion and extension of the fingers (rather than two bones). These are subject to severe elongation forces when adjacent fingers are loaded at opposing lengths.
As you have noted, there is pain in several spots. Your presentation is the stock standard. Being in multiple sites, the pain pattern makes definitive diagnosis a nightmare. I have always assumed the tear to be in the forearm where the flexor tendons come together and attach to the primary flexor muscle, flexor digitorum profundis, and the palm pain was referral. Gosh damn! I am not the repository of all medical wisdom -- it could be the other way around or even involve both sites.
Frivolous details like location need not impede management. You can pretty much climb as hard as you want if you follow one simple rule: don't split your fingers. Can't control your middle finger? Give them the relaxed bird. The half-crimp, where the middle two fingers are crimping and the corresponding fingers are technically open handing, can also be tetchy. This creates a minor shearing and, depending on the severity of injury, may be aggravating. If you are open-handing and your little finger is not long enough to be on the hold, then be sure not to curl it into your palm. Same with crimping if any fingers can't fit on the edge. Try and stack them under or on top of neighboring fingers. Though a little tricksome, it is better than laying off completely and focusing on your belay technique!