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Injuries and Medical Advice

Fingers: Torn A2 Pulley

I was pulling on a big sloper with my feet way under me when I felt a crunch and heard a pop in my middle finger between my knuckle in my hand and the first joint in my finger. It immediately hurt (but not a ton) and later there was swelling. I took ibuprofen and iced it.

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I was pulling on a big sloper with my feet way under me when I felt a crunch and heard a pop in my middle finger between my knuckle in my hand and the first joint in my finger. It immediately hurt (but not a ton) and later there was swelling. I took ibuprofen and iced it. Before bed I taped it to keep the swelling down. Today the pain is not as localized, but is an overall ache in my hand. The same thing happened several months ago. What gives?

Tracy Wilson | Carbondale, CO

It’s cool to be special, and snapping an A2 pulley in an open-hand position rather than a crimp is special indeed. The hold must have been reasonably angled such that you were flexing the metacarpophalangeal joints (the ones at the base of your fingers, just inside your palm). The popping noise, pain and swelling pattern probably means the full monty: ruptured.

Clearly you have been on the rough seas for a wee while. Tearing a second pulley (or the same one) in such a short time is not so much a wake-up call as it is a torpedo barreling through your porthole — something is amiss.

Generating sufficient force in this position to rupture a healthy pulley is unlikely. Which places you in one of two scenarios. Option 1: You have been marauding through the Land of Overtraining and the incumbent warlord has sliced you up. He is toying with you. Get the fuck out of there! Option 2: You are a mutant languishing in the Age of Stupid, with the voracious bite of a T-rex but the brains of an anemone. In other words, you are biting off more than you can chew. Jump the evolutionary queue and start a training program.

Stretch out your joints so as to allow even loading of the pulleys. When a finger joint is tight and accessory motions like shearing are reduced, the pulley can be unevenly loaded along its length, precipitating a tear from the end of more load. There is a stretching video on my web page (drjuliansaunders.com). There is also an article on taping that will help you manage your return to climbing. The month it will take to repair this pulley is less of a concern than the months it will take to properly strengthen all of them.

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