Injuries and Medical Advice

First Pulley Strain

I just managed to get a torn pulley rock climbing. This occurred in my ring finger after pulling on a mono. I have had neuromuscular massage twice. Any info on pulley strains?

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I just managed to get a torn pulley rock climbing. This occurred in my ring finger after pulling on a mono. I have had neuromuscular massage twice. Any info on pulley strains?

— Anonymous, rockandice.com

torn pulley rock climbing
Injuries to finger pulleys are common. Ironically, a ruptured pulley can be less painful than a partially torn one. Illustration by Steve Graepel.

What is “neuromuscular massage?” I’m in the manual-therapy field, but this version is a mystery to me. Does it have a happy ending? Does it help for a torn pulley from rock climbing?

To some extent there are different massage techniques, but often the labeling is more about marketing than delineation. I was driving through Durango,
Colorado, a few months back and saw a sign for “Medical Massage.” WTF is that? Not even Google could explain it to me. Differentiation of massage styles
comes down to semantics and falls into one of the following categories—painful, less painful, relaxing and/or downright fun.

Here’s a typical scenario: Bob goes to a masseuse. The therapist listens carefully, nods at the right times, then gets to work on Bob’s sore finger. Maybe
it was painful, maybe not, maybe Bob got wood, but no matter the tricky lexicon, Bob had his finger rubbed. The end.

Although the badges given to various types of massage may be no more than black-box marketing, the massage is unlikely to do any harm and highly likely
to encourage blood flow, thereby enhancing healing rates. Go to the practitioner whose massage and personality you like best, and I guarantee you it
will be the style that works best.

[Also Read Avoiding Fingerboard Injuries]

Pulley strains and ruptures are the most common injuries for climbers, period. Usually, with a little compromise and creativity on your part, they are
manageable. Dial back the training intensity and avoid your current project. Strategic taping to limit the specific range of motion that loads the
affected pulley should drastically reduce the pain and, after a week or two of rest, allow you back on the rock. You can turn taping into three-dimensional
origami, but the most effective method for protecting your pulley from further damage is to go round and round the knuckle until you can’t bend it.

Injury to the distal pulleys, around the DIP joint located at the end of your finger, cannot be protected using tape and will need outright rest until
it settles, usually in a few weeks.

Fully ruptured pulleys will require four to six weeks rest, followed by progressive loading thereafter.


This article appeared in Rock and Ice issue 221 (October 2014).