UKH

Afternoon all.

I've had a finger injury for the past 4-5 months. I haven't climbed in that time and as you can imagine I'm really starting to miss it. Fortunately for most of it I have been otherwise distracted, but when lockdown ends I'm keen to get back out there.

The problem is with my middle finger on my left hand. When I load it in a crimp or using a gripmaster (images below), I feel an almost bruise-like pain on the back (i.e. fingernail side) of the middle segment of my finger. When I release the load, the pain decreases. After loading,  when I press on the front of the middle segment of my finger, I get the same bruise-like pain. I don't recall a single event that made it happen, but I was pushing myself quite hard before Christmas so it could have built up through over-use.

https://www.trainingbeta.com/wp-content/uploads/2014/09/half-crimp-grip-pos...

https://waterstoneoutdoors.com/wp-content/uploads/2014/05/Gripmaster-red.jp...

I was referred to a team of physiotherapists and they seemed very confused by the injury. There is nothing to suggest it is a pulley, no pain when it isn't loaded etc. so the medical staff referred me to have an X-ray, which also came back positive. The physios also suggested it could be my triangular ligament, and gave me some stretches to complete. I've regained motion, but the pain persists. Since the X-ray I have now been referred to ultrasound, but the lockdown is making this slow and in my head it seems non-essential.

If anyone has had a similar injury or could help in any way I'd be really grateful for some advice for treatment. Thanks in advance.

Edit: I should say that I only feel this pain in a crimp postition and when I pull on something like a door handle with the force distributed over a small area on the middle segment of the finger.

Ultrasound is actually much better than an X-ray to see what may be going on in soft tissues. 

If things are still feeling confusing after the ultrasound I’d be happy to have a chat with you. Climbing is a very specific sport to return to following injury. 

Hard to give advice if you've already seen a team of physios, other than that you may be able to restart climbing but concentrate on open hand strength - 3 finger drag, volumes, slopers, big holds on steep ground etc? Sometimes a little use is better to aid recovery than total rest. Get Dave MacLeod's injuries book if you haven't already.

Is the tip of your finger bent up more than the same finger on  the other hand.

Does your middle joint feel bruised or swollen?

Thanks for the recommendation - I'll take a look at the book - think my old housemate had a copy!

No on both counts. Thanks for the response!

I experienced something extremely similar during the first 5 years of climbing. My PIP joint to my middle fingers was also quite swollen and the although nothing showed up suspected chronic trauma to my collateral ligaments. I had a course of therapeutic ultrasound, stretches and exercises etc which didn’t seem to do much at the time. I found that funnily enough it resolved on its own over times although it did take a while. 
I found that the biggest thing was - mix up what you’re doing both rock types and styles of climbing - following seasonal changes e.g early spring/ late autumn bouldering autumn and winter trad/indoor walls and summer sport seemed to help prevent over loading things chronically. Has made a big difference in injury prevention for me. Best of luck. 

Do the physios you have seen specialise in finger injuries? If not, I can recommend John Ostrovskis at 919 Clinic in Sheffield. He is set up for ultrasound and specialises in climbing finger injuries. He really helped me with DIP collateral ligament avulsion. Focussed shockwave therapy may be useful for a stubborn finger injury - worked well for me. 

Thanks for the response - they do not, though I have identified a private physio service near to me who I will approach once lockdown has lifted. Thanks for the recommendation - I am quite far from Sheffield, but it's good to know there are people who specialise in this.