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Rare finger injuries are common among climbers
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Finger, arm and shoulder injuries are common in extreme sports athletes, and according to an orthopaedic sports medicine specialist these maladies are often successfully treated with simple immobilization.
“We already know there are many injuries in climbers on the fingers and upper extremities,” Volker Schöffl, MD, of the Department of Sports Orthopedics-Sportsmedicine, at Klinikum Bamberg in Germany, said during his presentation. There are as many as 25 differential diagnoses for finger injury, he noted, and he often sees unique finger injuries in extreme sports athletes who present at his practice.
Among the most likely injuries are tendonitis, joint capsular strain, lumbrical shift phenomenon and stress fractures, Schöffl said. A common injury he sees in rock and mountain climbers is of the joint capsule which is sustained by straining a finger while climbing and placing fingers in small openings in rock faces. Rest through immobilization typically alleviates the injury.
Tendonitis, or inflammation of the tendons, is seen regularly in climbing populations, and can present as an acute onset. Diagnosis is based on clinical evaluation and ultrasound. Treatment involves immobilization, stress reduction to the affected area, hyaluronic acid or steroid injections, and utilization of tape to reduce friction when climbing, Schöffl said. Additional finger injuries involve lumbrical shift phenomenon, a generally rare disease that is often found in climbers. The muscle that stretches from the flexor tendon and inserts at the fingertip dorsal line can cause pain due to entanglement in the palm.
“These muscle bodies are often grown together in the middle of the palm, so climbers often have pain if they are hanging on one finger,” said Schöffl. If left untreated, the muscle shift within the palm can lead to a tear.
Stress fractures are an issue with climbers — particularly in children who climb. Prompt treatment is important in this population.
“The whole crucial point is early finding so that you preserve function,” he said. “If you have a young climber, 12 [years] to 16 years old, who has had finger pain for more than 1 week, they need to see a doctor.”
Another finger injury sometimes seen among climbers is avulsion amputations, caused by fingers being wrapped within and amputated by the quick movement of the rope when the climber is descending. The finger fragment can often be reattached successfully in these instances, Schöffl said. – by Katie Pfaff
- Reference:
- Schöffl V. Differential diagnosis of finger pain in sport climbers. Presented at: International Extreme Sports Medicine Annual Congress; June 13-14, 2014; Boulder, Colo., USA.
- For more information:
- Volker Schöffl, MD, can be reached at Klinikum Bamberg, Buger Straße 80, 96049 Bamberg, Germany; email: volker.schoeffl@sozialstiftung-bamberg.de.
Disclosure: Schöffl has no relevant financial disclosures.