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Presenter identifies most common finger injuries among climbers
Training in proper fall techniques may help climbers avoid finger injuries.
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BOULDER, Colo. — In a presentation at the International Extreme Sports Medicine Congress, Volker Schöffl, MD, PhD, MHBA, of the Klinikum Bamberg, Germany, said finger injuries are most common among climbers and could be partly avoided through certain grip techniques.
Among finger injuries, overstrain injuries and pulley injuries are the most common, according to Schöffl, with patients presenting with more A2 pulley tears than A4 pulley tears. He added multiple pulley tears presenting in one patient is concerning.
“The pulley injury is the classic climbing injury,” Schöffl said. “It has first been described in climbing. We see it also in the normal patients nowadays rarely, but it still exists.”
Management of finger injuries
Schöffl observed pulley tears are usually accompanied by a popping sound similar to when the Achilles’ tendon is injured and palmer-sided pain. Therapy for grade I, grade II and grade III pulley tears include conservative treatment with a pulley ring while patients with multiple pulley injuries undergo surgical repair, he said. According to Schöffl, postoperatively taping the finger is important because it can decrease the stress onto the pulley.
In overstrain injuries, he said tendonitis is the most frequent with clinical symptoms of palmer-sided pain that alleviated during climbing but returns. Diagnostics for these injuries include ultrasound and therapy, and Schöffl noted using H-tape for deflecting the tendon angle decreases friction. However, if use is longer than 6 weeks to 8 weeks, he recommends frequent cortisone or other injections.
Lastly, Schöffl said while stress fractures are relatively harmless, physicians need to follow strict guidelines for effective treatment.
“If a young climber has pain in the finger after training without acute trauma, [the patient] should rest for a week,” he said. “If it is not getting better, go see a doctor. For doctors, dorsal finger pain without trauma in an adolescent climber more than 1 week must get an MRI.”
Injury prevention
To avoid finger injuries while climbing, Schöffl recommended climbers relearn falling techniques, in which climbers hold the rope to help stabilize themselves at the end of a fall. However, this can cause rope burn or other injuries if the rope becomes wrapped around the climber’s finger, according to Schöffl.
“You have to train if you are falling not to have your hands on the rope to hold yourself,” he said. “Of course you are trying to hold yourself onto something, but you should have your hands in the air stabilizing your body. If you want to protect anything, you protect your head, but have [your hands] stabilizing and not on your harness. Then once you are sitting, you can still put your hands onto your harness and avoid flipping over to the back.” – by Casey Tingle
- Reference:
- Schöffl V. Differential diagnosis of finger pain in sports climbers. Presented at: International Extreme Sports Medicine Congress; June 10-11, 2016; Boulder, Colo.
- For more information:
- Volker Schöffl, MD, PhD, MHBA, can be reached at Klinikum Bamberg, Bugerstr.80, 96049, Bamberg, Germany; email: volker.schoeffl@me.com.
Disclosure: Schöffl reports no relevant financial disclosures.