Mild finger ache - when to stop

[jdb]

I was wondering what peoples thoughts were on when to stop/change training based on mild/minor finger ache's and soreness.

For aches in other areas ie shoulders/wrist, I normally try to keep training but alter movement patterns slightly / avoid specific types of movement that cause issues. However it seems trickier to do this for fingers.

At what point would you delay/change/stop training:
- If theres any ache/soreness before training
- Ache/soreness thats been present for several training sessions
- Only if there is acute pain present

Also if you carry on training through ache/soreness in fingers at what point would alarm bells start sounding:
- If soreness/ache is slightly worse the next day
- If its still slightly worse just before next training session
- If its the same (no improvement) before next training session

My current situation is as follows. Basically I have a mild soreness/ache in my right index finger (seems to be all along the palm side of finger & not isolated to a particular point). It is present in the background most of the day, but doesn't seem to react to pressure ie prodding with thumb or weighting (with feet on ground) in crimp/openhanded grips. It also seems almost entirely free of acute pain during climbing (maybe the very occasional slight twinge). The ache started after my final hangboard workout (number 7), this was using the beginners workout grips from the book (so no crimps). It has been almost 2 weeks since then, have been trying to do power exercises although have stuck to limit boulder so far (no campus) & had to skip one entirely. Initially there was some acute pain in the gap between the index and middle finger, but that has been gone for about a week now.

After a limit boulder session (2 days ago) it seemed slightly worse the next day, & either slightly worse or the same (as before the limit boulder session) the day after that when the next training day was scheduled. I decided to skip the campus session today, & just do a very light ARC session (1x20min) + supplementary exercises (pullup / hanging knee to elbow / pushup). Hoping to allow it to rest a little, but give it some stimulus to help it heal strong (that was the logic anyway). This was a very hard decision though, so got me wondering how much ache/soreness others are willing to train through.

Also if anyone has any idea's what it could be, would be appreciated. Don't think it's a pulley as I wasn't doing any crimping, & doesn't seem to fit well to other common injuries I know about either.

Thanks

[MarkAnderson]

I would only stop training if the pain is acute and intense. For aches or soreness I might adjust the intensity of my training but i wouldn't stop unless it had been going on for months with no improvement. If a particular Supp Ex was aggravating the injury I would consider replacing that exercise if reducing the intensity didn't help.

For your specific situation, it sounds like you may have strained the fascia between your I and M fingers (based on the acute pain between your I and M). If that is the case, that is not a serious injury. The fascia essentially serves no purpose, though it can be a source of annoying pain. A way to test this would be to curl your I finger down, and load the MR or MRP fingers (as you would when using an MR or MRP pcket) and see if it hurts. You may want to wrap your thumb over your I finger too.

If it's just a fascia strain, I wouldn't change anything. Maybe avoid pockets for a while if your goals will allow. It will go away eventually.

[jdb]

Thanks Mark, that's very useful to know. Seems a fine line between pushing too hard & not pushing hard enough, which takes a lot of experience to judge I think. I was perhaps being a bit over cautious, as have had quite a bit of time out due to finger injuries in the past.

The acute pain went away after a few days, after that it was just aching along the finger. Not sure if that could be related to a fascia strain or if it was 2 separate tweaks cause by the same incident.

I have continued doing the training after a brief drop in intensity, & although it still ache's a bit - it seems to be making positive progress.

Cheers

[stpatty]

Apr 12, 2015 9:26:10 GMT -7 MarkAnderson said:

I would only stop training if the pain is acute and intense. For aches or soreness I might adjust the intensity of my training but i wouldn't stop unless it had been going on for months with no improvement. 

Was just curious to what you would define as an intense and acute injury? For example, applying pressure to the base of the finger at the A2 pulley is causing some me some discomfort. I don't really notice it all that much when warming up or on the RPHB, and FWIW I've tapped it fairly tight. From your experience, do you recommend adjusting resistance on crimp-like grips or for this type aggravation or continue as planned?

Thanks!

[MarkAnderson]

I would not consider that intense or acute. That sounds mild and chronic, specifically like a case of tendovaginitis, which is essential inflammation, typically caused by overuse (or more often actually under-rest). For me, I find that hangboarding is a surefire cure for this condition, perhaps because there is so much rest built in.

Also, sometimes taping actually makes things worse by irritating the inflamed tissue. Have you considered not taping?

[stpatty]

Jun 3, 2015 19:09:13 GMT -7 MarkAnderson said:

For me, I find that hangboarding is a surefire cure for this condition, perhaps because there is so much rest built in.

Also, sometimes taping actually makes things worse by irritating the inflamed tissue. Have you considered not taping?

Glad to hear this, Mark. The thought of putting the strength phase on hold was a huge bummer. I did HB2 on Tuesday, and it still feels sore to the touch, but I'm hopeful that through the strength phase it starts to feel better (scheduled for the standard HB training day + 2 rest days).

I've always taped in the past when I had a tweaky/sore finger or whatever.. I have seen you mention on the forum that taping has made things worse for you, so you stopped. I guess it's a mental thing for me - adding the tape makes me feel safer, but it is probably just a placebo effect. I will experiment to see how it reacts without the tape tomorrow on my next HB workout.

Thanks.

[jessebruni]

Jun 3, 2015 19:09:13 GMT -7 MarkAnderson said:

...specifically like a case of tendovaginitis...

Did you just call him a pussy? 

[MarkAnderson]

 That's totally a real thing, you can look it up

[stpatty]

Guys, wanted to post an update since originally posting about my A2 ring finger pain when applying pressure at the base of the finger. The "tendovaginitis" that Mark explained above.

I ended up completing my strength phase with no issues, with PRs and significant gains - always an awesome feeling. The finger definitely was sore the day after but no acute pain, so I figured to continue with the plan (standard HB with two days rest).

Now I'm in the power phase, and it's beginning to get a little nerve-racking - the pain is creeping in and the A2 pain is definitely more significant. Finger is very stiff the next day and applying pressure at he base of the finger is painful for sure. I've gone through the first three campus workout and 2 LB workouts, according to the schedule. It's funny though, there isn't much pain while climbing after an extensive warmup, but it is very sore and painful to the touch the day after pulling hard on the campus board or on boulder problems.

Any recommendations? Traveling to Kalymnos and im super psyched to go, which makes me want to train. Stop the power workouts? It's a tough decision on how far to "push it".

[MarkAnderson]

It sounds exactly like tendovaginitis, but it's unfortunate that hangboarding didn't clear it up. In my experience, with that type of injury you need to exercise it or it won't get better. But you also need plenty of rest, and LBing is certainly much more intense than HBing. What is your schedule of rest days? My recommendation is that you add some extra rest into your schedule and limit the amount of closed crimping you do (that is, don't stop completely, but don't over-do it). My guess is (haven't been there) Kalymnos is not super crimpy, so you can probably get by without emphasizing that grip in training while the inflammation clears up.

Also make sure you're warming up well before doing anything intense with that finger. Are you still taping? Have you tried not taping?

[stpatty]

Jul 8, 2015 10:37:27 GMT -7 MarkAnderson said:

What is your schedule of rest days? My recommendation is that you add some extra rest into your schedule and limit the amount of closed crimping you do (that is, don't stop completely, but don't over-do it). My guess is (haven't been there) Kalymnos is not super crimpy, so you can probably get by without emphasizing that grip in training while the inflammation clears up.

Also make sure you're warming up well before doing anything intense with that finger. Are you still taping? Have you tried not taping?

Thanks for the reply, Mark. I'm following the experienced schedule from pg. 187 in the RPTM (although did intermediate for both HB and Campus board, minus double dynos that I replaced with additional max ladders and a couple bump exercises). Specifically my remaining schedule is:

Tomorrow: Campus 40 min
1 Rest Day
LB outdoors, but planned to do indoors due to extremely hot temps
1 Rest Day
Campus 45 min
2 rest days
LB
1 rest day
Originally planned to do an additional campus workout, since I do not have redpoint attempts planned (have plans for the NRG the following weekend), so i figured one more campus before going into PE wouldn't hurt......

Then obviously transition into PE phase.

I am no longer taping, I took your advice and dropped the tape and didn't even really notice a difference. I am definitely warming up plenty before doing anything power related, specifically with an extensive WBL. I try to avoid crimping at all cost, but even if I do full crimp once or twice it doesn't feel all that impacted, if I'm warmed up.

I think I'll take your advice and just take more rest in between workouts, maybe two rest days after every workout, even if it is just LB? Or maybe drop a campus workout?

[MarkAnderson]

Ya, I would say at the least take two rest days after a campus workout, but if you think campusing is the problem you can easily skip the remaining campus sessions. I definitely think you can afford to take more rest, so if I were you I would take two rest days after every session for a while and see if you notice any improvement.

[stpatty]

Jul 8, 2015 20:03:18 GMT -7 MarkAnderson said:

Ya, I would say at the least take two rest days after a campus workout, but if you think campusing is the problem you can easily skip the remaining campus sessions. I definitely think you can afford to take more rest, so if I were you I would take two rest days after every session for a while and see if you notice any improvement.

Wanted to post a progress report, since it's been a while... I continued through the program leading up to my trip to Kaly. I even mimic'd the "power maintenance" campusing exercises during my PE phase to prolong my power peak. Long story short, once getting to Kaly and adjusting to the style, I sent two "semi-projects" within a couple burns - which was preferable on a destination climbing trip. Both routes were at my previous-to-the-trip red point bests - 12b/7b. I was really psyched about that, but also psyched that my finger wasn't bothering me! Mark, you were right, Kaly definitely isn't a place for crimps - I didn't touch a small hold the entire time I was there, just plain fun!

When I returned from my trip it was a different story though, went to the NRG for two weekends in a row. The second weekend was a 4 day weekend. I continued to surprise myself, which was awesome. Sent multiple 12b 4-star classics at the NRG.. all in less than 5 burns, I did 4 12bs in short order which was far and away a huge improvement from this time last year. Okay enough spraying.... but after the trips to the NRG the tenovaginities definitely is back with authority, my ringer finger is again extremely tender to the touch at the A2 pulley. I took a week off after the second weekend at the NRG and went to the gym tonight and it seems like its back with a vengeance again. I just bouldered around at the gym, nothing specific. Can't seem to shake this one, which is concerning for the long term.. any advice, Mark?

[MarkAnderson]

Certainly trying to boulder off the couch is a bad idea with any injury. Basically you're going from nothing to the most intense type of climbing overnight.

My advice is to start a new cycle. Use a shorter Base Fitness Phase with less-than-usual volume (since extensive ARCing can cause/aggravate finger tendovaginitis). I find hangboarding is the best cure for tendovaginitis of the fingers. I think the regularly stimulus, long recovery periods, and relatively low TUT all help to encourage healing.

[stpatty]

Sept 18, 2015 8:53:53 GMT -7 MarkAnderson said:

I find hangboarding is the best cure for tendovaginitis of the fingers. I think the regularly stimulus, long recovery periods, and relatively low TUT all help to encourage healing.

Based on your HB comment I decided to just go right into HB rehab tonight, and continue with it until I'm back to 100%. Especially after re-reading your "keep fingers looking good" on pg 182 from the Flight of the Phoenix A2 injury you overcame.

I went to the gym and did a very conservative WBL (4 problems of each V0, V1 and V2), since ARC'ing isn't really an option at this gym. Came home and did the below HB workout. Since this is the first one, I wanted to keep it extremely conservative to see how I respond.. On all grips I did 3 sets of 7 reps of 7 seconds on/3 seconds off and 3 minutes rest in between sets. On all grips I did 50% of my previous best hang weight. All of the hangs felt so easy:

Med Edge (far left of edge) at 50% of previous PR (-70, for 115 lbs) - felt crazy easy.. some discomfort after the hangs when extending the fingers/doing ROM - the discomfort seems to be there when the tendon travels through the A2 pulley?

MR - Deep 2FP  at 50% of previous PR (-90, for 95 lbs) - no issues

Med Edge (far right of edge) at 50% of previous PR (-90, for 95 lbs) - same as first grip on Medium Edge

MRP - Deep 3FP at 50% of previous PR (-80 for 105 lbs) - no issues

I'm dedicated to taking 3 rest days between workouts and monitoring the load progression closely. I selected these grips because I feel like all of these trigger the injuries I've experienced on this tendon:

This is the second time I've done HB rehab (HB Rehab #1 as Forum Guest). Previously I had injured myself on MR - 2FP and it seemed to be a unit strain with pain localized in the wrist.... now, on the same tendon, the pain is around the A2. After that strength/HB rehab phase, I took 4 days rest and then began a new cycle at the beginning.

Towards the end of the new base fitness/ARC phase is when the pain crept up the tendon to the A2, but wasn't really "intense" - just sore to the touch (Intense ARC). I then continued through to strength phase and the finger healed up nicely, until the power phase when it became aggravated again (posted about this on this thread, scroll up). 

Long story short, my question is - is this tendon now considered a "chronic" injury, since I've been experiencing issues on this tendon since April? It's only recently become worse than normal, but has the damage been done? I guess there's no telling "how bad it is" until I see how it responds to some rehab, and I should just take it one workout at a time...

Also, after reading through the forum I was curious of tendovaginitis vs. trigger finger (Trigger Finger)  - are these essentially the same thing where in both scenarios the tendons are just inflamed? Reason I ask is that I do feel a small lateral lump below the A2 and the pain is not necessarily specific to closed crimps, it also appears on semi-closed crimps.

Thanks for the help.. injuries suck.