Pain in A2 Pulley when pressure is applied

[iclimb2improve]

So some time last week, I noticed if I applied pressure to the A2 pulley on my middle finger with my thumb that caused a slight, but kind of sharp pain. The pain in my finger was not acute, and it did not result in pain climbing or hangboarding (and so I continued HBing) until yesterday where I attempted to full crimp on a move during my warm up and caused a slight twinge. I immediately stopped full crimping (half crimping on SVNDER did not render pain) and attempted to open hand other edges which did not render any pain.

I held off asking about this injury since the last thing I thought was an injury just turned out to be a benign cyst, but considering that I felt pain crimping and that's required on my current goal route, has anyone had experience with this kind of injury and if so how should I proceed?

I have two more hangboard work outs planned and I've reached new PRs on several this season, so I would prefer not to stop training, but would not be completely opposed to it. Thank you for your time and help.

[iclimb2improve]

Update: So, I made the risk of continuing my training, regardless of the injury, moving into my power phase. When limit bouldering involving any hard crimping moves I tape my middle finger and it allows me to climb without pain and at my limit. I even climbed outdoors earlier this week to send one of my long term projects after three attempts(on a "roped bouldering day" that turned into projecting). The tenderness is still there when I apply pressure to my A2 pulley and hard crimping without tape seems to slightly irritate it (open handing does not however).

As mentioned in the main post, I've attained personal records on the hangboard, and now I've had person records on the campus board, boulder problems, and routes. I don't feel like I'm any where close to plateauing, but I also do not want to push myself too far and wind up in an event where I have to recover from a debilitating injury. My question is has anyone had to deal with this kind of dilemma of end a season early to prevent serious injury or to continue training and move into what could be your best performance phase to date? What did you decide to do and why? Lastly, what would you suggest I do?

[samb]

I had the exact same issue in my last cycle. It seemed unstable when I applied pressure in certain ways, and would get sore after a lot of climbing (and on hard crimps, like yours). I taped to make it stable and was able to continue through my performance phase with no issue. I even felt like climbing through it with tape made it stronger. With all that said, I would guess that the decision to climb through it vs. resting is a very risky one, as a thin line probably separates the right and wrong decision. To be safe I am currently taking an extended rest phase.

[iclimb2improve]

Thanks for the response!

So, I climbed Friday with a power session and the even with a taped finger I noticed that the injury has been getting slightly worse. Doing some reading and talking to a friend, the injury appears to be a grade 1 A2 pulley strain. Although not as common as acute injuries, pulley strains can be caused by micro tears and be made worse by climbing on it while the area is inflamed. The symptoms fit, especially the tender area and the pain crimping, so I have made the choice to end the season before doing more damage and start rehabbing next week (or the week after).

I made this decision to end the season for multiple reasons. One I figured if I want to reach my goal of climbing a 5.13a by the end of the year (a goal route has already been selected), and having any serious pulley strains would require multiple months of rehab to make it back to my current strength. Second, I already completed my goal route (a 5.12a) from last year during this season. The last reason is that this coming week will be one of the busiest in my semester, so I figured it would be better to more focus on school than training.

[James_E]

Mar 20, 2016 7:24:32 GMT -7 iclimb2improve said:

Thanks for the response!

So, I climbed Friday with a power session and the even with a taped finger I noticed that the injury has been getting slightly worse. Doing some reading and talking to a friend, the injury appears to be a grade 1 A2 pulley strain. Although not as common as acute injuries, pulley strains can be caused by micro tears and be made worse by climbing on it while the area is inflamed. The symptoms fit, especially the tender area and the pain crimping, so I have made the choice to end the season before doing more damage and start rehabbing next week (or the week after).

I made this decision to end the season for multiple reasons. One I figured if I want to reach my goal of climbing a 5.13a by the end of the year (a goal route has already been selected), and having any serious pulley strains would require multiple months of rehab to make it back to my current strength. Second, I already completed my goal route (a 5.12a) from last year during this season. The last reason is that this coming week will be one of the busiest in my semester, so I figured it would be better to more focus on school than training.

I'm currently grappling with this same issue. I ended my last season with a pulley strain, which didn't seem too serious. I took a few weeks rest while honeymooning in Central America, and came back to it still feeling sensitive. Open hand grips are fine. Even crimps seem fine, although with a slight sensitivity like it might not be at full strength. I have been taping, taking ibuprofen, and massaging the pulley and it isn't getting worse and may be getting slightly better. I'm about to start a hangboard phase and plan to use all open hand grips, and one half crimp grip with lots of weight removed. Does anyone have any other rehab tips to help it get back to 100% in the next 4-5 weeks before my power phase? At this point just the mental aspect is hurting my climbing as I find myself climbing much more tenuously. 

[tedwelser]

Mar 24, 2016 8:23:33 GMT -7 James_E said:

Mar 20, 2016 7:24:32 GMT -7 iclimb2improve said:

Thanks for the response!

 . . . .
Second, I already completed my goal route (a 5.12a) from last year during this season. The last reason is that this coming week will be one of the busiest in my semester, so I figured it would be better to more focus on school than training.

I'm currently grappling with this same issue. I ended my last season with a pulley strain, which didn't seem too serious. I took a few weeks rest while honeymooning in Central America, and came back to it still feeling sensitive. Open hand grips are fine. Even crimps seem fine, although with a slight sensitivity like it might not be at full strength. I have been taping, taking ibuprofen, and massaging the pulley and it isn't getting worse and may be getting slightly better. I'm about to start a hangboard phase and plan to use all open hand grips, and one half crimp grip with lots of weight removed. Does anyone have any other rehab tips to help it get back to 100% in the next 4-5 weeks before my power phase? At this point just the mental aspect is hurting my climbing as I find myself climbing much more tenuously. 

There is a sidebar discussion in the Rehab chapter of the RCTM that discusses Mark's road back from a major A2 pull.  It sounds like your situation might be a couple of months along the recovery path, but you should read that section and perhaps use it to help you adapt your HB plan.  

Basically, rehab HB work that includes the grips that bother your pulley are the key, except they have to be engaged from super low intensities until  you work up to the level that is just enough to spur a slight adaptive response.   Also, he includes more than normal rest between workouts 3 days.  But that is from the top of my head after reading the section and loaning the book to a friend in the same situation as you.