Tendon Care 101

Hi Steph,

Although I’m shooting you an email in hopes of getting some sound advice about injury, i do just have to say that you are pretty incredible in terms of both climbing and the lifestyle you’ve created for yourself; you’re really inspirational and i look up to as a climbing hero. (I know you get that every day with every incoming email but i thought i’d just jump on the bandwagon and tell you again, haha). Okay, to the important stuff. I’m 19, only started climbing at the end of high school, haven’t had any real climbing injuries, until now. I went to the Red over spring break with some guys from school. I ended up ripping/straining/messing/popping tendons in both hands on the second day. From what i’ve read thus far I have a flexor unit strain (does this sound right?)… it’s the same tendon in both hands…the tendon that goes to the ring and pinky fingers. i think my middle finger is okay but the ring finger is definitely bad (when strained, the sharp pain can be felt in the inside of the wrist too). This happened climbing open-handed on 2-3 finger pockets. Has this ever happened to you or others you know? What did you do? What is your advice in terms of can i still climb as long as i stay off pockets or should i lay off all climbing? Do you think other exercise like lifting weights would be a bad idea? I think it’s tricky because i can still crimp and climb other stuff without pain; it’s the pockets and open-hand that hurt…but does any climbing (whatever it may be) injure me further for the future? I would really appreciate it if you could give me any advice on this matter. Thank you so much. And thank you for the website and the blog; it’s great stuff!

Sincerely,
Jeff

Dear Jeff,
I hope your fingers are better now! Most climbers have to deal with tendon issues at some point. When I had been climbing for about five years, I strained my ring finger tendons while climbing in a gym, and it took a long time for them to feel good again. I have been fortunate to never have one of those horrible pop-and-tear injuries. The ring finger is one of the weakest fingers, and it’s pretty easy to hurt that one. I notice that sometimes I have a tendency to want to use only my first three fingers on a crimp, and if I make the effort to get my pinky finger on there too, it can feel like a stronger grip. I think this can help the ring finger too, as it gets loaded a little less. It’s also good to warm up a LOT, and to avoid cranking if you’re not warmed up. Another thing you don’t want to do is climb once a week, and then start trying as hard as you can the next time you climb, a week later. It’s better to climb 3-4 days a week and be consistent, and to have a solid base before asking too much of your tendons. But enough of the prevention….

So if you have hurt your tendon, you basically know it. Either your fingers just start to hurt when you grab holds, or you literally heard a horrible “pop” and then numbness followed by hurting. Personally, I have never bothered going to a doctor for something like this. Basically what they will tell you is that you hurt your tendon and it has to heal now. Which you already know.

The things you can do are: rest, ibuprofen, ice and tape. Generally if something isn’t hurting your finger, it isn’t making it worse. Most of my friends will go on a crack climbing binge if they have torn a finger tendon, or possibly big wall climbing or alpine climbing. My brother, an ER doctor, recommends two weeks of ibuprofen dosage for injuries like this, making sure you take the ibuprofen consistently every day, as it is the cumulative dose which keeps inflammation down and aids in healing. He says you can use regular, over the counter ibuprofen in a dose of 3 tablets 4 times a day, or 4 tablets 3 times a day. Take it for the first two weeks, and then only as needed. Of course, if you have had problems with ibuprofen, don’t do this.

When you are feeling better enough to climb, but still a little dubious about the fingers, tape them. I have heard people say you shouldn’t tape things that are injured because it keeps them weak. I don’t agree. I went through years where my ring fingers were always taped, and other years where my wrists were always taped, and other years where my ankles were always taped. Right now, I don’t need to tape any of them, but tape definitely kept me climbing when I had some recovering or weak links. So I’m all about taping myself back together, because basically it works. Tape is your friend!

I don’t know if this is official protocol or not for tendons, but when I have any kind of hand or wrist injury, I also do ice water immersion. I fill a coffee cup (if it’s a finger), or a larger tupperware container, with ice water, and just put the offending body part in there for a LONG TIME. After a while it stops hurting and you can leave it in there basically forever. The longer the better, in my opinion. You can do this while you’re driving.

And above all, take it easy on it. The body wants to heal, and it will, but you do have to listen to it and not do things that are stupid If you can climb in a way that truly does not make it hurt, that is probably fine. Doing things that make it hurt will just slow the healing. The great news is that there are many many fun things you can do that don’t involve hanging on your finger!

So I hope you are recovered, and enjoying the fall!
Steph