Hi, it is great to see such content on "Pain science" and progressive load for recovery. A good supplement to the video on A2 Pulley Injuries, which I unfortunately have at the moment... :(. First real injury over more than 10 years of climbing... I have a question/clarification regarding the pain level protocol and monitoring: How should the pain level be monitored? During the load and timed after the load is clearly stated, but how do we let our body tell us? Meaning should we touch/move/apply some sort of pressure to the sensitive part or just without any touch/movement/pressure? Eg. for fingers and A2 pulleys. Thanks !
Awesome! Yeah after the A2 video we felt we needed a follow up on that to help bridge the gap even better. Sorry to hear about your injury though, that's a bummer. Good question regarding the monitoring. I think the foundation will be just how the force is causing your body to react. If it's not causing any pain it's great, if it is, listen to it and see how it unfolds. If it starts to go into those yellow areas (longer duration, more than a 3/10 pain) then I think it's OK to supplement with touch/movement to assess how it is doing. That way you can make a more educated assessment on "should I do more or less". Does that answer your question?
@@HoopersBeta Hi, Yes perfect :) thanks again. I am doing progressive loading for few weeks now, listening to my body, monitoring pain and inflammatory reaction for, hopefully, optimal recovery. Hard to ensure the right balance though. Yet, I see great progress and pain, while applying pressure, is low and disappear completely after 2 days rest. Again, thanks for the great content ! If you would need any input for future content and I could help, I would be happy to do so :)
@@charlesfourcade825 hi charles, i was interesed to know on how your injury is doing now (1month ish later?) i just hurt my a2 pulley yesterday and dont actually know how bad it is but i hope it will recover fast!
Hi @@kunlaialps, it is slow but still going in the good direction. I injured my A2 mid of July actually. Back then I could not put any load without pain on half crimp grip (open hand was never an issue). 4 months after I can now do series of repeater of half crimp on 8mm edge or one arm lock off on 20mm edge with 8kg help with pulley system (pain level at 3). Before injury I was doing it with 5kg added weight so it is still not fully recovered. I re-started outdoor climbing and Moon Board about 1 month ago. Everything is closed now though... I hope this help. We can exchange further if you want.
@@charlesfourcade825Hi Charles. I hope you’re well. I just wondered, when you had your A2 pulley injury, how long were you not climbing at all for? When you had pain crimping, did you still climb open hand? Thanks.
This makes so much sense now. Came back to climbing after almost 1 year of lockdown and an old popped pulley was still sore after said year of rest time, but now after a couple weeks of climbing the pain is almost gone!
Hey Urik? What did you do to rehab this? As I’ve got the same issue. But I can’t get the 4/10 pain to go. Trying to rehab it through density hangs. Most my pain comes when I involve some rotation to my crimp position. So trying to add a little rotation into my Fingerboard rehab in order to ‘re learn the brain’.
Thank you so much for this video. I started following this advice (more or less) in february and today I declare my finger officially healed. Today I climbed my orginal level, whitout tape, with small edges and most importantly without pain.
Man, this channel is so good. You do such a great job with injury recovery and prevention, but also with general training and strength. A wonderful combination of tasteful (most of the time) humor and brilliant (all of the time) material! Crush on bruuuutheerr!
Injured my finger (i think A4?) in a bike crash 6 days ago. Splinted it for 2 days and WOW i was in pain when i took it off. 4 days of very light use and my finger has partial range of motion back. Good to know that retraining with slight pain is actually a good thing.
In med school we learned about nociceptors which is a specific system developed to avoid tissue damage and are dedicated to different kinds of pain like monomodal vs. polymodal efferent signals. An example might be a monomodal function of thermal damage with information carried by the Thermal nociceptive receptors... these fire at 40-43 degrees Celsius and form a tetramer that allows the influx of calcium to signal imminent thermal tissue damage. Likewise- mechanoreceptors which are less understood- are clearly functioning (we feel pain) and they can be cultured... the molecular cellular signaling in vivo has not been worked out. So I take issue with "there are no pain nerves" as a sweeping statement. I do agree with the statement, "we have not identified the Calcium channel moiety that is stimulated by an excess of mechanical force within the unmyelinated penetrating nociceptive fibers," but that doesn't matter to the argument here. The argument here (as I understand it) is that we feel pain even when there is no ongoing tissue damage or a behavior that we should exhibit to prevent further tissue damage. In this case, I completely agree and would point to a whole body of literature on central vs. peripheral pain, the mechanisms of chronic pain- and how to learn to live within the envelope of this pain and still fulfill your physical demands. What might be missing also from this message is age- If you wake up at my age without pain? you're dead... so get used to it now. If you use your body (I run 50 miles/week)... then it will hurt. And the hurt is just your body telling you that living is happening. 30 somethings talking about pain (even elite athletes)... just haven't woken up at 70.
What if I feel almost no pain (left ring finger pulley) while climbing, but then after a session or the next day the pain/stiffness/swelling feeling sets in. Does this mean I still need to climb easier / shorter sessions?
2 years later and not a doctor but this is exactly my issue for a very long time and all I can really tell you from my reading and looking around is that I think that's more of a finger joint capsulitis/synovitis issue and not an acute tendon or pulley injury most content is aimed at. If you ever figured out some way to keep increasing results without injury let me know lmao.
Loved this, super thorough! However, i was wondering if you could suggest more exercises in addition to the farmer crimp you mentioned to progressively load more? Thanks!
This is all lines up with my tricep tendon issues (i suspect tendonitis). Developed bad pain in it, likely from overuse at the gym so i took a big break from the gym due to the injury and other circumstances. When I came back to it a year later i still had the exact same pain, even with low loads. I decided to just try working through it while being more cautious with my form and weight increases, and after a handful of months its almost completely faded away.
Thanks for this, I badly injured my finger when my bull attacked me (yeah, I'm not a climber), my finger was under his halter when he tossed me over his head. It's been two months tonight since the attack. This video has really helped, I've just tried some of the exercise and my finger is feeling better already!
I injured my hands from defending karate kicks with my hands, even wearing fighting gloves. For more than 2 months I've felt weakness when squeezing my hand and almost a pain, as if the hand was warm inside. Especially when waking up. I had an MRI but it only showed some water inside the fingers and in a joint that hurts when I bend the finger. No arthritis or anything. The doctor said that finger injuries take time to heal but he didn't tell me anything else, not even about physiotherapy, medication, if I should stop or restart the activity. What do you think? I try to distract myself from it but the symptoms are there.
I hurt my index finger about 6 years ago, once and then another time after 2 weeks and the finger has been more stiff than normal ever since. The middle joint feels especially jank and the extensor tendon feels as if has become shorter/tighter. I've done physical therapy but it doesn't help. Will it ever heal or am I doomed?
Not to contradict the video but I’m pretty sure the body has both receptors for pain ‘nociceptors’ and dedicated nerve fibres ‘a delta’ which send the signal to the spinal cord. I understand that the signals change when going from acute to chronic. But these receptors and nerve fibres specifically for pain do exist in the body. So I’m a little confused when it suggested there arnt?
A delta fibers are stimulated by mechanical and thermal sensation. It is those two stimuli that can be perceived as pain. I'm saying there are literally no receptors called pain receptors. None that are just there with the sole purpose to make you say owe.
@@HoopersBeta This part of the video also didn't sit right with me. There's an entire wikipedia page on nociceptors (en.m.wikipedia.org/wiki/Nociceptor) which are dedicated to making us say "Ow" if a certain stimulus threshold is passed, they are literally termed "pain receptors". These are different from other mechanical/thermal receptors because "Only when the high threshold has been reached by either chemical, thermal, or mechanical environments are the nociceptors triggered." If you are interested in a scientific review check out www.cell.com/current-biology/comments/S0960-9822(17)30069-6#%20 which of course also introduces nociceptors with, "Nociception, the sensory mechanism that allows animals to sense and avoid potentially tissue-damaging stimuli, is critical for survival. This process relies on nociceptors, which are specialized neurons that detect and respond to potentially damaging forms of energy..."
I am a guitarist, not a climber....and somehow found this video. I’ve sliced a few fingers before, in the kitchen or opening stuff… still waiting on my middle fingertip to heal from a minor knife cut (still a pain to deal with cus it takes forever to heal) And all these people all over the forums and online recommend to use super glue and I think it’s the dumbest freaking thing in the world because fingertips are so sensitive and have several nerves which feel pain very easily. Use liquid bandage instead it’s not as harmful and is labeled as a first aid but it still didn’t make much of a difference in my healing. Do you have any therapy recommendations to help boost fingertip healing???
A question I am always left with is when you refer to counting how long pain lasts after load, is it pain without any aggravation? Like when I get off a climb my injured pulley does not hurt on its own, but will be more sensitive when I press on the pulley with my other hand. It feels inflamed as it only hurts when pressing hard before climbing but after a session it hurts (2-3/10 pain level) with softer presses.
This is great content... probably the best I've seen in free vlog format. Just wanted to note that the case study involves an A4 pulley injury and the pain science conversation used a tendon injury as the example. Different tissues respond differently to load.
wow, a rare instance where "meh, it doesn't hurt much, it's probably fine" is actually the correct attitude! love to hear it, was worried I'd have to completely avoid climbing for a while 🙌
Thanks for the awesome content, Cooper. Always come here for my climbing training and rehab advice. I'm current'y rehabing to me what seems to be a minor A4 pulley injury. I never actually "injured" it, but over the last month of climbing hard outdoors, it's sore when I warm up, I feel less confident with that finger/hand while climbing (even if I don't experience pain per se after warming up), and the next few day it feels swollen and 3/10 pain even just light crimping on a door frame, for example. When I do the farmer crimp protocol, I can actually work up to high loads (almost as high as my other, non-injured hand) with 0 - 2 /10 pain that dissipates within 10 seconds. However, the next morning, it fees swollen and sore (again 3-4/10 with the lightest crimping). Is this morning pain and swelling just a sign of tissue adaption? Do you think as long as I'm not producing more than 3/10 pain lasting < 10 secs while farming crimping that I'm safe, regardless of the morning after pain? Thanks so much!! - Dunavan
A few weeks ago, I hyperextended my ring finger distal phalange while crimping, and now I have joint pain, weakness, and hypermobiliy that is preventing me from crimping with that hand. I'm wondering, could this same rehabilitation technique be applied to a joint injury like this?
Thanks for the awesome video! This is such an important (and difficult!) part of injury treatment. How would you interpret pain reappearing a while after the assessment is done? For example no pain right after loading, but 4 of 10 pain 2/30/60 minutes after loading?
You'll need to be cautious on your loading if your pain takes that long to respond to. Monitor your signs and symptoms after you have completed the loading and be sure to write down as many factors as possible to minimize those symptoms. You don't want a 4/10 pain 30/60 minutes after.
Hello, thanks for the engaging and informative video. I am dealing with my first finger injury as a climber. My middle and ring fingers on my dominant hand are slightly swollen around the pip joints. The fingers often feel stiff and slightly weak when flexing against resistance. The range of motion is good and the fingers can be completely flexed and extended without pain if unloaded. There was no acute injury they just started to feel weaker and stiff in my last couple sessions so I have stopped climbing for a few days to assess. Does this sound like an injury to the pulley system or does it sound like more of a joint capsule thing? Do I sound like a good candidate for farmers crimps or should I wait until the swelling and stiffness has gone down? Also would finger extensions with a powerfingers help?
Hi, thanks for a very informative video! Do you have an understanding of how long to wait and rest after an acute injury before beginning this kind of rehab? Can I get right into very low pain stressing of the injured finger if no swelling or resting pain, or should one wait to begin this rehabbing? Thank you!
I know this is an old video, but thought I would comment anyway on how I haven't seen much on your channel dedicated to toe health. I did see your ankle health video. But it seems that big toe injuries are quite common in rock climbing. So I would be really curious to see you cover this topic if it ever interested you. Thanks for all the knowledge. Cheers
This is terrific for any tendon issues in the hands. Can this help with non climbing tendon issues, say like tendonosis due to years of repetitive use of a particular finger tendon, say the index finger knuckle?
What about chronic pulley injuries? I have examined my fingers and i most certainly have a pulley strain. The thing is, the pain started 8 months ago and i only started rehab about 1,5 months ago. Not only there is a rock solid small inflamation on the A2 region but i find it much harder to progress weight on that finger compared to oder recent injured fingers - wich logically doesn’t have that inflamation. I have come to 15kg feeling 2-3 pain without warming up but progress now is almost nonexistent. Should i go back to climbing? Rest more? I am struggling at the end of the rehab where my finger is already 75%, but doesn’t get much better. I would aprecciate some orientation in relation to my situation. Thank you!
Hopefully I'll get a response. I had a partial (maybe complete) a4 rupture on my ring finger in almost 5 months ago. I've done your retraining protocol from the A2 pulley injury video and it went somewhat well. Currently, I still have pain, but I'm at a lost on how to proceed. I still H-tape and do my farmer crimps at least twice a week. I can do up to 35lbs without H-taping, but I need to H-tape once going higher. With the H-tape, I can do up to ~60lbs for 4 reps. Any tips on returning to full confidence?
This helps a lot thank you! I have been dealing with a chronic A2 pulley injury for over 6 months and it's been driving me crazy. I have a question though. While I don't feel much pain on the hangboard or when climbing (unless I go too hard), I have gotten into the habit of pressing on where the pulley hurts. Thus, I may feel a little pain while climbing and no pain when I stop, but I press on the tendon and its still really sore. The other day I was setting and after forerunning, while my finger only hurt a little while climbing, I could tell that pressing on it felt worse after that day. This is just a long way of asking, if it hurts more to press on the area, does that indicate anything about the injury?
I don't tend to put much merit into pain with palpation, other than to say it may not be at 100%, yet :) It could be well on it's way, heck it could even be 99% there! That pain on palpation is adding an external pressure over the tissue typically in the opposite fashion of which it became injured (most A2 pulley injuries occurr from bowstringing or pulling away from the bone, not pressing into it) Thus, it is not a great way of determining extent of injury. That pain upon palpation could be mostly neurological or that protective response and not a great indicator of the true status of the underlying tissue. Hope this helps!
@@HoopersBeta thank you so much! I feel like it’s easy to fixate when it hurts to touch, but in reality I have little to no pain without palpating it. Thanks again for the reply :)
@@HoopersBeta omg thank you so much Jason I ve been searching for that information for weeks. In all the videos the talk is about "pain" but doesn't precise if the pain is at palpation or not. I've had almost no pain when pulling for 2 weeks (1-2 months into a pulley rehab process) but also still have this pain at palpation. Now I think I'm just gonna stop palpation it lol
Hello, nice video! I would have wanted some information about whether isometric/eccentric/concentric movement affects and how does it do so on the tissue loading or rehabilitation factors. This particular 'farmer's exercise' is as i see it an isometric movement, which should be carried out on the early stage of rehabilitation, right?
Had a few questions I hope you could answer. I had an a2 pulley strain about a month ago. I am doing a rehab routine to retrain the finger with light loading on farmer crimps. The initial sets have some pain in the 2-3 range, but in later sets this pain is down to 0-1 range. What is the explanation for this? That being said after the routine when I press on the injured area it is painful. The pain could even be going into the 3-5 range when doing this. Is this fine or should I reduce the weight and intensity? Also is there a difference between how the pain should be monitored when loading the finger versus pressing on the injured part of the pulley?
How do you test for an A1 pulley injury on the ring finger? I can do weighted half crimps on the tension block and no pain, but holding a jug hits directly on the A1 area and causes me pain
Does this only apply to when you're climbing? I had a mild pulley tweak maybe 3 months ago but it's still tender to touch when im not climbing. Tender only on maximal blanching pressure with palpation. But climbing is fine/pain free lol.
I believe i ruptured a pulley while deadlifting. I was losing my grip on the bar and and felt/heard a pop in my left ring finger. Only feel pain when i press/load weight at the base of the finger and the location of the A2 pulley. No swelling or redness. It's been about a week and ive abstained from any weight lifting, as pretty much everything requires a loaded grip (i.e. even just picking up plates to load on a barbell for bench press, which is almost exclusively a PUSH exercise). Im not sure of recovery timelines, so every day after last week, ive been testing the pain by simply picking up weights, going heavier progressively. How long do i need to completely rest before working out again? 6-8 weeks as the video says?
What if i have no pain when climbing or hangboard, i can crimp and open hand. But i have pain in my index finger joint when i put light pressure on it in a fully crimped position.
I developed CRPS when the docs told me to rest my wrist for 6 months cause pain wasn’t going away. The pain went away when I pushed through it in PT to restore function. When you immobilize or baby a part of the body and are convinced that you are injured, it will signal your brain to send pain signals
Thanks for the video, it’s very helpful! Do you have any tips for doing farmer crimps with no dedicated equipment? Replacing the weights is easy enough, but what can I use to replace the hold? I was thinking even a backpack with water bottles to control the weight, and using the upper lace as a hold. Would that work?
Hi, I just wanted to clarify the pain after the farmers crimps part of the vid. So I can do these without feeling much pain at all, however if I actually press my thumb into the A2 there is still quite a bit of pain. Should I continue with the program if this is the case? I have seen a physio who confirms there is no actual tendon damage, however there is alot of scar tissue from past injuries Thanks :)
Yeah I would keep it going just be aware of it. That pain from pressing into it is just a small part of the puzzle. Not one to overlook and should be considered, but not a hard stop as it is likely just responding to the external pressure and creating a higher level of pain than is normal or equitable to the level of injury.
How can I heal painful fingers and thumbs from too much gaming on mouse and keyboard and arcade fight stick, I get dull aches, sharp pain, soreness on the side of my index fingers base knuckles etc, are the tendons permanently damaged now, I’ve been resting a week?
Can I do this to get more movement from an old wrist fracture? I put endless hours into rehab post surgery but the lack of movement is a real hindrance being a musician and sports therapist... what are my options realistically?
So I'm pretty sure I injured my middle finger A3 pulley by overload of my tendon on the heaviest part of deadlift. I was using an outward grip on my right hand and as the load was too high on my last rep, I think I really caused a lot of injury to this pulley whilst trying my best to hold onto the bar. I think this injury is connected to my distal bicep tendon which has also been hurting significant which I believe got injured in the same exercise. Funny that the only content I can find on this type of injury on youtube is coming from climbers who deal with this probably more often than most.
With this protocol it should come to a point where it doesn't hurt at all?? After how long do tendons get to the level "pre-injury"? Do tendons get stronger after an injury?
Yes of course :) Your hands / fingers / body should certainly heal and get to the point of not having pain. Tendons, depending on the level of injury, typically take about 12-16 weeks to heal. Getting to "pre-injury" also depends on the severity and how much strength you have lost. Yes, you can be even stronger after injury if you are patient and work on good protocols to safely get stronger.
Awesome question! It can be applied in many different areas, from an FDP injury, to Runners Knee / patellafemoral pain syndrome. It is, of course, case by case. TFCC injuries aren't as applicable as often times the problem is the person continues to re-aggravate the injury with their activity or day to day motions.
ive gotten finger injuries in both middle fingers on both hands about 2years+ ago. have rested for long times before climbing again, with my most recent rest period being 2 months. basically i have been resting and climbing, resting and climbing, and its been 2 years but my finger still seems to hurt edit: is there an alternative excersise to the farmer crimps? ( e.g hangboard? )
You can safely load the fingers through hangboarding but only if you can modulate the weight you apply to the fingers. I hope you watched the video in it's entirety because I believe it could help you!
recently ruptured my A4 and am wondering at what point in the recovery process i should start to use PPP. After a few weeks of ROM exercises or right away?
Can we apply the same approach for thumb RSI because of drumming? It’s been 3 years and there is no limited range of motion but I have 1/10 scale pain that wont go away. Since I started to use powerball, resistance bands and dumbells I made a %40 progress in pain. However, I want to be able to play drums again but not sure what to do next.
Not much of a climber, but coming from a basketball player, still very interesting content. We also sprain our fingers all the time, and it always takes months to heal.
No hangs with arms overhead or in a similar fashion to the farmer crimp / carry? With arms overhead / on a hangboard the only challenge is being objective and knowing how much weight/force you're producing every time.
Thank you for the video. I have a pulley injury on my second toe and it's been stuck in a slightly curled position ever since I stubbed it. The ROM is maybe half of what it used to be. Can I break it into it's normal ROM?
So fun dumb stuff: the only way i was able to regain my tendon range in my thumb i cut once was stretching it just to its limits and trying to match the positioning to the healthier thumb. Eventually it caught up to confort level and i believe both thumbs are back on par. It was over a year since that injury, 1 month to actually heal the cut, 3 months of forcing its range ever further, the remainder to ease into trusting it more
Hey, like so many others here, I have a question. I now have the second A4 injury this year on my right hand, it's slowly getting there, I have climbing sessions without pain in the pulleys. However, my DIP hurts more when doing rehab protocols than the pulleys and they are also the bigger issue when climbing. I had an MRI because of my first pulley injury and they found nothing. Do you have an idea what might be the issue and how to deal with it?
If the MRI was a while ago and the swelling is new then the MRI wouldn't tell you too much, but... It could be that you lost range of motion in your fingers after the injuries and began developing some synovitis? I hate to just jump to that when I hear DIP swelling but without an evaluation it's harder to determine if there is another cause of the injury like a collateral ligament injury, volar plate injury, or others. We do have a video about synovitis / finger swelling. Check that out and see if it helps answer any of your questions! ua-cam.com/video/h-nOPJsBZz8/v-deo.html
I had a car wreck, my finger gotten broken from impact. I had surgery but they said rn eh couldn’t fix it due to it being broken in 3 different spots, I gotten the pins removed. Still can’t move my finger. Any suggestions ? I have pain. & I also have carpal tunnel.
I have a chronic injury from pulling my index finger (stupid I know, I did it during two different panic attacks), and I don't know what to do about it. It got stiff in the middle joint and after a while the extensor tendon got tight in a way that when I make a fist, I feel my finger's mid-joint pull on it and the tendon feels really tight over the knuckle. It's been about 6 years after the incident and the doctor now ordered me an MRI-test to see the soft-tissues. He said however that this happened because "the tendon's support muscles got weaker". I think he's wrong, the middle of my finger feels abnormally stiff also when it's straight, as if some tissue has hardened inside. what do you think?
Hi, great video as always, I have a question about training with slight pain ( 1-3 on a scale of ten like mentioned ). When I climb or put the injured finger to use I don’t feel increments of pain while putting more load on the finger, but rather a sudden sharp pain when reaching a certain point or with sudden movements. Any input on the matter would be much appreciated, and again great video per usual 👍.
Love the protocol you're describing! Very consistent with the net of what I've read and the protocols I use in my personal training (and a recent pulley rehab) Just a comment, please don't say you're "getting deep into understanding pain science" --because you aren't talking about hypotheses, experiments, testing, etc... i.e. Science, AT ALL. You're presenting your personal (and likely accurate because you're well read) interpretation of recent research and the presumed multitude of anecdotal cases you've experienced. You are NOT presenting comprehensive support for your personal opinions -- your background, the papers you've read, data, comprehensive explanations of your personal anecdotes, etc... insufficient support to help your viewers understand how to interpret the potential accuracy or error of your personal conclusions. You are presenting some papers to support your point of view (which generally I agree with) but you are NOT presenting a comprehensive review of the literature on this subject which may or may not include conclusions that conflict with your interpretation. It's easy to cherry-pick papers to support wrong conclusions. I don't think it's sufficient to present expert opinions on this topic anymore -- there are plenty of resources like Dave McCleod's excellent books which have given consistent and good advice on this topic for years. I'd love to seem more videos explaining the actual science (experiments, scans, tests, hypotheses that fail, etc...) rather than simple conclusions. This rings doubly true for teaching people how to learn scientifically (through personal experimentation) about their body and become better able to interpret the spectacular amount of data generated by their own senses -- i.e. the generalization that includes "pain science".
Great video, thank you. I am about a year post injury (moderate strain I guess, no rupture) of A2 pulley in my ring finger. What should I do when I have 0 pain during climbing but I feel pain the next day after a hard bouldering session? (About 2 on the scale I guess)
@@martinn2829 that's most likely just the pain science aspect with the hyperalgesia so you should be fine if there's no pain when climbing. Don't push too hard too quickly but you should be healing.
I’m about a year post injury and have been getting back to climbing, I have been doing this same thing on a hang board twice per week 3-5 reps for 10 seconds each, the pain is always at a 1 for less than 10 seconds after the hang. However easy climbing causes zero pain but sometimes I will feel slight pain after the session for about an hour is that ok?
Very helpful video! I injured my A2 about 7 weeks ago and could not crimp at all while climbing. So I stuck to open hand while climbing and rehab hangs. I was hanging on the 30mm for the first few weeks and it felt good. Then I didn't feel any pain while hanging on the 30 mm so, I thought it would be good to go down an edge. I then started using the 25mm and while I did not feel pain over a 3 threshold and no pain after, the next day my finger was sore. That happened a few times and after a full day of rest my finger didn't feel sore anymore. I'm wondering why that is? and how to keep progressing my hangs to avoid that.
They should be treated as different tools. The farmer crimps are an isometric activity whereas the finger rolls are isotonic. While the difference may seem subtle, it can be important depending on the issue you are hoping to address and the stage of it :) great question though!
Hey my one of my middle finger on my right hand is pointing to the right due to some poorly performed gripper training I did. It was months ago and I just rested it, but every time I try to go do it again, the finger aches again and points to the right, as in being angled to the right where there is blatantly more distance between that middle finger and the index finger compared to the distance between the left hand's middle and index fingers. I already paid way too much just to have it checked by physiotherapists who gave general advice but nothing specific so hopefully you know what I could do, I probably didn't give enough details but I figure you can ask and I'll explain it as best as possible. Would appreciate some method for this. Thanks
Not sure that your comment re absence of pain receptors on the body is correct - there are specialised receptors called nociceptors and they are present in connective tissues as well. I wonder if you could clarify this bit.
Therein lies the misconception. Yes, we have nociceptors that perceive pressure, temperature, and chemical that send the information to our brain that is perceived as pain, but we don't have "pain" receptors.
Can someone explain to me what a nociceptor is if not a dedicated pain receptor/nerve? I get everything else the doc said and it makes sense, but I had to scratch my head when I read "There are no dedicated pain nerves in the body".
Nociceptors detect pressure, temperature, and chemicals. Excessive pressure, temperature, or harmful chemicals will activate them and send a message to the brain. They are simply peripheral sensory neurons. Higher brain centers will decide if it is extreme enough to warrant a response such as pain. The point being, these are simply receptor providing feedback, the higher brain centers will decide how to interpret it.
Very interesting video! I have personally been dealing with a collateral joint/ligament injury (in both the middle joints, middle fingers) for the last 2 years or so. I've done almost every form of rehab I can think of. In the video, you use the Farmers Crimp for tendon/pulley injuries, do you think that this rehab could be applied to a collateral ligament injury?
When an injury lasts that long, my immediate response is two fold. 1) does pain science apply to this case and 2) what are they doing to constantly re-aggravate the injury? You may need to do a deeper look into your activities of daily living, work, climbing style, etc. Oh and 3rd, you may need to get the injury re-evaluated (or evaluated for the first time) to make sure it actually is a collateral ligament injury and not something else.
Thanks, you just helped me figure out what the name of my finger issue is (I think). Do you have the same/similar symptoms as me? - pain in fingers when pushing sideways on them - ability to crack fingers sideways - feeling of ligaments kinda slipping painfully if you move them a certain way, and associated crack sound and feeling - some pain during climbing on really crimpy stuff but usually pain is a bit after climbing - some pain when you bend your knuckles tightly as if to do tendon glides kinda Have you found anything that helps?
@@adampnewsome The only things I would say I have similar to you would be your last two points. However, now my fingers have made quite some progress over the last half year or so in the rehab I've been doing, so it is hard for me to tell if they had more of what you had in the past. The main thing that has helped the most recently is doing a hangboard protocol by Dr. Eva Lopez. en-eva-lopez.blogspot.com/2018/07/fingerboard-training-guide-iii-periodization-samples-of-maxhangs-training-programs-.html After that, I find that light finger stretching, massage, and blood flow control help reduce the pain and increase the mobility of the joint. Plus, rice bucket training helps more of the same in that essence. However these things do not result in healing the injury/getting it strong enough to climb again. I would recommend documenting the finger's progress. I've been doing so for the last year, and it's provided great affirmation and insight into the rehab I've been doing. At the very least, I would highly recommend looking into starting the hangboard routine if your fingers have been chronically injured (and it's a similar injury to what I have.) The fingers need to be loaded appropriately to get back to climbing shape, otherwise, they will never be strong enough for climbing.
@@Rees8269 great, thanks for all the helpful info. I've been considering starting hangboarding - I have an appt with my physio next week and I'll ask if he recommends it. The other things sound helpful as well 🤞🏼
Thanks so much for this info, I've started a routine based on this. Should I consider adding some extensor activation to inhibit tension in the flexor side as I feel like there's a lot of tightness there?
I don't feel the pain necessarily when im pulling only if it's extreme but it feels weak and when I squeeze my fingers hard or press on the base it hurts like a 4 or 5. Any advice? I also still have swelling on the injured fingers after 2 years
I'm currently dealing with what I think is an a3 pully injury with the ring finger of my left hand. It's moderately sensitive to the touch and hurts when I climb slopers (and certain pinches). Crimping however, even with maximum effort, does not cause pain. The finger does not hurt to close, there is no swelling or lingering pain. Interestingly, I've never had an a2 injury, all my finger injuries have been a3 on the middle and ring fingers, following this exact same set of conditions. 1. Is this actually a pully injury or perhaps tendon? 2. Is it safe to climb crimps? 3. Would following this protocol yield similar results, despite the difference in the injury and pain? 4. I've been lead to believe that a3 injuries are more rare, is this the case...and why am I only getting a3 injuries?
From your description I am not convinced it is an A3 pulley injury. Look up the Flexor Digitorum Superficialis. The insertion of this tendon is near the A3 pulley and is more active during slopers.
Hooper's Beta Hey Hooper could you make a video about that section of the fingers? That would be so helpful seeing as I have the same injury described above and I know a lot of climbers that had it as well. Its definitely not a pully injury but I’m still not sure what it is and how to rehab and prevent it. It would mean the world!! Love your content.
@@HoopersBeta Interesting! I am reading into the FDS and FDP now! I knew things existed there, but had no clue how they interact. I second the idea of making a video about these, and distinguishing the different injuries that may arise.
Last week I think I tore my a2 pulley. Middle finger went numb, swelled up and bruised around the area. Now I have a definite horizontal red line at the center of the a2 pulley area. Not too much pain at all now a week later but I'm a little worried to push the rehab. Any advice?
Sorry to hear of the injury! I would definitely follow a full rehab guide for a pulley rupture! If you're concerned about how to progress the rehab, speak to a skilled professional that is familiar with climbing injuries. I'm available for consults if needed! Check the website for details.
Hi, i'm a climber from germany. I recently misst a hold and felt into my left hand with only my ring and my middlefinger at the wall. I heard NO popping sound or anyhing. but in a second after my "fall" i noticed a pain at the bottom of my ringfinger right around the A1 Pully. A doctor told me nothing is ripped of its just an inflammation and i should pause climbing for 1-2 month. But i'm not sure, after 4 weeks not climbing at all it still hurts in totaly normal daylie tasks. I can trigger the pain if i pull my pinkie finger towards my palm and than straitan the ringfinger. Should i slowly climb a little bit? Or just wait it out, since an inflammation is maybe something else than a rupture... i dont know. I would love to hear your opinion on that.
Hallo! Check out our video on the lumbricals as well! Perform some of the tests there and see if our rehab program can guide you to healing! Sorry to hear of your injury, though! Ich hoffe es hilft! (entschuldigung. Mein Deutsch ist nicht so gut)
@@HoopersBeta Thank you for your Help. Yes i watched the lumbricals Videos and this is exactly my problem. If i lay down my hand on the table and fixiate the ringfinger i cant raise my pinkiefinger. If i try, the finger lifts about 1cm of the ground and than starts the pain. Its hard for me to figure out if its Grade 1 / 2 or 3. I can straighten the ringfinger without any pain but only if i hold my pinkie finger down with my other hand. If i try to hold my pinkie finger with his own muscles i cant rise my ringfinger by itself without major pain.
How can I tell whether I need to rest a pulley injury or of its recovered enough to climb? For example I have a a2 pulley strain that still has some pain and I don't want to somehow make it worse
10 years ago i felt a pop in my middle finger and just started climbing again since my 9 year old daughter showed interest and after a few weeks that finger swells up and gets stiff for a couple days after every climb
Sorry to hear that you're having issues after coming back to climbing! Volume? Intensity? If those are too high that can cause it. Similarly, over gripping?
@@HoopersBeta I am thinking volume and intensity, once I started working on v5 and 6 it started hurting again. Of course I let my ego take over knowing that it was too much for just a month back. Sticking to slopers, jugs, and anything that's comfy and open hand with light training in-between. Knowing a little discomfort and even a little pain that only sticks around for 5-10 seconds is ok was a big game changer for me and after just a couple weeks I am noticing some small changes in the right direction.
I think it's even worse with wrist and elbow injuries because with fingers it's easy (easier) to avoid certain activities to make sure that you are loading them just right for recovery while with wrists/elbows there are also those everyday tasks that you cannot avoid and cannot fully control (like you cannot avoid lifting your baby and you cannot control how many times per day you have to lift them - or sometimes you have to deal with firewood and it just has to be stacked in one weekend, etc.). So it's much harder to figure out the amount of exercise you should be doing to balance it with daily unavoidable activities.
I'm retraining an a2 injury at the moment. I find I have no pain or maybe 1/10 while doing farmers crimps but then an hour later will feel some slight 1/10 or 2/10 pain. Sometimes when I wake up the next day it's a little more sore. Still minimal pain. Do I keep going?
If it's still low like that it's OK but you may need to check some factors (are you allowing enough recovery time between sessions, are you increasing weight too quickly, etc).
@@HoopersBetathanks! potentially bit of both. I'm doing 2 sessions of 5 reps a day but only at 7.5kg. Not sure when I should be moving to 3 sessions a week rather than every day
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Hi, it is great to see such content on "Pain science" and progressive load for recovery. A good supplement to the video on A2 Pulley Injuries, which I unfortunately have at the moment... :(. First real injury over more than 10 years of climbing... I have a question/clarification regarding the pain level protocol and monitoring: How should the pain level be monitored? During the load and timed after the load is clearly stated, but how do we let our body tell us? Meaning should we touch/move/apply some sort of pressure to the sensitive part or just without any touch/movement/pressure? Eg. for fingers and A2 pulleys. Thanks !
Awesome! Yeah after the A2 video we felt we needed a follow up on that to help bridge the gap even better. Sorry to hear about your injury though, that's a bummer.
Good question regarding the monitoring. I think the foundation will be just how the force is causing your body to react. If it's not causing any pain it's great, if it is, listen to it and see how it unfolds. If it starts to go into those yellow areas (longer duration, more than a 3/10 pain) then I think it's OK to supplement with touch/movement to assess how it is doing. That way you can make a more educated assessment on "should I do more or less". Does that answer your question?
@@HoopersBeta Hi, Yes perfect :) thanks again. I am doing progressive loading for few weeks now, listening to my body, monitoring pain and inflammatory reaction for, hopefully, optimal recovery. Hard to ensure the right balance though. Yet, I see great progress and pain, while applying pressure, is low and disappear completely after 2 days rest. Again, thanks for the great content ! If you would need any input for future content and I could help, I would be happy to do so :)
@@charlesfourcade825 hi charles, i was interesed to know on how your injury is doing now (1month ish later?) i just hurt my a2 pulley yesterday and dont actually know how bad it is but i hope it will recover fast!
Hi @@kunlaialps, it is slow but still going in the good direction. I injured my A2 mid of July actually. Back then I could not put any load without pain on half crimp grip (open hand was never an issue). 4 months after I can now do series of repeater of half crimp on 8mm edge or one arm lock off on 20mm edge with 8kg help with pulley system (pain level at 3). Before injury I was doing it with 5kg added weight so it is still not fully recovered. I re-started outdoor climbing and Moon Board about 1 month ago. Everything is closed now though... I hope this help. We can exchange further if you want.
@@charlesfourcade825Hi Charles. I hope you’re well. I just wondered, when you had your A2 pulley injury, how long were you not climbing at all for? When you had pain crimping, did you still climb open hand? Thanks.
This makes so much sense now. Came back to climbing after almost 1 year of lockdown and an old popped pulley was still sore after said year of rest time, but now after a couple weeks of climbing the pain is almost gone!
Nice! What a wonderful example of this :) Thanks for sharing!
Hey Urik? What did you do to rehab this? As I’ve got the same issue. But I can’t get the 4/10 pain to go. Trying to rehab it through density hangs. Most my pain comes when I involve some rotation to my crimp position. So trying to add a little rotation into my Fingerboard rehab in order to ‘re learn the brain’.
@hoopersbeta would love your help here!
Thank you so much for this video. I started following this advice (more or less) in february and today I declare my finger officially healed. Today I climbed my orginal level, whitout tape, with small edges and most importantly without pain.
That’s great to hear, way to go!
I’m SO happy this is being talked about. I wish I would’ve known this with my chronic back pain three years ago.
Glad you found it useful! But, sorry that the information was available to you for your back pain! Hopefully you're recovering/recovered from that!
Man, this channel is so good. You do such a great job with injury recovery and prevention, but also with general training and strength. A wonderful combination of tasteful (most of the time) humor and brilliant (all of the time) material! Crush on bruuuutheerr!
Thank you for the comment! Much appreciated :) We'll keep it going with hopefully the same/similar recipe :)
I've seen a number of videos covering rehab of finger injuries and this is on another level, so good, thank you!
Thank you Dr Hooper. You are a true man of the people offering this information for free. Long may you send!
We are all about the sending! Thanks for your support.
Injured my finger (i think A4?) in a bike crash 6 days ago. Splinted it for 2 days and WOW i was in pain when i took it off. 4 days of very light use and my finger has partial range of motion back. Good to know that retraining with slight pain is actually a good thing.
In med school we learned about nociceptors which is a specific system developed to avoid tissue damage and are dedicated to different kinds of pain like monomodal vs. polymodal efferent signals. An example might be a monomodal function of thermal damage with information carried by the Thermal nociceptive receptors... these fire at 40-43 degrees Celsius and form a tetramer that allows the influx of calcium to signal imminent thermal tissue damage. Likewise- mechanoreceptors which are less understood- are clearly functioning (we feel pain) and they can be cultured... the molecular cellular signaling in vivo has not been worked out. So I take issue with "there are no pain nerves" as a sweeping statement. I do agree with the statement, "we have not identified the Calcium channel moiety that is stimulated by an excess of mechanical force within the unmyelinated penetrating nociceptive fibers," but that doesn't matter to the argument here. The argument here (as I understand it) is that we feel pain even when there is no ongoing tissue damage or a behavior that we should exhibit to prevent further tissue damage. In this case, I completely agree and would point to a whole body of literature on central vs. peripheral pain, the mechanisms of chronic pain- and how to learn to live within the envelope of this pain and still fulfill your physical demands. What might be missing also from this message is age- If you wake up at my age without pain? you're dead... so get used to it now. If you use your body (I run 50 miles/week)... then it will hurt. And the hurt is just your body telling you that living is happening. 30 somethings talking about pain (even elite athletes)... just haven't woken up at 70.
Your Videos are top notch! Thanks for putting in the effort :).
Liked this about 5 seconds in, thanks for the insight Dr. Hooper!
I’ve never climbed, but dislocated a couple of fingers falling. These guidelines and info are perfect!
Thanks for the video! Really helpful to understand how injuries work and how to treat them
What if I feel almost no pain (left ring finger pulley) while climbing, but then after a session or the next day the pain/stiffness/swelling feeling sets in. Does this mean I still need to climb easier / shorter sessions?
2 years later and not a doctor but this is exactly my issue for a very long time and all I can really tell you from my reading and looking around is that I think that's more of a finger joint capsulitis/synovitis issue and not an acute tendon or pulley injury most content is aimed at. If you ever figured out some way to keep increasing results without injury let me know lmao.
Well, if you are overweight - losing weight reduces load, so helps a lot.
Loved this, super thorough! However, i was wondering if you could suggest more exercises in addition to the farmer crimp you mentioned to progressively load more? Thanks!
This is all lines up with my tricep tendon issues (i suspect tendonitis). Developed bad pain in it, likely from overuse at the gym so i took a big break from the gym due to the injury and other circumstances.
When I came back to it a year later i still had the exact same pain, even with low loads. I decided to just try working through it while being more cautious with my form and weight increases, and after a handful of months its almost completely faded away.
Thanks for this, I badly injured my finger when my bull attacked me (yeah, I'm not a climber), my finger was under his halter when he tossed me over his head. It's been two months tonight since the attack.
This video has really helped, I've just tried some of the exercise and my finger is feeling better already!
Whoa! That's gnarly! Thanks for sharing and I'm glad the video is helpful!
I injured my hands from defending karate kicks with my hands, even wearing fighting gloves. For more than 2 months I've felt weakness when squeezing my hand and almost a pain, as if the hand was warm inside. Especially when waking up.
I had an MRI but it only showed some water inside the fingers and in a joint that hurts when I bend the finger. No arthritis or anything. The doctor said that finger injuries take time to heal but he didn't tell me anything else, not even about physiotherapy, medication, if I should stop or restart the activity. What do you think? I try to distract myself from it but the symptoms are there.
I hurt my index finger about 6 years ago, once and then another time after 2 weeks and the finger has been more stiff than normal ever since. The middle joint feels especially jank and the extensor tendon feels as if has become shorter/tighter. I've done physical therapy but it doesn't help. Will it ever heal or am I doomed?
ive been looking for this video for so long!! Thnak you, this is so helpful!
Not to contradict the video but I’m pretty sure the body has both receptors for pain ‘nociceptors’ and dedicated nerve fibres ‘a delta’ which send the signal to the spinal cord. I understand that the signals change when going from acute to chronic. But these receptors and nerve fibres specifically for pain do exist in the body. So I’m a little confused when it suggested there arnt?
A delta fibers are stimulated by mechanical and thermal sensation. It is those two stimuli that can be perceived as pain. I'm saying there are literally no receptors called pain receptors. None that are just there with the sole purpose to make you say owe.
@@HoopersBeta This part of the video also didn't sit right with me. There's an entire wikipedia page on nociceptors (en.m.wikipedia.org/wiki/Nociceptor) which are dedicated to making us say "Ow" if a certain stimulus threshold is passed, they are literally termed "pain receptors". These are different from other mechanical/thermal receptors because "Only when the high threshold has been reached by either chemical, thermal, or mechanical environments are the nociceptors triggered." If you are interested in a scientific review check out www.cell.com/current-biology/comments/S0960-9822(17)30069-6#%20 which of course also introduces nociceptors with, "Nociception, the sensory mechanism that allows animals to sense and avoid potentially tissue-damaging stimuli, is critical for survival. This process relies on nociceptors, which are specialized neurons that detect and respond to potentially damaging forms of energy..."
@@neuromodel wiki link is corrupt due to bracket FYI
en.m.wikipedia.org/wiki/Nociceptor
Thanks Dr for the incredible insights, really glad that someone is creating such content to help educated recreational climbers like us!
Our pleasure! Thanks for watching.
I am a guitarist, not a climber....and somehow found this video. I’ve sliced a few fingers before, in the kitchen or opening stuff… still waiting on my middle fingertip to heal from a minor knife cut (still a pain to deal with cus it takes forever to heal) And all these people all over the forums and online recommend to use super glue and I think it’s the dumbest freaking thing in the world because fingertips are so sensitive and have several nerves which feel pain very easily. Use liquid bandage instead it’s not as harmful and is labeled as a first aid but it still didn’t make much of a difference in my healing. Do you have any therapy recommendations to help
boost fingertip healing???
Awesome information, thank you so much! What does it mean when the pain comes only hours after training and lingers for 1-2 days at a low level?
Interesting video. I presume a similar protocol could be used for golfers elbow rehab?
A question I am always left with is when you refer to counting how long pain lasts after load, is it pain without any aggravation? Like when I get off a climb my injured pulley does not hurt on its own, but will be more sensitive when I press on the pulley with my other hand. It feels inflamed as it only hurts when pressing hard before climbing but after a session it hurts (2-3/10 pain level) with softer presses.
I'm not a climber at all (I'm an arm wrestler) but all of this advice completely applies to my wrist/hand tendon soreness
Happy that it was able to help you as well!
This is great content... probably the best I've seen in free vlog format. Just wanted to note that the case study involves an A4 pulley injury and the pain science conversation used a tendon injury as the example. Different tissues respond differently to load.
wow, a rare instance where "meh, it doesn't hurt much, it's probably fine" is actually the correct attitude! love to hear it, was worried I'd have to completely avoid climbing for a while 🙌
Thanks for sharing your expertise!
Wow awesome video here, is there any possibility of doing something like this for elbow injuries? Would really REALLY appreciate it!!!
Thanks for the awesome content, Cooper. Always come here for my climbing training and rehab advice.
I'm current'y rehabing to me what seems to be a minor A4 pulley injury. I never actually "injured" it, but over the last month of climbing hard outdoors, it's sore when I warm up, I feel less confident with that finger/hand while climbing (even if I don't experience pain per se after warming up), and the next few day it feels swollen and 3/10 pain even just light crimping on a door frame, for example.
When I do the farmer crimp protocol, I can actually work up to high loads (almost as high as my other, non-injured hand) with 0 - 2 /10 pain that dissipates within 10 seconds. However, the next morning, it fees swollen and sore (again 3-4/10 with the lightest crimping). Is this morning pain and swelling just a sign of tissue adaption? Do you think as long as I'm not producing more than 3/10 pain lasting < 10 secs while farming crimping that I'm safe, regardless of the morning after pain? Thanks so much!!
- Dunavan
A few weeks ago, I hyperextended my ring finger distal phalange while crimping, and now I have joint pain, weakness, and hypermobiliy that is preventing me from crimping with that hand. I'm wondering, could this same rehabilitation technique be applied to a joint injury like this?
Thanks for the awesome video! This is such an important (and difficult!) part of injury treatment. How would you interpret pain reappearing a while after the assessment is done? For example no pain right after loading, but 4 of 10 pain 2/30/60 minutes after loading?
You'll need to be cautious on your loading if your pain takes that long to respond to. Monitor your signs and symptoms after you have completed the loading and be sure to write down as many factors as possible to minimize those symptoms. You don't want a 4/10 pain 30/60 minutes after.
Hello, thanks for the engaging and informative video. I am dealing with my first finger injury as a climber. My middle and ring fingers on my dominant hand are slightly swollen around the pip joints. The fingers often feel stiff and slightly weak when flexing against resistance. The range of motion is good and the fingers can be completely flexed and extended without pain if unloaded. There was no acute injury they just started to feel weaker and stiff in my last couple sessions so I have stopped climbing for a few days to assess. Does this sound like an injury to the pulley system or does it sound like more of a joint capsule thing?
Do I sound like a good candidate for farmers crimps or should I wait until the swelling and stiffness has gone down? Also would finger extensions with a powerfingers help?
Hi, thanks for a very informative video! Do you have an understanding of how long to wait and rest after an acute injury before beginning this kind of rehab? Can I get right into very low pain stressing of the injured finger if no swelling or resting pain, or should one wait to begin this rehabbing?
Thank you!
I know this is an old video, but thought I would comment anyway on how I haven't seen much on your channel dedicated to toe health. I did see your ankle health video. But it seems that big toe injuries are quite common in rock climbing. So I would be really curious to see you cover this topic if it ever interested you. Thanks for all the knowledge. Cheers
This is terrific for any tendon issues in the hands. Can this help with non climbing tendon issues, say like tendonosis due to years of repetitive use of a particular finger tendon, say the index finger knuckle?
Great video as always, what alternative exercise(s) could you recommend for one who cannot replicate your rock-ring + sling setup?
What about chronic pulley injuries? I have examined my fingers and i most certainly have a pulley strain. The thing is, the pain started 8 months ago and i only started rehab about 1,5 months ago. Not only there is a rock solid small inflamation on the A2 region but i find it much harder to progress weight on that finger compared to oder recent injured fingers - wich logically doesn’t have that inflamation. I have come to 15kg feeling 2-3 pain without warming up but progress now is almost nonexistent. Should i go back to climbing? Rest more? I am struggling at the end of the rehab where my finger is already 75%, but doesn’t get much better. I would aprecciate some orientation in relation to my situation. Thank you!
Hopefully I'll get a response. I had a partial (maybe complete) a4 rupture on my ring finger in almost 5 months ago. I've done your retraining protocol from the A2 pulley injury video and it went somewhat well. Currently, I still have pain, but I'm at a lost on how to proceed. I still H-tape and do my farmer crimps at least twice a week. I can do up to 35lbs without H-taping, but I need to H-tape once going higher. With the H-tape, I can do up to ~60lbs for 4 reps. Any tips on returning to full confidence?
This helps a lot thank you! I have been dealing with a chronic A2 pulley injury for over 6 months and it's been driving me crazy. I have a question though. While I don't feel much pain on the hangboard or when climbing (unless I go too hard), I have gotten into the habit of pressing on where the pulley hurts. Thus, I may feel a little pain while climbing and no pain when I stop, but I press on the tendon and its still really sore. The other day I was setting and after forerunning, while my finger only hurt a little while climbing, I could tell that pressing on it felt worse after that day. This is just a long way of asking, if it hurts more to press on the area, does that indicate anything about the injury?
I have the same problem.
I don't tend to put much merit into pain with palpation, other than to say it may not be at 100%, yet :) It could be well on it's way, heck it could even be 99% there! That pain on palpation is adding an external pressure over the tissue typically in the opposite fashion of which it became injured (most A2 pulley injuries occurr from bowstringing or pulling away from the bone, not pressing into it) Thus, it is not a great way of determining extent of injury. That pain upon palpation could be mostly neurological or that protective response and not a great indicator of the true status of the underlying tissue. Hope this helps!
@@HoopersBeta thank you so much! I feel like it’s easy to fixate when it hurts to touch, but in reality I have little to no pain without palpating it. Thanks again for the reply :)
@@HoopersBeta omg thank you so much Jason I ve been searching for that information for weeks. In all the videos the talk is about "pain" but doesn't precise if the pain is at palpation or not. I've had almost no pain when pulling for 2 weeks (1-2 months into a pulley rehab process) but also still have this pain at palpation.
Now I think I'm just gonna stop palpation it lol
Hello, nice video! I would have wanted some information about whether isometric/eccentric/concentric movement affects and how does it do so on the tissue loading or rehabilitation factors. This particular 'farmer's exercise' is as i see it an isometric movement, which should be carried out on the early stage of rehabilitation, right?
Had a few questions I hope you could answer.
I had an a2 pulley strain about a month ago. I am doing a rehab routine to retrain the finger with light loading on farmer crimps. The initial sets have some pain in the 2-3 range, but in later sets this pain is down to 0-1 range. What is the explanation for this?
That being said after the routine when I press on the injured area it is painful. The pain could even be going into the 3-5 range when doing this. Is this fine or should I reduce the weight and intensity?
Also is there a difference between how the pain should be monitored when loading the finger versus pressing on the injured part of the pulley?
Congratulations on that really nice content! I got a kick question, should my finguer be suported by h taping while doing the farmer crimps?
Perfect !
I hope this will help me with my trigger finger?
How do you test for an A1 pulley injury on the ring finger? I can do weighted half crimps on the tension block and no pain, but holding a jug hits directly on the A1 area and causes me pain
I dont feel any pain in my finger when rehabbing, only discomfort. How do I know when to add more load to my finger?
Does this only apply to when you're climbing? I had a mild pulley tweak maybe 3 months ago but it's still tender to touch when im not climbing. Tender only on maximal blanching pressure with palpation. But climbing is fine/pain free lol.
I believe i ruptured a pulley while deadlifting. I was losing my grip on the bar and and felt/heard a pop in my left ring finger. Only feel pain when i press/load weight at the base of the finger and the location of the A2 pulley. No swelling or redness. It's been about a week and ive abstained from any weight lifting, as pretty much everything requires a loaded grip (i.e. even just picking up plates to load on a barbell for bench press, which is almost exclusively a PUSH exercise). Im not sure of recovery timelines, so every day after last week, ive been testing the pain by simply picking up weights, going heavier progressively.
How long do i need to completely rest before working out again? 6-8 weeks as the video says?
What if i have no pain when climbing or hangboard, i can crimp and open hand. But i have pain in my index finger joint when i put light pressure on it in a fully crimped position.
@hooper's beta - How long after an injury is it okay to start the pain protocol?
I developed CRPS when the docs told me to rest my wrist for 6 months cause pain wasn’t going away. The pain went away when I pushed through it in PT to restore function. When you immobilize or baby a part of the body and are convinced that you are injured, it will signal your brain to send pain signals
Thanks for sharing your experience, but sorry you went through that! Hoping that you're doing well now!
Thanks for the video, it’s very helpful!
Do you have any tips for doing farmer crimps with no dedicated equipment?
Replacing the weights is easy enough, but what can I use to replace the hold?
I was thinking even a backpack with water bottles to control the weight, and using the upper lace as a hold.
Would that work?
Hi, I just wanted to clarify the pain after the farmers crimps part of the vid. So I can do these without feeling much pain at all, however if I actually press my thumb into the A2 there is still quite a bit of pain. Should I continue with the program if this is the case? I have seen a physio who confirms there is no actual tendon damage, however there is alot of scar tissue from past injuries
Thanks :)
Yeah I would keep it going just be aware of it. That pain from pressing into it is just a small part of the puzzle. Not one to overlook and should be considered, but not a hard stop as it is likely just responding to the external pressure and creating a higher level of pain than is normal or equitable to the level of injury.
Hi,
is this also true for other areas, like running with a burning kind of pain in the soft tissue around the knee?
How can I heal painful fingers and thumbs from too much gaming on mouse and keyboard and arcade fight stick, I get dull aches, sharp pain, soreness on the side of my index fingers base knuckles etc, are the tendons permanently damaged now, I’ve been resting a week?
Epic video! Thanks guys
Can I do this to get more movement from an old wrist fracture? I put endless hours into rehab post surgery but the lack of movement is a real hindrance being a musician and sports therapist... what are my options realistically?
So I'm pretty sure I injured my middle finger A3 pulley by overload of my tendon on the heaviest part of deadlift. I was using an outward grip on my right hand and as the load was too high on my last rep, I think I really caused a lot of injury to this pulley whilst trying my best to hold onto the bar. I think this injury is connected to my distal bicep tendon which has also been hurting significant which I believe got injured in the same exercise. Funny that the only content I can find on this type of injury on youtube is coming from climbers who deal with this probably more often than most.
Thanks a lot! I realize that I shouldn´t worry too much about a little bit of pain.
My finger pad only hurts if I squeeze it, if I don't touch it there's no pain, is this relevant to the Proper Pain Protocol?
With this protocol it should come to a point where it doesn't hurt at all?? After how long do tendons get to the level "pre-injury"? Do tendons get stronger after an injury?
Yes of course :) Your hands / fingers / body should certainly heal and get to the point of not having pain. Tendons, depending on the level of injury, typically take about 12-16 weeks to heal. Getting to "pre-injury" also depends on the severity and how much strength you have lost. Yes, you can be even stronger after injury if you are patient and work on good protocols to safely get stronger.
How applicable is this for other tendon injuries? Like a TFCC injury for example
Awesome question! It can be applied in many different areas, from an FDP injury, to Runners Knee / patellafemoral pain syndrome. It is, of course, case by case. TFCC injuries aren't as applicable as often times the problem is the person continues to re-aggravate the injury with their activity or day to day motions.
ive gotten finger injuries in both middle fingers on both hands about 2years+ ago. have rested for long times before climbing again, with my most recent rest period being 2 months. basically i have been resting and climbing, resting and climbing, and its been 2 years but my finger still seems to hurt
edit: is there an alternative excersise to the farmer crimps? ( e.g hangboard? )
You can safely load the fingers through hangboarding but only if you can modulate the weight you apply to the fingers. I hope you watched the video in it's entirety because I believe it could help you!
recently ruptured my A4 and am wondering at what point in the recovery process i should start to use PPP. After a few weeks of ROM exercises or right away?
Can we apply the same approach for thumb RSI because of drumming? It’s been 3 years and there is no limited range of motion but I have 1/10 scale pain that wont go away. Since I started to use powerball, resistance bands and dumbells I made a %40 progress in pain. However, I want to be able to play drums again but not sure what to do next.
Not much of a climber, but coming from a basketball player, still very interesting content. We also sprain our fingers all the time, and it always takes months to heal.
Do you get MRIs to determine the grade of tear? And how do you treat the sprain? Cast or taping?
Excellent video! Do you reckon that "No Hangs" can be a safe and suitable exercise to supplement farmer crimps?
No hangs with arms overhead or in a similar fashion to the farmer crimp / carry? With arms overhead / on a hangboard the only challenge is being objective and knowing how much weight/force you're producing every time.
Thank you for the video. I have a pulley injury on my second toe and it's been stuck in a slightly curled position ever since I stubbed it. The ROM is maybe half of what it used to be. Can I break it into it's normal ROM?
So fun dumb stuff: the only way i was able to regain my tendon range in my thumb i cut once was stretching it just to its limits and trying to match the positioning to the healthier thumb. Eventually it caught up to confort level and i believe both thumbs are back on par.
It was over a year since that injury, 1 month to actually heal the cut, 3 months of forcing its range ever further, the remainder to ease into trusting it more
Hey, like so many others here, I have a question.
I now have the second A4 injury this year on my right hand, it's slowly getting there, I have climbing sessions without pain in the pulleys. However, my DIP hurts more when doing rehab protocols than the pulleys and they are also the bigger issue when climbing.
I had an MRI because of my first pulley injury and they found nothing.
Do you have an idea what might be the issue and how to deal with it?
If the MRI was a while ago and the swelling is new then the MRI wouldn't tell you too much, but...
It could be that you lost range of motion in your fingers after the injuries and began developing some synovitis? I hate to just jump to that when I hear DIP swelling but without an evaluation it's harder to determine if there is another cause of the injury like a collateral ligament injury, volar plate injury, or others.
We do have a video about synovitis / finger swelling. Check that out and see if it helps answer any of your questions!
ua-cam.com/video/h-nOPJsBZz8/v-deo.html
@@HoopersBeta Thanks for your answer. I checked out your link and will try the tendon glides and rest. Keep up the great work!
I had a car wreck, my finger gotten broken from impact. I had surgery but they said rn eh couldn’t fix it due to it being broken in 3 different spots, I gotten the pins removed. Still can’t move my finger. Any suggestions ? I have pain. & I also have carpal tunnel.
😥sending you love and healing sis
I have a chronic injury from pulling my index finger (stupid I know, I did it during two different panic attacks), and I don't know what to do about it. It got stiff in the middle joint and after a while the extensor tendon got tight in a way that when I make a fist, I feel my finger's mid-joint pull on it and the tendon feels really tight over the knuckle. It's been about 6 years after the incident and the doctor now ordered me an MRI-test to see the soft-tissues. He said however that this happened because "the tendon's support muscles got weaker". I think he's wrong, the middle of my finger feels abnormally stiff also when it's straight, as if some tissue has hardened inside. what do you think?
Hi, great video as always, I have a question about training with slight pain ( 1-3 on a scale of ten like mentioned ). When I climb or put the injured finger to use I don’t feel increments of pain while putting more load on the finger, but rather a sudden sharp pain when reaching a certain point or with sudden movements. Any input on the matter would be much appreciated, and again great video per usual 👍.
Love the protocol you're describing! Very consistent with the net of what I've read and the protocols I use in my personal training (and a recent pulley rehab)
Just a comment, please don't say you're "getting deep into understanding pain science" --because you aren't talking about hypotheses, experiments, testing, etc... i.e. Science, AT ALL.
You're presenting your personal (and likely accurate because you're well read) interpretation of recent research and the presumed multitude of anecdotal cases you've experienced. You are NOT presenting comprehensive support for your personal opinions -- your background, the papers you've read, data, comprehensive explanations of your personal anecdotes, etc... insufficient support to help your viewers understand how to interpret the potential accuracy or error of your personal conclusions. You are presenting some papers to support your point of view (which generally I agree with) but you are NOT presenting a comprehensive review of the literature on this subject which may or may not include conclusions that conflict with your interpretation. It's easy to cherry-pick papers to support wrong conclusions.
I don't think it's sufficient to present expert opinions on this topic anymore -- there are plenty of resources like Dave McCleod's excellent books which have given consistent and good advice on this topic for years. I'd love to seem more videos explaining the actual science (experiments, scans, tests, hypotheses that fail, etc...) rather than simple conclusions. This rings doubly true for teaching people how to learn scientifically (through personal experimentation) about their body and become better able to interpret the spectacular amount of data generated by their own senses -- i.e. the generalization that includes "pain science".
Great video, thank you.
I am about a year post injury (moderate strain I guess, no rupture) of A2 pulley in my ring finger. What should I do when I have 0 pain during climbing but I feel pain the next day after a hard bouldering session? (About 2 on the scale I guess)
Is it painful the next day as you press on it or just at rest?
Hooper's Beta Only when I press on it.
@@martinn2829 that's most likely just the pain science aspect with the hyperalgesia so you should be fine if there's no pain when climbing. Don't push too hard too quickly but you should be healing.
Hooper's Beta good to hear :) thank you so much for your replies and videos.
Hi, with the training protocol you present in the video, can i climb during the rehab period o just 4-5 times a week the exercises but no climbing?
I’m about a year post injury and have been getting back to climbing, I have been doing this same thing on a hang board twice per week 3-5 reps for 10 seconds each, the pain is always at a 1 for less than 10 seconds after the hang. However easy climbing causes zero pain but sometimes I will feel slight pain after the session for about an hour is that ok?
Yes
Very helpful video! I injured my A2 about 7 weeks ago and could not crimp at all while climbing. So I stuck to open hand while climbing and rehab hangs. I was hanging on the 30mm for the first few weeks and it felt good. Then I didn't feel any pain while hanging on the 30 mm so, I thought it would be good to go down an edge. I then started using the 25mm and while I did not feel pain over a 3 threshold and no pain after, the next day my finger was sore. That happened a few times and after a full day of rest my finger didn't feel sore anymore. I'm wondering why that is? and how to keep progressing my hangs to avoid that.
Great video. Can finger rolls/curls be used for rehab similar to Farmer Crimps?
They should be treated as different tools. The farmer crimps are an isometric activity whereas the finger rolls are isotonic. While the difference may seem subtle, it can be important depending on the issue you are hoping to address and the stage of it :) great question though!
@@HoopersBeta thanks. I have an A3 and was wondering if I can mix the isometric with isotonic. What is isotonic best application for?
@@HoopersBeta diving into the differences and when is what isometric and/or isotonic more applicable would be a good follow up video :)
Hey my one of my middle finger on my right hand is pointing to the right due to some poorly performed gripper training I did. It was months ago and I just rested it, but every time I try to go do it again, the finger aches again and points to the right, as in being angled to the right where there is blatantly more distance between that middle finger and the index finger compared to the distance between the left hand's middle and index fingers.
I already paid way too much just to have it checked by physiotherapists who gave general advice but nothing specific so hopefully you know what I could do, I probably didn't give enough details but I figure you can ask and I'll explain it as best as possible. Would appreciate some method for this.
Thanks
Not sure that your comment re absence of pain receptors on the body is correct - there are specialised receptors called nociceptors and they are present in connective tissues as well.
I wonder if you could clarify this bit.
Therein lies the misconception. Yes, we have nociceptors that perceive pressure, temperature, and chemical that send the information to our brain that is perceived as pain, but we don't have "pain" receptors.
I see comments on tendons but not much about ligaments... why ?
Can someone explain to me what a nociceptor is if not a dedicated pain receptor/nerve? I get everything else the doc said and it makes sense, but I had to scratch my head when I read "There are no dedicated pain nerves in the body".
Nociceptors detect pressure, temperature, and chemicals. Excessive pressure, temperature, or harmful chemicals will activate them and send a message to the brain. They are simply peripheral sensory neurons. Higher brain centers will decide if it is extreme enough to warrant a response such as pain. The point being, these are simply receptor providing feedback, the higher brain centers will decide how to interpret it.
Very interesting video! I have personally been dealing with a collateral joint/ligament injury (in both the middle joints, middle fingers) for the last 2 years or so. I've done almost every form of rehab I can think of. In the video, you use the Farmers Crimp for tendon/pulley injuries, do you think that this rehab could be applied to a collateral ligament injury?
When an injury lasts that long, my immediate response is two fold. 1) does pain science apply to this case and 2) what are they doing to constantly re-aggravate the injury? You may need to do a deeper look into your activities of daily living, work, climbing style, etc.
Oh and 3rd, you may need to get the injury re-evaluated (or evaluated for the first time) to make sure it actually is a collateral ligament injury and not something else.
Thanks, you just helped me figure out what the name of my finger issue is (I think). Do you have the same/similar symptoms as me?
- pain in fingers when pushing sideways on them
- ability to crack fingers sideways
- feeling of ligaments kinda slipping painfully if you move them a certain way, and associated crack sound and feeling
- some pain during climbing on really crimpy stuff but usually pain is a bit after climbing
- some pain when you bend your knuckles tightly as if to do tendon glides kinda
Have you found anything that helps?
@@adampnewsome The only things I would say I have similar to you would be your last two points. However, now my fingers have made quite some progress over the last half year or so in the rehab I've been doing, so it is hard for me to tell if they had more of what you had in the past.
The main thing that has helped the most recently is doing a hangboard protocol by Dr. Eva Lopez. en-eva-lopez.blogspot.com/2018/07/fingerboard-training-guide-iii-periodization-samples-of-maxhangs-training-programs-.html
After that, I find that light finger stretching, massage, and blood flow control help reduce the pain and increase the mobility of the joint. Plus, rice bucket training helps more of the same in that essence. However these things do not result in healing the injury/getting it strong enough to climb again.
I would recommend documenting the finger's progress. I've been doing so for the last year, and it's provided great affirmation and insight into the rehab I've been doing.
At the very least, I would highly recommend looking into starting the hangboard routine if your fingers have been chronically injured (and it's a similar injury to what I have.) The fingers need to be loaded appropriately to get back to climbing shape, otherwise, they will never be strong enough for climbing.
@@Rees8269 great, thanks for all the helpful info. I've been considering starting hangboarding - I have an appt with my physio next week and I'll ask if he recommends it. The other things sound helpful as well 🤞🏼
@@adampnewsome what did you find out. I'm having a similar issue for the last 6 months.
Thanks so much for this info, I've started a routine based on this. Should I consider adding some extensor activation to inhibit tension in the flexor side as I feel like there's a lot of tightness there?
I don't feel the pain necessarily when im pulling only if it's extreme but it feels weak and when I squeeze my fingers hard or press on the base it hurts like a 4 or 5. Any advice? I also still have swelling on the injured fingers after 2 years
Hoop with the inside scoop! thanks man!
I'm currently dealing with what I think is an a3 pully injury with the ring finger of my left hand. It's moderately sensitive to the touch and hurts when I climb slopers (and certain pinches). Crimping however, even with maximum effort, does not cause pain. The finger does not hurt to close, there is no swelling or lingering pain. Interestingly, I've never had an a2 injury, all my finger injuries have been a3 on the middle and ring fingers, following this exact same set of conditions.
1. Is this actually a pully injury or perhaps tendon?
2. Is it safe to climb crimps?
3. Would following this protocol yield similar results, despite the difference in the injury and pain?
4. I've been lead to believe that a3 injuries are more rare, is this the case...and why am I only getting a3 injuries?
From your description I am not convinced it is an A3 pulley injury. Look up the Flexor Digitorum Superficialis. The insertion of this tendon is near the A3 pulley and is more active during slopers.
Hooper's Beta Hey Hooper could you make a video about that section of the fingers? That would be so helpful seeing as I have the same injury described above and I know a lot of climbers that had it as well. Its definitely not a pully injury but I’m still not sure what it is and how to rehab and prevent it. It would mean the world!! Love your content.
@@Viktoryous good idea. It would be a nice series to learn to differentiate FDP and FDS injuries from Pulley injuries.
@@HoopersBeta Interesting! I am reading into the FDS and FDP now! I knew things existed there, but had no clue how they interact. I second the idea of making a video about these, and distinguishing the different injuries that may arise.
Last week I think I tore my a2 pulley. Middle finger went numb, swelled up and bruised around the area. Now I have a definite horizontal red line at the center of the a2 pulley area. Not too much pain at all now a week later but I'm a little worried to push the rehab. Any advice?
Sorry to hear of the injury! I would definitely follow a full rehab guide for a pulley rupture! If you're concerned about how to progress the rehab, speak to a skilled professional that is familiar with climbing injuries. I'm available for consults if needed! Check the website for details.
After how many days we should start doing this after a finger injury. A weight fell over my finger
Yes
Hi, i'm a climber from germany. I recently misst a hold and felt into my left hand with only my ring and my middlefinger at the wall. I heard NO popping sound or anyhing. but in a second after my "fall" i noticed a pain at the bottom of my ringfinger right around the A1 Pully. A doctor told me nothing is ripped of its just an inflammation and i should pause climbing for 1-2 month. But i'm not sure, after 4 weeks not climbing at all it still hurts in totaly normal daylie tasks. I can trigger the pain if i pull my pinkie finger towards my palm and than straitan the ringfinger. Should i slowly climb a little bit? Or just wait it out, since an inflammation is maybe something else than a rupture... i dont know. I would love to hear your opinion on that.
Hallo! Check out our video on the lumbricals as well! Perform some of the tests there and see if our rehab program can guide you to healing! Sorry to hear of your injury, though! Ich hoffe es hilft! (entschuldigung. Mein Deutsch ist nicht so gut)
@@HoopersBeta Thank you for your Help. Yes i watched the lumbricals Videos and this is exactly my problem. If i lay down my hand on the table and fixiate the ringfinger i cant raise my pinkiefinger. If i try, the finger lifts about 1cm of the ground and than starts the pain. Its hard for me to figure out if its Grade 1 / 2 or 3. I can straighten the ringfinger without any pain but only if i hold my pinkie finger down with my other hand. If i try to hold my pinkie finger with his own muscles i cant rise my ringfinger by itself without major pain.
How can I tell whether I need to rest a pulley injury or of its recovered enough to climb? For example I have a a2 pulley strain that still has some pain and I don't want to somehow make it worse
I was really surprised myself that my third digit DIP lateral ligament injury only got worse when I was forced on a COVID + surgery 2-month break.
Active recovery, such an optic topic!
10 years ago i felt a pop in my middle finger and just started climbing again since my 9 year old daughter showed interest and after a few weeks that finger swells up and gets stiff for a couple days after every climb
Sorry to hear that you're having issues after coming back to climbing! Volume? Intensity? If those are too high that can cause it. Similarly, over gripping?
@@HoopersBeta I am thinking volume and intensity, once I started working on v5 and 6 it started hurting again. Of course I let my ego take over knowing that it was too much for just a month back. Sticking to slopers, jugs, and anything that's comfy and open hand with light training in-between. Knowing a little discomfort and even a little pain that only sticks around for 5-10 seconds is ok was a big game changer for me and after just a couple weeks I am noticing some small changes in the right direction.
Lol i'm massaging my finger right now, wondering about this!
Thank you for reading my mind and putting this out!
I think it's even worse with wrist and elbow injuries because with fingers it's easy (easier) to avoid certain activities to make sure that you are loading them just right for recovery while with wrists/elbows there are also those everyday tasks that you cannot avoid and cannot fully control (like you cannot avoid lifting your baby and you cannot control how many times per day you have to lift them - or sometimes you have to deal with firewood and it just has to be stacked in one weekend, etc.). So it's much harder to figure out the amount of exercise you should be doing to balance it with daily unavoidable activities.
Please do a similar video but for fractures!
I'm retraining an a2 injury at the moment. I find I have no pain or maybe 1/10 while doing farmers crimps but then an hour later will feel some slight 1/10 or 2/10 pain. Sometimes when I wake up the next day it's a little more sore. Still minimal pain. Do I keep going?
If it's still low like that it's OK but you may need to check some factors (are you allowing enough recovery time between sessions, are you increasing weight too quickly, etc).
@@HoopersBetathanks! potentially bit of both. I'm doing 2 sessions of 5 reps a day but only at 7.5kg. Not sure when I should be moving to 3 sessions a week rather than every day