Acute finger tendon/pulley injury management with Dan Mirsky and Esther Smith
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- Опубліковано 2 кві 2017
- Join Esther Smith (DPT, Cert. MDT, NTP) and Dan Mirsky (climbing coach/athlete) as they help you manage, assess, and treat rock climbing related finger injuries. If you hear a loud pop or have sudden pain/weakness while climbing, stop right away and ice the area as soon as possible. Afterwards follow the five exercises outlined in this video to help assess and treat what's going on in your body.
This video is referenced in our blog post on Healing Nagging Finger Injuries, which covers both our Phase 1 Finger Recovery Program and Phase 2 Finger Remodeling Program: www.grassrootsphysicaltherapy...
Another technique we like to use is this swelling reduction taping method for persistent swelling: www.grassrootsphysicaltherapy....
Email us to schedule a Remote Self Treatment Consultation: info@grassrootsphysicaltherapy.com
Thank you so much! None of these top video "UA-cam doctors" provided any rehabilitation excercises. I am very greatful now I can do these tips to get better.
I just did a pulley this past weekend and it's my first ever injury. Thank you for the video, much appreciated.
Esther! These are all fantastic exercises! Thanks so much for sharing your knowledge with us.
Glad you enjoyed it!
Great exercises for healing the finger injury. It is extremely useful.
Thank you so much for making this video!
Wonderful video, definitely learned a lot and am applying these to my home therapy finger ligament injury
We're happy that you've found this video helpful!
Thanks for posting this !
Great video! I had a complete rupture of the A2 pulley on my left ring finger and strained the A1 on the same hand/finger. That was almost 3 months ago. Because I waited about a month to see a doctor, the healing process has been painfully slow. I just got the ok from my doctor to remove my thermoplastic splint 4 days ago. I started these exercises immediately and the results have been fantastic. Thanks gain for posting this.
You’re welcome!
This is great! I've been bothered by my index finger tendon for months now! Now it feels much better! Thank you! 😍
We're so glad to hear that this video resource is still helping people!
you are welcome!
Thank you so much Ester, your videos are incredibly useful
You are welcome! There is even more information on our website. Reach out if you have any questions!
@@GrassrootsSelfTreatment Already have, some wonderfully useful content! Thanks for sharing it all!
Thank you for posting. I have mild flexor tendon injury of ring finger caused by dog bite. This exercises are great help for me. Thank you again.
Hello Matt same case with me..Do you have stiffness, hw long it took to heal..
Hi maam..my anamika finger is injur after 15 year .then my finger is round..how exercises my finger strait..plz reply
Super helpful video! Thanks so much (:
Had a loud pop in my ring finger right hand after lifting 3 concrete blocks and did the same 3 weeks later on my ring finger left hand lifting a concrete beam 🤦♂️ not had medical advice as ive just been to busy at work, but as we're in lock down in the UK I will try your exercises, hopefully all goes well as I have been struggling, thanks for the video 🙂
Sorry to hear you've been injured! We have a more detailed article on healing finger injuries here: www.grassrootsphysicaltherapy.com/physical-therapy-treatment/2018/11/29/hang-right-part-3-healing-nagging-finger-injury
We also recommend seeking out treatment from a McKenzie certified therapist in your area: uk.mckenzieinstitute.org/patients/find-a-clinician/
That last one is awesome. I had a PT tell me to do a variation of that with my back against a wall, which really irritates my hands. I'll have to try my foam roller. Thanks!
Thanks for the feedback! We personally love the large foam roller and use it preventatively for ourselves as well. It's great to do after carrying a heavy pack or even just typing at a desk all day. Let us know how it goes for you!
Great video. Thank you.
You’re welcome! Glad it’s helpful.
Great video Guys. How often should you do this exercise if you have a pulley injury?
Thank you for the video and the great exercices ! I ruptured a A4 pulley 2 weeks ago and i'm wearing a pulley ring to heal. I was wondering if i should take out the ring or keep it while doing these exercices? Thanks again!
The pen rolling exercise is clever 💟
Super educational video, thank you. Any advice for palm muscles atrophy pls?
Thanks for watching! We recommend seeking a medical diagnosis from a certified hand therapist/specialist to get a treatment plan.
You may also find helpful information from our Hand & Wrist Self Treatment video: www.grassrootsselftreatment.com/products/hand-exercises-wrist-exercises
Heard a loud pop Yesterday on a bad hold.. will definitely be doing these. Thanks!!!
Me too man!!! At altitude gym Gatineau on the white 8/9 fuck my life man
@@MrLilpaki Ahh fuck dude!!! That's sucks so much... I know the feeling. Take care of your finger man, it will eventually be back to full strenght! Let me know if you have questions or whatever we can chat about it!!
@@DavidMartinBouldering definitely do have questions! Would you mind if I added you on Facebook ?
@@MrLilpaki Yes please do!
Hi David - we hope you are feeling better, but if you are still experiencing painful symptoms or limited range of motion, then we recommend that you seek out a professional medical diagnosis and care.
Thanks for the awesome video!! Second time in 3 years I needed to watch it though :(
How quickly after the injury would you start these exercises? The same day? The next day? 3 days later? A week later?
Thanks again!!
Great question! We recommend that you listen to your body! These exercises are not meant to exacerbate any issues you are having. So start slow and adjust as you go. Good luck!
Thanks again for this video. I succesfully repaired a A2 and A4 pulley rupture 3 years ago using these techniques. And here I am again for the same reason, three years later. Same finger, different hand this time. I wanted to express my gratidute again for sharing the knowledge with everyone. I was also wandering if it is normal for inflammation to the finger to persist after 3 or 4 weeks despite having established a rather good range of motion (say 90%)
Thanks for supporting this channel and finding the content useful! We always recommend that you see a licensed practitioner in your area for diagnosis and treatment. The severity of the pulley injury is important to assess as that will dictate the severity of swelling and prognosis on recovery/healing time. If the pulley was ruptured with bowstringing then you would need to consider splinting- these injuries can take months to resolve.
For future reference, check out this article www.grassrootsphysicaltherapy.com/physical-therapy-treatment/2018/11/29/hang-right-part-3-healing-nagging-finger-injury for a loading protocol.
At a certain point it will be important to load the tissue in order to remodel it and make it strong for climbing. This also builds in injury prevention as you will do the loading on both sides. If your injury is severe it is typical to still have swelling a month later, but you need to discover why.
Another technique we like to use is this swelling reduction taping method for persistent swelling: www.grassrootsphysicaltherapy.com/physical-therapy-treatment/2019/4/1/taping-for-finger-injuries.
@@GrassrootsSelfTreatment . Specialized assistance has proven surprisingly hard to get where I live unfortunately. I will do my best to recover following these protocols. They are really helpful. Thanks again!
@@GiorgosPlanar It's unfortunate that quality care can be difficult to find. If you are outside of the United States, you can search the International McKenzie Institutes website for a certified therapist: mckenzieinstitute.org/patients/find-a-clinician/
Hi Georgios, Curious to hear how your healing has progressed. I'm also struggling with prolonged inflammation after rupturing an A4 pulley over 4 weeks ago. I've been wearing a splint ring and doing ROM exercises but have seen no measurable improvement so far. Did you find a method to get the inflammation under control or did it just eventually improve over time? Hope you're back to 100%!
@@braunaaron Hi Aaron. Yes back to 100%. Hard moonbpoard session yesterday no problems at all. It took 6-7 months to reach this point and still on hard crimps and moonboard I am taping it. But it has healed and i feel no discomfort even on very specific and demanding loads. So have hope. For the swelling @Grassroots Self Treatment has offered some advice on the thread above which was game changer for yet another time. See the link above on this thread and read the swelling reduction treatment. This Coban self adhesive tape is great. Solid advise from @Grassroots Self Treatment yet another time... Hope you ll back climbing to your limit soon mate
Seems to me if you hear a pop and have weakness you need to go to a specialist or the ER ASAP because it probably requires surgery. I want to warn people; DO NOT bypass seeing a qualified doctor, (and I stress QUALIFIED) and just think you can treat it yourself. These exercises are for once the problem is repaired. A torn tendon or pulley is nothing to play with. I am going through similar rehabilitation now.
When I got to a hand clinic I was first sent to OT twice a week before the first doctor really knew the extent of the damage, and then when I still could not bend my finger closed after 2 weeks of therapy I knew something was really wrong and had to get a second opinion. That specialist did surgery and found out my tendon was 50% severed and that scar tissue had wrapped around the torn area and was wearing it down further. If I had continued doing exercises it would eventually have snapped completely and I'd have an even worse injury. It was a good thing they opened it up when they did because tendons will not heal on their own. They have to be sutured. The body will try but it ends up with all sorts of big lumps and adhesions that take months of therapy to rectify even after all that's removed. In my case, I had to wait 4 weeks to get in to see a specialist because it was during the COVID lockdown that it happened, and my GP was on telemedicine and communicating by phone and video chat. Due to my autoimmune diseases she felt it was too risky for me to go to the ER even though that's the usual procedure. My finger became infected on the inside where the joints are and I ended up with septic arthritis on top of the soft tissue injuries.
We're sorry you had to go through all of this during a difficult time to seek in person medical care!
Here are some of our blog posts that may be interesting to you (or others reading this thread) that go into depth about finger anatomy and healing injuries and provide the bigger context for this video.
www.grassrootsphysicaltherapy.com/physical-therapy-treatment/2017/12/12/pulley-injuries-explained-part-1
www.grassrootsphysicaltherapy.com/physical-therapy-treatment/2018/2/14/pulley-injuries-explained-part-2
www.grassrootsphysicaltherapy.com/physical-therapy-treatment/2018/11/29/hang-right-part-3-healing-nagging-finger-injury
Hi Esther thanks for this, I have read the documents you linked to here in the comments and I definitely fall into the "phase 2" remodelling. I became an avid climber for only a few months and then suffered an injury where my ring finger on my right hand is now permanently leaning into my middle finger with a pain in the forearm if I do anything stenuous along with a general weakness to that finger and arm/hand that has now been present for about 6 months, like you said I thought it would recover on it's own but here we are. My question is after I have done these exercies and load testing do I need to strap that finger in place or anything or should it recover on it's own into the correct position? I fully acknowledge that this is not medical advice.
Since your finger is no longer in alignment, you would likely benefit from seeking expert medical advice. Depending on where you live, we can work with you through a Virtual Visit. Otherwise, we recommend looking for a certified McKenzie therapist in your area. Here is the scheduling link if you are in AZ, CA, CO, GA, NJ, OR, SC, TX, UT, WY: www.grassrootsphysicaltherapy.com/sports-physical-therapist
I'm not exactly a climber but I did have a finger issue. sadly my diagnosis was not given at all by a medical professional but I started following a couple of these as soon as I noticed one of my fingers start to stiffen in the morning. I hope I'm not too late
Hello. I doubt you are too late. Let us know how it goes for you! These exercises can be great for anyone, not just climbers.
Grassroots Self Treatment well sadly it's been about eight weeks since my injury so I think I've developed the a good deal scar tissue already. it's been a radiating pain almost daily since about 3 weeks ago
i started bouldering 3 months ago and it's the worst sports for tendon injuries. Got one in my elbow last month, and now in my finger
Hope some of our videos have been helpful!
If I have a rupture of the a4 would you still recommend these exercises? If so when?
Without examining your particular injury we cannot comment on utilization or dosage. We encourage you to find a skilled practitioner in your area to help you determine the most appropriate exercises for you.
hey i know this is an older video but I recently did something to my flexor while pulling hard on a pocket. its been a few days now and I have full mobility, but certain moments hurt. How long should I wait till climbing again?
(Legal Disclaimer: the following reply is not intended to replace seeking professional medical advice for any injury you have sustained)
This video is still super relevant and the full context can be found within our blog post linked below. The guiding principle is that any symptoms you feel during activity must resolve within 10 minutes after climbing, with no loss of motion or associated stiffness produced by the activity. Otherwise, you are at risk for prolonging the healing process.
For a more detailed explanation, you will want to follow the advice for Phase 1 in the following blog post:
www.grassrootsphysicaltherapy.com/physical-therapy-treatment/2018/11/29/hang-right-part-3-healing-nagging-finger-injury
Email us to schedule a Remote Self Treatment Consultation: info@grassrootsphysicaltherapy.com
Three weeks ago, I suffered a partial disruption to the A2 pulley and some damage to the A3 pulley in my right ring finger while climbing indoors (diagnosis via ultrasound scan). Since then, I've had the finger immobilised in a hard splint. I no longer have any pain or swelling, but I do have a reduced range of motion in the finger (can't bring the fingertip fully closed when gripping). My question is: are these exercises suitable for a injury at my stage (21 days post) to begin the rehab process, or should I continue to keep the finger immobilised for longer yet? Thanks in advance!
Ashley Felton Hows your finger doing now? Is the range of motion getting better?
Please refer to this article for more info www.blackdiamondequipment.com/en_US/experience-story?cid=esther-smith-nagging-finger-injuries
These exercies has helped me so much. But when i try to straighten the ringer it hurts like hell. Is there something to do to improve also the straightening? I dont want to end up with a hooked finger 😅
Hello, please seek medical advise in your local area to help diagnose and treat your finger. The rice bucket and towel exercises have straightening movements. Simply straightening your finger repeatedly with and without resistance (into a band) can be tools as well.
Just happened upon this channel. I tweaked my finger about two weeks ago. Happened when I was campusing to a big hold. I grabbed the side of it but my fingers aggressively snapped off. Stupidly kept on climbing although without pain. Still feel a nagging weirdness in my middle finger base pulley. Did a hangboard session the other day that didn't bother it. Will definitely use these exercises to warm up my fingers. How can I judge my progress? Thanks!
Please refer to this article for more info. www.blackdiamondequipment.com/en_US/experience-story?cid=esther-smith-nagging-finger-injuries
check out our article on black diamond to learn more about your finger injury management: www.blackdiamondequipment.com/en/experience-story?cid=esther-smith-nagging-finger-injuries
My finger strain is a little strange.
My finger will be sore on the second pad the next day after climbing but i cant find a hang board position that irritates the finger.
All bodies and injuries react uniquely. Without evaluating you, it's difficult to give any feedback. If you are in one of our licensed states, we can treat your injury virtually. If you are outside of those states, we can do a remote consultation to assess your alignment while hanging, which may clear up downstream issues.
www.grassrootsphysicaltherapy.com/virtual-visits-physical-therapy
so Im going to ask here because I cant find anything related to it: so I holded my weight with my fingers too fast and now I have pain in the forearm it feels like a tendon, is there any exercise to recover for that or should I just wait? (Im literally writting this less than 20 minutes after it happened)
edit: should I use this exercises? Im new to this stuff
If you are still in pain, we recommend seeking out a medical evaluation from a McKenzie certified clinician. It is an international institute and you are likely to be able to find someone near you: mckenzieinstituteusa.org/
Hi! Would you alter the rehab period for a pinky pulley injury? I've somehow strained my A4 pinky pulley and am hugely tempted to just keep climbing open handed/ 3 fingered/ where there is no pain. Ironically, pain only occurs on larger holds/ jugs that are grabbed. Crimps, particularly on small holds, feel fine (perhaps because the pinky is too short to engage?).
We cannot comment on your rehab without evaluating you. Let pain be your guide and seek out care in your local area for detailed assistance. Hopefully the moves in this video are helpful for you. Often, fingers are tender to direct pressure (jug) and not load (crimp). You will still want to figure out the best way to heal that pinky. Good luck!
if your fingers stiffen is there any saving them?
That’s tough to answer without examining you. Generally you can help finger stiffness with mobility and flexibility exercises and try heat. Hope that answers your question.
I injured my index finger zobe 2 and i had surgery for 4 weeks now and still no movement in my finger fo you think i will still be able to move my finger like before injury?
If you have severely limited range of motion, then we recommend finding a McKenzie Method certified clinician to evaluate your finger and help you regain full function.
Find a Provider in the USA: www.mckenzieinstituteusa.org/
Find a Provider Internationally: mckenzieinstitute.org/
when should I start (post trauma) with this after an A4 rupture and A3 half rupture?
consult with a local PT or licensed provider to assess your injury and help you determine the best approach for you
@@GrassrootsSelfTreatment
The Dr. said that functional therapy with ring ligament protection (H-Tape) can be started from the 6th week. Your therapy (without tape) is more recommended for ring ligament strains and from the 2nd week + definitely continue climbing without full crimps
i had a tendon tear in the middle finger and underwent a surgery 1 year ago...it was perfectly fine but from the past 10 days i am having the pain...i don't know exactly why this happened...if i try to lift a bucket full of water...the rest of the day i am having a serious pain...i can't panic my parents right now as i am prepping for my exams and they will be super worried...any suggestions could be a great help
I'm sorry you are in pain, but we cannot diagnose or treat your issue online.
We recommend seeking out a medical evaluation from a McKenzie certified clinician. It is an international institute and you are likely to be able to find someone near you: mckenzieinstitute.org/
Hi guys, great video, very helpful for me as I had a pain in my hand and thought it was RSI from my job on on a computer but two weeks before I did go climbing so maybe that could of caused it? But it was two weeks later that I had the first sign of pain.
My ring finger was most affected in the A5 area , I also had a swelling appear and a sign of burst blood vessels as I have some small bruising again on the A5. This was the same with my middle finger and soon the the same sensations went to my left hand too. I was resting it, iceing it and performing stretches but it was no better. Anyway I began to massage my fingers and that instantly took away the sharp sensation whenever I touched or held an object. Do you think the tendon was stuck in the scar tissue ? Funny when I massaged just the swollen ring finger on my right hand the ache also went away on the left hand even though I hadn't touched it? Can you explain?
I feel i'm recovering now but I still have is the swelling even though it's reduced from me softening it during a finger massage but it's still there as is the small bruising and another thing is my tissue of the skin feels more tender as when I open a stiff bottle cap for instance it can leave a permanent indentation. I find more dents are appearing than usual in my hands and theres lines across my fingers that wasn't there before the injury. Is this maybe cause the tissue is healing hence why on the surface my skin is more prone to marking from holding objects with only light pressure applied?
Injured mine about two months ago and the pen one still hurts. Hopefully it will help strengthen it again though
please keep us updated. Going through this too, no mountain climbing whatsoever, I did this open a hood release, and I'm a guitar player, so I'm so depressed/angry about this.
@@nedflanders5302 it's my right hand so doesn't effect my guitar playing too much thankfully. I think these are helping but it's still a bit early to tell. The pen one hurts less now.
@@Dbdilly I'm left handed, so this happening to my right middle finger really hindered my guitar playing. I am still playing, but making a C or F chord is next to impossible, so I've resorted to power chords to supplement.
Going on a month now, so I am going to start trying the pen exercise.
@@nedflanders5302 We hope you're feeling better, but if you still have limited range of motion or stiffness in the finger, then we recommend seeking out a medical professional's diagnosis and care.
Do you do consultations?
Thanks for inquiring! We do remote athlete consultations for climbers who are not currently injured and want to learn how to prevent injury. Due to legal requirements, we cannot do a virtual physical therapy evaluations outside of our licensed states (Utah, California, and Wyoming). Email info@grassrootsphysicaltherapy.com for further information and to set up a consultation if these conditions apply to you.
I cut my flexors in my pinky. How do you get the finger to curl? Mine will not. The bucket of grain looks awesome, but I am allergic to wheat. Is there another thing to use? Something that will not mold?
We recommend seeking out a certified hand therapist/specialist to get a treatment plan for an extensive injury like that.
Most people use rice in the bucket because sand is too much resistance. A lower resistance substitute for wheat berries might be sorghum or corn. If you keep a lid on the bucket, it should reduce its chance of molding quickly.
@@GrassrootsSelfTreatment thank you so much for posting. I had to have debridement surgery as the stitches were coming out of my skin today. And they were not able to reattach the tendon. I will try this once everything is completely healed.
What to do with jammed thumb?
We recommend seeking out a medical evaluation from a McKenzie certified clinician. It is an international institute and you are likely to be able to find someone near you: mckenzieinstitute.org/
should i perform these even though im in pain ? happened 3 weeks ago
We wrote an article that goes into more detail of managing a finger injury. We also recommend being checked out by a McKenzie Method (MDT) certified PT in your area. If you are in one of our licensed states, we can do a virtual evaluation. Your pain symptoms should be your guide, yet you want to encourage gentle movement in your finger while it heals.
www.grassrootsphysicaltherapy.com/physical-therapy-treatment/2018/11/29/hang-right-part-3-healing-nagging-finger-injury
www.grassrootsphysicaltherapy.com/virtual-visits-physical-therapy
Esther Smith also shares her knowledge in this podcast if you enjoy listening instead of reading: www.trainingbeta.com/media/esther-fingers/
Grassroots Self Treatment yes I read it and it said the area will be tender go to the touch after six weeks . My question is should I perform these even when my hand hurts at rest ?
@@neilmacphail2534 If your hand hurts at rest 3 weeks out, we highly suggest seeking out a medical professional's diagnosis.
Grassroots Self Treatment I mean it’s gotten to no pain at rest before just haven’t been performing the therapy. Unless it’s a full blown rupture a medical diagnosis is PRICE and Advil. Been through this b4 just wanted to see if you had helpful input . Thanks anyway ! My faith has got my back
It hurts alot.
If this is causing pain, then stop immediately and seek out professional medical evaluation. We recommend finding a McKenzie certified clinician in your area: www.mckenzieinstituteusa.org/
If you are in one of our licensed states, then we can also evaluate your pain virtually: AZ, CA, GA, NJ, OR, SC, TX*, UT, WY.
*TX patients need a PT referral from a General Practitioner first.
I am on recovery myself at the present, making huge gains in only 2 months... This video helped alot, since my public EJSPANISH therapist just sent me straight home at week 3 saying i wouldnt move the finger again... (Wich I accepted because being crippled was enough of a time waster). After the accident, my left pinky was just GONE from my brain's reach; both flexor tendons got guillotined without mercy... After surgery I could definitely feel the finger was back into my nervous sistem, even if stiff like a rod... Altoough I couldn't move it the smallest bit, I felt the tendon hurt whenever I ordered it to move... IF IT HURTS, IT's THERE; IF THE PAIN IS PLEASANT, IT's WORKING OUT; AIN'T PLEASANT?; DON'T DO ATM.
I've been learning exercices by myself, since social security is garbage in Ispein... I regained about 50% range on the 2nd phalanx, and I was barely starting to feel some motion on the 3rd...
Today i spent like 4 hours doing all the exercices on this video on hardcore mode, and the progress is so inmense, that now i'm 100% sure that with hard work, I will be able to play guitar just like nothing ever happened in about a year or less.
Thanks for this video; 6 mins more useful than 3 weeks on EJPAÑA's Social Security hands.
(BTW I learned to write with my right hand because of this injury; unlocked the other hemisphere of my brain; BLESSINGS IN DISGUISE)
ARRIBA ESPAÑA! VIVA LA MUERTE! MUERA LA INTELIGENCIA! (lloro)
MY BEST WISHES OF SELF LOVE FOR THOSE WHO SUFFER FROM ANY PHYSICAL
3:55 also you can improvise one of those massage rings with a hair tie and some oil or lubricant. Olive oil warmed on the microwave makes it smooth...
We're glad to hear that this video is helpful! For a physical therapist who understands the loading strategies that Esther teachers to help remodel tissue, look for a McKenzie Certified clinician in Spain: mckenzieinstitute.org/patients/find-a-clinician/
First impression of this video: DAMN HER ARMS ARE JACKED!
#mcduffyskajukenbo 4:19 for good hand conditioning techniques
Came here due to waking up with sore fingers .
Pulleys are not flexor tendons...
check out this blog for more detail on the anatomy of the flexor tendon/pulley system
www.grassrootsphysicaltherapy.com/physical-therapy-treatment/2017/12/12/pulley-injuries-explained-part-1
I can’t even form a fist
If you have severely limited range of motion, then we recommend finding a McKenzie Method certified clinician, which can be found near you anywhere in the world.
Find a Provider in the USA: www.mckenzieinstituteusa.org/
Find a Provider Internationally: mckenzieinstitute.org/
hey i know this is an older video but I recently did something to my flexor while pulling hard on a pocket. its been a few days now and I have full mobility, but certain moments hurt. How long should I wait till climbing again?
Hi Jack! We hope you're doing ok. If you believe you've sustained an injury, we recommend seeking out a diagnosis from a medical professional.
Any activity or movements that cause pain during or after are a "red light" and should be stopped until a treatment plan is in place.
If you live in one of our licensed states (AZ, CA, CO, OR, TX, UT, WY), then you can book a virtual visit with one of our Doctors of Physical Therapy who specialize in climbing injuries.
grassrootspt.intakeq.com/booking