Climbing Injury: How I Overcame PIP Synovitis and Tenosynovitis
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- Опубліковано 8 лип 2024
- I had PIP synovitis and tenosynovitis from August 2021 to October/November 2021. It was a bad injury that affected my training and overall satisfaction with climbing. I decided to ultimately tone down a lot of my climbing for 1 month as a recovery period and logged everything I did to see what helped and what did not help. I summarize everything that I learned in this video.
Products mentioned:
Turmeric Curcumin with Bioperine: amzn.to/3Lvmp40
Antagonist Finger Bands: amzn.to/39fRV7D
Research Article mentioned:
"Effect of habitual knuckle cracking on hand function": www.ncbi.nlm.nih.gov/pmc/arti...
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- SUMMARY OF MAIN POINTS -
THINGS THAT DEFINITELY HELPED
- Knocking down the inflammation
- Turmeric with Bioperine
- Alternative: NSAIDS such as Ibuprofen (see your physician for best advice)
- Stopping knuckle/finger/wrist cracking
- “Extensive” 30 minute to 1 hour warmup before climbing sessions
- LOW INTENSITY HIGH VOLUME Climbing
- No training board during recovery month, just toprope/lead and gym boulders
THINGS THAT MIGHT HAVE HELPED
- Extensor bands, antagonist wrist curles
- Alternative: Rice Bucket Exercise
THINGS THAT DID NOT HELP
- Targeted finger curls WITHOUT a warmup
- Taping (may flare tenosynovitis)
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TIMESTAMPS
00:00 - Intro
00:29 - How I developed PIP Synovitis and Tenosynovitis
03:26 - Things/Habits that definitely helped with recovery
11:32 - Things that might have helped with recovery
12:48 - Things that did not help or aggravated the injury
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That's the most useful and insightful video about treating finger injury I've ever watched.
The supplement is a big takeaway for me, I was constantly using ice packs to try to reduce the inflammation physically but the improvement is really minor. Another one is the low-intensity climbing, which is something I had experienced but never recognised as a treatment.
What do you think about massaging the joints and forearms, do you think they are helpful?
Not sure about massaging the forearms because I never tried it. I did find stretching the affected finger backwards just enough for a stretch WITHOUT CRACKING THE FINGER to be helpful since our flexor tendon can be quite tight sometimes, especially the day after a session. I used to also stretch my forearms by putting my hands on the ground like if I were to do a handstand and stretching the forearms in various directions (fingers facing forward, sideways, backwards); not sure if this would help but it would help with tight forearms.
I used to massage the affected joint but found that it either didn’t really help or it made the inflammation irritated. Maybe i was doing it wrong or I would overdo it causing it to be more irritated. For my inflammation cases at least, I think just letting it heal without overly massaging or touching it was better.
Also vitamin C helps a lot, taking it three times daily for 500mg doses whilst recovering from trigger finger
Interesting about your finger cracking experiences. I started cracking my right middle finger sideways I don't know how long ago, and for the past few months I've had pain, which is why I came looking for videos on this. I stopped doing it a while ago due to it causing a bit of pain, and now I for sure will stay away from doing crack(ing). Thanks for the information and for sharing your experiences!
Bro, I love the thought you put into your videos! Keep producing content! :)
thanks for this video, its nice to hear someone else going through the same thing i did
been climbing 4-5 days regularly for my first two months, and immediately got this injury, really thankful for this video
Thank you so much for this! Very helpful
So glad you’re sharing this so I don’t have to make the same mistakes
Really helpful! Thank you SO much
This is so helpful! I remember watching this video half a year ago when I was looking for information online about trigger finger and thinking wow, glad you recovered and I hope I can recover too. Now I am here watching it again because I developed a PIP Synovitis (also on my middle finger lol). Knowing how other climbers have successfully dealt with similar injuries really made me feel better and more confident that I can pull it off as well. I guess learning to deal with these sorts of things is what avid climbers have to go through (to some extent). Again, thanks for all the info and making me hopeful about the situation! =)
Thank you for this video and the comment on taping and its effects on synovitis! I got a pulley injury years ago and started 'x taping' my fingers for added pulley support. But like you said, the extra support also stresses and compresses the PIP joint and it definitely developed into synovitis over the course of a few months.
I hope everyone keeps sending and training healthily. Listen to your body!!
Been climbing for about two and a half months and I’m pretty sure this is what I have. Thank you for the advice. I’ll definitely start incorporating it into my training.
I still have this issue because it’s v hard to not throw in high intensity days and I will definitely say that stopping cracking my knuckles did cut down the pain tremendously!! Thanks for sharing your insights!
This video is so useful for me. I currently am not injured but it makes me feel much better that at the very least I am aware of some approaches and prevention protocols to take.
thanks bro the tip about not cracking ur knuckles really helped me!
A tip that I have found helpful: Avoid jugs where you drape the injured joint over the hold. Pullup bars are bad too as they put DIRECT pressure on the joint causing lots of inflammation. I found that a really conservative targeted warmup on smaller hangboard edges worked best for me. Jug hauling for 30 minutes before your session can cause a lot of localized pressure on the joint when it is bent really get it aggravated.
Truth.
Thanks for sharing your experience. What helped me personally for sure is doing tendon gliding regularly, multiple times a day. Afterwards the inflamed joint always felt more mobile. A longer more thorough warm up for a climbing session has also helped. I take a lot of in between steps for finger loading before I reach a point where I feel ready to go all in on rather small crimps on a steep problem. I have also not cracked my fingers during this whole time but I don't know if that has made any difference.
Overall I would summarise my experience in the following way. Initially back off the hard climbing, mobilise the joint regularly, and then slowly and methodically rebuild intensity through controlled hangboarding and climbing. Be patient because this can take a couple of months.
Greta video thanks. I have a minor version of this where I get the stiff/sore fingers in the morning. I'm a pretty new climber and moving up the grades have made it flare up. Definitely will take the tips for longer warmups and the supplements. It definitely feels better when I do a long warmup and don't try to max out every time I go to the gym.
I actually said differently a couple months ago about cracking joints since i didn't feel like it impacted much as an entry level climber, but recently as I've been pushing grades and putting more stress on the fingers, I got the feeling that cracking (specifically the top part of) my finger wasn't helping and actually felt worse in the long term so I'm all on board now with not cracking joints
Im only 5 min in, my effect explanation of the pain, exactly what I have, looking forward for some results!!
thank you for this vid helpful tips that can save a lot of trial error time
These videos are very helpful, honestly, I just had a consultation with a doctor that was the most useless consultation in my entire life, she couldn't give me any information at all on what was happening and just blamed the sport.
I've been struggling with this for awhile and I'm looking forward to incorporating these tips! I've been cracking my knuckles for the past month because the relief made it seem like it might help long term - but for the next 2 weeks I'm gonna try not cracking and see if it leads to any kind of progress in the recovery!
any updates?
I found the same thing with sideways finger cracks. That one article that promotes it for climbers on google is freaking evil. It's not the same as normal knuckle cracks, your fingers shouldn't bend sideways like that. It provides immediate temporary relief but then swells it up 5 minutes later, which makes you do it again. Warming up my fingers with a hangboard + easy climbs very slowly combined with no sideways finger cracking were probably the 2 biggest things in my synovitis recovery a couple years ago. No need for cortisone, surgery, ice, rest etc. Definitely do not rest for long periods of time with synovitis, it just comes back.
I can attest to the part about long periods of rest. Took close to a 3 year break from climbing during COVID. First climbing session back resulted in immediate synovitis.
Thanks, this is helpful.
I have this in my index finger at the moment and it's really annoying.
Very cool video and lots of thoughts I agree with.
Some extra thoughts of mine:
I’ve been going through several pip inflammations and what was always key for me was once it starts feeling better to actively rehab using a fingerboard. It’s just so much more controlled than any move in the gym. Lots of times I would just feel better, warm up, hop on the board and do dynamic moves which would result in the inflammation to just immediately flare up again. Generally speaking you need to rehab the tissue after the inflammation. Even if it feels stable and without pain the connective passive tissue needs to be restructured. So using static holds on a fingerboard is the best controlled way to do this.
You can start very easy and once it feels better go back to 70-80% holds. Once you. An do max hangs again you should end up with stronger and healthier fingers again.
What I also found is that I could go climbing outdoors way earlier than indoors. Just because the holds are always different and not always the same flat crimps. Most smaller indoor holds put a lot of pressure on the middle finger PIP and there is always a very flat edge.
I have a very similar injury experience. I've also been doing low intensity arc training, 4x4s on bigger holds, and conditioning. I found that daily nohang finger curls for 2-3 min on a door jam, extensor band and hand/grip strength tool daily felt great with noticeably less pain when climbing. I try to use an open hand grip position when climbing and I use wide tape and glue to "cast" my entire middle while avoiding pressure areas along the tendon. Aequate rest and recovery are priorities for prehab/rehab.
I'm going through exactly the same symptoms on my middle knuckle for the first time after climbing for over 10 years. I'll try all these tips out and let you know how it worked for me. I'm crossing my fingers (but not cracking them).
hey, this is the best info on this injury I've found, is there a warm up video you would suggest? Thanks and keep up the thoughtful content!
Great vid I have this injury
Excellent video Boss. Watched the whole thing. Luckily I haven't really had this problem, but I'm going to stop cracking joints regardless.
Great info, thanks for this. How long did it take before you noticed that it was improving?
it makes sense. And also dry fire will definitely makes it worse maybe even worse than cracking joints
I've had what I think is pip synovitis in 6 fingers to varying degrees of severity for 1.5 years. When it first started feeling stiff and painful I took 3 weeks off with some improvement. 6 months later I broke my collarbone and didn't climb for 3-4 months to heal. However in those months off, my synovitis did not improve at all. The PA I saw about it said the only thing he could do is give me a shot of cortisol. Thus now I continue to climb with no real hope of improvement. In the last few weeks I feel like my knuckles improved a bit more due to more top roping and auto belays, but I'm still not 100%. Thanks for your video, I will try some of your tips.
Sideways cracking makes my inflamed PIP feel so much better...but the inflammation refuses to go away, so as you say it's probably not good for the joint. Wanted to mention that Dave MacLeod kinda stands alone in promoting 3 finger drag as a method to avoid injury (specifically pulley, but this grip is also MUCH softer on the joints) and says that through training he has become so strong in the open hand grip that he no longer has to crimp. Also, just want to reiterate how important warmup is: my DIP and PIP on index and middle finger are stiff/creaky/painful making even 5+ boulders hard, but a long progressive ~1hr warmup really limbers them up allowing me to pull unrestricted on 7b.
Hi, I've been treating tenosynovitis for over three months. During the treatment, the exercise that had the most impact was the curly finger exercise. Maybe there was an exaggerated load when you did it. I've been making it with just one kilo. Today I tried to increase 200 grams and felt slight discomfort, and I went back to one kilo. Thanks for the vid, Very useful.
Just to add some anecdotal adive, i found contrast baths really help me recover
yup this video is legit. i stopped cracking my knuckles and it helped the tendonitis in both my hands a lot better.
100% with you with the fact that cracking fingers harms them. I have been cracking my fingers for years and in every way imaginable and I have to say, if you do it, STOP! Great vid ;)
Excellent video, as all your videos are 💪🏼 thank you
Very useful vid. For me, I noticed that after a hard climbing session, the next 1-3 days, my middle finger would feel kinda funny when I wake up in the morning. It's hard to desribe the feeling from memory. Then, if i'd make a fist and let loose, the middle finger would be locked in that position for a bit longer than the other fingers. Very hard to describe but if you had this you will know 100% what I mean. Did some googling and found what it was (trigger finger; tenosynovitis). However, haven't found the cause of getting inflammation so easily (also in other spots like bicep tendons), despite my healthy diet and active lifestyle. Also haven't found a solution other than taping my finger the night after climbing and leaving it on/reapplying during the following days. Also, laying ice on it has become a routine for me. I try to warm up properly, but I haven't a warmup routine for my fingers that has worked just yet. For the bicep I have so there must be something... Edit: I'm not taping while climbing, I noticed the same that it would make it worse. I'm only taping my finger after to make it rest, I don't want this to be a permanent thing and I'm going to see a physio who specialises in hands soon.
Great content thank you for this! just a small question - it looks like you speed up your voice at parts or maybe i'm just imagining :D
Very appreciated! How long did it take in total?
very usefull, i have right now this kind of inflamation on the midlle finger
After months of thinking I had a strained pulley ligament in my finger I finally figured out this was the injury I had. One question I had was during the rehabilitation period how tired should you be after a climbing session. Should you stop the climbing session when you start to feel fatigued or should you stop when you still feel energized? Also is climbing on jugs bad for the finger because of the pressure that’s put on it?
I'm curious if you noticed inflammation in your wrist as well when dealing with the pip synovitis? I've been dealing with something similar for years but always have inflammation in my wrist and sometimes up through my elbow and shoulder as well . your tip on the low intensity was great. I always switch to adventure climbing when it flairs up and it helps a ton. Great way to get a lot of joy from your climbing while recovering.
great video! one question - would you suggest a few days or a week of complete rest to lessen inflamation before getting into the high volume/low intensity climbing? seeing a lot of conflicting stuff online about full rest or no full rest. (for context i have pip synovitis on one finger on each hand and have had it for about a year with varying degrees. Ive never taken a full rest really though so im thinking of taking full rest for the next two weeks then doing easy top roping and easing into crimping, etc)
From personal experience a full week of rest does not help if you go back climbing at the same intensity you used to. Thus, my preference is not taking a full week of rest but rather decreasing climbing days or anything finger-training related to 2 days per week, less half crimping and using more grip variations like 3 finger drag, and maybe adding in some rope climbing (5.11s and less) if it interests you. Implementing all of these changes would theoretically provide a lot less intensity and stress for your PIP synovitis and thus I don't see why a full week's rest is necessary.
By far, the most important thing I've found is taking the time to warm up for 30-40 minutes every session so that you do not increase the force applied to your joints too rapidly and "shock" them. For example, someone climbing near your max grade within 20 minutes of their session is too soon I think because the rapid shift in intensity felt by the fingers will cause it to be more inflammed compared to if the warm up was more slow. I think it's the worse advice any climbing influencer can give is say that you can squeeze a productive climbing session within an hour. I think it makes the injury potential way too high. If I want to have a good, productive climbing session that would lead to gains and no injury, at least a 2 hour session is necessary. My sessions average around 3 hours because i take finger warmups so seriously, which has kept me injury free since creation of this video. Hope this helps and your issues resolve!
Great video man, very helpful! How would you recover from a “pop” injury to your finger?
Search "Finger Injuries in Climbers | Lattice Training X Sheffield Climbing Clinic - Part 1", it's a good resource for differentiating finger injuries and you can do further research on the recovery options!
Did you take some time off the wall to recover? I understand you reduced your sessions but i would like to know if you have stoped for some time before introduce this "training changes". I have litterally the same issue and dont know if stop for 2/3 weeks or keep training carefully as you said to help the rehab... Ty man!
I think initially I stopped for a week, but I don't think it was helpful and it didn't improve my symptoms. There are people I know who had PIP synovitis or tenosynovitis whom took 1-2 months off and the time away from climbing didn't help them. It's more of climbing and lifestyle habit changes that will help you more with the rehab. If the inflammation is not too serious, I think you're better off just beginning the "training changes" right away, that way you can still climb and train different aspects of climbing. Change to 2 climbing sessions per week and increase gradually if you can tolerate more. 30 minute or longer warmup (critical). Low intensity low volume climbing. Most importantly no cracking your fingers at all costs. You'll see a big difference.
Stopping cracking is sooo damn hard. That habit has been ingrained in me since I was a kid
Experiencing PIP synovitis myself and deciding how to tackle it. Did you ever try or consider doing high rep low weight finger rolls? I’ve seen a lot of ppl say it helped the swelling and improved mobilization. Thanks!
Sounds like something similar to 12:50
It didn't help me, I think mainly because I didn't dedicate a long and slow warmup before I did the high rep low weight finger curls. I think if you do anything weight related, even if it's very little weight, you need to ease into it with a warmup rather than suddenly loading the joint with weighted finger rolls, even if theyre low weight. In my case, even with 6 lbs added, doing it with no adequate warmup aggravated my synovitis.
So it sounds like something more suitable to do during or immediately after a climbing sesh where your fingers are warmed up rather than something to quickly do while youre sitting at a desk. Hope this helps.
How long after your break did you resume moon boarding? Thanks for the video. I’m a week into no finger popping (it’s hard!)
Break was about 4-5 weeks and I gradually resumed moonboarding very slowly!
How long did you recovery take?
You switched back to your training plan after recovery…. How did you know when your were recovered ? Did you have full range of motion and zero pain/ discomfort ? The day you switched back to the moon board did it swell at all ?
Thanks !
Thanks for the advice! My climbing PT has me taping the synovitis like it's a pulley injury to prevent me from doing anything but open hand grips on jugs or crimps... but I noticed the same thing... One day I taped the wrong finger sport climbing outside and I had much less pain. I'm going to try this. Anyhow how long did it take you to recover? I'm currently at the point where if I try the moon or kilter board, underclings and pinches and certain holds feel like they press into the tender spot under my PIP joint, so I had to back off again. But outside, rock finally feels better. I'm wondering how you eased back into moon boarding and how long it took to get back to it?
I think you misunderstood the finger exercise. He was using the negative portion only to sorta lengthen out the finger and not using the full range of motion and curling the weight.
So I have the exact same injury in the exact same joint. However, my injury is actually from disc golf. Sounds odd, but the incredible whip and really over throwing caused it. I’ll try to not pop, but man, really annoying injury.
Do you speed up your videos a tiny bit? It's really bugging not knowing. Just curious!
Watch out with too much tumeric, you probably know more than me but Huberman noted it can inhibit androgen receptors
Thank you for bringing this up; I was totally unaware of it! Both the mentioned turmeric and NSAIDs shouldn't be taken long term. Just enough bring the inflammation down during the early recovery phase and then should be stopped thereafter.
So I am a fraid of physical therapist and occupation therapist .so I learning online ,how to good my fingers.
Hey Boss! did you take x3 of the turmeric pills 1 hour before your sesh? or did you space it out?
I usually did 3 before the sesh!
That rubber band is good but I can't find it.
My fingers are bully damaged by physical therapist and Occupation therapist . My other finger swelling went to physical therapy clinic ,and another finger are swelling by bully .
P R I C E
Very relatable. I sometimes lift things in my every day life in a way that puts sideways torque on the joint and it feels really bad while suffering from this. Have you started climbing harder again or are you still in the lower-intensity high volume climbing phase.
After it resolved, I climbed hard again! While still maintaining only climbing hard 2 days a week because that seems like the sweet spot for not aggravated the inflammation again.
@@bossclimbs how long did it take for you to be able to climb hard again and for how long did you kind of ignore the injury at first (like I'm sure everyone does) hoping it gets better.
@@bossclimbs also, thank you for the reply!
do you have any experience with a wrist injury?
wonder if he's a software engineer ;)
What you showed as a warmup was actually stretching and it's extremely dangerous to do before any kind of exercise! Stretch after, never before!
you just need to work on technique and worry about the training later. You aren't going to be a long term climber if you just do it for ego