Had a lumbrical injury around a year ago and all I could find was a video in german describing how to diagnose it. So amazing that this is out now. Great job guys!
Interesting, if I watched and processesed this video right I had a lumbrical injury too and I didn't found a video. And I'm german. :D My first doctor wasn't very helpful ever. The second one said that I should keep climbing but skip the holds which cause pain. So no pockets the rest was allright. But now I'm fully understanding what happened there.
I am currently recovering from an injury to one of my lumbricals. Thanks for this video, it gave me a much better understaiding of what I actually messed up.
This was a really useful video! I watched the a2 pulley video first because I assumed i injured my pulley, but this definitely fits my injury much better. A 2 finger pocket was the cause
I thought I had a pulley injury but after watching this video I’m positive its lumbrical. Thank you SO MUCH for providing such comprehensive information.
These videos are unbelievably helpful. Just had something pop climbing last night, I wouldn't have been able to diagnose it as an FDP or lumbrical injury without these differential diagnosis tips. Thanks so much!
Have had two of them now, recovery is fine if you keep 4 fingers together. I buddy taped my fingers together sometimes to make sure one didn't pop off a hold, otherwise I could climb as normal @@trailbytrail632
These vids are really helpful. I actually injured my left hand playing golf. I was overdoing it at the range, holding the club too much in the fingers and concentrating on increasing my wrist motion through the swing. After that session, developed screaming pain in my left palm (I'm right handed) from the lifeline up to the PIP in my middle, ring, and pinky finger, but particularly the ring finger. A week later and the pain has started to localize in various parts of my ring and middle finger, plus at the base of the fingers from the middle finger outward. I did a lot of research on golf websites but didn't find the info I needed. This is awesome! I'm 60 years old, relatively new to golf, yet still have a massive ego (when it comes to golf anyway) so I injure myself frequently by overdoing it - though not this severely. My plan is RICE for a while and then slowly get back into it. Any words of wisdom or encouragement or even a good scolding are greatly appreciated! Thanks so much!!!!
I'm studying some anatomy for a class and this was the perfect way to stay in an anatomy vibe while taking a break on organs. Haha Very informative, very interesting!
8:49 YUP I have a lumbrical injury. This is super helpful Mr Hooper thank you. If I flex too hard into my ring finger I feel the pain all the way down into my arm.
Felt some pain throughout my finger, hand, and arm during my sesh yesterday when my foot blew off a hold. Thought it was a FDP injury at first, but seeing as how the pain is more localized to my palm I am confident it is a lumbrical injury. thank you for all the amazing and clear info, love your videos. The injury seems pretty minor so I am hopeful that I'll be back on the wall soon
I got a lumbrical injury 7 months ago and it’s still quite painful. It’s really painful with pockets but with crimps and sloupers I can climb my max without pain. Excited for the rehab video!! Thanks in advance
Well done. This is a excellent demonstration of functional anatomy and structure. I really want to draw attention to differentiating lumbrical injury vs other intrapalmar/interosseous injury since that is such a common pitfall. I'm looking forward to watching your other vids. Way to be a fantastic resource!
never even heard of this, but thanks to the self-diagnosis tests, i'm sure this is it for me, and that makes sense as i remember it happened when my little finger popped out of a hold
I originally though I had an FDP injury, even had an ultrasound just for the doctor to say that there was no tear. Now I know that I had a lubrical injury and am excited to get back to training. Thanks!
Broke my 4th metacarpal a few decades back. Unfortunately the bone was not perfectly aligned once healed and it's always felt a little weird. I think this video spoke so much to why that is! My lumbricals are stuck out of alignment, so even during non-strenuous usage it feels kind of weird (aka out of aligment). I am sure there are mechanical issues with pully etc alignment as well. I am never going to be a top tier climber but, I am excited to try some of your rehab suggestions. My structural issue isn't going anywhere but maybe I can at least work around it more thoughtfully now! I love the anatomy and physiology focus of the channel. Thank you, 🙏
About 6 weeks ago I heard something snaping in my hand on a desperate deadpoint move to a shallow 3 fingers pocket, so at first I was thinking of a pulley rupture. Turns out I teared my lumbricals (looks like a grade II/III injury from what you describe), took a 10 days break from climbing (+ icing) and the pain is slowly starting to fade. Perfect timing to get some rehab advices, thanks a lot guys!
Holy Moly boys! These videos are top quality. Is it just Jason and Emile making them or do you have more people behind the scenes? If so, would be nice to have a video about the process (always enjoy the bloopers!)
Amazing, this happened to me around 2 years ago, based on your self assessment guide I should have goine to the hospital because i couldnt separate my fingers at all without searing pain (but hindsight is 2020!). The physio i visited had no idea what had happened to me (waste of 40 pounds) and i had my little and ring finger taped together for about a month all the time. After a while i took the tape off and practiced some stretching as you described, I just guessed that it would work. Thankfully my hand is feeling a lot better now after a lot of patience and a few re-injuries, but I think climbing pockets is out of the question for me forever. Thanks for this video, really interesting to learn more about what has been causing me pain for 2 years!
A little over 4 months ago I injured my lumbricals at the ring / pinky really badly during a 3 finger drag max weighted hang routine while hangboarding. I was in a position where I was in a lot of flexion with the pinky during the hang. It was a dull sound and quick tear at the lumbrical and even a shock all the way through to the belly of the forearm. The diagnoses was done pretty easily with the stress test you mentioned. I couldn't even resist the slightest amount of force. I've followed the rehab strictly and included daily hydrotherapy too. My strength levels aren't completely back yet but I'm getting there. I've learned to keep the proximal phalanges in line to those of the 'hanging' fingers ever since. I wasn't aware of this being proper form prior to the injury. I've payed attention to pro climbers regarding this form and see a lot of them do it properly but others don't, probably because of the significant increase in pulling power you gain from the quadriga effect in 'bad form'. They must be aware of the risks right? Curious to see your follow-up vid on this topic!
@J Gnot It's completely fine now but it took about 4-5 months to fully rehab, the last 10% took the longest. If it's a strain and you're already climbing, be sure to buddy tape the two fingers with the injured lumbrical together and check out hoopers other video on lumbricals for good rehab instructions.
Thanks for great video. I wish it would be there year ago when I hurt mine. Took me 4 days of research and Make or Break book to find out what was wrong back then.
That's awesome! Not the grade II part, but the fact that you were able to accurately diagnose! Now you can get your rehab started and get back to climbing quicker :)
So good... wow... I had this a year ago and I found nothing about it. I am immediately saving this video for future recovery tips. I have another unusual thing: when I press my ring finger against my thumb, I feel a mild sharp pain right below my elbow. Feels like golfer's elbow a bit, but the protocols from your other videos do not seem to help (curls with dumbbell). Icing helps, but it comes back after intense climbing. Must be some imbalance, but I struggled to find the trick to fix it long term. How about a video about it? :D probably it is not a generic injury, but would be good to get your view.
I injured my interosseous muscle !!! It wasn’t climbing, it was screwdriving a blunt screw into a piece of wood above me using 100% force. Lucky I’m a climber and found this video. Regular physio and rehab videos and content does not cover this !!!! Thanks. This is helpful! It feels better , but it took quite a few months.
You are amazing, and the timing when i found this video. I recently injured my hand after campusing a pocket with a weird twisting motion. And now when i extend my middle and ring and flex my pinky in…. In hurts in my palm
Darn, I should have watched the video before one of my training sessions; I trained pockets (trying to make em stronger) and went directly on my 3rd and 4th digit doing scapular pullups on both hands. Even as a physiology student I didn't realize the mechanical difference of the 2nd and 3rd digit versus the 4th and 5th. And as pointed in your video, the 4th digit on my right hand was the only one to be injured, Ha! Good video and very easy rehab, I'm back to climbing like normal just avoiding isolated pockets for a little while. Thank you for the updated knowledge!
Dr. Hooper thank you for being the answer to all my climbing questions! I love the professional quality of your videos and knowledge. May I ask how long you’ve been climbing and what difficulty of climbing you do? I’m always impressed by your strength but can’t find that info, and am curious to know as a fairly new climber myself.
Thanks a lot for the video, your channel is a incridible ressource ! Do you know where I could find more information on interpalmar plate injuries ? I injured my ring finger grabbing a quickdraw with it and according to the differential diagnosis part it seems more likely than a lumbrical injury
This video was an eye opener. I injured my finger 1 month ago after a hard crimp and I heard I pop, I thought my A1 was injured but for some reason I didn't bother me to climb. The only move that hurt was while flexing the pinky and stretching the ring finger. I cured it by taping those 2 finger together
Super interesting video! Though a have question, maybe for a future video, which kind of exercises for feet would you recommend in preparation for climbing and reinforcement? and what are the most common injuries?
So thankful for this video & the one on tenosynovitis… hurt my hands/wrists when I increased my rowing time from 30 min to 45 min (C2 L10) and have been in pain for a few weeks. Will definitely try the stretches outlined in both videos!
Do you have any more detail on the Interpalmar plate diagnosis/rehab? Injured my ring lumbrical a few months ago, healed and now just tweaked it again but I feel it more in between the ring and pinky finger like you described…
Dear Hooper, thank you so much for your nice explanatory video. I started climbing relatively regularly and intensely about 3 years ago and at some point both my hands (first left then the right) developed some callous tissue around the palm of the hands right under the pinky and ring finger. Some professionals mentioned Dupuytren's contracture but as I did your tests now I am experiencing pain making me think if an untreated lumbrical injury could also cause such contracture and therefore could be eased with your rehab suggestions? Thank you so much for your work. I will try the rehab in any case :)
I’m pretty certain I have a low-grade no tear lumbrical strain. I’ve done pulleys before and this was different… mechanism was a heinous 2 finger pocket undercling. It’s hard to diagnose those. And I feel pain in my forearm too (close to wrist)… but sharp pain in the finger if I, say, open my kitchen draws hastily. Just fyi for crushers out there who may think they have a mild strain.
I had what I believe is a lumbrical(IV) injury and there is almost no pain, but I do have a swollen mass of tissue that had some bruising that was localized to over the tendon/metacarpals, the swollen bipennate musculature sitting between those almost strips of discoloration. Does this sound typical to a lumbrical injury? I haven't seen a specialist, but range of motion, sensation, and strength all seem good after a minor climbing session to test.
Hmm now I’m wondering if the a2 pulley injury I got earlier this year was actually this injury. Can you hear/feel a pop in the palm when this happens too? I had pain radiating up into my a2 so I assumed it was that, but I had more pain in my palm and it did happen hanging from a 2 finger pocket after doing a bunch of climbs that also had pockets. Either way I’m recovered and climbing again now, but I did find this video very interesting! Thanks for always putting out great informative content!
Fantastic video as always! Little question: If the unipennate lumbricals of the middle and index fingers are stronger and less prone to injury than the bipennate lumbricals of the ring and pinky fingers, why don't we use the index and middle fingers on pockets, instead of the middle and ring fingers?
Great question! That's because more often the middle and ring fingers are stronger overall due to the orientation of the flexor tendons. The strength of the flexor tendons greatly outdoes the strength of the lumbricals.
Damn, I would have needed these info 2 months ago... Now it's finally going better but gosh it was bad (given your advice, I should have check it the a specialist I guess...). My basic anatomy skills gave me ideas of little exercises to do with a sharpie, at first with the 4 fingers, then gently trying to synchronize them. I can still feel it a bit and I wouldn't dare to grab a pocket for a while... I hope I didn't fuck it up :/ I had no clue that those muscles existed! This injury confused me so much. So thanks a lot for the video!
Sorry to hear of your injury! Hope this video was helpful and definitely be on the lookout for additional videos about rehab as well as pocket training in the future!
@@HoopersBeta I'll definitely check on that! Btw, thx a lot, you do an awesome job to help us understand what's going wrong with our bodies! Every time a friend gets injured I share one of your video haha
8:50 I have pain at this point with the isolated ring finger, but it's not in the hand near the muscles you've shown. The pain happens around the wrist and a little around the a2 pulley. Any thoughts? Thanks for your video!
These muscles will sometimes cramp from work. Repetitive grasping and shaking motions from making drinks. Is this a risk factor for climbing injuries and is there something I can do to prevent cramps in this area?
Could you provide the reference that says "Lumbricals only contribute 2% of MCP joint flexion (mechanically)"? Cannot think of another muscle mainly responsible for that, FDP/FDS generate more force than lumbricals on MCP flexion????
I like the finger ROM exercises to simply be opening and closing the hand. I'm not a big fan of the dragging/scraping that many do with the tendon glides.
Thanks for a great and informative video! What would you do if you’ve had issues with pockets for years (curling pinky when pulling with front three or mid two)? Maybe I’ll get a good answer in the next video 😅 cheers!
Recently injured what I thought was a lumbrical between my pinky and ring finger (hurt it on a 3 finger pocket) but after the differential diagnosis portion of this I suspect potentially also dorsal interosseous. My doctor didn't seem worried about the injury at all (2 weeks ago) and suggested buddy taping. How different is the rehab/retraining for the dorsal interosseous?
Question, I had a guy at the gym tell me that when going for 2 finger pocket holds that it would be best to use the middle and ring finger instead of the index and middle finger. Stating you'll have more chance of injuring using the index and middle finger "style" of pocket holds??
Typically the middle and ringer are stronger so more people by default use that position. You could also argue that with stronger fingers there's less chance of injury. But if you are stronger, that also means you can pull harder on those fingers so those two concepts sort of negate each other. From a lumbrical point of view it would be safer to use index and middle since they are unipennate and not bipennate. Good question!
This is interesting, because I am always overly careful with pockets, and certainly prefer index and middle. It naturally feels more stable. Had no idea that the lumbrcals are actually more stable like that compared to middle and ring.
Is it common to feel pain in the area where the FDP tendons and muscles connect as well as in the palm? Thought I'd gotten a FDP injury at first but the symptoms only matched a lumbrical injury.
Thanks for putting this info out into the community! Is it possible to injure your lumbrical between the middle and index finger? Seems improbable based on the anatomy but this is what I think I have based on cause of injury and tests from the video…
Depends on which finger produces the positive tests in relation to your discomfort. There is still a lumbrical between those fingers so it is possible. But you're correct, an interpalmar ligament injury is also possible / probable in that region.
Great video, as always ! Theoretically, in your opinion, would it be possible to injure your index lumbrical (I) from a fall while still hanging from a single jug? (or not that theoretically)
The lumbrical injury here on ring finger is because of sheering of the bipennate muscle. Since the index finger has a unipennate lumbrical it’s probably something else.
Where should i fill the pain in the injury test? Last week i felt a tweng while climbing in the base of the palm, more in the forearm. After massively google it i thought that it 3rd lumbrical strain. But now when i test it, i just fill a little bit of soreness in the forearm, but not a sharp pain or something like that.
Is it possible (or likely) to have injured both the A2 pulley in the ring finger and the adjacent lumbricals from a 2 finger pocket? I feel that I have symptoms characteristic of both injuries - the sharper pain being more consistent with the pulley injury and the dull pain consistent with the muscular injury. I was diagnosed and treated for a pulley injury but now that I'm doing better with the pulley I'm still feeling pain and tightness lower in the palm some days
Specifically for the the lumbricals, it can be safer but it does just sort of shift the load from the 4th lumbrical to the third so that may not make a huge difference. You can reduce the risk with the lumbricals when using the middle two fingers by changing the alignment of the adjacent MCP joints which reduces stress on the lumbricals.
@@HoopersBeta thanks a lot! I already injured my ring finger lumbricals prior to watching the video, so it's good to know I can still project my pocket climb with my pointer and middle instead.
I can move My fingers with no pain when the injured Finger is extendet. As soon as my Fingers are flexed and i then move the pinky i get pain at the base of the middel Finger. Is this still a lumbrical strain?
I have pain when i extend my index and ring finger and curl my middle two fingers in (pain is in the palm and my ring finger seems to be the issue). I don't have quite as much pain though when i extend the injured finger and flex the others (though there is some). not sure if this fits the diagnosis for a lumbrical injury?
I know this video has been published a long time ago, but can the pain manifest in the forearm ? I did got injured on a pocket-like hold and now I have a sharp pain in the forearm if I try to flex my pinky finger while keeping my ring finger straight. Additionally to that I have a small discomfort in the DIP joint of the ring finger. I tried to do a differential diagnosis based on other videos from this channel but nothing really conclusive.. in my daily life, the pain manifest for example just if i try to go in my jean pocket leaving the pinky out.. but in the forearm mostly, a bit in the finger but not as much as the forearm. If somebody reads me please help haha
Rest and hydration! This is a bit of a generalization and your case may be different, but stiffness is often a result of the intensity and frequency being greater than rest which overtime causes the stiffness. Hydration can be a factor for some people, though, as well.
Sure.. I'm Suffering with brachial palsy since 6yrs wish u were here in India😔 ur videos are very useful n healing to cure patience dr... God bless u..
I have no pain in ANY of these tests at all. The only pain i have is in the half crimp position. no pain in open hand or full crimp at all. Purely half crimp. on my index finger. any help thanks
Look at our other videos on finger injuries (FDP Injuries, Flexor Tenosynovitis, and A2 Pulley Injuries). If the pain is in your finger, it's probably not a lumbrical injury. -Emile
I only have pain when flexing my dip and then resisting pushing the finger back with my other hand. The pain is closer to my pulley rather than the lunbrical. The weird part is I sometimes feel the sharp pain down in my forearm. I’ve done the FDP test and had no pain. Does this sound like lumbrical or something completely different?
You said that with both pulley or flexor digitorum injuries the pain is similar when extending only the injured finger vs all fingers at the same time. In my case, it only hurts with an isolated ring finger (or ring + middle) but hurts more in the forearm just below the wrist than in the hand. What is going on then?
No sorry, I just avoided pockets for a while and it healed on its own pretty much. I still use index+middle finger for pockets now mostly. I recommend resting a bit after the injury but then starting rehab/climbing lightly. I used to tape my pinky to the ring finger just to be safe.
I've injured the lumbrical between my ring and piggy finger. Does it make any sense to tape the two together when going back to climbing? Does anyone have experience or expertise around this?
I know the lumbricals don't exist in the wrist but is there any way for a lumbrical injury to also extend a bit into the underside of the wrist? I fit the description and tests outlined, could it be possible that I had 2 injuries in one?
I have a question. Yesterday i climbed a middle finger mono (in which the whole finger fitted in, not just the tip) i weighted it too much and immediately felt pain in the middle of my forearm. I tested exactly perfectly for all of those tests, except the fact I don't have any pain in my hand, I only feel it in my forearm... is this possible with a lumbrical injury?
Interesting, the pain location can be quite important and is certainly odd that you don't have pain in the palm. It could come down to test execution and but the location makes me think FDP or FDS injury more than Lumbrical.
Similar question… tried a crux (I hope it was the crux anyway) dynamic move from a 2 finger pocket one too many times 2 days ago. Based on this video I’m pretty sure I have a grade 1 injury to the ring finger lumbrical. But, if I put my ring finger in the extended position by itself and load it (gently) I get pain in the lumbrical AND pain in the ring/pinky side tendon of my wrist. Do I have 2 injuries? 🤔
Had a lumbrical injury around a year ago and all I could find was a video in german describing how to diagnose it. So amazing that this is out now. Great job guys!
Thank you! Glad there is a resource for it out there now (plus more to come👍)
I think I saw the exact same German video.
Interesting, if I watched and processesed this video right I had a lumbrical injury too and I didn't found a video. And I'm german. :D My first doctor wasn't very helpful ever. The second one said that I should keep climbing but skip the holds which cause pain. So no pockets the rest was allright. But now I'm fully understanding what happened there.
I am currently recovering from an injury to one of my lumbricals. Thanks for this video, it gave me a much better understaiding of what I actually messed up.
Damn Hooper, injured my Lumbrical like 3 days ago. How did you know? Easily one of the best injury videos I’ve seen
I injured mine 3 days ago, he just knows.. ;)
Thanks for sharing all the awesome information! Really appreciate it!
Saving hands and keeping me climbing!!! Thank you
Oh wow, thank you! I didn't even know there was a donation option on UA-cam lol. Appreciate the support :)
I don't know how you don't have more views and subscribers... Keep up the good work!
Brilliant! thanks so much for taking the time to put this together, very helpful!
This was a really useful video! I watched the a2 pulley video first because I assumed i injured my pulley, but this definitely fits my injury much better. A 2 finger pocket was the cause
Awesome! Glad that this was helpful! Hopefully youtube recommended this video for you after the Pulley video so you didn't have to search too hard :)
I thought I had a pulley injury but after watching this video I’m positive its lumbrical. Thank you SO MUCH for providing such comprehensive information.
Oh nice that's awesome! I'm glad this helped cleared it up for you.
These videos are unbelievably helpful. Just had something pop climbing last night, I wouldn't have been able to diagnose it as an FDP or lumbrical injury without these differential diagnosis tips. Thanks so much!
Sorry to hear about the injury but very happy that our videos were helpful!!
How was the recovery? Just suffered the same thing a couple days ago
Have had two of them now, recovery is fine if you keep 4 fingers together. I buddy taped my fingers together sometimes to make sure one didn't pop off a hold, otherwise I could climb as normal @@trailbytrail632
These vids are really helpful. I actually injured my left hand playing golf. I was overdoing it at the range, holding the club too much in the fingers and concentrating on increasing my wrist motion through the swing. After that session, developed screaming pain in my left palm (I'm right handed) from the lifeline up to the PIP in my middle, ring, and pinky finger, but particularly the ring finger. A week later and the pain has started to localize in various parts of my ring and middle finger, plus at the base of the fingers from the middle finger outward. I did a lot of research on golf websites but didn't find the info I needed. This is awesome! I'm 60 years old, relatively new to golf, yet still have a massive ego (when it comes to golf anyway) so I injure myself frequently by overdoing it - though not this severely. My plan is RICE for a while and then slowly get back into it. Any words of wisdom or encouragement or even a good scolding are greatly appreciated! Thanks so much!!!!
I'm studying some anatomy for a class and this was the perfect way to stay in an anatomy vibe while taking a break on organs. Haha Very informative, very interesting!
8:49 YUP I have a lumbrical injury. This is super helpful Mr Hooper thank you. If I flex too hard into my ring finger I feel the pain all the way down into my arm.
Great information! Very detailed and clearly explained!
Amazing. Sending this to my injured boys.
Glad it is useful but sorry all your friends are injured!
the way he tries to hold his laughter in 8:28
We need one for the PIP synovitis !
Talks about timing!!! I just hurt mine last week!
You are incredible. Thank you
very helpful video! love the "differentail diagnosis" part
Felt some pain throughout my finger, hand, and arm during my sesh yesterday when my foot blew off a hold. Thought it was a FDP injury at first, but seeing as how the pain is more localized to my palm I am confident it is a lumbrical injury. thank you for all the amazing and clear info, love your videos. The injury seems pretty minor so I am hopeful that I'll be back on the wall soon
I knew I liked these videos for a reason. I just hurt my feathers on a sick 2 finger campus. I'll be keeping an eye on things and see how it feels
Very helpful, thank you! I knew I strained something, but the discomfort was inconsistent with a pulley injury. Looks like it was a lumbrical strain!
I just found out I have my lumbrical injured. Thanks a lot for the info and the tips for rehab. You are the best!
I got a lumbrical injury 7 months ago and it’s still quite painful. It’s really painful with pockets but with crimps and sloupers I can climb my max without pain. Excited for the rehab video!! Thanks in advance
Well done. This is a excellent demonstration of functional anatomy and structure. I really want to draw attention to differentiating lumbrical injury vs other intrapalmar/interosseous injury since that is such a common pitfall. I'm looking forward to watching your other vids. Way to be a fantastic resource!
Thanks! :)
This video was amazing, I learned so much. Thanks! I'm a new sub.
Welcome to the channel! Glad you found it so helpful :)
never even heard of this, but thanks to the self-diagnosis tests, i'm sure this is it for me, and that makes sense as i remember it happened when my little finger popped out of a hold
I originally though I had an FDP injury, even had an ultrasound just for the doctor to say that there was no tear. Now I know that I had a lubrical injury and am excited to get back to training. Thanks!
Broke my 4th metacarpal a few decades back. Unfortunately the bone was not perfectly aligned once healed and it's always felt a little weird. I think this video spoke so much to why that is!
My lumbricals are stuck out of alignment, so even during non-strenuous usage it feels kind of weird (aka out of aligment). I am sure there are mechanical issues with pully etc alignment as well.
I am never going to be a top tier climber but, I am excited to try some of your rehab suggestions. My structural issue isn't going anywhere but maybe I can at least work around it more thoughtfully now!
I love the anatomy and physiology focus of the channel.
Thank you,
🙏
About 6 weeks ago I heard something snaping in my hand on a desperate deadpoint move to a shallow 3 fingers pocket, so at first I was thinking of a pulley rupture. Turns out I teared my lumbricals (looks like a grade II/III injury from what you describe), took a 10 days break from climbing (+ icing) and the pain is slowly starting to fade. Perfect timing to get some rehab advices, thanks a lot guys!
Holy Moly boys! These videos are top quality. Is it just Jason and Emile making them or do you have more people behind the scenes? If so, would be nice to have a video about the process (always enjoy the bloopers!)
Thank you! It’s just the two of us. Would be fun to do a “how we make an episode of hooper’s beta” sometime :)
-Emile
yes, finally found which muscle I overstretch! Thanks!
Amazing, this happened to me around 2 years ago, based on your self assessment guide I should have goine to the hospital because i couldnt separate my fingers at all without searing pain (but hindsight is 2020!). The physio i visited had no idea what had happened to me (waste of 40 pounds) and i had my little and ring finger taped together for about a month all the time. After a while i took the tape off and practiced some stretching as you described, I just guessed that it would work. Thankfully my hand is feeling a lot better now after a lot of patience and a few re-injuries, but I think climbing pockets is out of the question for me forever. Thanks for this video, really interesting to learn more about what has been causing me pain for 2 years!
A little over 4 months ago I injured my lumbricals at the ring / pinky really badly during a 3 finger drag max weighted hang routine while hangboarding. I was in a position where I was in a lot of flexion with the pinky during the hang. It was a dull sound and quick tear at the lumbrical and even a shock all the way through to the belly of the forearm.
The diagnoses was done pretty easily with the stress test you mentioned. I couldn't even resist the slightest amount of force. I've followed the rehab strictly and included daily hydrotherapy too. My strength levels aren't completely back yet but I'm getting there.
I've learned to keep the proximal phalanges in line to those of the 'hanging' fingers ever since. I wasn't aware of this being proper form prior to the injury. I've payed attention to pro climbers regarding this form and see a lot of them do it properly but others don't, probably because of the significant increase in pulling power you gain from the quadriga effect in 'bad form'. They must be aware of the risks right? Curious to see your follow-up vid on this topic!
@J Gnot It's completely fine now but it took about 4-5 months to fully rehab, the last 10% took the longest. If it's a strain and you're already climbing, be sure to buddy tape the two fingers with the injured lumbrical together and check out hoopers other video on lumbricals for good rehab instructions.
@@sqealerrthats exactly what my physio who specializes in climbing injuries recommended and it helped my immensely
This is extremely helpful. Thank you so much!
Thanks for great video. I wish it would be there year ago when I hurt mine. Took me 4 days of research and Make or Break book to find out what was wrong back then.
Great Video, I was able to diagnose that I have a lumbrical injury with high accuracy with these tests. (grade II)
That's awesome! Not the grade II part, but the fact that you were able to accurately diagnose! Now you can get your rehab started and get back to climbing quicker :)
So good... wow... I had this a year ago and I found nothing about it. I am immediately saving this video for future recovery tips.
I have another unusual thing: when I press my ring finger against my thumb, I feel a mild sharp pain right below my elbow. Feels like golfer's elbow a bit, but the protocols from your other videos do not seem to help (curls with dumbbell). Icing helps, but it comes back after intense climbing. Must be some imbalance, but I struggled to find the trick to fix it long term. How about a video about it? :D probably it is not a generic injury, but would be good to get your view.
I was wondering what my injury is and out of nowhere Google recommended this video for me. That's a lot for the tips
Thanks, Google! Haha
I injured my interosseous muscle !!! It wasn’t climbing, it was screwdriving a blunt screw into a piece of wood above me using 100% force. Lucky I’m a climber and found this video. Regular physio and rehab videos and content does not cover this !!!! Thanks. This is helpful! It feels better , but it took quite a few months.
You are amazing, and the timing when i found this video. I recently injured my hand after campusing a pocket with a weird twisting motion. And now when i extend my middle and ring and flex my pinky in…. In hurts in my palm
Ouch, sorry to hear that! Heal up well and hope this video gets you from A-Z :)
Darn, I should have watched the video before one of my training sessions; I trained pockets (trying to make em stronger) and went directly on my 3rd and 4th digit doing scapular pullups on both hands. Even as a physiology student I didn't realize the mechanical difference of the 2nd and 3rd digit versus the 4th and 5th. And as pointed in your video, the 4th digit on my right hand was the only one to be injured, Ha! Good video and very easy rehab, I'm back to climbing like normal just avoiding isolated pockets for a little while. Thank you for the updated knowledge!
That's awesome! Thanks for sharing and the comments. Yeah, they are so strange, right? This was a fun video to make.
So glad I found this thank your for the insight. Huge help
Glad it was helpful!
I wish I had this 2 months ago XD
I thought it was an FDP this whole time, even though it didnt quite seem to fit. This is perfect. Thanks!
Dr. Hooper thank you for being the answer to all my climbing questions! I love the professional quality of your videos and knowledge. May I ask how long you’ve been climbing and what difficulty of climbing you do? I’m always impressed by your strength but can’t find that info, and am curious to know as a fairly new climber myself.
excellent stuff, thanks a lot for this video
You're welcome!
thanks for the video doc! loved the part on pad dab hahaha mmt days
Another fab video! Thanks doc! 👍👌
Glad you enjoyed it!
Thanks a lot for the video, your channel is a incridible ressource ! Do you know where I could find more information on interpalmar plate injuries ? I injured my ring finger grabbing a quickdraw with it and according to the differential diagnosis part it seems more likely than a lumbrical injury
This video was an eye opener. I injured my finger 1 month ago after a hard crimp and I heard I pop, I thought my A1 was injured but for some reason I didn't bother me to climb. The only move that hurt was while flexing the pinky and stretching the ring finger. I cured it by taping those 2 finger together
Super interesting video!
Though a have question, maybe for a future video, which kind of exercises for feet would you recommend in preparation for climbing and reinforcement? and what are the most common injuries?
My goodness the sweet sweet info!!!!
Not sure if i just wanted to ask for a lumbrical shift video or if I actually did... Either way, thanks for the video
So thankful for this video & the one on tenosynovitis… hurt my hands/wrists when I increased my rowing time from 30 min to 45 min (C2 L10) and have been in pain for a few weeks. Will definitely try the stretches outlined in both videos!
Do you have any more detail on the Interpalmar plate diagnosis/rehab? Injured my ring lumbrical a few months ago, healed and now just tweaked it again but I feel it more in between the ring and pinky finger like you described…
Dear Hooper, thank you so much for your nice explanatory video. I started climbing relatively regularly and intensely about 3 years ago and at some point both my hands (first left then the right) developed some callous tissue around the palm of the hands right under the pinky and ring finger. Some professionals mentioned Dupuytren's contracture but as I did your tests now I am experiencing pain making me think if an untreated lumbrical injury could also cause such contracture and therefore could be eased with your rehab suggestions? Thank you so much for your work. I will try the rehab in any case :)
amazing videos!
Thank you!
I’m pretty certain I have a low-grade no tear lumbrical strain. I’ve done pulleys before and this was different… mechanism was a heinous 2 finger pocket undercling. It’s hard to diagnose those. And I feel pain in my forearm too (close to wrist)… but sharp pain in the finger if I, say, open my kitchen draws hastily. Just fyi for crushers out there who may think they have a mild strain.
Your vids are top! Obrigado
Thank you! Much appreciated :)
Thanks this is awesome
I had what I believe is a lumbrical(IV) injury and there is almost no pain, but I do have a swollen mass of tissue that had some bruising that was localized to over the tendon/metacarpals, the swollen bipennate musculature sitting between those almost strips of discoloration. Does this sound typical to a lumbrical injury? I haven't seen a specialist, but range of motion, sensation, and strength all seem good after a minor climbing session to test.
Hmm now I’m wondering if the a2 pulley injury I got earlier this year was actually this injury. Can you hear/feel a pop in the palm when this happens too? I had pain radiating up into my a2 so I assumed it was that, but I had more pain in my palm and it did happen hanging from a 2 finger pocket after doing a bunch of climbs that also had pockets. Either way I’m recovered and climbing again now, but I did find this video very interesting! Thanks for always putting out great informative content!
Fantastic video as always!
Little question:
If the unipennate lumbricals of the middle and index fingers are stronger and less prone to injury than the bipennate lumbricals of the ring and pinky fingers, why don't we use the index and middle fingers on pockets, instead of the middle and ring fingers?
Great question! That's because more often the middle and ring fingers are stronger overall due to the orientation of the flexor tendons. The strength of the flexor tendons greatly outdoes the strength of the lumbricals.
Makes sense! Thanks again :)
Damn, I would have needed these info 2 months ago... Now it's finally going better but gosh it was bad (given your advice, I should have check it the a specialist I guess...). My basic anatomy skills gave me ideas of little exercises to do with a sharpie, at first with the 4 fingers, then gently trying to synchronize them. I can still feel it a bit and I wouldn't dare to grab a pocket for a while... I hope I didn't fuck it up :/ I had no clue that those muscles existed! This injury confused me so much. So thanks a lot for the video!
Sorry to hear of your injury! Hope this video was helpful and definitely be on the lookout for additional videos about rehab as well as pocket training in the future!
@@HoopersBeta I'll definitely check on that! Btw, thx a lot, you do an awesome job to help us understand what's going wrong with our bodies! Every time a friend gets injured I share one of your video haha
@@Kyllleur that's awesome! Thanks for the support.
"climbing injury" right right ;)
8:50 I have pain at this point with the isolated ring finger, but it's not in the hand near the muscles you've shown. The pain happens around the wrist and a little around the a2 pulley. Any thoughts? Thanks for your video!
These muscles will sometimes cramp from work. Repetitive grasping and shaking motions from making drinks. Is this a risk factor for climbing injuries and is there something I can do to prevent cramps in this area?
thank you soo much! but what should I do now when having an interpalmar plate injury?
Could you provide the reference that says "Lumbricals only contribute 2% of MCP joint flexion (mechanically)"? Cannot think of another muscle mainly responsible for that, FDP/FDS generate more force than lumbricals on MCP flexion????
Hopefully that Kirkland sponsorship works out for ya! :p xD
Hey Jason! You mentioned that finger ROM exercises were different than tendon glides and I'm curious why/how? Thanks!
I like the finger ROM exercises to simply be opening and closing the hand. I'm not a big fan of the dragging/scraping that many do with the tendon glides.
Thanks for a great and informative video! What would you do if you’ve had issues with pockets for years (curling pinky when pulling with front three or mid two)? Maybe I’ll get a good answer in the next video 😅 cheers!
We have a couple of upcoming videos that may/should help answer that for you!
Recently injured what I thought was a lumbrical between my pinky and ring finger (hurt it on a 3 finger pocket) but after the differential diagnosis portion of this I suspect potentially also dorsal interosseous. My doctor didn't seem worried about the injury at all (2 weeks ago) and suggested buddy taping. How different is the rehab/retraining for the dorsal interosseous?
Question, I had a guy at the gym tell me that when going for 2 finger pocket holds that it would be best to use the middle and ring finger instead of the index and middle finger. Stating you'll have more chance of injuring using the index and middle finger "style" of pocket holds??
Typically the middle and ringer are stronger so more people by default use that position. You could also argue that with stronger fingers there's less chance of injury. But if you are stronger, that also means you can pull harder on those fingers so those two concepts sort of negate each other. From a lumbrical point of view it would be safer to use index and middle since they are unipennate and not bipennate. Good question!
@@HoopersBeta Thanks for the insight!
This is interesting, because I am always overly careful with pockets, and certainly prefer index and middle. It naturally feels more stable. Had no idea that the lumbrcals are actually more stable like that compared to middle and ring.
Is it common to feel pain in the area where the FDP tendons and muscles connect as well as in the palm? Thought I'd gotten a FDP injury at first but the symptoms only matched a lumbrical injury.
Thanks for putting this info out into the community! Is it possible to injure your lumbrical between the middle and index finger? Seems improbable based on the anatomy but this is what I think I have based on cause of injury and tests from the video…
I suppose it could also be a interpalmar plate ligament injury but I’m not totally sure
Depends on which finger produces the positive tests in relation to your discomfort. There is still a lumbrical between those fingers so it is possible. But you're correct, an interpalmar ligament injury is also possible / probable in that region.
Great video, as always ! Theoretically, in your opinion, would it be possible to injure your index lumbrical (I) from a fall while still hanging from a single jug? (or not that theoretically)
The lumbrical injury here on ring finger is because of sheering of the bipennate muscle. Since the index finger has a unipennate lumbrical it’s probably something else.
Where should i fill the pain in the injury test? Last week i felt a tweng while climbing in the base of the palm, more in the forearm. After massively google it i thought that it 3rd lumbrical strain. But now when i test it, i just fill a little bit of soreness in the forearm, but not a sharp pain or something like that.
Is it possible (or likely) to have injured both the A2 pulley in the ring finger and the adjacent lumbricals from a 2 finger pocket? I feel that I have symptoms characteristic of both injuries - the sharper pain being more consistent with the pulley injury and the dull pain consistent with the muscular injury. I was diagnosed and treated for a pulley injury but now that I'm doing better with the pulley I'm still feeling pain and tightness lower in the palm some days
4:02 made me laugh
does the arrangement of the lumbricals mean that using the index and middle finger for pockets is safer than using the ring and middle finger?
Specifically for the the lumbricals, it can be safer but it does just sort of shift the load from the 4th lumbrical to the third so that may not make a huge difference. You can reduce the risk with the lumbricals when using the middle two fingers by changing the alignment of the adjacent MCP joints which reduces stress on the lumbricals.
@@HoopersBeta thanks a lot! I already injured my ring finger lumbricals prior to watching the video, so it's good to know I can still project my pocket climb with my pointer and middle instead.
Awesome!
Not me watching with my shredded right middle feather.
Poor feather :/
I can move My fingers with no pain when the injured Finger is extendet. As soon as my Fingers are flexed and i then move the pinky i get pain at the base of the middel Finger. Is this still a lumbrical strain?
I have pain when i extend my index and ring finger and curl my middle two fingers in (pain is in the palm and my ring finger seems to be the issue). I don't have quite as much pain though when i extend the injured finger and flex the others (though there is some). not sure if this fits the diagnosis for a lumbrical injury?
I know this video has been published a long time ago, but can the pain manifest in the forearm ?
I did got injured on a pocket-like hold and now I have a sharp pain in the forearm if I try to flex my pinky finger while keeping my ring finger straight. Additionally to that I have a small discomfort in the DIP joint of the ring finger. I tried to do a differential diagnosis based on other videos from this channel but nothing really conclusive.. in my daily life, the pain manifest for example just if i try to go in my jean pocket leaving the pinky out.. but in the forearm mostly, a bit in the finger but not as much as the forearm.
If somebody reads me please help haha
What would recommend for stiff fingers in the morning post activity? My fingers have been stiff post intense activity for several weeks.
Rest and hydration! This is a bit of a generalization and your case may be different, but stiffness is often a result of the intensity and frequency being greater than rest which overtime causes the stiffness. Hydration can be a factor for some people, though, as well.
Seems good i do hve problems with my hand where do u reside from which country dr... ??
We're in the U.S. You can schedule a virtual PT consult through our website if you'd like :)
Sure.. I'm Suffering with brachial palsy since 6yrs wish u were here in India😔 ur videos are very useful n healing to cure patience dr... God bless u..
I have no pain in ANY of these tests at all. The only pain i have is in the half crimp position. no pain in open hand or full crimp at all. Purely half crimp. on my index finger. any help thanks
Look at our other videos on finger injuries (FDP Injuries, Flexor Tenosynovitis, and A2 Pulley Injuries). If the pain is in your finger, it's probably not a lumbrical injury.
-Emile
I only have pain when flexing my dip and then resisting pushing the finger back with my other hand. The pain is closer to my pulley rather than the lunbrical. The weird part is I sometimes feel the sharp pain down in my forearm. I’ve done the FDP test and had no pain.
Does this sound like lumbrical or something completely different?
I do have the same sharp pain down in the forearm. Did you end up recover from your injury ?
You said that with both pulley or flexor digitorum injuries the pain is similar when extending only the injured finger vs all fingers at the same time.
In my case, it only hurts with an isolated ring finger (or ring + middle) but hurts more in the forearm just below the wrist than in the hand. What is going on then?
I have this same experience; the tests indicate lumbrical injury but I get the pain in my forearm. Did you learn anything more about this?
No sorry, I just avoided pockets for a while and it healed on its own pretty much. I still use index+middle finger for pockets now mostly.
I recommend resting a bit after the injury but then starting rehab/climbing lightly. I used to tape my pinky to the ring finger just to be safe.
@@asierrodriguezescalante6310 Will do, thanks a lot for your advice
I thought those Muscles are called interossei !!??? Am I wrong ?!?
I've injured the lumbrical between my ring and piggy finger. Does it make any sense to tape the two together when going back to climbing? Does anyone have experience or expertise around this?
Yes, buddy taping is a good idea for that.
I know the lumbricals don't exist in the wrist but is there any way for a lumbrical injury to also extend a bit into the underside of the wrist? I fit the description and tests outlined, could it be possible that I had 2 injuries in one?
Could be a 2 for 1, unfortunately. Could have injured the lumbricals and possibly the FDP.
When I had a bad lumbrical tear, pain shot down my forearm. From other testimonials, I assumed it was a nerve thing.
@Hooper's Beta i'm confused a bit are the lumbricals are the interossei or it is different ?
Different things
I have a question. Yesterday i climbed a middle finger mono (in which the whole finger fitted in, not just the tip) i weighted it too much and immediately felt pain in the middle of my forearm. I tested exactly perfectly for all of those tests, except the fact I don't have any pain in my hand, I only feel it in my forearm... is this possible with a lumbrical injury?
Interesting, the pain location can be quite important and is certainly odd that you don't have pain in the palm. It could come down to test execution and but the location makes me think FDP or FDS injury more than Lumbrical.
Similar question… tried a crux (I hope it was the crux anyway) dynamic move from a 2 finger pocket one too many times 2 days ago. Based on this video I’m pretty sure I have a grade 1 injury to the ring finger lumbrical. But, if I put my ring finger in the extended position by itself and load it (gently) I get pain in the lumbrical AND pain in the ring/pinky side tendon of my wrist. Do I have 2 injuries? 🤔
Doctor pleasure as usual to meet you! Is there any way to get in touch with you for a business enquiry?
After watching this video I am certain they have injured my lumbricals on multiple occasions
My hero academia