How To Assess an A4 Pulley Tear

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  • Опубліковано 19 лис 2024

КОМЕНТАРІ • 7

  • @fgandola76
    @fgandola76 Місяць тому

    first of all, thx for the great video. While i find some documentation on Anular pulley injuries A2 and A4 mostly, i find nothing about last C pulley ( C3 or C4 depending if you start at C0 or C1 ;-) , the one bellow the DIJ. IS it possible to damage C3 while A5 is ok and A4 light injurury ? can C3 be checked also on imaging ? not asking you to diagnose anything, just understand if at all possible and how i could get it checked. Thx a ton for great channel !!!

    • @TheClimbingDoctor
      @TheClimbingDoctor  Місяць тому +1

      US imaging in this video assess tendon bone distance - which is an indirect measurement of a pulley injury. Cruciate pulleys are just extensions of annular pulleys so not necessary to differentiate.

    • @fgandola76
      @fgandola76 Місяць тому

      @@TheClimbingDoctor Thx a lot for the quick reply. I did not realize Crutiate pulleys are extentions of annular pulleys. I just had an echography showing A4 more or less ok ( some area are not homogenous and distance of tendon ok) but with all symptoms of injured pulley), i was wondering if it could be the Crutiate pulley only ( as they are closer to joint, was wondering if tendon distance as assessment would still be relevant... anyway, great channel !!!!

  • @sammiller1003
    @sammiller1003 7 місяців тому

    Have you trued using a water bath? Lets you get the probe further away from the finger and would allow for proper bending of the finger while keeping image quality good.

    • @TheClimbingDoctor
      @TheClimbingDoctor  7 місяців тому

      It is a cool idea and it can be done with most units. It is interesting to see tendon movement with finger movement - but it is not very practical from a standardized assessment standpoint for pulley injuries since you really don't need to be able to see a large range of movement to diagnose an A4 pulley injury. You just need to identify bowstringing at rest and at load - which is fairly easy to do without the water set up.

  • @Qadow
    @Qadow 9 місяців тому

    Hello, I dont know if I´ll get a response but I will give it a shot.
    I was doing a dynamic move, and barelly caught the hold with my ring and middle finger, I was a bit short on the move, I felt something happened to my ring finger/palm. I caught the hold in a open hand position. If I try to mimic the hand position there is a quite a lot of pain with just small pressure/force. So being in the open hand and trying to pull with the tip of my finger.
    First I though it was a lumbrical muscle injury, but I am not convinced. I watched Hooper´s beta video about it, but I dont feel pain in my palm, I think, its somewhere between A4 to A5 area. But I am able to crimp with basically 0 pain on 25mm edge. I tried to localize the area with pallpation, but nothing is painful to touch.
    I know it very brief summary, but what do you think it could be ?
    Thank you if advance, if you answer. I´ll privide additional information if you need 🙂

    • @TheClimbingDoctor
      @TheClimbingDoctor  9 місяців тому

      The lumbricals attach from the FDP tendon so oftentime climbers have symptoms into their fingers or forearm in addition to the palm. The below article may help, best of luck!
      theclimbingdoctor.com/pocket-change-adapting-the-way-you-pull-on-pockets/