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Climbing Past Injury

As climbers we demand a lot from our bodies, especially our fingers. Hand injuries are among the most common injuries for rock climbers, and as a result, are also some of the most feared. When I first injured my hand I scoured the Internet looking for the answer to my pain. I read about flexor tendon tears, collateral ligament strains, hairline fractures, and A2 pulley strains and tears. The fear of four to six weeks sidelined seemed to be a growing reality in my mind. Images of tendons snapping like rubber bands and ligaments shredded like corn beef haunted my dreams. As much as I wanted to avoid the hassle of a doctor’s visit, I made an appointment.

IMG_3214

Me as I climb above the tricky starting moves of O’Kelley’s Crack. (Photo by: Victor Medeiros)

I wasn’t exactly aware that I had injured my hand when it happened. I was climbing the start of O’Kelley’s Crack (in Joshua Tree National Park), which starts as a thin crack just high enough off the ground to make it a challenge to reach. I repeatedly tried the same strenuous move – left hand in an insecure fist jam to a right hand thumbs up thin jam. Bringing my left hand up to join the right hand in the thin crack gave me some trouble. I cranked on my right hand a little harder… then fell. I cranked on my right hand even harder… still no luck. My stubbornness kicked in. I cranked hard and this time stuck the move. At that point I hadn’t felt anything had gone wrong in my hand. Aside from the normal pain of torqueing your fingers into small cracks, I hadn’t felt anything out of the ordinary. No pops or crunches. Nothing. I climbed O’Kelley’s Crack and even gave the neighboring crack, Wangerbanger a burn. At that point Adam and I packed up our gear and headed down the boulders at the base of the wall to connect back with the hiking trail. As I placed my right hand on a boulder and shifted my weight over the hand to jump down I felt searing pain shoot through the side of my hand. At that moment I knew something was wrong and I felt a distant concern for my ability to climb in the coming days. But I had never experienced a lasting injury due to climbing, which made me hopeful that this one wouldn’t last either.

The pain was concentrated in the MCP region of my pinky (the joint at the base of the finger) of my right hand. Pulling or pushing with my pinky finger generated a good deal of pain, which meant I was forced to become left-handed in everyday tasks, such as opening the van door. Living on the road you are constantly meeting new people, but shaking hands was out of the question. Any squeezing of the hand or banging the side against objects caused considerable pain. After a week and a half off from climbing from fear of making the injury worse, my hand was feeling considerably better. Adam and I went for a quick run up an easy route and although some movement caused pain, for the most part I was able to climb without hurting my hand. My optimism, however, was crushed only a day later when I belayed Adam for his birthday challenge (a tradition in the climbing community where you try to climb as many routes as you are old). After a day of belaying, pulling, and flaking ropes my hand ached with pain. I regressed back to where I was a couple weeks prior. After another week of watching others climb, I finally realized it was time to pay a visit to a doctor.

During my initial visit to an orthopedic doctor they X-rayed my hand, which showed no signs of fractures. The doctor told me I would need an MRI next and, as he turned his back and walked out of the room, he told me to watch basketball on TV this weekend instead of climbing. My eyes narrowed into what my mother refers to as the stink eye. I was not amused. My worst fear had been realized – the doctor didn’t understand the role climbing played in my life and, as a result, I wasn’t going to get answers to my questions. When would it be safe to climb again? How can I minimize a repeat of this injury? These were the real reasons I was sitting in his office. I didn’t necessarily feel the need to know what had gone haywire in my hand – I only cared how it affected the future of my climbing.

The Climbing Doctor first appeared on my radar after listening to an interview with him on The Enormocast last year. Not only is Dr. Vagy a Doctor of Physical Therapy, a Board Certified Orthopedic Clinical Specialist, and a Certified Strength and Conditioning Specialist, but he also is one of us – a climber. He has done a great deal of research regarding injury prevention and has taken on the task of spreading the word to help climbers improve their performance by gaining strength in a safe way. (This past winter Adam and I read a handful of articles he wrote and started to incorporate his pre-climbing warm up into our daily routine.) Visiting Dr. Vagy, who was already familiar with climbing specific injuries and dealing with climbers, seemed like the perfect solution to my problem. While Dr. Vagy is based out of Los Angeles, California, he gave the option of either an in-person consultation or a Skype consultation. I took advantage of my close proximity to the city and made an appointment following my MRI.

Abductor Digiti Minimi

Screenshot taken from Essential Anatomy App by 3D4Medical

Dr. Vagy started the evaluation by reviewing the radiologist’s impressions of the MRI, which ruled out the worst of my fears – my tendons and pulleys looked great, however, we were still left questioning what was causing the pain. After various range of motion and strength tests, he found that the pain in my MCP region was caused only when the pinky muscle was activated. Dr. Vagy’s diagnosis was a healed bone bruise with a strain/tendinosis in the digiti minimi (pinky muscle). Unlike tendon and pulley injuries, this injury wouldn’t increase my risk for future re-injury. The plan of action he prescribed was a series of range of motion and strengthening exercised to regain what had been lost since the injury. He also said I could return to climbing (yes!!) at 50% of my normal grade/duration, increasing the intensity/duration by 10% each time. He explained that mild soreness or pain isn’t a problem, however, if the pain persists simply ease off the level of activity. Finally, he suggested using kinesiology tape for the first few weeks while climbing to take strain off the area and provide both physical and mental support. Walking away from my appointment with Dr. Vagy, I was very glad that I had pursued a climbing specific doctor. I received detailed answers to my questions rather than being told to simply rest my hand until the pain subsided. For example, he suggested while big wall climbing to wrap my pointer finger over my thumb while jumaring to reduce weight on my pinky. Lucky for me, he was even familiar with the exact route I had injured myself on, which was even more reassuring.

Since leaving my appointment just over a week ago I’ve been back in Yosemite. After a little over two months of not climbing I am psyched to be back on rock to say the least! I’ve started to ease back into it and I already feel like I’m gaining strength back in my hand.

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