A2 Pulley Tear pt1
- January 21st, 2010
- By admin
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Well, I promised I’d write off my annoyment about my current injury and I will 
. So here it goes: last saturday I was at Dust, a bouldercontest in Eindhoven, The Netherlands, where I tried to send a 6C boulder after too little warming-up. While doing a crimp with my left hand, pivoting on my left foot with the intention of crossing my right arm in front of me to reach for the next grip I heard a dry ‘pop’ and saw my left ring fingertip bend into the wrong direction. Nice!
So this is what happended (the one on the left). Pretty crappy hm?
As I immediately knew what the deal was I went to the bar to get a hotpack, but almost fainted and had to sit down. I got a bad case of nausea, started sweating and shaking, turned white as a clean sheet and was dizzy…this lasted for about 15 minutes and was quite similar to what I experienced in 2008 when I almost tore off my right pectoralis major (peck, or ‘bovenste borstspier’ for Dutch readers). At least I’m familiar with what to expect when I suffer a trauma…Well, as it stands today I’m facing at least one month of no climbing, and approximately 3-4 months of recovery on the wall after that, depending on how well the pulley heals. I should probably be happy that it is only partially ruptured, not completely. If that had been the case I’d have had surgery to put the whole thing back in place, now it just feels really crappy when I put too much tension on it. By the way, again for Dutch readers: a pulley is a ‘ringbandje’ which keeps the tendon (pees) close to the finger bone. Without it your tendon would simply take a shortcut between both attached ends, resulting in ‘bowstringing’ (see image, complete tear). Getting sick yet from reading this? Imagine how I felt when I played the pulley-tearing movie in my mind over and over again in HD-quality and 7.1 dobly surround sound. How I hate having such a vivid imagination sometimes (as opposed to when some hot girl catches my gaze on the streets).
So, what happens next? Besides me being cranky as hell for the next few weeks and getting shivers down my spine everytime i think about what exactly happened again (I’m already sorry for my GF…she’ll have to put up with me all this time), the healing process is described in various sources as follows:
day 1-3: inflammation, pain, swelling. That’s alright…a swollen finger can’t move very well and that is egg-zactly the intention -keeping it immobilised as much as possible to avoid further damage. In my case it wasn’t all that swollen, so I kept moving it all the time without putting any strain on it. I’m past this stage now.
day 4-10: proliferation. New tissue is formed, the infrastructure (veins) is repaired and the wound is closed. I should avoid too much movement, possibly tape my finger to support the pulley while it closes and try to stimulate the blood flow to the affected area as much as I can. This can be done with ice-therapy (treating the area with ice for a short period of time) or heat therapy (applying heat for a longer period of time). Both can also be used in a heat-cold alternating combination. That is where I am now. I tape the finger only part of the day to avoid closing off the blood flow, stretch it softly from time to time and use cold water therapy -not the above mentioned but something different which has been described by David McLeod, the Scottish climber, on his website.
It means I’ll have to sit down at least once, but preferably twice a day with my hand in a bucket of moderately cold water to provoke what is called the ‘Lewis Reaction’: when I put my hand in the water my body will initially react by constricting the veins to prevent my blood from cooling, but after approximately 30 minutes my body will start doing the opposite to fight the cold and dilute the vessels, increasing the blood flow up to 500% in the cooled area. That is how I hope to speed up the transport of repair materials and the healing of the tissue itself. I’ll keep you updated on the results of this treatment.
day 10-31: production/remodelling. In this phase the actual tissue is formed again but the fibers are still placed randomly. To get them to align along the power direction of the pulley (the direction in which the most force is exerted on it) I will have to move my finger a lot and put some light load/pressure on it in the direction in which it will receive most of that. This will gradually increase the pull force it can handle, which should be back for about 20% after 3 weeks. In this phase I’ll have to continue the cold water treatment, stretching and I will start DFM (deep friction massage). In addition I’ll start squeezing my training foam, and in later stages use my powerball to increase the strength in the pulley.
day 31 and on: training. After the aforementioned phases it’s time to start climbing again on very easy routes, gently putting the climbing pull on the finger again. I’ll have to buddy-tape at first, then go on with single tape, and after 2 months tops I’d hope to go tapeless. It depends on how the finger feels though, but probably I’ll divide the increase in climbing level in periods of weeks like I did with my last tendon injury. Start with 4A for 3 weeks, then 5A for two week, 5B for two weeks and so on…rather extending a level with a whole week than moving up a level too soon. Patience is gold in this stage and it takes times for the pulley to grow strong again.
Something that I really plan on doing then is installing a simple fingertraining-board in my room, on which I intend to train the strength of my fingers for at least the next year to increase the base strength. And I’m not going to engage in another indoor bouldering contest…no way. I now have a 50% fuck up rate, which should be reason enough to avoid these events in the future .
Much thanks to davemcleod.com, onlineclimbingcoach.com, Frans Melskens (Sportklimtraining: streven naar het optimale) and my friend Joost (from time to time acting as my personal physiotherapist and a climbing buddy).
