Injuries and Medical Advice

Broken Finger Doesn’t Break Dream

A broken pinky fixed with screws is a common sports injury and repair, and should mend nicely, but restoring flexibility and strength will take sticking to a rehabilitation plan.

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Q:

I broke my pinky a couple of months ago, and had three screws installed the next day. I now have PT twice a week and am slowly getting movement back. When the fracture occurred I also damaged one of the ligaments. My doc says I can climb in another two months. Does this sound like a reasonable timeline?

—Rachel A. Johnson

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A:

Owe! That’s a good-n-proper job you’ve done there. Nice bit of carpentry by the doc as well; that should heal up quite well. Finger fractures are common to many sports and, whether inflicted by a basketball, somebody’s chin, or even jamming in a crack, they have the potential to really mess with your climbing in the long-term if not treated well.

The fracture doesn’t look like it extends into the joint surface, which is good— fractured synovial surfaces (the shiny part of the bone-end) are more likely to suffer early arthritic change. Once you remove the splint, that joint is going to be stiffer than a child’s pencil. Although pulley rupture in the little finger is uncommon, you are particularly primed for it given the joint rigidity that will follow immobilization, not too mention the four months of pulley deconditioning by way of not climbing.

At this stage, eight weeks down the track, you are probably just starting to deal with the loss of mobility in a more robust fashion. Regaining the accessory motions of the joint (both of the interphalangeal joints for that matter) is paramount for the flexor tendons to evenly load the pulleys.

Hand PT’s tend to be a conservative. That’s good when dealing with a hand that has been through a meat mincer, and the best possible outcome does not involve Yosemite. In your case, their idea of “functional” may not correspond to the realities of climbing. You will likely need to undertake the final part of your rehab of your own volition if your finger is to regain its strength.

Bend your finger into a “C” shape. Grab it by the end and twist it until you begin to feel alarmed. Now add a touch of side bending (you may need to adjust how you grip the finger so you can do this) and wince like your mother did when she gave birth to you. Hold for 30 seconds, then do it in the opposite direction. Do this 10 times every day.

You may feel the screws if you finger jam right on top of them, though I doubt the annoyance would be sufficient to warrant their removal.


Q:

Two days ago I was bouldering in a gym and, when I yarded on a four-finger side pull, I heard a few “clicks” coming from my ring finger, then felt pain. After that I stopped bouldering. The pain was mild, but went away after half an hour. After that the finger was only painful to touch. No swelling occurred, and I could still pull on it although it hurt. I rested a day and the pain went away, so I jumped on the hangboard. During the session I heard a distinct “pup” like sound that ended the session. The finger hurt for an hour. Now, the pain is gone and there is no swelling. However, I can barely put any weight on the finger. I think I can hear you saying, “You idiot!” :).

—Branko, via email

A:

There was a girl nearby, wasn’t there? That really cute brunette you’ve noticed over the last few weeks every Tuesday night. That’s why you were climbing, the irrationality of raging hormones versus common sense. You’re not an idiot; it’s quite natural.

What you are saying is that if you don’t actually use the finger it doesn’t hurt. That’s nice, at least you are not writhing in pain. Further, you are saying that if you do “weight” the finger, IT REALLY DUCKING HURTS. I don’t get it. Your confusion, that is. I can almost see you continually testing the finger as if turning a light switch on and off—light, dark, light, dark, lightdarklightdarklightdark WTF! WHY??

Being injured in some way affects your frontal-lobe brain function. That is, the ability to problem solve, particularly with feedback from the local environment, becomes so jangled that you could label it Bart Simpson Syndrome. Your finger is injured, and just because it doesn’t incessantly remind you like a broken femur protruding from your thigh doesn’t change anything.

The take-home is that “noises” don’t heal overnight. What you heard was the mellifluous sound of flesh tearing. Perhaps a voodoo reiki master could do something, but I don’t have such skills. My advice is to do it the old-fashioned way and give it time, let it heal.

Yes, you turned what was probably a mild pulley strain into what is probably a complete rupture. C’est la vie. At this point you need to give it four to six weeks rest, then start back gently on easy routes, then finger boarding with your feet on the ground, twiddling the end of your mustachio.

Make sure you get her number; it’s the only way of making the injury patently worthwhile.


Sure Signs Your Finger is Injured

1. Noises that occur while your fingers are under load– popping, snapping, crunching, tearing, and grinding are from serious flesh tearing.

2. Swelling can mean two things: If it follows a noise then refer to point #1. If the swelling is chronic over months, you may have a stress fracture, especially if you are young and still growing.

3. In the middle-aged and older, knuckles that grow bumps and are chronically sore are probably arthritic.

4. If a pulley is sore when you push on it, but is not sore while climbing, you are approaching a serious injury. This usually happens at the base of the finger on the front and is related to A2 pulley stress.


This article appeared in Rock and Ice 237


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