DIP Joint Finger Pain In Climbers - Steve Smith (Season 2, Episode 2)

[@brandonhoang]

Thanks for the additional resource on DIP synovitis. I've read nearly every thread/climbing article on synovitis and there are very few that focus on the DIP. Is it normal to have swelling and pain on only one side of the DIP joint? Unfortunately I have it on one middle finger that's been on and off for a while and 3 others that are more recent. It's truly one of the most annoying climbing injuries - for me I'm still trying to figure out the right intensity and volume so things don't flare up. What's doubly frustrating is I never full crimp and barely half and still got it.

[@derekcraig3617]

Had it in my middle finger PIP from 2016 to 2022... I saw Esther Smith (grassroots physical therapy) in late 2022. Haven't had it flare up since Esther set me straight with a great PT regime. You can heal from this it just take time, patience, and care to not aggravate it while rehabing it

[@StephenSmithDPT]

Hey Brandon, thanks for watching the podcast and sorry to hear you’re dealing with such a stubborn sounding DIP injury. Yes it can be common to just have pain and swelling in one side of the joint.

[@muscularibuprofen69]

Have had pip synovitis for over a year. I've tried everything, but I may have left it too long as it been chronic. What are your thoughts on surgical or medical intervention such as corticosteroids, synovitis operations and so on? There seems to be very little information out there on this, and their respective prognoses for climbers.

[@icocress]

Synovitis is a horrible injury. I have it on DIP & PIP joints on ring and middle finger - both hands 😔 It is chronic, tried a lot of things. I have a schedule for radiosynoviorthesis (RSO), than I will take 6 weeks off and will be doing only rehab exercises. I hope it will help.

[@TheClimbingDoctor]

Best of luck on the radiosynoviorthesis. Yeah, the key is recognizing it before it become chronic. Once chronic, it become hard to resolve. I recetnly wrote and peer reviewed journal article on the topic. May be worth checking out, see below: theclimbingdoctor.com/clinical-management-of-finger-joint-capsulitis-synovitis-in-a-rock-climber/

[@derekcraig3617]

it is curable. I had it from 2016-2022. you can get over it but you need to see a PT that is a climber and has successfully treated synovitis

[@icocress]

​@derekcraig3617 That is good to hear, that there is still hope 😊 Did you do any specific exerces, controlled volume, intensity?

[@ericmcelyea5089]

I suffer from this exact problem and have been playing around with making some kind of ring/device to wear on my finger that prevents the DIP from hyperextending and holds it in a flexed or flat position. Does that seem like a possible solution? I have 3d printed a few crude versions but haven't tested them out in actual climbing or seen the effect they have on crimp strength.

[@TheClimbingDoctor]

Interesting. If you like, you could send one over to me and I can take a look. If you go to my webpage theclimbingdoctor.com you can find my email address. Feel free to reference this comment and I would be happy to test out the design and offer some recommendations.

[@StephenSmithDPT]

This is interesting and it could maybe be possible, in the acute or unloading phase, however, as Jared and I discussed, you will want to gradually add the stress of more demanding joint angles to build up resiliency. My other concern would be if you block the DIP from moving, the PIP stress may likely increase, so be conscious of this when designing the splint/ring

[@huntrayisabeast16]

16:40 ish, is that the general rule for most of the population? my ring finger DIP is way more flexible (hyperextension) than my index, and a good bit than my middle. my index hardly breaks 10-15 degrees, my pinky DIP is wild though, it hyperextends to what looks like 75-80 degrees. i have some hypermobility though. either way, full crimping feels fucking awful an i almost never do it, especially doing thumb over index/middle.

[@TheClimbingDoctor]

There is variability in each person but many people exhibit that rule.

[@senorblondie]

I've got a large bump on my DIP from what I think was from a Mallet Fracture injury that occurred twice to this middle finger. The tip always hangs down somewhat and I can't extend it level anymore. I used to ring lock everything on double digit boulders but now it is crazy painful to crimp a couple years away from the injury. I pretty much only drag crimps now which has dropped my V points 😕 any suggestions to rehab this or is it a lost cause at this point 🤔

[@TheClimbingDoctor]

If the end of the finger hangs downward that is considered Mallet finger. Which you have identified as an injury to the thin tendon that straightens the end joint of your finger. Once the tendon is torn, it is not possible to actively straighten the finger. However, there are many climber who have a similar injury and can crimp hard and ring lock. My first advice would be to see a doctor of physical therapy to fully assess. It is likely they would set you up on a progress load protocol for crimps to habituate the tissues back to load. Hope that helps!

[@senorblondie]

@@TheClimbingDoctor Thx for the beta 👊🏼

[@StephenSmithDPT]

I agree with Jared on needing to be assessed by a healthcare professional. You may already be developing some arthritis due to several injuries

[@senorblondie]

@@StephenSmithDPT I'm sure I am. I've been bouldering seriously for 32 years, loads of injuries and damage unfortunately 😕

[@StephenSmithDPT]

I hear you, as Teddy Roosevelt said: “we must all either wear out or rust out, every one of us. My choice is to wear out.” Good luck