Finger Flexor Tenosynovitis in Rock Climbers (Causes, Diagnosis, Treatment)

Pulley injury: • A2 Pulley Injuries: Ev...
Flexor tendon injury: • How to Fix an FDP Inju...
⚡ AFFILIATE STORE: www.hoopersbeta.com/store
👕 Official T-shirts: teespring.com/stores/hoopersbeta
🔗 Links to website, show notes, etc: linktr.ee/hoopersbeta
📧 For business inquiries: [e-mail]
😍 Instagram: @hoopersbetaofficial
SPECIAL HOOPER'S BETA OFFERS & DISCOUNTS:
➡️ 20% off Frictitious hangboard+doorway mount: frictitiousclimbing.com/?ref=...
➡️ Free shipping on any Frictitious product with code "hoopers": frictitiousclimbing.com/?ref=...
➡️ 20% off KAYA PRO (climbing guidebooks, offline mode, gps, beta videos, etc.): app.kayaclimb.com/share/affil...
➡️ $10 off Tindeq Progressor with code "hoopersbeta": shorturl.at/mnxU5
➡️ REI (buy anything to support the channel): bit.ly/43eW9Tk
➡️ The Wall Climbing Gym: Get a Day Pass and Gear for $15 when you mention Hooper's Beta at the front desk: www.thewallclimbinggym.com/
➡️ Mesa Rim North City: Mention "Hooper's Beta" at the front desk for a one-week pass with free gear rental!
➡️ KZbin Memberships: Join the HB fam to get access to various perks, like priority comment responses -- bit.ly/3WVDWaY
OUR SERVICES:
⚕️INJURY & REHAB CONSULTS - JASON (virtual and in-person): www.hoopersbeta.com/private-s...
🧗 CLIMBING COACHING - DAN (virtual and in-person): [e-mail] or testpiececlimbing.com/schedul...
🎥 VIDEO SERVICES - EMILE (videography for KZbin, climbing videos, Instagram, etc.): email [e-mail]
WHO ARE WE?
Hooper's Beta is a passion project, started by Emile Modesitt and Jason Hooper. Help us create the Largest Library of Free Training and Recovery Videos for Climbers by subscribing, sharing, and shopping with the affiliate links below!
// RESEARCH CITATIONS //
Nonoperative Treatment of Finger Flexor Tenosynovitis in Sport Climbers-A Retrospective Descriptive Study Based on a Clinical 10-Year Database: bit.ly/3BdXoGp
Olympic competition climbing: the beginning of a new era-a narrative review bit.ly/3SB7MyV
Efficacy of corticosteroid injection in rock climber's tenosynovitis bit.ly/3rRGQjm
// SHOW NOTES //
Episode 118
www.hoopersbeta.com/library/f...
Key Points: Flexor Tenosynovitis vs A2 Pulley Injury, How to Diagnose Tenosynovitis, How to Treat Tenosynovitis, Corticosteroid Injection, Finger Pain from Climbing, Pulley Pain
// DISCLAIMER //
As always, exercises and rehab programs are to be performed assuming your own risk and should not be done if you feel you are at risk for injury. See a medical professional if you have concerns before starting a new training or recovery program.
#trainclimbsendrepeat #climbingtraining #doctorofphysicaltherapy

[@thesourlemon4058]

I'm literally having this problem right now. The timing is immaculate

[@HoopersBeta]

Sorry that you're dealing with this but I hope the video helps!!

[@koszonet]

Ditto, was convinced I'd ruptured a pulley but everything in this video makes perfect sense for it being tenosynovitis. Perfect timing

[@arthuralves904]

Mna, I just do training in the gym, and have been feeling this pain in my midle finger for years at the very same position that you pointed out on the thumbnail of the video. I've avoided doing a lot of training sessions because the pain was unbearable. Thank you for the information!

[@valeriomazzaglia3208]

Great video and amazing in depth description. I'm having the exact simptoms that were just described after a hard sloper session some 5/6weeks ago. Still having simptoms despite a 2 weeks rest...I just want to point out that the pain radiates trough the wrist too. Hope your advices will help

[@adrienl4949]

Was waiting for this video ! I Can now say confidently that I have a pulley injury (no pain in open hand but clearly during crimping, injured during a deadpoint on a small crimp in a overhang, no pain in thé forearm or during Finger extension) ! Thank you again !

[@HoopersBeta]

Glad this was helpful! (but sorry to hear of your injury!)

[@languagefreeassangeteacher5338]

Solid information, thank you!

[@ivanpaskalev9863]

Man, your videos are amazing

[@HoopersBeta]

Thank you!

[@cantfindabadassname]

I started climbing a month and a half ago and fell in love with it. Where I live there are a lot of outdoor climbing spots, a couple of them you can climb horizontally. At every chance i got i went climbing. Little did I now I was "that guy".. Definitely overdid things and am currently healing from what I now know is called tenosynovitis. Thank you for the informative video 👍🏻

[@nbka8rs]

Algogogogo. Been waiting for this one. You guys are awesome!!!

[@HoopersBeta]

Glad we could finally deliver!

[@littlevahn]

Thank you for the great info! Been wanting more info on this.

[@HoopersBeta]

Of course! Hopefully this helps!

[@imtoolazyyyy]

Great video! Can you cover capsulitis as well? I know at least a few climbers (myself included!) with this diagnosis, but hand doctors often don't have a recommendation for whether or not to keep climbing, or how to adapt climbing to reduce aggravation.

[@florvermassen1128]

Dear Hooper Amazingly informative videos, brilliant work. Could you do an episode on Dupuytren's contracture ("Viking's disease")? There seems to be quite a lot of cases (or at least similar symptoms) in the climbing community and not much info out there. Especially here in Scandinavia there will be a large interest due to genetic predisposition, although it appears that climbers all over the world have reported cases. Would be amazing, thanks.

[@BastienAdrien]

I have put this comment under some of your videos already and I feel I'm repetitive, however I feel like it is true: your vids/channel -> underrated/-viewed it is well thought through, backed by science, easy to understand, funny (love the intros & especially the "like & subscribe for more super sweet vids y'all" outro got me 😅) and comes with pracital tips to apply to training & climbing (I might be biased about all people loving science though coming from a immunobiology background) glad to see your channel growing though, keep'em coming!

[@HoopersBeta]

Hah :) Well even if it is repetitive, Emile and I love to see the support so thank you! We are happy that you enjoy watching them and glad that the channel is reaching more people every week.

[@idobenbassat6561]

really liked that one. Very informative as always! Can maybe make a video about the thumb? Thanks and love your channel 😎✌🏻

[@HoopersBeta]

Yeah we definitely need to do some videos about the thumb! It is quite important :) Thanks for supporting the channel!

[@jacobeden2083]

Appreciate the timing on this video! I'm returning to bouldering from what I thought was two pulley injuries in the same finger, and while one has healed, I still have pain in the DIP joint. Your chart only mentions PIP swelling, can this type of injury occur in the DIP as well?

[@grantnorman1854]

Perfect timing! I'm currently on rehab week 4 for this, following a very similar protocol. The cookie cutter rehab plan I'm following suggests half crimp 4 sets of 30 seconds with 3 minute rests (for weeks 3-8). I'm curious about the motivation to do 6-10 sets of 30s on 30s off, rather than longer rests

[@HoopersBeta]

That much rest is very typical for more intense recruitment. If it is quite low (submaximal) then the rest could be shorter.

[@TheJustymon]

Great video. This gave me more insight on a possible injury. But I think my injury is along the extensor side of my hand. Is there a video on extensor injuries?

[@skethoo]

Spent too many sessions on kilterboard recently and I think that was the cause. All symptoms just as you described in your video. Taping only prevents from overcrimping but also increases the pain while climbing. Can't hold jugs because it hurts. But small crimps don't hurt at all. So, I can't climb on easy routes with jugs. But it is completely fine to climb on vertical hard routes with tiny crimps and edges. Just avoiding overloading. Can go full power on big slopers as they don't engage fingers that much

[@albaperez3999]

Thank you very much! That was really helpful. I have exactly this problem and hadn't found so much information on how to treat it. How many times per week would you recommend the exercises?

[@alexandreaudin2070]

Hello, thanks for this great educative video, is there any way for non-health practicing to find this kind of scanning device ?

[@borjarevuelta6426]

Hi! I've had tenosynovitis 4-5 times in the last 3 years, 3 of those times diagnosed by a PT with ultrasounds. The first couple of times I experienced it, it differed from the typical pulley sprain in that the pain was not as acute and rather spread around the A2, plus I didn't hear any pop and it started hurting the day after. All of them were the result of too much training load with insuficient rest, but ultimately triggered by cutting feet and putting my pulley system under too much preassure. The protocol I followed for the first two times was progressive overload with a no-hang device over a couple of months, it took a long time but it worked and I was back on track. When it was diagnosed, I was given the instructions of not climbing for 2 weeks at all, and wearing a Schöffl ring to support the tendon and reduce the friction with the pulley, hence reducing inflammation. Two weeks for Schöffl completely cured the problem, and I was 100% just after two weeks. Now I'm suffering from something in between pulley sprain and tenosynovitis (it could be both). It hurst when I press on the pulley, but it barely hurts when I crimp. The pain was also located along the FDP on the dorsal side of the finger, around the methacarpal, way less than on the pulley system. My 2 cents.

[@xander63able]

Where can i find a Schöffl ring?

[@Cobold33]

Hey Dr. Hooper! Really appreciate your videos. I ruptured my palmar plate in the ring finger of the right hand 3 and a half months ago. I took the 3 month pause, like the doctor told me too. Now i'm trying to get back to climbing, but I don't really know where to go from here. Is there a video that i haven't seen? Or some advice i could follow? I would appreciate any answer, havent really found something usefull on google.

[@oystercatcher943]

Great video. I think I may have this after upping my climbing for 1 to 2-3 per weeks a 2-3 months ago. It’s minor pain - more discomfort but I’ve had it for a few weeks. I have a tiny bit of swelling overnight but can climb but I’m avoiding small crimps with high load. This helped me understand the problem

[@inavicu]

Hi, your channel has helped us lots, from deciding whether or nort see a physio to having a way to understand better some injuries. Thanks from many of us! Currently I am dealing with Tenosynovitis (almost recovered). I was wondering if doing pullups in half crimp could reappearance of Tenosynovitis or any other tendon issues?

[@Bobberg90]

Thanks, very informative. Second the suggestion about capsulitis. I had bruising on the back of my middle finger after a crimp, and think that is it. Will see someone soon.

[@faragematheus]

Great video! That looks like my "every 2 year injury" 😬 normally I can't even rest in the bar because it press right on where is the pain. Unfortunately my injuries last 2 to 3 months... To add, I like the opening hands exercises. They help the blood flow without any pain

[@sstrong42]

Fun! I had this, ignored it, and gave myself a super awesome partial thickness tear in my flexor tendon. It took like two months to heal.

[@knievel9140]

Great video! Unfortunately a few months too late for myself, but I think a lot of people actually mistake their Tenosynovitis for a pulley injury and risk making things worse. When I first felt the pain, it was pretty mild and I defaulted to the usual few days of break and then H-tape the pulley and start climbing again. With that one session I probably jumped from needing a few weeks of recovery to more than 4 months. During the session I felt fine, but for the next week even the slightest touch of the A2 pulley area of that finger was almost unbearable. What did it for me was then a longer break, slow progressive loading and finally climbing sessions with only open-hand gripping. Counter-intuitive but very helpful for me was avoiding jugs (as they pressed against the inflamed area) and not taping. I've since grown a little anxious to run into the same problem again though. In hindsight I know I was three weeks into a new training plan (personalised from a professional) and did a lot more than before that. I also now believe that 2 or 3 of my past smaller injuries would have been diagnosed similarly and I might be a bit more susceptible to it. I recently started to increase my training load again (I still want to complete the 16 week training plan that I paid for) but focus a lot more resting, nutrition and sleep and its going good so far. Would you agree with that approach or is it likely that the plan is probably just too much for me and I'm on track to do the same mistake again? Edit: Note that my Tenosynovitis was never professionally diagnosed. I self-diagnosed with the help of Volker Schöffl's book (which I can only recommend) after my symptoms didn't completely fit any of the injury assessments I found on my usual channels (meaning you).

[@xander63able]

Sadly i face the same situation even after a month off break with nearly no climbing after the first session today it starts again mildly. I also mostly notice it on jugs. Can you tell me the name of Volker Schöffl's book (does not matter if german or english) that helped you? Besides resting and open handed gripping did you do anything else?

[@knievel9140]

@@xander63able The book is "So weit die Hände greifen..." or "One move too many". I think the main thing really was focusing on open hand grip for me. Although I still struggle with inflammations if I start to train crimping specifically, it's fine now if I just crimp during climbing though.

[@gnomo82to]

@@knievel9140 was taping the thing that make it worse?

[@daria2784]

Had this problem in the last month. What I've done: had a 4 weeks break in climbing, after a week started to use acupressure ring to increase blood flow. Tried also local antiinflammation ointment and non-steroid antiinflammation pills. After a month of a break started to climb without any taping, but tried to avoid crimps and other aggressive holds.

[@thibaultmarhem537]

Thx for the vid ! Would pain with passive contraction be in that chart too ?

[@andremartins7503]

Hi. Love your videos :). You are amazing. I would really like to see you doing a video about hypermobilization in the hand joints. I don t think you have any.

[@HoopersBeta]

Hi Andre, thank you for the support! We are glad you love the videos. You're right we don't have a video on that yet. Are you referring to general hypermobilization or of a specific joint/region?

[@andremartins7503]

@@HoopersBeta Thanks so much for answer me :). So when i was talking about hypermobilization i was refering to the DIP and PIP joints.

[@HoopersBeta]

@@andremartins7503 gotcha! We do have a video discussing hypermoblity / hyperextension of the DIP while crimping but no we currently don't have a full length video regarding both. In general, it will be a "case by case" basis but with good strength training, monitoring of volume, and avoiding exclusively using 1 grip type, most people should be able to manage ok!

[@1preciousflower]

How do you tell the difference between a stress fracture and a pulley injury? I hear stress fractures are more common in women. I'm 6 weeks in to what my PT thought was a A4 injury (not full rupture) and the pain is still intermittently intense and sharp. I'm trying to keep in the 0-3 pain range but I imagine I shouldn't be putting weight if it's fractured?

[@zombiebot5807]

Is pain when pressing on the location also a symptom of this? I can still crimp without pain, but jugs or holds that hit the area that is sore are very painful.

[@nicolotedeschi5315]

Hey Hooper, thanks for the video was very informative! I was wondering if you have any experience in the use of Cetylated Fatty Acids tape/bandage around finger joints as a way to boost recovery / help with inflammation…thanks again!

[@algorerhythm2751]

I'm on week 6 right now, and it's mostly resolved aside from crimping! I found barbell holds in the finger tips were most helpful for tissue loading, at least for me!

[@HoopersBeta]

Glad that worked for you and that it is resolving! Keep being patient and I hope it heels up nicely the rest of the way!

[@djinn1985]

General question, I find that my synovitis gets worse with my golfers elbow and wrist discomfort (desk bound using mouse and keyboard all day). Do you have any tips on rehab/exercise tips for full chain fingers to shoulders?

[@moonlight00001]

Thanks ! My friend was thinking she might have tenosynovitis, I'll share this video with her.

[@HoopersBeta]

Thanks for sharing!

[@WyandWombat]

I had this several times in the past and I'm having it in my right middle finger again right now. What tends to cause this for me is pulling hard on pockets, especially shallow pockets. I think the reason is that I don't climb on pockets very often and I could just help it with training them more regularly instead of only going hard every once in a while. The good news is: This injury subsides from just leaving the affected finger alone for a while. I keep climbing but I actively avoid hard crimping and compression on the affected finger and will just do something else instead. Slopers for example. Taping the affected joint to immobilise it for the climbing session tends to help for me. If other injuries were as easy to deal with as this, the world would be a better place. The worst is still that damn elbow tendonitis.

[@K3pukk4]

Bingo, I probably got this about 4 weeks ago. It slowly built up while I was projecting a boulder where I needed to crimp really hard with my left hand on two different holds. After that, I took 2 weeks off from climbing, and now I have started climbing again trying to avoid full crimping. I get occasional pain in the finger if I use it too much. After watching this I think I will still climb on low intensity but try to use only open hand and maybe incorporate some low-intensity hangs. Thanks for the vid!

[@LilStinkyRat]

Wow great vid

[@HoopersBeta]

Thank you!

[@jisyang8781]

Topical application of Voltaren gel reduces inflammation and thus helps recovery from tenosynovitis injury. Voltaren is diclofenac (NSAID) in tube marketed for arthritis pain relief.

[@asdiary7996]

A lifesaver

[@jeffries848]

Been having issues with my left ring finger having some pain right around the joint closest to the tip. What’s weird is that is temporarily gets better when I pop my finger. Usually once I get warmed up it mostly goes away but then sometimes it get achy for a few hours after the session. Any thoughts?

[@SavageSenzu]

Is it possible to get this without rock climbing? I believe my symptoms match this from overuse and or rsi possibly. I get pain when holding or gripping things at around the A1 pulley but throughout the rest of the finger I get pain in the joints and at the tip occasionally. Arthritis was ruled out via x ray so I’m wondering if this is the issue I have.

[@mojmirkandrik441]

I think I have tenosynovitis for almost 3 months now. After initial swelling went away and I finished 2 weeks of complete rest I started to slowly load finger and increase intensity. Where I am not sure regarding my diagnosis is that it totally does not hurt while climbing. Only after session I feel the finger more sensitive for ca 1 day and it gets veery mildly swollen(skin maybe 1mm thicker as on the other finger). I am progressively increasing intensity for ca 2-3 months and almost on 100%(still avoiding crimping and watching carefully how long I train), but still especially when bending finger I feel some discomfort. Also I feel slight pain when rotating finger to sides. Is my approach good? I do like all the stuff in your video to treat it. I also visited physio treating fingers who considers my plan as good one and only added some palm stretches and palm pressure massage to the rehab menu.

[@pyr0m4st3r6]

What do you think of ice vibration therapy? It may sound weird but in the horse sport they are actually using this if horses have issues with ligaments or tendons in their legs. So i am wondering if that could actually be used for humans too.

[@AlchemyInstruments]

I've been climbing for almost 2 years and lately I've made it to v6. I've been climbing basically every 2 days lately though and developed a mild case of this. My stamina and power are definitely higher than before but I can't do weighted hangs or campus boarding now that I have this because I know it would make it worse. I've only ever done hangboarding with weight added, board climbing, and campus boarding once each so far but my sessions were really great and I was really strong in each category. These were on different occasions in totally different weeks just to try them each for the first time when I was nice and fresh and at the time uninjured and these didn't cause it. I'm certain it's because I've simply been climbing too much and sending crimpy overhung v6 projects and limit bouldering on v7's every single session. I could send a crimpy overhung v6 right now after a warm up without making it overtly worse but I don't want to keep this up. I'm going to take a week off and do some hangboarding with my feet planted on the ground and then get back to climbing 2-3x a week, doing mostly pumpy, pinchy, slopery climbs, and train non-finger-intensive things once maybe twice a week until I'm all better and I think my recovery will be good and my progression will still be good. I think I'll have to save that every 2 days level of volume until years down the road when I'm even more adapted, but also listen to my body when I get there as I'm doing now.

[@evanmendes1835]

What a great video! I´ve just came back from this injury and I´ve done pretty much everything you mentioned! Sadly, after my finger swelled up in mid-May, it took me a while (and 3 different PTs) to understand what was the story. Your vid would have defo helped! Went home and did the low intensity hangs, loading slowly (on top of antags and climbing specific trainings that did not put pressure on the finger) for around 6 weeks before another climbing trip. The results were amazing!! Finger is actually stronger than before and I only feel a bit of discomfort atm (1 out of 10 in the pain scale). I have a question though. I did the low intensity hangs everyday during that period, to ensure that I would increase blood flow and help healing. Also, I´d take collagen 30 mins before the "finger loading" sessions. Would that be ok for everyone or I was lucky I did not get any worse? Thanks for your amazing content! A friend recommended in spring and I can´t stop watching and learning! Really appreciate beast!

[@HoopersBeta]

Hi Evan, sorry to hear that you had to go to 3 different PT's but I'm glad that you finally found a solution and are doing well! The low intensity hangs can be done at a higher frequency and can stimulate the positive change that you experienced. It may not work perfectly for everyone but it isn't a terrible idea. Thank you for watching and for the support! We are glad you enjoy the vids :)

[@argiriskovanis6571]

I seem to have the same problem but also combined with a swelling finger. Is it possible? Thank you in advance

[@affordableaquariumservices1663]

How do you know if it’s an infection or just from repetitive use?

[@sachabk8579]

Had a tenosynovitis 2 months ago due to a too hard session after 4 weeks of inactivity. No physician could actually tell me what was happening to me and no one wanted to check this with ultra sound I checked on internet and a doctor told me that it was a tendon inflammation So I just put ice and squeezed a ball every day to rehab Your video would have been very useful for me 2 month earlier Btw I really love your work Thx from France

[@HoopersBeta]

Dang! Sorry for the injury and the issues properly diagnosing it. Hopefully this video can help others in the future :)

[@sachabk8579]

@@HoopersBeta yep hopefully you're here

[@wissamharb5684]

Always amazing content thank you!! I've been recovering from a pulley injury (A4 pulleys of middle and ring finger both at same time!) and honestly I did not do any therapy. I just stopped climbing for about 3 months, icing and all, and slowly started climbing and hangboarding again. Another 3 months later and I'm stronger than ever. However, i still feel tender in the fingers that were injured. Some days it hurts more than others. No swelling though. Deeper edges/pockets that put pressure on the A4 hurt a little so i try to avoid them. I feel that massaging the area helps sometimes. I wonder if what I have right now is Tenosynovitis because I feel it in my forearm. It feels like I always need to massage it for relief. Any thoughts? P.S. I'm currently in Tunisia for work and no one understands climbing injuries

[@veliborvasiljevic4897]

Currently having similar problem, had A2 ring finger injury about 3 months ago, returned to climbing slowly after 1 month, but now when I'm hangboarding in pockets/open hand I feel a little bit of pain on that A2 and also in the forearm. When I press on A2 it is a little bit painful but nothing major

[@Riad_Hadjiev]

Is tenosynovitis could be the consequence of excessive compression in the flexor muscles which provokes the appearance of trigger points in the forearm and incorrect functioning of DIP and PIP joints?

[@coltonchehowy907]

I just syarted climbing 7 weeks ago with zero experience and quickly progressed to about the V5-V6 level with having sent my first V7 just a few days ago. My fingers hurt. A lot. The pain lasts for days and theyre stiff. I thought it was just the adjustment period but now im learning that i went too hard too fast? Now i am scared to climb at all. Not really sure what to do cause if i wait for a week or two then go back to climbing won't i just reinjure myself? I dont know how to properly get into this brilliant sport while also challenging myself with boulder problems i find genuinely interesting and difficult. Should i stick to V5 non crimp climbs max for the first year until my fingers are okay with harder crimps? Or do i just have to wait years before i can actually start challenging myself? Im really frustrated and just want to have fun progressing but am scared i havent got the finger tendon strength that would pair with the rest of my capabilities. Any suggestions?

[@HoopersBeta]

There’s a LOT to unpack here. Too much for a succint response in a comment. But in short: take some rest days and let your fingers heal. You don’t need to stop climbing if you can control yourself, but if your fingers hurt badly you’re definitely doing something wrong, so back off the intensity. Stick to some friendlier/juggier climbs and take rest days in between until your fingers stop hurting. Do some rehab exercises if needed. Make sure you eat a decent diet and get decent sleep. Pay attention to how long your sessions are and how many days per week you’re climbing and modify until you find a cadence that doesn’t cause you significant pain. Watch videos from reputable sources about climbing and training for climbing (you don’t actually need to start “training” yet if you don’t want to, but it will be helpful to learn how load management and progressive overload works). If you have access, talk to a knowledgeable coach (run of the mill strong climbers can also be good sources of information sometimes, but they can also be terrible sources of information, so use caution - reputable coaches are much better). Also, by the sound of your comment you seem very focused on progression. There’s certainly nothing wrong with that, but make sure you focus on progressing your technique, route reading, mental strategies, strength, and resiliency, not just chasing grades. Oh, and have fun! Hope that helps! -Emile

[@aishanzhong365]

I have Tenosynovitis in PIP joint of both middle fingers. I had my corticosteroid injections 2 weeks ago, paired with resting from bouldering. Pain is significantly reduced, but slight soreness can come after bouldering.

[@HoopersBeta]

Do you mean tenosynovitis in the region of the PIP? If your pain is in the joint you might be referring to Synovitis or Capsulitis. Regardless, happy to hear that the injection is helping you I hope the pain continues to reduce!

[@Acorn18]

Great video thanks. Comparison table very helpful!Tenosynovitis seems most likely, except there is no pain. The knuckle just clicks....is that sometimes a symptom to your knowledge? Thanks!

[@HoopersBeta]

Clicking at the knuckle *can* be more indicative of joint synovitis.... but it could also be benign, or from another tight structure, etc.

[@Acorn18]

@@HoopersBeta hey thanks so much for your reply. I really appreciate you taking the time to give this extra info. Thank you! Such a great channel - love how entertaining and also informative your vids are. :)

[@alexrogers6254]

Through your network of colleagues, do you know of a clinician in the UK who is familiar with climbing injuries? I only have access to a general practitioner who doesn't take finger injuries seriously, especially if I can still carry out every day tasks. They aren't interested in me being able to do my hobbies.

[@LFHaunt]

I have this and my main symptom is tightness in my joint area, this is the pain that I mainly feel. It’s so bad that when I try to make a closed fist my middle finger has noticeably lost range of motion. I’ve had this for about a year now but I haven’t really tried to do anything about it because it doesn’t hurt when I climb. I use supportive taping, just below the knuckle and it helps a lot.

[@HoopersBeta]

Are you sure that it is flexor tenosynovitis and not joint / PIP Synovitis?

[@Callammurray]

It all makes sense now. This is what I had. I'll say what worked for me and that was progressively loading my fingers at the beginning of a session for 2 sets of 10 seconds on a 20mm edge. I usually start with my feet completely on the ground and pull down then lift up one foot, then tip toe and if I feel good, I might full load. Hope this helps someone. (I also stopped full crimping if I didn't need to, this probably had more to do with it but, the above is good practice for me now)

[@DutchBoulders]

To all the Synovitis-gang peeps in the comments. I have been dealing with swollen PIP joints and limited ROM for 6/7 years now, but am pain-free since 2 years. And the best advice I could anecdotally give is: integrate progressive hangboarding into your warm-up! Ever since I started hangboarding in my warm-ups, the pain in my PIP joints faded away. No more agony when I bumped my fingers into a door or whatever. It only takes about 10min, but saves you a lifetime of pain. My routine looks something like: - 10-15x recruitment pulls on 40mm edge - 3x 3s on-off hangs on 40mm edge - 5x 5s on-off hangs on 40mm edge - 10-15x recruitment pulls on 20mm edge - 3x 3s on-off hangs on 20mm edge - 5x 5s on-off hangs on 20mm edge And off to the races. I've tried a lot of different solutions before also together with a PT (rest, hangboard routines, icing, coban-tape, etc), but this is the ultimate solution for me. Still have my limited ROM in flexing my fingers, but that's just something to live with in order to be climbing.

[@Sam-yh6he]

I knew mine wasn't a pulley injury, but I didn't know what it was until I watched this video!! Even my doctor didn't know what was going on :'( Thank you for sharing this! My forearms hurt and are really tight, almost like they're pumped right after an extensive climbing session. I can't stretch my fingers passively or do pull-ups. Do you have any recommendations on relieving this kind of forearm pain?

[@HoopersBeta]

Glad this video was able to help you identify what's going on! Could be a number of reasons for the forearms, including nerve tension. Sounds like it may be worthwhile to have someone evaluate it closer for an accurate diagnosis.

[@thesinful]

I suffered from this a couple years ago and saw a physiotherapist who was also a climber. He recommended a similar protocol with the tension block, but also had me doing tendon gliding 3 times a day. Would you recommend the tendon gliding for a form of rehab for this injury?

[@HoopersBeta]

General range of motion is excellent to stimulate a bit of movement / blood flow. The tendon gliding with the scraping component I wouldn't be a huge fan here but it may not cause any harm.

[@gaelleantoine8971]

Thank you for all these explanations! I have this injury on the 4th finger at the A2 position. I have this since April 2022, I tried everything and it has never cured. The pain is now low and I don’t have any daily pain, but if I press the area it hurts. And also I can’t climb more than medium level, otherwise it hurts for days after… I use climbing bandage to be able to climb and it helps but I am afraid that I would never be able to climb at my maximum level again… I have another tendinite on my knee that has never cured also, even though nothing is visible on imaging now. Do you think that some injuries are not possible to cure? What would you recommend to cure a chronic injury?

[@gaelleantoine8971]

Also I have been climbing since I was a child, I am now 28 and this injury happened because I stopped for 2 years because of work and then I started again and I think I pushed myself too hard because I was used too be able to do a lot of climbing but my tendons might not had the time to strengthen enough.

[@Twavis14]

Had this pretty bad for a bit. 1x knuckle swelled while others remained normal. Had some treatment to break up scar tissue in the fore arm and dry needling done to the knuckle itself. I've had to limit myself to climbing every other day. I can still feel my knuckle aching and swelling if I do anything more than that.

[@HoopersBeta]

Always a good idea to listen to your body's tolerance to both volume and intensity.

[@w1zar13]

I think I have been climbing through this injury for almost a year now since half crimping doesn't really hurt. It's gotten to a point where my open hand and half crimp don't hurt but when i pull with middle fingers in isolation (mono pockets) I can barely load 5% of my bodyweight without immense pain. Are my fingers just screwed forever?

[@HoopersBeta]

I definitely wouldn't say screwed forever, probably just need an appropriate loading / rehab program.

[@lucasredondootero8537]

Is it possible to suffer it from it after a pulley injury? I have pain just when I squeeze my finger after crimping mostly around my A2 but the A4 is the one y ruptured. Congrats on the great content!!

[@HoopersBeta]

Yes, that is a possibility. Sorry to hear of the issues / injuries you are experiencing! But thank you for the support.

[@usmania187]

Great video. WOuld pain in the knuckle of the middle finger be Tenosynovitis? I've been managing it for more than fiver years but have never been able to get rid of it.

[@HoopersBeta]

Could be a synovitis of the actual joint if the pain is isolated just to the joint/knuckle. Sounds like it's worthy of a professional evaluation though if it has been around for 5 years.

[@aries_9130]

Please mind that I did not get a professional diagnosis, but am fairly certain that my "pulley injury" actually was a case of tenosynovitis - I felt that H-/X-taping did absolutely nothing to heal the injury which overlaps with your statement. I would even go as far as to say that in unnecessarily prolonged it. What helped me in the end was to reduce volume, avoid extremely crimpy boulders and focus on using the open handed grip more.

[@HoopersBeta]

Thanks for sharing! I love the forms of treatment that you ultimately chose to recover from this.

[@aries_9130]

@@HoopersBeta You're welcome and thanks for the great video!

[@arcusang9685]

I do a search for my pain... I think I hurt my collateral ligaments? Wonder if this video or the pulley injuries video helps? (o.o)

[@arcusang9685]

yep.... kzbin.info/www/bejne/pHW7ZKt8e5Zqr6M

[@zainilmaredia]

If I have pain in the base of my index finger for a few weeks now (no swelling) pain only occurs in certain movements. Would that be an A2 pulley related issue or A1. Could that be inflammation in the A1 pulley area?

[@HoopersBeta]

base of the index is less likely to be A2 (but still possible). Could be A1/ trigger finger but that's not all that common. Could be an intrinsic muscle or this flexor tenosynovitis issue.

[@cruxymirth]

hi, I noticed you're using a Clarius ultrasound. Which model? the image quality is nice

[@HoopersBeta]

I'm using the L20HD3. It's designed specifically for smaller surfaces such as fingers, which helps in the image quality. I love it!

[@rlm2610]

Hey rock doc! I'm currently having mild symptoms that point to this or possibly PIP synovitis. Would the suggested treatment be the same? Also, since the symptoms are still very mild - slight swelling, possibly some minimal stiffness, but no pain at all - am I correct in assuming that I could continue climbing and training if I only cut back on moonboarding and possibly max hangs, which are the most probable causes of overuse in my case? Or should I be more careful even in this mild/early stage? Thanks a lot for all your informative content!🙏🏻

[@user-lb1nu8uj5i]

Hi wonder if your swelling is gone ? I am 2 months in and finger still swollen 😢

[@rlm2610]

@@user-lb1nu8uj5i I'm sorry to hear it! I don't have any swelling but the stiffness remains, getting worse whenever I crimp. Decided to take a break from climbing ans focus on rehab with very light hangboarding. It seems to work, but progress is very slow and I sometimes get unexpected flare-ups. Trying to find the balance between under- and overtraining. Hope you find your way back to healthy fingers as well!

[@illegitimate0]

I would never recommend corticosteroids for any tendon-adjacent injuries. Corticosteroids have been shown to degrade tendon strength (which is why they never do more than 4/5 injections per joint), but also has very very weak evidence of outperforming non-injection treatments. Basically, very low chance of helping, with increased chances of making it worse in the long term. Hyaluronic acid is a very temporary treatment and can be very effective, but it can mask the problem by reducing friction. If you haven't done the due diligence for rehab with it, it'll just come right back. PRP is the only one that is therapeutic, but is relatively new as a treatment. For any non-muscular injury, achieving blood flow to the area while not irritating it is basically the goal for the beginning of rehab and treatment. Slow load progression follows, but the key is lack of irritation. Sensitization can occur with chronic or repetitive injuries, and minimizing irritation to the tissue during rehab is paramount to allow you to regain full pain-free function.

[@matyasmedlin7408]

Great video! However i still struggle identifing what is wrong with my right hand middle finger pip joint. After climbing I feel low intensity pain that gets way more intense when i curl my fingers into a fist. Does not hurt while crimping or open handing, so I haven't given it much attention but it scares me a little. Also popping sound and feeling in forearm on certrain holds and hand positions, is that normal? No pain whatsoever after the pop...

[@markdewey1587]

This sounds like mine. I tried finger glides, and stretches, but low intensity loading seems to be helping the most for me. I’ve been avoiding crimps for several weeks, and seems to help

[@LFHaunt]

This is what I have too. I believe this is the same thing as what is mentioned in the video?

[@matyasmedlin7408]

@@LFHaunt I didn't get that feeling that I have the condition explained, but I may have misunderstood

[@faarao44]

What if there is no pain during extension but pronounced pain and stifness during passive and active flexion?

[@HoopersBeta]

Hmm mostly I'd just say that's not enough information to provide an answer/clarity to what you're asking.

[@MrWolophilip]

Great video, thank you very much! I went through ultrasound and then went to PT. He told me to undergo laser treatment twice a week for two weeks. I have not heard of this before and could not a lot of information on it online, so I'm a bit sceptical as to how effective it is. Do you have any experience with laser heat treatment for finger flexor tenosynovitis? Or do you have any info on it as a good/bad/mediocre alternative treatment? Only asking as you did not list it in the alternative treatment part of the video. Thanks again ! :)

[@HoopersBeta]

I've never seen evidence on it for that specific treatment. Though, I'm sure there are better options out there.

[@MrWolophilip]

Thanks!@@HoopersBeta

[@tommilaurila2128]

Corticosteroid shots should be avoided as it might weaken tendons! Great video I study post surgery rehab and MSDs in general so I had the opportunity to ultrasound my own finger when it started giving me pain😅

[@zgd3200]

Seems likely this is what it happening on the middle finger of my right hand. I think this was caused by slightly too aggressive rehab of a pulley injury. I progressed into full crimp hang boarding and as the pulleys healed I continued to up the weight while keeping the 3x a week frequency, which combined with a slight incorporation of crimper climbs resulted in overuse. It was pretty obvious that it wasn't a pulley given the comparison and the fact that I get symptoms when trying hard on pinches which wasn't the case with the pulley injury. Also there is basically never a sharp pain, feel more like uncomfortable pressure, but definitely a qualitative difference in the type of pain. Hopefully another round of finger rehab will work out!

[@baumstanz]

I had a bony avulsion of the palmar plate after jumping to a hold and landing badly. Is that a common climbing injury?

[@HoopersBeta]

Sorry to hear that! Not extremely common specific to climbing but it is common with dislocations or hyperextensions of the finger.

[@BhavishyaPohani]

I have a bump in my ring finger at the base of the finger. The bump does hurt while pressed and does become inflamed as the session progresses. Do you have a video on this topic? I most likely have an A2 pulley injury and also have pain crimping in the same finger.

[@HoopersBeta]

We have a full length video on the A2 and also have one on trigger finger that you may want to watch!

[@Imthedragonreborn]

If it feels like a small hard stone in the finger, it's more likely to be a cyst. Pretty innocuous, had one for a couple years in the same spot you mention, then it disappeared. But you should get it checked to be sure.

[@fane7965]

I started climbing a month ago and going 3 times a week for one hour and leaving a day of rest in between climbs. But I got symptoms of synovitis, I was wondering if that sounds "normal" or if I may have other underlying issues, I feel like I get easily injured tendons, with other hobbies such as jumping rope. Starting to get really frustrated with my easily triggered injuries. I would appreciate any recommendations or pointers.

[@HoopersBeta]

It may have to do with other factors such as your warm up, the intensity of the climbs you're doing, or other factors like hydration and nutrition that aren't allowing proper healing time. But yes, there are other systemic issues that can cause a heightened inflammatory response but that would require a discussion with your primary care provider.

[@fane7965]

@@HoopersBeta Thank you! Is just so incredibly difficult to find a good PT in my area. Last one I went to almost literally tried to rip my thumb off 😂 🤦‍♂️👎

[@60SecondBoooks]

well ultrasounds take a 4 month wait here in germany. Soo ni chance there. Just going on with training and maybe looking on youtube.

[@blancheladera-puncer]

I finally know what my finger injury is called, thanks for this. My injury is on the left ring finger just below the PIP, the pain radiates all the way to the forearm, thats why I was certain it was not the pulley. wrapping a tape just around the affected area helps me climb coz I dont feel the pain on the finger and forearm. It^s just impossible for me to be painfree without taping.

[@HoopersBeta]

Glad this was helpful for you to identify the injury!

[@FissureRaiOh]

Do you have a video on pain on the sides of the middle knuckle, or can you tell me the likely name of this injury?

[@HoopersBeta]

Give this one a view! See if that helps. kzbin.info/www/bejne/nl7RgIOAqKeNsJo

[@FissureRaiOh]

@@HoopersBeta Wonderful, thank you!

[@stendo3402]

Hey so I think I have a fdp injury and I kinda feel like a slight popping or grinding feeling any idea what that is ?

[@stendo3402]

Both of my hands have this problem I’ve let them rest for long tim about 3 months left hand and 1 month half right hand and I just found your videos and have started loading them slowly

[@HoopersBeta]

Sorry to hear of the injury! Not sure, would need a more in depth analysis.

[@derekcraig3617]

I have had synovitis symptoms since 2016. But for me I have a slight swelling/deformation on the top of my right middle PIP joint

[@HoopersBeta]

Oof, that's a long history of symptoms! You might be referring to PIP joint synovitis though rather than flexor tenosynovitis?

[@derekcraig3617]

@@HoopersBeta Yes, I'd be surprised if the flexor is involved. The swelling and pain is on the top of my knuckle. I've seen all kinds of people about it but no dice yet. I have had some progress with one PT through the use of density hangs.

[@ZackRaborn]

Nice.

[@HoopersBeta]

🙏

[@whitey3017]

Here is my first experience with tenosytovitus (currently recovering). The last few months I stepped up another climbing grade, but I could only do extreme crimps in that grade (which is 8a for reference). I've had longlasting crimping sessions 3 days a week for 3 months and yeah I feel this pain in my 3 middle finger tendons both hands. After I started feeling the pain I stepped down a grade but I still crimped a lot for again 3 days a week. I could still hold every crimp position, but full crimps and slopers hurt the most. I felt the pain increasing until something snapped all the way from my finger to my forearm (this happened after 2 weeks of having the pain). I am incredibly irresponsible when it comes to climbing haha, I have no regrets however because I view this as a good experience. And here I am watching this video, noting things down and rethinking my life decisions haha. End of story. What this video describes sounds very accurate to me. I hope my experience can serve as a lesson to someone. If you feel pain, just stop before it gets worse.

[@butaleo]

Hey! It's there a way to heal chronic tenosynovitis? It's been 1.5 years; (

[@HoopersBeta]

Certainly! Many treatment options are covered in this video, it depends on what you've already tried and what has / hasn't been successful. Working with a professional would be recommended if it's been that long, though.

[@boulderingace7952]

Damn! So this is what I had!!

[@HoopersBeta]

Could certainly be!

[@Veloxzr]

Perfect timing for me with this video, but is there any difference in how this should be treated if you only have pain during palpation? Judging by the rehab advice, I should be able to climb quite extensively because I don't have any pain while climbing, but doing so makes the pain during palpation worse and worse over time.

[@slam4444]

Did you resolve this? This is what I’m experiencing right now! No discomfort while climbing, tender to palpate/ stretch the fingers outside the gym.

[@Veloxzr]

@@slam4444 It went away following the regular advice of reduced intensity while still exercising it, but I'm still not sure exactly what caused it or if it's any different that the finger injuries they normally talk about. In my personal experience, continuing to climb hard on it caused the pain to just continue.

[@Cattiy19]

I am in exactly the same situation…

[@santi_super_stunts2573]

My experience is one day my finger started swelling at the joint where the middle and proximal phalanx meet. It felt like a bruise , but also like I had a splinter. I had immediately noticed my pulleys did not hurt tho as I could crimp as hard as normal. Only thing that hurt was when I would grab medium sized crimps because the edge of the crimp would dig into the bruised area. As the swelling went down I got a small cyst with puss. Eventually the cyst went down and what’s left is a small bruised feeling and loose saggy skin. I tore the dead skin off and now it’s just slightly bruised feeling. Before my finger was bruised I was climbing almost 5 days a week

[@maxlevelmedia7448]

5:11 It's confirmed. Wrapping injured finger is aid.

[@LiamRappaport]

Never had a pulley injury, but sometimes if I’m pulling really (extremely) hard through one arm and my hand slips or unloads excessively fast, my forearm (between the bones) feels like it’s about to break. It doesn’t hurt until after I slip though and I tend to stop the offending boulder after 1-2 painful tries. No idea what it is.

[@HoopersBeta]

Could be nerve! Or it's just a shock load response after the massive contraction is terminated rapidly.

[@cinerati0n]

I was training a ton of crimps to get a specific crimp problem at my local gym and got this. I'm on 2nd day of rest and it's feeling a lot better, but I know once I climb tomorrow it'll likely aggravate it a bit.

[@HoopersBeta]

Oof well be careful then! Try not to overdo it and exacerbate your symptoms further.

[@gabys680]

Can you do one on sesamoiditis??

[@gabys680]

love your vids!

[@HoopersBeta]

Thanks Gaby! That one may take us a while to get to since it is a niche topic. But we will add it to the list :)

[@catbabies9178]

Please what IS this machine

[@HoopersBeta]

It's an Ultrasound Machine! Real time imaging, woot!

[@drewhellams7894]

What about DIP/PIP?

[@HoopersBeta]

Not sure what you're asking, but if you're referring to PIP or DIP synovitis, that's a separate video :)

[@MrBoubource]

7:44 I may have been this guy 😬

[@stokmanology]

Ok I'm convinced I have this now. Definitely on the recovery, as the injury/ pain started in October. I have had great luck with H taping to reduce crimping on the effected finger. I tape two anchors, above and below the MIP, then place the H on the back of the finger over the MIP. Works great so far!

[@HoopersBeta]

Glad that it's helping you AND that it's recovering, but sorry to hear of your injury! Yeah that is one useful application of taping, reduce the amount of crimping on the target finger :)

[@sebastiang.4206]

Okay. So, following your steps to find out what it is, I have both and none of them 😅 damn

[@HoopersBeta]

Haha dang! Have any of the other vids helped? May be time for you to go see someone to help interpret your results.

[@sebastiang.4206]

@Hooper's Beta I will watch some this evening. Iw working time again. Thanks for responding. Yeah, it happenend two days ago. I'll give it a few days to see if it revovers