Diagnosis
Despite the ever-increasing popular it y of our spor t, there is stil l a l ack of knowledge among healthcare practitioners about what climbers do and what injur ies we get. When assessing a climber with a histor y consistent with a pul ley injur y, I f irst look for the fol lowing physical signs: pain, swel ling, tender ness and sometimes br uising at the base of the f inger; pain increase with cr imping or direct pressure on the pul ley; less pain when gr ipping with open f ingers; and bowstr inging of f lexor tendons across the middle joint.
After reaching a diagnosis, I conf ir m it with i maging tests. X-rays should be ordered to r ule out a f ract ure of the bone. When I was a surgical resident, we reviewed al l scientif ic English language studies to deter mine the best diagnostic test for climber’s f inger. We found that dynamic ultrasound and mri are best for diagnosing this condition, provided that the radiolog ist per for ming and reading the test is experienced with these t ypes of injur ies.
To summarize, climber’s f inger is the most common injur y in rock climbers. It is a treatable condition, but is best prevented through safe training and climbing practices. If you have a f lexor pul ley injur y, the surest way to a swift recover y is through early, accurate diagnosis and patience i n adher ing to a super vised treatment plan.