18 February 2010

Icing - for tendon strains and other injuries

A lot of climbers get in touch asking about using Lewis reaction icing on other injuries besides finger pullies. The goal of the treatment is to increase blood flow, which if done well it seems to do very effectively. I’ve written recently about using it on elbows with the aid of a nearby bathroom wash basin. But what about tendon strains?
It seems nearly all tendon strains in climbers happen in the ring finger when using an openhanded three or two finger pocket grip with the little finger not used. The pain is a highly unpleasant twang that runs variously through the finger, palm and forearm right back to the flexor muscle belly. Can you assist healing this whole structure with Lewis reaction icing? The short answer is I don’t know. I’ve not seen reports from other climbers of it’s successful use. The last time I had a flexor unit strain myself was about 9 years ago and I was doing Lewis icing on the same hand at the time for a separate pulley injury. I couldn’t really say how much the icing helped. Possibly not that much, evidenced by lack of responsiveness of the pain level to adhering or skipping the treatment and the fact that the pulley had healed in around three months and the flexor unit strain took over a year to heal.
The tendon seemed to respond more to frequent stretching and long gentle warm-ups. And it didn’t slow my climbing down to much by strict adherence to using four fingers only on holds, either crimping, or with four finger openhanded grip. I’m researching this in detail right now for my book and will hopefully have more on this soon.


Sid said...

It would be great to know more about this type of injury. About four months ago, I pulled my ring finger in my right hand pulling hard on a two finger pocket. Accompanying the pain in the belly of my muscle was a pain at the base of my ring finger. I have since taken it very easy on the finger since then... However, about a week ago, I tried pulling on a shallow pocket and I felt a pain in the base of my ring finger. It's annoying because its not debilitating, but it prevents me from pulling hard on shallow pockets. Any idea what it might be?

Brian said...

Interesting post. A few days ago I strained my right ring finger in just the fashion you described (pulling on a 3 finger pocket). This has happened a few times, and I always attributed it to a lack of stretching and proper warm-up (which I usually do, but I have noticed that I didnt during the occasions I injured myself).

Two other things I have noticed.
1. A few days later, anything that gets the blood pumping (even a long (30-60 min) walk) makes a huge difference in the short term tenderness.
2. This time (vs. previous times) I stopped all climbing IMMEDIATELY. The injury feels less severe as a result.

I will be interested to read more.

Ian said...

I'm experiencing this exact type of injury right now. Last month I was holding on with my left hand using a three finger open hand grip and felt some pain at the base on my ring finger - there was no swelling, extreme pain, etc. It was just very tender when I pulled on it. Consequently, I took two weeks off from climbing completely and on my return, I made sure to tape around the base and just beneath the middle knuckle, which seemed to do me well. I also focused more on warming up, stretching and limiting any hard moves with that hand.

I've tried the cold water treatment described in a previous post; it seemed to help, but it's difficult for me to find time to do that.

One other thing - I'm 4 weeks into taking 2 tablets (daily) of Glucosamine Chondroitin. I'm not sure if that has anything to do with it, but I do feel like I can start to train harder with it (apparently it takes 6 weeks to feel any effect).

Very interested to hear more on this! I miss the campus board :(

Ian Evans said...

Perhaps submerging the entire forearm would be the way to do it for a flexor strain?

I've got such a strain in my right ring finger. Maybe I'll give it a shot for a month and see if I notice any difference. Of course, I've never had one of these strains before, so I don't have anything to compare results against.

Chri said...

I had such a tendon strain about a year ago when me feet slept away and while falling down I somehow managed to snag on a handhold with my ring finger unintentionally.

However for this injury I didn't really rest and nevertheless managed to be completely painfree after about 6 month.
Actually I focused a bit more on ice-climbing in the beginning but shifted back to rock as the spring came in.

I started to crimp much more than necessary.
If there where 2- or 3- finger pockets which had to been taken openhanded i really completely refused to using my ring finger for about half a year.
Furthermore i used a bit of taping - the best result seemed to have some taping around the wrist in the longer term.
Whereas i used a long stripe of tape along the strain fixed at the finger, the wrist and the beginning in muscle belly shortly after the accident which showed great effect too.

Brion said...

3 things:

1. I strained my right ring finger in the same way, immediately took two weeks off climbing and then eased back into it - mostly traversing on jugs. I used the cold water treatment for about 6 weeks following the injury and I didn't experience any noticeable results.

2. As Brian mentioned my finger also felt better after physical activity whether it involved the use of my finger or not.

3. It was 3 months before I was climbing at my limit again. It's been nearly a year now and my finger is still not 100%.

Anonymous said...

Omg, Brion one year? uh, I have same stuff, 2 of my fingers fell off while i was on and untergrip, and i got a strain on 2 fingers, from the fingers to palm to the end of the elbow! i couldn't touch my finger with the other, i felt the pain in the whole arm. I used ice immidiately, and..its about 1 month now, i can crimp, its no problem (the problem is that i have crimp injuries usually, I'm very strong at open hand..so this a huge punishement for me).
I can't grab anything open hand..or squeze something, pain comes immidiately. So, one year and ure stil not 100%?...shit..

Brion said...

Its just that I still cant grab all holds with two or three fingers. 4 fingers is perfectly fine and three fingers may be ok depending on the hold. My climbing hasn't slowed down at all, I just stay away from pockets.

Scott said...

I suppose I'll chime in as well on this, since I've suffered the same injury.

It actually happened during a crimp, to my ring and middle finger. There were several loud pops, a shooting pain down my arm and I fell right off. I had hyper-extended the first knuckle on both fingers which sprained the tendon all the way down to the wrist. I couldn't pull, squeeze, or do much with my hand for several weeks. There was a lot of swelling too. I used mostly ice during this period without much luck.

I went to the doctor about a month later and was given Celebrex and hand therapy for a month and a half along with no climbing.

The therapist used a mixture of hot and cold therapy. She would warm my hand first using parafin wax dip or heat pads for 10-15 minutes. It would be followed by a series of pinching and stretching exercises along with forearm strengthening exercises. The session would end with icing.

The results from the therapy and not climbing for several months were pretty dramatic as I quickly regained strength and lost the majority of the pain. The doctor said the soft tissue injury takes up to 6 months to heal and up to a year for nerve damage. I still experience some shooting nerve pain after working hard boulder problems that involve hard crimps and pulls.

JThibeau said...

When I first started I had a lot of trouble with my left elbow getting swollen and being really sore. I went to the doctor and she said just use ice and ibuprofen and take it easy. I found the best thing to to is warm up and stretch just as you said.