Collateral Ligament Injuries
Beth, Thanks for the injury related post. It is interesting to hear of all the injuries that pro climbers sustain. It is not limited to us amateur climbers. I saw you mention an injury to your collateral ligament. I was wondering if you could expand on this in a future blog post. I am currently suffering from a collateral ligament injury to my middle finger PIP joint, and I haven’t been able to find much information on this injury, related to rehabilitation beyond splinting and buddy taping. How much time did you take off? What were your strategies for resuming climbing?
Hi Mike –
Thank you so much for your question. I am so sorry to hear about your collateral ligament injury. I’ve had two serious collateral ligament injuries on my left index finger (where I had to take off time from climbing) and one minor one on my right index finger (where I didn’t take any time off, I buddy taped for a couple weeks and it healed). They can definitely be a frustrating injury and depending on the severity, can take some time to heal. My first injury was a result of crimping really hard while training on my wall in my garage. I’m especially crushed if I injure myself in the gym, as there are no good stories to tag onto the injury. Luckily, my most recent collateral injury was back when I was working on Cosmic Debris (5.13b) in Yosemite, so I felt a little more rad with that injury.
Crack climbing can be especially damaging to collateral ligaments, torquing the joint sideways and putting an unusual amount of stress on the short, thick piece of connective tissue. Cosmic Debris was particularly hard on my ligament as the crack is too wide to get solid finger locks, and as a result I relied heavily on the my ligaments by ring locking.
First off, let me just say loud and clear that I am not a doctor. I am in no way shape or form a qualified medical professional. But, I have spent a lot of time and money tracking down the best advice to heal quickly from injuries over my two decades as a professional climber. As I put in my last post, I was lucky enough to be seeing Brenda Cummings when I injured my collateral ligaments. My first suggestion, depending on the severity of your injury, would be to try and find a good Certified Hand Therapist. They are gurus with hands, working their magic on some of the body’s most delicate and intricate parts. With my first, most serious injury, I took a solid two months off of any climbing. However, I’m not sure this is the best approach for everyone. I should also state, that I heal very very slowly. Perhaps it’s due to my extremely hyper mobile joints, or my genetic make up, but I usually am a month longer than the “typical” healing time. For me, unless easy climbing will actually help the injury (as with some pulley injuries), it is worse for me to climb easy than to just take time off. I am not diligent or restrained enough to hold back before I injure myself further. Dave MacLeod, who is doing ongoing research on climbing training and injuries, just wrote a very good post on not taking time off. It is very important to know yourself and how your body responds to things.
One thing Brenda has seared into my head is blood flow. The problem with ligaments is they do not get very much blood flow, and therefore take a long time to heal. As a result, I made sure to keep my cardio exercise as high as possible. Every time I went for a bike ride, I imagined blood pumping through my tiny little index finger and healing the ligament. It also served a great outlet instead of festering inside and not climbing. I bought a punch pass to the local fitness gym to lift weights. I made sure not to do any exercises that increased the pain. Push ups, abs, and shoulder exercises were all okay for my injury. I avoided anything where I had to make a tight fist, as that would give me a very intense sharp pain.
I buddy taped (taping one finger to another) all the time; while cooking, biking, running, typing (which was a challenge at first), etc. I wanted to restrict any sideways motion which would flare up my finger. The last thing I wanted to do was prolong my injury from snagging my finger making my bed or doing the dishes. I also wore a tiny finger compression sleeve at night to reduce the swelling.
I made the trek from Estes Park to see Brenda in Fort Collins twice per week for a month. Brenda would massage the ligament and also used cold laser therapy. This was all to increase the blood flow to the ligament. Eventually, I started strengthening using the easiest color exercise putty. I slowly built up to making a fist with the putty in my palm.
Initially, starting to climb again was a very slow process. My first few sessions were mainly to regain confidence in my finger, not to test how far I could push it. I buddy taped for a good month when I started climbing again. For me, there was no reason to risk damaging the ligament again while I was building up strength and stability in the finger. I started climbing very easy on jugs and any hand hold that wouldn’t force my finger to be strained in a sideways position (gastons, hard pinches, and crimping). Gradually, I built up to smaller and smaller holds, and eventually crimping. It took several months before I felt confident enough to climb finger cracks, but those are the most severe on collateral ligaments.
I wish you the best of luck with your recovery. Remember to be patient with it. I know I always get frustrated with finger injuries as they seem so inconsequential and so small compared to other body parts. But their health and strength are vital to our sport. Please don’t hesitate to ask other questions or let me know how your recovery is going, I’m more than happy to help if I can.
All the best,