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The palm of Phil’s hand hurts after climbing so The Guru suggests a splint and strengthening programme

Apr 21st, 2015

Hi, I’ll try to include as much detail as I can:

About 6 months ago I started rock climbing; about 1 month ago after finishing
a session my hand hurt. I let it rest for about 2 weeks, until it felt pretty
much fine again. I went climbing again, and the next day the pain had
returned (it didn’t particularly hurt when I was actually doing the
exercise). It doesn’t seem to recover any more. I’ve seen two doctors since,
both of whom examined the hand and determined that there was no swelling, no
pain when squeezed, no breaks, no finger injuries. Generally, I can move,
push and grip things without trouble.

Specifically, it hurts when I grip things in a certain way and put pressure
on it (for example slicing bread, using door handles, opening tight lids).
When it seems to be getting better, one bad movement seems to put me back to
square one. It hurts most when squeezing (not particularly hard) by pushing
the right and left side of the hand together.

I’ve been recommended physiotherapy, which will be expensive, and prescribed
anti-inflammatories. Unless I take 2 or 3 full weeks off work (which I won’t
be able to justify), I’m not going to be able to immobilise it or properly
rest it. Is there anything else I can do? Is there any chance it will recover
on its own, given time?

Many thanks,

Phil

 

Apr 21st, 2015

The Guru Responded:

Hi Phil

 

Hands can be notoriously tricky – that’s why I’m going to hot potato this to my chief hand therapist, Lizzie.

 

She’ll have a much better clue – one thing though, where about in the hand does it hurt and what does it feel like?

 

Lizzie offers her words of wisdom:

Hands can take a beating when it comes to climbing, particularly in the palm of the hand. If you are fairly new to climbing it can take time to build the strength and endurance required.

 

The palm of the hand is made up of a complex structure called the flexor sheath. The sheath consists of pulleys that keeps the tendons close to the palm of the hand and tubes between the pulleys that allow your hand to stretch and compress with different grips.

 

Often with climbing the majority of the bodyweight is through your fingers putting a great load through the flexor sheath.

 

If you have excluded any bony injuries, you may respond well to a period of time in a custom made splint (from a hand therapist). This will prevent excessive loading and further trauma to your flexor sheath to allow the irritated tissue to heal. Sometimes taping the palm of your hand to keep the tendon closer to the palm may help to reduce the irritation of the flexor structures too. After a period of rest this must be followed by a graded strengthening program and a review of your climbing technique. It may be worth checking in with a Physio to see if there are any issues with control of your shoulders and neck that may be contributing to the overload issue in the first place.

 

If things do not settle it may be worth exploring further with an MRI scan to find out the structure causing the problem.

 

Good luck.

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