Finger Injury from Climbing: Advice from Doctor of Physical Therapy, Matt DeStefano


Recently I decided to up my training game
from the hangboard to the MoonBoard. For those who don’t know what a MoonBoard
is, it’s basically a steep wall with small crimps and small pinches. Compared to the hangboard, climbing on the
MoonBoard is way more intense on the fingers, but at the same time, it’s so much more
fun so I made the mistake of training hard on it for too long. I trained on the MoonBoard for one and a half
hours last weekend. After that, my left ring finger felt sore
for the entire week. Even though my left ring finger didn’t feel
a hundred percent this weekend, I made a bad decision to jump on the MoonBoard again because
I was mad about being shut down by a particular V4 route. I made a dynamic catch but I slipped the foot. Somehow I decided not to let go of my hands
maybe because it was one of the rare times that I was able to stick the low percentage
start move, so I thought it was my chance to send it, and then my left ring finger popped. It was loud and it hurt. After 11 years of climbing, I got my first
major finger injury. I went to my primary care doctor and the good
news is that he doesn’t think the injury is so serious that I need to get a MRI or
X-Ray. In order to have my finger injury fully diagnosed,
I decided to reach out to an expert, Matt DeStefano, a doctor of physical therapy specializing
in climbing injuries. I had a super fruitful one-hour session with
Matt. However, to make the video not too long, I
will skip the part where he diagnosed my fingers and taught me the details of the finger anatomy. I’ll show his advice on what action we should
take after having a finger injury. It’s probably more of a tendon strain instead
of a pulley injury. Because of where you are feeling the pain, the stress test that we
are doing, it’s pointing more towards the tendon, specifically the flexor digitorum
superficialis. Because we are still in the acute phase of the injury, what you wanna work
on right now is a lot of antagonist training, so we are talking about the finger flexors,
so you wanna work on the extensors. I would stay away from anything that’s gonna
be flexion based, so you are gonna dig your hands into the rice bucket. You are gonna
extend your fingers out and then you are going to pull up. Extending your fingers in the rice is gonna
be an exercise in and of itself, but then keeping the fingers extended as you pull them
back out of the rice is also going to work those muscles. To have a strong power grip to be able to
hold onto the crimp, we need roughly 30 degrees of wrist extension to have that power grip.
So if you have your wrist at neutral, you can really only do so much, but if you
come back into this position, now you can get a little bit more of a grip with your
flexors. These muscles do that. If you have a dumbbell, you can just do some wrist extension. So now
that you are rehabbing a finger flexor issue, you wanna focus on the antagonist. If there’s extra pressure from that pulley
on the healing tendon, then it’s just going to slow down the healing process, so we can
get a little bit of support here. Then it’s gonna help out. I think the finger taping for maybe another
4~5 days will be enough, just to get you out of the acute phase. And
if you do notice any swelling or anything like that, if you feel you wanna use some
ice, by all means. Some gentle tendon glides like this can also
be helpful as long as it is pain free, so if you have the protection of some tape, then
I think that will be good to do. You are not really squeezing very hard. You
are just gliding the tendon. You are basically just keeping the tendon
moving smoothly through the pulley. That’s just gonna keep scar tissue from building
up and keep it from getting tight down the line. If it were a pulley injury, we wouldn’t be
doing this this early, but again we are not necessarily looking at a pulley injury. We
are more looking at a tendon injury. Here is a often overlooked thing to work on
when we are talking about finger injuries. So sometimes when we have weakness in one
of our ankles, one of our legs, and we are trying to stand on one side, you know just
imagine if you are in that position and you have a lot of pressure on that foot, but it’s
kinda weak and it pops, and all of a sudden we have a lot of pressure on that hand, so
in the coming weeks, spend a lot of time on single leg balance exercises. This is information
from the climbing doctor, but it’s a really good warmup. You can do things like, standing
on one leg and doing flag exercises to work on the strength of those muscles, but you are
also working on that balance, and then you can also work on reverse flag. We are going
the other way. A lot of times people like we are talking about my hand, why are we focusing
on my ankles and stuff? It all works together as a system, so if you have a weakness down
here, it’s just putting a lot of stress on your hands and your fingers, so we want to
make sure that we are targeting everything. Lastly, I just want to tell all of you that
getting injured is not fun. My V7 project comes to a halt. My quest for a strict bar muscle-up also comes
to a halt. It’s just frustrating, so make sure you
don’t climb too hard and make the same mistake as I did. Also, Matt would like to remind you that these
4 tips are just for what happens early on in the process, so stay tuned for later rehab
information as the weeks go on. Matt recommends seeking the advice of a medical
professional for any injury before starting your own rehab process in order to ensure
that you’re on an efficient path to recovery without making the injury worse. If you’d like to get in touch with Matt for
a session, feel free to email him. He offers remote video treatment sessions,
and if you happen to be in San Diego, you can also visit him at the Mesa Rim co-working
center. Also, I am curious to know whether you have
suffered from a finger injury before. If you have, let me know in the comment section
below. See you in the next video.

72 Comments

  1. Any tips for an elbow injury? Feel like I strained a tendon in my elbow climbing. Been icing, resting, and doing some light pt to it, but wanna know if you have any tips

  2. That’s how I got over my injury, too! I messed up my finger after moonboarding and I just rested and iced but it wasn’t until more than a year later than I gave the rice bucket a try that my fingers have really gotten better than before I injured them. I also added heat to contrast with my ice baths for my hands along with finger stretches and I’m coming out of my two-year plateau.

  3. Very informative, thanks! Been dealing with a pulley injury for the past few months and have kept it taped since, it sucks!

  4. when my left middle finger popped it wasnt realy painfull. it felt quite dull. moving was possible holding stuff was all fine, but when i started to climb i couldnt hold V0 holds with this hand :'D 2 weeks complete of, splinted the finger. after that reeeeeealy slowly getting back to climbing, starting at like 0 with the left hand(even taped), while i nearly hold everything with right. sometimes even stretching the middlefinger away from the hand so i couldnt strain it. after like 2 month it was getting better, but the pain always returned when i started harder climbs or dynamic stuff with that hand. took me about half a year to realy recover from that. i started climbing without tape after like 4 month to accustem my finger again to the forces… but often had to tape again after a while.
    well i guess u will know better next time. i climbed 3 days straight when this happen. and even the moment it happend i felt stronger then ever before. dont overestimate yourself, i learnt. and give your hurting parts rest.
    im getting old x)

  5. I feel like the tests diagnosing the injury would make a (long) but extremely useful video. Having just injured my finger I spent a good amount of time looking through materials on it. At least as far as videos go there wasn't really anything I found detailing diagnosing an injury that was particularly useful. There are some podcasts and blog posts on TrainingBeta however without video it can be difficult to visualize. I did end up diagnosing it by using the book 'Make or Break' by Dave MacLeod which is a fantastic resource for those who are in need of the information.

  6. A very similar thing happened to me. If you haven't come across it already (which you probably have), I would recommend Esther Smith's protocol for healing tendon injuries. After a lot of time just resting the injury and seeing no improvement, I started following her instructions and have been seeing improvement quickly. She goes into her methodology in detail on The Training Beta podcast (episode 76) and its in writing here https://www.blackdiamondequipment.com/en_US/esther-smith-nagging-finger-injuries/esther-smith-nagging-finger-injuries.html. For me, instead of doing two finger pockets on a hangboard I use a no-hang device with weight cuz I feel like its more controlled but the principle is the same.

  7. Im not a climber, but i had to learn ropeclimbing for a "Tough Viking" (Obstacle Course Racing) and trained to much for several months and i think i sustained an similar injury as in the video.

  8. I have climbed 5.13 for 27 years (up to 13d) and climbed for 40, and have never had an injury. Currently working on my first 5.14. No one else trains like I do and no one else that I know of has such a long healthy climbing career.

    Good luck on your recovery.

  9. I ruptured one or two pulleys 8 weeks ago and my right ring finger still isn’t right. Still feels pretty weak and occasionally tender across the pulley.

    I initially taped it for 10 days, iced it, elevated and have since kept it moving, used rice buckets and more to strengthen it. I’m considering climbing easy stuff now, but it’s a long old process!

  10. Keep up the great work! Your videos are super helpful for the average day struggles of a climber. It was also nice meeting you at your climbing gym.

  11. Really looking forward to your update. I’m planning to start climbing when I’m done with my deployment. In addition to researching techniques and tips for beginners, injury prevention is another area I’m studying but honestly haven’t seen too much of. Geek climber fan #1

  12. Nope-never had finger injury-only flappers. 🤣Oh man-that sucks. Good though it’s not severe? Liked how the doc mentioned balance of feet/legs to hand-makes sense. Great vid. 🙏🙇

  13. This is so unfortunate!!! I did a V5 with two finger pockets a couple of times yesterday and my finger still feels a bit tweaked, so I'm with you on the finger problems. I hope our fingers recover soon.

    I know of a climber called Dave Macleod who has, if i recall, injured all of the fingers on both hands throughout his career, and as he got older, he stop getting injured. He attributed this to diet, sleep, and recovery. He has a lot of content up on youtube and a personal blog. Maybe it would be a good idea to check it out? He is 40 years old but still climbing very hard grades in a very large range of disciplines. I'm not sure if he has as much content on non-pulley injuries though.

    (also this is the first time I saw grotto in your videos, isn't it such a nice cute small gym but literally equipped with everything?)

  14. I had a similar injury about two months ago to the same exact finger. I am curious how you (or Matt) were able to distinguish between a pulley and a tendon injury. Could you explain more about that and how the treatment differs? Good luck!

  15. I’m a lucky duck and my family has insane tendons for some reason. My sister and I have been able to hang from two fingers for as long as I can remember. Now that we have both been climbing for a few years we can both put full weight on mono pockets for a good 10-15 seconds. Ive ripped a LOT of skin from my hands and have even broken both of my thumbs. Still no tendon injuries thank god. Hope you get feeling better man.

  16. currently recovering from a strained tendon myself (left ring finger as well) and not climbing is the hardest part. I'd love to see follow up vids and I guess its time to do more antagonist training…

  17. Thank you for sharing this bad experience! It reminds us to not train hard until we feel totally exhausted to lower the risk of any insuries. Every climbing and strength exercise should be done with correct movement. Maybe more than a 45 to 60 minute moonboard session is too much.

    I hope you have enough patience and your finger will fully recover!

  18. Have you noticed any swelling in your pip joints? Ive got two or three and been doing rehab and physio for a year but no improvement

  19. great video. I had a similar recommendation for ankle strengthening exercises, but doing it with your eyes closed. I was amazed by how much more difficult it was. Hope the rest of your recovery goes well.

  20. Injuries suck. I got golfer's elbow last year from pull ups. Its mostly gone but sometimes likes to remind me that its there when I do high rep bent arm pulling

  21. Awesome video. Been there too on the finger injury. Both strains and tears. I wish someone would have told me sooner to work on balance and footwork.

  22. On the flipside of rehab, can you make a video on injury prevention? Matt would be a great help with this too I'd assume.

  23. Whenever my fingers feel a bit sore, i tape them up and climb really easy routes on a 90 or less degree wall and basically train endurance.

  24. thats unlucky i had a big ankle sprain from climbing as a sorta major injury but that was few years ago and got over it though i nearly did the same ankle not long ago i got a semi sprain but that was nothing it was good in less than a week 😀 yet to get any major hand injuries, i had a very sore wrist from slopers but i just kept on doign them and got over it and now i have no issues with that

  25. I injured my FDP tendon about 6 months ago now. Very interesting to learn about crimping mechanics through that, as I could full crimp and half crimp painlessly but open hand crimp was painful.
    I found the point about wrist extension during crimping very interesting and explains why I sometimes get posterior wrist pain during crimping hard.

  26. Yup.. i fell and ruptured my tricep during competition. 6 month recovery and im back at the wall but i dropped 2 grades and not even 100% yet

    Sucks but kind of fun getting my basics down again

  27. Thanks for those extensor exercises! A full series of injury prevention exercises with Matt Stefano would be much appreciated. It's about time you start it for yourself (eg lack of antagonist strength hinders strength development), and would be very good promotion for Matt (found no YT channel).

  28. Yeah the moonboard is pretty brutal. I have no self control so I've done some 3 hour sessions on it and my fingers hurt the next day

  29. Same thing happend to me yesterday, but on the right hand. I was trying really hard on the hangingboard and tried to hang with only 4 fingers on a small crimp, which was tbh way out of my league, then suddenly my ringfinger made a loud noise and my hand snapped. Luckily it's also just the tendon and not the finger pulley :).

    Wish you a good recovery.

  30. I have a painful spot in my right ring finger. Where was the pain you had? Mine was at the base of my finger.
    Did he say whether these exercises would work for increasing finger strength as well as rehab. I like the rice idea. Great video🤠🤙

  31. The timing is insane, just having my first finger injury as well and it's not nice… For me though there was no 'one moment' where something popped. My middle finger just started hurting a little bit in some situations.

  32. Please give more rehab info, I have my own physio but I've had a finger injury myself and would greatly appreciate another point of view

  33. Hey, you may want to take a look at blood flow restriction as part of your recovery. I have the exact finger injury, been out for 3 months and it was very painful. My PT recommended to include BFR, as it allows to keep the muscle strong, by working type 2 muscle fibers, as the restriction creates hypoxia and therefore forces the muscle to recruit type 2 instead of type 1 muscle fibers. You can look at training beta’s article about that type of training for rehab and also the climbing doctor. Good luck with your recovery.

  34. I’m trying to recover from one and it’s been like 2 months and it skill keeps bugging me I don’t really know what it is but I completely understand the frustration

  35. Seems like climbers are notorious for getting psyched about an exercise or problem or route and then going to hard for too long and getting broken as a result. The best idea is to be honest with yourself about your level of overall fatigue. Either from a single sesh or over the course a training block, if you are not aware of how fatigued you are, you will get injured. Every time I get injured, it’s because I was really tired but felt I needed to keep pushing.
    In terms of rehab, keep it moving! I always have a few rubber bands in my pocket to put around my finger tips do extensions with, injured or not. Eccentrics are really good building strength through an injury too. You can still do pull-ups and other types of pulling if you use straps that are used in olympic lifting. This will take the work off your finger. There are plenty of work arounds so don’t lose hope!

  36. No finger injuries yet but I'm starting to get worried as I'm doing more and more crimpy climbing. Could you do a video or link me to another video about how to properly crimp and workouts other than climbing or hangboards.

  37. The same thing happened to me almost 2 years ago (I heard a distinct pop). My physical therapist asked me to do an ecography to have a sure diagnosis, I honestly think it's mandatory to do that kind of check. Luckily it was just a small wound to the pulley, but I could not climb for 3 months. Be very careful, because if you break the pulley you will not be able to climb for one year…

  38. I got "trigger finger" from exercising on rings. My pinky always pops when I close it. The only advice and aid I got was squeezing through finger exercises. Been like this for a month.

  39. 3 months ago something popped in my elbow while doing a dead point and I fell off the boulder. I still have a little pain, especially after I’ve been climbing pretty hard but I’m finally seeing a physical therapist. Climbing injuries are the worst! I’m starting to think our bodies weren’t made for the eccentric moves we put them through 🤔

  40. Dude I literally did the exact same thing just over two weeks ago!! However, good news is, if you’re serious about your rehab exercises as well as proper nutrition and rest it will heal up in no time! (Also depends on the severity though lol) I climbed a 5.11a today with no problems at all. Good luck with your recovery 💪🏼

  41. I climb at your gym. I also had a big pop last Tuesday the 27th. I'm getting an MRI and seeing a hand doctor this week or next. If I see you at the gym I will let you know how it's going. I was bouldering on the orange V3-V4 as soon as you walk into the bouldering area. Good luck

  42. Oh no! Sorry to hear this! I missed the video when it came up. (I think it took me weeks to watch all the Hachioji videos!) Get well soon!

  43. totally interested in seeing more of Matts advice… having finger joint paint on my left hand already for years and unable to get rid of it

Leave a Reply

Your email address will not be published. Required fields are marked *