Finger Injury Part I: the Perfect Storm

Finger Injury Part I: the Perfect Storm

Well friends, the time has come for me to join the ranks of the climbers who have come before me. I have my first finger injury.

Though I am a little bummed, this shit happens. So I might as well share my experience with you guys. Plus writing gives me something to do besides agonize about when I’ll be back to normal again.

I’ll be providing updates on this as I go, but let’s start from the beginning.

What happened?

It all started during a hangboard session. I warmed up like I always do. Then all of a sudden, on set three out of five of my max hangs, my left middle finger hyperextended at the knuckle – the distal interphalangeal (DIP) joint to be exact. It felt a little off – 5/10 on the pain scale, but nothing too extreme. I proceeded with the rest of my session. and was able to do my remaining hangs, with some pain. I trained as usual for the rest of the week.

A week later, some mild pain persisted, and I was working on a crimpy limit-level boulder. When I pulled down hard on one of the crimps, the same pain shot through my finger. I did not hear a pop, but I knew something was not right. It was the same feeling of hyperextension, only much worse. At that point, I decided that this was truly a problem. And so the healing process began. My finger was a little swollen and sore for a about 48 hours after.

But before we get into what caused this “Perfect Storm” (as Coach Hรถrst might say), let’s talk a little about the diagnosis.

An illustration of the finger joints for your reference.

RIP to my DIP

After discussing with a medical professional who is well-versed with climbers, I got this diagnosis: “chronic DIP joint cartilage defect”. To translate, the cartilage in my fingers is beat up from overuse. In preparation for a crimpy project in Rumney, New Hampshire, I have been dong a lot of crimping. While the crimp position (half or full) is critical for climbers who want to perform to the best of their ability, it is more strenuous on the hands than the open-handed position. Essentially, when we crimp, the cartilage in our finger joints gets compressed. Which, in my case, lead to my injury. Below is an illustration to give you an idea of what is going on between the knuckles.

I do not have arthrosis, but this visual sums it all up, albeit dramatically.
I sincerely hope my finger does not look like that on the inside…



With the diagnosis out of the way, let’s examine the perfect storm that lead to my injury.

The Perfect Storm

Since this is my injury and my blog, I’m going to go ahead and play Monday Morning quarterback
Injuries are multi-faceted, so here are the main factors that lead to mine, in my opinion.

  • Training load
  • Excess stress
  • Lack of sleep
  • Hormones
  • My ego

We will now break down each of these factors. Perhaps this will help you in your future endeavors – it might even prevent you from making mistakes of your own.

Training Load

As I write this, I’m working on preparing for a trip to Rumney, New Hampshire. Many of my project routes are crimp-intensive so my coach has intelligently programmed style-specific training. Which is great and makes a lot of sense. But notably, I have been doing more crimping than I typically do and I am hanging on a smaller edge than I have in the past. These progressions make sense for what I am training for, but it is a change in the stress I usually put on my fingers.

Throughout the training cycle, I felt really good. No signs of excessive fatigue and the numbers/quality of my sessions were improving. The training is obviously a factor in this, but I am good at taking my rest days and the training felt appropriately dosed.

In my opinion the 4-5 sessions per week I was doing were controlled and made sense. The training was a factor, but to me it was one of many. Perhaps without some of the other factors we’ll discuss, the training load would have been perfectly fine.

Stress

If you haven’t noticed, big changes are happening around here. In July I launched my coaching services, the website got a makeover and I rapidly started my coaching career! Which is amazing and I am so grateful. But I’ll let you in on a little secret: keeping a full-time job, adding another full-time job to it, and training for climbing is taxing on both the mind and body.

I have been exceptionally stressed lately and short on time to do anything about it. I’ve had stomach aches, headaches, my anxiety has been a lot worse than normal. I asked a lot of myself and my body could not keep up.

Of course, I love my clients and my business, and I would not trade this for anything in the world. I say all of this to point out that if you are severely stressed out a lot of the time, it is reasonable to anticipate that it could impact your training and your ability to recover.

Lack of Sleep

If you are an athlete you need to sleep like one. Unfortunately in the past month, I have not taken my own advice. As a coach, an athlete, and a full time project manager, some of my normal sleeping hours did not fit my schedule anymore.

Usually I like to sleep for 8+ hours each night. This works for me. In the heat of getting the business up and running though, this was cut down to about 6-7. Which still seems reasonable. I would say that this allowed me to survive, but not thrive. In the weeks leading up to my injury, I was sleeping less than I normally do. I would be remiss not to mention this important factor.

If you want to see a more concrete discussion on the relationship between sleep and athletic performance, here’s an interesting study examining this in relationship to professional Mixed Martial Arts athletes. Particularly interesting for us, since MMA fighting is similar to climbing in that it is a high-skill sport requiring command of a variety of energy systems for peak performance. Sound familiar?

Hormones

This is my favorite one to talk about because to some degree, I can’t do anything about this one. Ha! Let’s dig in. We all know that for the menstrual cycle in women to occur, there are hormonal changes occurring throughout the monthly cycle. One hormone that I found particularly interesting is Relaxin. Here is how this hormone is defined by the Society of Endocrinology: “Relaxin is a hormone produced by the ovary and the placenta… In preparation for childbirth, it relaxes the ligaments in the pelvis and softens and widens the cervix.”

Relaxin levels increase in the second half of the menstrual cycle. In this paper on the effects of relaxin on musculoskeletal systems, it states

Relaxin appears to decrease knee articular cartilage stiffness… Taken together, these findings suggested that in females, increased relaxin levels may result in undesirable effects on the articular cartilage.

The effect of relaxin on the musculoskeletal system

And you’ll never guess when my finger injury started…. The second half of my cycle.
Coincidence? I think not! You can refer to me as cartilage Nancy Drew from now on. I won’t mind.

A real page turner, guys.


My Ego

Lastly, let’s talk about the impact my ego had on my injury. Want to know what happened just before I really destroyed my finger? I am completely embarrassed to tell you about it, but it might save you the same mistake, so I’l sacrifice my pride and spill the beans. Right before my limit bouldering incident – my finger started showing some warning signs. It was hurting in my first attempt at this limit boulder. And I ignored it.

I was so close to sending my first V7 in this gym. And it was about to go down in two tries. My ego needed this validation to prove outright that my training was working. I taped that bastard up and pulled back on, even though my finger was already aching. Like clockwork, as I crimped down hard on the final crux hold – severe pain started shooting through my finger. I was off the wall and cursing myself faster than you can say quickdraw.

Even though my gut was telling me that I might need to be done with my session early – I could not resist getting a “gold star” for the day. This one mistake might have prolonged the healing process. I won’t go around dwelling on this, but goddamn, I will not ignore my instincts again. If your gut is telling you to be done – listen to it. Or your ego might screw you over in the meantime.

A PSA FOR ABSOLUTISTS
Notice that in my breakdown of my injury, I did not demonize any one training aspect, this is much more complex than all than any one part of my training. Did the initial incident happen on a hangboard? Sure. Did it get worse when I was crimping on a hard boulder? Yes. But does that mean that hangboarding or bouldering are “bad” activities? No. That’s ludicrous. As you can see from the above, injuries are a lot more complex than any one training methodology. Please don’t be dense enough to think hangboarding is evil. A medical professional is advising that I use a hangboard to heal myself for crying out loud. Injuries typically happen because of training volume along with many other factors. Additionally, dynamic loads (making dynamic moves while climbing) can sometimes be the straw that breaks the camel’s back.

Thank you for coming to my ted talk.

Forecasting storms

I hope that sharing my experience helps you forecast your own “perfect storms”. I will keep you all updated as I rehab and recover. Injuries are opportunities. I’m making mine an opportunity to help you learn from my mistakes and my recovery process.

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Resources

https://trainingforclimbing.com/podcast-39-climbing-injuries-a-perfect-storm-brewing/

Sleep Data, Physical Performance, and Injuries in Preparation for Professional Mixed Martial Arts

The Effect of Relaxin on Musculoskeletal Systems

Your Hormones: Relaxin

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