Climbing too much or on particularly bad holds can cause an overstraining of the flexor pulleys of the fingers (notably ring and middle fingers) This can be anything from a Grade I (strain) to a Grade III (complete rupture). Generally, if you have a Grade 3 injury you will have three phases of treatment. After graduating from Grade 3 treatment you will move to Grade II treatment, and finally Grade I treatment.

The grade based treatment and are just guidelines. You be the judge. If it hurt to climb, then don't climb. Avoiding pain is key to getting back to 100% (mild discomfort ok).

Grade III - Complete rupture of the pulley causing bowstringing of the tendon. Symptoms can include: Pain locally at the pulley (usually sharp), may feel/hear a 'pop' or 'crack', swelling and possible bruising, pain when squeezing or climbing, pain when extending your finger, pain with resisted flexion of the finger

Grade II – Partial rupture of the pulley tendon. Pain locally at the pulley, pain when squeezing or climbing, possible pain while extending your finger.

Grade I - Sprain of the finger ligaments (collateral ligaments), pain locally at the pulley, pain when squeezing or climbing.

General Notes on Treatment: (1) Go buy some TheraPutty! (Click here for link) All orthopedic doctors and physical therapists will recommend putty as a tool for successful recovery.

(2) The fingers generally receive poor blood flow so getting blood to the injured area is important. Contrast bathes have had mixed results in the literature, but it wouldn't hurt to try. To do a contrast bath, get a bowl of hot water, and ice water. Put injured finger in ice water for a few minutes, then place it immediately in the hot water for a few minutes. Repeat 3-5 times. Finish with the ice bath. This could be done after squeezing the putty ball to "flush out" the injured joint. Contrast bathes are probably more important in co-lateral lateral ligament injuries (pain on the side of finger) as they really get poor blood flow.

Grade III

Immediately
Stop climbing
Apply ice or cold immediately, no more than 15 minutes at a time (1-2 days)
Take ibuprofen for 1- 2 days. Inflammation usually isn't a big concern.
Keep the hand elevated

Week 1-2
Don't climb!
Don't immobilize the finger. Unless there is a lot of pain, open and close your hand often
VERY light massage at the site of the injury.
Concentrate on other aspects of your life.

Week 4-8
Warm the hands by use of a bath or an electric blanket, then squeeze the yellow (softest) putty. Don't push it, if there's pain…stop. Repeat a few times per day.

Go to Grade II Treatment.

Grade II

Week 1-2
No climbing
Warm the hands by use of a bath or an electric blanket, then squeeze the red putty. Don't push it, if there's pain…stop. Repeat a few times per day.
Lubricate and lightly massage at the site of the injury.

Week 3-6
Tape the injured finger, stretch your forearms (this relieves the stress on the finger tendons) and climb the biggest holds you can find. Start easy, this will be the quickest way to recovery. If you climb too hard, too fast, then return to the start of Grade 2 and do not collect $200. Always stretch your forearms after warming up and prior to climbing.

Start squeezing the medium to firm putty. Lubricate and massage the finger at the site of the injury. Start lightly and gradually increase the intensity using very short strokes on the injured site.

Go to Grade I Treatment

Grade I

Week 1
Tape the injured finger and continue to climb at a level well below your normal level. Gradually increase the stresses on the fingers. Stretch your forearms after warming up and prior to climbing. This relieves the stress on the finger tendons.

Squeeze the medium to firm putty a few times per day. Lubricate and massage the finger at the site of the injury. Start light and gradually increase intensity. Very short strokes on the injured site.

Take advice from a practitioner who specializes in climbing. However, if treated early and effectively, with an appropriately graded return to activity, recovery will usually take 3-8 weeks. However, if the injury is pushed beyond its stage of recovery, re-injury will occur and may result in a chronic injury that will require a much more protracted rehabilitation period.

Warm up thoroughly and stretch, paying particular attention to the elbow, wrist, and forearm.
Do easier routes and larger holds early in your climbing session.
Avoid overtraining (depending on how hard you are climbing, you may only want to climb every other day).
Take adequate rest and recovery periods (particularly if feeling ' under the weather').
Regularly massage the forearms.

Finger injuries are probably the most common of the upper limb injuries that are sustained in climbing. The large stresses transmitted through the flexor pulleys makes them more vulnerable. They can be traumatic or overuse in nature. Effective management is important for both climbing and everyday activities