Finger tendonitis

How hard did you climb after resting? I had a tenosynovitis (German: Sehnenscheidenentzündung) around early April. Right now I think I'm able to climb "normal" again i.e. rehabilitation and building up finger strength. But I'll still make sure not to overdo it. I rested for at least 3-4 weeks, after that I only did really easy routes (which means for me: maximum 5c, I used to climb 6b-6c). But you shouldn't look at the grade, rather make sure not to have any pain in your finger. I considered everything above a slight "yes I'm still hurt"-pain as bad and stopped immediately. But then again I don't know too much about the healing process of tendons... Get well soon!

Thanks for your reply. Yes, I meant tenosynovitis, not tendonitis. I probably climbed too hard too soon, both times. At the first time climbing after the rest I took it easy and realised there is no pain anymore so the next time I already climbed hard and the pain came back. I think I will do another rest for 4 weeks now and after that at least two more weeks of very light climbing. Anyone else experience with the healing of tenosynovitis?

If it's a tenosynovitis it usually takes long to heal (for me it took 3 months now). When you start climbing again be really careful not to climb too hard. Everything that causes more pain will set you back. Take small grade steps, warm up properly, stick to big jugs. I don't know if taping does help with that, if you do: use schöffl's annular ligament (Ringband) taping (X-taping?). google for "ringband taping", first hit should be link to a pdf where it's explained. Although it says it's good if your annular ligament is inflammated I've read somewhere that it should help with tenosynovitis, too. Another hint: Volker Schöffl's "So weit die Hände greifen" (engl: "One move too many..") is a good book on any climbing related injuries. I'm still waiting for the new edition that should come out soon, but if you have a friend who got it you should have a look at it.

Hi, I have found this old post meanwhile I was searching about tenosynovitis online. I have it right now in my middle finger since nearly 2 months and I have stopped climbing since one month. It has improved a bit (pain in daily activity has nearly gone) but the base if the finger is still swollen. Beside resting, I have done PT treatment and local injection of arnica. I have done also under-water ultrasound therapy but I think that resting was the most effective treatment. I have tried to go back on the wall a couple of days ago (only big jugs) but I still feel discomfort and swelling. I would like to know if you have solved your tenosynovitis (I see that the post is from 2013!), and how did you manage with it. Thanks, Elisabetta

Passive therapy (ultrasound, injections etc.) are mostly ineffective (completely useless) in these types of injuries. What works though, is to progressively load the affected tissue. i.e keep on climbing after a couple of weeks rest maximum. The loner you rest, the longer recovery will be. Stay away from the crimps. You will be surprised at how hard you can pull open-handed even when the finger is very painful when crimping. Some degree of pain after climbing is not detrimental. As long as the pain has subsided within 32-48 hours you should be completely fine. Recovery, when following the optimal-load-protocol will be about 3-4 months.

Thanks a lot for your reply. It's good to hear that. Actually I was going to try this progressive load protocol I have found on BD website: https://eu.blackdiamondequipment.com/en_IT/esther-smith-nagging-finger-injuries/esther-smith-nagging-finger-injuries.html Do you think I should place any tape on my finger? I used to do the X taping on my A2 pulley, but when I was diagnosed tenosynovitis I thought it was better not to compress the tendon. Do you have any suggestion to control swelling? Thanks

Some studies have shown that x-taping in some way reinforces the pulley tensile-strength. However, these are small-scale cadaver-studies which might not be applicable to real life scenarios. That being said, taping might be sensible in that it functions as a sort of reminder that you have to be somewhat careful. From personal experience I consider taping useful because it protects the tendon and pulleys from direct pressure. Like when using tweaky holds that squeeze straight onto the tendon/A2-pulley.

I have had tenosynovitis and was not sure how to approach it at the beginning. It felt complicated as only resting did not seem to solve the problem... My experience is that "load management" is the best way to come back to climbing without pain. It requires patience and discipline. At the very beginning it is probably wise to rest a bit, but I think that it is crucial to keep the finger active as soon as it is possible to move it relatively well. The tricky part is that, of course, too much load has to be avoided!! Some specific finger positions are also worse than others... It is all about listening to the body, taking good rests in between climbs/attempts and in between sessions, and remembering that it is always better to stop too early than too late. But I think that it is also crucial to actually use the fingers in a controlled way. Low-intensity dead-hangs on comfortable holds worked very well for me.

I agree, I have tried to do the dead hang test posted on the BD article and I found myself much more comfortable hanging on the board instead of climbing on big jugs. I really hope it will help to go back in shape.