Finger Injury part III: the Road to Recovery
It’s hard to believe that it’s only been six weeks since I tore the cartilage in one of my DIP joints (left middle finger to be exact). In the last installment of this series I talked about why I’m so glad I got help from a medical professional. Now I’ll give you some insight into what it looks like to recover from a finger injury. We’ll dig into both the physical and mental side of the climbing and rehab I have been doing over the past few weeks.
Finger Rehab: Heal the Injury, Maintain the Strength
I’ve been working with Dr. Tyler Nelson remotely for my rehabilitation protocols. I talked a bit in my last post about why you need to go to a doctor (a good one) when you have a finger injury.
Here is my opinion as a coach and an athlete. If your doctor says “just rest and it will get better” and they cannot give you a real diagnosis, you need to go see someone else.
As we know, tendons and connective tissues need load to heal. Therefore resting it for an extended period of time is not going to help you return to your favorite sport.
Dr. Nelson prescribes his rehab protocols knowing that when you are healthy again, you probably want to get back to crushing. Fortunately, as you heal an injury, you can continue to stimulate the healthy tissue surrounding it and keep that tissue strong. This way, when your injured tissue has recovered, you are not back at square one when it comes to strength.
The Rehabilitation Protocol
My rehabilitation process has involved going climbing outdoors (doctor’s orders!) and some unique protocols on the hangboard. Dr. Nelson has prescribed some long duration hangs in various finger positions for me. Since September 4, 2020 I have completed ten rehab sessions and I’ve been climbing outdoors fairly regularly.
Before we get into the rehab protocol, allow me to explain the impact of the injury. Before I got hurt, I could hang for ten seconds on a 15mm edge with 50lbs added (I weigh around 125lbs). After my injury, I could not hang for even a second on a 20mm edge (my bodyweight alone). The injury has had massive impacts on my finger strength, but through rehab I have experienced significant improvement in a fairly short amount of time.
The rehab protocol involves a long duration hangs on the hangboard. Here are some highlights of what I do during my rehab session.
- Jug : 3 sets of 30-45s hangs (or until failure). Some sets have been up to 70s…
- Open hand hang: 3 sets of 30-45s (or until failure). I have been using a 25mm 3-finger pocket for these.
- Flat edge hang: 2 sets of 30-45s (or until failure). Starting out I could only hang for about 20s, but now I have worked my way up to 45s. I use a massive 35mm edge for this since a smaller edge would be hard to hold for such a long time.
The whole session takes me about 45 minutes. The purpose of the long duration hangs is to stimulate both the injured and healthy tissue. Loading for these long durations helps the healthy tissue stay strong without overloading the injured tissue. The long duration slowly but surely recruits all of the tissue in the fingers – every last bit of my fingers are getting a workout!
*please note that this protocol was prescribed specifically for my injury. If you have an injury of your own, please seek out the advice of a qualified medical professional.
Crimpin’ Ain’t Easy
I warm up for these long duration hangs by doing some repeater-type hanging: 5s on 20s off. At the beginning, I could not use a 20mm half crimp for this warm-up. But in my last two sessions I have been able to hang for multiple 5s on a 20mm edge again. I never thought I would be so excited to half crimp my bodyweight on a 20mm edge, but seeing the progress has been amazing. My finger is definitely getting better.
Climbing While Injured
In addition to these hangboard sessions, I have still been out climbing. For the most part, my finger does not bother me much and I do not feel hindered by it. However, at the beginning of my trip to Rumney, pulling hard on crimps was terrifying. Some holds were painful. In the first couple of weeks of recovery, I had to bail off some routes because of the holds.
Generally, climbing open-handed was OK. However, if you aren’t aware, Rumney, New Hampshire has a very crimpy, bouldery style to it. Avoiding pulling hard on crimps is difficult here.
Overall, I have been keeping away from exceptionally small holds. At the outset of the trip, I did my best to stay away from any big throws with my left hand. Dynamic loading of the tissue can lead to reinjury, so Dr. Nelson advised that I keep my movement style as static as possible for a little while.
The challenge for me was staying true to my intuition when it was time to call it quits for the day. I also had to check in with myself the morning after a climbing day to evaluate how my finger felt. If you did not know – tendons and connective tissues injuries will become painful 12-24 hours after the fact if you overdo it the day before.
Every morning I record pain on a scale of 1-10 and stiffness on a scale of 1-10. This helps me keep determine whether or not I pushed too hard the day before. To my surprise, I only had any significant spikes in pain after one high volume day of climbing. Most of the time, my finger could handle more than I expected.
Tick List Adjustment
One of the most painful parts of this injury was changing my expectations. Leading up to this trip, I had planned an awesome tick list. I have never been able to be in a climbing area for a month, so the list I had planned was ambitious to say the least. Coach Blake Cash put together an awesome plan to prep me specifically for my projects and I was psyched to get on them. But then I got injured, so my expectations had to change.
Stripping away my own expectations while living in a cabin of friends who were crushing was hard. For example, there is a crag that’s about ninety minutes away that they like to go to on the weekends to avoid the Rumney crowds. I would love to join them, but there is only one route there that my injured finger can truly handle. Instead of sitting around watching, I stayed home and worked – strategic rest days.
Over the course of my time here I picked out projects that were appropriate for me and my finger. I was a little grouchy to be projecting “sub-maximal” routes at the beginning, but it’s what I needed to do. I ended up learning a lot from these, which is all that matters. I worked on this 11b called Student Loan over the course of three days – it helped me get better at clipping from underclings with slippery feet. I also put in a lot of work to send Apocalypse Later, an 11d with beta-intensive slab sequence at the top. Slab is not my strong suit, so this was a learning opportunity as well.
With all of these “sub-maximal” projects and consistent rehab sessions, I am actually getting glimpses of where I was pre-injury. I have put down a few proud sends and I am hopeful for the season ahead.
Sending: Bum Finger Edition
The first glimpse of success came a couple of weeks back with my flash of Barking Spiders, 11c. My hardest flash to date is 11c so it felt really good to be able to accomplish this again. I also redpointed a couple of 5.12as in the past week – very quickly in fact. Up until this trip, I had only sent one 5.12 in a day. I was able to do that again with my single-session redpoint of Captain Hook. Then a few days later, I put up Weevil Knevil, 5.12a, in a handful of burns.
I am getting back in the groove and am hopeful for what is to come.
In a week, I will be leaving Rumney and headed to the Red River Gorge. With all these signs of improvement, I’m starting to day dream about bigger objectives in the Red. I have also shaken off a lot of limiting beliefs with the help of my climbing mindset coach, Karly (check her out at projectdirectcoaching.com). During my first few weeks in Rumney, I believed that having trouble sending 5.11 meant that my hopes for sending harder grades later on in the season were totally dashed.
But since then, I have realized that having an injured finger makes climbing a little bit harder. Also, my performance in the middle of September with an injured finger in Rumney has little to with what I can get done in the Red River Gorge this season.
I have big goals for what remains of the fall. Overcoming an injury will make the sends more epic anyway. Onward and upward.
Have you overcome an injury? What lessons did you learn? Have any questions about my rehab? Drop a comment below or shoot me an email at firstname.lastname@example.org, I would love to hear from you!
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