Pulley Injuries

Pulley injuries are the most common type of finger injuries among rock climbers. To minimize the impact of a pulley injury on your climbing goals, it is important to understand the anatomy of the pulley system, the mechanism of injury, and how to prevent and treat finger injuries.

Anatomy of the Hand

Your fingers are composed of three bones: the proximal, middle, and distal phalanges. Ligaments connect and stabilize the bones while tendons connect muscles to bone enabling the force generated by the muscles to be transferred to the bones. Muscles in the forearms pull on the flexor tendons of the fingers which bends the fingers and ultimately enables climbers to crimp. For this process to work optimally, the flexor tendons must stay in close contact with the bone. This is where the finger pulley system comes into play. Flexor tendon pulleys (known as annular pulleys) named A1 through A5 form a casing of connective tissue that holds the tendons in proximity with the phalanges when bending the fingers. The pulleys create an efficient mechanism that allows for maximal force to be generated by the fingers.

Pulley Injuries

Our soft tissue can only tolerate a certain amount of load. If the amount of load placed on our tendons, ligaments, or pulleys exceeds the strength of the tissue, an injury will occur. Pulley injuries most often occur due to high amounts of load in the crimp grip, for example, making a dynamic move from a crimp hold. The severity of a pulley injury can range from a minor strain (partial stretch or tear) to a complete rupture (full tear) of the pulley. The symptoms of a pulley injury depend on the severity but generally include tenderness, swelling, redness, stiffness, and pain when crimping.

A physiotherapist can help to diagnose and assess the severity of your pulley injury and provide you with a rehabilitation plan to ensure proper recovery. As climbers themselves, the practitioners at Elios Health have a deep understanding of pulley injuries from the perspective of a practitioner and a climber and can provide you with a climbing-specific treatment plan to help get you back on the wall.

Want us to take a look at it? Book with our climbing physiotherapists on Main Street in Vancouver, and let us help you on your road to recovery!

Original article by Rachel Rubin-Sarganis
Photo of Jade Littlewood