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Is my finger injured or just tired? Five ways to tell the difference

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Have a finger that feels like it’s on the cusp of injury? Or are you debating whether your digit is truly injured or just sore from overtraining? Often we climb to the strength of our shoulders and our minds, but not that of our fingers. And so we push our digits a little too hard, letting nagging pain go unnoticed until it’s too late and the pain has become an injury, leading to unwanted time off.

Read on for five common symptoms to assist you in assessing if your finger is injured or merely tired from overtraining—with advice on what to do to get better.

1) Pain with load

Pain is a pretty great indicator that your body is trying to protect your finger. Swelling is usually the most common cause of pain, as it pushes on pain receptors within the finger. Repetitive overuse is usually the culprit here.

New research shows us that pain does not necessarily signify an injury—it’s more of a warning sign. In many cases, the brain creates pain to protect a previously injured area or one it feels is at high risk of injury. So there’s likely no need to freak out if you feel momentary pain in an otherwise healthy finger unless the other hallmarks of injury are present (immediate swelling, stiffness, and weakness).

For a common pain pattern involving an overworked finger, your finger might hurt slightly at first and then more and more over time, as swelling builds up. The good news, however, is that if you experience pain and swelling for only a short period—a few hours or days—you can relax and assume you are overtraining. However, if the symptoms persist beyond this window, start to be concerned. If uninjured, your finger should go back to being pain free with modification to your climbing, taking precautionary steps like a better warm-up, slower progression through the grades, etc.

What to do?

If you feel pain with use, either end your climbing session or change your climbing to unload the area (perhaps decrease the grade, modify the hold type to become pain free, and/or back off your intensity). Once you learn your patterns—which types of climbing are likely to flare up your body, and in which ways—you can change your climbing style to better sync with your body’s needs, ideally risking fewer injuries in the long run.

 

Delaney Miller's Fingers
Climbing Associate Editor Delaney Miller’s right hand after she heard a “pop” sound on Mind Control (5.14b) in Oliana, Spain, after trying to stick a dynamic move to a crimp on multiple attempts. Here, she’s just torn the A2 pulley on her ring finger but it hasn’t swelled up yet. “The month leading up the trip, I had tenderness and pain in several of my fingers. I went and got an ultrasound, and it turned out I had ganglion cysts on my tendons,” says Miller. “It seemed safe that I could ignore them. That assumption was wrong, as it would turn out.” Photo: Delaney Miller

2) Feeling a “pop, snap, or something give,” plus immediate swelling

This one is a dead giveaway—it’s a medical red flag. If you feel a pop or a snap with immediate pain (or weakness), assume that you’ve sustained an injury. Clinically speaking, all of my clients who felt “something give” in addition to experiencing immediate swelling (and joint stiffness) had usually sustained a pulley or flexor-tendon injury and needed more than 14 days off.

What to do? 

Stop climbing immediately: To allow your finger the most opportunity to properly heal, do not test the injury; you need proper time off and protection of the area, especially during the first week post-injury. To protect your damaged finger, you might kinesiotape the region for swelling, put a finger splint on it to support a pulley or joint, or contact your doc to get an X-ray to rule out a stress fracture. If you opt to do the bare minimum and feel that the area is not really injured, take a week off (just to make sure), and then if you feel like you can return to the wall, gently test the finger first on the ground with loading during normal daily tasks. If your finger remains pain free, has full range of motion, and you feel no symptoms (swelling or aching) in your everyday life, you can gradually return to your normal level of climbing over a few days. However, if you continue to have pain or weakness, you’re injured.

 

3) Bruising

Bruising without impact—say you smacked your finger on a hold or a cyst “popped,” in which case the bruise makes perfect sense—is another medical red flag. If you have finger swelling and tenderness in addition to bruising, especially after climbing aggressively at your top effort, chances are you have an acute injury that requires a visit to your medical provider. As a rule, even when you’re cranking your hardest, the front and back of your finger (areas that are mostly tendon and joint) should not bruise. If you see bruising, have any pain or swelling in the region around the bruise, and you sustained the bruise while pulling hard and heard a pop, get checked out for a stress fracture, which can be mistaken for a pulley injury.

What to do? 

First, take a photo for your records. If you’re symptomatic (bruising in addition to feeling other symptoms), visit your doc to explain the scenario. Ask for an X-ray to rule out an occult stress fracture if the finger continues to be symptomatic after the bruising decreases. Your doctor will also check the finger for vascular flow and other issues.

 

Creaky fingers
Climbing Digital Editor Steve Potter’s fingers after a long weekend of climbing; his pointer and middle fingers were especially swollen and stiff, with inflammation to old, chronic injuries on both digits. Photo: Steve Potter

4) Stiffness

As a metric for all climbers, stiffness in the joints is the perfect educator as to whether our climbing matches our finger fitness and health. Relax, my friend: Newly gained finger stiffness does not necessarily mean you have an injury (especially if it’s just in one joint), but it does mean that all the necessary ingredients for injury are present: too high of a load, inflammation, and tissue injury (however slight at first). So look to your training plan: If this is an easy week, or you’re just volume climbing, tweak your time and your grade to ensure your fingers can adjust before you add more challenge. If you feel your finger joints stiffen, especially the day after climbing, you could be simply pushing too hard for your fingers’ present fitness level.

What to do?

To gauge whether you’re overdoing it, listen to your finger symptoms after climbing/training to tell you if you’ve hit the sweet spot (in regards to volume and grade), or if your fingers think they’re being pushed too hard. You might just need to back off by one route or problem at the end of the session or decrease the difficulty of the climbs. If you’re a seasoned climber and your training plan is on point but your fingers have started aching, you might be seeing the return of old, chronic damage, which can be addressed by working on joint mobility and softening the forearms to unload and better manage tension in the region. Helpful tools here include the Rolflex, the Knot Out, and the Armaid, or rolling back and forth on your forearm with a good old can of tomato paste; you can also work on curling up each finger toward your palm with light overpressure to decrease stiffness.

 

Matt Samet fingers
Climbing Editor Matt Samet’s hand in a puffy state after two days in a row of training on plastic–one day was doubles on routes, the other was volume bouldering. Photo: Matt Samet

5) Puffiness

All of us have had a puffy, hot joints at one time or another: They’re a telltale sign that you’re stressing a specific region with too much tension, load, or overuse. I like to call this a “pre-injury,” and it’s often caused by loading your fingers too aggressively and too frequently/consecutively on micro-holds, especially crimps. If at any time your puffiness is accompanied by pain, stiffness, or weakness, consider yourself injured.

What to do? 

If it feels like a budding pre-injury, it likely is. If you’re simply overtraining, take a two to five days off until your finger/s appears (and feels) back to its old self.  Modify your next climbing session to be an easy day and reduce volume and intensity (avoiding any projects or holds that might irritate your finger). If it’s a pre-injury, the puffiness shouldn’t reappear; however, if puffiness reappears, you’re likely injured—time to visit your doctor,.

Doctor’s Note: This article is designed for educational purposes only and is in no way intended to treat or diagnose a finger injury. If in doubt about a potential injury, visit your medical doctor for an evaluation. Your finger tissues will heal better if you’re cautious, as opposed to continuing to climb on them (pretending you aren’t injured). Your goal, as always, is to climb for the long haul!

Dr. Lisa Brin (@theclimbingdoc) is a former USA Climbing medical consultant and the host of Un-Sprained, a climbing-injury podcast. She teaches climbers, parents, and coaches skills to avoid injury, train smarter, and recover more quickly using step-by-step plans. Learn more at climbinginjuriessolved.com