In this blog article, we are going to answer a question from one of our friends, Daniel. He asks, how can you heal capsulitis?  He was talking specifically about his DIP joints. But I'm just going to talk about the IP joints which include both the DIP and PIP joints. 

If you look at your finger, the joint closer to your fingernail is the DIP or the Distal Interphalangeal Joint, which is the thing that Daniel is dealing with. But most of the time, I'll see capsulitis affecting the knuckle closer to the palm, and that's called your PIP or the Proximal Interphalangeal Joint. 

What is Capsulitis? 

Capsulitis is a long-term swelling of the knuckles. Many climbers experience finger joint capsulitis. If you climb routes that are above what your body can tolerate, then this creates an excessive force that goes through your finger joints causing them to become irritated.  

If enough force passes through the breaking point, then a sprain or a tear will occur. If you climb on an injury-prone finger, then that can be harmful. You may end up losing range of motion or full mobility in that finger. Pretty much, if you have finger joint capsulitis, you will feel an achiness of the IP joints that lingers hours to days after climbing.    

What Can You Do When You Have Finger Joint Capsulitis?

1. Find a therapist who's certified in the Isele-method. I use what's called the Isele-method to help with finger injuries and capsulitis is one of the things that I treat all the time. Background about the Isele Method: Klaus Isele is a physiotherapist and osteopath who developed his own method of treating finger injuries, and I got to travel to Austria to learn from him. The Isele-method is a combination of manual techniques which means that I use my hands to work on your fingers that you just can't do on your own.
2. Decrease your climbing intensity and frequency. Finger joint capsulitis is tougher to treat, not because we don't know what's going on, but because the symptoms that you feel are going to be delayed. If it was something like a pulley injury, then when you immediately pull on a crimp, you're going to get that feedback right away that it’s hurting you. However, with capsulitis, you don't feel it at the moment. When you're climbing, you don't really feel anything bothering you. But once you’re done, and then if it lasts for days, then obviously, you've pushed past your body's ability to withstand the forces that you put through it with your climbing. 
3. Make sure you're climbing statically. What ends up happening when I'm rehabbing a climber, or helping a climber rehab is I set parameters for them to climb within. I don’t force them to climb but I will challenge them to see what they can handle so that we can still stimulate their fingers. But if it causes them to have this achiness that lasts like hours or days after climbing, then we reduce the intensity.

Taking a Rest Day Between Climbing Days

There's a common philosophy I hear with climbers, especially on climbing trips, “Two days on one day off.” It means that you climb for two days, and then you take a rest day. If you climb two days in a row, what ends up happening is you're climbing with collagen degradation in your tendons, so your body hasn't had that time to recover and your fingers are at an increased risk for injuries. 

Obviously, that sets you up for more injuries. So instead of doing two days on one day off, I would recommend taking at least one day in between climbing days. If I'm actually rehabbing a climber, then I make them take two days in between climbing sessions. I also give them more guidance. So usually, I'll go climb with them, and see how they do.

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