Whenever a climber approaches me with concerns about a finger injury, they always say it is a pulley injury. But, there's no way you can know that by just looking at your finger. Please understand that there are multiple finger injuries associated with climbing, and in this blog, we’re going to talk about one of them - lumbrical injuries - which happens to also present the same way as an A2 pulley injury.

What are Lumbrical Injuries?

Lumbrical injuries are muscles that start in your palm and connect to your fingers. You have the tendons of your FTP or Flexor Digitorum Profundus. Then, there are other tendons that lay on top of that called digitorum superficialis. Between these tendons, you will find the lumbrical muscles, or what they also called the interosseous muscles. These are very important for climbing because they help with stabilizing your tendons when gripping. 

So the special thing about these lumbar core muscles is they don't originate on a bone and connect to another bone. They actually originate in your tendons and connect to a particular part of your fingers. And that becomes super important because if you look where they connect, you're gonna see that it is in a similar location as your A2 pulley. This is the reason why many climbers often say they have a pulley injury and point to the pain they’re experiencing in this specific area. 

Why Do Climbers Get Lumbrical Injuries?

Pulling on Pockets

Lumbrical injuries typically happen when you're pulling on pockets. If someone were to get injured, and they mentioned pulling on a pocket hold, that would lead me to believe that it could possibly be a lumbrical injury. It's not 100%, though, because you would still have to run them through different tests to rule in and rule out certain injuries. But, this would be a perfect clue for me.

Quadriga Effect

One reason that a climber gets injured is because of something called the “Quadriga  Effect.” If you're pulling on a mono, which has the highest risks, your tendons will be pulled up and the rest of the fingers will be pulled down, then the muscles between your tendons get pulled apart -  and that’s when you get a lumbrical injury. 

When you're climbing really hard, it's not uncommon for you to bend your fingers forward and it creates the quadriga effect, which can provide some stability. But if you use it too much, or the stress is too much for your muscles to handle, then you're going to tear the lumbar muscles. 

What to Do If You Have a Lumbrical Injury

As I have mentioned before, if you treat your lumbrical injury like a pulley injury, you're not going to fix the problem. In fact, you're probably going to have way more headaches because you’ll get more frustrated from your finger not healing correctly. So make sure you're treating the right injury to get the right results. 

If you've got a lumbrical injury, these are three different things that I'd recommend: 

• Self-Treatment

Something you can do with your fingers is massage them yourself. You can pinch between the bones of your hands and you will feel a meaty texture. Your lumbrical muscles are between the tendons, so you have to massage down in between the bones. If you feel something that's a little bit tender, a little bit tense, then you can sink in on it and wait until the muscle relaxes. 

• Taping

There’s no research that shows taping helps with any type of injury. But when I work with climbers, they will say that taping makes them feel a little bit safer. I never take any kind of safety away from my climbers, I just recommend a better way to go about it. When you tape your fingers, you have to fasten two fingers together which will prevent the “Quadriga effect” from happening. Taping should just be used as a crutch. Just as you would only use crutches temporarily, the tape should only be used temporarily. Whether you believe it helps or it doesn’t, just don’t get addicted to it.

• Professional Consultation

Lastly, I would recommend you seek professional advice from an expert. Hopefully, you're going to find one who works with climbers. Keep in mind this rule of thumb, the sooner you get treated, the less visit usually takes and the faster recovery will happen. Please know that it is important to find a physical therapist or physiotherapist that works with rock climbers because working with someone who understands how climbing affects the body will make all the difference in the world.

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