How to Fix Lumbrical Pain (Lumbrical Injury, Pocket Climbing Injury)

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// TIMESTAMPS //
Context and Overview (00:00)
Part 1: Range of Motion Activities (01:12)
Part 2: Tissue Mobilization (02:04)
Part 3: Stretching (03:00)
Part 4: Retraining Flexors and Extensors (05:52)
Part 5: Retraining Lumbricals (08:11)
Part 6: Prognosis (12:19)
Outro and Bloopers (13:20)
// SHOW NOTES //
INTRODUCTION
Oh no! If you’re here I guess that means you injured your lumbricals :/ sad. BUT, there’s hope my friends! Because in this video, we’ll show you how to solve that! We’re going to cover HOW to rehab from a mild, moderate, and even severe lumbrical injury, with information on range of motion activities, stretching, retraining, and lumbrical strengthening.
If you love guides! Be sure to check out a simple guideline that helps make this entire process feel so much easier to follow and understand.
If you haven’t already, definitely check out our video on everything you need to know about the lumbricals! This will absolutely help you on your recovery journey as you’ll be able to better understand the anatomy and function of the lumbricals and why they get injured in the first place. That video will also help you determine the severity of your injury, which is important to know before starting rehab.
Rehab activities and timing for a lumbrical issue will depend on the severity, and if you suspect a high grade tear you need to see an orthopedic or hand specialist. If, on the other hand, you’re just suffering from a strain, Grade I-III, you will follow a standard protocol of range of motion, stretching, tissue mobility, and finally retraining.
Side note: with most grade I & II strains, you can continue to lightly climb! Just avoid exacerbating positions and consider buddy taping to help with this.
REHAB ACTIVITY 1: RANGE OF MOTION
If you have just a Grade I or II strain, I recommend starting range of motion right away. Active range of motion tendon mobility work will be best and I’ll describe all 3 movements in a moment. But first, I want to mention that the “L” position is the one to give the most attention to as it will best target the lumbricals. The “L” position is achieved by keeping the fingers extended but flexing at the metacarpal joint.
To do the active range of motion tendon mobility work as mentioned: pick 3 rows on your palm. #1 near the knuckle. #2 near the middle of the palm, and #3 near the base of the palm. Touch the pads of your fingers to each row while opening and extending your fingers all the way every repetition. This may look like “tendon gliding” but I don’t like the scraping or constant contact of the fingers pads sliding along the palm. Rather, we want to focus on just range of motion with flexion and extension of the joints.
If you have a Grade III or significant strain, you may still be able to start this as early as a day or two after the injury, but start out gentler. If there is discomfort with this, you may need to focus on a small, gentle range of motion. The more discomfort there is, the smaller and lighter your motion should be. If you do start this early, you will speed up the healing process.
Ran out of room!! For the rest, please check out the show notes:
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// DISCLAIMER //
As always, exercises and rehab programs are to be performed assuming your own risk and should not be done if you feel you are at risk for injury. See a medical professional if you have concerns before starting a new training or recovery program.
// IMAGE ATTRIBUTIONS //
// PRODUCERS //
Jason Hooper (PT, DPT, OCS, SCS)
and
Emile Modesitt (@emile166)
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#climbingtraining #trainclimbsendrepeat #physicaltherapy

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Опубликовано:

4 июл 2024

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Комментарии : 100

@kylebelzer2993 2 года назад

This channel is such a gold mine, I love it. I got hurt recently and went through the catalogue to try and self diagnose. 90%+ sure a lumbrical tear is what happened. I’m still seeing my PT, but it’s so much better to come into therapy as an active participant in the recovery process instead of blindly following the moves. Thanks for putting so much time into this.

@HoopersBeta 2 года назад

Great to hear, thank you!

@skrovinam 3 года назад

This is pure gold. Full rehab protocol for lumbrical strains. I feel I'm pretty sensitive in that area, so I'll try to pick some of the mobilization and strengthening exercises. Also seems to me like a great idea to include them in the warmup.

@93Jewell 2 года назад

Omg THANK YOU for these detailed videos on lumbrical injuries!! I got my first climbing injury via my ring finger lumbrical while pulling on a two finger pocket last week. I had only ever heard of pulley injuries, but now it all makes sense. This rehab video gives me a lot of hope to heal quickly, or at least get me back to some climbing soon. I’m so relieved to have this info, especially after being totally dismissed by a doctor.

@HoopersBeta 2 года назад

Awesome, thanks for sharing!

@DESERTCYCLI5T 6 месяцев назад

Dude, I can't even begin to describe the misery and frustration I've had for the last year with what is obvious lumbrical injuries. After watching your other video probably a couple of other muscle groups too. Two doctors and two months with a physical therapist and none of them even considered it. I even told them I couldn't hold a pen, grip my mountain bike bars, or play my guitar comfortably; or at all. No bells rang. Massaged my palm in front of them because it hurts so bad. No bells Told them how the muscles deep in my wrist and forearm were killing me. Nothing. They actually MRI'd a tiny swath of my wrist?? After a week of the first basic exercises I have had the first bit of pain-free mobility since last October. It's a month out to see a hand specialist but if I keep progressing there may be nothing to talk about. If they want me to go to a physical therapist. I'm gonna tell them I have one.😂 Thank You Thank You Thank You

@HoopersBeta 6 месяцев назад

Oh dang! Sorry to hear about your experience but also pretty stoked that our video was able to help you so much! That's awesome to hear in that regard :) I hope it continues to help and that you heal up well!

@DESERTCYCLI5T 6 месяцев назад

@@HoopersBeta I am stoked too! I should note that I actually hurt my hand, wrist and elbow doing all of the things above plus chopping a ton of wood on a two week mountain biking trip at the North Rim Grand Canyon. Oh and I'm 70 which doesn't make it any easier to heal from anything. Big trick now is not to hurt it throughout the day. BTW, did I mention I sent your two videos to the physical therapist...... in the interest of community service, of course. (rock climbing is popular around here) I don't climb, y'all are crazy 😁 Two wheels on the dirt or pavement is my jam. Thanks again, I won't bother you anymore. 👍👍 FYI I don't remember exactly what I searched for but lumbrical or pocket would've been in it. Your video popped up first. The algorithm got it right 👍

@auchfu Год назад

I just want to say that I am extremly gratefull for your videos. Up until recently I only watched your videos for entertainment and out of general interest. Sadly I injured my hand during climbing and was very confused as to what exactly was injured, well until now. So once again thank you so much for providing the climbing community with your insigths and expertise. Keep up the good work!

@Kyllleur 3 года назад

Let's get all those Lumbrical things back in shape for the summer! 🤘

@atakenaka Год назад

Jason, you're a life saver! Thank you so much for these injury videos, it really helps to calm the nerves when we have no idea of what it's happening after an injury. It's like a light in the end of the tunel.

@HoopersBeta Год назад

Thank you for the very kind comment! It is always great to hear how it is helping people :)

@wallanichtsoeinebarakobana9564 3 года назад

This content is so rare 🔥

@richardmannarino5066 2 года назад

I appreciate this video so much. Really great guidance to recovering

@emare4117 11 месяцев назад

Can't thank you enough. Your videos are extremely insightful. Active visualization through videos like this make all the difference in the world. You are awesome!! 🎉

@HoopersBeta 11 месяцев назад

You're very welcome!

@spartansamurai8902 2 года назад

So thankful for this video & the one on tenosynovitis… hurt my hands/wrists when I increased my rowing time from 30 min to 45 min (C2 L10) and have been in pain for a few weeks. Will definitely try the stretches outlined in both videos!

@colehibbard1191 2 года назад

Incredibly helpful video. I injured mine a few days ago at I think somewhere between a Grade II or III strain, and I’d be lost without you

@jurta2008 2 года назад

Thank you so much for your videos! I just stretched my lombrical yesterday on pocket holds and without you, I would still think that I'm (again) doomed with a pulley! I'm going to start the rehab today with some soft stretching and massaging and hopefully back on the wall soon! Thanks again for the well detailed video! Even though you're not getting enough views in my opinion, every one of them is someone that you helped with very frustrating injuries! Keep up with the good work!! 👍

@HoopersBeta 2 года назад

Well said! Thank you for sharing and for your support! I wish you a strong recovery and glad this video was helpful!!

@BryceU 7 месяцев назад

Hey Hooper, my buddy Josh turned me on to your channel. Really appreciate the diagnosis and rehab videos for Lumbrical injuries. Two finger cave pocket crux move definitely got me. I went 2 months without climbing and then was slowly easing back into climbing when I repeated the injury. That's when I found your video and now I feel much more confident with my plan to rehab. Cheers!

@HoopersBeta 7 месяцев назад

Thank you to Josh for the referral and thank you for the comment! Glad you are feeling more confident and hope you recovery well this second round!

@T-Rex-Index 2 года назад

Thank you so much for this video (and the diagnostic one)! I collected my first finger injury in september and without you I would have never known what was actually hurt and even less what to do for rehab. But thanks this rehab yesterday I had my first session without my buddy tape and man that felt so good 😄 Pls keep on the good work, it's so hard to find good information on all the little problems that surround climbing 🙏

@HoopersBeta 2 года назад

That's awesome! Sorry to hear about your injury but really happy to hear about your progress :) Happy climbing, keep up the good work (and thank you for the positive comments!)

@iPOOberlinwoods Год назад

Dude… thank you so much for these videos. Strained my lumbrical along my ring finger with a two finger pocket and was worried about A2. Followed your videos from A2 to FDP to this. You the man 🤙

@HoopersBeta Год назад

Awesome! Stoked this helped :)

@somebody553 9 месяцев назад

Awesome video!

@palehorseathletics1794 2 года назад

Dude, THANK YOU! Not just for the rad rehab program, but also for putting this info out there. I recently tweaked my finger and the only results I could find on finger injuries were collateral ligament strains and A2 pulley injuries. I knew these injuries didn't fit my symptoms and I was kinda geekin out wondering what was wrong with my hand. Seeing your videos on lumbrical stains brought me great peace of mind. Now I just gotta get started on recovery! Thanks again!

@HoopersBeta 2 года назад

Glad to hear it was helpful!!

@foxtrotwhisky4061 Год назад

Oustanding injury information and rehab video!

@HoopersBeta Год назад

Thank you!

@philm5872 3 месяца назад

This makes sense. I thought I may have had a pulley injury (and perhaps I do) but where you describe the pain is exactly where I have it. I also played guitar for the first time in a while and the stretching you do with that hand has made it quite sore again

@xandutheil67 Год назад

Thank you mate!!

@stevemcdowell123 6 месяцев назад

This channel rules.

@sarahshiplee5719 2 года назад

Thank god for this video (and the other LI one), strained mine last night. Can do all the ROM exercises and stretches with only a mild ache around the ring finger-palm when i move it. Hopefully it'll be ok in two weeks for my trip to peak district!

@HoopersBeta 2 года назад

Wishing you a speedy recovery!!

@rubenbaiocco6256 Год назад

Man, thanks a lot for these amazing videos. If I don't bother, I still have a little question, hope that you can help me one more time. I injured my lumbricals because of pinches in overhangs and not because of pockets...and the pain (mild, fortunately) is in index/middle finger area, not middle/ring as usual. Should I slightly change something in my rehab or does the one you suggest work anyways? Special thanks in advance!!

@QuartzCanvas Год назад

I had a ring finger A2 pulley injury about three months ago. Was getting much better and decided to hang on pockets to isolate that finger for more specific strengthening. On hang #4 i felt a twinge from my finger down to my forearm. Thank god is wasnt the pulley but my lumbrical is messed up. This is a huge help.

@thirzacarpenter9683 2 года назад

Thank you for this information! I injured my hand about 2 months ago, wasn't sure what the injury was and it seemed to improve, then re-injured just over a week ago and finally found my diagnosis! I'm not sure that i can get imaging to help determine the grade. After I injured it the second time, I definitely had some immediate swelling in my palm. I have found over the last week that I get almost immediate pain if I remove the buddy tape, almost any flexion without buddy tape seems to be painful. Are the severity of my symptoms any indication of the grade? Now that I have this buddy tape that has been so helpful, I'm not sure when I should take it off. Any suggestions? Thank you!!!

@mehrdokhtghassemi4607 3 года назад

Thank you so much🤗

@Biamondos982 Год назад

You’re a freaking life saver

@HoopersBeta Год назад

Happy to help!

@GetBackBeforeYouDie 2 года назад

Well, I can't but just thank you guys for the very helpful content you are uploading.

@HoopersBeta 2 года назад

Thanks for watching!

@nicholastoftemark7337 2 года назад

Do I need to take complete time off or can I still hang on bars for weighted pull ups or core work ?

@chosslife 3 года назад

What are you thoughts on using topical anti inflammatories? The same cream people use for arthritis (Diclofenac gel). It seems to work wonders for sore joints and pulleys but I wonder if I'm not getting the best healing potential by stopping the inflammation?

@freakinstoner Год назад

I obtained this injury on the f14 hold on the moonboard in oct last year (purgatory v4), and its still giving me issues now (cant hold slopers long and my crimp load strength is alot lower). For the longest time i had no idea what i actually injured or how to get my hand better. Im so glad i found this video! Going to try the rehab excercises, hopefully better late than never 😬😅 thanks for all the tips!!

@HoopersBeta Год назад

Dang! Sorry to hear about the injury and how long it's been bothering you! Hopefully these start to help and you can make a great recovery :)

@cesarrosales9373 15 дней назад

Thanks

@philipppfneisl1000 3 года назад

Hi. I really like your videos. I would need your expert opinion. I‘m cimbing 2 times a week and rather an average level around 6b-c. My problem is that i sometimes wake up in the night with stiff joints in my right hand. When I move the fingers it moves a way quickly but I‘m a bit worried. Do you have an advice for me what I can do. Many thanks

@angelojumped 3 года назад

How about a 'knee rehab' video?

@HoopersBeta 3 года назад

Yes! We've been wanting to do a video about knee injuries for a long time, but the complexity of the topic (or, more accurately, the challenge of distilling that complexity down to just a video or two) has kept us from doing it thus far. It is indeed on our (long) list, though, and perhaps if there is enough support for the idea we'll move it up in priority. Thanks for chiming in! -Emile

@angelojumped 3 года назад

@@HoopersBeta sure! Thank you already for answering, this interaction is so heartwarming. I know we are a big community, with a lot of questions and requests. Cudos for the amazing work!

@korraang6941 3 года назад

thanks!

@richardkim6512 Год назад

What are your recommendations for interossei injuries?

@fmreflex 3 года назад

I started to have pain on top of my DIP joint when pressing on it or crimping hard. I have had the injury for two years now and it still feels the same as when it started. Doctors I have seen have only said that this is what happens when you climb and nothing helpful🤔 it goes away if I rest for 1-2 weeks but always comes back even after 2 months of rest with rehabbing practises and slowly getting back to climbing. Any advice or what might cause the pain? Thanks

@maxpilling7796 Месяц назад

Not this popping up in my feed right as I’m feeling tweaky after pulling in pockets

@butaleo 2 года назад

THANK YOU! I finally discovered that I have a Lumbrical Injury. but when doing aforementioned exercises, area near my wrist hurts (which is swollen). is it connected?

@seanhaverstock6510 Год назад

4th time I've had this injury in climbing. 1st time I've known what it is. Every time because of a pocket. Thanks for all the information!

@HoopersBeta Год назад

Hopefully this is the last time!!

@spencerdickerson1620 3 года назад

I injured mine about 6 months ago and I never knew what it was until now but I just diy’ed some rehab exercises and it eventually got better

@artemiip 2 года назад

Did you end up recovering?

@jobro296 3 года назад

kind of unrelated, but maybe not; I'm one of those people that are missing one palmaris longus muscle, namely on the right side. I was wondering if you know whether or not that has any impact on climbing ability, and or may explain why I get injured on the right more often (also right handed)

@JustinConnor89 3 года назад

Any benefit from contrast baths for lumbricals strains?

@Joseleocol 2 года назад

My God, thank you.. It's all I can say.. Only one question, after the injury that cause me this problem, movility and functions seems fine (still recovering) but my knuckle (ring finger) seems to have dissappear.. I don't know if it is because of the swelling, but it doesn't look as sharp and pointy as the one of the other hand.. Is that OK?

@maldjia 2 года назад

Great explainer and very helpful video!!

@andreascolamiero616 3 года назад

I got injured on a 3-finger pocket a couple of years ago and never properly did rehab. I still climb but never on pockets and don't feel pain unless in awkward hand positions or some slopers. What stage of the rehab process would you recommend starting from and does it make sense to take a break from climbing? Thank you!

@andreioe2065 3 года назад

I've had almost the same thing happen to me like 2 years ago. I almost never mess with pockets and I only really feel it with difficult pinches and slopers. I'd also like to know the same thing

@alexbarcovsky4319 2 года назад

Just start hangboarding - long no-hangs on 3/4 pad 3 finger drags work like a charm for me. Had the problem for 6 months, after 3 weeks of 30 seconds on 30 seconds off 70% BW no-hangs on 16mm crimps, it was absolutely gone.

@bhargavsunkara4103 2 года назад

@@alexbarcovsky4319 how often and how many did you do these hangs?

@wallanichtsoeinebarakobana9564 3 года назад

Man you are ma man❤️😂

@nicholastoftemark7337 2 года назад

Also can I 3 finger half crimp for a while or will that mess with it to

@bronzethunderbeard1572 Год назад

This is helpful. I am sure I got at least a tear and injured a lumbrical in my right hand based of the flex tests. I lightly tried the stretch at 3:31 and cannot do this stretch without a lot of pain but is this worth a trip to an actual doctor if there is no loss of function? and what kind of doctor would I visit? Also I got this injury when I was establishing on a boulder with a crimpy undercling start in my gym, I guess I didn't warm up enough or something but was just trying it out and went for the first bump that was pretty high above my head and felt a pop followed by soreness in my forearm up into my ring finger. What is the best way to prevent injuries like this? Think it would have anything to do with hangboarding less lately but climbing the same higher grade problems?

@zach8933 7 месяцев назад

Hey man, I had a similar thing happen recently. Doing the tests he provides in the video, it looks like a lumbrical injury. But all of my pain is localized in the ring finger. Was your pain in your palm?

@joaohamalainen3090 2 года назад

I've diagnosed based on your videos a lumbrical injury on my right hand annular finger. I believe the injury occurred 3 months ago. It has not caused major issues, and climbing grade has improved progressively. Only now did I become more conscious about it when I slipped multiple times from a gnarly crimp. Is it too late to start rehab now? Is there something else I need to know, since I'm starting treatment only 3 months later?

@HoopersBeta 2 года назад

Not too late! You may be able to progress through some of the earlier phases a bit quicker but I would still start with the gentle rehab and then catch up to the later phases as tolerated by your body.

@pavelbelik6174 Год назад

Hi Hooper, I injured just yesterday and immediately went back to this vid I remembered from casual watching previously. When I do the first exercise I can feel screeching in the injured lumbrical when opening my hand and stretching my fingers, it’s like opening old rusty door. Is it common or should I wait/avoid the exercise? The pain is mild, like a 2/10. The strange feeling causes much more discomfort. Thanks for the great video, your channel is the best PT content for climbers!

@pavelbelik6174 Год назад

Update: On day 3 the screeching seems to mostly go away :)

@HoopersBeta Год назад

Oh nice! I'm glad it is going away :) yeah I would say in the initial state you described to use caution / give it a few days. I would still use caution at this point but you can start to gentle initiate some of those motions if the pain is still well managed.

@pavelbelik6174 Год назад

@@HoopersBeta Thanks so much for the reply! Im sloowly starting with the feather stretch, feeling it mostly in my forearm, looking forward to some easy climbing next week, buddy taped :). Thanks again so much for such an amazing video. TCSR

@grizzlytrip4973 3 года назад

Is it normal to feel slight pain down in my forearm when doing the more aggressive stretch on my ring finger?

@LazarCir1c 2 года назад

I feel the same slight pain in forearm, I expect i strained flexor tendon and lumbical at the same time

@oleshikaru Год назад

Sadly im back here again but its my dominant hand this time. thankfully not as severe an injury and only in the palm. its been 4 days since the "incident" and i dont have much pain left. its there, but its more subtle. this might be a silly idea, but if you dont have a foam/dog toy to squeeze, what about squeezing your other arm just below the elbow? thats where all the muscle is, so it can be a bit squishy. you also massage your other arm potentially while doing it haha. Can you tell im not a doctor? :D

@user-tm5rb3ne3e 10 месяцев назад

Thanks for the beta. I'm 99% sure I've got a lumbrical strain, but I also feel a twinge below the wrist in the fdp with certain movements. Could a lumbrical strain cause this, or I guess I could have both? Thanks

@HoopersBeta 10 месяцев назад

You could have both, yes. Since the lumbrical originates on the FDP tendon it's possible to hurt both simultaneously. But also since the lumbrical is heavily involved in proprioception/regulating force between the FDP and extensor tendon, an injury to the lumbrical can cause an allodynic or hyperalgesia pain response in the FDP tendon (those two terms very loosely meaning an abnormal and/or hyper sensitive pain response)

@user-tm5rb3ne3e 10 месяцев назад

@@HoopersBeta Thanks so much for the quick and detailed response! After watching your FDP video I'm pretty sure it's just the lumbrical as I don't have any pain in the finger except at the base. it's mostly in the palm, and twinges here and there from the wrist shooting towards the elbow. I was able to climb on it afterwards with buddy taping. Do you have a video on buddy taping? I just taped the middle and ring together on top of the a2 and a4. Is that the reccomended method? Thanks again. I watch all your videos and always take something away

@zurbruggpaul4360 3 месяца назад

I am a climber myself, but i have to admit i never had this from climbing ever… if you know you know ;)

@adriansth 3 года назад

I got this injury from a very cupped hand jam in a roof. Freaking destroyed my right indexfinger and hand. :(

@Lolsplays 3 месяца назад

Hello, can I have this injury but feel the pain only in my forearm? Thanks. I have watched your video for FDP and the test led me here but soon find out you only talk about the pain in the palm which I do not have at all.

@HoopersBeta 3 месяца назад

An isolated lumbrical injury is not likely to cause pain in the forearm. An injury to the FDP is more likely in that scenario, though it is certainly possible to have a mix of both.

@Lolsplays 3 месяца назад

Thank you for your time I apreciate it. You helped me a lot. Wish you the best of luck.

@enderbassett3570 3 месяца назад

I have this exact same problem. Heard a pop in my forearm while pocketing with my index and middle finger. Pain in forearm when I one finger pocket or pocket with my idex and middle fingers but no pain when pocketing with my middle and ring fingers.