How To Rehab a Climbing Pulley Injury

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Have you suffered from a pulley injury and feel lost on how best to diagnose the severity of injury and rehabilitate it? It is a lot easier than you think. Watch this video for a comprehensive look at how to get back to climbing safely. This video covers medical and clinical ways to diagnose pulley injuries, a clear timeline for returning to climbing and hangboarding, specific categories of rehabilitation, how to unload, increase motion, and improve finger strength to return to climbing after a pulley sprain.
For more details on pulley rehab protocols, check out the link below:
0:00 Start
0:14 Guidelines for return to climb based on pulley injury grade
1:08 Clinical criteria grading pulley injury
2:55 Return to climb timelines after a pulley injury
3:50 Defining easy, moderate, and hard climbing
5:21 Rehab Unloading: Taping and pulley protection splint
9:00 Rehab Mobility: Improve circulation, glide the tendon, and restore mobility
10:04 Rehab Strength: “no pain” and “low pain” techniques
15:00 Protecting the injury during rehab
RESOURCES
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💪 Pulley Rehab Protocol: theclimbingdoctor.com/product...
📝Full article here: theclimbingdoctor.com/how-to-...
LINKS
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🕸️Webpage: theclimbingdoctor.com
📸 Instagram: theclimbingdoctor.com/grid/
📍Pinterest: / theclimbingdoctor
🎙 Podcast: theclimbingdoctor.com/the-cli...
📝 Blog Articles: theclimbingdoctor.com/grid/
BOOKS, INJURY PROTOCOLS, AND REHAB TOOLS
===============================
Climb Injury-Free Book: theclimbingdoctor.com/product...
Self-Help Injury Protocols: theclimbingdoctor.com/rock-re...
Rehab Tools: theclimbingdoctor.com/rehab-p...
Brand Partner Discounts: theclimbingdoctor.com/brand-p...
INJURY REHAB COURSES
===============================
Courses for Medical Providers: theclimbingdoctor.com/courses/
Courses for Coaches: theclimbingdoctor.com/climbin...

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Опубликовано:

11 июл 2024

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Комментарии : 70

@jacobpickos733 Год назад

I was trying hard on a V7 project in the gym today...a sit-start straight into a two finger pocket in a cave. Felt a pop in my A2 when I went to the pocket. This is my first climbing injury... scary honestly - climbing is such a huge part of my life. Thank you for putting this information online for us. I will be referencing this over the next few months for sure.

@TheClimbingDoctor Год назад

Glad that the video is a helpful reference.

@samuelboriss9435 8 месяцев назад

How did your recovery go?

@jacobpickos733 8 месяцев назад

@@samuelboriss9435 I made a full recovery. I'm climbing a grade harder than I was a year ago.

@_trismegistus 7 месяцев назад

@@samuelboriss9435 Sadly he succumbed to his injury. :(

@brunorosadesouza2971 2 года назад

this class is gold

@roxanaelenabucur8222 5 месяцев назад

Hey Dude! I first found your video a few years ago when I - you guessed it, had a pulley injury. I find your video one of the most helpful and complete there is in the climbing world. I now write an article about injury prevention and I will include your video in it. It's amazing, thanks for sharing your knowledge, it's been really helpful!

@TheClimbingDoctor 5 месяцев назад

I am glad that you find the video useful!

@kishormore7977 Год назад

One of the best video found finally...Thanks

@TheClimbingDoctor Год назад

Thank you! Glad you found the video helpful.

@Stanginsean281 Год назад

This is amazing. Didn’t expect a climbing specific analysis going in. Even putting in what’s considered easy climbing vs moderate for regionalization and types of holds to avoid was amazing to see

@TheClimbingDoctor Год назад

Glad you found it helpful!

@adampnewsome 2 года назад

Super helpful video! Some photos/diagrams of what you're talking about around 11 min mark would be very helpful for those of us who are not doctors or PTs!

@TheClimbingDoctor 2 года назад

Happy you enjoy the videos! That would be a good idea to help aid in the clarity. I'll try to add something like that for my future lectures. But for now, hopefully the below helps: Isometric grip with isotonic pull: Gripping a portable hangboard attached to a resistance band or cable in front of you and rowing your arm back and forth into your body Isotonic grip with isometric pull: Same set up as above, but row the portable hangboard into your body, keep it there, and open and close the fingers (1/2 crimp to open hand) Isometric grip with isometric pull: Stand under a hangboard on a thin edge (or weight your body) and pull down (the arm and fingers don't move)

@danbookless7169 Год назад

Really helpful, really detailed GREAT VIDEO

@TheClimbingDoctor Год назад

Awesome. Glad you like it. It took a while to put together but I wanted to make sure that I made a highly detailed single video that could guide climbers in the right direction after a pulley injury.

@AyoMrB 2 года назад

This is so enlightening! You’re such a fantastic teacher. Have you ever personally experimented with gyroscopic tools such a the Powerball? I previously suffered from carpal tunnel syndrome and was able to significantly reduce symptoms by using this as it encourages blood flow, use of hand and forearm muscles, as well as progressive loading through the force and rotation angles and weight of the Powerball selected. I will be following this rehab system as well as strengthening with the Powerball once I get to a level where pain is minimal. Thanks Jared!

@TheClimbingDoctor 2 года назад

Yes, gyroscope balls are great for wrist range of motion, stability, and sensory motor control. They can be used as a great supplement to a pulley rehab program!

@maggiefagan9912 Год назад

I am a certified hand therapist. I did some climbing years ago but no longer lives in an area where I am likely to see this injury I am sure Hand therapists who climbers will really appreciate the detailed progression for return to sport. I have a client with pulley injury from other causes and reviewed making the pulley splint from your video. Thanks

@TheClimbingDoctor Год назад

So glad you find this helpful! Below is the article for the pulley splint as well for reference! theclimbingdoctor.com/pulleyprotection/

@MisterBleau 2 года назад

Gracias!👌🏼

@paulgilbreath4914 2 года назад

Thanks for sharing this information! I've been using a copy of the Ultimate Climber for years now and should probably pick up your book. Did you have a premonition? Unfortunately, this video was posted on a very useful day for me.

@TheClimbingDoctor 2 года назад

Hey Paul, psyched you have a copy of my original book. It’s been out of print for a while! Bummer about the recent finger injury. Hopefully the video helps!

@bernhardlangers778 2 года назад

I am 90 seconds into the video and already relieved quite a bit. The pandemic just sucked in so many ways: - don't have real rock around (barring prohibitively long drives) - gyms were shut down a lot - gained weight This in combination with rather good technique lead me to hop on the harder stuff maybe sooner than I should have. The muscles were fine and apart from quite small holds I could hold on to everything I could before. Tendons are a different story though. About two weeks ago I fell off a small pinch in the overhang after my foot slipped. Based on symptoms it's definitely just a strain, but working in retail and needing functional hands this is a good relief. Thank you so much for this explanation and input. Subbed and liked.

@TheClimbingDoctor 2 года назад

Thank you for sharing your story. Happy that you have found relief from the video.

@kelliesu1084 2 года назад

Thank you for putting out such useful content! I've listened to all of your TrainingBeta episodes and have learned so much from you and Neely. Question: for the loading stages that have more than 1 type of hold, do we do all sets of each hold type listed? For example, in No Pain stage 2, do we do 3 sets of open hand and 3 sets of 1/2 crimp (total of 6 sets)?

@TheClimbingDoctor 2 года назад

Hi Kellie, thanks for the nice words. A lot of the dosing for the hangs is dependent on the climber's ability and tolerance to volume. So protocols often need to be modified to the climber. However, with that being said, you are correct with the current protocol being 3 sets of 7 reps open hand. And 3 sets of 7 reps half crimp. A total of 6 sets. As long as they are pain-free and low load, this is an acceptable amount of load. If there is bowstringing on the ultrasound (Tendon bone distance greater than 2mm), then the hands must be performed with taping to protect the pulley.

@johnrodolfo 2 года назад

Oh hey its Jared Vagy. I take your movement impairment system courses on Medbridge!

@TheClimbingDoctor 2 года назад

Great to hear from you. Glad you enjoy the courses!

@dark-o 2 года назад

Great video. Can finger rolls/curls be used for rehab similar to pulls and hangs?

@TheClimbingDoctor 2 года назад

They are a great supplement for a "hang" or "no hang" strength exercise and I list finger curls as a level 2 strength exercise in my book since they can be performed at a lower weight and take the fingers through a full range of motion. However, since climbing is mostly an isometric sport for the fingers (or you could argue isometric with small range concentric and eccentric) some type of "hang" or "no hang" should be built into the rehab.

@nmwag88 Год назад

Hi! Would you alter the rehab period for a pinky pulley injury? I've somehow strained my A4 pinky pulley and am hugely tempted to just keep climbing open handed/ 3 fingered/ where there is no pain. Ironically, pain only occurs on larger holds/ jugs that are grabbed. Crimps, particularly on small holds, feel fine (perhaps because the pinky is too short to engage?).

@landonlee5615 Год назад

Hi! You mention how many times per week you should perform No Pain Hangs (3x/wk), but not for easy climbing if I recall. What's the volume of climbing I should aim for per week while simultaneously performing No/Low Pain Hang Stages? Thank you!

@SNUYounghoon Год назад

Huge thank you for sharing this great video! I got an a2 pulley rupture in my LH middle finger two weeks ago, and this video is really helpful! I’d like to ask a question that.. taping/wearing pulley splint during the rehab will be helpful/beneficial in terms of healing the pulley? or should I take off tapes/splint during the loading process?

@TheClimbingDoctor Год назад

In the early stages of a pulley rupture it is highly recommend to wear a pulley protection splint for up to 6 weeks. There has been research studies on the timeframe with effective results. A benefit of splinting is it keeps the tendon close to the bone and prevents scar tissue from forming underneath the tendon. Tape does not achieve the same result. There is a discussion currently among us medical providers in the community of whether or not the pulley splint needs to be worn for 23 hours a day and if it is okay to just wear when loading. Although there is the potential for that to be the case, there is currently no evidence to support it, so best practice currently is still to wear all day the splint for up to 6 weeks. So yes, it should be worn for sure when loading if in those time ranges.

@SNUYounghoon Год назад

Thank you for kind reply! Then, after 6 weeks, when I do the hangboarding (for rehab), pulley splint is necessary? or taking off the splint during the hangboard session and wearing it for daily life?

@TheClimbingDoctor Год назад

@@SNUYounghoon Yes, remove the splint but still tape when hangboarding or climbing. There is a good video that outlines the timelines clearly below: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-YU2-K4NFXnk.html

@SNUYounghoon Год назад

@@TheClimbingDoctor Thank you! 🥰

@flairfilmsUK 10 месяцев назад

Greeat video! I presume taping should be used only when climbing/doing excercises - or should tape be on 24/7?

@TheClimbingDoctor 10 месяцев назад

Yes, taping is only when climbing or performing exercises.

@adamwaks6779 2 года назад

Hello Jared, With clinically examination, if someone is experiencing pain with mild blanching palpation (Moderate category), but falls within the Mild category for the rest of the tests, how would you characterize them? Could you please elaborate a bit more on taping? Should it always be applied during rehabilitation?

@TheClimbingDoctor 2 года назад

Palpation is one of the more unreliable assessments of the cluster, so I would recommend classifying as “mild” in the case you mentioned. On the topic of taping, research by Lutter er al. indicates taping should be used after a pulley sprain as follows: Grade 1, 2 and 3: 3 months Grade 4a: greater than 12 months

@adamwaks6779 2 года назад

@@TheClimbingDoctor Thank you for your answers and the instructive video!

@ntvalencia Год назад

Thanks for sharing the information!!!! Only one question, is it necesary (or better) to have the damaged pulley taped all day? or is it better to tape just for exercise, it seems to me that better circulation is important in healing. Thanks again!

@TheClimbingDoctor Год назад

Depending on the grade of injury, you may need to wear a pulley protection splint throughout the day for up to 6 weeks. Taping is performed during exercises to improve tendon bone distance, it won't do much during daily activities since it needs to be wrapped tightly to be effective.

@keke4170 13 дней назад

Hi! Thanks for an informative video! 4 days ago my pulley popped while pulling from a crimp. At first, it seemed like a grade 3 pulley injury but now the healing process has been surprisingly fast and it doesnt’t hurt at all in daily activities. Only crimping with the finger creates pain but even that has decreases a quite a lot during these few days. What grade do you think this is and how long will the rehabilitation last?

@TheClimbingDoctor 10 дней назад

Go to the second table in the article below and perform the testing - either yourself or a medical provider (recommend). You will then be able to identify the grading. theclimbingdoctor.com/how-to-rehab-a-climbing-pulley-injury/

@user-jo6ht6sy2b Год назад

Thanks for the video. Really helpful. I have a question tho: Should the splint be taken off for the mobility exercises? Have an A2 rupture, but don't feel a lot of pain at all. Not quite sure if extending and flexing the pip joint through full range of motion could be dangerous for the tendon bone distance.

@TheClimbingDoctor Год назад

It typically depends on two factors. The grade of injury and the amount of finger stiffness. For a fully ruptured pulley on a finger that is not very stiff; no - keep it on. For a partial rupture on a stiff finger; likely yes - but substitute with H taping during the exercises. Those are two examples of simplified extremes - but oftentimes it is best for a medical provider to make the judgment call.

@user-jo6ht6sy2b Год назад

Totally forgot to write back. Thank you very much for the answer, definitely very helpful. I have one additional question: I tried finding info on it, but no answer anywhere. Can I belay with the splint on or should I just not belay in general with the injury?

@omeradanyodla2177 Год назад

If I don't have access to an pulley protection ring will you recommend to use instead one of the typing technics? not only in climbing but through out the day

@TheClimbingDoctor Год назад

There are several ways to get a pulley protection splint since there are now ones that are commercially available. 1. If you type in a search engine: "pulley protection splint" you can see the commercially available options. 2. You can make one for your finger that is custom by following the instructions below: theclimbingdoctor.com/pulleyprotection/ 3. You can see a local hand therapist who can fabricate one for you. Hope that helps!

@shinrarango 6 месяцев назад

i got a nice new pulley injury yday ready for the new year. stupid overhanging v5 wasnt even that hard just not warmed up enough

@TheClimbingDoctor 6 месяцев назад

Bummer. Well, hopefully this video will help get you back on track.

@michaelvogel7905 4 месяца назад

When improving circulation, gliding the tendon, and restoring mobility do you leave the tape or pulley splint on or take them off? In my case i am H taping and using a splint on my a2 and a4

@TheClimbingDoctor 4 месяца назад

For gliding the tendon and restoring mobility it is typically recommended for grade 2 injuries to perform in the early stages with tape on. For grade 3 and 4 injuries, it is recommended in the early stages to perform with the splint on, and then after the recommended 6 to 8 weeks of splint usage, to transition to performing with tape on. I recommend you to consult a medical provider for a your specific case scenario.

@michaelvogel7905 4 месяца назад

@@TheClimbingDoctor i did he told me I didn’t need surgery and to follow your protocol 😂 he was also very impressed by my h taping plus pulley pal splint combo

@TheClimbingDoctor 4 месяца назад

@@michaelvogel7905Haha, that's awesome. Best of luck on the rehab!

@antoinejackson4311 Год назад

Have someone demonstrate the exercises you're talking about. I have no idea what this should look like.

@TheClimbingDoctor Год назад

Hi Antoine, Thanks for your feedback. The goal of the video is less to show the exact exercises to perform but more to show the categories of exercises and the proposed timelines based on the grade or severity of injury. However, for more added context, see below for specific exercises videos as they may help with your understanding. See below and hopefully that helps clarify: Pulley protection splint creation and use: theclimbingdoctor.com/pulleyprotection/ H-taping: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-oJWHdwxdyXU.html Accupressure rings: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-v8HQlnLN0ao.html Tendon glides: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-BqvhdhFuoZs.html Varius methods to hang: instagram.com/p/CZ2TAtaODHc/

@yourshitsweakx100 11 месяцев назад

Ouch

@MorkulaMuussi 7 месяцев назад

I was doing 2 finger hangs on a hangboard and i felt a small strain on my index finger, it only hurts to hang on 2 fingers but no pain at different positions. How severe is this?

@TheClimbingDoctor 7 месяцев назад

If it was a pocket and hurts more open hand with the opposing fingers flexed vs. a crimp then you may want to make sure you didn't injury your lumbrical or flexor tendon. If you suspect a pulley injury you can use the criteria in the article below to identify if it is mild moderate or severe. Use the criteria from the chart below: theclimbingdoctor.com/how-to-rehab-a-climbing-pulley-injury/

@sigmastodon Год назад

This should be displayed in every climbing gym 24h 365 for every climber to be exposed and educated. Amazing video

@TheClimbingDoctor Год назад

Happy that you enjoy the video and feel so strongly about it!

@andrewhunter6536 4 месяца назад

Nothing about taping a4 or anything specific about a4? Maybe you have a different video? Is tape effective for a4?

@TheClimbingDoctor 4 месяца назад

The rehab is very similar but the grading is different. See the article below. Also, for taping, we are currently performing a research study to see if taping and splinting is necessary for A4 injuries since only one tendon travels beneath it whereas for A2 there are two tendons beneath it. Grading info below: theclimbingdoctor.com/climbing-pulley-injury-anatomy-biomechanics-and-research/

@andrewhunter6536 4 месяца назад

@@TheClimbingDoctor thanks for the information I will read it

@mikepiper3736 16 дней назад

Today I learned that the words "bone-tendon distance" make me very uncomfortable.

@TheClimbingDoctor 15 дней назад

Oh bummer. Well, know that bowstringing (bone tendon distance) it is actually a natural occurrence that happens any time that we put load onto the fingers. However, if the load exceeds capacity, the pulley can rupture and the distance is excessive. The good news though is that video outlines exactly what to do if and when it happens. So hopefully that puts you a bit more at ease!