To correspond some previous topic about UIAA youth competition, here is some rock climbing related hand injury articles that I searched through our library. But I can’t type Chinese so I can’t post Chinese translation. The attachment size is limited to only 256k, so I can’t post the whole pdf file but just the abstracts.
I hope these may help some people who are interested. There are more than hundreds of articles related to mountain climbing medicine in the PubMed web site: www.ncbi.nlm.nih.gov I am studying at a medical institute so I can access to most of them. Email me if you would like to read more.
Rock climbers are often using the unique crimp grip position to hold small ledges. Thereby the proximal interphalangeal (PIP) joints are flexed about 90 degrees and the distal interphalangeal joints are hyperextended maximally. During this position of the finger joints bowstringing of the flexor tendon is applying very high load to the flexor tendon pulleys and can cause injuries and overuse syndromes. The objective of this study was to investigate bowstringing and forces during crimp grip position. Two devices were built to measure the force and the distance of bowstringing and one device to measure forces at the fingertip. All measurements of 16 fingers of four subjects were made in vivo. The largest amount of bowstringing was caused by the flexor digitorum profundus tendon in the crimp grip position being less using slope grip position (PIP joint extended). During a warm-up, the distance of bowstringing over the distal edge of the A2 pulley increased by 0.6mm (30%) and was loaded about 3 times the force applied at the fingertip during crimp grip position. Load up to 116N was measured over the A2 pulley. Increase of force in one finger holds by the quadriga effect was shown using crimp and slope grip position.
PMID: 11165286 [PubMed - indexed for MEDLINE]
Biomechanical effectiveness of taping the A2 pulley in rock climbers.
Circular taping around the proximal phalanx is frequently used by rock climbers to treat tenosynovitis and to prevent injuries to the A2 pulley. The aim of this study was to determine the biomechanical effectiveness of such taping. Devices were built to measure physiological bowstringing in vivo, and to determine the force of bowstringing as well as the force applied to the pulley tape. Two kinds of taping on 16 fingers were measured during the typical crimp grip position. Taping over the A2 pulley decreased bowstringing by 2.8% and absorbed 11% of the force of bowstringing. Taping over the distal end of the proximal phalanx decreased bowstringing by 22% and absorbed 12% of the total force. Circular taping is minimally effective in relieving force on the A2 pulley. It is probably ineffective in preventing pulley ruptures.
PMID: 10763736 [PubMed - indexed for MEDLINE]
Finger pulley injuries in extreme rock climbers: depiction with dynamic US.
Klauser A, Frauscher F, Bodner G, Halpern EJ, Schocke MF, Springer P, Gabl M, Judmaier W, zur Nedden D.
PURPOSE: To determine the ability of dynamic ultrasonography (US) to depict finger pulley injuries in extreme rock climbers. MATERIALS AND METHODS: Sixty-four extreme rock climbers (climbing levels 8-11 on a scale ranging from 1 to 11; Union Internationale des Associations d'Alpinisme) with finger injuries (75 symptomatic and 181 asymptomatic fingers) were examined by using US, with the transducer operating at 12 MHz. The distance between the flexor tendon and phalanx was evaluated in extension and forced flexion at the level of the A2 and A4 annular pulleys as an indicator of tendon bowstringing. A distance between the flexor tendon and phalanx greater than 1.0 mm was interpreted as positive for a pulley injury. US findings were compared with those of magnetic resonance imaging. Surgical correlation was available in seven cases. Statistical analysis was performed by using analysis of variance, the Student t test, and the Bonferroni method. RESULTS: US depicted 16 (100%) of 16 complete A2 pulley ruptures, nine (100%) of nine complete A4 pulley ruptures, six (86%) of seven surgically proved complete combined A2 and A3 pulley ruptures, and 15 (100%) of 15 incomplete A2 pulley ruptures. Measurement of distance between the flexor tendon and phalanx was significantly different among patient subsets without pulley ruptures and those with incomplete, complete, or complete combined pulley ruptures (P <.001). The sensitivity of US for depiction of finger pulley injuries was 98%, and specificity was 100%. CONCLUSION: Dynamic US allows excellent depiction of finger pulley injuries in extreme rock climbers.
Closed rupture of the flexor tendon sheath has been known to occur in the elite rock climbing population. However, only one study has investigated the prevalence of this entity. PURPOSE: To examine an elite climbing group in this country for the prevalence of pulley rupture and report on other commonly occurring injuries in the hand and elbow. METHODS: 42 elite rock climbers competing at the U.S. national championships were evaluated by an injury survey and concentrated examination of the hand and elbow. Manual testing for clinical bowstringing was done for each finger, by the same examiner. RESULTS: 11 subjects (26%) had evidence of flexor pulley rupture or attenuation, as manifested by clinical bowstringing. Injury to the PIP collateral ligament had occurred in 17 subjects (40%). Other commonly occurring injury syndromes are described. CONCLUSION: Our results and others suggest that closed traumatic pulley rupture occurs with significant frequency in this population. In addition, all subjects with this injury continued to climb at a high standard and reported no functional disability.