In so doing, the pulleys assure proper movement and apposition of the flexor tendons relative to the adjacent osseous structures.Įight functional pulleys are found at each finger, extending from the volar plate of the metacarpal-phalangeal joint to the base of the distal phalanx. The pulleys are appropriately named, as they have a pulley-like function that allows the flexor muscle and tendon units to efficiently exert their force upon their respective fingers. The annular and cruciate pulleys are areas of focal thickening of the flexor tendon sheath that are of critical importance to the normal biomechanical function of the finger. Rupture of the A2 pulley of the finger (Climber’s Finger).
#Pulley closed hands free#
In his free time he is an avid rock climber, focusing mainly on bouldering.(3a) The proton density-weighted axial image confirms fluid, edema, and widening between the flexor tendons and the proximal phalanx, and discontinuity is noted within a soft tissue structure (arrow) along the radial aspect of the finger. He is scheduled to graduate from Texas State University’s School of Physical Therapy in 2021 with a Doctorate of Physical Therapy.
#Pulley closed hands series#
The next part of this 4-part series will focus on the Climber’s elbow.Īdam Arlitt is a Physical Therapy student who did a clinical rotation at MTI Physical Therapy’s Magnolia clinic in 2020. Should you sustain an injury while climbing, I encourage you to schedule an appointment with an MTI physical therapist who will guide you through your individual rehab process.
Injury prevention exercises will decrease the risk of injury, but it will not eliminate the risk entirely. Here is a link to a video of this exercise: īONUS: To decrease your risk of a finger flexor tendon injury, do this same exercise but perform 5-8 repetitions at about 70-85% of your 1 repetition max. To keep your pulleys healthy and decrease your risk of a pulley injury, you should aim to do 2-3 sets of 30 repetitions at about 30% of your 1 repetition max when performing this exercise. Since we want to avoid stretching the pulley ligaments while doing this, I recommend the following exercise to help improve the blood supply, while protecting the integrity of the pulleys.įinger Rolls: Begin by holding a barbell with your fingers and wrist fully flexed around it, then slowly unroll your wrist, then your fingers joint by joint until you are holding the barbell at your fingertips, then reverse the motion. This is best accomplished with light loads and high repetitions. Repeated motion causes compression and decompression in the area that helps blood diffuse from areas surrounding the ligament, into the ligament itself. Throughout our bodies, our ligaments receive nutrients from our blood that allow them to stay healthy. You can probably see why having healthy pulleys is important for climbing – no amount of muscle will keep you on the wall if your finger flexors cannot efficiently flex your fingers!Īs discussed above, the finger pulleys are ligaments, and ligaments have poor blood supply and are not meant to stretch. When climbers sustain a pulley injury, they are either fully tearing one of these ligaments, or partially tearing them which results in a looser ligament allowing the flexor tendon to pull away from the bone. Climbers primarily injure either an A2 pulley or an A4 pulley. Each pulley is a circular (annular) ligament that serves to keep your finger flexor tendons close to the bones allowing hinge points so you can curl your fingers. In this image, we see an illustration of the pulley system of the fingers. Tendons attach muscle to bone and can stretch while functioning as a “spring,” storing energy to increase the power of our muscles. If they are lengthened for a prolonged period, they have a hard time shortening back to their normal length and provide less stability for your joints. Ligaments attach bone to bone, provide stability and are not built to allow much stretch.
Ligaments and tendons are similar in multiple ways: both are made up of connective tissue fibers called collagen, and neither receive a direct blood supply, which means they have a poor ability to heal compared to other tissue types. Injuries to the hand typically involve ligaments and can affect the finger flexor tendons as well.
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