Swollen middle knuckle and pain

So for about 2 months or so, my middle finger knuckle has been swollen. It also hurts if I even lightly pull the end of the finger to either side. If I ball a tight fist it hurts, and the range of motion is much less than the other hand. It is also tender on the top. But the strange part is it doesnt ever hurt to climb. Gripping, whether rock or plastic doesnt seem to hurt it. but it hurts to the touch or sometimes even if I am putting my hand in my pocket, it will catch and hurt. Thought it might be a stress fracture? Not sure.

I have a similar story. About a month ago, I felt pain in my ring finger first knuckle after a hard bouldering session at the gym, specifically after pinching. I stopped climbing for two weeks and was able to start climbing again after that just fine...no tape even Then this last weekend, I climbed outside on pockets. Being stubborn and because I had the next day off too, I bouldered the next day. My finger felt sore after the first day, and was beginning to swell the next(Sunday), but I taped it and continued to climb. By Monday, I was unable to even remotely extend my finger or flex it into a fist, barely any range of motion and swollen like crazy. It is now Thursday night, I have no climbed since and have been icing it, taking Ibuprofen, slathering it with traumeel and apologizing to the climbing gods. It is still very swollen and painful to move. Got some x rays, which did not reveal any bony chips floating about, and showed clear joint spaces. The doc played with the joint for a bit, moving it side to side asking about pain, did some resistance extension and flexion tests, and told me I had sprained my joint, meaning partially torn the ligaments. He asked me what happened, like I had jammed it, or hit it, but I honestly don't even recall a moment of pain or trauma. I researched sprains of the finger a bit, and most of them result from jamming or hitting the finger, so this makes me wonder how the hell it is sprained, but it is definitely not happy. He said it would heal in about three to four weeks, and be solid to climb on in 6. He didn't recommend splinting because it atrophies the muscles in the fingers. SOoooo, sounds like maybe you had a bad sprain. Have you had the joint checked for stability? I can't believe it is still swollen after two months. Glucosamine is supposed to really help.
Good luck

I would get an x-ray if you are able. Swelling for that long can be indicative of a stress fracture.

definitely still swollen. Some days full range of motion, some days, very limited. Painful to touch the top of the knuckle. Any ideas on the effects of continuing to climb for a month or so, then take the much needed rest, if it is a stress fracture? I have a trip planned to the Red River gorge for a little over a month coming up soon. Funny thing is climbing doesnt cause direct pain in the finger.

I took two weeks off, icing it and resting it completely. I started climbing after that with a completely mummified finger...tape from the base to just below the last digit...and it has been fine(knock on wood). No more swelling, no more pain. Someone told me to tape it this way until I forget which finger to tape If yours is still swollen and painful, it sounds like you have done greater damage than me, or are continuing to damage it.

Cimbing in the Red probably wouldn't be too bad since it's usually big holds, but avoid the Gold Coast! Crimper heaven there. Maybe you should try taping like the previous poster- the whole finger. I can't guarentee you're going to make the finger worse, but you will prolong your healing process.

I have been experiencing something similar to what you describe for about 2 years now on my left ring finger. The swelling significantly increases during/after climbing hard (pinches and crimps seem to be the worst). But it doesn't really hurt too badly or limit my climbing except when trying to climb multiple days in a row. Actually I take that back, I can no longer climb finger cracks. With the knuckle being swollen, it is very difficult to get to work well with the other smaller fingers. And even if the crack is big enough, it is extremely painful on the top of the knuckle. In fact, it hurts even with minor contact, like to knock on a door... I've tried resting multiple times, one time as long as 3 months. The swelling went down, but the first day back climbing felt like it did before resting. So now I just climb on it, and deal with the swelling.

I have been to multiple doctors, and had multiple diagnoses ranging from tenosynovitis, ganglion cyst, and arthritis. The latest and hopefully correct diagnosis is that it is a bone spur. According to the doc, this is my body's natural response to the extreme stress in that particular knuckle, basically just laying down extra bone around the joint to try to increase the contact area and reduce the stress. An MRI showed some extra fluid around the joint, but according to the dr., these were a result of the tendons rubbing on the additional bone mass and causing swelling. Anyways, it might be worth getting an x-ray to see if you get the same diagnosis. I have never heard of any other climbers with the same diagnosis, but it came from a reputable hand specialist at a sports medicine clinic, so I'm inclined to trust it.

Please post any updates, or any findings from the doctor if you go.

I have the same symptoms both middle fingers PIP joint. Ice right after climbing is the only thing that keeps me climbing more days. Going to try more taping techniques though. Hoping that over time the joints get stronger and that I don't do too much damage in the process.

Just reposting here from my other thread: [climbinginjuries.com]

So 3 years since my original post have gone by. Several months ago the bump which I still think was a ganglion cyst went away. Gone. Range of movement improved, however, the pain, stiffness and swelling still occur after climbing hard. The left ringer finger is now fine, but now I have the problem in both middle fingers, PIP joint. I've continue to climb hard but have limited it to 1-3 times per month lately because of the swelling and work. Trying to break into 5.13 now, but the fingers definitely prevent me from climbing as often as I want. Point is I continue to climb harder through the injury, which may or may not be a bad idea.

I try to ice religiously which helps a lot, especially as soon as possible after climbing. Sometimes I bring a cooler of ice water to the crag. I find the sooner I ice, the less the swelling and inflammation. But I also find the harder I climb, the less my fingers can recover and still swell to the point I need several days to recover. I've tried to avoid NSAIDs, but I'm going back to them now to see if it helps. Still thinking about the finger doc recommending a cortisone shot a long time ago.

I'm going to try some more different taping techniques and see if that helps, including looking into the stretchy kinesio tape. Will try to find a kinesio specialist.

I've seen several posts about sore and swollen PIP joints without a lot of conclusions. I've taken as long as 6 months off, but the problem returns pretty much immediately after climbing hard again. I'm sort of coming to the conclusion that the soft tissue around the joint just can't handle the stresses of everyday hard climbing, but over time they get stronger, but that takes a long time, and some balance of hard climbing to stress them and recovery are required to keep them growing stronger over the course of years.

Thanks for the update on your condition. It does seem to be a confusing thing, this PIP joint swelling. I also think for some reason, some people are just more prone to it than others. For instance, my husband and I have been climbing for 14 years and neither one of us has ever had this issue. I regularly climb 5.13- and he regularly climbs 5.13+, so it doesn't seem to be the difficulty. But, we did take a long time to get to this point. Neither of us got good at climbing really fast, so we really worked our way through the grades and maybe our fingers then had a long time to build up tendon strength. Muscles do get stronger faster than tendons, so if you get strong really fast, you may be putting a lot of strain on the joints. Then once you irritate those joints, it seems like it's tough to get out of that cycle. Glad you've found a way to at least manage your problem.

Hey,

Been climbing about 3.5 yrs. also a PT. i recently have been more concerned about my Left 3rd PIP jt. It has been swollen for about 2.5 years. It is certainly worse with crimping and when i climb back to back which i have been doing more recently. My theory is that the lateral bands of the extensor tendon when you pull out a crimp can take lots of the load as your hand sort of forms a "boutonnier" like deformity.

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I find that if you tape to support the lateral bands by placing an anchor around your proximal phalanx and the middle phalanx and then wrap strips from the first phalanx over top of the knuckle and right around the middle phalanx (but not too tight) your hand isn't as strong but i can climb way more. It should prevent you from flexing the PIP joint as much.

I managed to get over it by doing some taping, resting a bit and doing the moon board which is on an angle that forces me to pinch rather than crimp more often. however, now i have increased bone mass on the lateral side of the joint which i think would have to be due to the ligamentous strain on the bone rather than the tendon because i don't think the tendon is connected to that part of the bone but the ligaments are...then again the ligaments would be most stressed in ext not FL which is the crimp position.....?

Anyhow.... all the strong climbers i know have some pretty swollen PIPs. i think its just the knuckles getting stronger but Aimee is probably right...the ligs prolly just can't keep up with the stress we put on them.