
Headaches With Eye Movement?
Are you experiencing headaches with things like reading or computer tasks? It might be because of small muscles in your neck? Check out this quick tip to learn more!
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Written by: Jason Smith, MSc(PT), CSEP-CPT, CIDN, FCAMPT, Registered Physiotherapist
Rock climbing can be a strenuous sport, and is especially strenuous to the muscles of our upper body. This is largely due to the tremendous tension we must generate in our body to keep us on the wall. No muscle-tendon system is stressed more than the finger flexor group of our hands and forearms. Of course, the smaller the holds are, and the steeper the route is, the harder our muscles have to work. Injuries involving the finger flexor tendons and muscles are very common in our sport, and can take a long time to heal, especially if appropriate injury management is not initiated early. If you think you’ve experienced one of these unfortunate injuries, there are some important principles for you to consider that will ensure you get the most out of your tendon rehabilitation:
*Note: This article is designed for informational purposes, and is not designed to replace an individualized rehab protocol. It is intended for those familiar with rock climbing. To obtain clarification regarding any unfamiliar terms, feel free to directly email the author at jsmith@grsm.ca
Anatomy
The finger flexor group is composed of many tissues. The main tissues which are subject to injury are:
A
B
C
Forearm Flexor Musculature: A. Superficial musculature including flexor digitorum superficialis (Sublimus), B. Deep musculature including flexor digitorum profondus, C. Flexor tendon sheath visible in blue 5
A
B
Finger flexor tendon pulleys pictured in A. From the side and B. From the palm side of the hand6
REHABILITATION PRINCIPLES
PRINCIPLE 1: Recognize these common signs and symptoms of flexor tendon system injury:
PRINCIPLE 2: Seek a proper diagnosis
The author performing isolated strength testing of the finger flexor tendons, which is helpful to differentiate FDS vs. FDP injury, differentiate tendon pulley injuries, and track improvement in strength over time.
PRINCIPLE 3: Rest!
PRINCIPLE 4: Return to climbing with restrictions
PRINCIPLE 5: Taping
Demonstration of taping techniques. H-taping is applied to the middle finger while circumferential taping is applied to the ring finger3
PRINCIPLE 6: Isometric loading
A
B
The author performing isometric tendon loading of the 4th digit, primarily loading A. Flexor digitorum superficialis and B. The Flexor digitorum profundus tendons
PRINCIPLE 7: Load integration
PRINCIPLE 8: There are endless principles!
**Watch for future articles regarding other common climbing injuries and self-rehabilitation guidelines
Jay has been rock climbing for 5 years, and has been treating rock climbers more regularly for the past 4 years. Jay graduated from McMaster University in 2011 with a Masters of Physiotherapy. His previous education includes a Bachelor of Arts in Kinesiology in 2009 from Western University. Jason has obtained his FCAMPT (Fellow of the Canadian Academy of Manipulative Physiotherapy) designation. This designation is internationally recognized, and follows a comprehensive post-graduate training program that solidifies manual therapy skills, teaches advanced clinical reasoning, and allows him to perform spinal manipulation. Jay is also certified in Integrative Dry Needling, which he uses to release muscular restrictions throughout in the body. Jay is also a Certified Personal Trainer with the Canadian Society for Exercise Physiology (CSEP-CPT).He enjoys working with high level athletes, especially towards the later stages of their rehab as they approach return to sport. In addition to this, Jay is a certified Sport First Responder, and former team physiotherapist for the Guelph Gryphon’s Men’s Varsity Rugby team.
References
Are you experiencing headaches with things like reading or computer tasks? It might be because of small muscles in your neck? Check out this quick tip to learn more!
This patient came in with a painful and disturbing clunking sensation while reaching overhead. With his consistency you can see his progress through his injury rehabilitation.
Many people don’t realize that they can come in BEFORE they have pain. You don’t have to wait until the pain effects your quality of life to come to physio.