This plan was developed after a Tele-Medicine Appointment with a client and is included in the price for a single 30 minute virtual PT session.
A2 Pulley injury – left ring finger, Gr I
DOI: circa 1/01/2021
Rehab start date: 2/12/2021
Goals: Decrease scar thickening at injury site, ensure scar is laid down in healthy and parallel bundles of collagen tissue, progressively increase strength in newly forming scar tissue with careful loading program, improve tendon gliding through the tendon/pulley interface.
Daily Program:
1) Massage around the entire A2 pulley area with deep finger pressure, extra time along areas of increased tenderness. 2-5 minutes , 3x per day
2) Gently “scrape” along A2 area with the blunt edge of a spoon or knife handle. Strokes should be both up and down. Extra time along areas of “crunchiness” or tenderness. 1-2 minutes, 2x per day
3) Tendon Glides 10 reps , 2x per day
4) Full flexion stretch of finger. Fully bend the finger at all of the joints. Finger pad should touch against palm. Hold for 5 seconds, 5 reps, 3x per day
5) Full Extension stretch. Straighten finger and apply overpressure until stretch is felt. Hold a full 30 seconds. 1-2 reps, 2x per day
Progressive Loading Program:
4 Week Hang Boarding Plan
Phase 1 (10 days): Every Third Day for 3 hang board sessions (Hang, Rest, Rest, Hang, Rest, Rest, Hang, Rest, Rest, Hang)
Should have little or no pain with hanging*. Any increase in soreness should go away within 1 hour of completing the hang board session. If you have pain with hanging or soreness after the workout then you will need to decrease intensity by unweighting with a pulley system, decreasing hang time, or increasing the size of the edge you are hanging from.
*If you’re unable to hang without pain then the loading program will need to be delayed a week and you can start with isometric holds with much less than body weight. Can pull on the flat edge of a table or counter top for isometric holds. Same hold and rest times and sets as phase 1. Can do isometrics every other day until you can begin the hang board program without pain.
25 or 30 mm edge with all 4 fingers, open grip position. 3 second hang, 10 second rest, 5 hangs = 1 set
Up to 5 sets unless you are feeling soreness then stop.
Phase 2 (9 Days): Every Third Day for 3 hang board sessions (Rest, Rest, Hang, Rest, Rest, Hang, Rest, Rest, Hang)
Phase 1 should feel easy with no pain during or soreness after before progressing to phase 2.
25 mm edge with all 4 fingers, open grip position. 5 second hang, 8 second rest, 5 hangs = 1 set
Up to 5 sets.
Phase 3 (12 days): Every 4th Day (Rest, Rest, Rest, Hang, Rest, Rest, Rest, Hang, Rest, Rest, Rest, Hang)
Can start experimenting with smaller edges and 3 finger holds. Same rules as before. Little or no pain during and minimal soreness after.
7 second hangs, 10 sec rest, 5 hangs = 1 set. Up to 6 sets
After phase 3 is completed then you can start increasing your climbing, bouldering, and training intensity. Progress slowly and back down if pain or soreness begins.
Should be ready for full climbing/bouldering trip after 8 weeks from rehab start date
Can do the same program as outlined with resistance bands and portable hang board block.
Tension Blocks
Frictitious Climbing Pinch, Port-A-Board, or Easy board
Frictitious also makes a doorway mount for their hangboards that doesn’t need to be screwed into the wall.
Tensionclimbing.com
Frictitiousclimbing.com
For more detailed information on Pulley Injuries go to www.wavetoolstherapy.com