Flexor pulley splints
A new treatment for an old problem
Most climbers know someone who has injured a finger flexor pulley or have done it themselves. Partial tears are debilitating. Full ruptures are devastating, often requiring surgery if more than one is ruptured. The good news is that the recovery is normally a full one. The downside is that it is a very slow recovery due to poor blood flow to the tissues and often takes months.
Taping is often used to support or assist the pulley during climbing, the theory being to minimise the loads the pulley has to manage. Sadly this is not very effective and can lead to false confidence. The stress reduction is statistically significant, but small and the tape needs frequent re-application (about every 20 minutes).
The theory is a sound and logical one, but to get the tape tight enough to be truly effective the circulation to the finger is cut off. Not ideal for a tissue we want to heal.
Micha Schneeberger B.S. and Dr. Andreas Schweizer M.D. recently published “Pulley Ruptures in Rock Climbers: Outcome of Conservative Treatment With the Pulley-Protection Splint-A Series of 47 Cases.” This showed the efficacy of using thermoplastic rings. They follow the same principles of taping, but provide much more support. It is possible to wear them for hours at a time, even when climbing. They allow for adequate blood flow to the finger whilst providing more effective support than taping.
The study showed they significantly improved recovery time and the success of rupture repair. This is due to the splint holding the tendon close to the bone for extended periods, allowing the pulley to heal around it.
They can be used to support full ruptures as well as partial tears.
A further very recently published paper by Hartnett, E et al. "Climbing while healing: An orthotic intervention for rock climbers with a low- grade A2 pulley injury, a case series." adds weight to pulley splints being used to support non-ruptured pulleys AND continuing to climb, without extending rehabilitation times.
One order will last you the entire rehab time as I send 3 of differing sizes as the swelling in the finger reduces.
They are custom made to your finger using a 3D printer and then sent out via the post to anywhere in the world.
Each splint is individually checked but you may wish to sand the edges a little to reduce any rubbing. This is fine to do and does not affect the ring.
They can be worn 23 hours a day, during work, climbing and other activities. Certain restrictions obviously apply and you should use the splints under the guidance of your chosen medical professional.
Pulley injuries are easily manageable remotely. They are now well understood and rehab is based around load management and symptom response.
I can also provide this service. Just go to the booking page.
concerns over de-gloving?
Whilst we can never say there is no risk to using a pulley splint when climbing every effort has been taken to ensure they are as safe as they can be.
You must continuously risk assess the situation and if it is appropriate to continue. This is a common skill in climbing. If you have any doubts, stop!
The ring was closed with 1.5 turns of climbing finger tape and placed between two karabiners in the same orientation as it is loaded in use.
A Tindeq load cell was placed below and the lower karabiner pulled until the ring broke.
The ring snapped at just 7.8kgs (7.6N).
For comparison a metal ring will typically achieve 400N+.
The plastic of the ring had deformed, but it was the climbing tape that had broken at the open end.