flexor pulley splints
These splints are designed to support you to self-manage mild A2 flexor tendon pulley sprains more effectively than with taping.
Evidence and research supporting this is provided at the bottom of this page.
They can be used for moderate to severe sprains, ruptures and post operatively, but this must be under the guidance of an appropriate medical practitioner.
I can provide this guidance and there is a £15 discount on assessment appointments (remote or face-to-face) with myself when you buy the splints (QR code on the tube).
Or you may wish to self manage with the guidance from my book, The Self-Rehabbed Climber. This has a £10 discount, from both the ebook and paper version, using the same QR code.
There are 3 quick and easy stages:
Diagnose – easy to follow guidelines to see if you do have an A2 sprain and what level it may be
2. Measure - How to select the right size of splints to purchase
3. Fit - How to fit and use the splints to speed your recovery and keep you climbing
Most climbers know someone who has injured a finger flexor pulley or have done it themselves. Partial tears (strains) 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 currently used to support 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 (around 13%) 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.
Volker Schoffl is the world's leading climbing medicine researcher and an orthopaedic surgeon. In this paper (Miro, P. H., Sabb, D. M., & Schöffl, V. (2021). Finger flexor pulley injuries in rock climbers. Wilderness & Environmental Medicine, 32(2), 247-258.) he concluded:
" The gradual return to climbing after a pulley injury always should be done under pulley protection. A device called the pulley-protection splint, specifically designed for conservative treatment of pulley ruptures, has shown good clinical results.49 The device is recommended to be placed shortly after injury and to be worn for 6 to 8 wk. When used correctly, the pulley-protection splint reduced the initial bowstringing at the A2 and A4 pulleys by 50 and 40%, respectively. The device’s unique shape is one of its main advantages over alternative methods, with collateral bulges designed to prevent compression of the surrounding neural and vascular supply of the finger, while still maintaining close apposition of the flexor tendons against the phalanx."
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.
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.
Pulley injuries are easily manageable remotely. They are now well understood and rehab is based around load management and symptom response.