Finger Stress Fracture

Although big, open-hand holds are typically easier on the fingers, they can be quite stressful on the elbow where the wrist flexors originate. Illustration Steve Graepel

Q:

I’m a 15-year-old competitive climber. My finger has been swollen for about two months, and has been getting progressively more painful when I climb, particularly on crimps. I have rested it, but I have lost a lot of movement, and it hurts just to hang on a chin-up bar. I have seen a physio, general practitioner and hand specialist, and am desperate to get better quickly as I need to start training again soon.

—Annabelle, Newcastle, Australia

A:

Annabelle, even with such limited information about your injury, I would bet the farm that your chronically swollen finger is a stress fracture. I’ll also say that it is a type-three Salter-Harris fracture of the proximal growth plate of the middle phalanx. Oh, and it will be on the back (posterior) side.

The only caveat I would attach to this seemingly audacious diagnosis is that your young age adds an element of uncertainty in how to label your injury. You see, the growth plates that are at each end of a growing finger bone gradually close in your teenage years as you reach your full-growth potential. Given that you are a 15-year-old female and have virtually reached skeletal maturity, the growth plates are almost gone, so defining the break as a Salter-Harris fracture may be a moot point.

First port of call is your doctor (again), who may or may not know what the hell you are talking about, but will almost certainly err toward a set of X-rays. These usually get the ball rolling. Next will be a CT or an MRI scan to get a better sense of how displaced the fragment is (usually not much). Your doctor will likely want an opinion from an orthopedic specialist. When the dust settles, you will find your finger immobilized for the next six weeks. Sorry, not quick!

Read the Stressed Out Fingers article on my website. It may identify some other contributing factors. Also, if you can’t manage your overly exuberant training program, consider getting a coach. If you have one already, consider finding a different one—coaches should be aware of the risks training and climbing place on a young body during its growing stages.


This article appeared in Rock and Ice 238


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