youth climbing

Key Take Aways

✅ Epiphyseal finger injuries are the predominant finger injury in youth climbers, not pulley injuries.  Etiology of epiphyseal finger injuries: repetitive stress over time more often than a single event.   

Unfortunately many youth athletes waited a significant amount of time before seeking medical attention (mean 127 days from onset of symptoms.

It is thought that most injuries occur from repetitive loading in the full crimp position (similar to pulley injuries), placing load on the central extensor tendon attachment at the growth plate.  

In this case series, non surgical (28)and surgical (9) were managed successfully using a therapeutic diagnostic algorithm

Following the algorithm let to:

     * Union of epiphyseal fracture

     * Most returned to pre injury climbing grade

     * Most youth climbers jhad no pain and reduced disability as measured by VAAS and the quickDASH at 1 year follow up

     * No recurrent fractures

Although outside the scope of this article, the authers do question the use of feetless campus board training in this population

Population

Elite youth climbers

Summary

Many competitive youth climbers develop pain in their fingers.  Most people's first thouight is a pulley injury of some sort, however, most youth finger injuries are not pulley injuries or any other soft tissue injury at all.  The most common youth climber finger injury is the epiphyseal growth plate fracture.  

Citation

Schöffl V, Schöffl I, Flohé S, El-Sheikh Y, Lutter C.  Evaluation of a Diagnostic- Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers.   Am J Sports Med. 2022 Jan; 50(1): 229-237.

Link

https://journals.sagepub.com/doi/epub/10.1177/03635465211056956