Hand Injury in Rock Climbers

Hand injuries for climbers follow a specific pattern that is known to and best-treated by Certified Hand Therapists.
Brooklyn Hand Therapy

Human fingers are not designed to carry 3-4 times body weight. This is how much pressure our phalangeal joints carry in a “crimp” position during a climb. In climbing athletes, Middle and the Ring digits’ are mostly involved. Chronic injuries include tendinitis and muscle strains. Digital pulley tears are very common among rock climbers we see in our Brooklyn Physical and Occupational practice. The causes vary. Some are cumulative: overtraining and poor planning. Some are acute like a sudden loss of footing. A similar injury may happen in other sports: gymnastics, basketball, weight lifting, contact sports. However, rock climbers’ finger injuries are unique.

Over the last 20 years research has been done to analyze injury distribution and injury risk involved. As the sport becomes more professionalized we see more involved injury patterns in our Williamsburg and Park Slope Brooklyn locations (because of our proximity to rock climbing gyms). Our rock-climbers physical therapy patient population is statistically consistent with the national average: an overwhelming majority of them are Hand injuries.

Know what to do when it happens.

Finger pulleys are fibrous anatomical structures around your digits that keep you tendons close to the bone. There are several, but the ones over the proximal and the middle phalanx, A-2, and A-4 are in the most vulnerable position. If damaged, your tendon pulls away from the bone. Resulting “bowstringing” of a tendon reduces its efficiency. Athletes often report a loud pop when it happens. Immediate pain is swelling ensue with a visible tendon bulge on the palmar surface of the hand. In the long run, if left untreated, it can lead to a loss of strength and motion in your hand.

Hand Therapy facilitates recovery

The good news is that most of finger pulley injuries do not require surgery and heal in approximately 4-8 weeks. During the healing, your body lays down collagen to repair the damage. It could be problematic as uncontrolled healing can lead to tissue adhesions. Skillful Physical or Occupational Therapy intervention guides healing. It prevents unnecessary scar formation and ensures the smooth gliding of the tendons. Hand therapists at our locations in Williamsburg, Park Slope, and Clinton Hill can fabricate a Pulley Protection Splint. The splint is effective and provides support while you gradually return to climbing. The specialized taping technique keeps tendon closer to the bone and thus assumes the function of a pulley.
Evidence suggests that any of the external support is not useful in preventing injury. The preventive program should include core strengthening and shoulder stabilization exercises.
Park Sports board-certified hand therapists are here to help!

Why Do I Have Tennis Elbow?

Why Do I Have Tennis Elbow?

You may recognize this situation: The doctor diagnoses your elbow pain as something called tennis elbow–but you’ve never played tennis at all! Don’t be confused by the name – tennis elbow is a common complaint, and a background in sports isn’t necessary to be afflicted.


The medical term for tennis elbow is lateral epicondylosis, referring to the tendons attached to the bone in your arm near your elbow. These are the tendons that extend the wrist and fingers. But after episodes of repeated gripping or lifting, these tendon anchor muscles can become inflamed or degenerated. When this happens, the attachment of these tendons becomes weakened, and places a strain on the muscles. This can lead to intense pain. It often starts at the bony point on the underside of the elbow and radiates down your forearm. The severe pain can wake you up at night, or stop you from lifting your morning cup of coffee. 


Treatment and Therapy

The treatment of tennis elbow targets improving the health of these strained tendons. Restoring strength to the connected muscles is also critically important. The first thing that doctors usually recommend to treat this condition is nonsurgical management. This can include anti-inflammatory medications or steroid injections into the painful area. But in the early stages, a referral to a hand therapist is also highly recommended!


An occupational therapist, or a therapist who specializes in working with the hand, wrist, and elbow, will identify what is needed to alleviate the pain in the short term and restore the tendon’s health in the long term. Hand therapists use manual techniques that will help you to move smoothly and comfortably through the stages of healing. In some cases, the therapist may need to customize a splint or brace for you. They will also develop a program of exercises and stretches that you can do at home when you are ready.


Whether you’re Roger Federer or an Average Joe, tennis elbow can be a painful, stressful ailment. But a good therapist is key to achieving your goals when it comes to recovering, and is the first step on the road to getting you back in the action!


Article written by Joanne E. Petrunik, OTR/L. Joanne specializes in Hand Therapy, Upper Extremity Rehabilitation, Sports Injuries and Pre- and Post- Operative Rehabilitation. You can request an appointment with Joanne at one of our locations.

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Treating Tendonitis for Rock Climbers

Written by Alex Ariza
Reviewed by Moussia Krinsky-Raskin, OTR/L

Sports injuries can occur from many different kinds of physical activities. This post will focus on how our occupational and physical therapists approach treating tendonitis, specifically for rock climbers feeling elbow, forearm, and finger pain.

Rock climbing is a very demanding sport requiring a lot of strength from your entire body. Grip strength is one of the most important factors in tackling new levels of difficulty in climbing. Working on strengthening your hands and forearms can prove to be challenging to develop without leading to injury.

Even professionals with many years of experience and skill can suffer from overworked flexors in their forearms and fingers.

When your flexors become inflamed from overuse – usually from your hands gripping tightly for prolonged periods of time – it can cause pain that can be felt from your fingers all the way to your elbow. This condition is called tendonitis.

Forearm Muscles - Flexors and Extensors

So what do you do if you suffer from tendonitis? The first step is rest. For many athletes, this can be very difficult to do, especially if they are training for a competition. Some may even be tempted to continue to train, creating more inflammation and a bigger problem to deal with.

Exercises that require gripping should be avoided for a brief period time. Each case is very specific to the individual, so this will vary from person to person.

Simultaneously, to counteract the inflammation, direct application of ice or a cold pack to the affected area is recommended, especially if swelling is visible. After the inflammation has subsided, light stretching can be followed as tolerated.

To help with stretching, our certified hand therapists recommend using heat prior to stretching or exercise to allow the muscles and tendons to loosen up.

You can use a warm towel or heating pad to do this.

Below is one recommendation from one of our occupational therapists, Moussia Krinsky-Raskin, for stretching. Remember, you do not want to stretch to the point when you are feeling pain. There should be some discomfort, but never pain.

  1. Straighten your arm in front of you as much as you can, bend your wrist towards your chest, palm facing you and hold for 5-10 seconds, or as much as you can handle it. This will stretch your extensors.
  2. Straighten your arm in front of you, palm facing outward, gently pull the back of your hand towards your chest and hold for 5-10 seconds. This will stretch your flexors.

Recovering from tendonitis requires patience. Remember to listen to your body. Don’t ignore pain. Continue to push through the pain following the “no pain no gain” mantra can cause far more damage than good – regardless of mind over matter. A badly injured tendon rarely recovers to its full strength afterward. If pain continues for more than a few weeks, it is strongly advised that you see a medical professional.

Here are some tips on how you can prevent tendonitis in the future:

  1. Take breaks often when training. Remember to treat rock climbing as if you were lifting heavy weights. There should be moments of rest between each “set” or climb that you attempt.
  2. Stretch before and after training and rock climbing. It is important that you keep your muscles loose and mobile.
  3. If you feel pain begin to creep up during your climb, stop. We understand that most people will disregard this piece of advice and want to continue training through the pain, but this will ensure longevity and maximum performance of your body in the long run. Don’t work yourself until you are out of commission!

Our physical therapists and occupational therapist are all sports rehabilitation specialists. They will work closely with you to help you recover quickly and teach you how to prevent injury in the future.

If you are just beginning to climb, we strongly encourage you to undergo a strength training program to help prep your body and prevent injury.

Do you currently suffer an injury from rock climbing? Our therapists can help.

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What We Can Learn From Angels Pitcher Shohei Ohtani’s Elbow Injury

Written by Boris Gilzon, PT, DPT, OCS, CHT and Alex Ariza

If you’re a fan of baseball you may have heard that New Los Angeles Angels pitcher, Shohei Ohtani, has a damaged Ulnar Collateral Ligament (UCL) in his pitching arm.

This is bad news for Ohtani, as his career relies heavily on the function his elbow. Although reports show that Ohtani only has a first-degree sprain, consistent use of his elbow can present serious problems down the line.

In the world of physical therapy, elbow pain does not get enough exposure and is often ignored. More often than not, people continue performing their daily activities that can exacerbate injury to the elbow and cause damage to the joint and ligaments.

Ulnar Collateral Ligament (UCL) Injury

As Physical Therapists, we see sports injuries in a different light, especially when they make the news. This post will share some of the intimate knowledge we possess from years of treating a number of injuries and conditions that athletes may face.

The Ulnar Collateral Ligament, located in the elbow, is a complex structure consisting of three bands. It is challenged more when the elbow is in flexion. During full elbow extension, the bony congruity provides additional stability.

Ulnar Collateral Ligament Anatomy

Ulnar Collateral Ligament injury is common in many overhead sports. The forces that can lead to injury on the elbow are generated when the elbow goes from flexion to extension at a high velocity. In Ohtani’s case, this would be frequently pitching at a consistent speed of 100 mph.

This injury occurs from repetitive valgus (a condition in which the bone segment distal to a joint is angled outward) stress on the medial (inner aspect) of the elbow. This kind of elbow sprain commonly occurs in baseball pitchers. It is less frequent in racket sports, volleyball, and hockey, but can still occur in athletes playing those sports.

Damage to the ligament can be caused by sudden trauma or a gradual stress. The most typical sign is a pain in the inner elbow while performing a physical activity. Patients commonly describe an elbow sprain as a twinge or sharp pain when pushing up, such as getting up from the chair.

If a ligament is compromised a patient may develop:

  • A sense of looseness or instability in the elbow.
  • Irritation of the ulnar nerve (aka the “funny bone”): This is felt as a tingling sensation or numbness in the small finger and ring finger.
  • Decreased ability to throw a baseball or other object overhead.

Treatment for Ulnar Collateral Ligament Injury

Ulnar Collateral Ligament injury can happen to anyone at any age. Parents and coaches should be aware of the issue and be alert if the child complains of the pain in the elbow.

Physical Therapy is the best first line of defense following this diagnosis. At Park Sports Physical Therapy, our Physical Therapists are skilled and experienced in treating elbow instability and ulnar collateral ligaments tears.

The treatment approach is based on thorough examination and biomechanical analysis of the activity that caused the condition.

It includes:

  • Strengthening weak muscle group
  • Activity modification.
  • Manual therapy and therapeutic modalities.

Post-Surgical Recovery

In cases of severe damage and instability, the ligament is reconstructed in what is commonly known as a Tommy Johns procedure. Physical Therapy treatment in this case follows an established post-surgical protocol. Our therapists work closely with an Orthopedic Surgeon to optimize post-surgical recovery and achieving the highest functional outcomes.

Do you suffer from Ulnar Collateral Ligament Injury? Take the first step to get out of pain by scheduling your appointment.

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Hand Therapy in Bedford Stuyvesant

If using your hands is causing you pain, then we provide some of the best hand therapy in Bedford Stuyvesant.

Regardless of what you typically do throughout the course of an average day, you are probably using your hands on a nearly constant basis.  Our hands are one of the main ways in which we interact with the world around us to get things done, and we rely on them heavily every day.

For this reason, if it becomes painful to move your hands or any body part related to the hands—like the wrist, forearm, elbow or shoulder—functioning in our daily lives can become extremely difficult.  Whether it’s an injury, an accident or a progressive condition, there are many problems that can lead to pain in the hands and surrounding area.  But whatever the cause of the pain, hand therapy is the best possible way to address the issue and help you to function normally once again.

A hand therapist is an occupational or physical therapist that specializes in treating a wide variety of injuries and conditions of the upper extremity, which includes the shoulder, elbow, forearm, wrist and hand.  Through extensive schooling and training, hand therapists are equipped to evaluate and treat these conditions with a number of different techniques.  The overall goal of treatment is to reduce pain, improve each patient’s function and help them return to their job or sport if the condition is holding them back.

Hand therapists are capable of managing just about any injury or condition that affects the upper extremity, or to bring patients back to full strength after surgery.  Some of the most common problems they treat include:

  • sprains and strains,
  • dislocations,
  • fractures,
  • carpal tunnel syndrome,
  • arthritis,
  • trigger finger,
  • sports injuries,
  • tendinitis, and
  • joint replacement surgery.

Treatment programs for each patient will depend on the type and location of their injury, as well as their specific overall goals.  In all cases, hand therapists will focus on helping the patient avoid surgery with the most appropriate treatments available.  This may include some of the following components:

  • Pain-relieving treatments like ice, heat and ultrasound
  • Stretching exercises
  • Strengthening exercises
  • Custom-made orthotics
  • Manual therapy applied to the injured area
  • Advice on how to modify daily activities to reduce further injury

Through the use of these and many other interventions, hand therapists will work closely with each patient and monitor their progress until they have recovered completely.  So if you’re dealing with any problems related to your hands, you should see one of our hand therapists right away.  It’s the safest and most effective way to regain your hand function and help you return to an easier daily life.

In any of our four offices we provide:

  • Hand Therapy in Clinton Hill,
  • Hand Therapy in Park Slope,
  • Hand Therapy in Fort Green,
  • Hand Therapy in Bedford Stuyvesant

Please call us today if you need a hand therapist to help you with your rehabilitation and recovery.

Click here for our office locations and contact information.