A2 Pulley Injuries in Rock Climbing

The A2 pulley is stressed up to 3–4 times the amount of load applied compared to the fingertip

Anatomy

Location of A1-A5 pulleys. From Neumann DA. Kinesiology of the Musculoskeletal System.St. Louis: Mosby, 2002.
Injury to the A2 flexor pulley. From Neumann DA. Kinesiology of the Musculoskeletal System. St.Louis: Mosby, 2002.
Image taken from: http://www.ajronline.org/doi/pdf/10.2214/ajr.167.2.8686601

Single pulley ruptures are generally treated non surgically

Strength deficits from the injured finger to the non injured side disappears after 3–6 months

Less water equals less elasticity which means more rigid tissues and maybe… pop!

Repetitive stress diminishes tissue integrity

If you’ve been climbing for less than a year, your fingers have yet to adapt to the weight of your body hanging on them.

PREVENTATIVE MEASURES

Don’t let your ego get the better of you

Taping to support the A2–A4 Pulley

Being a weekend warrior is one of the best ways of getting injured

your urine should be clear or have just a hint of yellow

Collagen turnover rate in your body is 300 days. So it will take up to a year for those pulleys to bulk up and keep you safe

Suspect a pulley Injury?

Videos of Popping Pulleys:

Left Hand
Right Hand
Left Hand
Left Hand Mono Pocket

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Dr. James Lee PT, DPT, FAAOMPT

Dr. James Lee PT, DPT, FAAOMPT

Owner of Lee Physical Therapy. We serve the Chicago community and are dedicated to quick recovery in order to safely return to activities you enjoy the most.