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Osteoarthritis And The Climbers Fingers

One  of the major concerns that climbers have as they get older is will climbing make them  more susceptible to osteoarthritis than non climbing folk.   While this is a common question, in actual fact it is a very difficult question to answer because the truth of the matter is that we just don't know.  We just don't know fully who is most susceptible to this condition and what role climbing truly plays in the causation.  The term Arthritis is translated in latin to mean  Arthro or Joint  and Itis to mean inflammation  or to put evening more simply, It is inflammation of the joint caused by damage to the cartilage and bone which often causes pain and disability to the climber or other unfortunate soul.

What goes wrong?

A joint is made up of two bones  which forms a joint. The joint is composed of articular cartilage on the ends of bones which provided a relatively friction free environment for the moving bones . The cartilage is made from  a complex  arrangement  of proteins and other clever stuff which once damaged does not heal very well if at all!  This super friction free material on the ends of your finger bones is a very effective shock absorber and friction reducer when in good health.  The articular cartilage as it is called in medical text books  is very thin in the the fingers.  It has been reported to be as thin as 1mm thick.  To put this into  perspective the the cartilage found  behind the knee cap is about 6mm thick comparatively.   Another important point to ram home is that the cartilage does not have a blood supply or active nerve supply.  

So why is this important?  

Well, if it does not have a good blood supply it means that when it is damaged it is unlikely to heal well if at all.  Because how will it get the products that it needs to repair ?  And the implications of a non existent nerve supply means that when you are overusing the cartilage and injuring it you won't know it until its too late.  Nerves are responsible for pain transmission , so if the cartilage has no nerve supply then it can't tell you to lay off when its hurting ! 

How does  the cartilage get its nutrition if its not from blood?

The cartilage gets it nutrition from the joint fluid  called  synovial fluid.  This  fluid is located  within the joint.

Why is this important? Well this is the important bit !  And write this down as it will change everything !  It is the gentle repetitive movement which provide the cartilage with its nutrition and protects it.  This means  that a separate warm up for the fingers which does not initially involve climbing is MANDATORY and not a Luxury !  Interestingly,  if a slow and progressive warm up causes a healthy diffusion of synovial  fluid into the joint to nourish and protect the cartilage, then  crimping on an edge causes a massive increase in peak pressure  forcing the synovial fluid out of the joint.  This is what puts the joints articular cartilage at risk of injury over time.  

What can you do about it? 1. Don't warm up with climbing until you have done a specific finger warm up

2. Watch out for the warning signs of over training  AKA :a painful and sore finger joint 

3. Reduce high risk training methods  that focus on extreme crimping positions  ( e.g working the same problem over and over again with crimps , and /or campus board training 

4. If you have a painful joint that is not resolving with a short period of rest then see a specialist like us at Inside Edge Physiotherapy or other healthcare professional. References:

Sylvester A, et al (2006) Factors influencing osteological changes in the hands and fingers of rock climbers Journal of Anatomy 209, pp597–609

Schoeffl  V et at (2016) One move too many , how to understand the injuries and overuse syndromes of rock climbing.  USA, Sharp End Publishing 

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