Causes of Finger Joint Pain (Including Carpal Bossing)
Our hands are not beautiful.
Stop and ask yourself how many climbers have the potential of becoming a hand model? The answer is none of them. Swollen joints, thickened skin, crooked digits etc. That’s the life of a climbers hand.
Something people don’t consider is why it actually happens. Just like your muscles get stronger and bigger with weight training, so do your bones and cartilage with smaller holds and long-term climbing.
The question is always ask is why are we surprised by this? It’s actually the bodies way of becoming more robust and resilient at a task we expose it to.
If this is done slowly and progressively over many years, it shouldn’t be interpreted as“risky” to the health of the fingers. If it’s done too quickly; however, that’s a different story.
overdoing climbing volume
You’ve heard me say many times that climbing volume is the #1 risk factor for finger injuries. With too high a volume (especially with full crimping) we dehydrate the cartilage inside the joint. If we use the same positions over and over, it happens in the same location.
Repetitive dehydration in the same location creates small tears in the cartilage. Like a dehydrated sponge you’re cleaning your bathroom grout with, it’s bound to break down. As a consequence we get more fluid to the joint to try and “fix” the problem. That’s the swelling component.
taking it slow
By contrast, if this process is done slowly, in a stepwise fashion, we build thicker and more robust cartilage over time.
We create cartilage, joint capsules, and ligaments that are more resilient to the repetitive stressors of climbing.
Image courtesy of Complete Anatomy
carpal bossing
Another reason you won’t be a hand model is the carpal boss. If you aren’t familiar with the anatomy, the carpal bones (8 of them) separate the long bones of the hand from the forearm (ulna and radius).
With repetitive flexion and extension of the wrist under load the index and middle fingers create compressive stress to the trapezoid and capitate (2 of the carpal bones) of the wrist.
As a result of this mechanical stress, the bony tissue becomes hypertrophied. This is commonly mistaken for a ganglion cyst which presents in the same location.
The real way to differentiate is whether it is “mobile” or not. If it feels calcified, it probably is, and there’s nothing you’re going to do about it. If it’s a cyst, the same could be said and there are “things” to do, but they don’t work well, unfortunately.
This is really common in trad climbers who intentionally shove their hands inside a crack to keep friction through the upper extremity.
If you have one of these and no pain, join the club. If you’ve got one of these with pain (not common) then you likely want to address it. You’re best off identifying the primary stressor and modifying your activity. It’s incredibly unlikely to go away.
Image courtesy of Complete Anatomy
Key takeaways:
You won’t be a hand model.
Training volume is most risky.
Arthritic changes are normal.
Think long-term with finger training.
Training age matters.