Stop Scraping and Rolling the Tendon Sheath
I remember the extra time it took in graduate school to dissect the pulleys of the hand.
It was an arduous process with a scalpel and forceps to demarcate the annular and cruciate pulleys.
It was challenging because once you go through the top layers, you run into the tendon sheath that runs the entire length of the finger.
To clearly identify the larger and thicker portions of that membrane, the pulleys, you have to clean it off carefully. And I don’t mean it’s fragile because it’s not.
You still have to use a new scalpel.
This membrane is incredibly important for the mechanics of the hand.
As we grow from babies into adolescents and adults, certain portions of this membrane thicken at the locations of the highest stress.
This is an adaptive response to using the hand.
So when a climber has an isolated pulley rupture, there’s no need to panic.
The tendon sheath is a “safety net” for the entire finger.
Because the annular pulleys are thickened and tightened portions of that membrane, you will now have some space (.24-.34 cm at first) between the tendon and the bone until the swelling drops (.05-.15 after).
There is no “best practice” and definitely no “best exercise” for rehab.
If someone says that there is, you should walk away. It’s a training habit (load management) discussion over 3 months of time. Staying confident, busy, and trusting in the body’s amazing ability to heal is the strategy.