

Finger or flexor pulley injuries are one of the most common climbing injuries both in the gym and outdoors. You might have heard terms like ‘A2 pulley’ or ‘pulley injury’ thrown around but not many people fully understand what the injury is.
In this article, we’re going to cover everything you need to know about finger pulley injuries, including:
A flexor or finger pulley is the name given for the annular (ring-shaped) connective tissue that keeps your finger tendons close to the bone. Depending on where they are in the finger depends on what they are called.
As seen below, we have five pulleys in each finger called A1, A2, A3, A4, A5. The tendons passing through them attach the muscles in your forearm to the bones in your finger.
In climbing, because each finger has three bones and three joints, each pulley is put under a different amount of stress depending on how you’re gripping the wall.
You’ve likely only heard of A2 (maybe A3) injuries because they are the most commonly injured. When the first finger joint is flexed past 90 degrees (seen below), there is 3–4 times more stress on the A2 pulley than at the fingertip. When the A2 pulley cannot bear the stress, you may hear and feel a pop as the tissue is sprained or torn.
They can be difficult to diagnose alone and we therefore strongly advise you to seek a medical professional’s assessment to help you grade the severity of your pulley injury. This can be done via an ultrasonography scan.
Severity is graded on a scale of 1-4 (1 being the least severe to 4 being the most severe):
Grade 1 – pulley sprain
Grade 2 – complete rupture of A4 or partial rupture of A2 or A3
Grade 3 – complete rupture of A2 or A3
Grade 4 – multiple ruptures as in A2/A3, A2/A3/A4, OR single rupture A2/A3 WITH trauma to the lumbrical muscles or other ligaments
As a rough guide, a grade 1 sprain describes a stretch or partial tear to the pulley, whereas a grade 2-4 rupture describes a complete tear of the pulley.
In both instances, your finger will have the following symptoms:
The good news is that not all injuries need surgery.
Invasive repair is now seen as a last resort and even then, usually only considered if you’ve ruptured multiple pulleys at the same time. However, this will largely depend on the severity of your injury.
Ultimately taping offers between 5-10% support to the injured finger. This is not a great deal but its still worth doing.
The honest answer: everybody heals differently, so this can vary – a Physiotherapist can help you with this decision though.
Once you have the go-ahead, generally speaking, climbers being treated conservatively (no surgery involved) can expect to follow a progressive rehabilitation programme outlined below. As you can see, supportive tapping will play an important role in your recovery.
Image property of Will Anglin5
If you want advice on your finger injury, our expert Physiotherapists and Sports Therapists can help to get you back on the wall!
Book An Appointment today or give us a call on 01273 711 399 for some free advice.
DISCLAIMER: All content within this column is provided for general information only and should not substitute for the medical advice of your own doctor or any other health care professional. S57 Health & Wellbeing Clinic is not responsible or liable for any diagnosis made by a user based on the content of this site.
Cookie | Duration | Description |
---|---|---|
cookielawinfo-checkbox-analytics | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics". |
cookielawinfo-checkbox-functional | 11 months | The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". |
cookielawinfo-checkbox-necessary | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary". |
cookielawinfo-checkbox-others | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other. |
cookielawinfo-checkbox-performance | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance". |
viewed_cookie_policy | 11 months | The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data. |