Finger Injuries in Recreational Rock Climbers—An MRI Study

Publication Date


Type of Culminating Activity


Degree Title

Master of Science in Exercise and Sport Studies



Major Advisor

Ronald P. Pfeiffer


Lorrie Kelley


Kevin G. Shea


Background: A questionnaire, clinical evaluation, and MRI of 20 recreational climbers’ hands were obtained. The study was designed to determine the prevalence of pulley pathology and tendon and joint pathology in recreational rock climbers. The descriptive study used a sample of convenience and MRI to evaluate the prevalence of abnormality and to identify the distribution of pathology specific to the A2 and A4 pulleys in recreational rock climbers. Additionally, the study collected data regarding non-pulley pathology that was identified through MRI.

Methods: Subjects were chosen through verbal communication and fliers. Subjects completed a questionnaire, underwent clinical hand evaluation by an occupational therapist and underwent MRI of bilateral digits, reviewed by a radiologist.

Results: Data collected from MRI was reported and compared to the questionnaire and the clinical evaluation. Nineteen of the 20 subjects (95%) had at least one abnormality to their hand identified by MRI. MRI identified 8 subjects with pathology involving one or more annular pulleys. Pulley-related pathology represented 18% of all pathology diagnosed. Seventeen subjects had joint-related pathology. Thirteen subjects demonstrated tendon-related pathology. Sixty-two percent of the subjects with pulley pathology experienced pain upon palpation. Forty-eight percent of subjects felt or heard a “pop” while climbing. There was no bowstringing of tendons found. Over half of subjects without pulley related pathology reported feeling pain and hearing a “pop” while climbing. Only 27% of these subjects experienced pain upon palpation without pulley pathology.

Conclusions: Five of eight (62%) subjects with pulley pathology experienced pain upon palpation over the areas of the digital pulleys. Self-reported symptoms and clinical examination findings for subjects without pulley-related pathology demonstrated more than half reported they experience pain, and more than half reported popping fingers while climbing. None of the subjects demonstrated bowstringing in the digits with MRI or upon clinical evaluation. This study provides a better understanding of what type of pathology is present in the fingers of recreational rock climbers.

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