Mike speaking on Climbers Pulley Injuries

Mike speaking on Climbers Pulley Injuries

Mike is excited to be speaking in Birmingham on Friday, at the annual meeting of the British Association of Hand Therapists (BAHT).

Mike has been asked to talk on pulley injuries in climbers. These injuries are quite common and fortunately partial tears that can be managed without surgery. 

However, if the flexor pulleys fully rupture and cause bowstringing of the flexor tendons, surgery can be performed to improve flexor power and prevent the bowstringing.

Mike will discuss injury prevention and this often involves adequate hydration and stretching prior to climbing.

If  an injury occurs clinical assessment will look for bruising and restricted flexion and hear the tell-tale history of a popping feeling in the finger as the pulley ruptures.

The most common method of investigating pulley ruptures in climbers is a dynamic ultrasound scan. This needs to be performed by experienced ultrasound user and will show the flexor tendons coming away from the bone as they start to bowstring. 

In his lecture Mike will show a technique using a strip of wrist extensor retinaculum to recreate the pulley system. Mike has recently been performing the surgery while away on the local anaesthetic with no tourniquet. Intraoperative patient feedback is vital to check the strength of the repair and also ensure that the flexor tendons glide freely underneath the newly reconstructed pulleys and do not have any restriction in their movement.


Mike is fortunate to work with excellent hand therapists who are able to offer optimal rehabilitation following such a potentially devastating injury.

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