By Matt DeStefano, PT, DPT

In this article, I’m going to discuss taping methods for your finger after sustaining a pulley injury. Remember from my first pulley injury article (Part 1) that finger pulleys are ligamentous structures that hold the flexor tendons of the fingers close to the bone to create a mechanical advantage for finger flexion. Finger pulleys are analogous to the eyelets on a fishing rod, without which would allow a bowstringing effect to occur when tension is placed on the fishing line (or tendon). When a pulley is strained or ruptured, bowstringing can occur which increases the tendon-bone distance, and creates excess stress on the remaining pulleys. The A2 pulley is the most commonly injured pulley and is very prone to injury when crimping due to the biomechanical forces present.1–9 During the rehab phase of a pulley injury, it is very important to offload the healing pulley, and tape can be a good option to get the job done. [Due to the biomechanics of the finger pulleys, taping is only indicated for use to offload your pulleys during a crimp grip, and has minimal necessity or effect on an open-handed grip.]

Over the years, many doctors and climbers have experimented with different types of finger taping to add structural support to an injured pulley. As you will read in this article, some methods are more effective than others. This article will educate you on the best method to use known as H-taping. As a brief note, taping of the fingers to support the pulleys will never be strong enough to replace the job of a pulley, but it can offload the tissue to avoid other complications during rehab. In addition, it must be mentioned that tape should not be used as a prophylactic measure over long periods of time. Your body’s ligaments and tendons all gain strength by applying gradual, therapeutic stresses to the tissue in order to increase collagen deposition and to help by aligning the fibers in the correct orientation. The more you climb, your body responds to the mechanical loads introduced by climbing and actually changes in morphology.10,11 In human physiology, “Davis’s Law” explains how our soft tissues grow/strengthen in response to stress. With a gradual progression to climbing intensity over many months to years, you will naturally strengthen your body’s tissues. In the case of finger pulleys the tensile strength increases. If you were to use finger taping all the time, the tape would share the load with your pulley, and your pulleys would not get that full therapeutic load. Ultimately, taping would keep them from having the best chance to naturally gain full strength. Therefore, taping to prevent pulley injuries is not recommended.

[Sidenote: your muscles grow and adapt much faster than your ligaments and tendons. Muscle can adapt on the order of weeks, whereas ligaments and tendons may take months to years to adapt. With that said, if you are a new climber and you got strong really quick, just remember that your pulleys (and other ligaments/tendons) are still playing catch-up. Your burly muscles might place too much stress on your growing pulleys, leaving you at risk of injury. Be careful and respect your body.]

Research On Pulley Taping

Schweizer Study : Circumferential Taping

BIOMECHANICAL EFFECTIVENESS OF TAPING THE A2 PULLEY IN ROCK CLIMBERS, 2000

In 2000, Dr. Andreas Schweizer conducted a study looking at the biomechanical effectiveness of circular (AKA circumferential) taping over the A2 pulley in climbers.12 Schweizer’s study consisted of using a distance measuring transducer to measure the amount of bowstringing (physiologically normal, not pathologic bowstringing) in the ring and middle finger during a crimp grip. He measured 4 participants (1 women and 2 men aged 30, and 1 man aged 58 years) ensuring to have the participants warm up their fingers and forearms prior to testing. Our fingers demonstrate normal physiologic bowstringing during warm-up of the tissues, so he wanted to control for this. Post-warm up, bowstringing becomes constant thereafter.

In the study, two locations of tape application were studied: (a) the tape was applied in a circular fashion over the distal edge of the A2 pulley, and (b) the tape was applied in a circular fashion over the distal end of the proximal phalanx.

Notice the pulley-tendon angle schematics to the left of each finger. Taping over the distal end of the proximal phalanx reduces the angle and perpendicular force on the pulley.