Grip Force Measurement as a Complement to High-Resolution Ultrasound in the Diagnosis and Follow-Up of A2 and A4 Finger Pulley Injuries

  1. Department of Physical Therapy, Universidad Camilo José Cela, 28692 Madrid, Spain;
  2. Eskura Osasun Zentroa, 20200 Beasain, Spain
  3. Orthopedics Department, Clínica Pakea-Mutualia, 20018 San Sebastián, Spain;
  4. Plastic Surgery Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona (Barcelona), Spain;
  5. Faculty of Health Sciences, Universitat Pompeu Fabra, 08002 Mataró, Spain;
  6. Ekin Fisioterapia Zentroa, 20550 Arechavaleta, Spain;

* Correspondence:


The ability of finger flexors to generate force has been studied in relation to climbing performance. However, not much attention has been paid to the decrease in finger grip force in relation to annular pulley injuries. The purpose of the present study was to determine if an injured annular pulley implies a finger flexor force decrease, as well as its relation to clinical and sonographic changes. We performed an observational study in 39 rock climbers with A2 or A4 pulley injuries to the 3rd or 4th fingers. The variables considered were pain upon palpation, ultrasound tendon-bone distance, and finger grip strength decrease. Three rock climbing grip types were considered: the one finger crimp, open crimp, and close crimp. Injured rock climbers presented a decrease in finger grip strength compared to non-injured controls when performing a one finger crimp (p < 0.001). There exists a significant correlation between a tendon-bone distance at the level of the injured pulley and a decreased finger grip strength measured by performing a one finger crimp (p = 0.006). A decrease in finger grip strength could be considered in the diagnostic and follow-up process of A2 and A4 pulley injuries to the 3rd and 4th fingers.