Collateral Ligament laxity in PIP; early arthritic symptoms; 15 month-long mental agony- SOS-CHT's & fellow'd MD's

Unfortunately the human body is not an easy field to work in, and it is not easy to tease out some issues (especially non traumatic chronic ones). For what it’s worth over the internet....

if I were able to put any pressure on the upper extremities without my PIP joint swelling (e.g: being on forearms and even for supported push-ups), I would be okay but not being able to do so has been maddening. It may just be that I'm injuring my PIP serially

This is odd is a bit odd at first, however if you are making a fist or giving transverse plane stress to the PIPJ I could see it being aggravated again each time you perform the exercise.

Per #1

You are correct hypermobile joints- The CHT I'm seeing now says my joints are supple. I've been screened for RA & Psoriatic arthritis 2 months ago and both were negative. I would be concerned you may fall into this type of hypermobility. Ehlers-Danlos syndrome At issue with this is that person produces collagen tissue that is more elastic, therefor joint mobility is excessive, and a person finds themselves ‘stretching’ to extreme end ranges to fulfill CNS needs. Does this sound like you? Something to be aware of. Lax connective tissue may be improved with immobilization, but maybe not.... EDS is challenging to work with/live with, and many clinicians (MD, rehab, or otherwise) are not super familiar with it nor how to help individuals with it. If you find many similarities here, PLEASE investigate further you your PCP and find an OT or PT in your area who works with EDS.

Per #2 You need near total immobilization of then PIP joint ONLY in extension to adaptively shorten the collateral ligaments. The MCP and DIP must be free to move. Depending on your global mobility you would be looking at several weeks with occasional freeing to perform VERY controlled PROM flex/ext while carefully managing medial/lateral stresses. In other words, tighten it up, but don’t loose too much flex, and don’t piss it off when moving it. Buddy taping to the SF for AAROM would be a progression down the road.

Per #3 Within the confines of the extension splint I would be performing lumbrical strengthening exercises, and digital tendon glides for all other unaffected digits. Whatever you do now, for god sakes STOP composite grip putty exercises. As you progress exercises to target the FDS and EDC would be indicated to promote further dynamic joint stability. As able, you should be addressing proximal muscle strength for the wrist and global UE to further support stable hand positions in space.

/r/climbharder Thread