The metacarpal head is cam-shaped and forms a condyloid joint with the proximal phalanx. The index and middle finger metacarpals are fixed relative to the carpus, while the ring and small finger metacarpals are mobile with a flexion-extension arc of motion of 15–25° at the carpometacarpal (CMC) joint. Taken together, they form a transverse arch supporting the palm. Slab climbs and approaches are the bigger challenges.The four finger metacarpals are concave on the palmar aspect. But when I did try the climbing gym I found it far less challenging than I expected. Walking easily and then running easily are my goals. (For me this time getting back climbing has been low priority for me. Sure I probably could have cut that 6.5 week at least 1.5weeks shorter, but is it worth the risk? In rehab now supposedly for 6 months, but I'm going to try to make that 3months. In my fastest recovery I broke a couple of ribs and overseas climbing withing 4 weeks! In my most recent injury I've now spent 6.5 weeks non weight bearing and about the same period in weight bearing rehab. And so listen to the experts and your own body. That said every injury and break is different. Either self guide via pain feedback or let a physio guid the rehab section. Which should only be 3-6 depending on the break. In general, let doctors guide you on the skeletal part of the recovery. I decided instead to use my pain response to determine when it would be safe for me to start climbing again.Good choice. The doctor recommended that I avoid climbing on the injured hand, until 4 months after the injury. Of course let pain be your guide, but the average physio seems to spend half their time pushing their patients beyond their pain comfort zone. I think most climbers don't have a problem with this. (Still broken a month later when I got x-rays.) One of my toes will never be the same as kept highly active on it for over a month. Several times it has taken me hours, days, weeks before I realised that this injury could be a break. ( See the bottom of this thread for pictures and injury reports) I'm currently still rehabbing from my first surgical experience. AVOID SURGERY if there is a realistic choice.My 3 pieces of wisdom regarding broken bones: This may result in higher strength upon removal of the cast and a shorter rehabilitation period. Climbing in a cast likely results in isometric strength training of the immobilized fingers, thereby reducing muscle atrophy, during immobilization.During the casting process, changing the angle of inclination of the immobilized wrist and fingers may affect the degree to which your free fingers will be able to reach and grasp holds.It may be possible to safely climb, while the broken bone is in a cast and has not completely healed, as long as the loads are sufficiently low to avoid inducing a pain response. I suspect that my starting strength would have been significantly lower and my rehab duration would have been significantly longer, if I had not been climbing in my cast. After about 3 weeks of rehab, my strength is about 90% of my pre-injury strength. When my using my fingers in a position near the middle of my range of motion, my strength was roughly 70% of my pre-injury strength. It took about 5 days to regain full range of motion. I was able to climb easy routes in the gym, on the same day that the cast was removed. In my case, the hand was cocked back, which may be the default position. Ensure that your hand is approximately inline with your forearm, when the cast is being applied.By default, the casting technician will likely try to flex your fingers to a position that is roughly in the middle of your range of motion. Ensure the fingers are oriented upwards, rather than flexed forward, when the cast is being applied.To maximize your ability to climb in the cast, I recommend doing the following: In retrospect, I should have asked the doctor & casting technician to make non-standard alterations to my cast. The cast limited my ability to use certain holds. I then started top roping easy routes in the gym, in my cast, three weeks after the injury occurred. I progressively loaded my injured hand, until i could hold half my weight without inducing a pain response. I decided instead to use my pain response to determine when it would be safe for me to start climbing again. In my particular case, the doctors that I consulted with did not know much about climbing. I had a cast that immobilized my wrist, pinky, and ring finger for 8 weeks.
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