What Climbers Should Know About Lumbricals (STRANGE Hand Muscles)

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// TIMESTAMPS //
Context and Video Overview (00:00)
Part 1: Anatomy of the Lumbricals (01:00)
Part 2: Function of the Lumbricals in Climbing (02:28)
Part 3: How the Lumbricals Get Injured (05:22)
Part 4: Symptoms of a Lumbrical Injury (07:10)
Part 5: Testing for a Lumbrical Injury (07:59)
Part 6: Differential Diagnosis (10:43)
Part 7: General Lumbrical Rehab Advice (13:43)
Brief Note on Prognosis (16:23)
Outro, Credits, and Bloopers (16:39)

// SHOW NOTES //

INTRO

As climbing has progressed in popularity and difficulty, climbers have been able to pull off incredible new moves that were once considered impossible. This inevitably means our bodies, and especially our fingers, are being pushed to new limits. But pushing the boundaries doesn’t come without a price. And lately, one of those prices has been the rise of an injury to a rather odd and even mysterious muscle.

VIDEO OVERVIEW

These injuries are typically due to pockets, or just hitting small holds with just 2-3 fingers, causing some fingers to remain in the extended position while an adjacent finger or two goes into a flexed position.

In this episode, we’re taking an in-depth look at these weird muscles in our hands called Lumbricals. We’ll talk about the structure of lumbricals so you can understand why they’re important and how they get injured, and we’ll go over how to test for a lumbrical injury as well as some general rehab advice. We’ll also have a separate video with detailed, step by step instructions on how to recover from a lumbrical injury, so keep an eye out for that.

Let’s get started with a little anatomy review of the lumbricals and what makes them so special.

PART 1: ANATOMY OF THE LUMBRICALS

The lumbricals are quite unique for a variety of reasons. For one, they originate AND insert in the hand, making them an intrinsic muscle. This is in contrast to an extrinsic muscle like the flexor digitorum profundus, which begins at the elbow and ends in the fingers!

Secondly, they’re not attached to any bones! They’re actually only attached to tendons, specifically the flexor digitorum profundus in the palm and extensor tendons in the fingers, which means their attachment points are completely mobile; they change position as the FDP and extensors move.

Thirdly, and most important for understanding how they get injured, the lumbricals of the pinky and ring fingers have a bipennate structure, while the middle and index fingers are unipennate.

A bipennate muscle is like a feather. The barbs of a feather go in opposite directions on either side of a central quill. With a bipennate muscle, the “quill” is a tendon and the “barbs” are muscle fibers. The muscle fibers of a bipennate lumbrical attach to the extensor tendon (the “quill”) of one finger and the flexor tendons of two fingers. This can lead to problems if those two fingers are moved in opposite directions while under force.


Ran out of room!! For the rest, please check out the show notes:
https://www.hoopersbeta.com/library/l...

// DISCLAIMER //
As always, exercises and rehab programs are to be performed assuming your own risk and should not be done if you feel you are at risk for injury. See a medical professional if you have concerns before starting a new training or recovery program.

// IMAGE ATTRIBUTIONS //
Balance scale: https://en.wikipedia.org/wiki/File:Ba...
Interossei muscles: OpenStax, CC BY 4.0 https://creativecommons.org/licenses/... via Wikimedia Commons

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Jason Hooper (PT, DPT, OCS, SCS)
and
Emile Modesitt (@emile166)

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