Il trattamento riabilitativo nelle lesioni del sistema delle pulegge dei flessori delle dita nei climber. Scoping Review

Finger flexor pulley system (FFPS) injuries are a specific clinical condition that is common in sport climbing’s domain. The grading system of FFPS has 4 levels of injury. Its general symptoms are: severe and sudden pain and swelling in the pulley area, possible numbness and the appearance of localized hematoma, the sound of a pop during the injury, loss of strength and muscular function, ROM limitation, “bowstringing”. Given the peculiarity of this injury, scientific evidence around it still is limited, and the role of the Physiotherapist is expected to be deepened and clarified. Objective This Scoping Review aims to analyze the scientific evidence about FFPS injuries in climbers and highlight the most effective rehabilitation treatments. Methods The research was carried out between May and August 2021 by means of these databases: PubMed, Cochrane Library and PEDro. Resulting from the research, 4 articles coherent with the research question and inclusion criteria were selected; they analyze conservative interventions in climbers with FFPS injury. Results The analyzed studies recommend that the conservative approach should be the first-choice treatment in FFPS injuries from the 1st to the 3rd level, while for the 4th level of FFPS injuries they recommend surgical repair and post-surgery physiotherapy. Usage of H-tape and pulley-protection splint (PPS) showed a statistically significant reduction of tendon to bone distance (TBD) and an increase in muscle strength. Conclusions The rehabilitation treatment in FFPS injuries has proven to be mostly effective and very important in bringing back climbers to their pre-injury level of performance. The results in term of complete functionality recovery and pain elimination were satisfactory. Usage of H-Tape and PPS is recommended during the rehabilitation period and RTS period because they have been proven effective for regaining mobility, strength, and function.