Ask Dr J – Issue 178 – Taping and the Cycle of Ignorance


I recently cut off the tip of my left index finger with a plate joiner. I am a new ice climber. How will this affect my ability to climb? I am 27 years old.

RUSSELL ICKES | Rock and Ice Forum


You, me and Tommy Caldwell— like peas in a pod! We should start a support group: Climbers who have stupidly cut off a bit of their finger.

I cut off the end of my index finger with a tomahawk. I would have had it stitched back on but Brandy, the pet dog, ate it before the first arterial squirt had hit the ground. That was in 1977; microsurgery meant it only needed one stitch. I guess there was not much left of yours. Presumably, Tommy could have had his stitched on but maybe he decided that such a handicap could not halt the momentum of victory.

Thanks for the photos. At least you won’t bite that fingernail for a while. The volume that appears gone now will fill in. Once it has healed, the scarred surface will likely be numb for some time. Given your age you may not ever get back full sensation.

In the first year or two it will be very sensitive to knocks and cold. Most ice climbers seem to feel an intractable and exquisite bond with everything uncomfortable so you may well enjoy the sport even more.

Certainly climbing is a no-no until the wound has healed. Chalk and dirt and the continual abrasion would cause more than a few healing hiccups. Healing may take several months. Once the surface has sealed with skin re-growth, start climbing on it tentatively, paying particular attention to discomfort and any tearing of the scar tissue.

Strength-wise you won’t be affected, outside of discomfort. I did mine at age seven and it has not adversely affected my climbing. Really, we can’t complain given Tommy’s performance since his altercation with a power saw.



A year and a half ago I fell mountaineering, banged my right kneecap and couldn’t walk for two weeks. I saw a doctor, who said that I had lost cartilage. For the past year my knee has constantly throbbed. It feels unstable and hurts when I climb. Prolonged sitting is very uncomfortable. My knee locks when I stand. Is there anything I can do before getting an MRI, since they are so expensive?

Carter Mcfarl and Rock and Ice Forum


A year and a half ! Stoic was only a reasonable response when medical solutions were restricted to amputation. Do your bit to stimulate the economy, and get an MRI. If you’re paying out of pocket, it will actually be half price for you to fly here, to Australia, and have one. Flights included!

Your synovial cartilage is hurting. That call is about as complicated as diagnosing virulent hegemony in the bones of the White House. Whether the assault on your cartilage occurred at the time of impact or over the following months is up for debate. Locking of the knee, and instability, are definite concerns and much harder to diagnose without an MRI. Could be a bone chip, torn meniscus, ruptured cruciate ligaments, yada yada. MRI!

Do the following three exercises to get it moving a little more freely.

Lie on your back with your injured leg relaxed over a chair facing sideways and in front of you, knee at 90 degrees and foot hanging off the other side. Get a mate to pretend your foot is the steering console for Grand Theft Auto, sweeping full lock turns left and right. Hold full lock for a mile or so in each direction and repeat a few times. Start holding each rotation with mild tension and build as the discomfort decreases.

Facing away from a table (or something around that height), place the top of your right foot on the tabletop and sit on your heel. While leaning back, point your knee toward the floor. Feel the burn and enjoy it for 30 seconds. Repeat a few times, morning and night.

Traction of your patella (kneecap) is like giving a cow a vaginal examination—awkward. Push your patella to one side. Grab the underside (with difficulty!) and ply it away from your knee. Hold till your fingers hurt and then push it the other way.

Those cheeky Ruskies have a missile lock on you. Employ some Maverick evasion maneuvers or that knee is going to crash and burn. Remedial yoga that targets the knee and hip and all the muscles between would be a good start. The usual arthritis supplements, namely glucosamine and fish oil, might also help. But first, get some fancy pictures.



I found a study comparing various taping methods for pulley injuries. It mentions the H taping method as the best. What is the H method?

WILCOX510 | Rock and Ice Forum


Let ’s keep it real —taping does virtually nothing except protect wounds. I read the research paper that introduces H taping and it is, for the most part, quite sensible in its recommendations. Unfortunately, most people have not read it and, once the “expert” at the crag demonstrates this fantastical method, the Cycle of Ignorance is set in motion. Before you can utter, “I’m a silly git,” climbers are taping simply because they have pulleys.

Two groups will benefit from this method (similar to crossing tape over the front of the joint, though it uses a single piece of divided tape) and they are at opposite ends of the spectrum: those who have ruptured a pulley, and those who have the mildest of strains combined with a pathological lack of restraint.

If you have a ruptured pulley, there may be some minor strength gains for one pull. Tape, however, loosens fast! By the time you reach the top of your 100-foot grunt, the protective function will have eroded somewhere between a lot and more than a lot. And right when you are pulling harder than a husky on speed … whammo!

The best taping method is the one that totally unloads the injured pulley and allows you to crimp while it recovers. Someone please tell me what that is. Though statistically significant, the reduction in tendon excursion (or pulley stretch) while crimping is only marginal (as opposed to not at all for other methods). Who knows how this actually affects pulley load. The A3, more than any other pulley, is quite elastic.

H taping has no effect when you are open handed because the pulley is barely loaded. You want your pulley to recover? Stop crimping! Simple.

Bowstringing of the tendon is reduced by 13 percent using H taping, according to this study alone. What if you are bowstringing an extra 30 percent because of a strained pulley? It’s a subterfuge. You are still well in the red and the next stop is pulley bankruptcy. Though dog poop with whipped cream will slip down a little easier, it still tastes like dog poop. Similarly, this method will help, but unless you have the mildest of strains, that dog poop will choke you.