Pulley Splint
How and When to Use
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A pulley splint is not needed for a grade I or II pulley injury.
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For the first 6 weeks post-injury, the pulley splint should be worn 24 hours a day, 7 days a week with the exception of manual therapy and range of motion exercises.
For weeks 7-8 post-injury, 24/7 use is not required but it should still be worn during all tissue loading exercises and any other activities that involve gripping (like resistance training).
After 8 weeks, use of the pulley splint can be discontinued entirely, though h-taping when climbing is recommended for up to 6 months post-injury.
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For the first 4 weeks post-injury, the pulley splint should be worn 24 hours a day, 7 days a week with the exception of manual therapy and range of motion exercises.
For weeks 5-6 post-injury, 24/7 use is not required but it should still be worn during all tissue loading exercises and any other activities that involve gripping (like resistance training).
After 6 weeks, use of the pulley splint can be discontinued entirely, though h-taping when climbing is recommended for up to 6 months post-injury.
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For the first 8 weeks post-injury, the pulley splint should be worn on top of H-taping in the A2 area (proximal phalanx) 24 hours a day, 7 days a week with the exception of manual therapy and range of motion exercises.
For weeks 9-10 post-injury, 24/7 use of splint + h-taping is not required but it should still be used during all tissue loading exercises and any other activities that involve gripping (like resistance training).
After 8 weeks, use of the pulley splint can be discontinued entirely, but h-taping when climbing is recommended for up to 1 year post-injury.
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For the first 6 weeks post-injury, the pulley splint should be worn on top of h-taping in the A4 area (middle phalanx) 24 hours a day, 7 days a week with the exception of manual therapy and range of motion exercises.
For weeks 7-8 post-injury, 24/7 use is not required but it should still be worn during all tissue loading exercises and any other activities that involve gripping (like resistance training).
After 8 weeks, use of the pulley splint can be discontinued entirely, but h-taping when climbing is recommended for up to 1 year post-injury.
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This grade of injury requires consultation from a medical professional and thus use of a pulley support should be guided by them.
How Tight to Wear It
The pulley splint should be snug enough that it does not move easily on its own, but not so tight that it causes pain or discomfort at rest or during activity.
You should feel some increase in pressure from the support over the pulley when loading the fingers, especially in a crimp position, but there should be only light pressure when at rest.
If you can’t feel any increase in pressure when loading the fingers, it’s too loose.
If you develop bruising or pain on the backside of your finger or feel like blood flow is being restricted, it’s too tight.
Having to adjust the splint tighter and looser throughout recovery is normal. Your finger size may change over the course of a day and over the course of your recovery. It’s OK to adjust or even swap sizes throughout the day as needed.
At night, keep it slightly looser. Our hands tend to swell a bit while we sleep, particularly if they’re recovering from injury, so it’s best to slightly loosen the splint when you go to bed to avoid being awakened by discomfort.
Cleaning
With prolonged use, the foam padding may start to smell a bit sour due to the build-up of sweat and grime.
To fix this, you can clean the splint and padding by washing it with a 50/50 mixture of warm water and white vinegar. Dish soap can work in place of vinegar if that’s all you have, though it may not be as effective at removing the smell.
Allow it to air dry before resuming usage.