Current literature recommends that conservative treatment take place for all but multiple concomitant pulley injuries. There is an even smaller amount of data that suggests conservative management as the modality of choice in all pulley injuries.

What the data also shows is that the vast majority of patients who undergo complete pulley ruptures will regain climbing strength in an average of eight months duration. Most of these individuals will not only regain their police strength but have reported increase in red point level. The overall timeframe to recovery seems to stem from when the recovery process starts. It is imperative that gentle pulley loading and recovery begin almost immediately after injury.