Friday, November 29, 2013

Recovering from climbing finger injuries

I seem to always be recovering from a finger injury, and I'm not entirely sure what to attribute the frequency of my injuries to. I'm sure the age at which I started climbing has something to do with it. Starting when I was 28 has made it difficult for my connective tissue to cope with the gains I've made in strength over the last 8 years, though at this point I generally feel that I'm able to really try hard without my tendons popping. Surely being injured so much is also due to me pushing myself too hard too often, and not recognizing when I'm in an overtrained state. See my article on overtraining for more on that.

There is one thing I know for sure. Bouldering is very hard on the body, and on the connective tissue of fingers specifically, and injuries are very much a reality for many climbers. Obviously its very frustrating to be injured, but finger injuries don't have to mean taking months off. A combination of active recovery and contrast bath therapy can help fingers recover in weeks.

Please note that its always a good idea to consult with a physician to judge the extent and severity of any injury. Though rare, some injuries can be quite severe and require surgery for a full recovery. The recovery regimen outlined here is intended to treat partial ruptures of the finger pulleys, which is one of the most common climbing injuries of the fingers and hand. For a full treatment on common climbing injuries, I recommend the book One Move Too Many.



Passive Recovery Period

Though its not necessary to take full rest for months, it is important to give acute injuries between 2 and 6 weeks of rest in order to let the injured area mend, depending on the severity of the rupture. Mild injuries may only require 2 weeks of couch time, while more severe injuries might need up to 6 weeks or more to mend.

The challenge here is knowing when to start your active recovery. Its very difficult to judge when this is, but with some guidelines and experience (the more injuries you recover from the more experienced you will be), knowing when to get moving doesn't have to be total guesswork.

Judging the Recovery

The injured area will be sensitive to the touch throughout the recovery. Pain tolerance is different for everybody, but I like to measure the pain on a 1-10 scale, and I have a few different ways to read it.

  1. Putting the finger in the crimp position and lightly activating the finger.
  2. Applying pressure to and probing the injured area.
  3. Tapping and rapping the injured area with your knuckles.
Often the injury will not be painful when lightly activating the finger (resist the temptation to grip hard!). I'd say if you feel pain from 3-10 on a 10 point scale, its probably too early to start active recovery.

I usually don't feel pain just when probing the injured area. If you feel pain from 2-10 on a 10 point scale, its probably too early to start active recovery.

Rapping or tapping the injured area with the knuckles of the opposite hand I've found to be the most effective way to judge the pain level and the progress of the recovery. If you feel pain up to 4 on the 10 point scale, you are probably OK with starting active recovery.


Active Recovery

One of the great misconceptions with recovering from climbing injuries is that you can't start climbing until all the pain is gone from the injury. This couldn't be further from the truth, in fact the injury probably won't be fully without pain until it has been climbed on for a month or more.

Though its important to start climbing again, respect the injury and take it slow at first! Since the crimp position is typically what causes these injuries, its important to avoid using the crimp position for the first couple of weeks of active recovery. Climb on slopers or jugs, and use the open hand position. At all costs avoid dynamic moves! Dynamic movement is the greatest risk for re-aggravating the injury.

High volume and low intensity is optimal for recovery. In other words, climb routes well below your onsight level. Bouldering is not a good idea! I recommend starting with routes two number grades below your onsight level. A climber onsighting 12c should start recovery by climbing routes in the 10c range.

Over the course of 4 weeks, progress to climbing near your onsight level. Here's an example regimen for a climber who onsights at the 12c level:

  • week one: two climbing workouts, each of 4 routes in the 10c-11a range
  • week two: two climbing workouts, each of 4 routes in the 10d-11b range
  • week three: up to three climbing workouts, each of 4-5 routes in the 11a-11d range
  • week four: climbing routes up to 12b, bouldering up to V5 (low volume bouldering)
  • week five: climbing routes up to 12d, bouldering up to V6 (low volume bouldering)
The injured area is expected to be a little more sore at the end of workouts and the following day. Two days after workouts, it should feel better than it did before the workout. Pay attention to the level of pain in the injured area before, after, and two days after workouts to help judge if you pushed too hard or not hard enough.

When the injured area feels better the morning after workouts, you know that you are on the way to a speedy and full recovery.



Taping

Some folks swear by taping, in the past I've been a strong proponent but these days not so much. If you must climb when injured, then I think taping is a good idea. There are two methods that are especially effective for supporting pulley injuries, the H-tape method, and the figure 8 method. Personally I like the H-tape method, and the level of support can be adjusted by how many layers of tape are used (each layer being another H), and by how tightly the tape is applied.

My final thought on taping is that if you think you need to tape, you probably shouldn't be climbing or shouldn't be climbing so hard.

Contrast Bath Therapy

The one thing that I absolutely swear by is contrast bath therapy. Rather than just icing, contrast bath therapy takes advantage of the body's natural reactions to hot and cold temperatures to dramatically improve local circulation and help recovery. Exposure to cold constricts the blood vessels, while exposure to heat dilates the blood vessels. Going back and forth pumps stagnant fluid out of the area, and conversely pumps in fresh fluid.

First, you'll need two bowls, one with ice water, one with hot water. The ice water should have enough ice such that it doesn't all melt by the time you are done. The bowl for the hot water needs to be something you can put over a burner. Put the hot water over a burner on your stove (do not turn on the burner unless your hand is in it!). Put the cold water somewhere nearby. When you are bathing your hand in the hot water, turn the burner on and off such that the water temperature stays about as hot as you can comfortably take.

Here's the regimen:
  1. cold water 1 minute
  2. hot water 4 minutes
  3. cold water 1 minute
  4. hot water 4 minutes
  5. cold water 1 minute
  6. hot water 4 minutes
  7. cold water 1 minute
Do this 2-3 times per day through passive and active recovery, and especially immediately following workouts!

Supplementation for Repairing Connective Tissue

Supplementation is a big subject on its own, so I'll briefly give my daily regimen for repairing connective tissue:

Well I hope this helps. The recovery process starts slow but accelerates as the injury heals. And remember, hardly any send is worth re-aggravating the injury.

Happy healing.

Tuesday, March 12, 2013

The 110% Alchemy Arm Sleeve to Treat Climber's Elbow

So pretty much as soon as I published my last post, discussing over training and the symptoms to look for, I promptly ignored that I wasn't sleeping well, continued to train, and developed a little tendonitis in my left elbow. Many climbers will be familiar with this condition - pain inside the elbow joint. Its caused by over training, typically, and is treated with rest, active recovery, and RICE (rest, ice, compress, elevate).

I'll quickly discuss why this is such a frequent injury for climbers. There's something called the medial epicondyl of the humerus, which is a junction where many tendons attach to bone, including the biceps and some of the tendons used to support flexion in the forearm (grabbing holds). When climbing, we typically rotate our hands towards the wall, which puts a little more extension on the forearm tendons attaching to the epicondyl, and though the arm may be straight or bent, we are almost always contracting the biceps, which pulls on the epicondyl in the opposite direction. Using a progressively more closed grip progressively puts more stress on the epicondyl. So to put it all together, if you climb a lot of crimps on faces, you are prone to "climber's elbow." I've also found that the campus board is an exercise that can focus a lot of stress on the epicondyl. With the campus board, the loads are obviously very high, and the wrist position and bent elbows focus a lot of the load on the epicondyl.

So back to my situation, I ignored my over-training symptoms, and continued with campus board sessions. I ended up with mild climber's elbow. The thing with any tendonitis is that you can't just keep training through it, or it will get worse. You have to let your body rest. But also you can't just rest 100%, as this doesn't stimulate the affected area to heal. So its a balance between continuing to train, and resting. I've found that you have to push injuries in a controlled way - don't be too shy about testing yourself when recovering from an injury. But the crucial point is to allow yourself time to recover between workouts. Depending on the injury, two or three days rest between workouts can be a very good idea.

I attempted to rest, and use active recovery, but my condition did not improve. Its a difficult area to ice as well, and easy to give up on an ice regimen, especially since I don't have a staffed training room supporting me...

At about this time I read a review in Climbing Magazine for the 110% Alchemy Arm Sleeve. I was willing to try it, given the glowing review, and given that I wanted to get back to training! Since it arrived, I've been using it following training sessions, and some mornings while I'm making coffee and brushing my teeth. Almost immediately my tendonitis symptoms became negligible and I've been back to a full training schedule with no lingering issues. This thing is a miracle, and if you suffer from climber's elbow you have to have this device!

Enjoy some totally unrelated pictures of +Adam Scheer in Bishop:

Pow Pow V8


Soul Slinger V9


Wednesday, February 6, 2013

Listening to Your Body to Avoid Overtraining

So, its been quite a while since I've posted! I've been itching to post again, and I've certainly learned a lot in the last couple of years, but probably the most important (and most cliche) is I've learned to listen to my body!

What does listening to your body get for you? Very importantly, it helps you avoid injury. Hand in hand with avoiding injury, it helps one to ride the natural peaks and valleys in your physical and mental capability to avoid overtraining. Its not possible for us to perform at our peak potential all the time. If we try to, we become prone to overtraining syndrome. Being in an overtrained state is very detrimental to athletic performance and general well being. Listening to our bodies can give us an indication of when our body is primed to tackle a tough project, and when it needs a few days of rest.

Why is it so important to avoid overtraining? It can take 3-6 weeks (or longer in extreme cases) to fully recover from an overtrained state. Long term fatigue is no joke, and not something you want to invite upon yourself! Sometimes by taking an extra day of rest, or dialing back the intensity for just a few training sessions, we can save ourselves weeks of recovery.

So back to that listening to your body thing, we hear it all the time, but what does that mean exactly? I think its really easy for people to listen very intently but not hear a thing! Its very helpful to have some things in mind that we should be listening for.

  • athletic performance
  • general mood and energy level
  • level of alertness in the morning
  • difficulty falling asleep
  • sex drive
  • shortness of breath from everyday activities
  • achey body and joints
  • for climbers especially - chronically inflamed finger joints

If you are usually flashing V5s, but lately are struggling on V4s, this is a pretty loud signal that your body needs a little break. It may be counter intuitive to stop training when you are performing poorly, but always keep in mind that quality exercise and training is far more valuable than a high quantity! Perfect practice makes perfect!

The indicator that I've found to be very reliable for myself is my general mood and energy level. If my motivation is high and my mood is positive, I know my body is probably ready for action. If I'm struggling to warm up, and not having fun, I know that its probably time for me to dial it back a bit.

Sleep is so important for recovery when training, and ironically when we get into an overtrained state, our bodies find it more difficult to sleep easy. Pay attention to your sleep cycles, if are having difficulty here, it could be a sign that its time for yet more sleep.

If you typically bound up stairs without shortness of breath or increased heart rate, and suddenly those same stairs don't feel so easy - watch out.

If you are waking up every day with achey joints, and especially for climbers - swollen fingers! Take it easy! Stop the campus board sessions, stop the weighted dead hangs, just go have some fun climbing and don't be so serious.

If you know me, you know that I'm fairly obsessed with planning my training and workouts, but sometimes you got to throw the hardcore training plan out the window in favor of just having fun - it gives your brain and body a break, and helps to avoid overtraining and injury. Just having fun in the gym or outside on rocks can renew your motivation to train and in the end training less might make you stronger than training more!

As always, quality over quantity, happy training.

Monday, July 12, 2010

Best of May Climbing Videos

If you take a look at the URL, you'll notice its changed. I've registered a hostname and "rebranded" the blog. Hope you like it. June best of is on the way.

A Day in Yosemite

Not even much climbing in this video, but its so well done, and Yosemite is so gorgeous...

Boulder World Cup Stop 1 - Greifense
The first in a series of really nice videos covering the World Cup competition.

Boulder World Cup Stop 2 - Vienna

The Sends: The Mother Superior
A 8B FA in Sweden, this is from a full length film. Great boulder, nice interview.

High Sierra Blocs Part 1
Part 2
I'm not sure exactly where this is, maybe Way Lake, but it looks awesome, and I wanna go!

Carlos Traversi Sends Jade
Obligatory. Interestingly, this bloc is settling at V14, maybe high end =).