Although you know how to create a path to the top of the mountain or wall while avoiding a fall, it is sometimes difficult to recognize and acknowledge imminent danger. Prevention is the pillar to any rehab program. And what if the way to prevent could also make you perform better?
That nagging pain in the back of your neck after hours of belaying… will it ever go away? Poor posture (see first picture) while looking up can create overwork in the muscles of the back of the neck and shoulders as well as hyperextended positions of the spine. Solution: don’t belay! However with this attitude you will never have partners to go climbing with. The next best option is having good posture during belaying. Think of a plumb-line going from the ear, through the center of your shoulder and trunk and keep it while you let your arms do the work. Don’t get lazy and be sure to keep the proper posture with chin slightly tucked, spine straight and shoulders back. You could also get cool belayer’s glasses! Prevention: During belaying, frequently change position of your neck and above all, observe good posture. Do chin tucks while laying on your back (2×20-30 reps).
Shoulder pain is not shoulder soreness and it is not just part of climbing. This is actually another result of poor posture. The nature of the shoulder joint is such that it has great mobility, however with great mobility comes great risk. If you don’t have the proper strength, endurance or motor control in the shoulder blade you can irritate one of the rotator cuff muscles, the biceps’ tendon or bursae that travel through a small little tunnel between your shoulder blade and humerus, and with poor posture they can end up like a fraying rope. Solution: T and Ys, side lying thoracic rotations, practice arm lifts with shoulder blades moving together. Prevention: strengthen your shoulder blade muscles, keep upper back and shoulders loose, and don’t ignore pain. The shoulder is a complex joint and if you don’t address pain it will come back to get you with a vengeance and you don’t want to have to rehabilitate from a rotator cuff surgery.
This is more of a traumatic event that can happen if you let go of the wall, boulder or cliff. If you have had one, however you probably fear the shoulder coming out of the socket again! Surgery is usually the end result of recurrent dislocations, as nerves and blood vessels can also be damaged in the process. Subluxations occur when the arm almost dislocates. This is a sign that your shoulder muscles are not strong enough to complete a movement (usually over head in a twisted position) with a normal and controlled movement. Solution and prevention: shoulder blade and rotator cuff strengthening and stabilization exercises like planks and exercises that isolate the rotator cuff.
Medial Elbow Pain
This is where muscles that control finger and wrist flexion attach, at the bony side of the elbow, through a common tendon. If the forces generated by the muscles are greater than what the tendon can take you can develop and acute tendonitis that develops into a tendonosis. Climbers have this problem in epic proportions! Beginner climbers are more at risk because they tend to crimp thinking that this is a stronger grip. Solution: open your hand more! Over time strength will grow and evidence suggests that you will actually develop greater endurance which means that you will be able to hang on longer. Stretch: palms on wall or ground with fingers up or down, elbow straight then flexed, hold 20-30 seconds and repeat 2-3 times after your climb.
Ulnar Collateral Ligament (UCL) Tear in the Elbow
You have returned to climbing after a long break or are a strong boulderer totally pumped but you are chicken winging it. Keeping that elbow out not only is going to increase the stress of the tendons on the lateral elbow but also put incredible weight on the medial elbow where the UCL supports your elbow. Unexpectedly you can hear a pop, and you might not actually feel the pain right away, and surgery is the only option here. Solution: keep your elbows in when crimping.
Tendon Junction Tears in the Forearm
Think about the place in your palm where your tendons in the fingers enter. They each control one finger but they join as they attach to a common muscle. If you leave one finger long but pull the others tight in to the palm you will feel the tension transition into the muscle slightly. If you pull on the finger that is not held tight you will feel the tension and strain in your forearm, and this is NOT a tear you want to have to rehab and definitely see you friendly PT. Solution and prevention: never pull the neighboring fingers tightly into your palm while simultaneously pulling on one, tow or even three fingers!
Triangular Fibrocartilage Complex (TFCC) in the Wrist
These are not really traumatic in nature, but more of a predominant and worsening pain throughout the wrist. At the base of your hand on the side of the pinky you have a small cartilage disc. Due to the large traction and shearing forces during pulls on large, round holds, climbers are susceptible to tearing the TFCC. Crimping will actually cause less aggravation to the wrist, however we already know that this is worst on the elbows and fingers. Don’t ignore this pain. If you have to shake your hands after a climbing attempt, back off!! Solution: Let it heal. You can actually still climb, but you have to do it after consulting with your neighborhood friendly physical therapist, and conservatively keeping pain away. Taping can help and this too can be done by your PT. Exercises to strengthen the wrist will add to its stability with the open hand position (2-3 sets of 10-15 reps of wrist extension while holding a can of soup, 2-4 times per week). Prevention: If you start to feel the wrist soreness, back off. Don’t go all out on the big slopers or macro features during any session. Whenever possible, vary the grips you choose when training.
Tears in the finger pulleys are practically unavoidable. Taping is actually pointless to prevent these tears particularly if you are already injured and in pain, like weight belts during Olympic lifts. So why tape? To limit potentially damaging finger motion and to remind yourself of your injury. Solution: Let the injury heal by avoiding aggravating moves. Tape your finger without cutting circulation and NEVER tape and injured finger to keep climbing. Taping the middle joint will limit your movement and force you to have more of an open hand grip.
Finger Stress Fractures
Improper progression to training and finger loading will create stress on the bone and cause injury. Look out for pain in the shaft of a bone that gets worst during a session. This is a sign to stop immediately and have that taken care of. Although calcium intake is important for both genders, women are at higher risk for bone loss and this can also affect these injuries. Solution: prevent! Listen to your body. Warm up and strengthen arms in the gym.
Meniscus Tears in the Knee
We all know that using your legs during a climb will save your arms, however pushing on a twisted knee (like when you press up from a heel rock over or driving out from a drop knee) can injure the meniscus in the knee. Another position the meniscus can be injured is when you bend your knee fully then try to push. Recovering from a mild meniscus tear with physical therapy has been shown to be just as effective as having surgery! Solution: avoid movements mentioned above. Strengthen your legs so you don’t overload the knee and stretch!
Ankle Sprains and Fractures
We all fall from time to time and your feet are usually first to hit the ground. Since your climbing shoes compress the foot they increase the risk for fractures and other injuries as you land. Prevention is the best medicine, however if you like climbing you like risk and adventure, however being smart about it will go a long way. Solution: use pads, use spotters. And yes, size does count. So you have a mild sprain, no big deal, but definitely practice balance because this type of strength with quick reactions is usually one that doesn’t return as it once used to be unless you practice.