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Advice needed on long term injuries (Read 9940 times)

ashtond6

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Advice needed on long term injuries
March 08, 2016, 06:19:13 pm
Right, any insight into the below would be really really appreciated. I'm so sick of it....

There is lots of info below, I've tried to get it in some order but its quite a hard timeline! I'd appreciate any advice.

I am around 85kg 6 ft 1, not really fat or anything like that, but heavy for my height.

Since 2012 I've had non stop injuries,  all of which are down my right arm. (palm, elbow, shoulder)

It all started in 2012 - I had really bad neck & shoulder pains. I saw 3 different physios  then a shoulder surgeon. I finally discovered I had a bulging disk in my neck. My shoulder was totally fine but the bulging disk was basically sat on the nerves.

I was told I had 2 options, surgery or ignore it. Very soon after this I went on a climbing trip to Squamish - after the first 3 nights of agony (laying down was the most painful activity). It just totally disappeared. (more or less, I get a crunchy neck if I have bad posture etc)

Following this, i've had non stop torment..... Later than year, I was lapping juggy routes on a 30-40 degree wall & felt a deep burning pain in my RH palm. Turned out to be a flexor tendon issue. This still rears up every few months & continues to be a problem to this day. I do a lot of antag exercises.

Also, one day (2013?) I did the Rasp, then tried Coventry Street, instant tennis elbow which I haven't been able to shift fully since. (weight lowers almost every day, checked by my physio)

I was always climbing 3 days per week, upping it to 4 days recently when the injuries allow. I'd say I pretty much always climb to exhaustion on 80% of these sessions. From what i've read, general consensus seems to be that 3 sessions a week isn't too much.... I never take more than 4 days off climbing.

Around Sept 2014 I also moved from 100% trad to almost 100% sport and bouldering. This also seemed to improve these injuries but they still seem constantly just round the corner.

All three of these injuries still niggle me today & I have to be really careful to make sure they don't come back. After the neck issue my physio assessed me & said there would be lots of scar tissue which could account for some of this. My shoulder is always 'crunchy'.

What sparked this message:      I did a physio last night, specifically during dumbell  bicep curls, I got a sharp deep pain in my RIGHT shoulder, right at the front (seems textbook tendonosis?) & basically I am so pissed off because:

I deliberately don't climb too much
I've seen loads of physios
I've had MRI scans
I do my antags at least 4 times per week
and my right arm tendons seem constantly injured!!!  :wall:

....& I'm going to Siurana in two weeks  :(

HELP   :boohoo:

ashtond6

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#1 Re: Advice needed on long term injuries
March 08, 2016, 06:23:59 pm
Another note......

I do a lot of stretching
I found theraband pointless and have recently upped this to dumbells

Fultonius

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#2 Re: Advice needed on long term injuries
March 08, 2016, 07:02:21 pm
Quote
I'd say I pretty much always climb to exhaustion on 80% of these sessions

I'm no expert, but this instantly rings alarm bells. Climbing to exhaustion = poor form = much more more likely to get/remain injured.

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#3 Re: Advice needed on long term injuries
March 08, 2016, 07:56:17 pm
I'd say I pretty much always climb to exhaustion on 80% of these sessions.

I'd agree with Fultonius. I tend to climb until I can no longer climb at ~60-70% (at a guess) my maximum and take about 2 hours to get to that point. I'm pretty sure that if I climbed to exhaustion each session my elbows would get pretty bad. More frequent but less intense sessions seems to be good for  preventing/healing injuries.

I'd recommend Dave McLeod's book as well for a bit of background on preventing injuries.

ashtond6

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#4 Re: Advice needed on long term injuries
March 08, 2016, 08:01:11 pm
Good start thanks guys!
I've read most of the book, I'll reread it.

I kinda felt that it focused on only certain popular climbing related injuries and my symptoms didn't really match!

finbarrr

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#5 Re: Advice needed on long term injuries
March 08, 2016, 08:02:40 pm
i'm not an "expert" either, but some physio education, and lots of experience with back/neck issues.

would seem like your neck/ spine may have "fixed" itself by creating a new movement pattern that stopped the disc problem getting worse, but transferred the problem to your arm.
no quick fix to that. sometimes a few massage sessions can help, and a specialised physic can help learn new movement patterns.
here in the netherlands we have specialised osteopath type doctors called "orthomanual doctors" who are really good at realigning spines, but that won't get rid of any bulging disc if you still have any.

three times week climbing is not much, three times a week till exhaustion is.
IF you do your antagonists on alternate days, you don't have any days to really rest your body.
doing antagonists a little less after climbing could give you more rest days.
i would really advise taking it down a notch , as Fultonius said: stop when you lose form.


ashtond6

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#6 Re: Advice needed on long term injuries
March 08, 2016, 08:46:05 pm
Thanks finbarrr, really interesting post

I guess that's why I wanted to post up- to try to learn more about how my arm is suffering from my neck issue. Any idea of that in the UK?

Also great point on the antags, as I normally:
Antags, climb, antags, climb, antags, climb, climb. So not a single 'full' rest. I was always led to believe that alternating was okay, as they are completely separate sets of muscles

I will try doing them after climbing sessions, and finishing these earlier

Also, anyone have any experience in sorting this shoulder problem in a short space of time. Currently doesn't hurt to put my arms up,  but the dull hot pain is always there!

petejh

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#7 Re: Advice needed on long term injuries
March 08, 2016, 10:38:59 pm
If you can, find a chiro - but not one who actually believes in the mumbo jumbo at the heart of chiro just one who's very clued-up on dealing with nerve impingement and how physical manipulation can help; ideally one who comes recommended by other climbers who you trust.

If you're anywhere near n.Wales I recommend (not that you know or should trust me!) seeing Iain at the n.Wales spine clinic.

If the nerves going into that right arm are compromised - e.g. where they exit the neck or somewhere in the shoulder joint - then some theories suggest that the comprised nerve firing (and compromised power) leaves muscles/tendons more susceptible to injury.

A good specialist can do some simple tests to test for compromised strength/power from nerve impingement.
« Last Edit: March 08, 2016, 11:09:06 pm by petejh »

petejh

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#8 Re: Advice needed on long term injuries
March 08, 2016, 11:10:11 pm
If you can, find a chiro - but not one who actually believes in the mumbo jumbo at the heart of chiro just one who's very clued-up on dealing with nerve impingement and how physical manipulation can help; ideally one who comes recommended by other climbers who you trust.

If you're anywhere near n.Wales I recommend (not that you know or should trust me!) seeing Iain at the n.Wales spine clinic.

If the nerves going into that right arm are compromised - e.g. where they exit the neck or somewhere in the shoulder joint - then some theories suggest that the compromised nerve firing (and compromised power) leaves muscles/tendons more susceptible to injury.

A good specialist can do some simple tests to test for compromised strength/power from nerve impingement.

bedrock

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#9 Advice needed on long term injuries
March 08, 2016, 11:15:56 pm
I found theraband pointless and have recently upped this to dumbells

I was told by my Physio that thereband is not a work out - it's about correct movement with resistance and keeping good form. He said shorten the resistance band but never do with weights as that is working the area/tendons in a different way.its not really a 'resistance'.


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lagerstarfish

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pretty much always climb to exhaustion on 80% of these sessions.

I have benefited enormously from learning to finish before exhaustion - wish I'd learnt this 20 years ago

I also benefited by learning to manage my back and neck pain - back then it was by following stuff from the Mckenzie Method with the help of a physio and books on managing your own neck and back. No doubt there have been some advances since then.

I did benefit from seeing a chiro, but the improvements always seemed to be temporary  - actually, that's not quite true - the chiro fixed my daily headaches permanently (stiff/rigid neck muscles following incident with lightning)

petejh

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Don't know why I've quoted myself in the post above  :blink:

thekettle

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To reinforce previous comments about climbing to exhaustion:
If you want to get fitter/stronger, you stimulate the body by working it harder than normal (the classic progressive overload stuff). This prompts it to make some adaptations whilst you rest/recover between sessions. The trick is to overload it just enough to prompt the adaptations to occur. Further overload (ie climbing to exhaustion) beyond this simply increases the recovery time, increases wear and tear on your body, without getting any additional gains.
When I get rising crescendo of aches/tweaks/old injuries returning, I take it as my body asking for a significant reduction in volume/intensity, and (unwillingly) do as it asks for a few weeks.

There's also the genetic element of how you respond to training stimulus, and how vulnerable you are to soft tissue damage.
I'm very injury prone, and have never physically been able to sustain more than 3 sessions a week (in 20 years of climbing), two of which are 'training'. This hasn't prevented me making good gains though. I also do a tedious amount of antagonist stuff to keep me from being a crooked mess.
Finally there's the 'how you climb' element. Your technique, posture and functional stability may well contribute towards it - as discussed in the first 6 chapters of Dave Mac's book.
I feel your pain! The hardest adjustment I've had to make is the psychological one of climbing slightly less than I want on a regular basis, despite it bringing me much better results  :slap:

a dense loner

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Don't know why I've quoted myself in the post above  :blink:

Because you're a climber and your ego's much bigger than your id?

petejh

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Please, I prefer the term mountain athlete.

Schnell

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Following this, i've had non stop torment..... Later than year, I was lapping juggy routes on a 30-40 degree wall & felt a deep burning pain in my RH palm. Turned out to be a flexor tendon issue. This still rears up every few months & continues to be a problem to this day. I do a lot of antag exercises.

Interested to see you're doing antagonist exercises for a flexor tendon strain. what exactly do these consist of? Just asking because I recently read this: http://drjuliansaunders.com/ask-dr-j-issue-211-why-icing-slows-healing-and-the-imbalance-myth/ which says that exercising wrist and finger extensors to prevent finger tweaks or anything else is total bollocks, but it seems to be a popular one these days nonetheless. I used to continuously get painful flexor tendon strains but based on Dave Mcs book I've found the way to rehab them is gentle, progressive loading.

36chambers

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Following this, i've had non stop torment..... Later than year, I was lapping juggy routes on a 30-40 degree wall & felt a deep burning pain in my RH palm. Turned out to be a flexor tendon issue. This still rears up every few months & continues to be a problem to this day. I do a lot of antag exercises.

Interested to see you're doing antagonist exercises for a flexor tendon strain. what exactly do these consist of? Just asking because I recently read this: http://drjuliansaunders.com/ask-dr-j-issue-211-why-icing-slows-healing-and-the-imbalance-myth/ which says that exercising wrist and finger extensors to prevent finger tweaks or anything else is total bollocks, but it seems to be a popular one these days nonetheless. I used to continuously get painful flexor tendon strains but based on Dave Mcs book I've found the way to rehab them is gentle, progressive loading.

Well and truly :offtopic:  :chair:  :spank: :read: etc.

TIL: that in Australia you don't have to have a degree in medicine, or a PhD, to call yourself a Doctor. Case study: Dr Julian Saunders, who's qualifications are:
"Bachelor of Biomedical Science (sports physiology)
Bachelor of Clinical Science
Masters of Health Science (Osteopathy)"

Apparently it's a loop hole in Australian Law (http://earnestkookaburra.blogspot.co.uk/2012/01/can-anyone-can-call-themselves-doctor.html)

I'm not trying to undermine "Dr J", he's been a registered osteopath since 2002, so he most probably knows his stuff. I just think plastering "Dr" across his website is a bit cheeky. Maybe I'm just bitter as I'm in a rut with my own PhD. Anyway, please continue as you were...  :whistle:

haydn jones

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Ive had big success with my golfers elbow by not climbing till failure.

the_dom

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A word of caution - a good friend of mine had continual shoulder and elbow issues (from climbing and other athletic endeavours) and ended up with deep vein thrombosis in said shoulder as a result of a muscular impingement of a vein.

They had to operate a few times and put in a stent to prevent a collapse, resulting in recommendation of "no upper body sport, ever". I'm not saying it's the case, but it may be the worst case scenario to cross off the list.

ashtond6

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Following this, i've had non stop torment..... Later than year, I was lapping juggy routes on a 30-40 degree wall & felt a deep burning pain in my RH palm. Turned out to be a flexor tendon issue. This still rears up every few months & continues to be a problem to this day. I do a lot of antag exercises.

Interested to see you're doing antagonist exercises for a flexor tendon strain. what exactly do these consist of? Just asking because I recently read this: http://drjuliansaunders.com/ask-dr-j-issue-211-why-icing-slows-healing-and-the-imbalance-myth/ which says that exercising wrist and finger extensors to prevent finger tweaks or anything else is total bollocks, but it seems to be a popular one these days nonetheless. I used to continuously get painful flexor tendon strains but based on Dave Mcs book I've found the way to rehab them is gentle, progressive loading.

More really helpful comments all round, thanks
Anyone wanna recommend how to get rid of this before Spain in 13 days? (The burning pain in shoulder) it's hard to know if it needs a few days to cool down, or heavy stretching etc etc

Ref the flexor tendon strain- not much rehab on it really. I found squeezing a stress ball before climbing helped. Also I used a tight elastic band to open my hand.
I found the metolious ball made it worse if I did both reps at once (squeeze one second, open on the band, repeat)

Stopping trad climbing cured it almost instantly. But that may not be the reason why - I was training mileage for Yosemite. Then did no crimping for best part of a month. Then I took 2 weeks off and tried sport climbing properly for the first time.
I think not over gripping and not locking off looking for gear etc helped loads, even though I was climbing much harder moves

siderunner

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One day completely off every week is a good rule IMO. Good for brain as well as body. With your history I'd be taking two consecutive days off climbing every week.

Interesting on trad, I've found the same. Think climbing faster helps. Plus for sure locking off to look into gear placements doesnt help.

You could consider a block of 4+ weeks of upper body weights to change the impact and strengthen the whole shoulder girdle. While dialling climbing right back to chilled fun and easy climbing a couple of times a week. Not sure what you already do and have done, but I'm thinking the 8-10 rep range using dumbbells while covering a range of movements and not going nuts on trying for PRs every session - rather focussing on perfect form. Maybe take weights up abd reps down after 4 weeks if it seems to be helping and not aggravating.

Personally I did have a lot of shoulder and neck injuries, and these are - touch wood - a thing of the past; my weight room time has given me visibly bigger - thiugh still weedy - shoulders and I'm sure that's whats helped.

I do also use therabands etc and am a big fan. You can buy elastics big enough for doing legs for my 110kg half-fijian step brother, so I'm pretty sure you'll find something stronger if you shop around. They're a lot more portable and storable than dumbbells.

Fultonius

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Short term - ibuprofen gel helped (or seem to help) my shoulder impingement a lot. Just calmed down the inflammation which seemed to be inhibiting normal movement.

finbarrr

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More really helpful comments all round, thanks
Anyone wanna recommend how to get rid of this before Spain in 13 days? (The burning pain in shoulder) it's hard to know if it needs a few days to cool down, or heavy stretching etc etc



as someone mentioned before, try to find a good chiropractor (or a manual therapist, or an osteopath) , preferably someone with good references, or at least lots of experience. they may be able to help with the burning sensations.
i have found heavy stretching makes situations worse. stretching is great for keeping things loose, but once there are knots and weak points, i find stretching stretches the weak points, leaves the knots. massage can resolve the knots.

ashtond6

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Thanks siderunner, some good news- kind of...
I've just tried to take it back to basis, I re-read my theraband exercises, turns out I've been doing them so long, what they have become is totally different to what I'm supposed to be doing! I guess it's changed a tiny, unnotiable bit weekly for 2/3 years.

Anyway I did some very calm careful reps tonight (2 days after the new injury) and it felt super hard and super good like I'd never done them before. Basically means my theraband routine was doing FA... obviously not good news but great to get some progress with my routine. I think 2 days rest a week will be good

Am planning to rest till Friday  (4 days after this injury) then see how it feels easy climbing.  can't lay off for 4 weeks due to Spain in 13 days but after Spain I will do!

Ibuprofen gel added to the pack list  :punk:

ashtond6

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More really helpful comments all round, thanks
Anyone wanna recommend how to get rid of this before Spain in 13 days? (The burning pain in shoulder) it's hard to know if it needs a few days to cool down, or heavy stretching etc etc



as someone mentioned before, try to find a good chiropractor (or a manual therapist, or an osteopath) , preferably someone with good references, or at least lots of experience. they may be able to help with the burning sensations.
i have found heavy stretching makes situations worse. stretching is great for keeping things loose, but once there are knots and weak points, i find stretching stretches the weak points, leaves the knots. massage can resolve the knots.

Anyone know any good chiropractors in Sheffield???

 

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