[DaveyDave]

Hi there,

I injured my elbow two months ago, and have been following exercises and icing and stuff but no major improvements. It's not a massive pain, but enough to put me off climbing/training. I feel a twinge around the funny-bone area when locking off or tensing my bicep at an acute angle. Any ideas?

Cheers!
Dave

[HPclinic]

Hi,

Controversially for this site, I have a running injury. Right knee, when slightly bent and loaded with any lateral movement outwards. Hurts, feels weak. Only noticeable when loaded in that way. Feels like a tendon on the inside of the knee. Medial collateral ligament perhaps? Been bugging me for a couple of weeks. Now becoming a problem for running.
Don't know how I did it. Most likely running as I've been increasing mileage recently while doing less bouldering, though obv can't rule out a bouldering fall (but I'd be more likely to notice an acute injury while bouldering I presume).

Can you recommend any exercises to help? Should I brace it for running? Is an exercise bike / rowing an appropriate way to reduce the load on it from running?

Hi, doesn't sound like a ligament problem as you would normally notice a movement that would have been the cause  of the strain as well as possible swelling. You may be impinging the inside of the knee along the joint line. If you have increased your mileage too quickly and not allowed all your tissues to adapt this may be the cause as the loading is very different to bouldering. Certainly try some cycling and rowing in the mean time to continue exercising and restart some walk runs as symptoms reduce. Some discomfort is acceptable but not pain during and after. You may also need your running style reviewed and observation of certain knee and hip movements just in case there is an underlying biomechanical cause.
Let me know how you are going
regards matt

[HPclinic]

Hi there,

I injured my elbow two months ago, and have been following exercises and icing and stuff but no major improvements. It's not a massive pain, but enough to put me off climbing/training. I feel a twinge around the funny-bone area when locking off or tensing my bicep at an acute angle. Any ideas?

Cheers!
Dave

Hi, there is a nerve called your ulnar nerve around the inside of your elbow that is superficial ie you can feel it and if you knock it, it will give you pins and needles into your little finger (hence the funny feeling). If you are locking out then you may be overstretching it. When you are contracting your biceps in a fully bent elbow position then this also definitely be compressing the elbow joint so the symptoms could be from this. I would suggest avoiding excessive flexion and locking out manoeuvres and perhaps lay off the harder grades until symptoms settle. Do lots of reaching above your head and move the elbow in to extension ie straight. It may be worth visiting a local physio just for a review.
regards
matt

[Stewart]

Hi Matt,
I heard a crack in my wrist and a sharp pain while hanging from a sloper. That was 2 months ago and I've not climbed since. It's still very painful on the top of my hand right next to the wrist and the wrist itself. Pain is worse when fully extending the wrist joint (which made me think it's not a tendon/ligament as surely the pain would be worse during wrist flexion?!) I can't really put any weight on it but an x-ray has come back clear which suggests it is a soft tissue injury. I have a wrist support from my physio but often seem to to re-tweek it doing every day things like opening a door handle etc. I'm trying to decide if i need to be more patient and give it a chance to heal or go private and seek a MRI scan etc.

Any advice?
Thanks

[Doylo]

I've got a re occurrence of a problem I had 3 years ago with my left elbow. It's sore and tender right on the outside tip. It doesn't really hurt when I'm climbing, I can feel it more pushing than pulling. I saw someone about it years ago but they couldn't really pinpoint the problem and just told me to ice it. I had some time off and did some pressups and it got better and has pretty much been ok until recently. Any ideas?

[Paul B]

I managed to hurt my LH ring finger last night (after a thorough warm-up, and not doing anything particularly stupid).

Unlike previous injuries (which were usually ring finger A2) this hurts highers up the finger on the palm side (I'd take a guess at the A4 region).

I was crimped on quite a positive hold and reaching through statically when I decided it didnt' feel right and went to let go. As I did this I felt a crunching (perhaps tearing) sensation to the point at which I asked others nearby if it'd been audible. They hadn't heard anything.

Discomfort was pretty much instantaneous although not sharp, more dull. I stopped climbing and began sulking instantly as well as submerging my hand in cold water.

Since then I've iced it and taken a lot of Vitamin I(bruprofen).

This morning, the finger has a similarily dull pain, especially if I reach across my palm or put the finger in a vaguely crimped position. I've stopped testing it now.

Thoughts?
One move too may suggests that damage to the A3/4s isn't as catastrophic as an A2 injury. I hope it's right.

Also a member of this parish said that he used to suffer from A2s a lot, however, having damaged a lot of those his injuries have crept towards the end of his fingers and now he suffers from A3s and 4s getting damaged. Is this a regular pattern?

Thanks in advance.

[Will Hunt]

For perhaps the last winter I've had a bit of a niggling in my left shoulder. Since turning to filthy sport climbing this spring, this has started to flare up and tonight I have had to pass up the wall as I've felt it giving me pangs while sat at work today.

Its basically a pain that runs down the rear of my neck (left side) and down into my shoulder blade to a point that feels quite central in my shoulder. This doesn't really hurt while climbing, but after getting on the sport I've certainly noticed it in the days after. Particularly pronounced when I turn my head to the right.  After a session at Malham on Sunday it wasn't great. Went for an 'enthusiastic' swim last night (mainly breast stroke) and today its been pretty poor.

Any idea what this might be and what I ought to do to make amends? Thanks in advance for any help you can give!

[HPclinic]

Hi Matt,
I heard a crack in my wrist and a sharp pain while hanging from a sloper. That was 2 months ago and I've not climbed since. It's still very painful on the top of my hand right next to the wrist and the wrist itself. Pain is worse when fully extending the wrist joint (which made me think it's not a tendon/ligament as surely the pain would be worse during wrist flexion?!) I can't really put any weight on it but an x-ray has come back clear which suggests it is a soft tissue injury. I have a wrist support from my physio but often seem to to re-tweek it doing every day things like opening a door handle etc. I'm trying to decide if i need to be more patient and give it a chance to heal or go private and seek a MRI scan etc.

Any advice?
Thanks

Hi, you sound like you are impinging something. When you extend your wrist there are many carpal bones articulating with the radius and ulnar (forearm bones) and there are many individual ligaments attaching to each carpal bone and to the radius and ulnar. There is also articular disc or pad that can be disrupted. You will not see these conditions on an xray unless there is a really obvious gap between some of the bones.
I wonder whether you have either strained a ligament or the articular pad. If there is a little more movement because of a ligament sprain (or possible tightness post strain) then this may cause an impingement and ultimately discomfort (look up triangular fibrocartilage complex injuries on google).
I would suggest a consultation with a physio and or try conservative measures. Try taping the wrist with a basic around the joint technique (not too tight ie no pins and needles into the hand) You may find this gives some stability. You could try doing some lower grade climbs that put stress through the wrist but not in extremes of extension and see how that goes for a couple of weeks. Increase as symptoms allow.
Let me know how you are going.
regards Matt

[HPclinic]

I've got a re occurrence of a problem I had 3 years ago with my left elbow. It's sore and tender right on the outside tip. It doesn't really hurt when I'm climbing, I can feel it more pushing than pulling. I saw someone about it years ago but they couldn't really pinpoint the problem and just told me to ice it. I had some time off and did some pressups and it got better and has pretty much been ok until recently. Any ideas?

Hi, it is good that you are still able to climb. The pushing element may indicate that you are compressing the elbow joint or that you are using the extensor muscles in your forearm. The fact that you can do most things tends to eliminate possible 'tennis elbow problems' although this condition is too often used for any lateral elbow problems.
When people develop problems we will ask if you have had a specific injury or if not have you changed any training or intensity/volume of climbing recently. Sometimes an injury is more cumulative ie small strains over time.
I suppose sensibly you should try backing off the grades and intensity for a few weeks and see if this lessens symptoms. I would also make sure if you are in a job involving using computers that you avoid prolonged sitting positions and repetitive mouse use. Basically have a bit of variety in your day.
If you have any more relevant info. then let me know and see a physio locally if symptoms are persisting.
regards
Matt

[HPclinic]

I managed to hurt my LH ring finger last night (after a thorough warm-up, and not doing anything particularly stupid).

Unlike previous injuries (which were usually ring finger A2) this hurts highers up the finger on the palm side (I'd take a guess at the A4 region).

I was crimped on quite a positive hold and reaching through statically when I decided it didnt' feel right and went to let go. As I did this I felt a crunching (perhaps tearing) sensation to the point at which I asked others nearby if it'd been audible. They hadn't heard anything.

Discomfort was pretty much instantaneous although not sharp, more dull. I stopped climbing and began sulking instantly as well as submerging my hand in cold water.

Since then I've iced it and taken a lot of Vitamin I(bruprofen).

This morning, the finger has a similarily dull pain, especially if I reach across my palm or put the finger in a vaguely crimped position. I've stopped testing it now.

Thoughts?
One move too may suggests that damage to the A3/4s isn't as catastrophic as an A2 injury. I hope it's right.

Also a member of this parish said that he used to suffer from A2s a lot, however, having damaged a lot of those his injuries have crept towards the end of his fingers and now he suffers from A3s and 4s getting damaged. Is this a regular pattern?

Thanks in advance.

Hi the injury you report does sound like a pulley strain. A total rupture can be more of an audible 'pop'. These injuries are more often treated conservatively and need time to repair with slow progression of loading to increase the tissue strength.
The distal pulleys ie A3 and 4 are more commonly injured due to the stresses on the tendon when crimping. Any pulley injuries may increase tension on the uninjured pulleys but if rehabilitated correctly ie not overloading the injured tissue too early then this shouldn't necessarily occur.
Also check that the control at all your finger joints is equal. What I mean by this is apply some resistance to the tip of the ring finger from a clenched fist position. You should be able to uncurl you finger against resistance without any individual joint "snapping" backwards. Once the finger is straight curl it back to the palm against resistance, again with control. Start these exercises now and apply as much resistance as you can control. Do 15-20 repetitions X 2-3 times, as long as you have control.
We often find people that have strained a pulley loose control at some of the finger joints.
When returning to climbing after 2-3 weeks start with bigger jug type holds and then as symptoms allow add in crimps. Some discomfort is acceptable and as mentioned you do need to stress the injured tissue in a controlled way for it to improve. Taping may help but the jury is out on this, ultimately it may give some support.
Let me know how you are going.
Regards
Matt

 

[HPclinic]

For perhaps the last winter I've had a bit of a niggling in my left shoulder. Since turning to filthy sport climbing this spring, this has started to flare up and tonight I have had to pass up the wall as I've felt it giving me pangs while sat at work today.

Its basically a pain that runs down the rear of my neck (left side) and down into my shoulder blade to a point that feels quite central in my shoulder. This doesn't really hurt while climbing, but after getting on the sport I've certainly noticed it in the days after. Particularly pronounced when I turn my head to the right.  After a session at Malham on Sunday it wasn't great. Went for an 'enthusiastic' swim last night (mainly breast stroke) and today its been pretty poor.

Any idea what this might be and what I ought to do to make amends? Thanks in advance for any help you can give!

Hi it sounds like the problem is coming from your neck more so than the shoulder. The cervical spine will refer pain in to the shoulder, shoulder blade area, arm and even in to the hand and fingers.
The fact that breast stroke irritated it probably means that the neck isn't liking excessive or repetitive extension ie looking up. In the daytime take care that you are not slumping when you sit which tends to promote a forward head position. Often climbers become stiff in their mid back regions and this can affect neck and shoulder positions/movements. Basically try to do some stretches for this area and be more aware of your posture.
I would recommend you see a physio as you have had this since the winter.
Regards
Matt

[Doylo]

Thanks. I think it is cumulative and eventually just gets that bit worse. I'll try and ease off a bit.

[fried]

I have a question about shouler flexibility, it doesn't cause me any pain but I wonder if it has any knock-on effects.

I'm 42 years old, and as long as I can remember I've had a problem with shoulder flexibility. I did a spell of Yoga in Indai a long while ago, and the teacher was quite surprised at my lack of mobility. I didn't think too much of it at the time; as Indians are always shocked by the lack of flexibility of westerners.

I cannot put my arms vertically above my head with my elbows locked I reckon I'm about 15° off vertical. If I try exercises such as squads with a broom handle locked elbows above my head i'm about 45° off vertical.

Is this normal at my age? Is there any thing I can do to improve mobility? Does it matter? or are there repucussions?

I have a slight scoliosis of the spine too, not sure if that is relevant or not.

[Muenchener]

My yoga teacher in India had seen enough westerners to not be surprised by anything any more, but I have the same problem. Eagerly awaiting replies to this one.

Have you seen the video of BKS Iyengar from 1938? Amazing. There's a bit where he folds his legs into lotus whilst going up into a handstand. A well known British yoga teacher once said to me "you know that bit where he folds his legs into lotus whilst going up into a handstand? Forget ever learning to do that if your school had chairs"

[sidewinder]

Suffering from another finger issue, seemingly different to the normal, so thought I would ask here.

For the last couple of days and after a few weeks with perhaps more crimping than normal, on straightening my left hand, the middle finger catches slightly and 'clicks' audibly just before fully straightening.  This seems to happens about 10% of the time I straighten my fingers, more if I have had my hand still for a while.   The source seems to be the joint between the lower and middle phalanx, on the little finger side of the hand and towards the back side rather than palm side.

There is no pain and it doesn't seem particularly tender.  There might be a small lump, but I have now been playing with the finger too long trying to work out what is happening to objectively know.

Any ideas?  It seems to share some of the symptons of trigger finger (which seems a not good thing to get) but in the wrong place. I was thinking along the lines of small cyst/tendon sheath inflamation/tendon damage/bone fragment/spur?  I was planning some rest, massage, ice? and trying to keep it mobile (squidgy ball/putty)?  Might is be worth having some sort of scan to see what is happening if it doesn't stop soon?

[HPclinic]

My yoga teacher in India had seen enough westerners to not be surprised by anything any more, but I have the same problem. Eagerly awaiting replies to this one.

Have you seen the video of BKS Iyengar from 1938? Amazing. There's a bit where he folds his legs into lotus whilst going up into a handstand. A well known British yoga teacher once said to me "you know that bit where he folds his legs into lotus whilst going up into a handstand? Forget ever learning to do that if your school had chairs"

Hi see the response to the previous question re flexibility. Interestingly you will find that westerners have difficultly squatting down into a sitting position with feet flat on the floor where as if you travel to the middle and far east you see people in the street sitting like this for hours. They have probably sat like this since they were children (children actually tend to squat like this in western countries- so when do we loose this ability? We sit in chairs!) and hence there joints and tissues have been conditioned.
When you are physically mature it becomes more difficult to gain muscle length and joint flexibility. Some people are just tight but often can reflect what you did as a child. Swimmers have flexible shoulders and gymnasts are flexible...
regards
Matt

[HPclinic]

Suffering from another finger issue, seemingly different to the normal, so thought I would ask here.

For the last couple of days and after a few weeks with perhaps more crimping than normal, on straightening my left hand, the middle finger catches slightly and 'clicks' audibly just before fully straightening.  This seems to happens about 10% of the time I straighten my fingers, more if I have had my hand still for a while.   The source seems to be the joint between the lower and middle phalanx, on the little finger side of the hand and towards the back side rather than palm side.

There is no pain and it doesn't seem particularly tender.  There might be a small lump, but I have now been playing with the finger too long trying to work out what is happening to objectively know.

Any ideas?  It seems to share some of the symptons of trigger finger (which seems a not good thing to get) but in the wrong place. I was thinking along the lines of small cyst/tendon sheath inflamation/tendon damage/bone fragment/spur?  I was planning some rest, massage, ice? and trying to keep it mobile (squidgy ball/putty)?  Might is be worth having some sort of scan to see what is happening if it doesn't stop soon?

Hi again, clicking is always difficult to determine where it is coming from. Joints will certainly click and this can be the surfaces passing over each other. If it is not painful then I would suspect more of a tendon issue as you have suggested. You will certainly get a catching sensation if there is a mild inflammatory response of the tendon sheath. As it only a couple of days old and you report having done more crimping of late then I would suggest backing off and doing all the things you have discussed. I wouldn't diagnose a trigger finger just yet and also if it is on the back of your hand then this would probably exclude a trigger finger.
Make sure you stretch the finger into extension and back right off the climbing for the next two weeks, in particular the crimping which obviously puts more stress through the finger tendons. Keep the fingers moving as tendons like to glide within the sheath and synovial fluid.
regards
Matt

[sidewinder]

Thanks, a lot. I will do this and see what happens.  Is there a limit to how much massage one should do?

Keep the fingers moving as tendons like to glide within the sheath and synovial fluid.
regards
Matt

[Will Hunt]

For perhaps the last winter I've had a bit of a niggling in my left shoulder. Since turning to filthy sport climbing this spring, this has started to flare up and tonight I have had to pass up the wall as I've felt it giving me pangs while sat at work today.

Its basically a pain that runs down the rear of my neck (left side) and down into my shoulder blade to a point that feels quite central in my shoulder. This doesn't really hurt while climbing, but after getting on the sport I've certainly noticed it in the days after. Particularly pronounced when I turn my head to the right.  After a session at Malham on Sunday it wasn't great. Went for an 'enthusiastic' swim last night (mainly breast stroke) and today its been pretty poor.

Any idea what this might be and what I ought to do to make amends? Thanks in advance for any help you can give!

Hi it sounds like the problem is coming from your neck more so than the shoulder. The cervical spine will refer pain in to the shoulder, shoulder blade area, arm and even in to the hand and fingers.
The fact that breast stroke irritated it probably means that the neck isn't liking excessive or repetitive extension ie looking up. In the daytime take care that you are not slumping when you sit which tends to promote a forward head position. Often climbers become stiff in their mid back regions and this can affect neck and shoulder positions/movements. Basically try to do some stretches for this area and be more aware of your posture.
I would recommend you see a physio as you have had this since the winter.
Regards
Matt

Thanks very much Matt. Thinking about this, this could be linked to my road bike. I've had a it a few years and have never really had it fitted properly for headset height etc. Long rides can cause quite a bit of stiffness in neck and shoulder (particularly the left) which I often try to stretch out in the saddle. I think I'll get that sorted and see a physio.

[turnipturned]

For perhaps the last winter I've had a bit of a niggling in my left shoulder. Since turning to filthy sport climbing this spring, this has started to flare up and tonight I have had to pass up the wall as I've felt it giving me pangs while sat at work today.

Its basically a pain that runs down the rear of my neck (left side) and down into my shoulder blade to a point that feels quite central in my shoulder. This doesn't really hurt while climbing, but after getting on the sport I've certainly noticed it in the days after. Particularly pronounced when I turn my head to the right.  After a session at Malham on Sunday it wasn't great. Went for an 'enthusiastic' swim last night (mainly breast stroke) and today its been pretty poor.

Any idea what this might be and what I ought to do to make amends? Thanks in advance for any help you can give!

Hi it sounds like the problem is coming from your neck more so than the shoulder. The cervical spine will refer pain in to the shoulder, shoulder blade area, arm and even in to the hand and fingers.
The fact that breast stroke irritated it probably means that the neck isn't liking excessive or repetitive extension ie looking up. In the daytime take care that you are not slumping when you sit which tends to promote a forward head position. Often climbers become stiff in their mid back regions and this can affect neck and shoulder positions/movements. Basically try to do some stretches for this area and be more aware of your posture.
I would recommend you see a physio as you have had this since the winter.
Regards
Matt

Thanks very much Matt. Thinking about this, this could be linked to my road bike. I've had a it a few years and have never really had it fitted properly for headset height etc. Long rides can cause quite a bit of stiffness in neck and shoulder (particularly the left) which I often try to stretch out in the saddle. I think I'll get that sorted and see a physio.

Do you spend a lot of time at a desk Will? I am no expert in the slightest but sounds like a posture thing to me!

[sidewinder]

Thanks for your advice, unfortunately, despite doing no climbing and stretching/massaging/icing over the last week and a half, the clicking and catching on my finger continues (catching perhaps not quite as bad) also there is definitely an intermittent, small, soft lump on the side of the finger at the site of the problem, so I am thinking it could well be some sort of small cyst which the tendon is catching on/...?  Gonna see a dr tomo and see what they say.

[webbo]

I have another foot problem. Right foot it started 2 weeks ago after about 4 hours cycling
I got a burning session in the ball off my foot which spread across to my little toe, I have this before towards the end of along ride. It does not happen every long ride, I did 148 miles with no problem last year.
Usually after finishing it goes away however this time it has persisted, also my middle toe looks swollen and red. I am now getting pain in my toe when I wear my climbing shoes. Most of my toes curl under due to 40 years of climbing shoes.
I saw my GP yesterday he is sending me for an X-ray to rule out a stress fracture, his other thought was a tendon problem. His treatment suggestions were pain relief and rest.
I am not aware of doing anything different or banging my foot in to anything.
Any ideas.

[Boredboy]

Thanks for your advice, unfortunately, despite doing no climbing and stretching/massaging/icing over the last week and a half, the clicking and catching on my finger continues (catching perhaps not quite as bad) also there is definitely an intermittent, small, soft lump on the side of the finger at the site of the problem, so I am thinking it could well be some sort of small cyst which the tendon is catching on/...?  Gonna see a dr tomo and see what they say.

Flexor tendon ganglion cysts aren't uncommon apparently:

 http://www.bssh.ac.uk/patients/commonhandconditions/ganglioncysts

[sidewinder]

indeed, dr suggests benign cyst is the very likely option and that as no pain/impingement on finger function it should be fine to ignore it and that although noisy, the noise is not indicative of damage being caused.  Now to get used to the unsettling noise ...

[B0405413]

Hello,

I've had these symptoms for over two years now: pain and ache in my right shoulder area, particularly my shoulder blade,  and weak grip in my ring finger and pinky in right hand. I have seen a number of specialists and they all seem to think it's the ulnar nerve, and that it came about due to a joint clicking habit. I notice that this arm fatigues much faster than my other during climbing. Can the ulnar nerve get trapped in the shoulder area?

Any help is greatly appreciated, Thanks.