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New 'Physio Clinic' Q&A session (Read 106132 times)

HPclinic

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New 'Physio Clinic' Q&A session
June 07, 2013, 03:43:43 pm
Online injury clinic ..............

Do you have an injury or a problem that is stopping you climbing or causing you pain?  Starting on Friday 14 June @midday on UKbouldering Steve and Matt (physios at Hallamshire Physiotherapy clinic) will be answering any questions you may have on the forum.  Send questions to us before next Friday and we will try to give sensible, clear and practical advice that is research based. 
« Last Edit: September 28, 2013, 06:21:52 pm by habrich, Reason: sub-title for front page »

shark

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#1 Re: New 'Physio Clinic' Q&A session
June 07, 2013, 04:19:26 pm
Thanks Steve,

Just to be clear if you post your questions on this thread then Steve and Matt will answer them next friday lunchtime.

If it goes OK they will log on each friday afternoon thereafter to answer questions posed the previous week.

Obviously it can be more of an interactive discussion on friday lunchtimes.

Luke Owens

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#2 Re: New 'Physio Clinic' Q&A session
June 07, 2013, 04:41:14 pm
Great idea, thanks guys!

I have minor golfers elbow on my right elbow. Can't pinpoint a defining moment which caused it but it's definitely from climbing.

I have had it for a few months, but it's never been painful enough to stop me climbing and I very rarely feel pain while climbing unless I do a really deep lock off or pull up with that arm. It only seems to ache/hurt afterwards when I've warmed down. More niggling pain than anything.

I've tried all the usual things for shifting it, stretching, icing, weights etc. but it always seems to linger. I've now give up on all of the above due to no results, probably not the best idea.

Do you recommend I just need to perserve with the stretching etc or something else?

Also any advice on preventing reoccurance would be great.

Many thanks,

Domingo

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#3 Re: New 'Physio Clinic' Q&A session
June 09, 2013, 01:30:19 pm
I've damaged the pulley tendon (I believe) on my right hand ring finger and it just wonít heal! I did it whilst climbing, my foot popped off whilst I was moving my left hand and all my weight went through the crimp I was holding with my right hand. I heard like a tearing/cracking sound.

I stopped climbing for 2 weeks; during that time I was using a stiff stress ball to exercise the finger and it felt ok to grip things. I tried to go back to climbing, but as soon as I tried to put weight through it I had a lot of pain.

I stopped again for 3 weeks and went back to using the stress ball and massaging and stretching my finger. Though when I went back this time I still had pain when I was weighting my hand with my body weight, even though Iíd tapped the finger up.

I once again stopped and this time I went and saw my doctor. He told me to take it easy on it for a couple of months, but donít stop using it completely. I therefore completely stopped climbing for 2 months, but still worked out in the gym with weights which didnít hurt.

I went back to climbing last week and itís still not right, I can hold jugs and slopers with it but it doesnít feel quite right. Itís nowhere near as painful, but there is no way I could crimp on it, or would want to put my full body weight through it.
The finger doesnít swell and Iíve not noticed any bruising. It doesnít hurt normally, only when I massage it. Itís just as a soon as I try to put weight through it.

Should I stop again?

What other things can I do to help it heal?

Is it possible to permanently damage the finger?

2 Tru

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#4 Re: New 'Physio Clinic' Q&A session
June 11, 2013, 01:08:45 pm
 :off: possibly but prevention is better than cure.

As someone who is approaching 30 I'm increasingly aware I'm not a kid anymore and although there are plenty of weekly training programmes on how to get strong there is little on what the average climbing should be doing on a weekly basis to prevent climbing injury?

General advice on antagonistic training, stretches, warm up and early identification of injuries (rotor cuff, tennis elbow, finger injuries etc) that you could fit into and around a training programme would be very helpful, thank you.


James Malloch

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#5 Re: New 'Physio Clinic' Q&A session
June 11, 2013, 01:56:32 pm
An elbow question...

A number of times in the last few months, when lowering off a route and having a shake out, I've had a problem in my right elbow.

It seems that a tendon (I think) has a little spasm which trys to make my arm close/contract. You can see the part spasming as it rises out of the joint a bit. Also, it's not very painful unless you try to straighten your arm whilst it's going on.

Each time it's happend after I've done a route close to my limit, then had a decent break and then done an easier route afterwards as a kind of cool down (still fairly close to my limit, damn Malham's 7a warm ups/cool downs).

It has also happened when really pulling/locking off on some undercuts. Was planning to try and get to a physio soon, just waiting for my work's health plan to say they can cover it. But might as well see if it's a known kind of problem first.

Thanks.

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#6 Re: New 'Physio Clinic' Q&A session
June 11, 2013, 02:36:39 pm
My right forearm feels constantly tired even after a couple of days of no climbing.  My left arm is fine,when i've felt tired like this before its always been ok the next day.  There's no pain but i can feel it even doing day to day things like picking things up or even typing. Just over a week ago i was hammering off some old rusty bolts and my forearm really felt it afterwards, i've been trying pretty hard on the climbing front since so it's possible i suffered some micro trauma and haven't let it heal (my theory anyway)? Any ideas/advice?

Duma

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#7 Re: New 'Physio Clinic' Q&A session
June 11, 2013, 04:24:54 pm
 :lol:

chris05

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#8 Re: New 'Physio Clinic' Q&A session
June 11, 2013, 05:13:31 pm
Hi

I have had long-standing (8+ years) problems with my Ďelbowsí both when I climb and surf, especially if I try to do a number of days-on. There is no particular point of pain, it can be diffuse throughout the bicep, tricep, elbow joint and top of the forearm. I'm fairly sure it isnít golfers or tennis elbow (although I have tried the exercises for these for fairly long periods just in case).

I have been to see a couple of physios who have struggled to diagnose the problem as itís not usually present unless I have been climbing or surfing for a couple of days.

I also get a lot of stiffness/soreness in my shoulders (I believe in the rotator cuff area) when sitting at a desk and whilst running. I guess this may be the root of the problem. I have followed a few theraband routines for a reasonable length of time but although these seem to help a little, they donít seem to help long-term.

It doesnít seem to matter if I take time out from these activities or if I slowly build up. I am 30 years old and it would be nice to be able to climb or surf for more than a day without pain! I have resorted to popping ibuprofen on surf trips which seems to help up to a point but obviously isnít a good long-term solution.

Many thanks for any help in advance.

Chris

P.S. Sorry for the Dear Deidre  type post!

rich d

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#9 Re: New 'Physio Clinic' Q&A session
June 11, 2013, 09:33:56 pm
Dear Diedre,
I broke my ankle a few years back, didn't do anything with it apart from rice at the time as I thought it was a bad sprain.
A couple of years ago it swelled up and I had an X-ray at the hospital and was told that I'd broken it, there was some bone floating around and that There was early(ish as I'm 40) onset of arthritis.
Apart from euthanisia is there anything you'd suggest as it is a definate weak point and flares up if I'm carrying heavy packs, or the kids.

psychomansam

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Dear Aunt Agony,

A couple of years ago, while playing squash, a took a sideways lunge. Pain. Collapsed. To put it in laymans terms, I tore my groin. Well, it seems to be something connecting my right leg to the bottom of my abs. It hurt to walk, get out of bed, cough etc for about a month. It healed up slowly and eventually I got back to climbing. A few months ago, I tried playing squash again. After about 6 sessions, hey presto, I re-aggravated it. I could still climb but only just. It's almost healed up now, but I'm worried it'll happen again, I can't play squash  and would appreciate any ideas for exercises that could fix it.

It effects lateral movement but also seems to connect into the bottom of the abs, or just below I guess. I can't hang on a pull-up bar when it's bad.

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I have a problem that's been troubling me for a couple of months in my left heel. Its on the outside slightly to the left of the Achilles. Initially there was slight swelling but that's gone down with icing. If I stretch it by keeping my heel flat on the floor and bend my knee forward over my toes its tight and painful. The main issue is climbing shoes either exacerbate it or caused it due to the pressure of the rand in this area. I cut the rand on an old pair of shoes and generally I can climb with no discomfort and not much soreness later. however if I wear my muria velcros, tight and down toed I have to keep taking them off to relieve the mild discomfort and it will be sore the next day although this will ease with stretching and movement.
I did see my GP and he just said take over the counter Anti Inflammatorys which eased it in the initial stages.

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Hi guys.

I have a finger issue that i can't find any info on, would be great to hear ur thoughts. On my right hand my first joints seem very 'tight' and i have progressively been finding it harder and harder to make a full fist as the full range of motion is not there, especially in my index and middle fingers. Especially on my middle finger the first joint feels quite tender and 'bruised' to the touch with slight but not significant swelling. All fingers have full climbing strength and do not hurt under load at all. As i say it feels more like a bruise than a strain. I use the crimp position a lot and reason that it may be due to hyper extending the first joints in very tight crimp positions. I have been climbing normally for a while and it seems manageable enough but would be interested if there is a possibility that it is a more serious issue that may need special treatment.

many thanks


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Chaps

I have a pain in the outside of my right elbow, just on/below the knobbly bit of elbow bone on the wrist side if you see what I mean and below the bump of muscle that sticks out when you flex the joint to 90deg or so. It doesn't affect climbing but appeared around Xmas aftre a heavy training program running up to Xmas and hasn't gone away. If this is golfers/climbers elbow could you please advise on an exercise regime to address the issue as I would like to nipo any deteriorating condition in the bud, if it helps I am 50 and train approx 3 times per week on average when fit ...

Many thanks guys

Johnny Brown

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Wow, busy day for these guys tomorrow!

I bruised my right heel about two months ago. I couldn't rest it, so spent a month basically walking on my toes on my right leg. This made my calf ache a bit on long walks. Now I can walk normally again, heel is fine, but my right knee has started having twinges where it briefly feels weak and unstable. I had an arthroscopy on the inside of the knee about eight years ago, to 'tidy up' cartilage (a torn flap was visible on MRI, but the surgeon couldn't find it). Any ideas?

LucyB

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Bet you're wishing you'd never asked.....

Tennis elbow for me, diagnosed by a couple of medical types I climb with now and again. It started when I bashed my elbow on a hold, and then got steadily worse. It is worse if I don't climb at all, and I have been surprisingly careful when climbing - stopping if a particular move hurts it and so on.

I'm just wondering if there are other exercises I can be doing to help it clear up - is there a tin of beans thing I should be doing?

nai

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Hi Steve

I had what appeared to be an open & shut case of Golfers Elbow (it would feel like a strap was being tightened around my forearm immediately below the elbow when performing tasks like squeezing a plastic bottle or unscrewing a jar lid.  I would also feel a tweak on the inside just below the elbow when straightening or bending the elbow fully).  I tried wrist curls and icing but it hasn't responded to either.

Knowing how you work I looked into other possible causes and I saw both your and Joe Le Sage's video advice on here and subsequently noticed that my right shoulder was much stiffer than my left (maybe 20 degrees difference when performing a Scarf Stretch at that point), also if I dug my fingers into my back/shoulder muscles beneath my scapula I'd experience moderate pain.

I decided to work on my shoulder and started rotator cuff exercises and scarf stretches and both my elbow and shoulder improved, I also did some gentle climbing and the symptoms could disappear almost entirely for a day or two afterwards.  Recently I've been climbing at increasing intensity without pain and managing to do more and more.

This week though the symptoms have returned.  I climbed on Monday, did quite a strenuous swim on Tuesday and today the elbow is tweaky again.  Having fallen out of the habit of doing them, I tried the shoulder exercises again and it is also stiff, a bit crunchy and fingers-in-the-scapula generates pain again.

It appears I have a shoulder problem, does it sound like I have an elbow issue too or is it possible the shoulder is causing the symptoms in the elbow?


Thanks

Ian

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Sheesh, reading this thread makes me realise how lucky I am to only have slightly dodgy hamstrings at the moment.

RichK

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Fellas,

I'm 48 with shoulder injuries.....lots :(

Some history: SLAP tears in both shoulders, R since 2007(MRI diagnosis - L. Funk), 2nd diagnosis on R Feb 13.
Rotator cuff tears front and back & SLAP on L shoulder.

Still climbing & MTB & wanting to prolong surgery as long as possible. Climbing up to 7c/+ sport & trad E4/5. I climb/train 3 times a week & ride once/twice a week.

From what Funk says the SLAP's probably won't heal without intervention. He also encouraged me to continue until things become unmanageable (I suspect he is saying this not too disappoint). He said he'd always(95%) be able to repair. 
I avoid pull ups, press ups and weights as they all seem to aggravate. However, I'm able to train on circuit boards with not too many problems. Physio is limited to standerd theraband stuff prior to climbing. If I increase the theraband stuff and add in rotator cuff ex with light weight - the ones sitting and rotating shoulder from horizontal to vert + same but lying on side then pain increases. Thus I tend to avoid the last 2.
If I'm careful I manage and I back off/rest if pain increases. The biggest issue is walking in with a heavy trad sac. As you'd expect my L(SLAP & Rot cuff) is far worse than R .

Can you point me towards any exercises that may well repair/ strengthen the rotator cuff other than the light weight(1-1.5KG) ones mentioned. I appreciate I'm asking a lot. Funk mentioned rowing as an option?
Cheers





HPclinic

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Great idea, thanks guys!

I have minor golfers elbow on my right elbow. Can't pinpoint a defining moment which caused it but it's definitely from climbing.

I have had it for a few months, but it's never been painful enough to stop me climbing and I very rarely feel pain while climbing unless I do a really deep lock off or pull up with that arm. It only seems to ache/hurt afterwards when I've warmed down. More niggling pain than anything.

I've tried all the usual things for shifting it, stretching, icing, weights etc. but it always seems to linger. I've now give up on all of the above due to no results, probably not the best idea.

Do you recommend I just need to perserve with the stretching etc or something else?

Also any advice on preventing reoccurance would be great.

Many thanks,

I assume you are right handed?

You've tried the local things which dont work so it is probably referred from the shouder/neck area maybe from overuse of a mouse at work??

Worth trying swapping hands on the mouse and get your arm above your head during the working day and report back.

We are producing a video on elbow rehab and you may get some ideas from that.

HTH

HPclinic

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I've damaged the pulley tendon (I believe) on my right hand ring finger and it just wonít heal! I did it whilst climbing, my foot popped off whilst I was moving my left hand and all my weight went through the crimp I was holding with my right hand. I heard like a tearing/cracking sound.

I stopped climbing for 2 weeks; during that time I was using a stiff stress ball to exercise the finger and it felt ok to grip things. I tried to go back to climbing, but as soon as I tried to put weight through it I had a lot of pain.

I stopped again for 3 weeks and went back to using the stress ball and massaging and stretching my finger. Though when I went back this time I still had pain when I was weighting my hand with my body weight, even though Iíd tapped the finger up.

I once again stopped and this time I went and saw my doctor. He told me to take it easy on it for a couple of months, but donít stop using it completely. I therefore completely stopped climbing for 2 months, but still worked out in the gym with weights which didnít hurt.

I went back to climbing last week and itís still not right, I can hold jugs and slopers with it but it doesnít feel quite right. Itís nowhere near as painful, but there is no way I could crimp on it, or would want to put my full body weight through it.
The finger doesnít swell and Iíve not noticed any bruising. It doesnít hurt normally, only when I massage it. Itís just as a soon as I try to put weight through it.

Should I stop again?

What other things can I do to help it heal?

Is it possible to permanently damage the finger?

You should probably attempt to gradually start introducing crimps in a controlled and careful manner probably on a fingerboard. This will require patience and caution but have faith - tissues  respond to progressive load. You're confidence has probably been knocked and you may be hypervigilant about the injury which can drive the pain.

Given that you have long history here I recommend getting professional advice if this doesnt work. 

HPclinic

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:off: possibly but prevention is better than cure.

As someone who is approaching 30 I'm increasingly aware I'm not a kid anymore and although there are plenty of weekly training programmes on how to get strong there is little on what the average climbing should be doing on a weekly basis to prevent climbing injury?

General advice on antagonistic training, stretches, warm up and early identification of injuries (rotor cuff, tennis elbow, finger injuries etc) that you could fit into and around a training programme would be very helpful, thank you.

First up 30 isnt old !

Back extensions, outward rotations ie the opposite of climbing are all good things to do. Any activities involve rotation like boxing, tennis are all good too.

Don't become a "chair shaped climber" !

HPclinic

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An elbow question...

A number of times in the last few months, when lowering off a route and having a shake out, I've had a problem in my right elbow.

It seems that a tendon (I think) has a little spasm which trys to make my arm close/contract. You can see the part spasming as it rises out of the joint a bit. Also, it's not very painful unless you try to straighten your arm whilst it's going on.

Each time it's happend after I've done a route close to my limit, then had a decent break and then done an easier route afterwards as a kind of cool down (still fairly close to my limit, damn Malham's 7a warm ups/cool downs).

It has also happened when really pulling/locking off on some undercuts. Was planning to try and get to a physio soon, just waiting for my work's health plan to say they can cover it. But might as well see if it's a known kind of problem first.

Thanks.

Possibly your arm is cramping because the bicep muscle is trying to protect the nerve. Are you getting any pins and needles or neck pain? It maybe that your neck needs looking at. When sitting get the arm above your head to get the load of your neck.

And as you are probably aware cool downs need to be at a lower grade.

HPclinic

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My right forearm feels constantly tired even after a couple of days of no climbing.  My left arm is fine,when i've felt tired like this before its always been ok the next day.  There's no pain but i can feel it even doing day to day things like picking things up or even typing. Just over a week ago i was hammering off some old rusty bolts and my forearm really felt it afterwards, i've been trying pretty hard on the climbing front since so it's possible i suffered some micro trauma and haven't let it heal (my theory anyway)? Any ideas/advice?

This is likely a nerve problem also especially as it is only in one arm. See last response to James Malloch. You need to get that checked by GP or a recommended Physio and look to exclude neck issues or local nerve involvement.

HPclinic

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Hi

I have had long-standing (8+ years) problems with my Ďelbowsí both when I climb and surf, especially if I try to do a number of days-on. There is no particular point of pain, it can be diffuse throughout the bicep, tricep, elbow joint and top of the forearm. I'm fairly sure it isnít golfers or tennis elbow (although I have tried the exercises for these for fairly long periods just in case).

I have been to see a couple of physios who have struggled to diagnose the problem as itís not usually present unless I have been climbing or surfing for a couple of days.

I also get a lot of stiffness/soreness in my shoulders (I believe in the rotator cuff area) when sitting at a desk and whilst running. I guess this may be the root of the problem. I have followed a few theraband routines for a reasonable length of time but although these seem to help a little, they donít seem to help long-term.

It doesnít seem to matter if I take time out from these activities or if I slowly build up. I am 30 years old and it would be nice to be able to climb or surf for more than a day without pain! I have resorted to popping ibuprofen on surf trips which seems to help up to a point but obviously isnít a good long-term solution.

Many thanks for any help in advance.

Chris

P.S. Sorry for the Dear Deidre  type post!

This is again likely referred from thorax or neck. On a surfboard paddling out you need more thoracic extension rather than compensating with your neck. Daily and before climbing do thoracic extensions with a gymball but don't overcompensate by overstretching your lower back. Currently you are hammering everything through your shoulders and upper back in a bad position probably. See how you get on.

Best wishes, Deidre