UKBouldering.com
the shizzle => diet, training and injuries => Topic started by: HPclinic on June 07, 2013, 03:43:43 pm
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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.
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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.
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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,
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I've damaged the pulley tendon (I believe) on my right hand ring finger and it just won’t 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 I’d 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 don’t stop using it completely. I therefore completely stopped climbing for 2 months, but still worked out in the gym with weights which didn’t hurt.
I went back to climbing last week and it’s still not right, I can hold jugs and slopers with it but it doesn’t feel quite right. It’s 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 doesn’t swell and I’ve not noticed any bruising. It doesn’t hurt normally, only when I massage it. It’s 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?
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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.
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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.
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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?
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:lol:
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Hi
I have had long-standing (8+ years) problems with my ‘elbows’ 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 isn’t 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 it’s 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 don’t seem to help long-term.
It doesn’t 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 isn’t a good long-term solution.
Many thanks for any help in advance.
Chris
P.S. Sorry for the Dear Deidre type post!
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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.
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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
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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?
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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?
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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.
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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
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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
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I've damaged the pulley tendon (I believe) on my right hand ring finger and it just won’t 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 I’d 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 don’t stop using it completely. I therefore completely stopped climbing for 2 months, but still worked out in the gym with weights which didn’t hurt.
I went back to climbing last week and it’s still not right, I can hold jugs and slopers with it but it doesn’t feel quite right. It’s 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 doesn’t swell and I’ve not noticed any bruising. It doesn’t hurt normally, only when I massage it. It’s 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.
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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" !
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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.
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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.
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Hi
I have had long-standing (8+ years) problems with my ‘elbows’ 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 isn’t 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 it’s 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 don’t seem to help long-term.
It doesn’t 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 isn’t 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
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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" !
I'm interested - how does swimming work as an exercise on this front - I've always thought that all that waving arms about in the water must be good for general shoulder stuff,,,?
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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.
Either you have a bit of bone floating in the joint surface or your ankle has reduced weight bearing dorsiflexion which needs to be regained ie foot fixed with knee moving forward. If the latter doesnt work best see your GP and you may need to be referred to an orthopaedic surgeon. This is highly treatable.
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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.
Sounds like you might have a small hernia which needs checking with your GP in the first instance. Assuming not then your sitting position needs to be looked at to reduce tightness in your groin region. Back stretches and practice lunges prior to exercise on a daily basis are worth experimenting with.
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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.
This has caused some debate between us. Try calf stretches 2 or 3 times a day and some local massage before climbing and report back. You are right to relieve the pressure on it as it maybe compression of a small nerve on the outside of the ankle.
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I like it "Some debate" This sort describes my sporting injury history. I forgot to mention I am a bit on the mature side 58
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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
Sounds like you have a joint reaction (mild arthritis) and stiffness is the response due to the way it is being used/overloaded. Stretch individual joints daily and introduce more variation ie open handing holds instead of crimping. Drop the grade to let it settle and improve. Sorry!.
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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
We will be producing a video that may help but it in the meantime it sounds like you need to address your training by introducing more variety perhaps ie pushing weights if you arent doing this already.
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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" !
I'm interested - how does swimming work as an exercise on this front - I've always thought that all that waving arms about in the water must be good for general shoulder stuff,,,?
Doing crawl is good but requires good technique with plenty of rotation - something often missing with climbers!
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Round about this time last year I injured my wrist. This was diagnosed as a torn TFCC and treated by arthroscopic debridement. Cue long layoff from climbing.
I had the surgery towards the end of last year.
At some point during this layoff I started having achilles tendon problems for which the physio recommended eccentric calf raises. This seemed to work & in April this year I booked a trip to Bleau to test the recovering wrist ( having completely forgotten the achilles problems)
2 consecutive days of gentle climbing in my baggy warm-up shoes produced very high levels of pain in the heel & eventually I just couldn't bear to put my left shoe on.
2 months of icing & stretching & eccentric calf raises later & i have some slight residual discomfort when walking but any pressure on the heel is still very painful preventing me from wearing climbing shoes.
The pain seems to be in the bone where the achilles attaches rather than in the tendon itself.
I have tried custom orthotics & the physio is now suggesting a cortisone injection.
Any thoughts suggestions welcome
Thanks
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Thanks to Steve, Matt and Ian for their time this afternoon.
Unfortunately we have run out of time but hopefully they will revisit during the week to answer the outstanding questions (or you can see them in person!).
Please bear in mind that they are responding to a snapshot of your predicament as you perceive it and are responding accordingly and giving the best advice that they can in the circumstances.
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http://en.wikipedia.org/wiki/Haglund's_deformity (http://en.wikipedia.org/wiki/Haglund's_deformity)
Any chance you could have this (I do) mine is normally fine but if I wear shoes that rub on the area (guide tennies particularly bad), it causes a flare up of tendonitus(sp?) like symyptoms. Wearing soft/no backed shoes (Sanuks/crocs), padding the backs of shoes with shiny (reduces friction) insole foam, moisturising skin around the area (reduces friction) and finding climbing shoes that fit my feet well, so they tightly fit without moving/rubbing are my injury management strategies.
I like it "Some debate" This sort describes my sporting injury history. I forgot to mention I am a bit on the mature side 58
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It sounds possible but what puzzles me is that it only started this year and I have been ramming my feet in to misshapen shoes on and off for 40 years and it came on after a period when I'd not been wearing climbing shoes due to having a finger injury. Also I'm not sure my shoes move/rub as they are usually to tight to do this.
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For me, I only started having problems after wearing an ill fitting pair of hired ice skating boots. So if it is what I have, possibly it could even be that your feet changed a bit during a period of not wearing the climbing shoes and that they now irritate them? Once inflamed I find that any pressure, regardless of 'rubbing' makes it worse, hence I try to make sure it is not getting irritated as much as possible (typed while sitting in my office in fake crocs, with smart shoes tucked under the desk in case of visitors).
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Its worth bearing in mind although I have been avoiding wearing shoes that rub and customised my climbing shoes. I will try whats recommended and report back, although I'm not sure I could cope with the ridicule of wearing crocs.
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Sounds like this would fit my problem as well. How did you customise your shoes I can't see any way to do it?
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I cut the rand on either side of the left pull tag. This is on a pair of sportiva kantanas, they are fine to climb in on my home board but on not so steep stuff my heel can lift out.
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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
Sounds like you have a joint reaction (mild arthritis) and stiffness is the response due to the way it is being used/overloaded. Stretch individual joints daily and introduce more variation ie open handing holds instead of crimping. Drop the grade to let it settle and improve. Sorry!.
This sounds like a mirror of three joint pains I am suffering in my fingers and corresponds with the diagnosis I've just had from a hand therapist.
She also recommended warming the hands before climbing, and cooling them after, and recommended pain killers for pain management :-\
She also suggested looking into whether I had an intolerance to the tomato / nightshade family of fruits/veg, which include tomatoes, peppers, aubergines. I eat loads of these so I am going to try it out. Info on joint pain and tomato allergy http://www.livestrong.com/article/496041-tomatoes-peppers-for-joint-pain/ (http://www.livestrong.com/article/496041-tomatoes-peppers-for-joint-pain/)
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I cut the rand on either side of the left pull tag. This is on a pair of sportiva kantanas, they are fine to climb in on my home board but on not so steep stuff my heel can lift out.
Thanks. I think I'd have to cut the heel away completely :-((
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Hi
I have had long-standing (8+ years) problems with my ‘elbows’ 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 isn’t 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 it’s 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 don’t seem to help long-term.
It doesn’t 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 isn’t 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
Many thanks for this. I will give it a try.
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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.
Thanks a lot. Thinking about it the problem started straight after the hammering so I think it's a pinched nerve. Taking ibuprofen and hoping it'll clear up soon with rest :'(
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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.
Either you have a bit of bone floating in the joint surface or your ankle has reduced weight bearing dorsiflexion which needs to be regained ie foot fixed with knee moving forward. If the latter doesnt work best see your GP and you may need to be referred to an orthopaedic surgeon. This is highly treatable.
cheers, much more useful than A and E
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Round about this time last year I injured my wrist. This was diagnosed as a torn TFCC and treated by arthroscopic debridement. Cue long layoff from climbing.
I had the surgery towards the end of last year.
At some point during this layoff I started having achilles tendon problems for which the physio recommended eccentric calf raises. This seemed to work & in April this year I booked a trip to Bleau to test the recovering wrist ( having completely forgotten the achilles problems)
2 consecutive days of gentle climbing in my baggy warm-up shoes produced very high levels of pain in the heel & eventually I just couldn't bear to put my left shoe on.
2 months of icing & stretching & eccentric calf raises later & i have some slight residual discomfort when walking but any pressure on the heel is still very painful preventing me from wearing climbing shoes.
The pain seems to be in the bone where the achilles attaches rather than in the tendon itself.
I have tried custom orthotics & the physio is now suggesting a cortisone injection.
Any thoughts suggestions welcome
Thanks
Thanks for the question. Eccentric loading of the Achilles tendon has some research to suggest it works but from my clinical practice it makes more sense to remove stress on the overloaded tendon (I rarely prescribe eccentric loading exercises and see many people achilles problems who have not responded to this approach).
Usually climbing in not a major problem with achilles tendonitis as the runners are usually harder to settle (I assume you are not running?). I would try to see how you are using the calf and achilles. For example, do you walk by 'bouncing' and are your calves overdeveloped as a result. Try walking by keeping the foot flat and lean forward slightly (as we walk many people with achilles tendon problems 'push' with the calf and this causes repeated overloading of the tendon that manifests itself as pain when walking. Try to change your climbing style so as not push repeatedly through the ankle. Your Physio should watch you walk and even climb and suggest changes to your movement to help remove stress on the achilles.
PS
Regarding injections I am not a major fan and I would not have an injection before removing the stress on the tendon as outlined above. If you do go down the injection route be careful not to have more than three as steroids can weaken the tendon and possibly increase the risk of rupture. I would stop stretching as there is no evidence it works and it might be traumatising the tendon with repeat loading. Tell me how you get on.
Steve
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It sounds possible but what puzzles me is that it only started this year and I have been ramming my feet in to misshapen shoes on and off for 40 years and it came on after a period when I'd not been wearing climbing shoes due to having a finger injury. Also I'm not sure my shoes move/rub as they are usually to tight to do this.
I agree, if you have worn climbing shoes for 40 years your feet will have adapted to the compression that they produce. The problem can be if your foot has not been on the position for while (due to finger injury). Rate of change on tissues is a common problem so wear the shoes daily around the house and try gradually increase the time until you can climb pain free. I like the idea of having a range of shoes as this can change stress points on the foot. Your feet wont like the compression and then loading with climbing after time off. This is not age related in my opinion so some good news!. Steve
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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
Sounds like you have a joint reaction (mild arthritis) and stiffness is the response due to the way it is being used/overloaded. Stretch individual joints daily and introduce more variation ie open handing holds instead of crimping. Drop the grade to let it settle and improve. Sorry!.
This sounds like a mirror of three joint pains I am suffering in my fingers and corresponds with the diagnosis I've just had from a hand therapist.
She also recommended warming the hands before climbing, and cooling them after, and recommended pain killers for pain management :-\
She also suggested looking into whether I had an intolerance to the tomato / nightshade family of fruits/veg, which include tomatoes, peppers, aubergines. I eat loads of these so I am going to try it out. Info on joint pain and tomato allergy http://www.livestrong.com/article/496041-tomatoes-peppers-for-joint-pain/ (http://www.livestrong.com/article/496041-tomatoes-peppers-for-joint-pain/)
Most climbers get changes on the finger joints as a result of loading fingers in their sport. The x-ray will show changes on joint surfaces but not necessarily be painful. These joint changes are morphological changes in response to load on the joints and as long as the rate of loads on the joints doesn't change too rapidly, there is no problem in my experience. The good news joint love been loaded and they will respond to movement. That is probably why climbers hands ache after a break from climbing as the normal stresses are removed. 'Use it or lose it'.
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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
From the description it sounds like 'Tennis elbow' (not really a diagnosis but means you have pain over the outside of the elbow). The good news is climbing at 50 is not, from my experience of treating climbers aged 50 plus, going to stop you improving. If you can climb pain free it does make me wonder what sort of training you do. With your training consider doing weights that make you push for example shoulder and chest presses. Include more rotation exercises and I think kettle bells are a useful exercise and even boxing. Don't overload the lateral elbow with dead hangs and finger pulls until the pain settles. Matt is making a video on elbow rehab and exercises and that should be on the site soon.
Tell me how you get on. Steve
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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?
Johnny. Sounds like you compressed your knee as you landed on your heel. Knees don't like compression loads so if you we're having problems before with the knee is likely to take longer to recover. Additionally as you limped you will have aggravated the knee further.
If your knee locks or swells excessively you might have a cartilage tear and so you will need to see your GP. If its not, start to exercise the knee by performing daily step ups, 'sit-to -stand', lunges and modified squats. Gradually add weight to the exercises and make sure your walking has returned to normal (walking poles are useful to reeducate rotation and forward momentum). If that doesn't help see a recommended Physio. Thanks Steve.
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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?
Hi LucyB. It's interesting that it is worse if you don't climb. That makes sense as even painful tendons are usually better when they are loaded. It is natural to protect the elbow climbing but overprotection can lead to more pain. I assume its several weeks since the injury so gradually introduce the moves that you have avoided. Try strengthening the arm and shoulder with shoulder presses (see other posts and Matts rehab for elbow pain coming to the site soon for more training ideas) and don't specifically strengthen the forearm muscles. Local gentle massage over the lateral forearm muscles might be useful but there is no evidence that deep tissue and 'scar tissue release' helps. Thanks Steve
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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
Ian
Thanks for the detailed report and I would agree you don't have a local elbow problem. It could be from the shoulder but from what you are saying with the medial scapular pain you have a neck involvement. Also the medial pain (golfers elbow) would suggest referred pain into this region. I assume its your right elbow so check if your right shoulder is low and causing stress on the neck(and shoulder). I would elevate the shoulder up (shoulder shrugs are a good exercise for this) and stretch the right lat dori muscle. Stop the rotor cuff exercises and stretch your neck if it is stiff. Do that for a couple of weeks but keep climbing and see if that helps. See Matts video on elbow rehab coming soon to the site. Tell me how you get on.
Steve
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Sheesh, reading this thread makes me realise how lucky I am to only have slightly dodgy hamstrings at the moment.
Andy. Yes you are 'lucky' with hamstring problems. I bet you sit at a desk all day and have a tight lower lumbar spine. The hamstrings are tighten up in response to back pain/stiffness and sitting only compounds this. This is why stretching the hamstrings doesn't usually give a longterm solution. Try stretching your lumbar spine ad see what happens to your hamstrings. Thanks Steve
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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
Thanks Rick. From your history you either have made a bad decision selecting your parents (we sometimes inherit less than ideal tissues/joints!) or you are using your shoulders in an abnormal way. I suspect the latter. Pain when carrying a ruck sac is common (i expect you will also get pain on carrying heavy bags and lifting heavy objects off the floor) if your shoulders are low or depressed and this will cause you to stress the shoulder joint as you move into rotation or flexion. If climbing doesn't cause a problem continue and stop the rotator cuff exercises (when your shoulder gets over 120 degrees they work anyway so climbers have stronger rotator cuff muscles than 90% of the general population).
Many climbers have rotator cuff tears that are not painful ( a recent study of international javelin throwers showed that 40% had rotator cuff tears but NO pain-or 5 years later after the follow up). Do any resistance exercise with shoulders higher(develop a Galic shrug!) and I expect your shoulders to feel much better
Try this and I agree with Prof Funk to avoid surgery. Tell me how you get on.
Cheers Steve
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I have finally finished the replies to this weeks climbing injuries questions and answer session. See if it makes sense and look out for Matts elbow rehab and exercise ideas video coming to the site soon. We will be answering more questions next week at 12 noon on Friday (June 21). I'm now going to have a large drink to help my 'warm down'. :2thumbsup:
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Hi Steve, Many Thanks for your reply, I'll give your suggestions a go.
Quick (hopefully) question referring to swimming:
Doing crawl is good but requires good technique with plenty of rotation - something often missing with climbers!
I only swim while my nipper is having her lesson and the opportunity for 35 minutes exercise is preferable to sitting watching with a group of chit-chatting mummies. I'm unlikely to have good technique or lots of rotation and my neck usually feels stiff afterwards. The problem is with my right arm and I always breathe to my left in the water (when I saw you previously you told me I didn't like moving to my right) so my left shoulder moves in a completely different path and I think will be rotating a lot more than my right. Could this be contributing to, or even the cause of, the symptoms?
Again, many thanks for your reply, enjoy your drink
Cheers
Ian
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The problem is with my right arm and I always breathe to my left in the water
I breathe every 3rd arm stroke ie alternate sides. Took some getting used to initially but quickly becomes second nature.
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Hi Steve, Many Thanks for your reply, I'll give your suggestions a go.
Quick (hopefully) question referring to swimming:
Doing crawl is good but requires good technique with plenty of rotation - something often missing with climbers!
I only swim while my nipper is having her lesson and the opportunity for 35 minutes exercise is preferable to sitting watching with a group of chit-chatting mummies. I'm unlikely to have good technique or lots of rotation and my neck usually feels stiff afterwards. The problem is with my right arm and I always breathe to my left in the water (when I saw you previously you told me I didn't like moving to my right) so my left shoulder moves in a completely different path and I think will be rotating a lot more than my right. Could this be contributing to, or even the cause of, the symptoms?
Again, many thanks for your reply, enjoy your drink
Cheers
Ian
I would stretch before swimming and work on thoracic rotation to either side (sitting in a chair and rotating your upper body around). Practice breathing to the right and aim to add more variety to your swimming technique. Do this slowly as changing stresses to a new position can cause soreness. Steve
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The problem is with my right arm and I always breathe to my left in the water
I breathe every 3rd arm stroke ie alternate sides. Took some getting used to initially but quickly becomes second nature.
I have tried but there's only so much pool water you can swallow during a session, looks like I'll have to try harder...
I would stretch before swimming and work on thoracic rotation to either side (sitting in a chair and rotating your upper body around). Practice breathing to the right and aim to add more variety to your swimming technique. Do this slowly as changing stresses to a new position can cause soreness. Steve
I'll give this a go, many thanks once again.
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This is a great idea!
I've been suffering with an elbow issue for the past 6 weeks or so and it's just begining to get to a point where I can climb again but it's not comfortable afterwards! Not sure how it occured but it was after a session on Arch Enemies when I first noticed it (and by noticed I mean - :furious: ouch! The next day!) so I'm thinking maybe a big move to jug where pretty much everything cut loose? Or the hard top section which involves pulling pretty hard on a pretty poor crack on steep ground - then again it could be throwing a ball for me dog but I'm not convinced tbh! :doubt:
Basically I've had a sports massure and a physio have a brief look and it appears that it's the brachioradialis that has somehow been torn/pulled etc... Basically I can crimp fine but as soon as I pinch anything it's pretty painful (if I squeeze my hand to a fist it hurts even sat here now!)...
Kinda holding off going to see someone due to funding issues right now but can you tell me if there are any specific things that I need to be doing to sort this out? My physio mate mentioned getting right in there with deep (read: painful) massage and then ice which I'm happy to do but don't wanna twat it any more.
Properly getting me down now - but on the plus side my running is going well :-\
Thanks,
:D
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As boxing has been recommended as a good form of shoulder exercise - maybe we should start a UKB fight club? ;)
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Tennis was also mentioned.
Anyone for Swingball?
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As boxing has been recommended as a good form of shoulder exercise - maybe we should start a UKB fight club? ;)
Good idea-swap tennis elbow for head injuries! Variety of exercise is important but hitting bags and not people is probably better. Steve
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I bet you sit at a desk all day and have a tight lower lumbar spine.
Yes indeed.
The hamstrings are tighten up in response to back pain/stiffness and sitting only compounds this. This is why stretching the hamstrings doesn't usually give a longterm solution. Try stretching your lumbar spine ad see what happens to your hamstrings. Thanks Steve
I see! Thanks for the advice, I'll get to work on it. The problem originally started when pulling on my right heel in an awkward position but has seemed to spread to my left hamstring as well now! It gets quite painful on long-distance drives and I end up having to use the accelerator with my left foot for a bit to rest my right leg. I'll do some lower back stretches and let you know whether driving to Aberdeen this weekend, back from Aberdeen next, then to Brittany the following weekend hurts or not. (I suspect it will!) Thanks!
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Andi check out Joe's videos, he has a few for lumbar spine stuff http://www.youtube.com/channel/UCob_Fn1Qyjf9-RRNfle_T7w (http://www.youtube.com/channel/UCob_Fn1Qyjf9-RRNfle_T7w)
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Cheers, I just found those on his blog too.
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Thanks for the question. Eccentric loading of the Achilles tendon has some research to suggest it works but from my clinical practice it makes more sense to remove stress on the overloaded tendon (I rarely prescribe eccentric loading exercises and see many people achilles problems who have not responded to this approach).
.....
PS
Regarding injections I am not a major fan and I would not have an injection before removing the stress on the tendon as outlined above. If you do go down the injection route be careful not to have more than three as steroids can weaken the tendon and possibly increase the risk of rupture. I would stop stretching as there is no evidence it works and it might be traumatising the tendon with repeat loading. Tell me how you get on.
Steve
Thanks for taking the time to answer. I was dubious about the injection myself.
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I bet you sit at a desk all day and have a tight lower lumbar spine.
Yes indeed.
The hamstrings are tighten up in response to back pain/stiffness and sitting only compounds this. This is why stretching the hamstrings doesn't usually give a longterm solution. Try stretching your lumbar spine ad see what happens to your hamstrings. Thanks Steve
I see! Thanks for the advice, I'll get to work on it. The problem originally started when pulling on my right heel in an awkward position but has seemed to spread to my left hamstring as well now! It gets quite painful on long-distance drives and I end up having to use the accelerator with my left foot for a bit to rest my right leg. I'll do some lower back stretches and let you know whether driving to Aberdeen this weekend, back from Aberdeen next, then to Brittany the following weekend hurts or not. (I suspect it will!) Thanks!
Andy
If you have a stiff/painful back and heel pain with hamstring pain you might be getting a mild form of sciatica. When you drive for long journeys the sciatic nerve is often irritated by sitting with your leg stretched out. Try moving the seat forward slightly to take the stress of the nerve and try some lumbar support (an old rolled up towel is fine). Steve
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Cheers, I'll try that. No heel pain thankfully! Problem now is that when I move the seat forward I tend to drive faster for some reason...
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Deidre we will be answering any questions you have on climbing injuries on Friday (21 June) at midday. Thanks
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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
Thanks for the reply.
Yeah i'm right handed, I do work in an office on a computer all day. Will try swapping the mouse around.
If it's possibly coming from the shoulder/neck area I'm guessing I would benefit from stretching these throughout the day?
Thanks,
Luke
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Hi Matt and Steve thank you for giving your time and expertise generously in this way.
I'm middle aged, climbing for decades but in recent years not very frequently. The last twelve months I have been able to climb more (2-3 times weekly) and have been mixing doing routes, power/stamina training and bouldering with good progress and no injuries.
This week I have tightness and some pain around the right medial epicondyle. What do you recommend?
Should I avoid strenuous climbing if it's tight/sore at the start of a session?
Thanks again.
Jon
( I teach so mostly stood up at work, some use of computer in evenings).
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Interview with Matt from Hallamshire Physiotherapy on Vimeo (http://vimeo.com/68788372)
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Hi Matt and Steve thank you for giving your time and expertise generously in this way.
I'm middle aged, climbing for decades but in recent years not very frequently. The last twelve months I have been able to climb more (2-3 times weekly) and have been mixing doing routes, power/stamina training and bouldering with good progress and no injuries.
This week I have tightness and some pain around the right medial epicondyle. What do you recommend?
Should I avoid strenuous climbing if it's tight/sore at the start of a session?
Thanks again.
Jon
( I teach so mostly stood up at work, some use of computer in evenings).
Thanks for the question Jon. It sounds like you have increased your climbing sensibly so not sure why the local elbow pain have occured. As a teacher, have you been sitting and marking more ? If so, check if your right shoulder is dropping down when on the computer/laptop. If the right shoulder drops and this is common in climbers with tight lats (latissimus dorsi muscle), stretch the right arm often above your head. Back off the grades until symptoms settle and then slowly increase again. Most medial elbow problems are a result of many factors as the tendon is overloaded (and joint/nerve/ muscle etc).
Hope that helps
Steve & Matt
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Great I'll do the stretches you suggest. Thanks for replying.
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HI,
I don't know if you're doing it this week or not, but thought I'd post up on the off chance.
For the last 3 weeks or so I've had a burning pain on and off between my shoulder blades. Sometimes it's slightly more to the right, but is generally fairly central and affects most of my upper back. It's not stopped me climbing, and climbing is actually one of the times it hurts the least. I've done a bit of research online to see what it could be, and originally was just make sure to stretch daily with some shoulder rotations added in with a very light resistance band. I've been taken anti-inflamatories (naproxen) and cut my climbing down to one session a week, with less power based problems. At first I thought all this was helping, but it has gotten much worse again and I found some other places where it said stretching the muscles out might be bad for it! So now I'm confused, in pain, and could use some help!
Cheers,
Tyco
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HI,
I don't know if you're doing it this week or not, but thought I'd post up on the off chance.
For the last 3 weeks or so I've had a burning pain on and off between my shoulder blades. Sometimes it's slightly more to the right, but is generally fairly central and affects most of my upper back. It's not stopped me climbing, and climbing is actually one of the times it hurts the least. I've done a bit of research online to see what it could be, and originally was just make sure to stretch daily with some shoulder rotations added in with a very light resistance band. I've been taken anti-inflamatories (naproxen) and cut my climbing down to one session a week, with less power based problems. At first I thought all this was helping, but it has gotten much worse again and I found some other places where it said stretching the muscles out might be bad for it! So now I'm confused, in pain, and could use some help!
Cheers,
Tyco
Hi,
the first thing to comment on is that if it feels easier when you climb it is probably more linked to what you are doing in the daytime. If the work you do is more sedentary/sititing then try and avoid sustatined positions by regular standing and moving. As you mentioned the right side is worse take care with excessive mouse use and don't be reaching too far forward. We would advice to continue climbing but at a lower level for a couple of weeks. Back off the streching as that tends to increase focus on the area, go for more rotation based activites such as boxing,swimming or basic trunk rotations. Hope this helps, let us know.
regards Matt and Ian
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Hi, we have just finished the question and answer session today. Don't forget we are answering questions every week and we are also at the Cliff hanger event in Sheffield for any quetions or advice. Bye for now, Matt, Ian and Steve
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Hi,
the first thing to comment on is that if it feels easier when you climb it is probably more linked to what you are doing in the daytime. If the work you do is more sedentary/sititing then try and avoid sustatined positions by regular standing and moving. As you mentioned the right side is worse take care with excessive mouse use and don't be reaching too far forward. We would advice to continue climbing but at a lower level for a couple of weeks. Back off the streching as that tends to increase focus on the area, go for more rotation based activites such as boxing,swimming or basic trunk rotations. Hope this helps, let us know.
regards Matt and Ian
Cheers for the advice, I might come chat to you a bit at Clifhanger as well!
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Ian
Thanks for the detailed report and I would agree you don't have a local elbow problem. It could be from the shoulder but from what you are saying with the medial scapular pain you have a neck involvement. Also the medial pain (golfers elbow) would suggest referred pain into this region. I assume its your right elbow so check if your right shoulder is low and causing stress on the neck(and shoulder). I would elevate the shoulder up (shoulder shrugs are a good exercise for this) and stretch the right lat dori muscle. Stop the rotor cuff exercises and stretch your neck if it is stiff. Do that for a couple of weeks but keep climbing and see if that helps. See Matts video on elbow rehab coming soon to the site. Tell me how you get on.
Steve
Hi Steve
I have been stretching my neck and lats, doing shrugs 1-3 times a day and just started lying across a Swiss Ball as suggested in Matt's video. My symptoms have 90% cleared up, I still have the odd twinge in my elbow but nothing more than discomfort rather than pain. I have also been able to resume a full climbing schedule (5-6 sessions a week) without issue so I think it's fair to say you've nailed it.
The right side of my neck and my right shoulder are still quite stiff and the shoulder is still low but I don't suppose years of misuse and neglect are going to be undone in a couple of weeks. I'll stick at it and see how it goes
Again, many thanks for your help. Hopefully I'll have chance to drop in and say Hello at the weekend.
Ian
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I pulled my lower back out (a vertebrae or two above my arse I reckon) 3.5 weeks ago doing some fairly stupid indoor bouldering (laybacking with my feet above me). It was fairly painful getting about for the first few days(co-codamol, ibugel, hot showers). I had to stop running and climbing. Did my first bit of climbing (some outdoor bouldering) after two weeks as it had been feeling pretty ropey up til then. I've been out a few times now and it's allowing me to climb, and seems to appreciate being mobilized, but I can still feel it a bit both when climbing and not. I've only tried a gentle run but it made it a bit sore. I've also sat in the sauna a few times, which makes it feel awesome!
I've been doing a few happy/angry cats followed by lying on my back, stretching out straight then raising my knees and dropping them to each side (30 secs in each position, just to stretch out), and finally scrunching/holding them in close. Have finished with some child poses for a while - but I still can't get fully into child pose without pulling on the lower back uncomfortably - instead I'm resting my arms on the floor and not dropping my head quite down.
Basically, it does seem to be improving slowly, but I was wondering if you could recommend anything to help get it going again, and to strengthen it once it's recovered.
Background info:
The only core I do at the moment is the shoulder-lock press-ups John Ostrovskis gets all climbers to do - which have been great for my shoulder injuries. They work my abs and lower back a bit due to holding in that position for a while - so I normally do the above stretches routinely afterwards.
I'm a 6'4 97kg punter. :strongbench:
cheers guys
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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.
This has caused some debate between us. Try calf stretches 2 or 3 times a day and some local massage before climbing and report back. You are right to relieve the pressure on it as it maybe compression of a small nerve on the outside of the ankle.
Progress report.
Doing the above as directed. I am still experiecing some stiffness and slight aching first thing on a morning and after prelonged sitting. I can now wear climbing shoes that before were too painful although there is slight discomfort but I don't get the pain and aching the following day.
I still don't have flexability I had before depite the stretching.
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I pulled my lower back out (a vertebrae or two above my arse I reckon) 3.5 weeks ago doing some fairly stupid indoor bouldering (laybacking with my feet above me). It was fairly painful getting about for the first few days(co-codamol, ibugel, hot showers). I had to stop running and climbing. Did my first bit of climbing (some outdoor bouldering) after two weeks as it had been feeling pretty ropey up til then. I've been out a few times now and it's allowing me to climb, and seems to appreciate being mobilized, but I can still feel it a bit both when climbing and not. I've only tried a gentle run but it made it a bit sore. I've also sat in the sauna a few times, which makes it feel awesome!
I've been doing a few happy/angry cats followed by lying on my back, stretching out straight then raising my knees and dropping them to each side (30 secs in each position, just to stretch out), and finally scrunching/holding them in close. Have finished with some child poses for a while - but I still can't get fully into child pose without pulling on the lower back uncomfortably - instead I'm resting my arms on the floor and not dropping my head quite down.
Basically, it does seem to be improving slowly, but I was wondering if you could recommend anything to help get it going again, and to strengthen it once it's recovered.
Background info:
The only core I do at the moment is the shoulder-lock press-ups John Ostrovskis gets all climbers to do - which have been great for my shoulder injuries. They work my abs and lower back a bit due to holding in that position for a while - so I normally do the above stretches routinely afterwards.
I'm a 6'4 97kg punter. :strongbench:
cheers guys
Hi, It sounds as if the lower back symptoms are definately going in the right direction and more often than not the stiffness is usually the persisting problem. It can be a combination of the brain wanting to protect the lower back and not letting you relax it when bending. The childs pose position is a great passive stretch. I would also get your pelvis moving by either lying on your back with your knees bent and try to flatten your lower back against the bed or do the same movement in sitting. I would then try in sitting to slowly bend forward between your legs and touch the floor. Try to relax your tummy muscles. Progress this into standing with enough knee and hip bend to uncurl you back into standing. You will feel tension in your lower back but this will become easier. Climb at a level that is below your usual standard and progress from there. I am sure your core is strong enough and the most important thing is efficient movement and not having overactive back and abdominals that will restrict movement. Also try to relax when running ie don't be rigid and make sure your trunk is rotating.
Hope this helps and if you are at the Cliffhanger event in Sheffield then we are their this weekend for any questions and advice.
regards
Matt
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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.
This has caused some debate between us. Try calf stretches 2 or 3 times a day and some local massage before climbing and report back. You are right to relieve the pressure on it as it maybe compression of a small nerve on the outside of the ankle.
Progress report.
Doing the above as directed. I am still experiecing some stiffness and slight aching first thing on a morning and after prelonged sitting. I can now wear climbing shoes that before were too painful although there is slight discomfort but I don't get the pain and aching the following day.
I still don't have flexability I had before depite the stretching.
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.
This has caused some debate between us. Try calf stretches 2 or 3 times a day and some local massage before climbing and report back. You are right to relieve the pressure on it as it maybe compression of a small nerve on the outside of the ankle.
Progress report.
Doing the above as directed. I am still experiecing some stiffness and slight aching first thing on a morning and after prelonged sitting. I can now wear climbing shoes that before were too painful although there is slight discomfort but I don't get the pain and aching the following day.
I still don't have flexability I had before depite the stretching.
It sounds like things are progressing and usually achilles type problems and in your case maybe some compression of one of the small nerves in your heel area, take time. You should find that the flexibility will slowly improve over the next month by climbing below your normal standard back to your normal standard. You may find some dynamic stretches such as lowering your heel when standing on the edge of a step helpful prior to climbing. All i would say is slowly load the tissues again and avoid progressing too quickly and overloading the achilles.
We are at the Cliffhanger event tomorrow in Shefield so if you are thir come and have a chat.
Regards
Matt
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Thanks for the reply and the offer of being seen at Cliffhanger but due other commitments and being in the badlands of North Lincolnshire I can't make it.
You mention climbing below my normal standard back to my normal standard. So far this injury has not effected my climbing as generally I don't climb on consecutive days and when it was at its worse after a day I could usually get my adapted shoe on.
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Hi there,
I'm looking for some help with my 'sore arm' issue! For a few years now (particularly bad flare-up last year and most recent case this week, hence the post) my right bicep has been in slight on and off pain after a session in which I have had to lash for holds whilst tired. This only ever happens with the right arm; the pain is where the bi meets the shoulder/chest muscle and comes and goes with body position. It doesn't seem to effect my function too much, I went climbing yesterday and there was no pain when climbing and I didn't feel any weaker than normal! There is a very subtle bruise in the location I described and the easiest way to bring on the symptoms is to pinch the top of the bi.
One way to describe the sensation is that I feel is as though I need to stretch the bicep out, like a tightness along with the slight soreness pain. Odd I know!
When I am not having a bout of this I still notice some very mild symptoms occasionally.
I've had quite a lot of deep massage and needling on it but the condition still returned this week!
Any pointers/advice would be much appreciated.
Rich
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I've got a small ganglion cyst on the palm side of my left wrist,(going down of its own accord) second time I've had it, no obvious pattern with onset. No real pain, but wrist feels a little weaker than usual (that should read even weaker). Are there any preventative exercises worth doing? I did break my wrist a few times from 16 to early 20's but it seemed to recover well and hasn't bothered me in the 20 years since (apart from these 2 ganglion thingies). Thanks Rich
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Hi,
Normally I just read around for the hilarity but thought I'd ask a question just to be sure...
I've been bouldering for about 8 weeks and have made some progress (i.e. I can nor describe it as 'bouldering' rather than just 'leaning against start holds on a boulder'). Recently I've had a dull twinge in my left shoulder.
My left arm feels weak and hard to lift especially when I reach across my body (towards my right shoulder) the pain runs from the top of my shoulder to the top of my bicep?
The pain is noticeable bit nothing that I would normally worry about, and I seem to be able to climb fine with it? Just a dull ache that lingers...
Any ideas? Particularly if its something I might aggravate further by continuing to climb?
Great resource BTW.
Cheers.
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Interview with Alison from Hallamshire Physios on Vimeo (http://vimeo.com/70166824)
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Hi there,
I'm looking for some help with my 'sore arm' issue! For a few years now (particularly bad flare-up last year and most recent case this week, hence the post) my right bicep has been in slight on and off pain after a session in which I have had to lash for holds whilst tired. This only ever happens with the right arm; the pain is where the bi meets the shoulder/chest muscle and comes and goes with body position. It doesn't seem to effect my function too much, I went climbing yesterday and there was no pain when climbing and I didn't feel any weaker than normal! There is a very subtle bruise in the location I described and the easiest way to bring on the symptoms is to pinch the top of the bi.
One way to describe the sensation is that I feel is as though I need to stretch the bicep out, like a tightness along with the slight soreness pain. Odd I know!
When I am not having a bout of this I still notice some very mild symptoms occasionally.
I've had quite a lot of deep massage and needling on it but the condition still returned this week!
Any pointers/advice would be much appreciated.
Rich
Hi rich
The biceps does not seem to be a problem if climbing is not a problem (hence why local rubbing does not help) The muscle is reacting to nerve compression in the upper arm. I suspect you are pulling the shoulder forward (protracting) to achieve the static holds. Also ensure you are not stressing your neck when you climb by leading forward with your head. It's more complicated than a local muscle injury so aim to change the shoulder position and check the neck position. Try this but you might need a full assessment.
Steve and Matt.
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I've got a small ganglion cyst on the palm side of my left wrist,(going down of its own accord) second time I've had it, no obvious pattern with onset. No real pain, but wrist feels a little weaker than usual (that should read even weaker). Are there any preventative exercises worth doing? I did break my wrist a few times from 16 to early 20's but it seemed to recover well and hasn't bothered me in the 20 years since (apart from these 2 ganglion thingies). Thanks Rich
Hi rich
The swelling in the wrist is probably as a result of the stress going through the joint and yes it's best to rest it temporarily. With the repeated fractures you might have damaged the ligaments in the wrist and with time the joint is reacting.
The carpal joint is complex and there are 8 bones that should move and if these are stiff you will probably experience pain. Try taping the wrist for a few weeks and slowly increase the grades again. Try some localised stretching of your wrist using your first finger and thumb and see how you get on.
Thanks Steve and Matt.
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Cheers for the advice. I can now legitimately wear a Keith Lemon bandage ooossh
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Hi,
Normally I just read around for the hilarity but thought I'd ask a question just to be sure...
I've been bouldering for about 8 weeks and have made some progress (i.e. I can nor describe it as 'bouldering' rather than just 'leaning against start holds on a boulder'). Recently I've had a dull twinge in my left shoulder.
My left arm feels weak and hard to lift especially when I reach across my body (towards my right shoulder) the pain runs from the top of my shoulder to the top of my bicep?
The pain is noticeable bit nothing that I would normally worry about, and I seem to be able to climb fine with it? Just a dull ache that lingers...
Any ideas? Particularly if its something I might aggravate further by continuing to climb?
Great resource BTW.
Cheers.
Hi, it sounds like you are getting a mild impingement but only when you compress the shoulder ie arm across your body. As you are new to climbing back off a few grades and make sure you do not progress too quickly, tissues take time to adapt. Also ensure when you are reaching for the holds that you are lengthening through your trunk. Check you are not depressing the shoulder as this is also poor position to move from. Try doing exercises that are opposite to the climbing positions ie outward rotation exercises for the arm and back extension exercises. see how you get on and feedback.
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Hi there,
I'm looking for some help with my 'sore arm' issue! For a few years now (particularly bad flare-up last year and most recent case this week, hence the post) my right bicep has been in slight on and off pain after a session in which I have had to lash for holds whilst tired. This only ever happens with the right arm; the pain is where the bi meets the shoulder/chest muscle and comes and goes with body position. It doesn't seem to effect my function too much, I went climbing yesterday and there was no pain when climbing and I didn't feel any weaker than normal! There is a very subtle bruise in the location I described and the easiest way to bring on the symptoms is to pinch the top of the bi.
One way to describe the sensation is that I feel is as though I need to stretch the bicep out, like a tightness along with the slight soreness pain. Odd I know!
When I am not having a bout of this I still notice some very mild symptoms occasionally.
I've had quite a lot of deep massage and needling on it but the condition still returned this week!
Any pointers/advice would be much appreciated.
Rich
Hi rich
The biceps does not seem to be a problem if climbing is not a problem (hence why local rubbing does not help) The muscle is reacting to nerve compression in the upper arm. I suspect you are pulling the shoulder forward (protracting) to achieve the static holds. Also ensure you are not stressing your neck when you climb by leading forward with your head. It's more complicated than a local muscle injury so aim to change the shoulder position and check the neck position. Try this but you might need a full assessment.
Steve and Matt.
Many thanks, I'll consider this new info and get in touch if I need further help.
Rich
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Thanks for the advice, I've laid off for a while... and the pain moved around my neck and shoulder. I've done some stretches and it seems to have cleared up. Thanks. I friend did make a fair point that due to the history of racket sports my left arm is probably weaker than my right by a significant margin... im probably just asking too much of it.
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Hi,
I have developed a pain at the front of my shoulder, which moves down my biceps. Not sure what caused it and it has deteriorated quite rapidly from a mild twinge to not being able to climb at all without pain over the past week or so.
It occurs when I pull down and even a mild contraction into a pull up position is really painful. I can even feel some mild pain if I bend my arm at 90 degrees and rotate my palms upwards and out.
Strange thing is I haven't been climbing much lately but had started doing some shoulder presses and narrow grip push ups to reduce the risk of impingement over the past few weeks.... could this have caused the problem?
Many thanks.
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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
I tried swapping the mouse round for a couple of weeks. I have less pain now and I'm not feeling it while climbing or wrose after climbing but it is still there niggling.
I can only really feel it if I do a lock off/pull up or if I straighten my arm out infront of me and stretch my fingers back towards the floor (I can really feel it then!)
Would be nice to completely get rid of it although it's not really stopping me doing anything.
Anything else I can try as you said it might be shoulder/neck related?
Thanks,
Luke
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Another week another Boo Boo! :'(
Whilst climbing on Tuesday eve I was mid move with my left foot heel-hooking a good hold. I suppose it was a pretty full-on heel-hook with my knee turned away from the rock, my other foot not contributing much and pulling quite a lot on that left heel.
There was a loud crack and I collapsed out of the move, no pain, just the unpleasant feeling of something giving way. I lowered to the ground and found that I could stand/walk ok. Gave up on the session though.
So first of all the knee seemed to start to stiffen up and was worst on Wed morning. This has begun to subside (Thurs morning) but been replaced by a soreness below the knee, back of the leg on the 'off-side' (or upper calf). I imagine that there will be other symptoms too if I were to try putting the leg into positions other than regular stuff (walking, stairs, etc). But I've been a bit reluctant to examine this yet due to fear of pain and further damage!
I've been cooling the area, taking ibuprofen and trying to move about during the day.
I guess my plan is to see how things progress over the next few days before I do anything about it; but I would be very keen to hear what you guys think is the cause/remedy.
Many thanks for any help you can give.
Rich
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Is it possible to tear a toe pulley?
i've been climbing every day this week but switching it up between overhanging and vertical, and doing a lot more balancy, vertical climbing than usual, where the feet are doing a lot of work on tiny edges.
today after a bouldering session the big toe on my left foot is distinctly painful when pushing down, and if i touch it is sore in the area where the A2 pulley would be if toes had a2's
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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
I tried swapping the mouse round for a couple of weeks. I have less pain now and I'm not feeling it while climbing or wrose after climbing but it is still there niggling.
I can only really feel it if I do a lock off/pull up or if I straighten my arm out infront of me and stretch my fingers back towards the floor (I can really feel it then!)
Would be nice to completely get rid of it although it's not really stopping me doing anything.
Anything else I can try as you said it might be shoulder/neck related?
Thanks,
Luke
Hi Luke Try doing a series of shrugs (lifting shoulder up with arms straight) with weight. This has a tendency to remove the stress from the neck of of your arm. I might give you further improvement in the elbow symptoms. Also do shoulder presses above your head (opposite of climbing action) with resistance to de-weight the neck. If nothing else it will help the climbing.
Steve
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Another week another Boo Boo! :'(
Whilst climbing on Tuesday eve I was mid move with my left foot heel-hooking a good hold. I suppose it was a pretty full-on heel-hook with my knee turned away from the rock, my other foot not contributing much and pulling quite a lot on that left heel.
There was a loud crack and I collapsed out of the move, no pain, just the unpleasant feeling of something giving way. I lowered to the ground and found that I could stand/walk ok. Gave up on the session though.
So first of all the knee seemed to start to stiffen up and was worst on Wed morning. This has begun to subside (Thurs morning) but been replaced by a soreness below the knee, back of the leg on the 'off-side' (or upper calf). I imagine that there will be other symptoms too if I were to try putting the leg into positions other than regular stuff (walking, stairs, etc). But I've been a bit reluctant to examine this yet due to fear of pain and further damage!
I've been cooling the area, taking ibuprofen and trying to move about during the day.
I guess my plan is to see how things progress over the next few days before I do anything about it; but I would be very keen to hear what you guys think is the cause/remedy.
Many thanks for any help you can give.
Rich
Rich. Sounds like you have damaged a knee ligament. If you snap them they are often not painful and you can get pain/swelling around the calf. I would recommend getting your knee assessed by a professional as it needs careful management . Is your knee unstable?
Steve
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Another week another Boo Boo! :'(
Whilst climbing on Tuesday eve I was mid move with my left foot heel-hooking a good hold. I suppose it was a pretty full-on heel-hook with my knee turned away from the rock, my other foot not contributing much and pulling quite a lot on that left heel.
There was a loud crack and I collapsed out of the move, no pain, just the unpleasant feeling of something giving way. I lowered to the ground and found that I could stand/walk ok. Gave up on the session though.
So first of all the knee seemed to start to stiffen up and was worst on Wed morning. This has begun to subside (Thurs morning) but been replaced by a soreness below the knee, back of the leg on the 'off-side' (or upper calf). I imagine that there will be other symptoms too if I were to try putting the leg into positions other than regular stuff (walking, stairs, etc). But I've been a bit reluctant to examine this yet due to fear of pain and further damage!
I've been cooling the area, taking ibuprofen and trying to move about during the day.
I guess my plan is to see how things progress over the next few days before I do anything about it; but I would be very keen to hear what you guys think is the cause/remedy.
Many thanks for any help you can give.
Rich
Rich. Sounds like you have damaged a knee ligament. If you snap them they are often not painful and you can get pain/swelling around the calf. I would recommend getting your knee assessed by a professional as it needs careful management . Is your knee unstable?
Steve
Cheers Steve,
Well with the noise it made I wouldn't be surprised if something had snapped. I wouldn't say it was unstable but I am only walking, not tried any more unusual movements since doing it. There isn't any noticeable swelling either; just the ache in the top of the calf.
Please could you advise me on what route you would take with this; regarding assessment and treatment? I'm sure a good physio such as yourselves would give me a correct assessment, but if something is snapped or badly torn will this not need some imaging to diagnose and possibly surgery to fix? I guess this would mean having to go to my GP spend a long time on some waiting list?
Sorry if this sounds rude towards physios, I really just want to make sure I understand the best way forward.
Rich
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Is it possible to tear a toe pulley?
i've been climbing every day this week but switching it up between overhanging and vertical, and doing a lot more balancy, vertical climbing than usual, where the feet are doing a lot of work on tiny edges.
today after a bouldering session the big toe on my left foot is distinctly painful when pushing down, and if i touch it is sore in the area where the A2 pulley would be if toes had a2's
It is possible to have a pulley injury but these are not common. More likely you have over stressed the joint where the metatarsal joins the tarsal bone. Try stretching and possibly icing the area and it should improve (whatever the cause is!).
Steve
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Another week another Boo Boo! :'(
Whilst climbing on Tuesday eve I was mid move with my left foot heel-hooking a good hold. I suppose it was a pretty full-on heel-hook with my knee turned away from the rock, my other foot not contributing much and pulling quite a lot on that left heel.
There was a loud crack and I collapsed out of the move, no pain, just the unpleasant feeling of something giving way. I lowered to the ground and found that I could stand/walk ok. Gave up on the session though.
So first of all the knee seemed to start to stiffen up and was worst on Wed morning. This has begun to subside (Thurs morning) but been replaced by a soreness below the knee, back of the leg on the 'off-side' (or upper calf). I imagine that there will be other symptoms too if I were to try putting the leg into positions other than regular stuff (walking, stairs, etc). But I've been a bit reluctant to examine this yet due to fear of pain and further damage!
I've been cooling the area, taking ibuprofen and trying to move about during the day.
I guess my plan is to see how things progress over the next few days before I do anything about it; but I would be very keen to hear what you guys think is the cause/remedy.
Many thanks for any help you can give.
Rich
Rich. Sounds like you have damaged a knee ligament. If you snap them they are often not painful and you can get pain/swelling around the calf. I would recommend getting your knee assessed by a professional as it needs careful management . Is your knee unstable?
Steve
Cheers Steve,
Well with the noise it made I wouldn't be surprised if something had snapped. I wouldn't say it was unstable but I am only walking, not tried any more unusual movements since doing it. There isn't any noticeable swelling either; just the ache in the top of the calf.
Please could you advise me on what route you would take with this; regarding assessment and treatment? I'm sure a good physio such as yourselves would give me a correct assessment, but if something is snapped or badly torn will this not need some imaging to diagnose and possibly surgery to fix? I guess this would mean having to go to my GP spend a long time on some waiting list?
Sorry if this sounds rude towards physios, I really just want to make sure I understand the best way forward.
Rich
Hullo
Your symptoms sound very similar to an injury I had back in November. I was also heelhooking quite aggressively, heard a bang etc. Was quite painful for a couple of weeks when walking but very little swelling if any. I didn't feel unstable at all on the knee.
I was worried about it, so saw GP and physio. Both thought there was nothing wrong, but I'm lucky to have private healthcare at work so got an MRI anyway. This showed a fully ruptured Lateral Collateral Ligament (the one down the outside). This sounds bad and I bricked myself after assuming that I'd need surgery and a year of rehab etc. etc. But the consultant I saw actually recommended non-surgical treatment since I wasn't experiencing instability. I did a load of physio over the following months and then consultant made final call that no surgery necessary. The only climbing stuff it stopped me from doing was heel hooks (obv), knee bars and high steps/tough rockovers on that side.
Would definitely agree that it's worth getting checked out by a professional if possible.
Good luck
Adam
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Cheers for the info Adam.
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Another week another Boo Boo! :'(
Whilst climbing on Tuesday eve I was mid move with my left foot heel-hooking a good hold. I suppose it was a pretty full-on heel-hook with my knee turned away from the rock, my other foot not contributing much and pulling quite a lot on that left heel.
There was a loud crack and I collapsed out of the move, no pain, just the unpleasant feeling of something giving way. I lowered to the ground and found that I could stand/walk ok. Gave up on the session though.
So first of all the knee seemed to start to stiffen up and was worst on Wed morning. This has begun to subside (Thurs morning) but been replaced by a soreness below the knee, back of the leg on the 'off-side' (or upper calf). I imagine that there will be other symptoms too if I were to try putting the leg into positions other than regular stuff (walking, stairs, etc). But I've been a bit reluctant to examine this yet due to fear of pain and further damage!
I've been cooling the area, taking ibuprofen and trying to move about during the day.
I guess my plan is to see how things progress over the next few days before I do anything about it; but I would be very keen to hear what you guys think is the cause/remedy.
Many thanks for any help you can give.
Rich
Rich. Sounds like you have damaged a knee ligament. If you snap them they are often not painful and you can get pain/swelling around the calf. I would recommend getting your knee assessed by a professional as it needs careful management . Is your knee unstable?
Steve
Cheers Steve,
Well with the noise it made I wouldn't be surprised if something had snapped. I wouldn't say it was unstable but I am only walking, not tried any more unusual movements since doing it. There isn't any noticeable swelling either; just the ache in the top of the calf.
Please could you advise me on what route you would take with this; regarding assessment and treatment? I'm sure a good physio such as yourselves would give me a correct assessment, but if something is snapped or badly torn will this not need some imaging to diagnose and possibly surgery to fix? I guess this would mean having to go to my GP spend a long time on some waiting list?
Sorry if this sounds rude towards physios, I really just want to make sure I understand the best way forward.
Rich
Hullo
Your symptoms sound very similar to an injury I had back in November. I was also heelhooking quite aggressively, heard a bang etc. Was quite painful for a couple of weeks when walking but very little swelling if any. I didn't feel unstable at all on the knee.
I was worried about it, so saw GP and physio. Both thought there was nothing wrong, but I'm lucky to have private healthcare at work so got an MRI anyway. This showed a fully ruptured Lateral Collateral Ligament (the one down the outside). This sounds bad and I bricked myself after assuming that I'd need surgery and a year of rehab etc. etc. But the consultant I saw actually recommended non-surgical treatment since I wasn't experiencing instability. I did a load of physio over the following months and then consultant made final call that no surgery necessary. The only climbing stuff it stopped me from doing was heel hooks (obv), knee bars and high steps/tough rockovers on that side.
Would definitely agree that it's worth getting checked out by a professional if possible.
Good luck
Adam
Rich
I know it's difficult but most knee ligament injuries are best treated conservatively. If its not swollen or feeling unstable it should respond to correct Physio aimed at restoring dynamic control. Most health professionals that I see with similar injuries avoid surgery and always seem to prefer non surgical routes. If conservative rehab fails you can always have an operation and failure to respond to conservative treatment is an indication for surgery.
I see many climbers, skiers and rugby players with ligament ruptures who manage to perform at high levels with no problem.
Hope that helps
Steve
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Hi Luke Try doing a series of shrugs (lifting shoulder up with arms straight) with weight. This has a tendency to remove the stress from the neck of of your arm. I might give you further improvement in the elbow symptoms. Also do shoulder presses above your head (opposite of climbing action) with resistance to de-weight the neck. If nothing else it will help the climbing.
Steve
Thanks Steve, will try this out!
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Hi, I've got an issue with the proximal interphalangeal joint on my right middle finger - It's tender to touch on the top of the joint (back hand side), and more so after climbing. I think the issue started on the 1st of June with an impact on the end of the finger (down the direction of the finger) when it was straight. (I was trying to drop my hand down into a slot, but missed). doesn't really bother me when climbing, but is definitely more painful afterward. I had assumed it'd clear up gradually, but it seems to have been unchanged for a while now.
Thanks for any advice!
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The next physio advice session will start at midday on Friday 2 August 2013. We will endeavour to give you our best guess/clinical opinion!
Any feedback from people we have already given advice would be great.
Steve
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Hi, started a new thread but looks like I should've asked here. Excuse copy and paste:
'getting on for a month ago, I did a little bridge jump and, because the pool was quite shallow, I used my arms to slow me down more quickly on hitting the water. I've done plenty of this sort of thing (DWS, etc.) in the past and never had any issues but I seem to have caused problems in both shoulders this time. Annoyingly, slightly adrenalised at the time, I did the jump a couple of times without realising I was doing much damage. :slap: Fortunately, straight afterwards I sensibly went home and rested them I I got on the most shouldery route at my grade in the area - crux all out jump into reverse crucifix :slap: :slap: :slap: I'm sure other people must've suffered this from DWS if you don't tuck your arms right and the water rags them up? Anyway, I would trawl the net first before asking but I have a lousy connection at the moment so, any recommendations on what I should be doing to sort them? They've improved slowly just with stretches, press-ups and and theraband stuff based on basic knowledge and intuition but thought it worth an ask for more advice if it's a common(ish) one. It actually hurt a fair bit to lift and cross my arms in front of me at first but I can climb and day to day stuff fine now. Breaking the lock from fully straight arm seems to be the main problem area and can sometimes sense an unpleasant pinching effect when hanging from fully locked arms....... Standard rotator cuff malfunction? For what it's worth, I think the water jump just precipitated an underlying problem/weakness/inbalance so keen to try and get a good solution. Sorry, rambling. Any help much appreciated.'
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Hi, I've got an issue with the proximal interphalangeal joint on my right middle finger - It's tender to touch on the top of the joint (back hand side), and more so after climbing. I think the issue started on the 1st of June with an impact on the end of the finger (down the direction of the finger) when it was straight. (I was trying to drop my hand down into a slot, but missed). doesn't really bother me when climbing, but is definitely more painful afterward. I had assumed it'd clear up gradually, but it seems to have been unchanged for a while now.
Thanks for any advice!
Hi, sounds as if you compressed the joint and probably had an imflammatory reaction at the time. It definately sounds more joint than tendon hence you can still climb. Make sure you have full movement in both flexion (bending) and extension (straightening) and compare it to the same finger on the other hand. Keep stretching it and it will settle with time. These type of joint injuries can take months. Hope this helps. Regards Matt
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Hi, started a new thread but looks like I should've asked here. Excuse copy and paste:
'getting on for a month ago, I did a little bridge jump and, because the pool was quite shallow, I used my arms to slow me down more quickly on hitting the water. I've done plenty of this sort of thing (DWS, etc.) in the past and never had any issues but I seem to have caused problems in both shoulders this time. Annoyingly, slightly adrenalised at the time, I did the jump a couple of times without realising I was doing much damage. :slap: Fortunately, straight afterwards I sensibly went home and rested them I I got on the most shouldery route at my grade in the area - crux all out jump into reverse crucifix :slap: :slap: :slap: I'm sure other people must've suffered this from DWS if you don't tuck your arms right and the water rags them up? Anyway, I would trawl the net first before asking but I have a lousy connection at the moment so, any recommendations on what I should be doing to sort them? They've improved slowly just with stretches, press-ups and and theraband stuff based on basic knowledge and intuition but thought it worth an ask for more advice if it's a common(ish) one. It actually hurt a fair bit to lift and cross my arms in front of me at first but I can climb and day to day stuff fine now. Breaking the lock from fully straight arm seems to be the main problem area and can sometimes sense an unpleasant pinching effect when hanging from fully locked arms....... Standard rotator cuff malfunction? For what it's worth, I think the water jump just precipitated an underlying problem/weakness/inbalance so keen to try and get a good solution. Sorry, rambling. Any help much appreciated.'
Hi, I think if the arms were outstretched then you have probably over depressed them relative to your neck. This would have also caused a degree of traction on your neck. It would be unlucky to have rotator cuff injuries in both shoulders and it would also limit your climbing so you have either overstretched the brachial plexus (bundle of nerves coming out from both sides of your neck) or caused a bit of a stretch to the shoulder capsule (ligamentous 'sock' surrounding your shoulder joint) - both of which will settle. Initially i would regularly shrug your shoulders throughout the day as well as do exercises with light weights above your head making sure your shoulders are not dropped (such as shoulder presses etc). Also check your lats (Latissimus Dorsi) as they may be tight and over contracted when you hit the water and make sure you have full neck movements. It all sounds as if it is going in the right direction and hope this helps, let me know. Regards Matt
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Hi, I've got an issue with the proximal interphalangeal joint on my right middle finger - It's tender to touch on the top of the joint (back hand side), and more so after climbing. I think the issue started on the 1st of June with an impact on the end of the finger (down the direction of the finger) when it was straight. (I was trying to drop my hand down into a slot, but missed). doesn't really bother me when climbing, but is definitely more painful afterward. I had assumed it'd clear up gradually, but it seems to have been unchanged for a while now.
Thanks for any advice!
Hi, sounds as if you compressed the joint and probably had an imflammatory reaction at the time. It definately sounds more joint than tendon hence you can still climb. Make sure you have full movement in both flexion (bending) and extension (straightening) and compare it to the same finger on the other hand. Keep stretching it and it will settle with time. These type of joint injuries can take months. Hope this helps. Regards Matt
Thanks Matt, I do seem to have full movement, though it's a bit sore in full flexion. Will do the stretching. Is climbing on it likely to be doing any harm? Seemed worse this weekend after a fairly intense week, so am probably going to lay off for the next few days and see if it improves.
Thanks again. (How is HPclinic only at +4 karma - this thread is an amazing resource!)
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We will be answering any questions you might have about your ageing bodies today! I am away next week but Matt will be available to answer questions next week thanks Steve
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Hi Steve,
I've recently been on a trip where I did alot of steep ascents and descents without any falls/trips etc, since coming back the ball of my right foot feels tender and while climbing at the wall i've noticed a pain that feels like it's going diagnoally across the top of the same foot when any sort of twist is applied through that foot. I don't remember any specific problems when I was walking and I only noticed it getting off the plane.
Any ideas? Sorry I can't be more specific I dont know much about these things
cheers,
Guy
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Hi Steve
I'm certainly no spritely youth, am not particularly injured, but have just felt creaky in the fingers all of this year. Have had many finger injuries over the years and maybe the creakiness is just to be expected. there is no pain or discomfort when climbing or performing other activities. the only real change to my routine this year over previous has been religiously cold-water-treatmenting my hands each evening, but the creakiness preceeded the cold watering.
Any ideas, is this just to be expected as the body gets older?
Cheers
Roddy
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Hi Steve,
I've recently been on a trip where I did alot of steep ascents and descents without any falls/trips etc, since coming back the ball of my right foot feels tender and while climbing at the wall i've noticed a pain that feels like it's going diagnoally across the top of the same foot when any sort of twist is applied through that foot. I don't remember any specific problems when I was walking and I only noticed it getting off the plane.
Any ideas? Sorry I can't be more specific I dont know much about these things
cheers,
Guy
Hi Guy, the problem has probably occurred due to the descending more so than the ascending. You would have been braking and putting more weight through the front of the foot. If you were also walking daily you would have had cumulative loading of the tissues each day and doing more than you would in an average week. It will get easier but perhaps go for lower grade climbs with bigger foot holds while the forefoot is recovering. Perhaps try some lower impact activities such as cycling to get the foot moving and not be in sustained positions.
Hope this helps.
Matt
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Hi Steve
I'm certainly no spritely youth, am not particularly injured, but have just felt creaky in the fingers all of this year. Have had many finger injuries over the years and maybe the creakiness is just to be expected. there is no pain or discomfort when climbing or performing other activities. the only real change to my routine this year over previous has been religiously cold-water-treatmenting my hands each evening, but the creakiness preceeded the cold watering.
Any ideas, is this just to be expected as the body gets older?
Cheers
Roddy
Hi Roddy, I would recommend hot/warm water rather than cold and 'creakiness' could be either tendons or joint noise. Nothing to worry about except keep the hands moving and stretch out all your finger joints prior to climbing.
regards Matt
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Hi Steve
I'm certainly no spritely youth, am not particularly injured, but have just felt creaky in the fingers all of this year. Have had many finger injuries over the years and maybe the creakiness is just to be expected. there is no pain or discomfort when climbing or performing other activities. the only real change to my routine this year over previous has been religiously cold-water-treatmenting my hands each evening, but the creakiness preceeded the cold watering.
Any ideas, is this just to be expected as the body gets older?
Cheers
Roddy
Hi Roddy, I would recommend hot/warm water rather than cold and 'creakiness' could be either tendons or joint noise. Nothing to worry about except keep the hands moving and stretch out all your finger joints prior to climbing.
regards Matt
Thanks steve Matt, will try the warm stuff :2thumbsup:
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Hi Steve,
I've recently been on a trip where I did alot of steep ascents and descents without any falls/trips etc, since coming back the ball of my right foot feels tender and while climbing at the wall i've noticed a pain that feels like it's going diagnoally across the top of the same foot when any sort of twist is applied through that foot. I don't remember any specific problems when I was walking and I only noticed it getting off the plane.
Any ideas? Sorry I can't be more specific I dont know much about these things
cheers,
Guy
Hi Guy, the problem has probably occurred due to the descending more so than the ascending. You would have been braking and putting more weight through the front of the foot. If you were also walking daily you would have had cumulative loading of the tissues each day and doing more than you would in an average week. It will get easier but perhaps go for lower grade climbs with bigger foot holds while the forefoot is recovering. Perhaps try some lower impact activities such as cycling to get the foot moving and not be in sustained positions.
Hope this helps.
Matt
thanks Matt
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Hi, I've got an issue with the proximal interphalangeal joint on my right middle finger - It's tender to touch on the top of the joint (back hand side), and more so after climbing. I think the issue started on the 1st of June with an impact on the end of the finger (down the direction of the finger) when it was straight. (I was trying to drop my hand down into a slot, but missed). doesn't really bother me when climbing, but is definitely more painful afterward. I had assumed it'd clear up gradually, but it seems to have been unchanged for a while now.
Thanks for any advice!
Hi, sounds as if you compressed the joint and probably had an imflammatory reaction at the time. It definately sounds more joint than tendon hence you can still climb. Make sure you have full movement in both flexion (bending) and extension (straightening) and compare it to the same finger on the other hand. Keep stretching it and it will settle with time. These type of joint injuries can take months. Hope this helps. Regards Matt
Thanks Matt, I do seem to have full movement, though it's a bit sore in full flexion. Will do the stretching. Is climbing on it likely to be doing any harm? Seemed worse this weekend after a fairly intense week, so am probably going to lay off for the next few days and see if it improves.
Thanks again. (How is HPclinic only at +4 karma - this thread is an amazing resource!)
Hi, you won't be causing any harm but it will probably be more sore if you increase the load through it too quickly. Just lay off the intensity a bit and increase gradually. Watch Alison's video back a few bloggs regarding cumulative loading and finger injuries. regards
Matt
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Hi, I've got a shoulder injury which I'd appreciate your advice on.
At present I have a significant weakness (and mild pain) when externally rotating the forearm (i.e. during one of the classic theraband rotator cuff exercises).
If I perform the scarf test I have significant pain on the outside of my shoulder (Deltoid area). This is particularly painful if, during scarf test, I raise or lower the elbow against resistance.
Massaging the pectoral muscle (pec minor area) does offer some short term reduction in pain of scarf test and increases strength of external rotation.
Had this injury for 3-4 months. Symptoms have eased but now seem very resistant to clearing up fully.
No hard (or even intermediate) climbing has been possible during this period.
Any ideas on how I can help finally clear this up?
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Hi, I've got a shoulder injury which I'd appreciate your advice on.
At present I have a significant weakness (and mild pain) when externally rotating the forearm (i.e. during one of the classic theraband rotator cuff exercises).
If I perform the scarf test I have significant pain on the outside of my shoulder (Deltoid area). This is particularly painful if, during scarf test, I raise or lower the elbow against resistance.
Massaging the pectoral muscle (pec minor area) does offer some short term reduction in pain of scarf test and increases strength of external rotation.
Had this injury for 3-4 months. Symptoms have eased but now seem very resistant to clearing up fully.
No hard (or even intermediate) climbing has been possible during this period.
Any ideas on how I can help finally clear this up?
Hi, if you have had a problem for 3-4 months then you may be compensating by holding the shoulder in a protected position. This can sometimes continue to provoke the symptoms and also in some instances put your shoulder a mechanically poor position and hence it will feel weaker. Have a look in the mirror and make sure the shoulder isn't too depressed or elevated. More often or not the shoulder becomes more dropped (depressed) and this can create an impingement. If it does look dropped then practice shrugging the shoulder a little and then lift your arm towards the ceiling (shoulder press). If this feels easier then add some light weights. I would also recommend seeing a physio as it has been going on for a while and it isn't always easy to analyse the shoulder yourself. Let me know how you get on or if you find that the shoulder is doing different things to the opposite one.
regards Matt
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Thanks Matt, I'll try this later. Will let you know how it goes.
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Hi, got quick a question about tendon unit flexor strain thingy.
I injured my wrist before xmas and then re-tweaked it back in June, so it hurts when I use my middle two but not when I fully crimp. So I concluded that it was a tendon unit flexor strain (injured it open handed on a middle 2 pocket).
So I've been still training but avoiding middle 2 pockets (so using front 2 etc) as its still fine to climb normally on slopers, pinches and crimps. However I'm slightly concerned as I have a lump on my right wrist which i think is a results of the injury.
Do you have any tips for the treatment? Would taping my wrist be of any benefit? Should I be concerned about this lump?
Rather annoying as I'd quite like to train my middle two but realise thats a long way off!
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Hi, I've got a shoulder injury which I'd appreciate your advice on.
At present I have a significant weakness (and mild pain) when externally rotating the forearm (i.e. during one of the classic theraband rotator cuff exercises).
If I perform the scarf test I have significant pain on the outside of my shoulder (Deltoid area). This is particularly painful if, during scarf test, I raise or lower the elbow against resistance.
Massaging the pectoral muscle (pec minor area) does offer some short term reduction in pain of scarf test and increases strength of external rotation.
Had this injury for 3-4 months. Symptoms have eased but now seem very resistant to clearing up fully.
No hard (or even intermediate) climbing has been possible during this period.
Any ideas on how I can help finally clear this up?
Hi, if you have had a problem for 3-4 months then you may be compensating by holding the shoulder in a protected position. This can sometimes continue to provoke the symptoms and also in some instances put your shoulder a mechanically poor position and hence it will feel weaker. Have a look in the mirror and make sure the shoulder isn't too depressed or elevated. More often or not the shoulder becomes more dropped (depressed) and this can create an impingement. If it does look dropped then practice shrugging the shoulder a little and then lift your arm towards the ceiling (shoulder press). If this feels easier then add some light weights. I would also recommend seeing a physio as it has been going on for a while and it isn't always easy to analyse the shoulder yourself. Let me know how you get on or if you find that the shoulder is doing different things to the opposite one.
regards Matt
Hi Matt,
It's not really apparent if one shoulder is at a different height to the other. The injured one may possibly be very slightly depressed.
What I did find quite amazing was that in performing the scarf test in front of the mirror on my good side the arm comes across the body and the muscle running from shoulder to neck (trapezius?) remains pretty much static.
On the injured side when I perform the scarf test the trapezius rises massively and the shoulder lifts upwards and in (towards the neck) to a very different position.
I've tried some light shoulder presses but didn't notice much effect.
Think I might give you a call.
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Hi, got quick a question about tendon unit flexor strain thingy.
I injured my wrist before xmas and then re-tweaked it back in June, so it hurts when I use my middle two but not when I fully crimp. So I concluded that it was a tendon unit flexor strain (injured it open handed on a middle 2 pocket).
So I've been still training but avoiding middle 2 pockets (so using front 2 etc) as its still fine to climb normally on slopers, pinches and crimps. However I'm slightly concerned as I have a lump on my right wrist which i think is a results of the injury.
Do you have any tips for the treatment? Would taping my wrist be of any benefit? Should I be concerned about this lump?
Rather annoying as I'd quite like to train my middle two but realise thats a long way off!
Hi it sounds as if you have a ganglion cyst. They occur near to joints such as the wrist and tedons. They are fluid filled sacs that can occur due to repetitive stress around the joint and tendon but are nothing to worry about. You could try taping to give the wrist a bit more support. You should also start to use your middle two fingers but start on a lot lower grades and increase the load gradually over a 6 week period particularly if you have had a pulley injury. Hope this helps.
Matt
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Hi, I've got a shoulder injury which I'd appreciate your advice on.
At present I have a significant weakness (and mild pain) when externally rotating the forearm (i.e. during one of the classic theraband rotator cuff exercises).
If I perform the scarf test I have significant pain on the outside of my shoulder (Deltoid area). This is particularly painful if, during scarf test, I raise or lower the elbow against resistance.
Massaging the pectoral muscle (pec minor area) does offer some short term reduction in pain of scarf test and increases strength of external rotation.
Had this injury for 3-4 months. Symptoms have eased but now seem very resistant to clearing up fully.
No hard (or even intermediate) climbing has been possible during this period.
Any ideas on how I can help finally clear this up?
Hi, if you have had a problem for 3-4 months then you may be compensating by holding the shoulder in a protected position. This can sometimes continue to provoke the symptoms and also in some instances put your shoulder a mechanically poor position and hence it will feel weaker. Have a look in the mirror and make sure the shoulder isn't too depressed or elevated. More often or not the shoulder becomes more dropped (depressed) and this can create an impingement. If it does look dropped then practice shrugging the shoulder a little and then lift your arm towards the ceiling (shoulder press). If this feels easier then add some light weights. I would also recommend seeing a physio as it has been going on for a while and it isn't always easy to analyse the shoulder yourself. Let me know how you get on or if you find that the shoulder is doing different things to the opposite one.
regards Matt
Hi Matt,
It's not really apparent if one shoulder is at a different height to the other. The injured one may possibly be very slightly depressed.
What I did find quite amazing was that in performing the scarf test in front of the mirror on my good side the arm comes across the body and the muscle running from shoulder to neck (trapezius?) remains pretty much static.
On the injured side when I perform the scarf test the trapezius rises massively and the shoulder lifts upwards and in (towards the neck) to a very different position.
I've tried some light shoulder presses but didn't notice much effect.
Think I might give you a call.
Hi, have you seen Steve as he thinks your problem sounds familiar? If so how are you going?
Matt
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I sometimes get a dull ache on the inside of my elbows, near where the bicep joins the elbow. It's been happening for a couple of years now, usually my right arm, and after a few sessions of powerful bouldering- anything really slappy or big locks between holds on steep ground. Usually clears up again in a couple of days with rest / pressups, etc. But it's becoming a bit annoying and I can't seem to completely get rid of it so any advice would be great, thanks
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Hi, I've got a shoulder injury which I'd appreciate your advice on.
At present I have a significant weakness (and mild pain) when externally rotating the forearm (i.e. during one of the classic theraband rotator cuff exercises).
If I perform the scarf test I have significant pain on the outside of my shoulder (Deltoid area). This is particularly painful if, during scarf test, I raise or lower the elbow against resistance.
Massaging the pectoral muscle (pec minor area) does offer some short term reduction in pain of scarf test and increases strength of external rotation.
Had this injury for 3-4 months. Symptoms have eased but now seem very resistant to clearing up fully.
No hard (or even intermediate) climbing has been possible during this period.
Any ideas on how I can help finally clear this up?
Hi, if you have had a problem for 3-4 months then you may be compensating by holding the shoulder in a protected position. This can sometimes continue to provoke the symptoms and also in some instances put your shoulder a mechanically poor position and hence it will feel weaker. Have a look in the mirror and make sure the shoulder isn't too depressed or elevated. More often or not the shoulder becomes more dropped (depressed) and this can create an impingement. If it does look dropped then practice shrugging the shoulder a little and then lift your arm towards the ceiling (shoulder press). If this feels easier then add some light weights. I would also recommend seeing a physio as it has been going on for a while and it isn't always easy to analyse the shoulder yourself. Let me know how you get on or if you find that the shoulder is doing different things to the opposite one.
regards Matt
Hi Matt,
It's not really apparent if one shoulder is at a different height to the other. The injured one may possibly be very slightly depressed.
What I did find quite amazing was that in performing the scarf test in front of the mirror on my good side the arm comes across the body and the muscle running from shoulder to neck (trapezius?) remains pretty much static.
On the injured side when I perform the scarf test the trapezius rises massively and the shoulder lifts upwards and in (towards the neck) to a very different position.
I've tried some light shoulder presses but didn't notice much effect.
Think I might give you a call.
Hi, have you seen Steve as he thinks your problem sounds familiar? If so how are you going?
Matt
Hi Matt, Following your advice and recognising the substantially differnt look of one shoulder compared to the other I booked in for a consultation. Got a slot with Steve.
Steve thinks (in my laymans terms) that the root of the problem is that my job entails sitting all day at a computer driving a mouse. This has led to a tightening on the right hand which is pulling my shoulder down and out of position. Got some stretches and hunch exercises to do as well as making adjustments to seating arrangemnt at work etc. trying to recognise when I am favouring LH side over RH side and consiously making adjustments.
Will see how it goes.
Thanks for you advice.
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Don't know what I've done to my back, but got dull ache at the bottom of my ribs about 4 inches to left of middle of spine. Aches most of the time and get a stabbing pain if I lean over to the right more that about 30 degress from upright. Ok leaning backwards and forwards (slightly worse, but not like leaning over to side). Haven't done anything specific to bring it on, think I first felt it lifting up our youngest about a week ago and it hasn't gone away.
Any advice, other than seeing a professional? (which I intend doing if it doesn't improve).
Thanks
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Don't know what I've done to my back, but got dull ache at the bottom of my ribs about 4 inches to left of middle of spine. Aches most of the time and get a stabbing pain if I lean over to the right more that about 30 degress from upright. Ok leaning backwards and forwards (slightly worse, but not like leaning over to side). Haven't done anything specific to bring it on, think I first felt it lifting up our youngest about a week ago and it hasn't gone away.
Any advice, other than seeing a professional? (which I intend doing if it doesn't improve).
Thanks
Hi, it sounds as if you have strained/irritated either your lower thoracic facet joints (where one segment joins another) or where the ribs join into your thoracic spine. These strains are often acutely painful and niggle when you stretch them or compress them. I would recommend that you do some rotatory trunk movements in sitting as well as bending forward in sitting to touch the floor. When you are lifting your little ones try and carry them on both sides and minimise the leaning back. Movement and exercise should clear it up but occasionally a few treatment sessions help things along. See how you go.
Regards Matt
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I sometimes get a dull ache on the inside of my elbows, near where the bicep joins the elbow. It's been happening for a couple of years now, usually my right arm, and after a few sessions of powerful bouldering- anything really slappy or big locks between holds on steep ground. Usually clears up again in a couple of days with rest / pressups, etc. But it's becoming a bit annoying and I can't seem to completely get rid of it so any advice would be great, thanks
Hi, you could be compressing a nerve (median) when you are fully bending your elbow with a biceps contraction ie in locking out. Do you get any pins and needles or numbness? There are some nerve movements/mobilisations that may help, these involve taking your arm out to the side, straightening your elbow with your fingers pointing downwards (starting position is like carrying a tray) and look towards your hand. Then bend the elbow again and look the opposite way. Do about 30 of these twice daily. The other observations we would want to look at would be your shoulder position as you may be compensating. It could also be that you are compressing and loading the elbow and the joint is crumbling a bit. Ultimately it goes away which is good but it may require an assessment if it's getting worse or not clearing up. Let me know how you get on.
Regards Matt
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I would recommend that you do some rotatory trunk movements in sitting as well as bending forward in sitting to touch the floor.
Been doing some twisting and stretching and it's improving already. Thanks for help.
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Hi, for about a year I've been having problems with my elbows, neck and back. Initially I stopped climbing I stopped climbing for about 3 months but the problems didn't go, if anything they got worse. i tried doing the tendonitis weight exercises but thu didnt seem to help (after a few months of being very strict). More recently through lots of stretching, shoulder shrugs and hot baths after climbing the symptoms have calmed down (ie my elbows rarely hurt) but I can't quite get rid of the fore arm tension and neck pain. My forearms seem tense in the morning but I stretch them a lot throughout the day. It seems that too much climbing only makes my neck stuff and forearms a little stiff an the only thing that gets the inside of my elbows hurting is day to day activities (drying hair and using my phone etc). Wondering if there is any specific back workouts I could do to finally get rid of my problems.
Hope all that rambling made sense and thanks in advance for any replies
Dave
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Hi, for about a year I've been having problems with my elbows, neck and back. Initially I stopped climbing I stopped climbing for about 3 months but the problems didn't go, if anything they got worse. i tried doing the tendonitis weight exercises but thu didnt seem to help (after a few months of being very strict). More recently through lots of stretching, shoulder shrugs and hot baths after climbing the symptoms have calmed down (ie my elbows rarely hurt) but I can't quite get rid of the fore arm tension and neck pain. My forearms seem tense in the morning but I stretch them a lot throughout the day. It seems that too much climbing only makes my neck stuff and forearms a little stiff an the only thing that gets the inside of my elbows hurting is day to day activities (drying hair and using my phone etc). Wondering if there is any specific back workouts I could do to finally get rid of my problems.
Hope all that rambling made sense and thanks in advance for any replies
Dave
Hi, when you have bilateral (both sides) problems we would tend to look more centrally ie your neck. It sounds as if you are loading the neck and overstretching the brachial plexus (the nerves coming out of your neck into your arm). It would make sense that the shoulder shrugs helped because you are in effect unloading the neck. If you are sitting most of the day check that you are not slumping and depressing your shoulders. Also when you are bouldering make sure you are elongating (lengthening) your trunk and reaching upwards with your arms when traversing. Just a check because we see climbers that have neck and shoulder problems and they are not able to let there side trunk/back muscles lengthen and tend to pull downwards. Continue with your shoulder shrugs and also try shoulder press (arms above head) exercises with light to medium weights making sure you elevate your shoulders. If you have better shoulder and trunk positions you will feel stronger and also use your forearms less. Let me know if this helps.
regards
matt
-
Hi, for about a year I've been having problems with my elbows, neck and back. Initially I stopped climbing I stopped climbing for about 3 months but the problems didn't go, if anything they got worse. i tried doing the tendonitis weight exercises but thu didnt seem to help (after a few months of being very strict). More recently through lots of stretching, shoulder shrugs and hot baths after climbing the symptoms have calmed down (ie my elbows rarely hurt) but I can't quite get rid of the fore arm tension and neck pain. My forearms seem tense in the morning but I stretch them a lot throughout the day. It seems that too much climbing only makes my neck stuff and forearms a little stiff an the only thing that gets the inside of my elbows hurting is day to day activities (drying hair and using my phone etc). Wondering if there is any specific back workouts I could do to finally get rid of my problems.
Hope all that rambling made sense and thanks in advance for any replies
Dave
Hi, when you have bilateral (both sides) problems we would tend to look more centrally ie your neck. It sounds as if you are loading the neck and overstretching the brachial plexus (the nerves coming out of your neck into your arm). It would make sense that the shoulder shrugs helped because you are in effect unloading the neck. If you are sitting most of the day check that you are not slumping and depressing your shoulders. Also when you are bouldering make sure you are elongating (lengthening) your trunk and reaching upwards with your arms when traversing. Just a check because we see climbers that have neck and shoulder problems and they are not able to let there side trunk/back muscles lengthen and tend to pull downwards. Continue with your shoulder shrugs and also try shoulder press (arms above head) exercises with light to medium weights making sure you elevate your shoulders. If you have better shoulder and trunk positions you will feel stronger and also use your forearms less. Let me know if this helps. I sometimes get a dull ache on the inside of my elbows, near where the bicep joins the elbow. It's been happening for a couple of years now, usually my right arm, and after a few sessions of powerful bouldering- anything really slappy or big locks between holds on steep ground. Usually clears up again in a couple of days with rest / pressups, etc. But it's becoming a bit annoying and I can't seem to completely get rid of it so any advice would be great, thanks
Hi, you could be compressing a nerve (median) when you are fully bending your elbow with a biceps contraction ie in locking out. Do you get any pins and needles or numbness? There are some nerve movements/mobilisations that may help, these involve taking your arm out to the side, straightening your elbow with your fingers pointing downwards (starting position is like carrying a tray) and look towards your hand. Then bend the elbow again and look the opposite way. Do about 30 of these twice daily. The other observations we would want to look at would be your shoulder position as you may be compensating. It could also be that you are compressing and loading the elbow and the joint is crumbling a bit. Ultimately it goes away which is good but it may require an assessment if it's getting worse or not clearing up. Let me know how you get on.
Regards Matt
Hi again, just noticed that you said both elbows can be a problem. If this is the case the above comments are still relevant but you may also be dropping/depressing your shoulders when locking out and causing a more general nerve stretch. Try lots of shoulder shrugs and look at your shoulder positions when climbing ie don't let them drop too much. regards
regards
matt
I sometimes get a dull ache on the inside of my elbows, near where the bicep joins the elbow. It's been happening for a couple of years now, usually my right arm, and after a few sessions of powerful bouldering- anything really slappy or big locks between holds on steep ground. Usually clears up again in a couple of days with rest / pressups, etc. But it's becoming a bit annoying and I can't seem to completely get rid of it so any advice would be great, thanks
Hi, you could be compressing a nerve (median) when you are fully bending your elbow with a biceps contraction ie in locking out. Do you get any pins and needles or numbness? There are some nerve movements/mobilisations that may help, these involve taking your arm out to the side, straightening your elbow with your fingers pointing downwards (starting position is like carrying a tray) and look towards your hand. Then bend the elbow again and look the opposite way. Do about 30 of these twice daily. The other observations we would want to look at would be your shoulder position as you may be compensating. It could also be that you are compressing and loading the elbow and the joint is crumbling a bit. Ultimately it goes away which is good but it may require an assessment if it's getting worse or not clearing up. Let me know how you get on.
Regards Matt
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For about the last 3 months I have had a problem in the top of my forearm. It has never been too painful to climb on and after about an hour and half of climbing the issue is pretty much non existent.
If i put my forearm palm down on a table, the problem is pretty much at the top of the forearm in the centre. Its about 2 inches away from the elbow crease. It just feels like there is tension in there a lot of the time and when I climb on it there is a lot of pressure in there and it gets pumped really quickly and doesn't go away properly till about an hour and a half into climbing.
I have tried massaging it, icing it, stretching it, and all sorts of dumbell and elastic band based exercises to help it but nothing really works.
I can not climb on it for a week and the dull pressure feeling goes away a bit but then it comes back without provocation and without me climbing on it. Its usually when I am not at work for a while that this happens as I am a lot more active so my arm is not by a keyboard all day, it is by my side or moving a lot more as I am out and about.
Any ideas on what this could be or any tests I can do to help you advise me. Anything like brushing my teeth sets it off. It doesn't hurt it, it just feels like the pressure in there builds up and the whole forearm aches / gets pumped.
None of the classic tennis elbow aggravating actions cause any pain at all and I would have said its too far from the elbow to be that anyway. Please help.
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Hi,
Great clinic.
This might be a new one for you.
I have a chronic ache on the inside of my R elbow - a few inches down from the joint. Sometimes burning pain like tendonitis. Hurts more when I flex my elbow completely and then pronate or supinate my arm - hurts most at the end of the pronation and supination. Lock-offs hurt. I was thinking maybe distal bicep tendonitis and started doing reverse curls (15lb) but this seemed to make it worse. Injured it in the spring doing repeated compression sloper moves kind of slapping a big sloper and rotating the arm in.
Of course i didn't let it rest and now it seems to be getting worse. After a session I've recently started to get some little clicking deep in the forearm (like trigger finger feeling) when I pronate my arm w elbow a little flexed.
Any ideas welcome. Thanks!
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thanks to all i'm Glad to visitor of this post !
:goodidea:
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Great thread.
Doctor I have a problem... thats how I'm supposed to start these right? ;D
Ok right hand ring finger, on inside of first knuckle is sore when pushed, feel it when climbing, doesnt stop me doing much but I've been steering away from really pinchy routes and last night I start to use fingerboard and avoided two finger hangs using that finger but also towards the end felt it on three finger open hands. After 6 weeks its now less painful than it was.
I'm guessing I've just strained the pully on that side and avoiding use of it, massaging it occasionally will let it slowly recover?
Cheers me dear.
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For about the last 3 months I have had a problem in the top of my forearm. It has never been too painful to climb on and after about an hour and half of climbing the issue is pretty much non existent.
If i put my forearm palm down on a table, the problem is pretty much at the top of the forearm in the centre. Its about 2 inches away from the elbow crease. It just feels like there is tension in there a lot of the time and when I climb on it there is a lot of pressure in there and it gets pumped really quickly and doesn't go away properly till about an hour and a half into climbing.
I have tried massaging it, icing it, stretching it, and all sorts of dumbell and elastic band based exercises to help it but nothing really works.
I can not climb on it for a week and the dull pressure feeling goes away a bit but then it comes back without provocation and without me climbing on it. Its usually when I am not at work for a while that this happens as I am a lot more active so my arm is not by a keyboard all day, it is by my side or moving a lot more as I am out and about.
Any ideas on what this could be or any tests I can do to help you advise me. Anything like brushing my teeth sets it off. It doesn't hurt it, it just feels like the pressure in there builds up and the whole forearm aches / gets pumped.
None of the classic tennis elbow aggravating actions cause any pain at all and I would have said its too far from the elbow to be that anyway. Please help.
Hi, it sounds like you could be compressing or irritating a nerve. The median nerve travels down the middle of your arm. I would check that your neck movements are full ie forward, backward and rotatory movements. You are feeling it when you are moving and it is down by your side so i would also check that your shoulder on the side of the problem isn't dropped as this may be tractioning/stretching your neck on this side. You may also be doing this compensatory movement when you climb. I would try doing exercises to encourage shoulder elevation such as shoulder presses but make sure you are reaching up and streching your side trunk muscles and you will then not be depressing your shoulder. See how you go and get back to me if you are compensating. regards Matt
-
Hi,
Great clinic.
This might be a new one for you.
I have a chronic ache on the inside of my R elbow - a few inches down from the joint. Sometimes burning pain like tendonitis. Hurts more when I flex my elbow completely and then pronate or supinate my arm - hurts most at the end of the pronation and supination. Lock-offs hurt. I was thinking maybe distal bicep tendonitis and started doing reverse curls (15lb) but this seemed to make it worse. Injured it in the spring doing repeated compression sloper moves kind of slapping a big sloper and rotating the arm in.
Of course i didn't let it rest and now it seems to be getting worse. After a session I've recently started to get some little clicking deep in the forearm (like trigger finger feeling) when I pronate my arm w elbow a little flexed.
Any ideas welcome. Thanks!
Hi, it sounds like you could be irritating a nerve rather than a tendon. The median nerve travels down the middle of your arm and the ulnar on the inside. The nerves go through and are underneath/ontop of muscles so when they are irritated they can easily be provoked when compressing them (locking off) and moving muscles that are close by. I would check that your neck movements are full ie forward, backward and rotatory movements. You need to back off from the climbing for a few weeks and then return to lower grades and increase as able. Get a friend to look at how you are climbing and make sure you are not compensating and doing different things with that arm and side. See how you go and you may need a consultation if not settling.regards matt
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Great thread.
Doctor I have a problem... thats how I'm supposed to start these right? ;D
Ok right hand ring finger, on inside of first knuckle is sore when pushed, feel it when climbing, doesnt stop me doing much but I've been steering away from really pinchy routes and last night I start to use fingerboard and avoided two finger hangs using that finger but also towards the end felt it on three finger open hands. After 6 weeks its now less painful than it was.
I'm guessing I've just strained the pully on that side and avoiding use of it, massaging it occasionally will let it slowly recover?
Cheers me dear.
Hi, i think you could be right. You could also be overloading the finger joint. Whatever the problem you have done the right thing by decreasing the load and allowing it to recover somewhat. Have a look at the video by Alison Macfarlane further back (not sure what page) that discusses pulley/finger injuries and cumulative strains and loads. Regards
Matt
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quick question, regarding medial epicondylitis (?) I've got pain on the inside of my left elbow - medial epicondyle, presumably from an acute tear thrashing about and not resting enough, been achey for about a fortnight now. It hasn't stopped me climbing, but it isn't diminishing (I haven't tempered my grade - this may be the issue). I've been doing the eccentrics, stretching and some postural/antagonistic work as described in your previous posts, alongside some judicious icing. Should I be having a period off (week or 2?)in order for the pain to settle? (- it can occur on such minimal activities as putting the handbrake on. )
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Cheers Matt , will look the video up now. :great:
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Hi, it sounds like you could be compressing or irritating a nerve. The median nerve travels down the middle of your arm. I would check that your neck movements are full ie forward, backward and rotatory movements. You are feeling it when you are moving and it is down by your side so i would also check that your shoulder on the side of the problem isn't dropped as this may be tractioning/stretching your neck on this side. You may also be doing this compensatory movement when you climb. I would try doing exercises to encourage shoulder elevation such as shoulder presses but make sure you are reaching up and streching your side trunk muscles and you will then not be depressing your shoulder. See how you go and get back to me if you are compensating. regards Matt
Firstly, thank you for replying to my post.
I ended up going to see the physio at my local wall and she said that I had the early stages of tennis elbow and had done for quite a while. She suggested that due to all the different exercises I had been doing to fix it for the last few months I had staved off full blown tennis elbow but kept it low lever and persistent. Because I never knew exactly what it was I hadn't done enough of any particular treatment to fix it but it was enough to keep it from progressing. She massages a rather big knot out of my forearm muscle just below the elbow tendon and advised me to keep doing this and to do palm down wrist curls and ice it.
It does seem to be getting better and its nowhere near as pressured as it was before so I think its working but since you mention my shoulders I will try to explain what I am feeling there. The issue is with the right arm to start with. Putting my neck backwards, forwards is fine and doesn't stretch much in the neck. When the neck rolls to the left or right I can feel a stretch. Going to the left feels tighter (so the right hand side of the neck muscles are tighter?)
If I stretch my arm above my head with a slightly bent arm I can feel a twinge in the front of the deltoid where it joins the bicep and I definitely feel it more in the right arm than the left. I have started doing some shoulder presses as you suggested with 12.5kg in each hand and can do about 12 reps before I get fatigued but I have only done these for about a week now (every few days and perhaps 3 sets each time).
Should I be upping the weight and lowering the reps or vice versa and does what I have said above make any sense. I don't think the physio is particularly climbing focussed but she seemed to know what she was talking about so it would be good to have a second opinion / advice.
Thanks again.
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quick question, regarding medial epicondylitis (?) I've got pain on the inside of my left elbow - medial epicondyle, presumably from an acute tear thrashing about and not resting enough, been achey for about a fortnight now. It hasn't stopped me climbing, but it isn't diminishing (I haven't tempered my grade - this may be the issue). I've been doing the eccentrics, stretching and some postural/antagonistic work as described in your previous posts, alongside some judicious icing. Should I be having a period off (week or 2?)in order for the pain to settle? (- it can occur on such minimal activities as putting the handbrake on. )
If the pain is not getting worse with climbing I would continue. Tissues respond well to load and its part of the stimulus to recovery and repair (its a myth that we need complete rest for tissue repair) . Don't increase the grade until the pain has settled but try adding neck stretches to your routine and see if that resolves the issues faster. Tell us how you get on.
Cheers
Steve
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Thanks for getting back to me and on the weekend too! I shall go and appall others with my ineptitude then!
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Hi, it sounds like you could be compressing or irritating a nerve. The median nerve travels down the middle of your arm. I would check that your neck movements are full ie forward, backward and rotatory movements. You are feeling it when you are moving and it is down by your side so i would also check that your shoulder on the side of the problem isn't dropped as this may be tractioning/stretching your neck on this side. You may also be doing this compensatory movement when you climb. I would try doing exercises to encourage shoulder elevation such as shoulder presses but make sure you are reaching up and streching your side trunk muscles and you will then not be depressing your shoulder. See how you go and get back to me if you are compensating. regards Matt
Firstly, thank you for replying to my post.
I ended up going to see the physio at my local wall and she said that I had the early stages of tennis elbow and had done for quite a while. She suggested that due to all the different exercises I had been doing to fix it for the last few months I had staved off full blown tennis elbow but kept it low lever and persistent. Because I never knew exactly what it was I hadn't done enough of any particular treatment to fix it but it was enough to keep it from progressing. She massages a rather big knot out of my forearm muscle just below the elbow tendon and advised me to keep doing this and to do palm down wrist curls and ice it.
It does seem to be getting better and its nowhere near as pressured as it was before so I think its working but since you mention my shoulders I will try to explain what I am feeling there. The issue is with the right arm to start with. Putting my neck backwards, forwards is fine and doesn't stretch much in the neck. When the neck rolls to the left or right I can feel a stretch. Going to the left feels tighter (so the right hand side of the neck muscles are tighter?)
If I stretch my arm above my head with a slightly bent arm I can feel a twinge in the front of the deltoid where it joins the bicep and I definitely feel it more in the right arm than the left. I have started doing some shoulder presses as you suggested with 12.5kg in each hand and can do about 12 reps before I get fatigued but I have only done these for about a week now (every few days and perhaps 3 sets each time).
Should I be upping the weight and lowering the reps or vice versa and does what I have said above make any sense. I don't think the physio is particularly climbing focussed but she seemed to know what she was talking about so it would be good to have a second opinion / advice.
Thanks again.
Hi again, I am pleased symptoms are settling. I would continue with the higher reps for the next 3-4 weeks and perhaps increase the weight when it becomes easy. One of the main reasons for giving you these exercises was that I was guessing that you are/were slightly depressing your shoulder when using it so hence doing some elevation exercises to oppose this. Regarding the stretches, just try and hitch the shoulder slightly when rotating the neck and see if that makes a difference and do the same for the above head stretches (it sounds like you may be very slightly pinching the shoulder).
If you are going to the physio get them to check the shoulder position.
regards
matt
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Hi, for about a year I've been having problems with my elbows, neck and back. Initially I stopped climbing I stopped climbing for about 3 months but the problems didn't go, if anything they got worse. i tried doing the tendonitis weight exercises but thu didnt seem to help (after a few months of being very strict). More recently through lots of stretching, shoulder shrugs and hot baths after climbing the symptoms have calmed down (ie my elbows rarely hurt) but I can't quite get rid of the fore arm tension and neck pain. My forearms seem tense in the morning but I stretch them a lot throughout the day. It seems that too much climbing only makes my neck stuff and forearms a little stiff an the only thing that gets the inside of my elbows hurting is day to day activities (drying hair and using my phone etc). Wondering if there is any specific back workouts I could do to finally get rid of my problems.
Hope all that rambling made sense and thanks in advance for any replies
Dave
Hi, when you have bilateral (both sides) problems we would tend to look more centrally ie your neck. It sounds as if you are loading the neck and overstretching the brachial plexus (the nerves coming out of your neck into your arm). It would make sense that the shoulder shrugs helped because you are in effect unloading the neck. If you are sitting most of the day check that you are not slumping and depressing your shoulders. Also when you are bouldering make sure you are elongating (lengthening) your trunk and reaching upwards with your arms when traversing. Just a check because we see climbers that have neck and shoulder problems and they are not able to let there side trunk/back muscles lengthen and tend to pull downwards. Continue with your shoulder shrugs and also try shoulder press (arms above head) exercises with light to medium weights making sure you elevate your shoulders. If you have better shoulder and trunk positions you will feel stronger and also use your forearms less. Let me know if this helps. I sometimes get a dull ache on the inside of my elbows, near where the bicep joins the elbow. It's been happening for a couple of years now, usually my right arm, and after a few sessions of powerful bouldering- anything really slappy or big locks between holds on steep ground. Usually clears up again in a couple of days with rest / pressups, etc. But it's becoming a bit annoying and I can't seem to completely get rid of it so any advice would be great, thanks
Hi, you could be compressing a nerve (median) when you are fully bending your elbow with a biceps contraction ie in locking out. Do you get any pins and needles or numbness? There are some nerve movements/mobilisations that may help, these involve taking your arm out to the side, straightening your elbow with your fingers pointing downwards (starting position is like carrying a tray) and look towards your hand. Then bend the elbow again and look the opposite way. Do about 30 of these twice daily. The other observations we would want to look at would be your shoulder position as you may be compensating. It could also be that you are compressing and loading the elbow and the joint is crumbling a bit. Ultimately it goes away which is good but it may require an assessment if it's getting worse or not clearing up. Let me know how you get on.
Regards Matt
Hi again, just noticed that you said both elbows can be a problem. If this is the case the above comments are still relevant but you may also be dropping/depressing your shoulders when locking out and causing a more general nerve stretch. Try lots of shoulder shrugs and look at your shoulder positions when climbing ie don't let them drop too much. regards
regards
matt
I sometimes get a dull ache on the inside of my elbows, near where the bicep joins the elbow. It's been happening for a couple of years now, usually my right arm, and after a few sessions of powerful bouldering- anything really slappy or big locks between holds on steep ground. Usually clears up again in a couple of days with rest / pressups, etc. But it's becoming a bit annoying and I can't seem to completely get rid of it so any advice would be great, thanks
Hi, you could be compressing a nerve (median) when you are fully bending your elbow with a biceps contraction ie in locking out. Do you get any pins and needles or numbness? There are some nerve movements/mobilisations that may help, these involve taking your arm out to the side, straightening your elbow with your fingers pointing downwards (starting position is like carrying a tray) and look towards your hand. Then bend the elbow again and look the opposite way. Do about 30 of these twice daily. The other observations we would want to look at would be your shoulder position as you may be compensating. It could also be that you are compressing and loading the elbow and the joint is crumbling a bit. Ultimately it goes away which is good but it may require an assessment if it's getting worse or not clearing up. Let me know how you get on.
Regards Matt
Hi just noticed the word crumbling, sorry meant grumbling!! Hope this didn't alarm you. Regards
Matt
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Hi,
Since August the base of my middle left finger has been hurting after repetitive crimping. If i have 2 days off it stops hurting and i can climb on my limit, I had it checked out and was told it is most likely inflammation of the muscle and not tendon related. It hurts more to touch then to actually use. I have been icing and massaging it but still climbing quite hard. Just wondering if you have any idea what could have caused it/be causing it and the best way for it to recover?
Thanks a lot,
George
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Hi,
Since August the base of my middle left finger has been hurting after repetitive crimping. If i have 2 days off it stops hurting and i can climb on my limit, I had it checked out and was told it is most likely inflammation of the muscle and not tendon related. It hurts more to touch then to actually use. I have been icing and massaging it but still climbing quite hard. Just wondering if you have any idea what could have caused it/be causing it and the best way for it to recover?
Thanks a lot,
George
Hi George, it sounds like you have either irritated the joint or perhaps straining one of the pulleys in your finger. The index and middle finger pulleys are often the ones that can get irritated. There are several of them and they basically keep the tendon in place and take the load off it. Like any exercise if you are climbing hard then you will get cumulative strain and this is normal and enables the tissues to increase in strength BUT you must allow time between hard sessions and have easier periods to gain the benefits. You will have to back off the harder grades and increase again gradually. Let me know how you get on. Also have a look at the video several pages back of Alison McFarlane talking about finger injuries and cumulative strains.
Regards Matt
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Hello. On and off for a few months I've had a problem with the knuckle of my left middle finger. Particularly after climbing fingery things, if I leave my finger bent for any period of time (i.e. when asleep) it locks a bit and won't straighten without a small click which seems to come from the upper lateral (palms down) part of the knuckle. There's no pain on climbing, and only slight pain if I really squeeze the knuckle on the same place. It also feels generally stiff but I can't tell if that's real or a psychological overlay. Obviously this is causing no real problems as yet, but it's a bit worrying.
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Hello. On and off for a few months I've had a problem with the knuckle of my left middle finger. Particularly after climbing fingery things, if I leave my finger bent for any period of time (i.e. when asleep) it locks a bit and won't straighten without a small click which seems to come from the upper lateral (palms down) part of the knuckle. There's no pain on climbing, and only slight pain if I really squeeze the knuckle on the same place. It also feels generally stiff but I can't tell if that's real or a psychological overlay. Obviously this is causing no real problems as yet, but it's a bit worrying.
Hi, it could be that the joint is getting mildly irritated due to increased compressive loads particularly when your using small finger holds. Keep the finger moving throughout the day and make sure you can fully bend and straighten it. Also occasionally the tendon (if it is on the palmer aspect) can catch and if it worsens and will not unlock easily then this is called a trigger finger. At this stage don't worry and regularly stretch the finger particularly in to a straight position and sometimes a little massage around this area helps. Let me know how you get on.
Matt
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Thank you.
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About 4 weeks ago I hurt my finger on a route. I didn't realise until afterwards. For the next few weeks is was really stiff and I couldn't straighten it. Then when it felt better I climbed again. It felt fine, no pain or discomfort but the next day it was stiff again. This has happened a few times now and I'm starting to despair. It's the 2nd joint on my ring finger. Feel like it may need a longer lay off but I know in a few days it will feel fine again.
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About 4 weeks ago I hurt my finger on a route. I didn't realise until afterwards. For the next few weeks is was really stiff and I couldn't straighten it. Then when it felt better I climbed again. It felt fine, no pain or discomfort but the next day it was stiff again. This has happened a few times now and I'm starting to despair. It's the 2nd joint on my ring finger. Feel like it may need a longer lay off but I know in a few days it will feel fine again.
Hi, you may have either mildly sprained a pulley or irritated the joint. Both problems can be cause by cumulative loading and will result in the finger wanting to flex/bend. Make sure you have full extension (straighten) of the 2nd joint particularly when the wrist is extended (lift wrist upwards). I would suggest you continue climbing but reduce you grades and amount of crimping until you have less stiffness and increase as able.
regards Matt
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Thanks :thumbsup:it's hard to know how hard I can pull as it stiffens up after climbing. I guess I'll have to take it easy.
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Hi there
I saw Matt about this at Cliffhanger but the problem is back with either an additional or possibly a separate issue. My left arm has a small, knotty hard lump in the wrist and a larger, softer fluid-like lump further up the arm, as per the picture. These are the symptoms I showed Matt previously and the advice to back off worked, but then trying to step it up again has produced the same result. The big fluid lump reduced but the knotty lump has never gone away.
(http://static.ow.ly/photos/normal/3F5Ui.jpg)
The new symptoms are that in the left hand my ring and middle fingers are stiff for a few days after climbing and I have discomfort, bordering on pain, when I squeeze a fist. The ring finger is slightly worse and if I pinch it at the base it hurts slightly more than when making a fist.
Cheers
Ian
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I have a problem with my neck and I'd be interested in your opinion.
I think the problem first appeared while using a trampoline, back in may, and has re-occured a few times when doing similar bouncing movements. I describe it as tweaking my neck.
I experience a pain that i would describe as feeling like a trapped nerve in the back of my neck on my left side, just to the left of my spine, maybe about an inch from the top of my neck. Prodding here hurts but doing so does seem to help.
Stretching by pulling my head down into my right arm pit also seems to help. When doing this i get a referred pain in my rotator cuff.
It tends to clear-up after a little a week or so. And climbing seems to help if anything.
Thanks
James
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Hiya, hope i'm posting this properly (first time on here) this message is for the physio clinic Q and A forum:
injured inner forearm whilst bouldering last thursday
Happened whilst pulling on three finger pocket.. So open handed I think, move felt fine , was repeating it as working on a problem, heard a pop and sharp pain span inner forearm. No pain or swelling or bruising apart from when I try hanging open handed or push against slight resistance with ring finger.. That's when I felt pain about 3/4 of the way down inner forearm and bit in finger. It's fine doing pull ups on jugs or larger flat holds.
was a tiny bit sore when I pressed in same place I feel pain in forearm
was hurting if i pulled or pressed against any resistance with my ring finger but only hurts now when try pulling gently with my ring finger open handed... which i'm doing very gently to see if it's still an issue (on the door frame)
no pain when i try doing any hanging or pulling/pressing with another finger to assist
was going to tyake it very easy for afew days, haven't climbed for three days.. intending on doing a bit tonight
i'm thinking it's muscular rather than tendon?
any advice greatly appreciated.
thanks
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Andrea,
I'm not from HP so feel free to ignore the following.
When you say 3/4 down the forearm, do you mean the wrist end or the elbow end?
This sounds like a strain (partial tear) of one of the finger flexor muscle-tendon units. Towards the wrist, the muscle turns into tendon. Since you had power, some pain on resistance, and no obvious deformity a rupture seems less likely (with all the cautions of internet diagnosis). Whether it is tendon, muscle, or the junction of the two is hard to say from the information we have.
The management at this stage will be similar for tendon or muscle: lots of ice, relative rest for a couple of days, followed by cautious increase of the loading on the structure as it heals. This should be PAIN FREE both during and after. In the other place you say you are doing manual work and suggest that you could be doing easy climbing. The manual work counts as rehab. as long as it is not making the area sore. Obviously any climbing needs to be very easy and static. Rather than climbing, it might be easier to control the the amount of stress through the area by doing short hangs on a pull-up bar with feet on, progressing time on in the first instance before increasing load.
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Just a random, quick, mildly technical question which may not even be relevant here, but... :-\
Is there a difference between a pilon fracture and a 'third distal tibial fracture with articular involvement'?
(I know, but there's a perfectly reasonable motive for the question)
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Have a question re: this:
http://www.ukclimbing.com/forums/t.php?t=570080&new=7580146#x7580146
(http://www.ukclimbing.com/forums/t.php?t=570080&new=7580146#x7580146)
Basically it's a type of finger injury that seems quite common among climbers.
Pain in finger joints which hurts when the joint is pressed or knocked but doesn't hurt or affect ability to pull on holds.
Doesn't show up in ultrasound on my case; other people have remarked doesn't show up on Xrays.
On seeing a hand therapist she suggested it might be arthritis but it seems so common among climbers that I'm not sure. Had a previous similar injury which resolved in 18-months/2 years. Joint remains 'thicker' than other unaffected joints, but no difference in ROM or pain etc.
Any thoughts as to what this mystery condition might be?
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Hi there
I saw Matt about this at Cliffhanger but the problem is back with either an additional or possibly a separate issue. My left arm has a small, knotty hard lump in the wrist and a larger, softer fluid-like lump further up the arm, as per the picture. These are the symptoms I showed Matt previously and the advice to back off worked, but then trying to step it up again has produced the same result. The big fluid lump reduced but the knotty lump has never gone away.
(http://static.ow.ly/photos/normal/3F5Ui.jpg)
The new symptoms are that in the left hand my ring and middle fingers are stiff for a few days after climbing and I have discomfort, bordering on pain, when I squeeze a fist. The ring finger is slightly worse and if I pinch it at the base it hurts slightly more than when making a fist.
Cheers
Ian
Hi NAI
The picture shows the right hand? Anyway I suspect you have either torn the insertion in on of the tendons that inserts into the wrist (FCR) and this would produce swelling in the muscle belly ('soft swelling in forearm) and local wrist problem. If the initial injury was high load injury you might have damaged the ligaments in the radial side of the wrist and the muscles in the forearm are trying to compensate for the loss of control.
Either way work out which moves provoke the pain/swelling and avoid them for a couple of weeks. Possibly tape the wrist to reduce stress and don't over stretch the wrist. Try forearm strengthening exercises with weights but if you continue to have symptoms you need a professional opinion.
Do you get symptoms with thumb movements/loading?
Cheers
Steve
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I have a problem with my neck and I'd be interested in your opinion.
I think the problem first appeared while using a trampoline, back in may, and has re-occured a few times when doing similar bouncing movements. I describe it as tweaking my neck.
I experience a pain that i would describe as feeling like a trapped nerve in the back of my neck on my left side, just to the left of my spine, maybe about an inch from the top of my neck. Prodding here hurts but doing so does seem to help.
Stretching by pulling my head down into my right arm pit also seems to help. When doing this i get a referred pain in my rotator cuff.
It tends to clear-up after a little a week or so. And climbing seems to help if anything.
Thanks
James
hi James
Sounds like a neck problem with referral to your shoulder. Pain often refers down the inside of the shoulder blade and suggests you are stressing the neck with bouncing. If climbing is okay and actually improves the pain I suspect its not a shoulder problem. When you bounce you are either tensing your neck (or its stiff due to work position) and this is causing the neck joints to be stressed. (you see a similar thing with neck pain during running).
Before you bounce move your neck for 5 mins and stretch your shoulders above your head. Many climbers force their shoulder down which can cause neck pain with faulty loading.
Cheers
Steve
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Hiya, hope i'm posting this properly (first time on here) this message is for the physio clinic Q and A forum:
injured inner forearm whilst bouldering last thursday
Happened whilst pulling on three finger pocket.. So open handed I think, move felt fine , was repeating it as working on a problem, heard a pop and sharp pain span inner forearm. No pain or swelling or bruising apart from when I try hanging open handed or push against slight resistance with ring finger.. That's when I felt pain about 3/4 of the way down inner forearm and bit in finger. It's fine doing pull ups on jugs or larger flat holds.
was a tiny bit sore when I pressed in same place I feel pain in forearm
was hurting if i pulled or pressed against any resistance with my ring finger but only hurts now when try pulling gently with my ring finger open handed... which i'm doing very gently to see if it's still an issue (on the door frame)
no pain when i try doing any hanging or pulling/pressing with another finger to assist
was going to tyake it very easy for afew days, haven't climbed for three days.. intending on doing a bit tonight
i'm thinking it's muscular rather than tendon?
any advice greatly appreciated.
thanks
Hi Andrea
I would agree with Duncan, it sounds like a simple muscle strain and should improve with gradual loading. I can only assumed you increased the climbing too quickly or practised a particular move too often to cause the over loading of the forearm muscles. Vary your climbing and avoid any specific painful holds, but climb as the muscle will respond to controlled stress and this does help tissue recovery. Try that and give some feedback.
Thanks
Steve
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Just a random, quick, mildly technical question which may not even be relevant here, but... :-\
Is there a difference between a pilon fracture and a 'third distal tibial fracture with articular involvement'?
(I know, but there's a perfectly reasonable motive for the question)
Hi Lopez
A Pilon fracture ( French for pestle) is a high energy crushing injury cased by a fall or RTA. They usually involve the acticular surfaces (joint) in my experiences. It is probably possible to get a Pilon fracture without articualr involvement but its not common in my experience. Joints do not like compression and fractures into the joint can cause long term problems (arthritis etc). I am not an Orthopaedic surgeon ad they are the best people to give advice in this case. It usually involves surgical repair and close attention is given to the joint with regards alignment. Hope that helps.
Steve
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Hi NAI
The picture shows the right hand? Anyway I suspect you have either torn the insertion in on of the tendons that inserts into the wrist (FCR) and this would produce swelling in the muscle belly ('soft swelling in forearm) and local wrist problem. If the initial injury was high load injury you might have damaged the ligaments in the radial side of the wrist and the muscles in the forearm are trying to compensate for the loss of control.
Either way work out which moves provoke the pain/swelling and avoid them for a couple of weeks. Possibly tape the wrist to reduce stress and don't over stretch the wrist. Try forearm strengthening exercises with weights but if you continue to have symptoms you need a professional opinion.
Do you get symptoms with thumb movements/loading?
Cheers
Steve
Hi Steve
Thanks for replying. It's actually my left arm if that makes any difference?
I think I need to come and see you for a definitive diagnosis, I've had this for a while now and would like to get it sorted.
Ian
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Hi NAI
The picture shows the right hand? Anyway I suspect you have either torn the insertion in on of the tendons that inserts into the wrist (FCR) and this would produce swelling in the muscle belly ('soft swelling in forearm) and local wrist problem. If the initial injury was high load injury you might have damaged the ligaments in the radial side of the wrist and the muscles in the forearm are trying to compensate for the loss of control.
Either way work out which moves provoke the pain/swelling and avoid them for a couple of weeks. Possibly tape the wrist to reduce stress and don't over stretch the wrist. Try forearm strengthening exercises with weights but if you continue to have symptoms you need a professional opinion.
Do you get symptoms with thumb movements/loading?
Cheers
Steve
Hi Steve
Thanks for replying. It's actually my left arm if that makes any difference?
I think I need to come and see you for a definitive diagnosis, I've had this for a while now and would like to get it sorted.
Ian
It must have been your muscular arms that fooled me. Apologies. Its the ulnar side (FCU) and possibly medial wrist ligaments.
Cheers
Steve
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Have a question re: this:
http://www.ukclimbing.com/forums/t.php?t=570080&new=7580146#x7580146
(http://www.ukclimbing.com/forums/t.php?t=570080&new=7580146#x7580146)
Basically it's a type of finger injury that seems quite common among climbers.
Pain in finger joints which hurts when the joint is pressed or knocked but doesn't hurt or affect ability to pull on holds.
Doesn't show up in ultrasound on my case; other people have remarked doesn't show up on Xrays.
On seeing a hand therapist she suggested it might be arthritis but it seems so common among climbers that I'm not sure. Had a previous similar injury which resolved in 18-months/2 years. Joint remains 'thicker' than other unaffected joints, but no difference in ROM or pain etc.
Any thoughts as to what this mystery condition might be?
Rocksteady
Excellent question and one which needs a wider view of pain and how we can get fooled by local tenderness. Basically you can use the hand and climbing does not cause a problem (so no OA, tears or ruptures in my opinion). After an injury there is a sensitisation process (peripherally and centrally-spinal cord and brain) which can cause us to experience pain (on touch or with movement). The tissues are normal on imaging (US, MRI and X-ray) and loads well with activity. We can experience pain without tissue damage (consider people who have continuing foot pain following an amputation) and what you might be experiencing is pain over the joint as a result of the previous injury and subsequent sensitisation process.
So what should you do?
1. Keep climbing and progressively load the hand/arm/body with a variety of movements.
2. Don't keep pressing the finger to see how its going (this can only cause us to focus on the pain).
This sensitisation process is normal and is often worse if we worry about the injury. (For a more detailed overview of pain and how our brain get fooled sometimes watch Prof Moseley-go to HallamshirePhysiotherapy.com site and click 'Chronic pain' and then select the second video). The brain produces pain as a perceived threat and it is always making decision about what we will experience. (that why when you are dangling 50m over a steep cliff and the hold is really poor and you could fall-you don't have pain in the old knee injury!)
Tell me how you got on. Does that help explain the painful hand?
Best wishes
Steve
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Rocksteady
Excellent question and one which needs a wider view of pain and how we can get fooled by local tenderness. Basically you can use the hand and climbing does not cause a problem (so no OA, tears or ruptures in my opinion). After an injury there is a sensitisation process (peripherally and centrally-spinal cord and brain) which can cause us to experience pain (on touch or with movement). The tissues are normal on imaging (US, MRI and X-ray) and loads well with activity. We can experience pain without tissue damage (consider people who have continuing foot pain following an amputation) and what you might be experiencing is pain over the joint as a result of the previous injury and subsequent sensitisation process.
So what should you do?
1. Keep climbing and progressively load the hand/arm/body with a variety of movements.
2. Don't keep pressing the finger to see how its going (this can only cause us to focus on the pain).
This sensitisation process is normal and is often worse if we worry about the injury. (For a more detailed overview of pain and how our brain get fooled sometimes watch Prof Moseley-go to HallamshirePhysiotherapy.com site and click 'Chronic pain' and then select the second video). The brain produces pain as a perceived threat and it is always making decision about what we will experience. (that why when you are dangling 50m over a steep cliff and the hold is really poor and you could fall-you don't have pain in the old knee injury!)
Tell me how you got on. Does that help explain the painful hand?
Best wishes
Steve
Many thanks for this, very interesting and seems to make sense in relation to what I've experienced. I wonder if it is post-ligament damage for example. Will keep an eye on it and report back.
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For the last 3-4 weeks I've had an off and on soreness/pain/swelling in my left middle finger near the DIP joint. The sensitivity seems to be on the top and sides of the DIP joint towards to fingertip. I don't recall doing anything specific to injure it, and can't seem to pinpoint what makes it sore, so I've just continued traning/climbing on it. However, It has now gotten a bit more consistant, but I still can't figure out any triggers or causes. Any Ideas?
Thanks,
Todd
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Hi,
I had a left knee arthroscopy 2 weeks ago, which, removed a 1" by 1/2" radial tear of the meniscus. The swelling has pretty much gone and my range of movement and strength are probably 70%. I am following the standard set of physio exercises and some very light yoga, are there any additional exercises you could recommend before for returning to climbing.
Also how long should I leave it and/or what level should I be at before starting to climb again?
Thanks
James
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Hi nice physio people. I posted this RFI over on UKC but then spotted this thread and thought I'd ask you guys on your perspective, being less inclined to cutting and maiming than the average orthopod. Physio perspective much appreciated!
Basically I have a partial scapholunate ligament tear, diagnosed on MR arthogram, and am waiting to see my orthopaedic surgeon (an upper limb specialist), and I'm keen to be armed with a few alternative perspectives before I go see him.
I reckon (although I'm far from sure) that the original injury happened just over a year ago in Yosemite, probably torquing hard off a fist jam - it really wasn't that bad at the time, and I didn't lose any climbing time at all, but ever since my left wrist has felt a bit "loose" and unstable, particularly when doing open-handed hangs. In that year I've climbed as hard as I ever have and it's not really held me back.
About a month ago I did something else to it during an indoor wall session - not really sure what - but it was sore and stiff for about 5-7 days during which it was definitely impingeing on dressing/washing and my job. During that time I decided I'd better get it seen to in case it wasn't going to get better or in case I was putting my wrist at risk by ignoring it. Found a friendly orthopaedic surgeon (who is a hand/wrist specialist) and got myself a dynamic CT (fancy but not much use diagnostically) and, just today, an MR arthrogram, which has shown a partial scapholunate ligament tear.
Now, in the meantime my wrist is essentially back to how it's been since the original injury in Yosemite - not painful but a bit loose and wobbly, and I've had no problems going back to light training (including one-arm lock + lowers, static campus rung hangs, gentle bouldering). I can't do press ups (pain on wrist hyperextensions) but I've been doing tuck planches on clenched fists. So it's not like my wrist is really causing me much of a problem at the moment. My concern is that looking at the very varied literature around the place, there's a risk of progression of these injuries, and I certainly don't want to end up with an arthritic and useless wrist in a few years' time... But I also don't want arthroscopes, knives or bits of tendons (which may not stand up to further fist jams) stuck into my wrist unnecessarily. Hence the request for information.
Cheers for reading!
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Hi,
I had a left knee arthroscopy 2 weeks ago, which, removed a 1" by 1/2" radial tear of the meniscus. The swelling has pretty much gone and my range of movement and strength are probably 70%. I am following the standard set of physio exercises and some very light yoga, are there any additional exercises you could recommend before for returning to climbing.
Also how long should I leave it and/or what level should I be at before starting to climb again?
Thanks
James
Hi James, in theory you have had the problem removed and as long as the effusion/swelling has reduced then you should be getting back to climbing again in a graduated way.
I would imagine you have had some time (at least 2 weeks) away from climbing so you will certainly need to climb at a lower grade, less volume and keep your sessions shorter. If you are getting muscular soreness then this is ok and would be expected after a duration away from climbing. If you have increased pain just back off on the volume and intensity. Basically gradually increase the volume and intensity in a controlled objective way.
If the physio exercises involve staic lunges and wall slides then these are similar to the type of movements your legs are doing when climbing ie weight transference on to the supporting leg and pushing through the knee and hips.
If you have any issues let me know, just increase the climbing in a steady controlled way. Good luck.
Matt
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Hi James, in theory you have had the problem removed and as long as the effusion/swelling has reduced then you should be getting back to climbing again in a graduated way.
I would imagine you have had some time (at least 2 weeks) away from climbing so you will certainly need to climb at a lower grade, less volume and keep your sessions shorter. If you are getting muscular soreness then this is ok and would be expected after a duration away from climbing. If you have increased pain just back off on the volume and intensity. Basically gradually increase the volume and intensity in a controlled objective way.
If the physio exercises involve staic lunges and wall slides then these are similar to the type of movements your legs are doing when climbing ie weight transference on to the supporting leg and pushing through the knee and hips.
If you have any issues let me know, just increase the climbing in a steady controlled way. Good luck.
Matt
Great thank you Matt, I will slowly build it up. I was just worried about squashing (landing on it) or twisting too much while it is still healing (or is there nothing to heal and it is just about getting the supporting strength back into the leg) I suppose climbing more straight on wouldn't hurt in building some strength anyway.
Thanks again
James
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Hi nice physio people. I posted this RFI over on UKC but then spotted this thread and thought I'd ask you guys on your perspective, being less inclined to cutting and maiming than the average orthopod. Physio perspective much appreciated!
Basically I have a partial scapholunate ligament tear, diagnosed on MR arthogram, and am waiting to see my orthopaedic surgeon (an upper limb specialist), and I'm keen to be armed with a few alternative perspectives before I go see him.
I reckon (although I'm far from sure) that the original injury happened just over a year ago in Yosemite, probably torquing hard off a fist jam - it really wasn't that bad at the time, and I didn't lose any climbing time at all, but ever since my left wrist has felt a bit "loose" and unstable, particularly when doing open-handed hangs. In that year I've climbed as hard as I ever have and it's not really held me back.
About a month ago I did something else to it during an indoor wall session - not really sure what - but it was sore and stiff for about 5-7 days during which it was definitely impingeing on dressing/washing and my job. During that time I decided I'd better get it seen to in case it wasn't going to get better or in case I was putting my wrist at risk by ignoring it. Found a friendly orthopaedic surgeon (who is a hand/wrist specialist) and got myself a dynamic CT (fancy but not much use diagnostically) and, just today, an MR arthrogram, which has shown a partial scapholunate ligament tear.
Now, in the meantime my wrist is essentially back to how it's been since the original injury in Yosemite - not painful but a bit loose and wobbly, and I've had no problems going back to light training (including one-arm lock + lowers, static campus rung hangs, gentle bouldering). I can't do press ups (pain on wrist hyperextensions) but I've been doing tuck planches on clenched fists. So it's not like my wrist is really causing me much of a problem at the moment. My concern is that looking at the very varied literature around the place, there's a risk of progression of these injuries, and I certainly don't want to end up with an arthritic and useless years' time... But I also don't want arthroscopes, knives or bits of tendons (which may not stand up to further fist jams) stuck into my wrist unnecessarily. Hence the request for information.
Cheers for reading!
Hi Pete, this is a very debatable subject of whether you should continue conservatively or go along the surgical route.
Interestingly your dynamic CT didn't show any abnormal gapping or positional changes which you would probably expect from a full rupture. A partial tear could mean that the majority of the ligament is still intact and this may be why you can still climb at a good level. There are also 3 different parts to this ligament and some are more structurally important.
With regards to arthritic changes the literature doesn't really support this and we often find similar myths/anecdotal information is given to patients following other ligament injuries such as the cruciate ligaments in the knees, again the literature on correlating arthritic changes with ligaments injuries isn't conclusive. One study for example followed up on patients 7 years after a scapholunate ligament injury and found no arthritic changes. The internet is a fantastic source of info. but take care because some of the information scares people and isn't backed up with scientific evidence.
Have you tried using wrist tape or supports and if so does this make a difference?
Personally if you are gradually loading the wrist and slowly returning to your previous grades then i would continue conservatively unless the pain increases and you are no longer able to climb. If wrist extension when loaded is sore ie when doing a press up then continue to use your fists or not do them. I feel that a press up isn't similar to any climb moves or positions and there are plenty of other exercises to compliment your climbing.
Perhaps still see the surgeon and discuss the options as ultimately it is your decision.
We are also assuming that the ligament is the problem and sometimes this is the red herring i.e, it was already injured but asymptomatic!!
Hope this helps and if you are local to Sheffield perhaps book an appointment for a more thorough look.
Regards
Matt
Hi James, in theory you have had the problem removed and as long as the effusion/swelling has reduced then you should be getting back to climbing again in a graduated way.
I would imagine you have had some time (at least 2 weeks) away from climbing so you will certainly need to climb at a lower grade, less volume and keep your sessions shorter. If you are getting muscular soreness then this is ok and would be expected after a duration away from climbing. If you have increased pain just back off on the volume and intensity. Basically gradually increase the volume and intensity in a controlled objective way.
If the physio exercises involve staic lunges and wall slides then these are similar to the type of movements your legs are doing when climbing ie weight transference on to the supporting leg and pushing through the knee and hips.
If you have any issues let me know, just increase the climbing in a steady controlled way. Good luck.
Matt
Great thank you Matt, I will slowly build it up. I was just worried about squashing (landing on it) or twisting too much while it is still healing (or is there nothing to heal and it is just about getting the supporting strength back into the leg) I suppose climbing more straight on wouldn't hurt in building some strength anyway.
Thanks again
James
Hi James, the menicus has been trimmed and the offending tear will no longer be causing a mechnical problem. Cartilidge likes to be compressed (but not overloaded). You will have some muscle inhibition and weakness but getting back to exercise will help to return the equilibrium and control around the knee.
Matt
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Hi Matt,
Thanks for that, that's really helpful. Have you got a reference for that 7 year study? That's exactly the sort of info I'm looking for really and didn't come across it searching. I'm a doctor and I've got an Athens password (although Google Scholar's usually more helpful...)
Yeah I'm not convinced the dynamic CT was done in the best way... I gather they've only just started doing them at my hospital, and, since I emphasised that there was a definite "clunk" only on specific loading (resisting passive ulnar deviation from neutral), they gamely set up a big water bottle in the scanner for me to push my hand against, but with the weirdness of the set-up - lying on my front in the Superman position etc - and maybe some performance anxiety, I couldn't make it happen. It didn't show any major gapping or subluxation, but it certainly feels + looks to me like my lunate's clunking dorsally when I do that specific movement.
The MR report says it's the volar fibres which are torn, if that helps. I understand the dorsal ones are probably more important. I've had a look at the images myself and it does, for what it's worth, look like a really tiny leak of contrast compared to the examples (mostly full ruptures) I've seen on the internet. So I guess that's good!
I haven't tried any taping or supports - not really sure where to start, which I guess is where I might need a physio! As for the press-ups, I tend to use the tuck planches as an all-round antagonist exercise for triceps, rotator cuff and for some core, but I will indeed keep a close eye, and if I think it's causing me issues I'll drop it happily.
I'm also glad you've mentioned the red herring possibility - I certainly wondered this, both my wrists are pretty hypermobile to be honest and I'm not totally convinced it's the whole story.
Unfortunately I'm not in Sheffield... I'm based in Bradford at the moment, and if you had any recommendations for sports physio people more local to me, particularly any who are used to dealing with (and sympathetic to!) climbers, I'd really appreciate that.
Pete.
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Unfortunately I'm not in Sheffield... I'm based in Bradford at the moment,
Fuck it, drive to Sheff. Its not that far from Bradford. I have driven over from Manchester to see Alison back in the day and never felt it was too much trouble.
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For the last 3-4 weeks I've had an off and on soreness/pain/swelling in my left middle finger near the DIP joint. The sensitivity seems to be on the top and sides of the DIP joint towards to fingertip. I don't recall doing anything specific to injure it, and can't seem to pinpoint what makes it sore, so I've just continued traning/climbing on it. However, It has now gotten a bit more consistant, but I still can't figure out any triggers or causes. Any Ideas?
Thanks,
Todd
Any thoughts on the finger. I'm happy to give more details as I'm stumped....
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For the last 3-4 weeks I've had an off and on soreness/pain/swelling in my left middle finger near the DIP joint. The sensitivity seems to be on the top and sides of the DIP joint towards to fingertip. I don't recall doing anything specific to injure it, and can't seem to pinpoint what makes it sore, so I've just continued traning/climbing on it. However, It has now gotten a bit more consistant, but I still can't figure out any triggers or causes. Any Ideas?
Thanks,
Todd
Any thoughts on the finger. I'm happy to give more details as I'm stumped....
It would appear that crimping is what does it, open/sloper/[pockets are fine. It almost seems as though it something being compressed on the fingernail side of the finger when the DIP joint flexes back during crimping.
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Not sure how I've done it but I have managed somehow to injure myself. I'm not sure what I've done or exactly what to call it so I'm looking for some advice as to what I may have done and any help advise as to stretches or exercise which could help relieve it.
Symptoms
Numbness in my hand; across the back and in in the palm.
Numbness in fingers and thumb; mostly the thumb and back two
Pain in the forearm; in the area just shy of the elbow
Pain in the upper arm; just round the outside of the elbow, though it hasn't risen higher at all.
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:wall:
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Hope you can offer some advice. Hopefully I've given enough info without making it way too long!
Background: I dislocated my elbow back in February this year, it was quite a bad dislocation, but there were no fractures. I had it reduced at A&E, had it cast, which I asked to be removed completely after 9 days (they wanted to cast it for at least 3 weeks). It healed quite well (certainly much better than the doctors seemed to think it would), I have not far off complete range of motion back. The missing part seems to be in bending it rather than straightening it, though it no longer hyper-extends like my other elbow does. I did have an electrical test on the ulna nerve as my arm went to sleep when I was asleep/lying down for quite a long time after the injury, but it was found to be ok, and I no longer have this problem. When I bend my arm, the knobbly bit on the inside of the elbow is more prominent on the dislocated one than the other one, and this is quite close to where it hurts (just a bit further round).
I now find when climbing that arm gets really pumped compared to the other one, and after doing routes last night and getting very pumped, it was a bit painful at the time, and really painful when I woke up this morning. It's not actually in the elbow joint that's sore, but at the back of my arm just above it, and I can't really work out what it is/what I could do to make it better. Most of the literature on elbow dislocations focus on returning ROM and the joint itself (which seems to be fine and I have no problems campussing, bouldering quite hard (for me), doing pullups etc. :strongbench:). I'd also love to not get so pumped in that arm. I did think it might be getting pumped more because it does not totally straighten so I'm not hanging on a completely straight arm in between moves, but I'm not sure that explains it (what with the pain at the back of my arm).
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Hi Guys,
Just wondering if you have some good advice for a problem I've been having.
I sprained (type 2 i think the physio said) my ankle in February.
Saw the physio, got it loosened up. Damaged it the next day slipping on a wet floor.
But carried on with the ice and exercises until they became fairly easy, so for 2 or so months with a little easy low-load climbing after the first month; subsequently increasing the load to normal by May time and pushing through over summer.
I noticed that when I walk through particularly cold areas (even over a short period of time), my knee and ankle on that side get stiff. I have also started jogging/running doing hill reps on grass for half an hour at a time. Needless to say both my ankle and knee flare up if i run down the hill; but i also find that if I really run fast up the hill, then my knee and ankle start to hurt and the gate of my step seems to get wider and my foot starts to point further outwards. By this point its normally been half an hour and I drag myself back home for a stretch and hot shower.
Would that suggest that one specific muscle set is weak? Should I try and exercise my leg and calf muscles more?
Cheers!
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Hi Guys,
Tried out a new core workout on Tuesday morning and it was fairly hard. I was fine all day Tuesday but then since yesterday (Wednesday) I've been getting a quite severe pain on the front of my hips everytime I'm stood up straight. It's hasn't eased off at all today even after an hour of yoga. Any suggestions as to what this might be and what I should do to help it calm down?
Cheers!
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Hi Matt,
Thanks for that, that's really helpful. Have you got a reference for that 7 year study? That's exactly the sort of info I'm looking for really and didn't come across it searching. I'm a doctor and I've got an Athens password (although Google Scholar's usually more helpful...)
Yeah I'm not convinced the dynamic CT was done in the best way... I gather they've only just started doing them at my hospital, and, since I emphasised that there was a definite "clunk" only on specific loading (resisting passive ulnar deviation from neutral), they gamely set up a big water bottle in the scanner for me to push my hand against, but with the weirdness of the set-up - lying on my front in the Superman position etc - and maybe some performance anxiety, I couldn't make it happen. It didn't show any major gapping or subluxation, but it certainly feels + looks to me like my lunate's clunking dorsally when I do that specific movement.
The MR report says it's the volar fibres which are torn, if that helps. I understand the dorsal ones are probably more important. I've had a look at the images myself and it does, for what it's worth, look like a really tiny leak of contrast compared to the examples (mostly full ruptures) I've seen on the internet. So I guess that's good!
I haven't tried any taping or supports - not really sure where to start, which I guess is where I might need a physio! As for the press-ups, I tend to use the tuck planches as an all-round antagonist exercise for triceps, rotator cuff and for some core, but I will indeed keep a close eye, and if I think it's causing me issues I'll drop it happily.
I'm also glad you've mentioned the red herring possibility - I certainly wondered this, both my wrists are pretty hypermobile to be honest and I'm not totally convinced it's the whole story.
Unfortunately I'm not in Sheffield... I'm based in Bradford at the moment, and if you had any recommendations for sports physio people more local to me, particularly any who are used to dealing with (and sympathetic to!) climbers, I'd really appreciate that.
Pete.
Hi Pete the ref is ....O’Meeghan et al 2003. The Natural History of an Untreated Isolated Scapholunate Interosseus Ligament Injury. J Hand Surg Eur Vol August 2003 vol. 28 no. 4 307-310
I unfortunately don't know any sports physios in the Bradford area, but i will ask my colleagues.
You mentioned your wrists are hypermobile so controlling the amount of movement is probably more important ie avoid excessive end range movements and positions. It makes sense that you get pain with pressups because you will probably be at end range of extension with additional load.
Interestingly you may find that you have always had a small scapholunate tear and this may be a common thing with climbers, particularly if you are hypermobile?
You are also correct in that the dorsal part of the ligament is the most important.
Try a wide sports tape around your wrist that will go either side of the joint line between carpals and radias/ulnar. You could experiment with rigid tape or the more current/ popular rock tape that has more elastic properties.
Let me know how you get on.
Regards
Matt
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Hello Physio peeps,
I've had some shoulder impingement in the past and I think it might have crept back in after a session at the wall where I did an odd shouldery move. Afterwards I had a very slight niggle on the back of my shoulder (sort of inside the shoulder-blade). As it wasn't much of note I've since had about 3-4 training sessions and during the last of these I decided it had got worse and stopped as a result. That was yesterday.
Does this sound like a regular shoulder impingement to you; such that I would do active rest, ice, ibuprofen and the usual exercises. Or is it worth seeking out some hands on assessment?
Also does any other treatment (such as massage/needles) actually help with recovery or is this just witchcraft?
Cheers,
Rich
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For the last 3-4 weeks I've had an off and on soreness/pain/swelling in my left middle finger near the DIP joint. The sensitivity seems to be on the top and sides of the DIP joint towards to fingertip. I don't recall doing anything specific to injure it, and can't seem to pinpoint what makes it sore, so I've just continued traning/climbing on it. However, It has now gotten a bit more consistant, but I still can't figure out any triggers or causes. Any Ideas?
Thanks,
Todd
Any thoughts on the finger. I'm happy to give more details as I'm stumped....
It would appear that crimping is what does it, open/sloper/[pockets are fine. It almost seems as though it something being compressed on the fingernail side of the finger when the DIP joint flexes back during crimping.
Hi Todd,
it sounds like it could be an A5 pulley irritation. This pulley is located on the distal DIP joint. As you may know the more common pulley to injury is the A2 but any of the pulleys can be strained or overloaded. The open crimp puts a large load on all of the pulleys. I would back off the crimping and go for the bigger holds as it is important to still put stress through the tendons and pulleys but not to overload them and cause microtrauma cumulative strains. Basically if you can climb with only mild discomfort then this is ok but don't climb through pain and you shouldn't have a lot of stiffness the next day.
To progress back to crimping start to introduce the odd move and see how it feels. If it is painful do less, if it is ok add a few more moves. You need to have a base that is pain free and move forward and progress the good stresses of climbing to the tendons. Let the tissues adapt but don't overload.
Regards
Matt
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Not sure how I've done it but I have managed somehow to injure myself. I'm not sure what I've done or exactly what to call it so I'm looking for some advice as to what I may have done and any help advise as to stretches or exercise which could help relieve it.
Symptoms
Numbness in my hand; across the back and in in the palm.
Numbness in fingers and thumb; mostly the thumb and back two
Pain in the forearm; in the area just shy of the elbow
Pain in the upper arm; just round the outside of the elbow, though it hasn't risen higher at all.
Hi, it sounds like you have irritated a nerve in your neck. The symptoms are specific to a certain level. It has probably occured over a period of time and doesn't have to be a specific incident. It is often related to sustained sitting positions with a poor posture and a lack of movement. If you are mainly sitting in the daytime at a computer then regularly change position to break up prolonged positions particularly if they are slumped. I would reccomend you see a local physio for a thorough examination as the symptoms can hang around and you need to know how to best manage them.
Regards
Matt
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Hope you can offer some advice. Hopefully I've given enough info without making it way too long!
Background: I dislocated my elbow back in February this year, it was quite a bad dislocation, but there were no fractures. I had it reduced at A&E, had it cast, which I asked to be removed completely after 9 days (they wanted to cast it for at least 3 weeks). It healed quite well (certainly much better than the doctors seemed to think it would), I have not far off complete range of motion back. The missing part seems to be in bending it rather than straightening it, though it no longer hyper-extends like my other elbow does. I did have an electrical test on the ulna nerve as my arm went to sleep when I was asleep/lying down for quite a long time after the injury, but it was found to be ok, and I no longer have this problem. When I bend my arm, the knobbly bit on the inside of the elbow is more prominent on the dislocated one than the other one, and this is quite close to where it hurts (just a bit further round).
I now find when climbing that arm gets really pumped compared to the other one, and after doing routes last night and getting very pumped, it was a bit painful at the time, and really painful when I woke up this morning. It's not actually in the elbow joint that's sore, but at the back of my arm just above it, and I can't really work out what it is/what I could do to make it better. Most of the literature on elbow dislocations focus on returning ROM and the joint itself (which seems to be fine and I have no problems campussing, bouldering quite hard (for me), doing pullups etc. :strongbench:). I'd also love to not get so pumped in that arm. I did think it might be getting pumped more because it does not totally straighten so I'm not hanging on a completely straight arm in between moves, but I'm not sure that explains it (what with the pain at the back of my arm).
Hi, you sound like you are doing very well and you have a good range of movement. Often regaining full elbow extension can be a problem. You have regained this and it isn't a bad thing that it no longer hyperextends. Although the ulnar nerve has recovered you may still have some sensitivity with it. Often with dislocations at any joint the nerves can be overstretched.
Try testing how the ulnar nerve moves by comparing sides. To begin, stretch your arm out to the side and have your fingers pointing towards the celing, palm facing outwards, then bend your elbow and continue to move your fingers towards your face (thumb facing forward) until your fingers are on your cheek pointing downwards. You may get a normal pulling sensation. Compare to the other side. If it is more uncomfortable or the discomfort doesn't allow you to do the full movement then it is more sensitive. I would google ulnar nerve mobilsation exercises and try these.
The fact that your arm is getting more pumped is probably because you are still lacking some strength and it won't just be your forarm muscles, all of the left arm will have become weaker and may not have been fully addressed. This lack of global strength may be putting more of a stress through the elbow and this may be the source of the problem.
I would expect a degree of discomfort for up to a year following this kind of injury. You may benefit from a physio review specific to climbing.
Regards
Matt
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Hi Guys,
Just wondering if you have some good advice for a problem I've been having.
I sprained (type 2 i think the physio said) my ankle in February.
Saw the physio, got it loosened up. Damaged it the next day slipping on a wet floor.
But carried on with the ice and exercises until they became fairly easy, so for 2 or so months with a little easy low-load climbing after the first month; subsequently increasing the load to normal by May time and pushing through over summer.
I noticed that when I walk through particularly cold areas (even over a short period of time), my knee and ankle on that side get stiff. I have also started jogging/running doing hill reps on grass for half an hour at a time. Needless to say both my ankle and knee flare up if i run down the hill; but i also find that if I really run fast up the hill, then my knee and ankle start to hurt and the gate of my step seems to get wider and my foot starts to point further outwards. By this point its normally been half an hour and I drag myself back home for a stretch and hot shower.
Would that suggest that one specific muscle set is weak? Should I try and exercise my leg and calf muscles more?
Cheers!
Hi, We often see chronic ankle injuries and the most common presentations are that the ankle is still lacking dorsiflexion (foot moving towards shin such as in a lunge position) in weight bearing and there is a loss in dynamic ankle activity such as jumping or hopping. If you are experiencing knee and ankle pain it sounds as if your ankle may not have regained full movement and you are compressing the joint as well as the knee having to compensate for this restriction. Up and down hills will be worse.
The range of movement needs to be tested in weight bearing as you don't always see it when just moving the ankle. To test and compare sides start on the good leg, with your toes against a wall you should be able to easily bend your knee and touch the wall also. Slowly slide your foot back in increments until you have to lift your heel. This is the weight bearing range of ankle dorsiflexion. Compare to the symptom side.
Also try and hop as high as you can on either leg and see if there is a difference.
See how that goes and you may need to get some help if the joint is still restricted.
Regards
Matt
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Hi Guys,
Just wondering if you have some good advice for a problem I've been having.
I sprained (type 2 i think the physio said) my ankle in February.
Saw the physio, got it loosened up. Damaged it the next day slipping on a wet floor.
But carried on with the ice and exercises until they became fairly easy, so for 2 or so months with a little easy low-load climbing after the first month; subsequently increasing the load to normal by May time and pushing through over summer.
I noticed that when I walk through particularly cold areas (even over a short period of time), my knee and ankle on that side get stiff. I have also started jogging/running doing hill reps on grass for half an hour at a time. Needless to say both my ankle and knee flare up if i run down the hill; but i also find that if I really run fast up the hill, then my knee and ankle start to hurt and the gate of my step seems to get wider and my foot starts to point further outwards. By this point its normally been half an hour and I drag myself back home for a stretch and hot shower.
Would that suggest that one specific muscle set is weak? Should I try and exercise my leg and calf muscles more?
Cheers!
Hi, We often see chronic ankle injuries and the most common presentations are that the ankle is still lacking dorsiflexion (foot moving towards shin such as in a lunge position) in weight bearing and there is a loss in dynamic ankle activity such as jumping or hopping. If you are experiencing knee and ankle pain it sounds as if your ankle may not have regained full movement and you are compressing the joint as well as the knee having to compensate for this restriction. Up and down hills will be worse.
The range of movement needs to be tested in weight bearing as you don't always see it when just moving the ankle. To test and compare sides start on the good leg, with your toes against a wall you should be able to easily bend your knee and touch the wall also. Slowly slide your foot back in increments until you have to lift your heel. This is the weight bearing range of ankle dorsiflexion. Compare to the symptom side.
Also try and hop as high as you can on either leg and see if there is a difference.
See how that goes and you may need to get some help if the joint is still restricted.
Regards
Matt
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Hi Guys,
Tried out a new core workout on Tuesday morning and it was fairly hard. I was fine all day Tuesday but then since yesterday (Wednesday) I've been getting a quite severe pain on the front of my hips everytime I'm stood up straight. It's hasn't eased off at all today even after an hour of yoga. Any suggestions as to what this might be and what I should do to help it calm down?
Cheers!
Hi, sounds like you are getting DOMS (delayed onset muscle soreness) which is a normal muscular response to new or excessive loading of the muscles and usually occurs 24-48hrs after (hence the delayed). If you were doing a lot of core type exercises then you may have been compensating with your hip flexors (deep and in front of the hips) as opposed to your abdominals. For instance if you do a sit up then the abdominals often initiate the movement but the hip flexors will continue to pull you forward to your knees. Don't go mad with core exercises as the most important thing is to be strong and controlled through movement and not become to ridged.
Let me know if it doesn't settle.
Regards
Matt
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Hello Physio peeps,
I've had some shoulder impingement in the past and I think it might have crept back in after a session at the wall where I did an odd shouldery move. Afterwards I had a very slight niggle on the back of my shoulder (sort of inside the shoulder-blade). As it wasn't much of note I've since had about 3-4 training sessions and during the last of these I decided it had got worse and stopped as a result. That was yesterday.
Does this sound like a regular shoulder impingement to you; such that I would do active rest, ice, ibuprofen and the usual exercises. Or is it worth seeking out some hands on assessment?
Also does any other treatment (such as massage/needles) actually help with recovery or is this just witchcraft?
Cheers,
Rich
Hi Rich, if it is near to the shoulder blade then it could be that you have irritated a thoracic joint or even where the rib attaches to the spine. Characteristically the pain is usually quite sharp and may benefit from ibuprofen. Normally they settle with movements of the shoulder, neck and upper back relatively quickly.
If your shoulder is impinging then you will find movements of the arm will be painful sometimes around shoulder height (approx 90 degrees). If it is sore then check to see if your shoulders are at different levels, ie is the symptomatic shoulder depressed. If so then this can lead to a mechanical impingment. Too much load or intense bouldering may have lead to this also. You could try backing of the grades and volume of climbing and see if this is tolerable. Progress as symptoms allow (some discomfort is exceptable but not pain . If it contiues get a review from a physio as rest alone isn't enough.
Regards
Matt
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Hi, you sound like you are doing very well and you have a good range of movement. Often regaining full elbow extension can be a problem. You have regained this and it isn't a bad thing that it no longer hyperextends. Although the ulnar nerve has recovered you may still have some sensitivity with it. Often with dislocations at any joint the nerves can be overstretched.
Try testing how the ulnar nerve moves by comparing sides. To begin, stretch your arm out to the side and have your fingers pointing towards the celing, palm facing outwards, then bend your elbow and continue to move your fingers towards your face (thumb facing forward) until your fingers are on your cheek pointing downwards. You may get a normal pulling sensation. Compare to the other side. If it is more uncomfortable or the discomfort doesn't allow you to do the full movement then it is more sensitive. I would google ulnar nerve mobilsation exercises and try these.
The fact that your arm is getting more pumped is probably because you are still lacking some strength and it won't just be your forarm muscles, all of the left arm will have become weaker and may not have been fully addressed. This lack of global strength may be putting more of a stress through the elbow and this may be the source of the problem.
I would expect a degree of discomfort for up to a year following this kind of injury. You may benefit from a physio review specific to climbing.
Regards
Matt
Yeah, I feel a lot of tension in the back of the elbow when it's bent, so probably the ulnar nerve exercises will help, thanks. Not sure how much strength I actually lost though, as I was only not climbing for 7 weeks end of Feb, all of March, beginning of April. I hadn't really considered seeing a physio again (after the NHS one ran out), but it probably would be a good idea in the new year.
Thanks again.
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For the last 3-4 weeks I've had an off and on soreness/pain/swelling in my left middle finger near the DIP joint. The sensitivity seems to be on the top and sides of the DIP joint towards to fingertip. I don't recall doing anything specific to injure it, and can't seem to pinpoint what makes it sore, so I've just continued traning/climbing on it. However, It has now gotten a bit more consistant, but I still can't figure out any triggers or causes. Any Ideas?
Thanks,
Todd
Any thoughts on the finger. I'm happy to give more details as I'm stumped....
It would appear that crimping is what does it, open/sloper/[pockets are fine. It almost seems as though it something being compressed on the fingernail side of the finger when the DIP joint flexes back during crimping.
Hi Todd,
it sounds like it could be an A5 pulley irritation. This pulley is located on the distal DIP joint. As you may know the more common pulley to injury is the A2 but any of the pulleys can be strained or overloaded. The open crimp puts a large load on all of the pulleys. I would back off the crimping and go for the bigger holds as it is important to still put stress through the tendons and pulleys but not to overload them and cause microtrauma cumulative strains. Basically if you can climb with only mild discomfort then this is ok but don't climb through pain and you shouldn't have a lot of stiffness the next day.
To progress back to crimping start to introduce the odd move and see how it feels. If it is painful do less, if it is ok add a few more moves. You need to have a base that is pain free and move forward and progress the good stresses of climbing to the tendons. Let the tissues adapt but don't overload.
Regards
Matt
Thanks!
"Basically if you can climb with only mild discomfort then this is ok but don't climb through pain and you shouldn't have a lot of stiffness the next day. "
So this is what's odd. It never hurts to climb on it, or even when fingerboarding on it. When crimping it feels weak and After crimping hard it hurts, but never while doing it. It's afterward and the next day that it's swollen and/or sensitive. Massage really seems to help. Anyway, I'll take it easy on the crimping for a while and see if it goes away.
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Not sure how I've done it but I have managed somehow to injure myself. I'm not sure what I've done or exactly what to call it so I'm looking for some advice as to what I may have done and any help advise as to stretches or exercise which could help relieve it.
Symptoms
Numbness in my hand; across the back and in in the palm.
Numbness in fingers and thumb; mostly the thumb and back two
Pain in the forearm; in the area just shy of the elbow
Pain in the upper arm; just round the outside of the elbow, though it hasn't risen higher at all.
Hi, it sounds like you have irritated a nerve in your neck. The symptoms are specific to a certain level. It has probably occured over a period of time and doesn't have to be a specific incident. It is often related to sustained sitting positions with a poor posture and a lack of movement. If you are mainly sitting in the daytime at a computer then regularly change position to break up prolonged positions particularly if they are slumped. I would reccomend you see a local physio for a thorough examination as the symptoms can hang around and you need to know how to best manage them.
Regards
Matt
Thanks Matt. If its neck related I think I might know how I've done it - stood at a pillar drill for hours cutting splinting plates.
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Hi
Recently started to feel pain in my left elbow on the inside. Seems like a clear case of golfers elbow and the pain origins from my ring finger, only my ring finger actually. Placing my underarm flat on the table palm down the pain in the elbow comes then i press down into the table with my ring finger not the other ones. Previously had the exact same problem on the right side. Open handed and sloopers cause pain in the elbow but crimping and half crimping is fine.
What seemed to help on the right side was avoiding jugs, sloopers and just use crimp and half crimp on small holds. Not sure if it's mainly the grip or the fact that going for much smaller holds made my training sessions much shorter, never really used that grip as everyone said it was so dangerous for your fingers. Also that stretch Tom Randall recommend seems to have had positive results.
What kind of excentric exercise would be useful for my ring finger?
Any recommendations what to do to get rid of it and maybe how to prevent it from coming back?
//Tresor
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Hello
Hope you can help.
I had open surgery on my elbow 3 weeks ago, to remove bone spurs in the joint which apparently are a result of wear and tear, and they also displaced the ulnar nerve (think that's what it's called). My arm had got to the point were the bone spurs were preventing me fully straightening my arm. Post-op I wasn't given any physio or exercises to do - just an appointment to see the ortho consultant in January.
The majority of the worst of the visible swelling in the forearm has gone down, but it is still tight, swollen and very tender inside and around the elbow and around the wound, however the range of movement is still very poor, in fact it seems to be getting worse. I keep trying to get my arm to straighten and bend but I would say the max range of movement I can get is 30 degrees at best. Can't bend it to a 90 degrees angle yet, and some way off straightening. It feels like there is something physically restricting movement inside - it feels like if I try to extend it or bend it past a certain point it is going to snap or something! I assume swelling and inflammation are causing this.
Can you recommend any gentle exercises that may help improve mobility. I am worried if I wait until January when I see the consultant there will be other problems occurring with muscles and tendons from lack of use.
Thanks
Nic
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Hello
Hope you can help.
I had open surgery on my elbow 3 weeks ago, to remove bone spurs in the joint which apparently are a result of wear and tear, and they also displaced the ulnar nerve (think that's what it's called). My arm had got to the point were the bone spurs were preventing me fully straightening my arm. Post-op I wasn't given any physio or exercises to do - just an appointment to see the ortho consultant in January.
The majority of the worst of the visible swelling in the forearm has gone down, but it is still tight, swollen and very tender inside and around the elbow and around the wound, however the range of movement is still very poor, in fact it seems to be getting worse. I keep trying to get my arm to straighten and bend but I would say the max range of movement I can get is 30 degrees at best. Can't bend it to a 90 degrees angle yet, and some way off straightening. It feels like there is something physically restricting movement inside - it feels like if I try to extend it or bend it past a certain point it is going to snap or something! I assume swelling and inflammation are causing this.
Can you recommend any gentle exercises that may help improve mobility. I am worried if I wait until January when I see the consultant there will be other problems occurring with muscles and tendons from lack of use.
Thanks
Nic
Hi nic
I read this today and thought you needed a prompt reply. However, it is very difficult to give specific advice about your elbow without examining it. I would contact the hospital and ask for a review and see if they will refer you to Physio. It sounds like you require rehabilitation given the slow progress so far. If they won't refer you for NHS Physio ask if they will let you see a private Physio (recommended) closer to your home.
I suspect they have moved the ulnar nerve and this might be contributing to your symptoms. If you develop increasing weakness and/or pain in your forearm see your GP.
With bony spurt removal there should be no reason not to start early movement but your surgeon might have a reason why they do not want to start this early.
Sorry if this sounds vague but I need further information. If you want to ring me Monday at the clinic I would be happy to discuss progress. (0114 2671223).
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Hello
Hope you can help.
I had open surgery on my elbow 3 weeks ago, to remove bone spurs in the joint which apparently are a result of wear and tear, and they also displaced the ulnar nerve (think that's what it's called). My arm had got to the point were the bone spurs were preventing me fully straightening my arm. Post-op I wasn't given any physio or exercises to do - just an appointment to see the ortho consultant in January.
The majority of the worst of the visible swelling in the forearm has gone down, but it is still tight, swollen and very tender inside and around the elbow and around the wound, however the range of movement is still very poor, in fact it seems to be getting worse. I keep trying to get my arm to straighten and bend but I would say the max range of movement I can get is 30 degrees at best. Can't bend it to a 90 degrees angle yet, and some way off straightening. It feels like there is something physically restricting movement inside - it feels like if I try to extend it or bend it past a certain point it is going to snap or something! I assume swelling and inflammation are causing this.
Can you recommend any gentle exercises that may help improve mobility. I am worried if I wait until January when I see the consultant there will be other problems occurring with muscles and tendons from lack of use.
Thanks
Nic
Hi nic
I read this today and thought you needed a prompt reply. However, it is very difficult to give specific advice about your elbow without examining it. I would contact the hospital and ask for a review and see if they will refer you to Physio. It sounds like you require rehabilitation given the slow progress so far. If they won't refer you for NHS Physio ask if they will let you see a private Physio (recommended) closer to your home.
I suspect they have moved the ulnar nerve and this might be contributing to your symptoms. If you develop increasing weakness and/or pain in your forearm see your GP.
With bony spurt removal there should be no reason not to start early movement but your surgeon might have a reason why they do not want to start this early.
Sorry if this sounds vague but I need further information. If you want to ring me Monday at the clinic I would be happy to discuss progress. (0114 2671223).
PS nic ask to speak to Steve if you ring.
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Hi
Recently started to feel pain in my left elbow on the inside. Seems like a clear case of golfers elbow and the pain origins from my ring finger, only my ring finger actually. Placing my underarm flat on the table palm down the pain in the elbow comes then i press down into the table with my ring finger not the other ones. Previously had the exact same problem on the right side. Open handed and sloopers cause pain in the elbow but crimping and half crimping is fine.
What seemed to help on the right side was avoiding jugs, sloopers and just use crimp and half crimp on small holds. Not sure if it's mainly the grip or the fact that going for much smaller holds made my training sessions much shorter, never really used that grip as everyone said it was so dangerous for your fingers. Also that stretch Tom Randall recommend seems to have had positive results.
What kind of excentric exercise would be useful for my ring finger?
Any recommendations what to do to get rid of it and maybe how to prevent it from coming back?
//Tresor
Hi, i am always mildly sceptical with the term 'golfers elbow' (as i am with tennis elbow) as i know from experience as they can be more than just a tendon pathology. Eccentric exercises have mixed results and again this illustrates that it isn't always a tendon problem. I would tend to assess the neck, upper back (which is nearly always stiff in climbers) and shoulder control and stability. Sometimes proximal (shoulder and upper back)weaknesses and reduced rotation can lead to excessive stresses and overuse at the elbow. We also observe that a lot of climbers can have depressed or dropped shoulders and this can sometimes irritate the nerves through traction as well as it being a poor mechanical position for the shoulder to work from.
There is also a nerve (ulnar) that is on the inside of the elbow and can be a source of symptoms (i have given some previous advice on this page about ulnar nerve exercises - have a look and just try!) either local at the elbow and/or the neck.
The last thing to consider is what you do at work and if it involves a lot of sitting, typing and mouse use then incorporate movements above your head throughout the day and avoid sustained poor postures, basically stand and move whenever possible.
Climbers are a specific group in that they put a lot of stresses through their forearms but depending on how efficient you are depends on how much you are using your grip.
You are right to review the holds that are causing your pain and it is wise to decrease these but continue to climb even if it means reducing yor grades. Rest isn't the best option and by restructuring your training volume and intensity you will still be able to climb. Slowly increase as symptoms allow.
The Tom Randall stretch seems more localised to the elbow as the wrist isn't fully extended. Stretches don't normally help so i wonder whether it is working the elbow joint or the neural structures, like i said there can be many origins of the symptoms.
If it helps do it. Let me know how you get on.
regards
Matt
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Hi, I have injured my tendons in my right hand.
The cause was that I was pulling on a two finger pocket through a roof with my middle two fingers, when my foot slipped heel hooking and my body swung out, overloading my hands. I tried to hold the swing but failed and came off. I think it was as my fingers came out of the pocket, rather than when my foot slipped, that i felt the pain.
Symptoms: the initial pain was dull rather than sharp and went after a few seconds. However, it was deep within my wrist (perhaps 1-2 inches from my hand) rather than in my fingers. As soon i tried to pull on to another problem, there was instant pain again, and a feeling of tenderness/fragility all along the tendon from wrist to fingers (although i cant really tell which of the middle two fi gers it is). After 9 days it has not improved much - past tendon I juries ive had have been pains in fingers that tended to clear up quickly.
If I use all 4 fingers and load my hand in a straight direction, I feel no pain - I can hang off medium crimps on a fingerboard quite happily as normal. On a sloper it is ok with all 4, but feelz like it would cause damage if if I slipped off. However, anything a bit twisted or using fewer fingers - or worse both, is qhickly painful. Some positions cause pain even at lower loads, for example yesterday i picked up a heavy book at an awkward angle and had to instantly drop it. Strangely, I think the pain has now migrated to be more in the hand thN wrist, although this may be position dependent.
Im really looking for help with what the injury actually is, how long it might take to heal, and importantly whether I should try to continue light training, or rest it completely. And also, if rest, am I ok to train straight on with 4 fingers if there is no pain?
Many thanks!
Simon
-
Hi, I’ve had an injury on the middle finger of each hand for more than a year now- it gets better with rest or climbing solely on big holds but never completely goes away. I flared it up again on my left hand just before Christmas and have decided to try and fix it for good this time so I’m most of the way through my second week of not climbing and icing every evening. It’d be good to get a professional opinion of what the injury is and whether I need to do anything different or supplementary to what I’m doing.
It’s on the back (ie the knuckle) of the PIP joint of each middle finger (slightly on the ring finger of my right too)- when I aggravate it the joint swells up noticeably and I can’t bend the finger very far due to pain on the knuckle. Even when it’s at its best neither finger will bend enough to touch the tip to the base of the palm- currently I can get my right to about 1.5cm away and my left only to 2.5-3cm away. The slightly affected right ring finger will almost touch but not quite.
Thanks!
-
Hi
Recently started to feel pain in my left elbow on the inside. Seems like a clear case of golfers elbow and the pain origins from my ring finger, only my ring finger actually. Placing my underarm flat on the table palm down the pain in the elbow comes then i press down into the table with my ring finger not the other ones. Previously had the exact same problem on the right side. Open handed and sloopers cause pain in the elbow but crimping and half crimping is fine.
What seemed to help on the right side was avoiding jugs, sloopers and just use crimp and half crimp on small holds. Not sure if it's mainly the grip or the fact that going for much smaller holds made my training sessions much shorter, never really used that grip as everyone said it was so dangerous for your fingers. Also that stretch Tom Randall recommend seems to have had positive results.
What kind of excentric exercise would be useful for my ring finger?
Any recommendations what to do to get rid of it and maybe how to prevent it from coming back?
//Tresor
Hi, i am always mildly sceptical with the term 'golfers elbow' (as i am with tennis elbow) as i know from experience as they can be more than just a tendon pathology. Eccentric exercises have mixed results and again this illustrates that it isn't always a tendon problem. I would tend to assess the neck, upper back (which is nearly always stiff in climbers) and shoulder control and stability. Sometimes proximal (shoulder and upper back)weaknesses and reduced rotation can lead to excessive stresses and overuse at the elbow. We also observe that a lot of climbers can have depressed or dropped shoulders and this can sometimes irritate the nerves through traction as well as it being a poor mechanical position for the shoulder to work from.
There is also a nerve (ulnar) that is on the inside of the elbow and can be a source of symptoms (i have given some previous advice on this page about ulnar nerve exercises - have a look and just try!) either local at the elbow and/or the neck.
The last thing to consider is what you do at work and if it involves a lot of sitting, typing and mouse use then incorporate movements above your head throughout the day and avoid sustained poor postures, basically stand and move whenever possible.
Climbers are a specific group in that they put a lot of stresses through their forearms but depending on how efficient you are depends on how much you are using your grip.
You are right to review the holds that are causing your pain and it is wise to decrease these but continue to climb even if it means reducing yor grades. Rest isn't the best option and by restructuring your training volume and intensity you will still be able to climb. Slowly increase as symptoms allow.
The Tom Randall stretch seems more localised to the elbow as the wrist isn't fully extended. Stretches don't normally help so i wonder whether it is working the elbow joint or the neural structures, like i said there can be many origins of the symptoms.
If it helps do it. Let me know how you get on.
regards
Matt
Hi
Thanks for your input, much appreciated. Sorry for the late reply from my side but christmas stopped me from any climbing related stuff. The rest actually seemed to help to some extent this time, rest in like carrying around a 1,5 and a 2,5 year old and doing a few home improvement projects. Managed to get around to climb yesterday and got convinced by a friend to visit another local climbing gym in my town, he said the grips there were more like my moonboard and he was right and the walls were much steeper than my ordinary gym.
Feel much better in the left elbow today and still no sign of pain in my right. Can't say for sure if it is the grips themselves or the fact that steeper wall and poorer grips reduces the amount of actual climbing.
Just really happy right now as it feels I pretty much dialed in what to do and what not to do to get this sorted. Regarding the nerve thing I actually visited a chiropractor about my back as I have some "locked discs" (freely translated from swedish) I guess from years of bad posture at the desk and carrying around kids for almost 3 years now. He got more interested in the elbows as it was something he was certain he could fix but he couldn't find anything nothing wrong with the neck or shoulders.
If it is the tendoins will they become stronger with time or will I be in risk of getting these kinds of injuries all the time?
Really glad as I think I now know how to handle this.
//Tresor
-
Hi, I have injured my tendons in my right hand.
The cause was that I was pulling on a two finger pocket through a roof with my middle two fingers, when my foot slipped heel hooking and my body swung out, overloading my hands. I tried to hold the swing but failed and came off. I think it was as my fingers came out of the pocket, rather than when my foot slipped, that i felt the pain.
Symptoms: the initial pain was dull rather than sharp and went after a few seconds. However, it was deep within my wrist (perhaps 1-2 inches from my hand) rather than in my fingers. As soon i tried to pull on to another problem, there was instant pain again, and a feeling of tenderness/fragility all along the tendon from wrist to fingers (although i cant really tell which of the middle two fi gers it is). After 9 days it has not improved much - past tendon I juries ive had have been pains in fingers that tended to clear up quickly.
If I use all 4 fingers and load my hand in a straight direction, I feel no pain - I can hang off medium crimps on a fingerboard quite happily as normal. On a sloper it is ok with all 4, but feelz like it would cause damage if if I slipped off. However, anything a bit twisted or using fewer fingers - or worse both, is qhickly painful. Some positions cause pain even at lower loads, for example yesterday i picked up a heavy book at an awkward angle and had to instantly drop it. Strangely, I think the pain has now migrated to be more in the hand thN wrist, although this may be position dependent.
Im really looking for help with what the injury actually is, how long it might take to heal, and importantly whether I should try to continue light training, or rest it completely. And also, if rest, am I ok to train straight on with 4 fingers if there is no pain?
Many thanks!
Simon
Hi Simon, sorry about the delay in getting back to you but with xmas and holidays today is the first friday Q and A of the year. I would certainly recommend light training as opposed to total rest as you need to put some stress through the muscles and tendons for improvement to occur. It sounds like you have overloaded the tendons and rather than get a pulley injury it is further along and closer to the muscle tendon junction. The reason it is less painful when you use all fingers is that you are distributing the load through all the finger tendons and not two. It will probably take 4-6 weeks of progression back up the grades and increasing the load as well as progressing from larger holds to crimping and individual finger holds. Graded stresses will allow tissues to strengthen but too much load will not allow the tissues to adapt and strengthen. Some discomfort is acceptable but sharp pain is not.
Let me know how you are going.
regards
Matt
-
Hi, I've had an injury on the middle finger of each hand for more than a year now- it gets better with rest or climbing solely on big holds but never completely goes away. I flared it up again on my left hand just before Christmas and have decided to try and fix it for good this time so I'm most of the way through my second week of not climbing and icing every evening. It'd be good to get a professional opinion of what the injury is and whether I need to do anything different or supplementary to what I'm doing.
It's on the back (IE the knuckle) of the PIP joint of each middle finger (slightly on the ring finger of my right too)- when I aggravate it the joint swells up noticeably and I can't bend the finger very far due to pain on the knuckle. Even when it's at its best neither finger will bend enough to touch the tip to the base of the palm- currently I can get my right to about 1.5cm away and my left only to 2.5-3cm away. The slightly affected right ring finger will almost touch but not quite.
Thanks!
Hi, it definitely sounds like it is more of a joint problem than a tendon. As you will know climbers tend to put more load/strain through the middle and ring fingers. The joint is reacting by swelling and then the capsule (ligamentous structure surrounding the joint) is tightening up. I wouldn't advocate total rest but climb using larger holds. I think you need to regularly stretch the joint into both flexion (bending towards the palm) and extension (fingers flat on a table and push the joint straight) to try and regain full ranges. Climbers fingers can get tight and the joints can look thicker due to the continual loading etc. Try and regain the range of movement and then incorporate occasional finger holds but not too many at first. If you are local it might be worth a visit just to teach you how to self manage.
regards
Matt
-
Hi
Recently started to feel pain in my left elbow on the inside. Seems like a clear case of golfers elbow and the pain origins from my ring finger, only my ring finger actually. Placing my underarm flat on the table palm down the pain in the elbow comes then i press down into the table with my ring finger not the other ones. Previously had the exact same problem on the right side. Open handed and sloopers cause pain in the elbow but crimping and half crimping is fine.
What seemed to help on the right side was avoiding jugs, sloopers and just use crimp and half crimp on small holds. Not sure if it's mainly the grip or the fact that going for much smaller holds made my training sessions much shorter, never really used that grip as everyone said it was so dangerous for your fingers. Also that stretch Tom Randall recommend seems to have had positive results.
What kind of excentric exercise would be useful for my ring finger?
Any recommendations what to do to get rid of it and maybe how to prevent it from coming back?
//Tresor
Hi, i am always mildly sceptical with the term 'golfers elbow' (as i am with tennis elbow) as i know from experience as they can be more than just a tendon pathology. Eccentric exercises have mixed results and again this illustrates that it isn't always a tendon problem. I would tend to assess the neck, upper back (which is nearly always stiff in climbers) and shoulder control and stability. Sometimes proximal (shoulder and upper back)weaknesses and reduced rotation can lead to excessive stresses and overuse at the elbow. We also observe that a lot of climbers can have depressed or dropped shoulders and this can sometimes irritate the nerves through traction as well as it being a poor mechanical position for the shoulder to work from.
There is also a nerve (ulnar) that is on the inside of the elbow and can be a source of symptoms (i have given some previous advice on this page about ulnar nerve exercises - have a look and just try!) either local at the elbow and/or the neck.
The last thing to consider is what you do at work and if it involves a lot of sitting, typing and mouse use then incorporate movements above your head throughout the day and avoid sustained poor postures, basically stand and move whenever possible.
Climbers are a specific group in that they put a lot of stresses through their forearms but depending on how efficient you are depends on how much you are using your grip.
You are right to review the holds that are causing your pain and it is wise to decrease these but continue to climb even if it means reducing yor grades. Rest isn't the best option and by restructuring your training volume and intensity you will still be able to climb. Slowly increase as symptoms allow.
The Tom Randall stretch seems more localised to the elbow as the wrist isn't fully extended. Stretches don't normally help so i wonder whether it is working the elbow joint or the neural structures, like i said there can be many origins of the symptoms.
If it helps do it. Let me know how you get on.
regards
Matt
Hi
Thanks for your input, much appreciated. Sorry for the late reply from my side but christmas stopped me from any climbing related stuff. The rest actually seemed to help to some extent this time, rest in like carrying around a 1,5 and a 2,5 year old and doing a few home improvement projects. Managed to get around to climb yesterday and got convinced by a friend to visit another local climbing gym in my town, he said the grips there were more like my moonboard and he was right and the walls were much steeper than my ordinary gym.
Feel much better in the left elbow today and still no sign of pain in my right. Can't say for sure if it is the grips themselves or the fact that steeper wall and poorer grips reduces the amount of actual climbing.
Just really happy right now as it feels I pretty much dialed in what to do and what not to do to get this sorted. Regarding the nerve thing I actually visited a chiropractor about my back as I have some "locked discs" (freely translated from swedish) I guess from years of bad posture at the desk and carrying around kids for almost 3 years now. He got more interested in the elbows as it was something he was certain he could fix but he couldn't find anything nothing wrong with the neck or shoulders.
If it is the tendoins will they become stronger with time or will I be in risk of getting these kinds of injuries all the time?
Really glad as I think I now know how to handle this.
//Tresor
Hi again, IF!! it is a tendon then it should improve as long as the load does not exceed the tissues ability to adapt. Any how you sound like you are managing better and looking at all possible contributing factors.
Regards
Matt
-
Sorry to sully this thread with a lower limb problem but .....
As I mentioned when I saw you last week, while off climbing I've started running and was intending to do a marathon.
I generally run five or six times per month and cover ~50km. However when I started my training I weighed up my current distance capabilities then jumped straight into an intermediate training schedule covering over 50km in five runs over one week.
After one long run I had a sore Achilles for a day and tight calves. The Achilles soreness went quickly and reasoning that the calves would loosen up when warm I carried on with my next run, but unfortunately toward the end the Achilles suddenly started to hurt badly and I ended up limping home quite badly. I spent a week resting, icing & stretching and it felt fine, I was able to do things like: climb using small footholds; scramble with the kids climbing over and around rocks; and run up stairs, all pain free.
I then tried a short trot and it was fine for 30 minutes before it started niggling again. This was yesterday and again my calves are tightened up and legs are generally much sorer than I'd expect for such a gentle run. This despite warming down much more thoroughly than normal.
Anyway, I'm sure it's not an Achilles problem (otherwise I wouldn't be able to weight a small foothold?) but that's where it's manifesting. This point on my calf is quite tender if that helps.
(http://farm6.staticflickr.com/5533/11993468413_61a0bb9883_c.jpg) (http://www.flickr.com/photos/ijt/11993468413/)
I've found some stretches and yoga poses to try, anything else you could suggest? Some sites suggest massage using a tennis ball?
Cheers
Ian
-
Sorry to sully this thread with a lower limb problem but .....
As I mentioned when I saw you last week, while off climbing I've started running and was intending to do a marathon.
I generally run five or six times per month and cover ~50km. However when I started my training I weighed up my current distance capabilities then jumped straight into an intermediate training schedule covering over 50km in five runs over one week.
After one long run I had a sore Achilles for a day and tight calves. The Achilles soreness went quickly and reasoning that the calves would loosen up when warm I carried on with my next run, but unfortunately toward the end the Achilles suddenly started to hurt badly and I ended up limping home quite badly. I spent a week resting, icing & stretching and it felt fine, I was able to do things like: climb using small footholds; scramble with the kids climbing over and around rocks; and run up stairs, all pain free.
I then tried a short trot and it was fine for 30 minutes before it started niggling again. This was yesterday and again my calves are tightened up and legs are generally much sorer than I'd expect for such a gentle run. This despite warming down much more thoroughly than normal.
Anyway, I'm sure it's not an Achilles problem (otherwise I wouldn't be able to weight a small foothold?) but that's where it's manifesting. This point on my calf is quite tender if that helps.
(http://farm6.staticflickr.com/5533/11993468413_61a0bb9883_c.jpg) (http://www.flickr.com/photos/ijt/11993468413/)
I've found some stretches and yoga poses to try, anything else you could suggest? Some sites suggest massage using a tennis ball?
Cheers
Ian
Hi Ian, you most definitely have increased your running volume too soon and as a result have a cumulative strain. It would be similar to a climber only climbing 1-2 a week and then going away for a two week period and climbing most days. You should always be cautious when increasing volume too quickly and overloading the muscle more than it can adapt (Have a look at this link and go to the quantification of stress pdf, http://www.therunningclinic.com/en/runners-information/tools-for-runners.php (http://www.therunningclinic.com/en/runners-information/tools-for-runners.php)).
Your previous running was probably not enough and hence you would be better to run atleast 4-6 a week but start with smaller volumes and even start with walk - runs particularly as you now have an injury. Have a look at the same link as above but look at the interval programmes 1 and 2. You are better to run frequently and do not increase the volume more than 10%.
The injury could also be due to asymmetries that may need to be addressed.
I would initially reduce volume (either using the more conservative interval programme 1 or the less interval programme 2) so that you are running relatively pain free and only increase when you are comfortable. At least this way you have objective markers and you can assess the progress. Massage may relieve some tightness but the best thing is to put a degree of stress through the problem area but an amount that will strengthen the tissue and not overload it.
Hope this helps and come and see either Steve or myself if you aren't improving.
regards
Matt
-
I know I have strained a finger yesterday but I would like some help trying to work out how bad it is, having not had finger stain in the past I don't rally have a frame of reference.
Pushing a roof problem yesterday I had the majority of my weight held on one hand and one foot when moving for the next hold. As I did so the was a pop/crack sound - similar to joints cracking in my finger, ring finger of my right hand. I lost grip and fell. The grip would have been a half crimp.
It isn't generally painfully but it does ache if put through a full range of motion. It ache mostly in the midsection of the finger - between the two middle joints. To flex the finger doesn't make ache increase during the movement but it does change the feeling, to a thick sausagey sensation.
In terms of movement, I can flex from the hand fine and the first joint moving up the finger. I can't curl the joint to the tip very well or far and the whole finger feels weak in general and slightly plump, and slightly numb.
So far I have treated it with:
Stopped climbing immediately.
Cold compress
Elevation
And over night, anti inflammatories and sleep.
Hope you can help
Richard
-
I know I have strained a finger yesterday but I would like some help trying to work out how bad it is, having not had finger stain in the past I don't rally have a frame of reference.
Pushing a roof problem yesterday I had the majority of my weight held on one hand and one foot when moving for the next hold. As I did so the was a pop/crack sound - similar to joints cracking in my finger, ring finger of my right hand. I lost grip and fell. The grip would have been a half crimp.
It isn't generally painfully but it does ache if put through a full range of motion. It ache mostly in the midsection of the finger - between the two middle joints. To flex the finger doesn't make ache increase during the movement but it does change the feeling, to a thick sausagey sensation.
In terms of movement, I can flex from the hand fine and the first joint moving up the finger. I can't curl the joint to the tip very well or far and the whole finger feels weak in general and slightly plump, and slightly numb.
So far I have treated it with:
Stopped climbing immediately.
Cold compress
Elevation
And over night, anti inflammatories and sleep.
Hope you can help
Richard
Hi Richard, sorry for the delay in response but we only answer questions on a friday each week. It sounds as if you have strained a pulley possibly your A2. Basically you have 5 ligamentous pulleys on each finger and their aim is to keep the tendons in place. Crimping puts a large load on these and more commonly the middle and ring fingers tend to be the ones that are injured.
Usually you have to have a period of rest then slowly reload the fingers in a graded way to allow the tisue to heal and then strengthen. You need to have full movement in all your fingers and it is certainly (now a week on) ok to push the stretches or movements now. You will have to start with bigger jug holds and slowly introduce crimping. Some discomfort is acceptable but not pain. Increase resistance as able.
A good exercise to regain a nice curl and uncurl of the 3 joints in your middle finger is to start with the fingers fully flexed and give a little resistance to the end of the finger and keep this pressure on throughout the movement. Then slowly uncurl the finger and check if all the joints are uncurling in an equal fashion ie none of them are flicking straight. Increase the resistance as long as they uncurl equally.
Let me know how things are going.
regards
Matt
-
Hi
I think I have tight pec muscles (major and minor), which are pulling my shoulders out of position and giving me pain. Most probably as a result of poor posture and bouldering.
I am trying to correct my posture, but my back muscles are constantly having to fight the pecs. I have tried various stretches but they are quite difficult muscles to stretch without torquing the shoulder joint.
I read that active stretching can be more effective than passive or static? Can you give some advice on the best way to get these muscles to stretch and lengthen?
Cheers
Bagger
-
I know I have strained a finger yesterday but I would like some help trying to work out how bad it is, having not had finger stain in the past I don't rally have a frame of reference.
Pushing a roof problem yesterday I had the majority of my weight held on one hand and one foot when moving for the next hold. As I did so the was a pop/crack sound - similar to joints cracking in my finger, ring finger of my right hand. I lost grip and fell. The grip would have been a half crimp.
It isn't generally painfully but it does ache if put through a full range of motion. It ache mostly in the midsection of the finger - between the two middle joints. To flex the finger doesn't make ache increase during the movement but it does change the feeling, to a thick sausagey sensation.
In terms of movement, I can flex from the hand fine and the first joint moving up the finger. I can't curl the joint to the tip very well or far and the whole finger feels weak in general and slightly plump, and slightly numb.
So far I have treated it with:
Stopped climbing immediately.
Cold compress
Elevation
And over night, anti inflammatories and sleep.
Hope you can help
Richard
Hi Richard, sorry for the delay in response but we only answer questions on a friday each week. It sounds as if you have strained a pulley possibly your A2. Basically you have 5 ligamentous pulleys on each finger and their aim is to keep the tendons in place. Crimping puts a large load on these and more commonly the middle and ring fingers tend to be the ones that are injured.
Usually you have to have a period of rest then slowly reload the fingers in a graded way to allow the tisue to heal and then strengthen. You need to have full movement in all your fingers and it is certainly (now a week on) ok to push the stretches or movements now. You will have to start with bigger jug holds and slowly introduce crimping. Some discomfort is acceptable but not pain. Increase resistance as able.
A good exercise to regain a nice curl and uncurl of the 3 joints in your middle finger is to start with the fingers fully flexed and give a little resistance to the end of the finger and keep this pressure on throughout the movement. Then slowly uncurl the finger and check if all the joints are uncurling in an equal fashion ie none of them are flicking straight. Increase the resistance as long as they uncurl equally.
Let me know how things are going.
regards
Matt
Hi matt
Thanks for getting back to me. After being pested by the otherhalf and my finger going blackish and heavy bruising starting to come out I went to my local minor injuries unit. When I asked for them to look at scanning to see if it was a pulley injury the nurse looked confussed, i explained about how i had done it and that a puleyl injury was a distinct possibility. She said she didnt quiet understand and that id need to have a an xray first then see the dr. A quick xray and a brief chat l lead to a referal later that day to the hand specialist at the local hospital. The dr at the hospital looked at the xrays examined the hand and fingers and told me that tmy volar plate has torn a section of bone off and that I was going to be referred to an advanced hand therapy specialist at another hospital (lucky for me its closer to home). Ive seen the specialist there and she was really helpful and patient with my questions and with any luck im on the right track to recovery, she did say that it might take up to 12 weeks to heal but if i behave myself (no climbing, no downhill, no trackdays extremely careful with work) and do whatever is needed is could be lucky and shave a little time off. then get back to building it up. the only lucky one in this mess is my brother who is going to pinch my brand new kintaros which arrived earlier this week after i order them the thursday before the injury on the friday.... ::)
thanks again for your help and advise matt.
rich
-
I know I have strained a finger yesterday but I would like some help trying to work out how bad it is, having not had finger stain in the past I don't rally have a frame of reference.
Pushing a roof problem yesterday I had the majority of my weight held on one hand and one foot when moving for the next hold. As I did so the was a pop/crack sound - similar to joints cracking in my finger, ring finger of my right hand. I lost grip and fell. The grip would have been a half crimp.
It isn't generally painfully but it does ache if put through a full range of motion. It ache mostly in the midsection of the finger - between the two middle joints. To flex the finger doesn't make ache increase during the movement but it does change the feeling, to a thick sausagey sensation.
In terms of movement, I can flex from the hand fine and the first joint moving up the finger. I can't curl the joint to the tip very well or far and the whole finger feels weak in general and slightly plump, and slightly numb.
So far I have treated it with:
Stopped climbing immediately.
Cold compress
Elevation
And over night, anti inflammatories and sleep.
Hope you can help
Richard
Hi Richard, sorry for the delay in response but we only answer questions on a friday each week. It sounds as if you have strained a pulley possibly your A2. Basically you have 5 ligamentous pulleys on each finger and their aim is to keep the tendons in place. Crimping puts a large load on these and more commonly the middle and ring fingers tend to be the ones that are injured.
Usually you have to have a period of rest then slowly reload the fingers in a graded way to allow the tisue to heal and then strengthen. You need to have full movement in all your fingers and it is certainly (now a week on) ok to push the stretches or movements now. You will have to start with bigger jug holds and slowly introduce crimping. Some discomfort is acceptable but not pain. Increase resistance as able.
A good exercise to regain a nice curl and uncurl of the 3 joints in your middle finger is to start with the fingers fully flexed and give a little resistance to the end of the finger and keep this pressure on throughout the movement. Then slowly uncurl the finger and check if all the joints are uncurling in an equal fashion ie none of them are flicking straight. Increase the resistance as long as they uncurl equally.
Let me know how things are going.
regards
Matt
Hi matt
Thanks for getting back to me. After being pested by the otherhalf and my finger going blackish and heavy bruising starting to come out I went to my local minor injuries unit. When I asked for them to look at scanning to see if it was a pulley injury the nurse looked confussed, i explained about how i had done it and that a puleyl injury was a distinct possibility. She said she didnt quiet understand and that id need to have a an xray first then see the dr. A quick xray and a brief chat l lead to a referal later that day to the hand specialist at the local hospital. The dr at the hospital looked at the xrays examined the hand and fingers and told me that tmy volar plate has torn a section of bone off and that I was going to be referred to an advanced hand therapy specialist at another hospital (lucky for me its closer to home). Ive seen the specialist there and she was really helpful and patient with my questions and with any luck im on the right track to recovery, she did say that it might take up to 12 weeks to heal but if i behave myself (no climbing, no downhill, no trackdays extremely careful with work) and do whatever is needed is could be lucky and shave a little time off. then get back to building it up. the only lucky one in this mess is my brother who is going to pinch my brand new kintaros which arrived earlier this week after i order them the thursday before the injury on the friday.... ::)
thanks again for your help and advise matt.
rich
Hi Rich, thanks for the feedback. The volar plate is attached to the A1,3 and 5 at the joints so the force obviously pulled a little bit of bone off. I am glad the treatment is conservative as these type of injuries do recover and surgical outcomes are not always favourable. start to move asap and perhaps see a physio that is a hand specialist or familiar with climbing injuries.
all the best Matt
-
Hi
I think I have tight pec muscles (major and minor), which are pulling my shoulders out of position and giving me pain. Most probably as a result of poor posture and bouldering.
I am trying to correct my posture, but my back muscles are constantly having to fight the pecs. I have tried various stretches but they are quite difficult muscles to stretch without torquing the shoulder joint.
I read that active stretching can be more effective than passive or static? Can you give some advice on the best way to get these muscles to stretch and lengthen?
Cheers
Bagger
Hi Bagger, the issues that climbers often have with postures is that they work a lot of the muscles ie the pecs and biceps that all tend to pull us forward into a flexed (kyphotic ) position. Combine this with a sitting job and this reinforces a flexed posture. We recommend regular standing and moving when possible and walks at lunchtime, basically variety of movement and not sustained poor postures during
Be careful with excessive pec stretching as it sounds as if you are stressing the front of the shoulder joint. I would tend to do the opposite movements to what the pectoral muscles (agonist) do ie work the antagonist muscle groups. An example would be holding a light weight in your right hand, start with it infront of your left hip and move across your body and out to the right side above your head. Be careful when you do biceps exercises (elbow bends) that your pecs aren't overly contracting. The aim is do decrease overactivity of the pecs and return the balance of agonist and antagonist muscles.
A good a safe stretch to the pecs and the thoracic spine (mid/upper back - this tends to be stiff in climbers) is lying backwards over a gym ball and slowly take your arms out to the side to where you feel the pecs stretching. You should feel the mid/upper back stretching and your back will be supported by the curve of the ball.
Hope this helps
regards
Matt
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The good news is there are many physiotherapy solutions to a frozen shoulder and relief can be obtained quickly once treatment begins. With treatment, pain will decrease and the ability to move the joint will slowly return.
-
Hi there,
Was doing a campus board session yesterday and noticed some pain in my brachialis so stopped and have iced etc. Have one very sore point and a slight discomfort flexing elbow so hoping its not too serious.
I did do a boulder problem the other day that required a deep lock and reach and I got a shooting pain down the side of my neck, have read that neck/shoulder probs can result in brachialis problems so could it be related? I am recovering from a strained hamstring so have increased the fingerboarding , pullups and campusing recently so guess I've overdone it which may be the cause? :(
Once the initial inflammation has settled am I ok to start doing dead hangs?Will using it 'statically' inflame it? Or do I need to lay off for a while and see a physio for best results?
Many thanks!
-
The good news is there are many physiotherapy solutions to a frozen shoulder and relief can be obtained quickly once treatment begins. With treatment, pain will decrease and the ability to move the joint will slowly return.
Hi, this is an interesting and debatable pathology.
Adhesive capsulitis (frozen shoulder) is often missed diagnosed and hence you find a variety of shoulder pathologies can be put under this diagnosis when shoulder movements are restricted.
A true adhesive capsulitis will restrict movement in all ranges and at certain stages of the pathology patients are best to continue with exercises alone as manual techniques may only have short term benefits. There are no links to the cause of the pathology and it can last for many months and into years. In my experience there are certain stages that benefit from manual treatments particularly when the acute 'freezing' phase has stopped and stiffness is then the main problem. The good news is that the pathology will settle and full movement in most cases will return, and this is important for the patient to know.
-
Hi there,
Was doing a campus board session yesterday and noticed some pain in my brachialis so stopped and have iced etc. Have one very sore point and a slight discomfort flexing elbow so hoping its not too serious.
I did do a boulder problem the other day that required a deep lock and reach and I got a shooting pain down the side of my neck, have read that neck/shoulder probs can result in brachialis problems so could it be related? I am recovering from a strained hamstring so have increased the fingerboarding , pullups and campusing recently so guess I've overdone it which may be the cause? :(
Once the initial inflammation has settled am I ok to start doing dead hangs?Will using it 'statically' inflame it? Or do I need to lay off for a while and see a physio for best results?
Many thanks!
Hi, if you are also doing dyno moves on the campus board this will bring in more biceps/brachialis activity to gain the momentum. These muscles will have to contract and slow down the movement. As i am sure you know campus board exercises are intense and if you are also doing more upper body work due to your hamstring strain then i think you are right in that you have just overloaded things. You are also right in that neck pain can refer into the arm and when you were locking out that puts alot of compressive load through the elbow and tension through you neck and trunk (on that side) to basically fix/stabilise your movement. Check you have full neck movement ie rotation left and right, looking up and down aswell as a combination of the above. I would recommend decreasing the intensity of your climbing and grades, and move rather than be too static even if this involves more traversing than up. If this is too painful then have a couple of days rest from climbing but try and do some form of exercise.
If this doesn't settle go and see a physio.
regards
Matt
-
Hi, I have injured my tendons in my right hand.
The cause was that I was pulling on a two finger pocket through a roof with my middle two fingers, when my foot slipped heel hooking and my body swung out, overloading my hands. I tried to hold the swing but failed and came off. I think it was as my fingers came out of the pocket, rather than when my foot slipped, that i felt the pain.
Symptoms: the initial pain was dull rather than sharp and went after a few seconds. However, it was deep within my wrist (perhaps 1-2 inches from my hand) rather than in my fingers. As soon i tried to pull on to another problem, there was instant pain again, and a feeling of tenderness/fragility all along the tendon from wrist to fingers (although i cant really tell which of the middle two fi gers it is). After 9 days it has not improved much - past tendon I juries ive had have been pains in fingers that tended to clear up quickly.
If I use all 4 fingers and load my hand in a straight direction, I feel no pain - I can hang off medium crimps on a fingerboard quite happily as normal. On a sloper it is ok with all 4, but feelz like it would cause damage if if I slipped off. However, anything a bit twisted or using fewer fingers - or worse both, is qhickly painful. Some positions cause pain even at lower loads, for example yesterday i picked up a heavy book at an awkward angle and had to instantly drop it. Strangely, I think the pain has now migrated to be more in the hand thN wrist, although this may be position dependent.
Im really looking for help with what the injury actually is, how long it might take to heal, and importantly whether I should try to continue light training, or rest it completely. And also, if rest, am I ok to train straight on with 4 fingers if there is no pain?
Many thanks!
Simon
Hi Simon, sorry about the delay in getting back to you but with xmas and holidays today is the first friday Q and A of the year. I would certainly recommend light training as opposed to total rest as you need to put some stress through the muscles and tendons for improvement to occur. It sounds like you have overloaded the tendons and rather than get a pulley injury it is further along and closer to the muscle tendon junction. The reason it is less painful when you use all fingers is that you are distributing the load through all the finger tendons and not two. It will probably take 4-6 weeks of progression back up the grades and increasing the load as well as progressing from larger holds to crimping and individual finger holds. Graded stresses will allow tissues to strengthen but too much load will not allow the tissues to adapt and strengthen. Some discomfort is acceptable but sharp pain is not.
Let me know how you are going.
regards
Matt
Hi Matt,
Thanks for getting back to me. It's mostly developed as you predicted - I'm 6-7 weeks post-injury now and been back to full strength with 4 fingers for a few weeks. I'm almost there with three fingers as well, as of the last fortnight or so - the only thing that causes pain is if I do max hangs on the front three on the small rung on a BM2000. So I'm being very careful with this! Back three is now fine and, weirdly, whether the front three hurts depends on the position of my unloaded little finger.
I started the other night weighting two fingers properly for the first time (on the better pockets) - front and back two were ok but using middle two on the decent pockets still gives a little pain (dull ache, not sharp, but obviously I don't want to do anything silly). Overall recovery seems to be going pretty well. I'm doing a lot of low intensity stamina training at the wall but avoiding small pockets, and just trying to develop/recover my strength on these on the finger board - although its higher load, I figure its also much more controlled, and the last thing I want to do is pop out of something unexpectedly again.
Do you have any further advice?
Thanks!
Simon
-
Hi, I have injured my tendons in my right hand.
The cause was that I was pulling on a two finger pocket through a roof with my middle two fingers, when my foot slipped heel hooking and my body swung out, overloading my hands. I tried to hold the swing but failed and came off. I think it was as my fingers came out of the pocket, rather than when my foot slipped, that i felt the pain.
Symptoms: the initial pain was dull rather than sharp and went after a few seconds. However, it was deep within my wrist (perhaps 1-2 inches from my hand) rather than in my fingers. As soon i tried to pull on to another problem, there was instant pain again, and a feeling of tenderness/fragility all along the tendon from wrist to fingers (although i cant really tell which of the middle two fi gers it is). After 9 days it has not improved much - past tendon I juries ive had have been pains in fingers that tended to clear up quickly.
If I use all 4 fingers and load my hand in a straight direction, I feel no pain - I can hang off medium crimps on a fingerboard quite happily as normal. On a sloper it is ok with all 4, but feelz like it would cause damage if if I slipped off. However, anything a bit twisted or using fewer fingers - or worse both, is qhickly painful. Some positions cause pain even at lower loads, for example yesterday i picked up a heavy book at an awkward angle and had to instantly drop it. Strangely, I think the pain has now migrated to be more in the hand thN wrist, although this may be position dependent.
Im really looking for help with what the injury actually is, how long it might take to heal, and importantly whether I should try to continue light training, or rest it completely. And also, if rest, am I ok to train straight on with 4 fingers if there is no pain?
Many thanks!
Simon
Hi Simon, sorry about the delay in getting back to you but with xmas and holidays today is the first friday Q and A of the year. I would certainly recommend light training as opposed to total rest as you need to put some stress through the muscles and tendons for improvement to occur. It sounds like you have overloaded the tendons and rather than get a pulley injury it is further along and closer to the muscle tendon junction. The reason it is less painful when you use all fingers is that you are distributing the load through all the finger tendons and not two. It will probably take 4-6 weeks of progression back up the grades and increasing the load as well as progressing from larger holds to crimping and individual finger holds. Graded stresses will allow tissues to strengthen but too much load will not allow the tissues to adapt and strengthen. Some discomfort is acceptable but sharp pain is not.
Let me know how you are going.
regards
Matt
Hi Matt,
Thanks for getting back to me. It's mostly developed as you predicted - I'm 6-7 weeks post-injury now and been back to full strength with 4 fingers for a few weeks. I'm almost there with three fingers as well, as of the last fortnight or so - the only thing that causes pain is if I do max hangs on the front three on the small rung on a BM2000. So I'm being very careful with this! Back three is now fine and, weirdly, whether the front three hurts depends on the position of my unloaded little finger.
I started the other night weighting two fingers properly for the first time (on the better pockets) - front and back two were ok but using middle two on the decent pockets still gives a little pain (dull ache, not sharp, but obviously I don't want to do anything silly). Overall recovery seems to be going pretty well. I'm doing a lot of low intensity stamina training at the wall but avoiding small pockets, and just trying to develop/recover my strength on these on the finger board - although its higher load, I figure its also much more controlled, and the last thing I want to do is pop out of something unexpectedly again.
Do you have any further advice?
Thanks!
Simon
Hi Simon, i am glad things are progressing and you have been sensible in your grading of exercises.
The possible reason for the pain when the little finger is in unloaded in different positions may be due to the fact that all 4 fingers have tendons from the same 2 muscle bellies (Flexor digitorum superficialis and flexor digitorum profundus) and the pull on the actual muscle from the tendons will differ if one of the tendons is unloaded. The little and index fingers also have extra muscles/tendons so that they can move independently to the ring and middle fingers.
It is right to now ok to increase the load through the tendons, and to be objective and more controlled start to increase the time on these holds and don't have to many intense sessions close together. Don't push into pain but some discomfort is acceptable. Continue as you are.
regards
Matt
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Hi
Ok my problem/pain is in my right bicep. I can make it hurt by contracting bicep with my palm facing out. The pain is near the elbow end of the bicep. Its been like this a while, about month and half. I train or boulder lets say an average of 4/5 days a week, maybe pushing it a bit recently. I actually have a similar pain in the left bicep as well, but less so.
cheers in advance
-
Hi Guys,
Since New Year I've been doing quite a bit of specific climbing training. Volume wise it's probably been no more than my usual climbing schedule, but definitely more targeted exercises (fingerboarding, steep boards, pull ups, core etc). I've factored in easy weeks every fourth week and have had a sports massage during this week.
Despite also trying to do antagonistic exercises to keep things balanced (press ups, tricep extensions, bench press etc) over the last week or 2 I've developed alot of discomfort in my trapezius, around the inside of the shoulder blade area.
I went to see a sports massage therapist and he said it was in spasm, particularly on my left side. Previous to this I also went to see someone at The Clinic on Abbeydale Road to get some pointers on general posture. I've not got the classic climber's hunch, but was told my head is a bit far forward and to do some of the exercises where you tuck your chin down and press back with your neck muscles.
I've upped the amount of rest and reduced training sessions on consecutive days, but the pain and discomfort is still there, often on both sides of the trapezius, in that same area. When climbing on steep stuff it can definitely feel like it's uncomfortable when I'm reaching or stretching for holds.
Most injuries or tweaks that I've had in the past I've treated with a bit of cold water immersion to stimulate some blood flow, but it's quite difficult to do that with this one!
Any thoughts would be greatfully received.
Thanks
Gus
-
Hi
Ok my problem/pain is in my right bicep. I can make it hurt by contracting bicep with my palm facing out. The pain is near the elbow end of the bicep. Its been like this a while, about month and half. I train or boulder lets say an average of 4/5 days a week, maybe pushing it a bit recently. I actually have a similar pain in the left bicep as well, but less so.
cheers in advance
Hi, it is difficult to say whether you have a purely biceps problem as it could also be deeper ie elbow joint. It hurts when you have your palm facing outwards which is actually taking load off the biceps (the biceps flexes and rotates the lower arm from palm down to up). It could be that you are compressing the joint ie fully flexed elbow and a biceps contraction.
As both biceps are hurting it is probably more due to the recent increase in intensity. I would tend to think that you need to back off on the intensity and climb at a pain free level and then slowly increase the loads/grade as symptoms allow. Maybe stay away from locking out on the elbows for the next few week. When you are back to climbing fully again just make sure you monitor the intense sessions and ensure you have easier sessions on following days particularly when you are climbing frequently.
Other possibilities are that sometimes the neck or upper back can refer pain and we would tend to assess what your shoulder and trunk is doing and are you pulling too much through your elbows. Hope this helps and let me know if symptoms persist, regards
Matt
-
Hi Guys,
Since New Year I've been doing quite a bit of specific climbing training. Volume wise it's probably been no more than my usual climbing schedule, but definitely more targeted exercises (fingerboarding, steep boards, pull ups, core etc). I've factored in easy weeks every fourth week and have had a sports massage during this week.
Despite also trying to do antagonistic exercises to keep things balanced (press ups, tricep extensions, bench press etc) over the last week or 2 I've developed alot of discomfort in my trapezius, around the inside of the shoulder blade area.
I went to see a sports massage therapist and he said it was in spasm, particularly on my left side. Previous to this I also went to see someone at The Clinic on Abbeydale Road to get some pointers on general posture. I've not got the classic climber's hunch, but was told my head is a bit far forward and to do some of the exercises where you tuck your chin down and press back with your neck muscles.
I've upped the amount of rest and reduced training sessions on consecutive days, but the pain and discomfort is still there, often on both sides of the trapezius, in that same area. When climbing on steep stuff it can definitely feel like it's uncomfortable when I'm reaching or stretching for holds.
Most injuries or tweaks that I've had in the past I've treated with a bit of cold water immersion to stimulate some blood flow, but it's quite difficult to do that with this one!
Any thoughts would be greatfully received.
Thanks
Gus
Hi Gus, it sounds like the discomfort could be coming from your thoracic spine. You say that your posture is quite flexed and you have been given some neck exercises. I would look at stretching/moving a little lower ie your upper/mid thoracic spine as stiffness here is common in climbers. If your are flexed at this part of your spine then your head will be forward and your shoulder movements will be restricted. Perhaps as you have been doing steeper climbing ie requiring more above head reaching, then this has niggled the area mentioned. Also of note is that if your working involves a lot of sitting and + or - poor postures then this only reinforces stiffness. Move around in the daytime and stand whenever possible, variety is key.
I would recommend exercises to mobilise your thoracic spine, these could involve reaching above your head with alternate arms but make sure you are lifting your ribs and chest ie extend your thoracic spine. Also try some trunk rotations as well as lying back over a gym ball. Also make sure that you have some easier sessions within your more intense weeks. See how you go and it may be worth a look if symptoms persist.
Regards
Matt
-
Hi
Ok my problem/pain is in my right bicep. I can make it hurt by contracting bicep with my palm facing out. The pain is near the elbow end of the bicep. Its been like this a while, about month and half. I train or boulder lets say an average of 4/5 days a week, maybe pushing it a bit recently. I actually have a similar pain in the left bicep as well, but less so.
cheers in advance
Hi, it is difficult to say whether you have a purely biceps problem as it could also be deeper ie elbow joint. It hurts when you have your palm facing outwards which is actually taking load off the biceps (the biceps flexes and rotates the lower arm from palm down to up). It could be that you are compressing the joint ie fully flexed elbow and a biceps contraction.
As both biceps are hurting it is probably more due to the recent increase in intensity. I would tend to think that you need to back off on the intensity and climb at a pain free level and then slowly increase the loads/grade as symptoms allow. Maybe stay away from locking out on the elbows for the next few week. When you are back to climbing fully again just make sure you monitor the intense sessions and ensure you have easier sessions on following days particularly when you are climbing frequently.
Other possibilities are that sometimes the neck or upper back can refer pain and we would tend to assess what your shoulder and trunk is doing and are you pulling too much through your elbows. Hope this helps and let me know if symptoms persist, regards
Matt
Hi Mat
Thanks for your reply. I just gave myself a little test. The right bicep is quite a bit worse and hurts if I do a regular bicep curl, as well as the palms out indicator I gave you. It doesn't hurt deadhanging. Thinking back I did do quite a lot of deep lock training on rings and campus boards about two/three months ago. Since then I have been focusing on projects which are generally steep and fingery and haven't caused much pain. The pain got worse three days ago after a session on a problem that again involved a deep lock on a big hold.
I did some research and thought maybe distal bicep tendonitis.
I've also been climbing a very long time, ie I'm old! so maybe posture is a key as well.
cheers Andy
-
Hi Gus, it sounds like the discomfort could be coming from your thoracic spine. You say that your posture is quite flexed and you have been given some neck exercises. I would look at stretching/moving a little lower ie your upper/mid thoracic spine as stiffness here is common in climbers. If your are flexed at this part of your spine then your head will be forward and your shoulder movements will be restricted. Perhaps as you have been doing steeper climbing ie requiring more above head reaching, then this has niggled the area mentioned. Also of note is that if your working involves a lot of sitting and + or - poor postures then this only reinforces stiffness. Move around in the daytime and stand whenever possible, variety is key.
I would recommend exercises to mobilise your thoracic spine, these could involve reaching above your head with alternate arms but make sure you are lifting your ribs and chest ie extend your thoracic spine. Also try some trunk rotations as well as lying back over a gym ball. Also make sure that you have some easier sessions within your more intense weeks. See how you go and it may be worth a look if symptoms persist.
Regards
Matt
[/quote]
Thanks Matt, will give thi a go and see how I get on.
Cheers
Gus
-
Hi Gus, it sounds like the discomfort could be coming from your thoracic spine. You say that your posture is quite flexed and you have been given some neck exercises. I would look at stretching/moving a little lower ie your upper/mid thoracic spine as stiffness here is common in climbers. If your are flexed at this part of your spine then your head will be forward and your shoulder movements will be restricted. Perhaps as you have been doing steeper climbing ie requiring more above head reaching, then this has niggled the area mentioned. Also of note is that if your working involves a lot of sitting and + or - poor postures then this only reinforces stiffness. Move around in the daytime and stand whenever possible, variety is key.
I would recommend exercises to mobilise your thoracic spine, these could involve reaching above your head with alternate arms but make sure you are lifting your ribs and chest ie extend your thoracic spine. Also try some trunk rotations as well as lying back over a gym ball. Also make sure that you have some easier sessions within your more intense weeks. See how you go and it may be worth a look if symptoms persist.
Regards
Matt
Thanks Matt, will give thi a go and see how I get on.
Cheers
Gus
[/quote]
Been doing the exercises you suggested this week, particular the stretching for the ceiling leading with my ribs and chest. An interesting/slightly odd thing that happens when I do it with both arms is that there's an audible "cracking noise" that comes from my spine, around the area of discomfort (lower trapezius). Any thoughts on this? Should I be worried?
There's still tightness there but it's definitely better than it was. Might drop in for an appointment if it carries on. Is it just a case of ring up and book?
Thanks
Gus
-
Hi
Ok my problem/pain is in my right bicep. I can make it hurt by contracting bicep with my palm facing out. The pain is near the elbow end of the bicep. Its been like this a while, about month and half. I train or boulder lets say an average of 4/5 days a week, maybe pushing it a bit recently. I actually have a similar pain in the left bicep as well, but less so.
cheers in advance
Hi, it is difficult to say whether you have a purely biceps problem as it could also be deeper ie elbow joint. It hurts when you have your palm facing outwards which is actually taking load off the biceps (the biceps flexes and rotates the lower arm from palm down to up). It could be that you are compressing the joint ie fully flexed elbow and a biceps contraction.
As both biceps are hurting it is probably more due to the recent increase in intensity. I would tend to think that you need to back off on the intensity and climb at a pain free level and then slowly increase the loads/grade as symptoms allow. Maybe stay away from locking out on the elbows for the next few week. When you are back to climbing fully again just make sure you monitor the intense sessions and ensure you have easier sessions on following days particularly when you are climbing frequently.
Other possibilities are that sometimes the neck or upper back can refer pain and we would tend to assess what your shoulder and trunk is doing and are you pulling too much through your elbows. Hope this helps and let me know if symptoms persist, regards
Matt
Hi Mat
Thanks for your reply. I just gave myself a little test. The right bicep is quite a bit worse and hurts if I do a regular bicep curl, as well as the palms out indicator I gave you. It doesn't hurt deadhanging. Thinking back I did do quite a lot of deep lock training on rings and campus boards about two/three months ago. Since then I have been focusing on projects which are generally steep and fingery and haven't caused much pain. The pain got worse three days ago after a session on a problem that again involved a deep lock on a big hold.
I did some research and thought maybe distal bicep tendonitis.
I've also been climbing a very long time, ie I'm old! so maybe posture is a key as well.
cheers Andy
Hi Andy, you may have overloaded the distal tendon but it is less likely to be a tendonitis ie inflammatory as it has been going on for a 2 month period. It could be more of a tendonosis ie more wear and and tear, but only a problem if the tendon is overloaded to soon or too much. It is difficult for an exact diagnosis when it is deep elbow pain. The action you describe is both when the biceps is contracting and the joint is being compressed (also some of the nerves around the elbow can be compressed).
Poor posture can certainly contribute and often climbers are stiff in their mid back region. This area is important for reaching and stretching your arms out for holds. If you are in a sedentary sitting job then make sure you move regularly and do neck and trunk rotations and lift your chest and occasionally reach towards the ceiling.
As before avoid extensive locking out positions and reduce your load and grades. Increase as able and maybe you need to come in or visit a physio.
regards
Matt
-
Hi Gus, it sounds like the discomfort could be coming from your thoracic spine. You say that your posture is quite flexed and you have been given some neck exercises. I would look at stretching/moving a little lower ie your upper/mid thoracic spine as stiffness here is common in climbers. If your are flexed at this part of your spine then your head will be forward and your shoulder movements will be restricted. Perhaps as you have been doing steeper climbing ie requiring more above head reaching, then this has niggled the area mentioned. Also of note is that if your working involves a lot of sitting and + or - poor postures then this only reinforces stiffness. Move around in the daytime and stand whenever possible, variety is key.
I would recommend exercises to mobilise your thoracic spine, these could involve reaching above your head with alternate arms but make sure you are lifting your ribs and chest ie extend your thoracic spine. Also try some trunk rotations as well as lying back over a gym ball. Also make sure that you have some easier sessions within your more intense weeks. See how you go and it may be worth a look if symptoms persist.
Regards
Matt
Thanks Matt, will give thi a go and see how I get on.
Cheers
Gus
Been doing the exercises you suggested this week, particular the stretching for the ceiling leading with my ribs and chest. An interesting/slightly odd thing that happens when I do it with both arms is that there's an audible "cracking noise" that comes from my spine, around the area of discomfort (lower trapezius). Any thoughts on this? Should I be worried?
There's still tightness there but it's definitely better than it was. Might drop in for an appointment if it carries on. Is it just a case of ring up and book?
Thanks
Gus
[/quote]Hi Gus, the cracking is probably your stiff thoracic spine moving, don't worry about this, it's a good thing because you seem to be targeting the right area. If you need to book then just give us a call.
regards
Matt
-
Cross post from NNFN.
What causes mid back spasms? Last night during training I got this sudden sharp pain just below the shoulder blade, just lateral to the spine. Feels like a spasm. It is catchy and worsened with certain movements and breathing. Only relief comes from traction to the arm on that side. Any advice to rehab this and avoid it in the future? I have had them before and they get better after a few days but usually involve lots of soreness, :'(
-
Cross post from NNFN.
What causes mid back spasms? Last night during training I got this sudden sharp pain just below the shoulder blade, just lateral to the spine. Feels like a spasm. It is catchy and worsened with certain movements and breathing. Only relief comes from traction to the arm on that side. Any advice to rehab this and avoid it in the future? I have had them before and they get better after a few days but usually involve lots of soreness, :'(
Hi, it sounds like you have irritated/strained one of the joints that connect your ribs to your spine (costoveterbral or costotransverse joints). The muscle spasm is more likely to be due to protection or guarding. They can be very sore and precisely as you described the symptoms ie with breathing (when your ribs move upwards) and sharp/catching.
We find that a lot of climbers have stiff thoracic (mid) spines, this can also be exaggerated if you have a predominantly sitting job. We recommend doing extension type stretches for your mid back and this can involve lying backwards over a gym ball or lifting your arms above your head whilst breathing in and reaching through your ribs. Also try some sitting trunk rotations. Take care of your daily sitting positions ie no prolonged slumping, basically move whenever possible.
hope this helps
regards
Matt
-
Hi. I'm having a slight issue with my shoulder, nothing major but I'd like to know what I can do to fix it. It seems my left shoulder is weaker than my right. When practicing one arm pullups I can quite happily initiate the movement with my right arm from a deadhang, but with my left shoulder it hurts to start the pull, right at the start of the movement. I've also noticed my left shoulder hurts after weighted pullups where my right is fine.
What exercises do you recommend to strengthen the shoulder joint and keep it healthy?
Many thanks.
-
Hi,
6 weeks ago I got my right middle finger stuck in a mono as I moved away from it. It bent backwards and there was an obvious crack but initially no pain so I assumed it was just the joint clicking. I carried on climbing in that session and it started to ache so I stopped. For the first week it was slightly swollen and achey in the joint and I lacked full range of motion for a week or two. Since then Ive been climbing on it, trying to avoid anything that hurts. Some sessions it will feel almost fine, and others I wont be able to crimp at all. The problem is in the DIP joint on the side closest to my index finger.
Lateral movement hurts the most (i.e. pushing the fingertip sideways towards the ring finger). Applying pressure to the swollen area gives mild pain in certain places. Open handing is normally fine, as long as no twisting is involved. On better days crimping is fine if pulling straight down, on worse days any half or full crimping causes the joint to ache.
My vague diagnosis is a hyper extension of the DIP joint which has injured the collateral ligament (although I don't actually know if the collateral ligament exists in the DIP joint or just the PIP). 6 weeks since I did it and its still slightly swollen on the side, towards the top, as the picture shows. Swelling increases a bit after climbing but is always quite minimal.
Any ideas on what I've done and how to help it recover would be much appreciated.
Thanks,
Will
(http://farm8.staticflickr.com/7456/13298369075_a4b3db6b78_z.jpg)
-
Hi. I'm having a slight issue with my shoulder, nothing major but I'd like to know what I can do to fix it. It seems my left shoulder is weaker than my right. When practicing one arm pullups I can quite happily initiate the movement with my right arm from a deadhang, but with my left shoulder it hurts to start the pull, right at the start of the movement. I've also noticed my left shoulder hurts after weighted pullups where my right is fine.
What exercises do you recommend to strengthen the shoulder joint and keep it healthy?
Many thanks.
hi
The relative weakness in the left shoulder could be caused by many factors. I assume you are right handed and have not injured your left shoulder/arm before?
Right handed people tend to be 10% stronger on their right hand compared to the left (left handed people are more equal as they are forced to live in a right handed world-its an advantage!). Your control with your left shoulder, and all the left side of the body, will be reduced so you need to specifically strengthen that side. Put more variety into your climbing so that you force the left hand side of your body to work. Consider the routes you struggle with and I bet they require more control with the left side of your body. Regards strengthening, don't force the left shoulder/arm to lift the same weight as the right. Drop the weight with the pull ups and even the starting point. You should not experience pain and if you are at the start of the movement you could have some instability in the shoulder and the muscle is struggling to compensate. Train above your head and do antagonistic movements (pressing above and external rotation for example). Work with kettle bells so the left shoulder has to rotate and change to different movement patterns). Aim for variety of movement and tell us how you progress.
Steve
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Hi,
6 weeks ago I got my right middle finger stuck in a mono as I moved away from it. It bent backwards and there was an obvious crack but initially no pain so I assumed it was just the joint clicking. I carried on climbing in that session and it started to ache so I stopped. For the first week it was slightly swollen and achey in the joint and I lacked full range of motion for a week or two. Since then Ive been climbing on it, trying to avoid anything that hurts. Some sessions it will feel almost fine, and others I wont be able to crimp at all. The problem is in the DIP joint on the side closest to my index finger.
Lateral movement hurts the most (i.e. pushing the fingertip sideways towards the ring finger). Applying pressure to the swollen area gives mild pain in certain places. Open handing is normally fine, as long as no twisting is involved. On better days crimping is fine if pulling straight down, on worse days any half or full crimping causes the joint to ache.
My vague diagnosis is a hyper extension of the DIP joint which has injured the collateral ligament (although I don't actually know if the collateral ligament exists in the DIP joint or just the PIP). 6 weeks since I did it and its still slightly swollen on the side, towards the top, as the picture shows. Swelling increases a bit after climbing but is always quite minimal.
Any ideas on what I've done and how to help it recover would be much appreciated.
Thanks,
Will
Hi Will
It sounds like you have hyperextended you DIP and possible collateral ligament damage. Most climbers DIP joints are often held in a fixed flexion position so forcing hyperextension will be more problematical than most other people. Combined with the loading stresses you require to climb and any slight limitation could take months to settle. I would stress the finger joint daily to levels that do not elicit pain, discomfort or a reaction afterwards. This could be at work pulling on corners of doors or tables etc to stimulate tissue repair with controlled stress. I suspect it could take 10-12 weeks improve but possible 9-12 months before it is symptom free. Please let us know how you got on.
Steve
(http://farm8.staticflickr.com/7456/13298369075_a4b3db6b78_z.jpg)
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Pulled,strained a muscle in my ribs due to coughing. Any advice on rehabing it? It currently Hurts when I breath in deeply, cough or sneeze.
Cheers Rich
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I've had an issue with what feels to be the left side of my thorocolumbar fascia for the last couple of months. If I lean over, lift my legs up, or just do anything that requires the usage of my lower back I get a sharp pain. Short term, it tends to go away if I hang on a bar and roll my knees up into my chest or spend some time stretching out, but it's always there otherwise. Even sitting up when I'm getting out of bed hurts! Any idea what it might be?
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Pulled,strained a muscle in my ribs due to coughing. Any advice on rehabing it? It currently Hurts when I breath in deeply, cough or sneeze.
Cheers Rich
Hi Rich, if it is muscular it should clear up quickly and i would recommend reducing your grades so that the climbing is relatively comfortable and increase intensity as able. Alternatively you may have irritated where the rib joins the spine. As you breathe the ribs move up and down like buckets handles .When you cough and sneeze this also increases intra-abdominal pressure and moves the ribs. Try some trunk rotations, leaning back over a gym ball as well as alternate arm elevation ie any movements of the mid back and ribs. If it doesn't settle it may be worth visiting a physio.
Regards
Matt
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I've had an issue with what feels to be the left side of my thorocolumbar fascia for the last couple of months. If I lean over, lift my legs up, or just do anything that requires the usage of my lower back I get a sharp pain. Short term, it tends to go away if I hang on a bar and roll my knees up into my chest or spend some time stretching out, but it's always there otherwise. Even sitting up when I'm getting out of bed hurts! Any idea what it might be?
Hi, it sounds like the symptoms are coming from your lower back region. You may be bending too much from this region ie initiating the movement from this area rather than equally through your hips, mid and upper back. I would also be interested in what you do in the daytime ie do you sit for prolonged periods and if you do are you bending/slumping too much at the lumbar spine. In this instance you will be causing a cumulative strain that is now progressing in to climbing. The relief from stretching makes sense.
When you have discomfort or pain for a while you can also start to compensate and move differently and the muscles can start to guard and prevent normal movement.
I would suggest you get reviewed by a physio. In the meantime take care of your posture if you do sit a lot and try and bend more from the hips.
regards
Matt
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Pulled,strained a muscle in my ribs due to coughing. Any advice on rehabing it? It currently Hurts when I breath in deeply, cough or sneeze.
Cheers Rich
Hi Rich, if it is muscular it should clear up quickly and i would recommend reducing your grades so that the climbing is relatively comfortable and increase intensity as able. Alternatively you may have irritated where the rib joins the spine. As you breathe the ribs move up and down like buckets handles .When you cough and sneeze this also increases intra-abdominal pressure and moves the ribs. Try some trunk rotations, leaning back over a gym ball as well as alternate arm elevation ie any movements of the mid back and ribs. If it doesn't settle it may be worth visiting a physio.
Regards
Matt
thanks Matt, nearly cleared up now, managed a light bouldering session last weekend, but stayed off hanging and pull ups during the week. will try those rotations and elevations. Thanks again Rich
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Another finger injury question.
About 2.5 weeks ago I injured my right ring finger near the MCP joint while crimping. It made a popping sound (similar to popping a knuckle) at the time and I quit climbing immediately for the day. All the classic causes i think- not enough warm-up, overworked from previous days, etc. Based on the location/event I think it's the A1, but looking up info on the interweb indicates the A1 pulley is rarely injured.
If not the A1, what else would it be and how could I differentiate? If it was something else, would the treatment be any different from the standard treatment for a pulley - i.e. rest until swelling goes down, then light pain free openhanded climbing, progressing over time to harder openhanded, and eventually to crimping as long as it stays pain free.
Thanks,
Todd
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Another finger injury question.
About 2.5 weeks ago I injured my right ring finger near the MCP joint while crimping. It made a popping sound (similar to popping a knuckle) at the time and I quit climbing immediately for the day. All the classic causes i think- not enough warm-up, overworked from previous days, etc. Based on the location/event I think it's the A1, but looking up info on the interweb indicates the A1 pulley is rarely injured.
If not the A1, what else would it be and how could I differentiate? If it was something else, would the treatment be any different from the standard treatment for a pulley - i.e. rest until swelling goes down, then light pain free openhanded climbing, progressing over time to harder openhanded, and eventually to crimping as long as it stays pain free.
Thanks,
Todd
Hi Todd, A1 pulleys are less likely to be injury as you have mentioned but ultimately they still can be strained. The A2 pulley is only slightly above the A1 so it could be that you have strained this pulley. Usually the subjective signs are a popping sensation or noise as you have described when injuring a pulley. As you have probably read the best treatment is conservative and you are correct with the progression ie slowly increase the volume and intensity as symptoms allow to ultimately promote tissue adaptation to stresses. Slowly introduce crimping. You could also use tape over the pulley sites although the jury is out on whether this helps. I would also recommend that you do some finger exercises. Basically make a fist and then slowly uncurl the fingers individually against a bit of resistance. What should occur is that each individual joint should uncurl in a controlled fashion (not flick back) back to a straight finger. Then do the opposite ie curl your finger back to the palm against resistance. Increase the resistance as long as your fingers curl and uncurl in a controlled fashion and do as many as you can before fatigue.
Hope this helps.
Matt
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22 days and no problematic injuries ?
Must be a record
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Boom!
I've injured what feels like the longhead of bicep tendon in my shoulder: a dull ache at the front of the shoulder near where where the bicep joins. I did it on a high gaston move (annoyingly on my first proper route following a six month layoff following spine surgery). It's been 19 days now and I haven't climbed on it. It doesn't hurt too badly with light resistance - more just what feels like hard to shift inflammation. I've started light therabanding and some scapular press-up+ and normal press-ups. My question is about deep friction massage.
I had a similar injury from mixed climbing in Canada about 8 years ago - then it was quite a bad strain of 3 of the 4 rotator cuff muscles from falling onto one arm and twisting. My left shoulder has since then been way tighter than the right one, presumably from scar tissue shortening. Back then I saw a Canadian physio for 6 weeks who did some sickeningly painful deep massage during the rehab phase, using these little blunt metal 'blades' called graston tools: http://www.grastontechnique.com/. (http://www.grastontechnique.com/.) It seemed to work well then and I'm wondering if I should try to aggressively massage this one during the healing phase and if there's much evidence to show it improves healing time? Also any general tips for rehabbing a minor bicep longhead strain which is starting to feel stubbornly inflammatory.
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Hi!
I managed to injure my left hand ring finger while bouldering on a two finger pocket where alot of load was put on the ring finger. Initially i didn't think it was so bad. I experienced some pain in my palm but i still finished the session with some easy traverse (no pain). Now after 4 days of complete rest i can hardly load the finger at all in open hand before there's pain. The pain is located from about the middle of the palm to the first knuckle. Loading the finger in a crimp position is much less painful.
Any advice?
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Please help!
I was doing some front-3 half crimping on the fingerboard two days ago, when I felt a sudden twinge in my left ring finger. I moved on, and had a decent session. However, the next day, it hurt (and still hurts) to extend my middle and ring fingers to the limit of their range of motion.
There's no inflammation or pain with pressure on the finger, and it doesn't feel like it would hurt when crimping again or using four fingers open handed. The only thing that seems to hurt is this extension, but it's quite noticeable (hurts when I catch it on something, not climbing).
I'm not quit sure what I've done, so any diagnosis and/or advice would be very much appreciated!
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Back in January when I was climbing, using an open handing pinch at an awkward angle my wrist cracked. It was a bit painful afterwards. Since then it's never got any better but never got any worse until now. It seems to play up more when i'm draging holds and I can feel it really pulling on my wrist like it's going to pop! When I also hit a hold in a certain way and I feel the pain my grip goes very weak.
Any ideas? Not sure what i've done and how to sort it...
Cheers
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ok played 9 holes of golf there on Tuesday for the first time in my life. Mid way through I started getting a pain in the outside of my elbow. It eased off after a day or so and have done a couple of short sessions in the wall with only a little discomfort since.
Today I am getting a sharp pain in the outside of my elbow when I rotate my forearm outwards and, to a lesser extent, straighten my arm.
Is it possible to get acute tennis elbow from golf??
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Only if you play with a Racquet instead of a club.
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The way I was swinging those clubs I may as well have been...
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Boom!
I've injured what feels like the longhead of bicep tendon in my shoulder: a dull ache at the front of the shoulder near where where the bicep joins. I did it on a high gaston move (annoyingly on my first proper route following a six month layoff following spine surgery). It's been 19 days now and I haven't climbed on it. It doesn't hurt too badly with light resistance - more just what feels like hard to shift inflammation. I've started light therabanding and some scapular press-up+ and normal press-ups. My question is about deep friction massage.
I had a similar injury from mixed climbing in Canada about 8 years ago - then it was quite a bad strain of 3 of the 4 rotator cuff muscles from falling onto one arm and twisting. My left shoulder has since then been way tighter than the right one, presumably from scar tissue shortening. Back then I saw a Canadian physio for 6 weeks who did some sickeningly painful deep massage during the rehab phase, using these little blunt metal 'blades' called graston tools: http://www.grastontechnique.com/. (http://www.grastontechnique.com/.) It seemed to work well then and I'm wondering if I should try to aggressively massage this one during the healing phase and if there's much evidence to show it improves healing time? Also any general tips for rehabbing a minor bicep longhead strain which is starting to feel stubbornly inflammatory.
Hi, sorry about the delayed response I have been away. I know you are now a few weeks further on. I am presuming you have not ruptured the head as you would notice a large lump when you bend your elbow and it would feel extremely weak.
In theory there shouldn't be any inflammation now and I am sceptical on whether frictions will help (evidence on frictions is poor). They certainly will not harm you but the tissue will be more mature now. The best way to recover is to increase tissue strength and to put a graduated load through it ie lower grades/ low intensity and slowly increase as symptoms allow.
The things to be careful of are any compensations at the shoulder i.e. is it more forward when you are loading the arm and if there is a chronic tightness are you again compensating. Let me know how it is now as this mail is 2 weeks old.
regards Matt
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Thanks for the reply Matt. I restarted climbing at low intensity about a week ago. It feels fine with anything apart from gastons (which was how I tweaked it). Now it's feeling good enough for my trad proj's!
I haven't done much frictioning, just a couple of times around the time I posted. Have been doing lots of pressup + in an attempt to wake up the serratus, therabanding in various configurations to try to target rotator cuff. I've also been doing a lot of other core/kinetic chain exercises from a personal trainer I've been seeing for rehab following back surgery last year, and this work targets the shoulders too. Especially useful are some thoracic mobility exercises.
I'm aware of it being much tighter than the uninjured shoulder - it always has been since the previous rotator cuff tears - so I'm trying to stretch it a few times per week: scarf stretch, pecs stretch against doorframe, kneeling 'bowed forward' yoga type stretch with arms out in front on ground. Any other stretches I can find on the web.
Great thread you've got going here.
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Hi!
I managed to injure my left hand ring finger while bouldering on a two finger pocket where alot of load was put on the ring finger. Initially i didn't think it was so bad. I experienced some pain in my palm but i still finished the session with some easy traverse (no pain). Now after 4 days of complete rest i can hardly load the finger at all in open hand before there's pain. The pain is located from about the middle of the palm to the first knuckle. Loading the finger in a crimp position is much less painful.
Any advice?
Hi, sorry about the delayed response I have been away. It sounds more like a tendon strain rather than a classic pulley injury. The tendons for your ring finger are attached to the same muscle belly as all of the other finger tendons.They are separate tendons in the palms so I think you may have strained it near to the A1 pulley. That would make sense regarding crimping as I would expect a pulley injury to not tolerate this type of hold.
I would imagine you have tried to climb again as it is now a few weeks on from the initial strain. Basically gradually load the hand on a variety of holds and increase as symptoms allow. You need to load the tendon but in a graduated way. Please let me know how things are going as this is a delayed response.
regards Matt
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Please help!
I was doing some front-3 half crimping on the fingerboard two days ago, when I felt a sudden twinge in my left ring finger. I moved on, and had a decent session. However, the next day, it hurt (and still hurts) to extend my middle and ring fingers to the limit of their range of motion.
There's no inflammation or pain with pressure on the finger, and it doesn't feel like it would hurt when crimping again or using four fingers open handed. The only thing that seems to hurt is this extension, but it's quite noticeable (hurts when I catch it on something, not climbing).
I'm not quit sure what I've done, so any diagnosis and/or advice would be very much appreciated!
Hi, it could be that you have overloaded or irritated the joint. Inflammation will not always be present or easily seen. Pain with extension could indicate a mild pulley or cruciate ligament strain. The best thing would be to back off the intensity of the climbing and start stretching the finger. Try to regain full extension. You may have already started back climbing so just ease in to the increased loading manoeuvres and crimping. If it is not going in the right direction send me another post.
regards
Matt
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I have an issue with the end joint of my left middle finger (near C3, I guess?). The pain seems to be localised around the outside side of the finger.
With the finger fully extended, if I push upwards against the tip and resist it (like an isometric hold), I can feel a pain in the joint. Doing the same thing with a bent finger is fine. Climbing pretty much mirrors this; crimping is okay, open handed not so much.
It happened about 10 days ago and has gotten a bit better since then, but I've not noticed any improvement over the last 4 or 5 days specifically. Should I just give it another week of no climbing? I find it quite difficult to limit myself to only easy things...
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Hi HP clinic,
I have a right elbow FCU tendinopathy on the epiciondyle itself ie right where the tendon joins the bone. I've been receiving treatment from a physio whose advice I respect, but progress is currently poor.
I'm doing neg eccentrics with an 8kg dumbell, 2 sets of 15, 5 secs duration per rep, once a day.
My climbing is limited to 2-3 hrs a week spread over 2-3 indoor sessions , avoiding extending my arm ie only using the arm in a limited range. This is manageable, but still causes soreness.
Have you used any different protocols for similar tendinopathies with a measure of success? Any suggestions about a different approach? My climbing has really hit the buffers: I'm not really enjoying being a 95% ex-climber.
thanks!
Jon
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Back in January when I was climbing, using an open handing pinch at an awkward angle my wrist cracked. It was a bit painful afterwards. Since then it's never got any better but never got any worse until now. It seems to play up more when i'm draging holds and I can feel it really pulling on my wrist like it's going to pop! When I also hit a hold in a certain way and I feel the pain my grip goes very weak.
Any ideas? Not sure what i've done and how to sort it...
Cheers
Hi sorry about the delay in responding. We have had holidays and a backlog of responses.
It doesn't sound like a tendon issue as I think you would not have been able to continue climbing. When a joint cracks it is difficult to say what the sound is from. Sometimes it is a release of pressure or tendons flicking over a boney prominence. The fact that your wrist feels weak may indicate a mild subluxation of one of your small carpal bones and the pain is inhibiting the movement or there is a mechanical disadvantage. Depending on where you feel the pain there is also a cartilage disc between one of the joints that occasional moves and again causes discomfort. It may be worth visiting a physio or you may now have found that the problem is resolving as your message is 2 weeks old. if you wish call me for further advice on 0114 2671223.
Let me know how you are going.
regards
Matt
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ok played 9 holes of golf there on Tuesday for the first time in my life. Mid way through I started getting a pain in the outside of my elbow. It eased off after a day or so and have done a couple of short sessions in the wall with only a little discomfort since.
Today I am getting a sharp pain in the outside of my elbow when I rotate my forearm outwards and, to a lesser extent, straighten my arm.
Is it possible to get acute tennis elbow from golf??
Hi, if you are trying any activity or sport that is new to you regardless of strength and fitness then you can be prone to injuries. Basically we adapt to an activity over time, and stresses to muscles, bones, ligaments and tendons are necessary to get stronger and hopefully improve. For example a climbers finger tendons will be a lot stronger than an average person and usually there are boney changes at the finger joints due to putting stresses through them and jamming them into small holes. To cut a long story short you can irritate the common muscle/tendon attachment at the elbow. It may also be that the joint is grumbling from twisting and over extending during the golf stroke. Hopefully this has settled now but let me know if you are experiencing further problems.
regards
Matt
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I have an issue with the end joint of my left middle finger (near C3, I guess?). The pain seems to be localised around the outside side of the finger.
With the finger fully extended, if I push upwards against the tip and resist it (like an isometric hold), I can feel a pain in the joint. Doing the same thing with a bent finger is fine. Climbing pretty much mirrors this; crimping is okay, open handed not so much.
It happened about 10 days ago and has gotten a bit better since then, but I've not noticed any improvement over the last 4 or 5 days specifically. Should I just give it another week of no climbing? I find it quite difficult to limit myself to only easy things...
Hi, The fact you can crimp but open handed is more uncomfortable may be related to a tendon issue or pulley. Basically you have two flexor tendons running up the fingers with 5 pulleys (A1-5) and cruciate type ligaments keeping them in place. One of the tendons finishes below the last joint so it may be that the crimp is using the longer of the two tendons and hence you are ok. If it is a pulley strain then you do need to back off and SLOWLY increase the grades and volume as symptoms allow. As long as you grade the progression things should settle. Total rest at this stage isn't really indicated.
let me know how you are going.
Regards
Matt
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Hi HP clinic,
I have a right elbow FCU tendinopathy on the epiciondyle itself ie right where the tendon joins the bone. I've been receiving treatment from a physio whose advice I respect, but progress is currently poor.
I'm doing neg eccentrics with an 8kg dumbell, 2 sets of 15, 5 secs duration per rep, once a day.
My climbing is limited to 2-3 hrs a week spread over 2-3 indoor sessions , avoiding extending my arm ie only using the arm in a limited range. This is manageable, but still causes soreness.
Have you used any different protocols for similar tendinopathies with a measure of success? Any suggestions about a different approach? My climbing has really hit the buffers: I'm not really enjoying being a 95% ex-climber.
thanks!
Jon
Hi Jon, the exercises you have been given are certainly ones that are commonly given although the evidence on the use of them is still debateable. It is all too easy to think that just doing eccentric exercises will be the cure. The weight you are using is quiet a lot, I would be tempted to reduce the weight, do higher reps ie 20+ and twice a day. The evidence for eccentric exercises is more to do with Achilles tendonopathies.
The other structures that can give similar type symptoms around the elbow are nerves and the joint itself. The cervical spine can also refer in to the elbow.
I would also consider what you do in the day ie are you doing a lot of typing or mouse work. If so look at posture and where you arm is ie are you reaching forward too much or slumping when you sit. Climbers tend to be stiff in the thoracic spine and will tend to favour slumped positions, so every now and then reach to the ceiling and lift your chest X10.
I would also consider what you are doing with you arm and trunk when you are climbing as you may be compensating and overusing your forearm for a more proximal weakness.
Taping the elbow or muscle belly may reduce symptoms during climbing.
Climb at a level that is relatively comfortable and start with 20-30mins (may be less). If this is ok during, after and the next day then slowly add routes or time as symptoms allow. Basically graded progression is best rather than climbing and it being too sore.
Hope this helps and I would subtley ask the physio about some of the things I have mentioned.
regards
Matt
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Brilliant Matt,
Thanks for taking the time to reply. I'll think about those other things and see if we can tweak the exercises. I'd be happier if I were making some better progress.
Regards
Jon
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Hello HPclinic,
Back in January I felt a slight twinge in my left hand middle finger when climbing. I didn't really notice any pain at the time so finished my session. The following morning it felt sore at the base of the finger. Being an idiot I carried on climbing on it for another few weeks and it wasn't until March that I started trying to manage the situation.
The current status is that climbing open handed on my finger feels OK, but any holds in the full crimp position make it hurt. It is also slightly swollen towards the base and when I massage it there is what feels like a small lump on the left hand side of the proximal phalanx.
I don't think it is a pulley injury as I've had these before. Just wondered if you had any advice on what it could be and suggestions for managing it.
Thanks.
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ok played 9 holes of golf there on Tuesday for the first time in my life. Mid way through I started getting a pain in the outside of my elbow. It eased off after a day or so and have done a couple of short sessions in the wall with only a little discomfort since.
Today I am getting a sharp pain in the outside of my elbow when I rotate my forearm outwards and, to a lesser extent, straighten my arm.
Is it possible to get acute tennis elbow from golf??
Hi, if you are trying any activity or sport that is new to you regardless of strength and fitness then you can be prone to injuries. Basically we adapt to an activity over time, and stresses to muscles, bones, ligaments and tendons are necessary to get stronger and hopefully improve. For example a climbers finger tendons will be a lot stronger than an average person and usually there are boney changes at the finger joints due to putting stresses through them and jamming them into small holes. To cut a long story short you can irritate the common muscle/tendon attachment at the elbow. It may also be that the joint is grumbling from twisting and over extending during the golf stroke. Hopefully this has settled now but let me know if you are experiencing further problems.
regards
Matt
Thanks for the reply, thankfully its since settled down but for sure no more golf for me! bouldering is much safer,..
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Hello HPclinic,
Back in January I felt a slight twinge in my left hand middle finger when climbing. I didn't really notice any pain at the time so finished my session. The following morning it felt sore at the base of the finger. Being an idiot I carried on climbing on it for another few weeks and it wasn't until March that I started trying to manage the situation.
The current status is that climbing open handed on my finger feels OK, but any holds in the full crimp position make it hurt. It is also slightly swollen towards the base and when I massage it there is what feels like a small lump on the left hand side of the proximal phalanx.
I don't think it is a pulley injury as I've had these before. Just wondered if you had any advice on what it could be and suggestions for managing it.
Thanks.
Hi, as you probably know crimping will put more stresses through the tendons and in particular the distal pulleys. It is difficult to say whether it started off as a small pulley strain and you may have continued to overload it. It is ok to climb but there will be a period where you have to back off the intensity and the grades. You need to climb as symptoms allow and increase gradually to allow the tissue to adapt to stresses ie add in more crimps.
It could also be that the joint is irritated. Check that you have full extension and flexion. 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 middle finger from a clenched fist position. You should be able to uncurl you finger without any joint "snapping" backwards. Once the finger is straight curl it back to the palm, again with control. Apply as much resistance as you can control.
let me know if things are changing, otherwise visit a local physio for a more detailed look.
regards Matt
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While moving above a small pinch/crimp something felt wrong in my RH middle finger (yesterday) I stopped and abandoned my holiday :slap:. I now have noticeable swelling between the knuckles of my third (middle) and fourth (ring) finger, along with pain in the base of the third finger when I fully straighten the finger, resist on a very open crimp positions and some pain if I make the third and fourth finger move contrary to each other (always at base of finger rather than standard ring pulley pain I have experienced before).
This is outside my normal finger injury/rehab experience, I am guessing I have done something around where the tendons of the third and fourth finger meet/are shared? Any advice other than rest/ice/cold water (how long icing before switching to cold water)? Any taping strategies that may help on returning to climbing?
Thanks in advance.
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I have an ongoing collateral ligament injury in a middle finger. Since pushing it too hard again last weekend it now clicks and crunches like nothing else when stretched, and sometimes clicks quite a lot just opening and closing it. Any thoughts/advice on how concerning that should be?
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While moving above a small pinch/crimp something felt wrong in my RH middle finger (yesterday) I stopped and abandoned my holiday :slap:. I now have noticeable swelling between the knuckles of my third (middle) and fourth (ring) finger, along with pain in the base of the third finger when I fully straighten the finger, resist on a very open crimp positions and some pain if I make the third and fourth finger move contrary to each other (always at base of finger rather than standard ring pulley pain I have experienced before).
This is outside my normal finger injury/rehab experience, I am guessing I have done something around where the tendons of the third and fourth finger meet/are shared? Any advice other than rest/ice/cold water (how long icing before switching to cold water)? Any taping strategies that may help on returning to climbing?
Thanks in advance.
Hi, the tendons for your third and forth fingers are separate although from the same muscle belly further up your arm (deep and superficial tendons come from flexor digitorum longus and flexor profundus muscles). As you may know you have 5 ligaments known as your A1-5 pulleys and there is one at the base of your fingers (A1) although less commonly strained. You seem to have either strained this or the tendon/tendon sheath as you are getting pain with increased tension or load. Either way the management would be similar. For the first three days (and longer if you like) ice is a good idea to minimise the amount of swelling. Ultimately swelling is normal and is part of tissue repair. After this period regular finger flexion and extension is necessary and then add graded resistance by curling and uncurling individual fingers using the other hand ie start with fingers into the palm then add resistance to the tip of the finger and slowly uncurl making sure that the movement is smooth without joints snapping backwards. When the finger is straight then curl back to the palm smoothly. Discomfort is acceptable. Increase resistance as symptoms allow.
Start climbing on lower grades with bigger holds and add occasionally add crimps. Gradually increase the loads to put a controlled stress through the fingers and progress as symptoms allow.
Hope this helps and let me know how you are going.
Regards
Matt
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I have an ongoing collateral ligament injury in a middle finger. Since pushing it too hard again last weekend it now clicks and crunches like nothing else when stretched, and sometimes clicks quite a lot just opening and closing it. Any thoughts/advice on how concerning that should be?
Hi, might need a little more info. on how you injured it? The collateral ligs will be strained when the fingers are moved excessively lateral ie sideways, or repetitively laterally. If you feel it is one of the collaterals then try taping specifically around the joint and back off any finger jams or any sideway strains for 2-3 weeks as symptoms allow.
The only other thing is that the noise/clicking could be coming from the joint itself or the tendon sheath. The same advice would apply ie back of the grades and loading and make sure you have full flexion and extension at all the joints of that finger. Let me know how you are going. Regards Matt
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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?
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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
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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
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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
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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
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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?
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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.
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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!
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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
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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
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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
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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
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Thanks. I think it is cumulative and eventually just gets that bit worse. I'll try and ease off a bit.
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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.
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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"
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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?
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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
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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
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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
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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.
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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!
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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.
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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.
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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 (http://www.bssh.ac.uk/patients/commonhandconditions/ganglioncysts)
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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 ...
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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.
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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 ...
Hi, Ganglions can come and go. They can become a problem if they get bigger. Ease back in to the climbing and see how things go.
regards
Matt
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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.
Hi, the problem sounds more likely to be coming from higher up ie your neck. The cervical spine can refer in to the shoulder blade area and the weakness in your little and ring finger correlate to a lower neck issue. There can be many reasons for this. I would suggest you go and see a physio to analyse the reasons why this is persisting.
Regards
Matt
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Hi Steve
I'm certainly no spritely youth, am not particularly injured, but have just felt creaky in the fingers all of this year. Have had many finger injuries over the years and maybe the creakiness is just to be expected. there is no pain or discomfort when climbing or performing other activities. the only real change to my routine this year over previous has been religiously cold-water-treatmenting my hands each evening, but the creakiness preceeded the cold watering.
Any ideas, is this just to be expected as the body gets older?
Cheers
Roddy
Hi Roddy, I would recommend hot/warm water rather than cold and 'creakiness' could be either tendons or joint noise. Nothing to worry about except keep the hands moving and stretch out all your finger joints prior to climbing.
regards Matt
Thanks steve Matt, will try the warm stuff :2thumbsup:
Bit of a long running one this, but thought i should give a little feedback.
I completely stopped the cold water treatment and get warm water treatment via doing the washing up and erm, washing generally.
when i stopped the cold water treatment, my fingers stopped feeling worse, but due to old tears etc. still felt very fudgy through the latter part of last year.
i started taping my ring finger A2s again (the cheaty restrictive way) at the start of this year and felt a bit better still, however, i have since changed something else that has made a bigger difference.
i had been taking ghlucosamine sulphate for a long time and was also pretty reliant on the old vitamin I on training days. I have completely stopped both and feel much better. i have also been using the compex to lengthen (or at least loosen off) my forearms regularly and can now boulder tape free and even half-crimped feels semi-solid. i can even play with the captains of crush again for the first time in 5 or so years, without it feeling like something is going to cut loose in my hand/finger/forearm.
Thanks for setting me down what ended up being a long and meandering post road to a more sensible path :icon_beerchug:
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Hi, seldom post and not quite sure how this thread works.
Got to the lead wall quite a lot over the winter and managed to bump up grades from f6b/6b+ to f7a. Managed five so far and close to a 7a+ after one session. Do tiny tiny bit of weights and inconsistent finger boarding but not regular as don't like to train before going out on the rock.
Have a recurrent issue-yesterday at the Gap in South Wales-warmed up 5+, 6a, 6a+ 6b and then got on a vertical power endurance 7a putting in the clips. On first redpoint within three or four moves got burning sensation in forearm and forearm contracts strongly up-it does not feel like I have any control over it and it takes effort to bring it back to straight, needless to say it is the end of climbing for the day, this is not the first time this has happened. There is no residual pain once I stop but once it has happened it feels like it could go again at any point in that session.
In my mind it started two or three years ago on a steep 6b+ in Kalymnos when I was wearing a long sleeved top rolled half way up my forearms perhaps a bit too tight-not sure if I could have crushed something-may not be connected but it is frustrating when other things are going so well.
Symptoms are so specific I am not sure how to search for it at the minute.
So any ideas?
Thanks in advance
Rich
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Just spent 45 minutes writing up and it failed to post! Devastating. Here it is again:
Hi guys,
4 weeks ago I was in Whistler on holiday and I gave downhill biking a go for 3 days. After every run my back 3 fingers were moulded tightly around the handlebars and it was painful to uncurl them. I knew this was because I was squeezing the handlbars hard and tried to release a little when I could. I also thought the soreness was temporary and likely because I was trying out an activity I wasn't used to. After a week of rest only my little fingers remained sore and it seemed like my hands were healing.
Unfortunately, it's been another 3 weeks since and they've made little progress getting better. I've experienced almost every type of finger injury so far (tendons, pulleys, joints, ligaments, lumbricals, etc) and know what it feels like and what to do about it. This is like nothing I've experienced before - either that or I have a combination of the aforementioned injuries that is making it too difficult for me to isolate.
With both little fingers, if I pull on them in an open-handed position there is pain along the sides of the finger and from the DIP joint. When I pull on them in a crimped position the pain is a lot worse and comes once again from the sides of the finger and around mainly the DIP joint, which is felt on the underside. However, my left little finger is worse than my right and displays some mild swelling around the base of the finger and there is pain when I prod the inside of the MCP joint. I still have maximum mobility and can carry out day-to-day tasks without noticing either, with the exception of stretching the MCP joint such as when using my hands flat to push myself up from the floor/chair.
Thanks for any help or guidance.
Jack
(P.s. after my 2 visits to your practice the shoulder is more permanently up now with a bit of weighted shrug work and the pain on the inside of my elbow is diminishing at full lock as a result - thanks so much!)
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Sorry, in the above post it should say PIP joints in place of DIP joints.
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Hi, seldom post and not quite sure how this thread works.
Got to the lead wall quite a lot over the winter and managed to bump up grades from f6b/6b+ to f7a. Managed five so far and close to a 7a+ after one session. Do tiny tiny bit of weights and inconsistent finger boarding but not regular as don't like to train before going out on the rock.
Have a recurrent issue-yesterday at the Gap in South Wales-warmed up 5+, 6a, 6a+ 6b and then got on a vertical power endurance 7a putting in the clips. On first redpoint within three or four moves got burning sensation in forearm and forearm contracts strongly up-it does not feel like I have any control over it and it takes effort to bring it back to straight, needless to say it is the end of climbing for the day, this is not the first time this has happened. There is no residual pain once I stop but once it has happened it feels like it could go again at any point in that session.
In my mind it started two or three years ago on a steep 6b+ in Kalymnos when I was wearing a long sleeved top rolled half way up my forearms perhaps a bit too tight-not sure if I could have crushed something-may not be connected but it is frustrating when other things are going so well.
Symptoms are so specific I am not sure how to search for it at the minute.
So any ideas?
Thanks in advance
Rich
Hi my apologies on the delayed response, as you can imagine it is holiday season.
It sounds like you are compressing a nerve in your forearm after you are pumped and getting a type of involuntary reaction. I have occasionally seen this in climbers and I would class it as compartment syndrome. Basically muscles can become overdeveloped or the fascia that separate the muscle compartments can become tight. When you exercise a muscle it will increase the blood flow to it and there will also be the by products of exercise, this in turn will increases the size of the muscle. If the compartment is tight the pressure will increase causing possible ischaemia (decreased blood flow) and compression of the nerve.
At this stage I would manage this by regular stretches of the wrist and fingers with elbow flexed and extended. After higher grades lift your arm above your head and move your wrist and fingers to aid drainage. You can also try regular self massage by going across the muscle belly (transverse) as opposed to along the muscle. This may also help if you get these involuntary actions.
Try and monitor when it occurs and back off the intensity. Perhaps have more regular rests and have easier days ie avoid cumulative loading.
see how you go and let me know if this helps, otherwise come and see us or a physio nearby.
regards
Matt
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Just spent 45 minutes writing up and it failed to post! Devastating. Here it is again:
Hi guys,
4 weeks ago I was in Whistler on holiday and I gave downhill biking a go for 3 days. After every run my back 3 fingers were moulded tightly around the handlebars and it was painful to uncurl them. I knew this was because I was squeezing the handlbars hard and tried to release a little when I could. I also thought the soreness was temporary and likely because I was trying out an activity I wasn't used to. After a week of rest only my little fingers remained sore and it seemed like my hands were healing.
Unfortunately, it's been another 3 weeks since and they've made little progress getting better. I've experienced almost every type of finger injury so far (tendons, pulleys, joints, ligaments, lumbricals, etc) and know what it feels like and what to do about it. This is like nothing I've experienced before - either that or I have a combination of the aforementioned injuries that is making it too difficult for me to isolate.
With both little fingers, if I pull on them in an open-handed position there is pain along the sides of the finger and from the DIP joint. When I pull on them in a crimped position the pain is a lot worse and comes once again from the sides of the finger and around mainly the DIP joint, which is felt on the underside. However, my left little finger is worse than my right and displays some mild swelling around the base of the finger and there is pain when I prod the inside of the MCP joint. I still have maximum mobility and can carry out day-to-day tasks without noticing either, with the exception of stretching the MCP joint such as when using my hands flat to push myself up from the floor/chair.
Thanks for any help or guidance.
Jack
(P.s. after my 2 visits to your practice the shoulder is more permanently up now with a bit of weighted shrug work and the pain on the inside of my elbow is diminishing at full lock as a result - thanks so much!)
Hi Jack, it sounds like a tendon type injury/cumulative strain. When mtbing off mountains there is an awful lot of braking (mainly with the first couple of fingers and occasionally all) and gripping. The loading is different to climbing and more sustained ie you are not getting a rest in between holds as in climbing. The finger joints can also become uncomfortable due to the sustained compression and gripping. Make sure you can fully extend all your finger joints with your wrist extended and your elbow straight. If not stretch them out even if it is uncomfortable. Try some local massage after putting your hands into some warm/hot water.
I would continue to climb but back off the grades and increase as able.
Alternatively if it is not settling then pop in for a better look.
regards
Matt
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Cheers for your reply, helpful and food for thought.
Further to my original post and with a bit more thought I realise that it seldom (never) happens at the start of the day, it occurs after a reasonable amount of exertion so perhaps I can head it off by pacing myself and not rushing through a bunch of warm ups and doing what you suggest in between.
Have not had it the last few sessions which perhaps means I am not pulling hard enough-seems to come and go like that, ie it will happen every session for a while and then stop for a while-always coming back though.
many thanks
Rich
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Hi guys,
Just got back from a 3 week trip and I've got a really tender spot in my palm, just where the crease is 2cm below the little finger is. Any ideas what it might be? It doesn't really hurt except for when I poke it.
Cheers,
Dave
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Hi guys,
Just got back from a 3 week trip and I've got a really tender spot in my palm, just where the crease is 2cm below the little finger is. Any ideas what it might be? It doesn't really hurt except for when I poke it.
Cheers,
Dave
Hi Dave, the metatarsal-phalangeal joint is under this crease and it may be sore from excessive loading and climbing (cumulative strain from daily climbing). If you have been doing a lot more climbing than usual then you might need to back off the grades over the next week or two to allow some recovery. If it were a tendon issue then I think it would be more painful when climbing.
keep the fingers moving and let me know how things go.
regards
Matt
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Hi
I got back from a bouldering trip to Font a week ago. I've had a sore shoulder since leaving. I didn't fall and nothing unusual happend whilst climbing. I can can lift my arm forwards, back and up with no issue. If I try to lift my arm out to the side it hurts my shoulder once my hand is at waist height. I'm guessing rotator cuff? I'm not sure how long I should rest for? I found some exercises to do but I'm not sure how hard to push them? If at all.
Any help much appreciated
Cheers
Matt
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Hi
I got back from a bouldering trip to Font a week ago. I've had a sore shoulder since leaving. I didn't fall and nothing unusual happend whilst climbing. I can can lift my arm forwards, back and up with no issue. If I try to lift my arm out to the side it hurts my shoulder once my hand is at waist height. I'm guessing rotator cuff? I'm not sure how long I should rest for? I found some exercises to do but I'm not sure how hard to push them? If at all.
Any help much appreciated
Cheers
Matt
Hi Matt, I would imagine you have had more of an intense week of climbing when you have been away. It sounds more cumulative than anything specific (as you have mentioned).
It might be that you have had a mild strain of the rotator cuff and this has affected the way you move your shoulder ie you may be getting a mild impingement. This is commonly felt when taking the arm out to the side.
I would suggest backing off the grades over the next two weeks (enough to be climbing relatively pain free) and slowly increase the volume and intensity as the symptoms allow.
If symptoms are not settling down then go and see a physio before you develop any compensations.
regards
Matt
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Hi
I was wondering if there are any exercises you could suggest to recover plantar flexion range of the ankle. I'm a good 15/20 degrees short on the right ankle ever since i broke it a year ago, and the Physio i was seeing wouldn't help me out as according to him i don't need to be able to fully extend my foot :furious:
Google not been too helpful either. Are there any type of stretches or something that would actually help to recover those extra couple of inches? I'm already a bit of a short arse, so that extra range is pretty valuable to reach holds and the extra springiness in the more dynamic moves would be handy.
Thanks a lot
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Sit on your heels?
Reduce the padding under your shins/ankles as you regain flexibility.
(http://blogs.yogajournal.com/activeyogi/files/2012/11/Ankle.jpg)
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Hi Matt
I have a tender spot in/around my Trapezius on the right side and also quite stiff around the neck and shoulders. It looks like there's a slight swelling you can see in the picture.
I rested a few days then reduced the intensity of my sessions and have been doing neck stretches and shrugs, also tried using a tennis ball for massage but quite unsuccessfully.
What would you recommend to get this sorted out?
Thanks
Ian
(http://farm6.staticflickr.com/5594/14883834249_a34b87d94e_z.jpg)
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Hi
I was wondering if there are any exercises you could suggest to recover plantar flexion range of the ankle. I'm a good 15/20 degrees short on the right ankle ever since i broke it a year ago, and the Physio i was seeing wouldn't help me out as according to him i don't need to be able to fully extend my foot :furious:
Google not been too helpful either. Are there any type of stretches or something that would actually help to recover those extra couple of inches? I'm already a bit of a short arse, so that extra range is pretty valuable to reach holds and the extra springiness in the more dynamic moves would be handy.
Thanks a lot
Hi, the exercise/stretch that Duncan has suggested is a good one. Just make sure you don't compensate by rotating your foot.
A year on post fracture can be difficult to change. I would also look at what your calf raises are like and dynamic movements such as hopping. Compare to your good leg. What did you fracture ?Also maybe get a second opinion from another physio?
let me know how it is going and any further info. may help me.
regards
matt
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Hi Matt
I have a tender spot in/around my Trapezius on the right side and also quite stiff around the neck and shoulders. It looks like there's a slight swelling you can see in the picture.
I rested a few days then reduced the intensity of my sessions and have been doing neck stretches and shrugs, also tried using a tennis ball for massage but quite unsuccessfully.
What would you recommend to get this sorted out?
Thanks
Ian
(http://farm6.staticflickr.com/5594/14883834249_a34b87d94e_z.jpg)
Hi Ian, It is not common to have swelling in this area, it may be the muscle is slightly more prominent due to the general shoulder girdle position.
Your right shoulder looks slightly more depressed and protracted (forward) than your left. This would tend to suggest your pects on the right are tighter ie pulling your shoulder forward. If your shoulder is slightly down then this makes it more mechanically weaker ie the muscles are not in there optimal position. I wouldn't over stretch the neck on the right side because in theory you are slightly stretching these structures already.
Try shoulder presses and exercises to elevate the shoulder and if you are doing any other shoulder exercises try and lift the shoulder slighgtly but don't pull it back too much. If symptoms are persisting I would recommend a consultation as it would be good to observe you moving as this may be causing the discomfort.
Working postures are also important to look at as you may be dropping the shoulder when using a mouse for example.
regards
Matt
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Thanks Duncan and Matt, i'll be giving that a try.
Yes, it could be hard to get anything out of it a year on, but i may as well try. Since nothing has been done so far i reckon i should get at least a little improvement, or i hope so at least.
Fracture was a pilon + fibula which was effectively neglected for 2 months... and after that even though the doc sent an urgent referral for physio it still took a further 3 months for my first appointment to come through, only to end up with somebody fresh from school who said he didn't know what to do. So a further month to get re-referred to a second physio who gave up after 4 20 minute sessions saying that everything he would try i was already doing it by myself and there was no point in me going to see him any more. Got to love the NHS :blink:
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Thanks Duncan and Matt, i'll be giving that a try.
Yes, it could be hard to get anything out of it a year on, but i may as well try. Since nothing has been done so far i reckon i should get at least a little improvement, or i hope so at least.
Fracture was a pilon + fibula which was effectively neglected for 2 months... and after that even though the doc sent an urgent referral for physio it still took a further 3 months for my first appointment to come through, only to end up with somebody fresh from school who said he didn't know what to do. So a further month to get re-referred to a second physio who gave up after 4 20 minute sessions saying that everything he would try i was already doing it by myself and there was no point in me going to see him any more. Got to love the NHS :blink:
Hi, no problems. The fracture you mention is a more complicated one than just the fibula. I am sorry you didn't receive treatment earlier. Keep stretching it and hopefully you will regain some more movement, and as I said test you calf raises and can you bounce on it?
regards
matt
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The fracture you mention is a more complicated one than just the fibula.
Yes, the fibula was incidental, so much so that the latest doc said there was no need to heal it as according to him it has no use :o Luckily it healed on its own, albeit in a rather funky configuration...
test you calf raises and can you bounce on it?
Calf raises barely. I can just about push on the toes and get the heel off the ground a little over an inch doing a single calf raise. Getting pretty strong with static strength though thanks to climbing.
Bouncing no way as the calve is still not strong enough to 'launch' me and definitely not even close to cushion the landing through the ball of the foot if you know what i mean. Still going down stairs landing on the heel...
Work in progress that is, but according to the physio since the muscle doesn't travel much then it won't strengthen either? Think he was talking out his ass though, as i'm definitely seeing improvements on that and with a bit of momentum i can feel the push when lightly skipping or trying to 'run' up stairs which it wasn't happening some weeks ago.
Thanks
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The fracture you mention is a more complicated one than just the fibula.
Yes, the fibula was incidental, so much so that the latest doc said there was no need to heal it as according to him it has no use :o Luckily it healed on its own, albeit in a rather funky configuration...
test you calf raises and can you bounce on it?
Calf raises barely. I can just about push on the toes and get the heel off the ground a little over an inch doing a single calf raise. Getting pretty strong with static strength though thanks to climbing.
Bouncing no way as the calve is still not strong enough to 'launch' me and definitely not even close to cushion the landing through the ball of the foot if you know what i mean. Still going down stairs landing on the heel...
Work in progress that is, but according to the physio since the muscle doesn't travel much then it won't strengthen either? Think he was talking out his ass though, as i'm definitely seeing improvements on that and with a bit of momentum i can feel the push when lightly skipping or trying to 'run' up stairs which it wasn't happening some weeks ago.
Thanks
Hi, it sounds like it is changing and definitely keep going. In theory your calf will strengthen and also the bounce will return and start to control your foot. Sometimes it can feel strong but it can still take time to be able to hop and then reabsorb the energy on landing for the next hop. Patients often report that their ankle feels wooden. Try leaning forward on to a kitchen worktop and do little supported bounces from the left to right foot (both single and double small bounces). You might find this is a start as you can't hop unsupported.
Using your body weight is probably the best way to self mobilise that tight scar tissue as it tends to be hard work when trying to stretch it with your hands.
Let me know how your are going.
Regards
Matt
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Hello HP Clinic.
I have a recently acquired problem I was hoping you could possibly advise me on. I have started with some discomfort in my left elbow. I've never had any trouble with it before. I've had a niggling pain in it, certainly worse when my arm is fully bent. I do a physical job which isn't helping but being self employed, no one pays you for being off ill though. Climbing wise it's been slowing me down, and tonight it reduced me to a stop. I just couldn't put any power through my arm at all and started peeling off problems, even easy stuff. The sore area is just up from my actual elbow joint, a few inches up my forearm. Sorry about the lack of specifics, quite hard to describe. Tonight it has also left me with pins and needles in my forearm and the back of my hand, which is a first. My training sensei has advised I treat it with ice and heat, and anti inflammatory if needed. Any other input at all? I have my first trip to font at the end of the month, so no pressure :'(
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Hi there Steve and gang,
Hoping you can help me out; as you have done in the past...
Whilst climbing on Tuesday I was doing a move where was hanging by my arms and trying to lift my feet up to a foot hold very high up and to my left. So I basically doing an awkward knee lift and twist, which I must admit didn't feel plausible, but I was just trying to stay on the route!
My attempt ended with a sharp pain on the right side of the front of my torso at the bottom of my ribs and was accompanied by snappy noise.
The pain now comes when moving around in bed, looking over left shoulder (reversing!) and various other things where I engage my right hand side upper body. As I write this I am less than 48hrs in so might be jumping the gun a bit as I imagine that a period of healing might just sort it out. But because of that unpleasant noise at the point of the injury I thought I would try to get some understanding of what I might have done to myself!
Any ideas?
Many thanks for any help.
Richard W
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...
oh and I forgot to say, it also hurts if I sneeze, laugh or take a deep breath. :(
Richard.
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Hello HP Clinic.
I have a recently acquired problem I was hoping you could possibly advise me on. I have started with some discomfort in my left elbow. I've never had any trouble with it before. I've had a niggling pain in it, certainly worse when my arm is fully bent. I do a physical job which isn't helping but being self employed, no one pays you for being off ill though. Climbing wise it's been slowing me down, and tonight it reduced me to a stop. I just couldn't put any power through my arm at all and started peeling off problems, even easy stuff. The sore area is just up from my actual elbow joint, a few inches up my forearm. Sorry about the lack of specifics, quite hard to describe. Tonight it has also left me with pins and needles in my forearm and the back of my hand, which is a first. My training sensei has advised I treat it with ice and heat, and anti inflammatory if needed. Any other input at all? I have my first trip to font at the end of the month, so no pressure :'(
Hi, the first thing that springs to mind when you describe pins and needles is that you have irritated or compressed a nerve around the elbow.
The median nerve (http://en.wikipedia.org/wiki/Median_nerve#mediaviewer/File:Nerves_of_the_left_upper_extremity.gif (http://en.wikipedia.org/wiki/Median_nerve#mediaviewer/File:Nerves_of_the_left_upper_extremity.gif)) runs through the front of the elbow and the radial nerve slightly to the outside. If you have been doing a lot of locking out and fully bending your elbow then you might have compressed them a little more than they would like.
I would recommend that you stay away from any locking out manoeuvres or too much elbow bending with strong biceps contraction. Try this nerve mobilisation technique from this link Median Nerve Mobilization (Glides - Slider) (http://www.youtube.com/watch?v=ANY7yPRn-qk#ws)
Let me know how things are going and if it is not settling see a physio.
regards
Matt
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Hi there Steve and gang,
Hoping you can help me out; as you have done in the past...
Whilst climbing on Tuesday I was doing a move where was hanging by my arms and trying to lift my feet up to a foot hold very high up and to my left. So I basically doing an awkward knee lift and twist, which I must admit didn't feel plausible, but I was just trying to stay on the route!
My attempt ended with a sharp pain on the right side of the front of my torso at the bottom of my ribs and was accompanied by snappy noise.
The pain now comes when moving around in bed, looking over left shoulder (reversing!) and various other things where I engage my right hand side upper body. As I write this I am less than 48hrs in so might be jumping the gun a bit as I imagine that a period of healing might just sort it out. But because of that unpleasant noise at the point of the injury I thought I would try to get some understanding of what I might have done to myself!
Any ideas?
Many thanks for any help.
Richard W
Hi Richard,
It sounds like it could be muscular. The click or pop could have come from a joint either from the thoracic spine or lower rib area. Sometimes if the force is at an end range of movement ie extreme stretch, then a joint will release a bubble of CO2 and you will here a pop. We will sometimes get a similar sound if we administer a controlled manipulation.
I don't feel it is anything to worry about and you are right it is still very acute. Keep gently moving your neck and trunk as symptoms allow and ease off the grades. Slowly increase the grades as symptoms allow.
Let me know how your are going next week.
regards Matt
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Matt,
Thanks for the help, I'll see how it improves in the next few days.
Richard.
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Hi
I have a problem with my right shoulder but this particular problem has effected both shoulders at different points in my life.
When I raise my arm it feels like its ROM gets restricted as I'm approaching shoulder height and it becomes uncomfortable as I get above shoulder height. I have very pronounced Acroniums and I wonder if it's causing some sort of obstruction when I raise my arm. I can feel a bit of crunching around that area when trying to do exercises that require raising my and and when I am lowering from a one-arm pull up, I can feel a bit of crunching on the way down at the last stage of lowering, perhaps the last inch or two.
I have a feeling that some of the problem is that I'm not putting my joint into a great position sometimes when climbing (not pulling my shoulders back and down?). I don't really do any antagonistic work on my shoulders and seeing as I climb so much I'm sure that proper shoulder position and antagonistic stuff would help with this?
I'd appreciate any advice you can give and most likely, I'd come in for you guys to take a look. Who would be the best person to see regarding shoudlers?
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Matt,
Thanks for the help, I'll see how it improves in the next few days.
Richard.
Update: Well my coughing breathing moving in bed is no longer a problem. Just getting a bit of pain if engage my abs with some certain movements. a regular sit up is ok and it wasn't 2 weeks ago. Although the hypochondriac in me would like an exact diagnosis, I think I may be better to continue staying as active as I can be whilst avoiding anything that causes the pain. then hopefully a few more weeks might see it right. Does this sound like the best way forward?
Cheers,
Richard
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Two Fridays with no reply, I take it that this thread has fizzled out now?
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Hi
I have a problem with my right shoulder but this particular problem has effected both shoulders at different points in my life.
When I raise my arm it feels like its ROM gets restricted as I'm approaching shoulder height and it becomes uncomfortable as I get above shoulder height. I have very pronounced Acroniums and I wonder if it's causing some sort of obstruction when I raise my arm. I can feel a bit of crunching around that area when trying to do exercises that require raising my and and when I am lowering from a one-arm pull up, I can feel a bit of crunching on the way down at the last stage of lowering, perhaps the last inch or two.
I have a feeling that some of the problem is that I'm not putting my joint into a great position sometimes when climbing (not pulling my shoulders back and down?). I don't really do any antagonistic work on my shoulders and seeing as I climb so much I'm sure that proper shoulder position and antagonistic stuff would help with this?
I'd appreciate any advice you can give and most likely, I'd come in for you guys to take a look. Who would be the best person to see regarding shoudlers?
Hi, sorry about the delay in responding, I have been on hols plus illness.
It sounds like you are impinging ie getting increased pinching/ compression of the rotator cuff muscles (small muscles that are the foundation of all your shoulder movements - they basically keep your shoulders stable). This problem often occurs around the shoulder height position.
You may be tight in your side trunk muscles and this will pull down on your shoulders and put them at a mechanical disadvantage. Your thoracic spine (mid) is important for shoulder movements and this may also be stiff.
Don't necessarily pull your shoulders down and back as this may increase symptoms. The shoulder girdle position needs to be looked at but in conjunction with the rest of your body.
I think it would be best to either book in with myself or Steve at the clinic as I don't think we can fully understand your problem until we look at you.
kind regards Matt
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Matt,
Thanks for the help, I'll see how it improves in the next few days.
Richard.
Update: Well my coughing breathing moving in bed is no longer a problem. Just getting a bit of pain if engage my abs with some certain movements. a regular sit up is ok and it wasn't 2 weeks ago. Although the hypochondriac in me would like an exact diagnosis, I think I may be better to continue staying as active as I can be whilst avoiding anything that causes the pain. then hopefully a few more weeks might see it right. Does this sound like the best way forward?
Cheers,
Richard
Hi that sounds like the best way. keep increasing the volume and intensity of the climbing as symptoms allow.
Regards Matt, sorry about the delay in responding
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Hi
Ok my problem/pain is in my right bicep. I can make it hurt by contracting bicep with my palm facing out. The pain is near the elbow end of the bicep. Its been like this a while, about month and half. I train or boulder lets say an average of 4/5 days a week, maybe pushing it a bit recently. I actually have a similar pain in the left bicep as well, but less so.
cheers in advance
Hi, it is difficult to say whether you have a purely biceps problem as it could also be deeper ie elbow joint. It hurts when you have your palm facing outwards which is actually taking load off the biceps (the biceps flexes and rotates the lower arm from palm down to up). It could be that you are compressing the joint ie fully flexed elbow and a biceps contraction.
As both biceps are hurting it is probably more due to the recent increase in intensity. I would tend to think that you need to back off on the intensity and climb at a pain free level and then slowly increase the loads/grade as symptoms allow. Maybe stay away from locking out on the elbows for the next few week. When you are back to climbing fully again just make sure you monitor the intense sessions and ensure you have easier sessions on following days particularly when you are climbing frequently.
Other possibilities are that sometimes the neck or upper back can refer pain and we would tend to assess what your shoulder and trunk is doing and are you pulling too much through your elbows. Hope this helps and let me know if symptoms persist, regards
Matt
Hi Mat
Thanks for your reply. I just gave myself a little test. The right bicep is quite a bit worse and hurts if I do a regular bicep curl, as well as the palms out indicator I gave you. It doesn't hurt deadhanging. Thinking back I did do quite a lot of deep lock training on rings and campus boards about two/three months ago. Since then I have been focusing on projects which are generally steep and fingery and haven't caused much pain. The pain got worse three days ago after a session on a problem that again involved a deep lock on a big hold.
I did some research and thought maybe distal bicep tendonitis.
I've also been climbing a very long time, ie I'm old! so maybe posture is a key as well.
cheers Andy
Hi Andy, you may have overloaded the distal tendon but it is less likely to be a tendonitis ie inflammatory as it has been going on for a 2 month period. It could be more of a tendonosis ie more wear and and tear, but only a problem if the tendon is overloaded to soon or too much. It is difficult for an exact diagnosis when it is deep elbow pain. The action you describe is both when the biceps is contracting and the joint is being compressed (also some of the nerves around the elbow can be compressed).
Poor posture can certainly contribute and often climbers are stiff in their mid back region. This area is important for reaching and stretching your arms out for holds. If you are in a sedentary sitting job then make sure you move regularly and do neck and trunk rotations and lift your chest and occasionally reach towards the ceiling.
As before avoid extensive locking out positions and reduce your load and grades. Increase as able and maybe you need to come in or visit a physio.
regards
Matt
Hi Matt
Slightly worrying how long ago my original post was! I still have a deep bicep pain, worse in my right bicep. Hurts now in some everyday situations, such as carrying a laptop with bent arm, and when I wake up, a good stretch helps. pain is no worse when climbing and doesn't limit a session at all. Getting a bit fed up with it now. Any ideas? cheers Andy
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How long does it take for tennis elbow to improve? Mine has been giving me problems for a few months now. I had it diagonsed first by a GP, confirmed by a physion, and have been doing eccentric curls as recommended by Dave MacLeod, Julian Saunders etc, and there's not been much sign of improvement. I've barely climbed at all since I did it.
Thanks
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Sorry this is a post from my partner (who isnt on ukb), not me:
Hello. I am on a long climbing trip at the moment and my right elbow has been really sore for about 2 months. It is painful on the bone on the thumb side but also some pain up the back of my arm. I also have a neck problem which I have had for a few years and I guess might be connected. I have pain in the muscle that runs from the neck to the shoulder and sometimes this makes my upper back really tight where it meets the spine. I can reduce this issue by massaging the pressure point (??) on my neck to remove the tightness across my back, which leaves a sore lump on the pressure point in my neck. Any suggestions for stretches/remedial action that might be useful? I seem to notice more pain in my elbow when I use flat rarther than in cut holds. I get pain when I use my fingers - e.g. picking up a bottle. The elbow is the main problem currently but any suggestions for either if you feel the neck and shoulder issues are not connected would be great.
Many thanks,
Caryl
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Hi
Ok my problem/pain is in my right bicep. I can make it hurt by contracting bicep with my palm facing out. The pain is near the elbow end of the bicep. Its been like this a while, about month and half. I train or boulder lets say an average of 4/5 days a week, maybe pushing it a bit recently. I actually have a similar pain in the left bicep as well, but less so.
cheers in advance
Hi, it is difficult to say whether you have a purely biceps problem as it could also be deeper ie elbow joint. It hurts when you have your palm facing outwards which is actually taking load off the biceps (the biceps flexes and rotates the lower arm from palm down to up). It could be that you are compressing the joint ie fully flexed elbow and a biceps contraction.
As both biceps are hurting it is probably more due to the recent increase in intensity. I would tend to think that you need to back off on the intensity and climb at a pain free level and then slowly increase the loads/grade as symptoms allow. Maybe stay away from locking out on the elbows for the next few week. When you are back to climbing fully again just make sure you monitor the intense sessions and ensure you have easier sessions on following days particularly when you are climbing frequently.
Other possibilities are that sometimes the neck or upper back can refer pain and we would tend to assess what your shoulder and trunk is doing and are you pulling too much through your elbows. Hope this helps and let me know if symptoms persist, regards
Matt
Hi Mat
Thanks for your reply. I just gave myself a little test. The right bicep is quite a bit worse and hurts if I do a regular bicep curl, as well as the palms out indicator I gave you. It doesn't hurt deadhanging. Thinking back I did do quite a lot of deep lock training on rings and campus boards about two/three months ago. Since then I have been focusing on projects which are generally steep and fingery and haven't caused much pain. The pain got worse three days ago after a session on a problem that again involved a deep lock on a big hold.
I did some research and thought maybe distal bicep tendonitis.
I've also been climbing a very long time, ie I'm old! so maybe posture is a key as well.
cheers Andy
Hi Andy, you may have overloaded the distal tendon but it is less likely to be a tendonitis ie inflammatory as it has been going on for a 2 month period. It could be more of a tendonosis ie more wear and and tear, but only a problem if the tendon is overloaded to soon or too much. It is difficult for an exact diagnosis when it is deep elbow pain. The action you describe is both when the biceps is contracting and the joint is being compressed (also some of the nerves around the elbow can be compressed).
Poor posture can certainly contribute and often climbers are stiff in their mid back region. This area is important for reaching and stretching your arms out for holds. If you are in a sedentary sitting job then make sure you move regularly and do neck and trunk rotations and lift your chest and occasionally reach towards the ceiling.
As before avoid extensive locking out positions and reduce your load and grades. Increase as able and maybe you need to come in or visit a physio.
regards
Matt
Hi Matt
Slightly worrying how long ago my original post was! I still have a deep bicep pain, worse in my right bicep. Hurts now in some everyday situations, such as carrying a laptop with bent arm, and when I wake up, a good stretch helps. pain is no worse when climbing and doesn't limit a session at all. Getting a bit fed up with it now. Any ideas? cheers Andy
Hi Andy, I am sorry to hear your are still experiencing problems. I think it would be best to book an appointment with a physio to get a full assessment. If you are local to Sheffield either book in with myself or Steve Hodgson.
regards
Matt
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Hi there,
I've a sharp pain (almost spasm) in my lower left back moving down the top of the back of my left buttock (if that makes sense). Hard/impossible to put socks on first thing, but eases off after I've been up and moving for a bit. I'm wondering if its lower back (where I've had problems before) or something to do with my leg/bum/hamstring area? It came on after (a few hours after) trying some high leg compression moves...
Doing some basic stretches - and single leg raises (esp left) seem to twinge it....
Tom
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Sorry this is a post from my partner (who isnt on ukb), not me:
Hello. I am on a long climbing trip at the moment and my right elbow has been really sore for about 2 months. It is painful on the bone on the thumb side but also some pain up the back of my arm. I also have a neck problem which I have had for a few years and I guess might be connected. I have pain in the muscle that runs from the neck to the shoulder and sometimes this makes my upper back really tight where it meets the spine. I can reduce this issue by massaging the pressure point (??) on my neck to remove the tightness across my back, which leaves a sore lump on the pressure point in my neck. Any suggestions for stretches/remedial action that might be useful? I seem to notice more pain in my elbow when I use flat rarther than in cut holds. I get pain when I use my fingers - e.g. picking up a bottle. The elbow is the main problem currently but any suggestions for either if you feel the neck and shoulder issues are not connected would be great.
Many thanks,
Caryl
Hi Caryl, read the previous response to the post on elbow pain. I would certainly look at your neck to begin with as the cervical spine can definitely refer pain into the elbow and further down your arm. As you have had this problem for a couple of months you may also be compensating due to the elbow pain and causing increased tension around the neck (get someone to look at whether you are doing odd movements with your arm etc). Make sure you have full neck rotation and that you have full trunk rotation in sitting. If it is possible you need to back off on the intensity of the climbs and try and climb with minimal symptoms. If it is possible it may be worth getting an elbow support or if you are away from civilisation then try and tape just below they sore spot on your elbow. You can attach the tape to the extensor muscle group and pull either way. Try it one way and see how picking up a bottle is. If it doesn't help pull the tape the other way. Be careful not to go right around the arm or too tight. Let me know how you are going and perhaps catch up with a physio on your return.
regards
Matt
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Hi there,
I've a sharp pain (almost spasm) in my lower left back moving down the top of the back of my left buttock (if that makes sense). Hard/impossible to put socks on first thing, but eases off after I've been up and moving for a bit. I'm wondering if its lower back (where I've had problems before) or something to do with my leg/bum/hamstring area? It came on after (a few hours after) trying some high leg compression moves...
Doing some basic stretches - and single leg raises (esp left) seem to twinge it....
Tom
Hi Tom, it sounds like you have irritated your lower back and getting a bit of referred pain into your left buttock. This will usually settle down within 2 weeks particularly as you only have local pain ie not going down in to your leg. The morning stiffness is quite characteristic of acute lower back pain particularly as you have been still for 7-8 hours. As long as you feel better for moving then continue to increase your walking and do some basic lower back exercises ie knees to chest, trunk rotations and some pelvic tilts.
The first 2-3 days can be painful but then you should improve and start to move better. The sooner you can relax and bend forward without guarding or spasms the better things will be. Perhaps lay off the climbing until you can move with minimal stiffness but kee active ie don't sit around. Let me know how you are going and if things aren't progressing give us a call. Sometimes we need to assess why you have had lower back pain particularly if it is reoccuring
regards
Matt
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Thanks Matt - off to a wedding tonight, so I now have the perfect excuse not to dance then! :D
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I am on a long climbing trip at the moment
I think Caryl's injury has been brought on by her partner's excess smugness/relentless amazing venue photo posting...
HP guys - I rolled my ankle last week and was wondering what sort of rehabilitation exercises I should be doing? Cheers!
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Thanks Matt - off to a wedding tonight, so I now have the perfect excuse not to dance then! :D
Went to see a physio in Manc on Monday - and it seems I have a strained/pulled glute.. Still painful..
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How long does it take for tennis elbow to improve? Mine has been giving me problems for a few months now. I had it diagonsed first by a GP, confirmed by a physion, and have been doing eccentric curls as recommended by Dave MacLeod, Julian Saunders etc, and there's not been much sign of improvement. I've barely climbed at all since I did it.
Thanks
Was this one overlooked?
Thanks Again
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Matt,
Thanks for the reply, much appreciated. We are back in the uk for a few weeks soon so I will definitely see a physio. Good suggestions re taping and support too. Will investigate.
Caryl via Benf
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How long does it take for tennis elbow to improve? Mine has been giving me problems for a few months now. I had it diagonsed first by a GP, confirmed by a physion, and have been doing eccentric curls as recommended by Dave MacLeod, Julian Saunders etc, and there's not been much sign of improvement. I've barely climbed at all since I did it.
Thanks
.
Was this one overlooked?
Thanks Again
Hi sorry I must have overlooked your email.
This would probably suggest that your initial diagnosis is probably incorrect. Unfortunately Tennis elbow is often used for any elbow pain. Eccentric exercises don't always help and the evidence on whether they work for the upper limbs is debatable.
The elbow joint can refer pain and there are also nerves that pass through or near to the elbow. These can become compressed or over stretched. I would also look at what your shoulder and trunk are doing as weakness or loss of control around these areas will mean more stress through your elbow. I would also want to clear your neck as this can also refer into your elbow area.
If you are local then perhaps I would come in for an assessment or get another opinion.
regards
Matt
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Thanks Matt - off to a wedding tonight, so I now have the perfect excuse not to dance then! :D
Went to see a physio in Manc on Monday - and it seems I have a strained/pulled glute.. Still painful..
Hi, sorry to be devils advocate but I have never seen anyone with a gluts strain in 17 years! get your back checked out soon.
regards
Matt
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Hi Matt - was having another session when you replied...
She worked my lower back and also hamstring a lot... But spent 15 min hammering my glute (deep) and you could feel it free up...
A week on it feels like someone is twisting a knife deep in my arse/buttock above the hip whenever I transition between standing up or sitting down. She also talked a lot about linkage from right shoulder to left lower back (and where the pain is) wondering whether it was linked to R shoulder issues I had 25 yrs ago.
Dead hanging banned too :(
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Hi Matt - was having another session when you replied...
She worked my lower back and also hamstring a lot... But spent 15 min hammering my glute (deep) and you could feel it free up...
A week on it feels like someone is twisting a knife deep in my arse/buttock above the hip whenever I transition between standing up or sitting down. She also talked a lot about linkage from right shoulder to left lower back (and where the pain is) wondering whether it was linked to R shoulder issues I had 25 yrs ago.
Dead hanging banned too :(
Hi, it sounds like she is thinking more along the lower back direction. You will often get pain referred into the buttock and it will sometimes become over reactive and try and protect your lower back. Previous shoulder injuries can most definitely cause back pain if you change the way you move or compensate.
All he best
matt
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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
After studiously not getting round to seeing a physio this has now come to a head. In the past month I've had two "episodes" where I've felt a sudden jolt of pain in the muscle in question (girlfriend tells me its the trapezius) which then makes head movment left, right, up, and down very painful for a number of days. On each occasion this has been set off when drying my hair after getting out of the shower! NSAIDs seemed to help and I've been back climbing on it fairly quickly.
Aside from the 'episodes' I also had a lot of trouble whilst on holiday - long stretches driving the camper van causing short-term discomfort.
I'm off to see the physio tonight so will report back with their verdict. I suspect it is a posture thing (as suggested elsewhere on this thread) that could well be exacerbated by carrying heavy pads up long walk ins, playing the violin etc.
Hopefully will be told I can still climb and train and get some exercises for strenghthening.
So, not after advice as such, just wanted to provide follow up for anyone searching for similar ailments.
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It's obviously caused by drying your hair! Get a crop - job done. £40 please :)
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How long does it take for tennis elbow to improve? Mine has been giving me problems for a few months now. I had it diagonsed first by a GP, confirmed by a physion, and have been doing eccentric curls as recommended by Dave MacLeod, Julian Saunders etc, and there's not been much sign of improvement. I've barely climbed at all since I did it.
Thanks
.
Was this one overlooked?
Thanks Again
Hi sorry I must have overlooked your email.
This would probably suggest that your initial diagnosis is probably incorrect. Unfortunately Tennis elbow is often used for any elbow pain. Eccentric exercises don't always help and the evidence on whether they work for the upper limbs is debatable.
The elbow joint can refer pain and there are also nerves that pass through or near to the elbow. These can become compressed or over stretched. I would also look at what your shoulder and trunk are doing as weakness or loss of control around these areas will mean more stress through your elbow. I would also want to clear your neck as this can also refer into your elbow area.
If you are local then perhaps I would come in for an assessment or get another opinion.
regards
Matt
Hi Matt, Thanks for this reply, since been to another physio who also agreed it was tennis elbow, and recommended eccentric curls too, plus did a bit of accupuncture, which may or may not have helped. Sadly I'm in Aberdeen and good climbing physios locally are a bit thin on the ground!
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I don't know if tennis elbow is similar to golfers elbow in terms of prognosis, but when I had golfers a physio friend mentioned 18 months as a ballpark for pretty much getting rid of issues, and that was about right for me. Obviously gradual over that time though, and I still do the eccentrics most climbing days to avoid a repeat bout.
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Not what I wanted to hear, but thanks Alex.
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Obviously each casevis different but during that 18 month period I managed to keep training and did my hardest ever redpoints and onsights so there's still hope! Just had to modify training around what caused agro
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Paul B?
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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
After studiously not getting round to seeing a physio this has now come to a head. In the past month I've had two "episodes" where I've felt a sudden jolt of pain in the muscle in question (girlfriend tells me its the trapezius) which then makes head movment left, right, up, and down very painful for a number of days. On each occasion this has been set off when drying my hair after getting out of the shower! NSAIDs seemed to help and I've been back climbing on it fairly quickly.
Aside from the 'episodes' I also had a lot of trouble whilst on holiday - long stretches driving the camper van causing short-term discomfort.
I'm off to see the physio tonight so will report back with their verdict. I suspect it is a posture thing (as suggested elsewhere on this thread) that could well be exacerbated by carrying heavy pads up long walk ins, playing the violin etc.
Hopefully will be told I can still climb and train and get some exercises for strenghthening.
So, not after advice as such, just wanted to provide follow up for anyone searching for similar ailments.
Posture posture posture. Got to get some lumbar support to make me sit up straight and do some exercises.
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Which is what I've been told... Hunched shoulders = over curved and stressed lower back.
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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
After studiously not getting round to seeing a physio this has now come to a head. In the past month I've had two "episodes" where I've felt a sudden jolt of pain in the muscle in question (girlfriend tells me its the trapezius) which then makes head movment left, right, up, and down very painful for a number of days. On each occasion this has been set off when drying my hair after getting out of the shower! NSAIDs seemed to help and I've been back climbing on it fairly quickly.
Aside from the 'episodes' I also had a lot of trouble whilst on holiday - long stretches driving the camper van causing short-term discomfort.
I'm off to see the physio tonight so will report back with their verdict. I suspect it is a posture thing (as suggested elsewhere on this thread) that could well be exacerbated by carrying heavy pads up long walk ins, playing the violin etc.
Hopefully will be told I can still climb and train and get some exercises for strenghthening.
So, not after advice as such, just wanted to provide follow up for anyone searching for similar ailments.
Posture posture posture. Got to get some lumbar support to make me sit up straight and do some exercises.
Had second physio session today (NHS) and had 30 mins of soft tissue massage to get rid of knots in the shoulder. He thinks these are a symptom of the postural problem. Plan is to carry on doing the exercises I've got at the moment, practicing proper posture, and then meet again on Wednesday for bit more massage and to go through some strengthening exercises.
The massaging of the knots seems to have worked well. Really smoothed stuff out back there. So far so good.
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Hi Matt.
Sorry for 'hijacking' the intended purpose of this thread, but i got myself in a medical related pickle yet again and was wondering if your clinic could be of help. Maybe i should just contact the clinic direct, but i thought i may just as well use you as a first port of call ;)
I'll try to be brief, but somehow i always manage to complicate everything... to try to cut a long story short, i'm due shortly back in hospital for an arthroscopic surgery of the ankle to debride an anterior soft tissue impingement and for removal of an osteochondral defect and perform a microfracture.
Now, problem number one is that as of the hospital's standard plan for this intervention i will not be referred for physiotherapy until week 6 (NWB for this period), meaning that even being optimistic it won't be till week 10 at the earliest that i get to see a physio. :furious:
Problem number 2, and the main issue, is that after telling the surgeon i was not prepared to follow 'that' plan and that hence i was not willing to give permission to allow for the OCD procedure, he instructed me to (and was quite insistent that i do) 'do my own research' and make my own decision based on that, hinting that even though he had to give me that treatment plan i maybe should, if i chose, not to follow his directions.
We have a good relation and he knows i'm reasonably capable and knowledgeable from some long conversations we have had, so he knew that i would find that the latest studies show that early weight bearing and mobilization give the same outcomes with the advantage of an earlier return to normal life and considerably less disruption.
So my pickle is that the surgeon is somewhat telling me to go on with early rehabilitation and weight bearing, while at the same time because of hospital guidelines he must follow he can't help me or provide assistance for doing so... :-\
So why am i telling you all this?
I'm due to be in Sheffield the whole of next week, and was wondering if there's somebody in your clinic with expertise in early weight bearing and mobilization following this procedure who would be able to see me and put together a draft rehabilitation plan. Not sure how common it is to provide plans pre-operatively, but, well, my other option is to go at it alone, so worth a try.
Thanks Matt
(p.s. So much for being brief...)
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I don't know if tennis elbow is similar to golfers elbow in terms of prognosis, but when I had golfers a physio friend mentioned 18 months as a ballpark for pretty much getting rid of issues, and that was about right for me. Obviously gradual over that time though, and I still do the eccentrics most climbing days to avoid a repeat bout.
Golfer's too, took 18 months, now much improved...
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Hi Matt.
Sorry for 'hijacking' the intended purpose of this thread, but i got myself in a medical related pickle yet again and was wondering if your clinic could be of help. Maybe i should just contact the clinic direct, but i thought i may just as well use you as a first port of call ;)
I'll try to be brief, but somehow i always manage to complicate everything... to try to cut a long story short, i'm due shortly back in hospital for an arthroscopic surgery of the ankle to debride an anterior soft tissue impingement and for removal of an osteochondral defect and perform a microfracture.
Now, problem number one is that as of the hospital's standard plan for this intervention i will not be referred for physiotherapy until week 6 (NWB for this period), meaning that even being optimistic it won't be till week 10 at the earliest that i get to see a physio. :furious:
Problem number 2, and the main issue, is that after telling the surgeon i was not prepared to follow 'that' plan and that hence i was not willing to give permission to allow for the OCD procedure, he instructed me to (and was quite insistent that i do) 'do my own research' and make my own decision based on that, hinting that even though he had to give me that treatment plan i maybe should, if i chose, not to follow his directions.
We have a good relation and he knows i'm reasonably capable and knowledgeable from some long conversations we have had, so he knew that i would find that the latest studies show that early weight bearing and mobilization give the same outcomes with the advantage of an earlier return to normal life and considerably less disruption.
So my pickle is that the surgeon is somewhat telling me to go on with early rehabilitation and weight bearing, while at the same time because of hospital guidelines he must follow he can't help me or provide assistance for doing so... :-\
So why am i telling you all this?
I'm due to be in Sheffield the whole of next week, and was wondering if there's somebody in your clinic with expertise in early weight bearing and mobilization following this procedure who would be able to see me and put together a draft rehabilitation plan. Not sure how common it is to provide plans pre-operatively, but, well, my other option is to go at it alone, so worth a try.
Thanks Matt
(p.s. So much for being brief...)
Hi, I presume you have a restricted ankle hence the arthroscopy and debridement. The osteochondral lesion will be "tidied" up and the microfractures will stimulate the bone cells to make a type of cartilage. I know it is crucial not to overload this area as you want this reaction to occur. In the long term you want the best possible outcome and I appreciate there isn't a lot of research in this area.
Myself, Steve or Ian could see you so get in contact asap. I am also around until 5 o'clock today so if you get this message then maybe call me 0114 267 1223 for a more detailed chat.
regards
Matt
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How long does it take for tennis elbow to improve? Mine has been giving me problems for a few months now. I had it diagonsed first by a GP, confirmed by a physion, and have been doing eccentric curls as recommended by Dave MacLeod, Julian Saunders etc, and there's not been much sign of improvement. I've barely climbed at all since I did it.
Thanks
.Hi, I am sorry you have yet again been given the same advice and surprise, surprise it is no better. I would recommend that you perhaps print off my comments and see someone experienced ie look more globally and check the things I suggested (neck, Shoulder, median/radial/ulnar nerves around the elbow etc).
The physio doesn't necessarily have to be experienced in climbing but understand normal movement and compensations. Also true tennis elbow can get better in a very short time if treated properly but can be individual and in some cases take months. It is important to keep people active as long as symptoms don't worsen. It is good to move!
Hope this helps.
regards Matt
Was this one overlooked?
Thanks Again
Hi sorry I must have overlooked your email.
This would probably suggest that your initial diagnosis is probably incorrect. Unfortunately Tennis elbow is often used for any elbow pain. Eccentric exercises don't always help and the evidence on whether they work for the upper limbs is debatable.
The elbow joint can refer pain and there are also nerves that pass through or near to the elbow. These can become compressed or over stretched. I would also look at what your shoulder and trunk are doing as weakness or loss of control around these areas will mean more stress through your elbow. I would also want to clear your neck as this can also refer into your elbow area.
If you are local then perhaps I would come in for an assessment or get another opinion.
regards
Matt
Hi Matt, Thanks for this reply, since been to another physio who also agreed it was tennis elbow, and recommended eccentric curls too, plus did a bit of accupuncture, which may or may not have helped. Sadly I'm in Aberdeen and good climbing physios locally are a bit thin on the ground!
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Thanks Matt, i spoke with a lady on the phone and i'm booked to see Ian on Monday :thumbsup:
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Hi
I appear to have damaged my left ring finger while warming up on the home board yesterday - foot slipped while the left hand was open handed and felt a twinge in the finger and going down the fore-arm. Today I have a tender area around the base/right side of the finger first joint and when I put any weight on in an open or half-crimp position then there is the same pain down the fore-arm. In a full crimp or on a jug there doesn't seem to be any pain (t lowish load). It isn't the same as the more typical pulley injury I've had before so any advice on what it might be and rehabilitation would be appreciated!
Cheers.
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Hi
Ok my problem/pain is in my right bicep. I can make it hurt by contracting bicep with my palm facing out. The pain is near the elbow end of the bicep. Its been like this a while, about month and half. I train or boulder lets say an average of 4/5 days a week, maybe pushing it a bit recently. I actually have a similar pain in the left bicep as well, but less so.
cheers in advance
Hi, it is difficult to say whether you have a purely biceps problem as it could also be deeper ie elbow joint. It hurts when you have your palm facing outwards which is actually taking load off the biceps (the biceps flexes and rotates the lower arm from palm down to up). It could be that you are compressing the joint ie fully flexed elbow and a biceps contraction.
As both biceps are hurting it is probably more due to the recent increase in intensity. I would tend to think that you need to back off on the intensity and climb at a pain free level and then slowly increase the loads/grade as symptoms allow. Maybe stay away from locking out on the elbows for the next few week. When you are back to climbing fully again just make sure you monitor the intense sessions and ensure you have easier sessions on following days particularly when you are climbing frequently.
Other possibilities are that sometimes the neck or upper back can refer pain and we would tend to assess what your shoulder and trunk is doing and are you pulling too much through your elbows. Hope this helps and let me know if symptoms persist, regards
Matt
Hi Mat
Thanks for your reply. I just gave myself a little test. The right bicep is quite a bit worse and hurts if I do a regular bicep curl, as well as the palms out indicator I gave you. It doesn't hurt deadhanging. Thinking back I did do quite a lot of deep lock training on rings and campus boards about two/three months ago. Since then I have been focusing on projects which are generally steep and fingery and haven't caused much pain. The pain got worse three days ago after a session on a problem that again involved a deep lock on a big hold.
I did some research and thought maybe distal bicep tendonitis.
I've also been climbing a very long time, ie I'm old! so maybe posture is a key as well.
cheers Andy
Hi Andy, you may have overloaded the distal tendon but it is less likely to be a tendonitis ie inflammatory as it has been going on for a 2 month period. It could be more of a tendonosis ie more wear and and tear, but only a problem if the tendon is overloaded to soon or too much. It is difficult for an exact diagnosis when it is deep elbow pain. The action you describe is both when the biceps is contracting and the joint is being compressed (also some of the nerves around the elbow can be compressed).
Poor posture can certainly contribute and often climbers are stiff in their mid back region. This area is important for reaching and stretching your arms out for holds. If you are in a sedentary sitting job then make sure you move regularly and do neck and trunk rotations and lift your chest and occasionally reach towards the ceiling.
As before avoid extensive locking out positions and reduce your load and grades. Increase as able and maybe you need to come in or visit a physio.
regards
Matt
Hi Matt
Slightly worrying how long ago my original post was! I still have a deep bicep pain, worse in my right bicep. Hurts now in some everyday situations, such as carrying a laptop with bent arm, and when I wake up, a good stretch helps. pain is no worse when climbing and doesn't limit a session at all. Getting a bit fed up with it now. Any ideas? cheers Andy
Hi Andy, I am sorry to hear your are still experiencing problems. I think it would be best to book an appointment with a physio to get a full assessment. If you are local to Sheffield either book in with myself or Steve Hodgson.
regards
Matt
hello again...I had an ultrasound on my shoulders and biceps, no problems revealed in the biceps, but mild tendonopathy in the shoulders, any links or excersises you could refer me too for shoulder rehab...seems that the bicep rehab I've been doing may have been a waste of time.
cheers Andy
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Hi
Ok my problem/pain is in my right bicep. I can make it hurt by contracting bicep with my palm facing out. The pain is near the elbow end of the bicep. Its been like this a while, about month and half. I train or boulder lets say an average of 4/5 days a week, maybe pushing it a bit recently. I actually have a similar pain in the left bicep as well, but less so.
cheers in advance
Hi, it is difficult to say whether you have a purely biceps problem as it could also be deeper ie elbow joint. It hurts when you have your palm facing outwards which is actually taking load off the biceps (the biceps flexes and rotates the lower arm from palm down to up). It could be that you are compressing the joint ie fully flexed elbow and a biceps contraction.
As both biceps are hurting it is probably more due to the recent increase in intensity. I would tend to think that you need to back off on the intensity and climb at a pain free level and then slowly increase the loads/grade as symptoms allow. Maybe stay away from locking out on the elbows for the next few week. When you are back to climbing fully again just make sure you monitor the intense sessions and ensure you have easier sessions on following days particularly when you are climbing frequently.
Other possibilities are that sometimes the neck or upper back can refer pain and we would tend to assess what your shoulder and trunk is doing and are you pulling too much through your elbows. Hope this helps and let me know if symptoms persist, regards
Matt
Hi Mat
Thanks for your reply. I just gave myself a little test. The right bicep is quite a bit worse and hurts if I do a regular bicep curl, as well as the palms out indicator I gave you. It doesn't hurt deadhanging. Thinking back I did do quite a lot of deep lock training on rings and campus boards about two/three months ago. Since then I have been focusing on projects which are generally steep and fingery and haven't caused much pain. The pain got worse three days ago after a session on a problem that again involved a deep lock on a big hold.
I did some research and thought maybe distal bicep tendonitis.
I've also been climbing a very long time, ie I'm old! so maybe posture is a key as well.
cheers Andy
Hi Andy, you may have overloaded the distal tendon but it is less likely to be a tendonitis ie inflammatory as it has been going on for a 2 month period. It could be more of a tendonosis ie more wear and and tear, but only a problem if the tendon is overloaded to soon or too much. It is difficult for an exact diagnosis when it is deep elbow pain. The action you describe is both when the biceps is contracting and the joint is being compressed (also some of the nerves around the elbow can be compressed).
Poor posture can certainly contribute and often climbers are stiff in their mid back region. This area is important for reaching and stretching your arms out for holds. If you are in a sedentary sitting job then make sure you move regularly and do neck and trunk rotations and lift your chest and occasionally reach towards the ceiling.
As before avoid extensive locking out positions and reduce your load and grades. Increase as able and maybe you need to come in or visit a physio.
regards
Matt
Hi Matt
Slightly worrying how long ago my original post was! I still have a deep bicep pain, worse in my right bicep. Hurts now in some everyday situations, such as carrying a laptop with bent arm, and when I wake up, a good stretch helps. pain is no worse when climbing and doesn't limit a session at all. Getting a bit fed up with it now. Any ideas? cheers Andy
Hi Andy, I am sorry to hear your are still experiencing problems. I think it would be best to book an appointment with a physio to get a full assessment. If you are local to Sheffield either book in with myself or Steve Hodgson.
regards
Matt
hello again...I had an ultrasound on my shoulders and biceps, no problems revealed in the biceps, but mild tendonopathy in the shoulders, any links or excersises you could refer me too for shoulder rehab...seems that the bicep rehab I've been doing may have been a waste of time.
cheers Andy
Hi Andy, the mild tendinopathy in the shoulders is most probably no different to 100 climbers with/without symptoms. These findings are normal. The other things I have previously mentioned need to be excluded. Locking out can overload and increase stress to quite a few structures. This will not be seen on a scan. I suggest an assessment by a local physio as just giving you general exercises won't help. It is not a case of just strengthening and things will improve.
kind regards
Matt
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Hi
Whilst I wait for an appointment with the local GP I thought I'd seek some basic advice from you guys . I have very recently developed pain in my elbow area on the inside. Hard to describe but here goes (apologies for the appalling descriptive skills):
With my arm extended palm uppermost - On the elbow area there are two bony bumps, the lower is what I think of as the elbow itself. The pain localised to the area between the two bumps and on the actual elbow bone area. Like a Muppet I have been training lots of Repeaters recently and am pretty damned sure know I neglected stretches afterwards... The most pain is felt if I stand with my fist on my head, thumb down and press up against resistance, eg talking off a t-shirt.
Suspect Golfers but not no idea to be honest - I have had mild Tennis elbow before and press ups sorted thanks to your advice previously :) - I would like to start doing eccentrics and the broom handle exercises as per the UKC article - I also intend to do press ups daily - I wont fingerboard again until I get a professional view. Any ideas what the issue may be please? Would these exercises be OK and what sort of eccentrics should I do?
Sports physios are a rare commodity in Fife and am seriously considering a trip to the TCA Glasgow to see the physio there to get some advice from a body who has treated climbers regularly unlike my GP.
Many thanks, H
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Update: the pain has virtually disappeared as has the tenderness in the area described above, so presume not golfers. I'm going to rest for a few more days then slowly start training again monitoring carefully but not retrun to the volume I was at or to end up doing 2 training sessions plus a day climbing in 4 days!I have restructured training to ensure I have enough rest days and for reduced volume - my old body obviously needs a less agressive schedule and more rest between so I'm listening to it.
Cheers.
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Update: the pain has virtually disappeared as has the tenderness in the area described above, so presume not golfers. I'm going to rest for a few more days then slowly start training again monitoring carefully but not retrun to the volume I was at or to end up doing 2 training sessions plus a day climbing in 4 days!I have restructured training to ensure I have enough rest days and for reduced volume - my old body obviously needs a less agressive schedule and more rest between so I'm listening to it.
Cheers.
Hi, I think you are right as tendon problems tend to stick around. The elbow joint itself can be overloaded and particularly if you are locking out a lot. As I have often commented on, the tennis or golfers elbow type presentations can be referred pain from the neck or shoulder, nerve pain in and around the elbow or from the joint itself. I would also look at whether you are flexible and move well through your trunk ie you need good elongation and rotation through you spine to allow you to reach.
Most importantly you have looked at your training volume and intensity and sometimes this does need altering, remember recovery is part of progression. As physio's we are more interested in why this has occurred.
It is always difficult to diagnose without seeing you but if symptoms have regressed then slowly increase intensity as symptoms allow and if not maybe a trip to Glasgow might help things along.
regards
Matt
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Thanks for the advice Matt, really appreciate it; classic over-enthusiasm got the better of me - lesson well and truly learned! :slap:
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Hi, I've been having some issues for my shoulder for just over 2 months now.
I have had 5 physio sessions, and it's been diagnosed as an inflammed bicep tendon.
When I first noticed the issue, when it was at its worse, it came on as a dull ache during climbing, and then would progress to become really painful. Since the injury, and treatment (which has consisted of massage and stretches) started the injury has got better: there has been less pain and only an occasional stiffness/ache.
About a month ago, I did some endurance stuff on an overhanging wall, and as soon as I came off the pain was back in full force. My shoulder felt weaker, and when in a relaxed position my injured (right) shoulder sat a lot lower than my healthy left one.
I went back to the physio and he said that I'd caused it to flare up, but that the injury itself was nearly gone and that there was some residual weakness.
In the last month I have climbed numerous times with no pain. I always make an effort to do a decent warm up, and stretch after/between sessions. However, this Saturday I was doing some fairly easy bouldering/routes and the ache (although no real pain) came back. I continued climbing, and after the session the ache went away. Sunday I climbed for about an hour with no irritation. Yesterday, I climbed indoors and I had a pain in my shoulder, although without the characteristic ache, which prompted me to stop climbing. After the session, even when walking to a restaurant, the pain was intensifying, and it stopped when I was resting. In bed last night the pain was quite intense no matter what position I slept in.
The pain in this instance has felt different to usual - there has been little of the characteristic ache, and the pain has had a weird feeling to it - it feels sort of like when you lick a battery, kind of electrical (weird description but it's hard to describe!). I wonder if I have in fact trapped or irritated a nerve which is causing this pain?
To compound all of this, I'm going on a trip to Chulilla in a week!
Any advice on what to do/likelihood of the nerve issue would be much appreciated.
Thanks,
Theo.
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Hi, I've been having some issues for my shoulder for just over 2 months now.
I have had 5 physio sessions, and it's been diagnosed as an inflammed bicep tendon.
When I first noticed the issue, when it was at its worse, it came on as a dull ache during climbing, and then would progress to become really painful. Since the injury, and treatment (which has consisted of massage and stretches) started the injury has got better: there has been less pain and only an occasional stiffness/ache.
About a month ago, I did some endurance stuff on an overhanging wall, and as soon as I came off the pain was back in full force. My shoulder felt weaker, and when in a relaxed position my injured (right) shoulder sat a lot lower than my healthy left one.
I went back to the physio and he said that I'd caused it to flare up, but that the injury itself was nearly gone and that there was some residual weakness.
In the last month I have climbed numerous times with no pain. I always make an effort to do a decent warm up, and stretch after/between sessions. However, this Saturday I was doing some fairly easy bouldering/routes and the ache (although no real pain) came back. I continued climbing, and after the session the ache went away. Sunday I climbed for about an hour with no irritation. Yesterday, I climbed indoors and I had a pain in my shoulder, although without the characteristic ache, which prompted me to stop climbing. After the session, even when walking to a restaurant, the pain was intensifying, and it stopped when I was resting. In bed last night the pain was quite intense no matter what position I slept in.
The pain in this instance has felt different to usual - there has been little of the characteristic ache, and the pain has had a weird feeling to it - it feels sort of like when you lick a battery, kind of electrical (weird description but it's hard to describe!). I wonder if I have in fact trapped or irritated a nerve which is causing this pain?
To compound all of this, I'm going on a trip to Chulilla in a week!
Any advice on what to do/likelihood of the nerve issue would be much appreciated.
Thanks,
Theo.
Hi Theo,
The history you have given makes me think it is not an inflamed tendon. The fact that the symptoms are inconsistent again seems to suggest perhaps more of a neck or shoulder problem. The more recent symptoms do suggest a more nerve irritation. You observed that your right shoulder was more depressed than the left. This may be relevant as you may be putting additional traction on the brachial plexus (nerves coming out of your 5th to 7th levels of your neck and travelling under your collar bone towards the shoulder). Try supporting your arm in a sling or when sitting rest it up on some pillows. Does this make it feel easier? If it does then you are unloading the neural structures and giving them a chance to settle. They can be sensitive structures when irritated. Arm and neck movements are good but nothing that stirs it up.
Try some shoulder shrugs and when you are climbing make sure you are elongating you right side of your trunk when you reach up. This is important for shoulder girdle function and it lessens the chance of impinging your shoulder.
Perhaps go back to the physio and make sure they look a little more global and at how you move. They shouldn't be just focussing on your tendon! You want to know why these symptoms are occurring and have you any weakness or control issues/compensations?
I would suggest you rest your arm (as mentioned above) this week as the training you have done prior to your trip (although slightly interrupted) will be enough and you won't gain any improvements this week by training. Take care with looking up when you are belaying as this will compress your neck if done badly.
Hope this helps.
regards
Matt
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I am currently suffering from Achilles Tendonitis, bumps on the back of my heel. Doing stretches to relive it, would it still be ok to going climbing? Thanks Charlie :)
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Thanks for the advice Matt, very helpful. May have to get some stylish belay glasses.
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I am currently suffering from Achilles Tendonitis, bumps on the back of my heel. Doing stretches to relive it, would it still be ok to going climbing? Thanks Charlie :)
Hi Charlie, I presume the bumps are on the tendon attachment to the bone. It depends whether climbing has been the irritating factor. It isn't a common climbing injury but I have seen it and uit has usually occured when the foot holds are less supportive when progressing through the grades. If the tendon problem has occurred from running or a different activity then the climbing might actually help.
The current thinking on tendon rehab is a graded increase in load to the tendon and this can be different in individuals. You want to stress the tendon but not overload it. If it is acute then I would suggest a heel raise to decrease the load when walking and do not overstretch it particularly if there is not a length issue ie is it the same as the other leg.
Perhaps start with easier grades and bigger foot holds and progress from there.
regards
Matt
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Hi Matt,
Just after some advice if possible on how best to rehab a torn A4 pulley on my ring finger. I popped it just under a week ago- it made a nice pinging noise but didn't hurt at the time. Now the tenderness is mostly gone I've started ice water treatment once a day and gently squeezing a sponge ball. It actually feels pretty good which makes me think that the tear was a very small one, so I guess what I'm asking is - when can I start climbing again, and what can I do to help heal and strengthen the finger? I haven't had a finger injury like this before so it's new territory really. Is it worth taping, I've heard mixed things about this?
Cheers for your time!
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Hi Matt,
Just after some advice if possible on how best to rehab a torn A4 pulley on my ring finger. I popped it just under a week ago- it made a nice pinging noise but didn't hurt at the time. Now the tenderness is mostly gone I've started ice water treatment once a day and gently squeezing a sponge ball. It actually feels pretty good which makes me think that the tear was a very small one, so I guess what I'm asking is - when can I start climbing again, and what can I do to help heal and strengthen the finger? I haven't had a finger injury like this before so it's new territory really. Is it worth taping, I've heard mixed things about this?
Cheers for your time!
Hi, I am sorry about the delay in responding as I have been away for the half term. You are probably well on your way to recovering now. Usually there is a period after the initial injury when you need to treat the inflammatory response and slowly regain normal movement at the finger both into extension and flexion. You then need to gradually load the finger with resistance in and out of finger to palm (use the other hand to add resistance). Basically you should be able to bend your finger into and out of the palm against resistance without any of the finger joints 'snapping into extension ie the finger should curl into the palm and uncurl out of the palm against resistance (this can be increased). Try testing this. By now you might have started doing lower grade climbing with big holds. Slowly start to add occasional crimp holds and continue to gradually load.
The trick is to gradually load the tendon and the pulley system against increasing stress.
Call the clinic if you have any questions or respond to this post but I will only be able to pick it up next Friday.
cheers Matt
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Thanks Matt,
I really appreciate the reply. I think I got lucky with this one, I started climbing again, and although it seems to be pretty tender to begin with and feels weak compared to how it was before the tear, I can still boulder at around 70-80%. I'm avoiding crimps but the biggest pain is a lot of indoor holds seem to dig in just where it hurts the most.
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I've woken up today with a very unhappy right knee. I had a few goes on a problem with quite a powerful throw off a high heel last night. I didn't feel anything pop or go at the time but the go I did the problem I was definitely aware that the knee felt a bit wrong after the move. I finished my session (at least another hour of climbing though no more right heels) without any discomfort and walked around for the rest of the evening with no problems.
I woke up with it very stiff and sore when trying to move it, the head of the fibula is quite tender to the touch. I have full ROM with a just a little pain when the knee is full bent if I am not weighting the leg, bending it far when standing on it feels a bit grim. What seems to be the big problem in terms of movement is if I lie with my knees bent at 90 degrees on the left side, I really struggle to lift the lower right leg from the left. Walking is generally ok so long as I go very slow, feels quite unnatural though. Worst functional thing is going down stairs, bending the bad leg to put the good one the next step down isn't very nice.
I've just been taking it pretty easy today and working from home with a bit of icing. I guess I'm looking for a rough prognosis and how worried I should be? I'm in Sheffield and happy to come and see you guys but wondering if it's worth seeing my GP or if I'm just being paranoid and it'll be ok in a few days. Also, does this sound like something that would benefit from a knee support?
Cheers,
Alistair
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For the last 1/2 weeks I've had I have got a constant tingling sensation in my fingers and sounds like it's pops when I pick up something or go to a hold, worse when I've just woken up, some times get a weak hand. Just hoping it's not Carpel Tunnel? Cheers Charlie.
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I've woken up today with a very unhappy right knee. I had a few goes on a problem with quite a powerful throw off a high heel last night. I didn't feel anything pop or go at the time but the go I did the problem I was definitely aware that the knee felt a bit wrong after the move. I finished my session (at least another hour of climbing though no more right heels) without any discomfort and walked around for the rest of the evening with no problems.
I woke up with it very stiff and sore when trying to move it, the head of the fibula is quite tender to the touch. I have full ROM with a just a little pain when the knee is full bent if I am not weighting the leg, bending it far when standing on it feels a bit grim. What seems to be the big problem in terms of movement is if I lie with my knees bent at 90 degrees on the left side, I really struggle to lift the lower right leg from the left. Walking is generally ok so long as I go very slow, feels quite unnatural though. Worst functional thing is going down stairs, bending the bad leg to put the good one the next step down isn't very nice.
I've just been taking it pretty easy today and working from home with a bit of icing. I guess I'm looking for a rough prognosis and how worried I should be? I'm in Sheffield and happy to come and see you guys but wondering if it's worth seeing my GP or if I'm just being paranoid and it'll be ok in a few days. Also, does this sound like something that would benefit from a knee support?
Cheers,
Alistair
Hi Alistair, it is a little difficult to give you an exact diagnosis but the good things are that you have;
-no swelling
-your knee is not locking or giving way
-and at the time you didn't feel anything tear or pop.
If I have understood then the mechanism of the injury may be a muscular strain. Some of the hamstrings attach to the head of fibular and there is a muscle called popliteus that assists in rotation of the lower leg when the knee is in flexion. These should settle with the correct management.
It may be worth calling the clinic and having a chat and we can decide whether it is worth an assessment.
If symptoms are progressing then ease back into the climbing over the next few weeks starting at lower grades and build up. Initially avoid heel hooks.
either call me today or let me know and I will pick up the post next Friday.
regards
Matt
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For the last 1/2 weeks I've had I have got a constant tingling sensation in my fingers and sounds like it's pops when I pick up something or go to a hold, worse when I've just woken up, some times get a weak hand. Just hoping it's not Carpel Tunnel? Cheers Charlie.
Hi Charlie, tingling would indicate some nerve compression or irritation as well as the weakness. This could be from your neck or wrist area (as you have mentioned). I would suggest you book in to see a local physio as this needs to be sorted asap.
In the meantime try wearing a splint at night and see if it makes a difference.
regards
Matt
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Hi Matt,
I've started doing some squats in the gym recently. The weight I'm using doesn't seem excessive (80kg, bodyweight is 76kg), in that I'm not particularly sore after each session and I can happily maintain what looks to me like good form throughout. However, for a couple of hours after each session, I've had some numbness/pins and needles in my right arm. This is mainly in the tip of my thumb, the thumb side of my index finger and, to a lesser extent, along my radius and lateral upper arm. I'm guessing this is a nerve issue? It feels quite tight all around the medial side of my elbow when I'm actually lifting, and my shoulder flexibility isn't great...
What should I do? I'm not too worried about this at the moment as the effects seem temporary and have perhaps been decreasing slightly in severity (I've done 4 sessions over 4 weeks so far). If it is flexibility related, will continuing to do the exercise improve things gradually? It certainly feels like a decent non-painful stretch for some things I know should improve.
Thanks,
Ben
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What type of squat are you donig?
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Sorry, should have been more specific. Back squats:
(http://www.menshealth.com/powertraining/cms/uploads/1/backsquatB.jpg)
I've got my hands quite a bit closer together than the picture, though. Shoulder width plus 6", maybe?
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Hi Matt,
I've started doing some squats in the gym recently. The weight I'm using doesn't seem excessive (80kg, bodyweight is 76kg), in that I'm not particularly sore after each session and I can happily maintain what looks to me like good form throughout. However, for a couple of hours after each session, I've had some numbness/pins and needles in my right arm. This is mainly in the tip of my thumb, the thumb side of my index finger and, to a lesser extent, along my radius and lateral upper arm. I'm guessing this is a nerve issue? It feels quite tight all around the medial side of my elbow when I'm actually lifting, and my shoulder flexibility isn't great...
What should I do? I'm not too worried about this at the moment as the effects seem temporary and have perhaps been decreasing slightly in severity (I've done 4 sessions over 4 weeks so far). If it is flexibility related, will continuing to do the exercise improve things gradually? It certainly feels like a decent non-painful stretch for some things I know should improve.
Thanks,
Ben
Hi Ben, it definitely sounds like a nerve issue particularly as you are getting pretty specific symptoms.
There could be a few reasons why you are getting them. To begin with check that you are not protracting your head/neck too far forward or looking up as you may be impinging or compressing a nerve root at its origin. Secondly you may not have the flexibility at the shoulders ie external rotation when your arms are above your head. What might be occurring if this is the case is that you may be over extending the wrist and tractioning the nerves around the wrist. It definitely sounds like a positioning problem and if it is slowly improving then you may be getting used to the weight and your flexibility may be changing. The exercise is new to you and I would probably have started on a lower weight and higher repetitions for the first month and slowly increase the weight and decrease the reps as you require. Your muscles and soft tissues need time to adapt even if it feels easy.
Hope this helps and contact us at the clinic if symptoms persist.
kind regards
Matt
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Hi Matt,
4 weeks ago I injured my shoulder/triceps, not sure how i did it, nothing felt bad during my usual week of training but my best guess is I strained it doing reverse shoulder fly's with a resistance band as these are the only new excesses Ive been incorporating into my training as a way to warm down after weights.
The week that followed the injury i took off training my shoulders all together as pretty much the most painfull thing I found was to hang from a bar or fingerboard. Climbing outside didn't hurt so Ive continued to do that.
Ive visited my usual physio twice, he has told me that Ive damaged my sub scapularis rotator cuff and i should avoid doing anything painfull but to rehab regularly doing the usual rotator cuff exercises with a band or light weight...
This Ive been doing now for 3 weeks, and Ive started to reintroduce fingerboarding although i find warming up painfull!
What do you think?
Thanks in advance
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Hi Matt,
4 weeks ago I injured my shoulder/triceps, not sure how i did it, nothing felt bad during my usual week of training but my best guess is I strained it doing reverse shoulder fly's with a resistance band as these are the only new excesses Ive been incorporating into my training as a way to warm down after weights.
The week that followed the injury i took off training my shoulders all together as pretty much the most painfull thing I found was to hang from a bar or fingerboard. Climbing outside didn't hurt so Ive continued to do that.
Ive visited my usual physio twice, he has told me that Ive damaged my sub scapularis rotator cuff and i should avoid doing anything painfull but to rehab regularly doing the usual rotator cuff exercises with a band or light weight...
This Ive been doing now for 3 weeks, and Ive started to reintroduce fingerboarding although i find warming up painfull!
What do you think?
Thanks in advance
Hi,
I am trying to work out what you might have strained or injured. The reverse shoulder fly would probably bias the posterior cuff ie infraspinatus or teres minor more than subscapularis as you are rotating your shoulder outwards. Often all of the cuff muscles can be working together so to isolate a specific muscle strain is difficult. The exercises you are doing will be fine. It makes sense that you are getting some discomfort from hanging as all the cuff muscles will be working to keep the shoulder in the right place. I think you are getting more discomfort indoors as it tends to be more intense. Think about graded exercises and putting graded stress through the shoulder, so don't go too quickly on to the finger boards try bigger holds and progress on to more crimps and then finger boarding.
Ultimately make sure that when you move your shoulder (look in the mirror) you are not getting any compensations ie hitching of the shoulder.
Give me or Steve a call if you want to discuss in more detail.
Regards
Matt
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Thanks for that Matt,
yeah, its hard to say what did it but all the discomfort is in the lower rear part of my shoulder... putting my hand behind my back is agony atm but becomes bearable once warmed up a bit!
I will back off the hangs and persevere with the stretches for a couple more weeks.
Thanks again
Eddie
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Hi there,
I have picked up a hamstring strain which has now recurred and is in danger of becoming (literally!) a pain in the butt.
Started about 1 month ago, after a hard session threshold bouldering using a poor R heel hook. After the session I noticed a pull in my R hamstring roughly at the buttock crease.
Few days rest and it seemed to have gone, did some medium runs and modest climbing no probs.
BUT about a week ago I did a harder route which needed a high step then aggressively pulling down on that high (and out to the side) right toe. Started hurting again to the extent where I can feel the pull all the time, and even non-heel hook climbing hurts if I step above knee height.
At present I am resting it and have done a bit of gentle foam rolling to try and loosen up the tightness in the general area. Anything else I can do to speed recovery?
I am conscious that I have neglected my usual yoga and stretching over the last 4 months in the quest for more power. Haven't been doing any leg weights recently, and usually do 2 modest runs each week (30-40mins c 6k).
Btw Matt, please do remind us where your practise is, and how to book with you!
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Hey Matt - amazing resource - ta muchly.
I cant remember how I did it, but I do remember a sort of numb sensation down the back of my hand from between my index and middle knuckles running down about half way to my wrist. The numbness wore off pretty quickly and I assumed I'd just bashed a hold on the way down. Never stopped climbing.
Now about a week later I have a very tender area that extends from what feels like the same area between the knuckles mentioned above down to my wrist. It's a shooting pain if I touch it and similar shooting pain and tightness if I extend my arm and try to fully articulate my fist?
I've asked my GP who reckons its something to do with an extensor tendon (tear?) and has prescribed ibuprofen gel (which seems pretty useless because its sore to apply..). Keen on a second opinion and any advice?
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Hi there,
I have picked up a hamstring strain which has now recurred and is in danger of becoming (literally!) a pain in the butt.
Started about 1 month ago, after a hard session threshold bouldering using a poor R heel hook. After the session I noticed a pull in my R hamstring roughly at the buttock crease.
Few days rest and it seemed to have gone, did some medium runs and modest climbing no probs.
BUT about a week ago I did a harder route which needed a high step then aggressively pulling down on that high (and out to the side) right toe. Started hurting again to the extent where I can feel the pull all the time, and even non-heel hook climbing hurts if I step above knee height.
At present I am resting it and have done a bit of gentle foam rolling to try and loosen up the tightness in the general area. Anything else I can do to speed recovery?
I am conscious that I have neglected my usual yoga and stretching over the last 4 months in the quest for more power. Haven't been doing any leg weights recently, and usually do 2 modest runs each week (30-40mins c 6k).
Btw Matt, please do remind us where your practise is, and how to book with you!
Hi, it could be a hamstring strain and it should be able to be rehabilitated. I would normally like to make sure you haven't irritated your sciatic nerve which can sometimes seem like it is a hamstring strain (particularly if it reoccurs). In theory when you strain a muscle it should heal and during this process if you gradually load it again it should recover. You may have overloaded it too soon. I am based at the Hallamshire Physiotherapy clinic. If is still bothering you then either give me a call next week or book in. Sorry about the delay in responding I have been away for easter.
Regards
Matt
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Hey Matt - amazing resource - ta muchly.
I cant remember how I did it, but I do remember a sort of numb sensation down the back of my hand from between my index and middle knuckles running down about half way to my wrist. The numbness wore off pretty quickly and I assumed I'd just bashed a hold on the way down. Never stopped climbing.
Now about a week later I have a very tender area that extends from what feels like the same area between the knuckles mentioned above down to my wrist. It's a shooting pain if I touch it and similar shooting pain and tightness if I extend my arm and try to fully articulate my fist?
I've asked my GP who reckons its something to do with an extensor tendon (tear?) and has prescribed ibuprofen gel (which seems pretty useless because its sore to apply..). Keen on a second opinion and any advice?
Hi, sorry about the delay in responding, I have been away for easter. Numbness tends to mean nerve irritation. You may have compressed or stretched part of the radial nerve into your hand. It should recover with regular wrist movements. Perhaps give me a call on 0114 2671223 next week if it hasn't settled and we can have a better discussion.
regards
Matt
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Thanks Matt, that all sounds sensible and I'm now working on a more gradual loading with gentle weights - so far so good. Appreciate the warning about sciatic nerve, will book in if it flares up.
Much appreciate you advice, Andy
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I injured my A2 about 3.5 months ago and I think I have perhaps been a little harsh on it at times since then but I have been able to climb on it at 90% plus of normal use without really having any issue but it still nags at me and I can feel that there is something wrong with it most of the time. If I hit it against something unexpectedly it hurts but prodding it afterwards doesn't produce the same reaction. It was never a particularly bad injury and there was no pop etc.
I have taken nearly a week of because I am on holiday and its a little better (doesn't really feel like anything is wrong). I type on a computer all day for work usually so I don't know if the lack of climbing or lack of typing is what is helping.
Is this normal? I think that somewhere in dave macleods literature it mentions that sometimes you will feel a pulley injury for months after its healed and then one day it will just disappear but I wanted to hear your opinions on this.
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I injured my A2 about 3.5 months ago and I think I have perhaps been a little harsh on it at times since then but I have been able to climb on it at 90% plus of normal use without really having any issue but it still nags at me and I can feel that there is something wrong with it most of the time. If I hit it against something unexpectedly it hurts but prodding it afterwards doesn't produce the same reaction. It was never a particularly bad injury and there was no pop etc.
I have taken nearly a week of because I am on holiday and its a little better (doesn't really feel like anything is wrong). I type on a computer all day for work usually so I don't know if the lack of climbing or lack of typing is what is helping.
Is this normal? I think that somewhere in dave macleods literature it mentions that sometimes you will feel a pulley injury for months after its healed and then one day it will just disappear but I wanted to hear your opinions on this.
Hi, in my experience the pulley injuries do take months to rehabilitate but this does depend on the degree of strain or in the worst case scenario a complete rupture. The A2 pulley is the most common injured. I would say that if you had completely ruptured the pulley you would have heard a 'pop' and definitely would have had to stop immediately.
If you have had a strain then you would of been able to return to climbing quite quickly. It sounds like you may have overloaded the injury a little too quickly. Normally we recommend staying away from any crimping in the first 2-4 weeks and then slowly add some.
By now the injury should be healed but perhaps back off the harder grades and see how it feels and increase load gradually.
If symptoms are still persisting or not changing then give me a call.
regards
Matt
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Hey Matt - amazing resource - ta muchly.
I cant remember how I did it, but I do remember a sort of numb sensation down the back of my hand from between my index and middle knuckles running down about half way to my wrist. The numbness wore off pretty quickly and I assumed I'd just bashed a hold on the way down. Never stopped climbing.
Now about a week later I have a very tender area that extends from what feels like the same area between the knuckles mentioned above down to my wrist. It's a shooting pain if I touch it and similar shooting pain and tightness if I extend my arm and try to fully articulate my fist?
I've asked my GP who reckons its something to do with an extensor tendon (tear?) and has prescribed ibuprofen gel (which seems pretty useless because its sore to apply..). Keen on a second opinion and any advice?
Hi, sorry about the delay in responding, I have been away for easter. Numbness tends to mean nerve irritation. You may have compressed or stretched part of the radial nerve into your hand. It should recover with regular wrist movements. Perhaps give me a call on 0114 2671223 next week if it hasn't settled and we can have a better discussion.
regards
Matt
Matt - Thanks a bunch for this - I've been off line for a while but got this through a friends phone so I've been keeping an eye on things for a couple of weeks now and what you mention above seems to be correct - and very useful. Things are slowly getting back to normal - shooting pains are much less intense and much less frequent - numbness is getting pretty rare.
If anything else develops then I'll get back.
Again - many thanks!
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Hi guys,
Firstly thanks, this is a great idea!
Secondly, I've been suggested to post something here as I have finger pain that is currently preventing me climbing at my normal level. This started approx 3 weeks ago after I had completed a series of crimpy problems on the edge of my ability, which I had been working for a few back to back sessions.
The pain/ache is generally at the base of my fingers (base of my proximal phalanges), predominantly my ring fingers. I have noticed this before when I have been over-crimping on problems, have subsequently eased off for a couple of weeks alongside taping below my knuckle joint (which seemed to help with the ache whilst climbing) and things have improved.
This time however feels a bit different, particularly on my right ring finger, the ache is more constant with pain if I squeeze my hand around something. I have also noticed pain in my knuckle joint and if I squeeze my intermediate phalanges it is also tender.
If I massage around my proximal phalanges the ache seems to ease, ibuprofen has also helped. I have continued to climb approx 2-3 times a week restricting myself to easier problems and trying to open-hand or pinch only (I have noticed though a bad tendency to want to crimp most things!) this however still causes some level of discomfort.
I'd be interested to hear any suggestions as to what this might be, whether I should see a physio in person whether it sounds like fatigue or an injury, taping suggestions, exercise suggestions or anything else important!
Thanks,
Beccie
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Hi guys,
Firstly thanks, this is a great idea!
Secondly, I've been suggested to post something here as I have finger pain that is currently preventing me climbing at my normal level. This started approx 3 weeks ago after I had completed a series of crimpy problems on the edge of my ability, which I had been working for a few back to back sessions.
The pain/ache is generally at the base of my fingers (base of my proximal phalanges), predominantly my ring fingers. I have noticed this before when I have been over-crimping on problems, have subsequently eased off for a couple of weeks alongside taping below my knuckle joint (which seemed to help with the ache whilst climbing) and things have improved.
This time however feels a bit different, particularly on my right ring finger, the ache is more constant with pain if I squeeze my hand around something. I have also noticed pain in my knuckle joint and if I squeeze my intermediate phalanges it is also tender.
If I massage around my proximal phalanges the ache seems to ease, ibuprofen has also helped. I have continued to climb approx 2-3 times a week restricting myself to easier problems and trying to open-hand or pinch only (I have noticed though a bad tendency to want to crimp most things!) this however still causes some level of discomfort.
I'd be interested to hear any suggestions as to what this might be, whether I should see a physio in person whether it sounds like fatigue or an injury, taping suggestions, exercise suggestions or anything else important!
Thanks,
Beccie
Hi Beccie,
It sounds like an A2 pulley sprain. It is a common area to strain and the ring finger is often the more common finger to injure. It may also be a finger tendon strain. These type of injuries can vary and respond to gradual loading and management. You sound like you are going in the right direction. I would lay off the amount of crimping and see if symptoms settle and then add the occasional crimp. Perhaps initially try standing and do a crimp hold then decrease the support ie increase the weight through the hand by bending your knees. I think you might just have to be a bit more disciplined with the crimping and increase the amount as symptoms allow. It is important to load the pulleys and tendons to increase strength.
Continue with your massaging the area and I would tape.
I would also be interested in what your shoulder control/strength is like and how mobile your back is (particularly your trunk rotation).
If symptoms are persisting then see a physio or give us a call for further advice.
Kind regards
Matt
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Thanks Matt,
I'd say that my trunk rotation is probably quite poor compared to my general flexibility.
My shoulders are getting stronger but my right shoulder has a history of weakness and instability after a dislocation (and immediate relocation) several years ago that was then mis-diagnosed as a rotator cuff injury. Investigative surgery was inconclusive and I then had months of physio to re-strengthen and stabilise the shoulder.
I've found climbing has helped with the strength but I still run with a base level of muscle tension and discomfort from my right shoulder.
I mention the above as I have also noticed in massaging my shoulder/arm above the elbow today that this is triggering a tingling sensation down to my hand (I've had this before due to my shoulder) and believe it is when I've pushed across a nerve.
Depending on any additional thoughts I think I'll make an appointment to see the physio at our local wall.
Thanks again!
Beccie
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Hi guys,
I've had an elbow problem now for over a year on my right arm. There's no real specific area of pain, but it hurts deep inside the elbow when locking off/doing pullups or compression moves. Also I get a really sharp pain right at the base of the tricep if I press outwards with totally a totally bent arm (like a pushup from lying down). Throwing things seems to make it worse aswell.
Everyone seems to think its an ulnar nerve thing, and I've tried eccentrics, ulnar flossing, rest, not rest etc but had no really significant improvements since I did it (brought on after a heavy day of bouldering). Seen about 5 or 6 physios aswell, all to no avail.
Any ideas what I've got, or any last ditch efforts I can make to fix it?
Cheers,
Dave
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Thanks Matt,
I'd say that my trunk rotation is probably quite poor compared to my general flexibility.
My shoulders are getting stronger but my right shoulder has a history of weakness and instability after a dislocation (and immediate relocation) several years ago that was then mis-diagnosed as a rotator cuff injury. Investigative surgery was inconclusive and I then had months of physio to re-strengthen and stabilise the shoulder.
I've found climbing has helped with the strength but I still run with a base level of muscle tension and discomfort from my right shoulder.
I mention the above as I have also noticed in massaging my shoulder/arm above the elbow today that this is triggering a tingling sensation down to my hand (I've had this before due to my shoulder) and believe it is when I've pushed across a nerve.
Depending on any additional thoughts I think I'll make an appointment to see the physio at our local wall.
Thanks again!
Beccie
Hi Beccie, that sounds like a good idea particularly if there may be some nerve involvement.
regards
Matt
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Hi guys,
I've had an elbow problem now for over a year on my right arm. There's no real specific area of pain, but it hurts deep inside the elbow when locking off/doing pullups or compression moves. Also I get a really sharp pain right at the base of the tricep if I press outwards with totally a totally bent arm (like a pushup from lying down). Throwing things seems to make it worse aswell.
Everyone seems to think its an ulnar nerve thing, and I've tried eccentrics, ulnar flossing, rest, not rest etc but had no really significant improvements since I did it (brought on after a heavy day of bouldering). Seen about 5 or 6 physios aswell, all to no avail.
Any ideas what I've got, or any last ditch efforts I can make to fix it?
Cheers,
Dave
Hi Dave, if the pain is deep inside your elbow it could be that you are compressing the elbow joint (more specifically the humeral ulnar part). You may also be compressing the median nerve that runs beside your biceps and crosses the elbow joint.
I would also be interested in what you are doing further up the movement chain ie what positions your shoulder/scapular and neck are in. It is obviously difficult to fully understand your problem without looking at you. Perhaps give me a call next week on 0114 267 1223. I am in the clinic tues to fri.
regards
matt
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Hi guys,
I'm having some real wrist problems. I'm getting a really sharp pain on the little finger side of my wrist. It comes on when there's any twisting force on my wrist (undercuts and sidepulls you pull up against are bad). But also when I'm pushing against my fingers, like washing my face or hair. Weirdly, it doesn't hurt on slopers. Holding a heavy saucepan or using a screwdriver aren't ideal either.
I assumed it was a TFCC injury, but I can more or less push down in a press up position pain-free. I've tried taping it, resting it, using it - all seem to work sometimes but not at others.
Any idea what's going on? Cheers!
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Hi,
I've been having some trouble with my left forearm for around 8 weeks now roughly. I'm vaguely pinpointing it to 3 sessions I had in quick succession on a problem and route with left hand undercut/side pull hold and a weird guppy hold (the keel hold on the keel at Almscliffe).
It's tender to touch about half way along the forearm on the anterior/palmar surface of the ulnar. Its not tender when pressed on the other side which makes me think it's what's being compressed between the bone and my finger causing the pain, rather than the bone itself. The tender area is probably 1-2 inches long.
When climbing, the pain is more like a dull throbbing and isn't obviously exacerbated by any particular orientation, it's probably a bit worse on undercutty side pulls but only marginally. After having a few days off it eases and I have a session where it's not too bad but then it just comes back. To be honest I was expecting it to sort itself out with a few enforced 4-5 day rests but it hasn't improved whatsoever.
I've just had another few days off and think I'll just do some easy climbing trying not to aggravate it.
I expect that in this case more rest might actually be the solution but I'm really not sure what's going on and wondered if you had any idea what it sounded like from my crude history?
Thanks
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Hi guys,
I'm having some real wrist problems. I'm getting a really sharp pain on the little finger side of my wrist. It comes on when there's any twisting force on my wrist (undercuts and sidepulls you pull up against are bad). But also when I'm pushing against my fingers, like washing my face or hair. Weirdly, it doesn't hurt on slopers. Holding a heavy saucepan or using a screwdriver aren't ideal either.
I assumed it was a TFCC injury, but I can more or less push down in a press up position pain-free. I've tried taping it, resting it, using it - all seem to work sometimes but not at others.
Any idea what's going on? Cheers!
Hi sorry about the delayed response, I have been away.
The description you give does tend to suggest a TFCC injury and symptom reproduction isn't always consistent. There are also other structures that can give similar symptoms. Sometimes the ulnar nerve can be compressed or irritated at the wrist/hand or at the neck and can refer into this area.
If we are thinking it is more likely to be a TFCC injury then initially I would recommend a 2 week period of relative rest with the use of a wrist splint to minimise movement. Sometimes a short period of minimal movement can help as everyday movements don't always allow total rest. I am not normally an advocate of total rest but I have found for this type of problem this is sometimes necessary. You would still want to occasionally move the wrist but having a control on the amount is important.
On returning I would recommend starting on lower grade climbs and minimise side pulls and twisting actions.
If symptoms don't settle then an arthrogram may be necessary which involves injecting dye into the wrist and seeing if there is disruption to the TFCC. Even if there is it can still be managed conservatively.
Alternatively it may be worth getting a physio assessment.
regards
Matt
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Hi,
I've been having some trouble with my left forearm for around 8 weeks now roughly. I'm vaguely pinpointing it to 3 sessions I had in quick succession on a problem and route with left hand undercut/side pull hold and a weird guppy hold (the keel hold on the keel at Almscliffe).
It's tender to touch about half way along the forearm on the anterior/palmar surface of the ulnar. Its not tender when pressed on the other side which makes me think it's what's being compressed between the bone and my finger causing the pain, rather than the bone itself. The tender area is probably 1-2 inches long.
When climbing, the pain is more like a dull throbbing and isn't obviously exacerbated by any particular orientation, it's probably a bit worse on undercutty side pulls but only marginally. After having a few days off it eases and I have a session where it's not too bad but then it just comes back. To be honest I was expecting it to sort itself out with a few enforced 4-5 day rests but it hasn't improved whatsoever.
I've just had another few days off and think I'll just do some easy climbing trying not to aggravate it.
I expect that in this case more rest might actually be the solution but I'm really not sure what's going on and wondered if you had any idea what it sounded like from my crude history?
Thanks
Hi sorry about the delayed response, I have been away.
From your description it sounds like it is in the area of the muscle tendon junction. The holds you mention will have put increased loading on this area and three consecutive sessions probably contributed with cumulative micro trauma leading to a strain. This type of injury would normally take 2-3 weeks to settle but needs to be managed correctly. Sometimes you can overload this area too soon. It is important to put stresses through this area as you need to strengthen it but it needs to be graded and gradual (frustrating I know!) as symptoms allow. There is also the ulnar nerve that can give similar symptoms in this area. I would still manage it by graded exposure to increased stresses.
If symptoms persist then give me a call 0114 2671223 or see a local physio.
regards Matt
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Hello, I injured what I think is the A2 pulley in my left ring finger. I have been icing it, using a finger roller thing and climbing only on stuff that doesnt aggravate it. Whilst it doesn't hurt very much at all, even becoming unnoticable much of the time. As soon as a hold digs into the area it is extremely painful. Also the morning after climbing it is also very sore when pulling with the finger. Once I am warmed up it is also fine to climb on stuff that doesn't dig into it.
What else can I do to heal the finger? It has been a couple of months now, and whilst the injury isn't putting holding me back really, it is still painful and worrying the days after. It doesn't seem to be getting any better or worse, just stalling.
thanks
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Hi Matt
Few finger issues all on the right hand:
First up, the spot circled is very tender when pressed, Any idea what this is? I've been avoiding crimping and can climb open-hand ok and it doesn't appear to harming it any further, I assume the answer to this is keep avoiding crimping?
(http://images.tapatalk-cdn.com/15/07/10/76450f0dcfb6dd0874866324e2604870.jpg)
Next up, bit of a trauma injury, moved my finger sideways while it was still deep in a pocket and now have lots of swelling around the PIP, two weeks on I can just about make a fist. Been icing it and climbing at a reduced level with it heavily taped so it can't be bent. Still quite tender around the joint though even 2 weeks on.
(http://images.tapatalk-cdn.com/15/07/10/6539879dba4f60416560679667d4accf.jpg)
(http://images.tapatalk-cdn.com/15/07/10/7baf8474b71fe7deb4e0c0ec3303907c.jpg)
Last up but most long standing my finger nail (forefinger) is growing distorted, any ideas what could be causing this?
(http://images.tapatalk-cdn.com/15/07/10/e0a6f7a7b790c416e3801f50ec09925e.jpg)
Cheers
Ian
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Hello, I injured what I think is the A2 pulley in my left ring finger. I have been icing it, using a finger roller thing and climbing only on stuff that doesnt aggravate it. Whilst it doesn't hurt very much at all, even becoming unnoticable much of the time. As soon as a hold digs into the area it is extremely painful. Also the morning after climbing it is also very sore when pulling with the finger. Once I am warmed up it is also fine to climb on stuff that doesn't dig into it.
What else can I do to heal the finger? It has been a couple of months now, and whilst the injury isn't putting holding me back really, it is still painful and worrying the days after. It doesn't seem to be getting any better or worse, just stalling.
thanks
Hi the pulley would have healed by now but it is probably crumbling if a little too overloaded. Back off the grades for the next two weeks and slowly introduce crimping in a graded fashion. You could also try some massaging into this area . As you know the A2 pulley is the most common injury and both of the flexor tendons pass through it so it has to withstand a lot of stress. It will improve just keep increasing the loads as symptoms allow. Keep me posted and call the clinic on 0114 2671223 if you have any queries.
regards
Matt
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Hi Matt
Few finger issues all on the right hand:
First up, the spot circled is very tender when pressed, Any idea what this is? I've been avoiding crimping and can climb open-hand ok and it doesn't appear to harming it any further, I assume the answer to this is keep avoiding crimping?
(http://images.tapatalk-cdn.com/15/07/10/76450f0dcfb6dd0874866324e2604870.jpg)
Next up, bit of a trauma injury, moved my finger sideways while it was still deep in a pocket and now have lots of swelling around the PIP, two weeks on I can just about make a fist. Been icing it and climbing at a reduced level with it heavily taped so it can't be bent. Still quite tender around the joint though even 2 weeks on.
(http://images.tapatalk-cdn.com/15/07/10/6539879dba4f60416560679667d4accf.jpg)
(http://images.tapatalk-cdn.com/15/07/10/7baf8474b71fe7deb4e0c0ec3303907c.jpg)
Last up but most long standing my finger nail (forefinger) is growing distorted, any ideas what could be causing this?
(http://images.tapatalk-cdn.com/15/07/10/e0a6f7a7b790c416e3801f50ec09925e.jpg)
Cheers
Ian
Hi Ian, the first problem looks like it could be an A1 pulley injury. You are correct back off the crimping for a couple of weeks and slowly add them again.
The second problem could be trauma to the joint and/or the collateral ligaments. Keep moving it and you can be relatively aggressive with the stretches. They do take at least 3-4 weeks to settle and the swelling does tend to hang around.
The third issue it that you may have disrupted the nail bed and you may find this always grows through like this. Give me a call if these issues are not settling on 01142671223.
Regards
Matt
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Hi,
I have a hand injury sustained whilst pulling on a pocket with my hand twisted slightly. I heard something crack in my wrist/hand - no particular pain straight away but I stopped climbing and iced it.
Following this the next day I am able to do most movements pain free although clenching a fist is painful through the centre of my palm and I get an occasional pain that shoots up to my elbow when gripping things - using my middle 2 fingers especially. There is also some tightness felt if I try and stretch my fingers back. There is no swelling at all and my hand generally just feels a bit weak,
Any advice on what to do would be much appreciated, I don't feel its worthy of a doctors visit as I have nearly full range of movement, and it seems to only be aggravate by gripping in a certain way -although I know I definitely can't climb or pull with it,
Thanks
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Hi,
I have a hand injury sustained whilst pulling on a pocket with my hand twisted slightly. I heard something crack in my wrist/hand - no particular pain straight away but I stopped climbing and iced it.
Following this the next day I am able to do most movements pain free although clenching a fist is painful through the centre of my palm and I get an occasional pain that shoots up to my elbow when gripping things - using my middle 2 fingers especially. There is also some tightness felt if I try and stretch my fingers back. There is no swelling at all and my hand generally just feels a bit weak,
Any advice on what to do would be much appreciated, I don't feel its worthy of a doctors visit as I have nearly full range of movement, and it seems to only be aggravate by gripping in a certain way -although I know I definitely can't climb or pull with it,
Thanks
Hi, it is a little difficult to know exactly what you have done. You could be getting weakness from a tendon strain or sometimes the median nerve in your wrist could have become compressed or irritated. I think probably the former particularly as you heard a crack (the same happens with pulley type injuries but your description of the pain seems a bit lower into the palm). It is good you have full range of wrist movement.
I would start to gently load the wrist again on much easier grades and just traverse on a bouldering wall so that you can have more control on the amount of effort. If it is not settling within the next two weeks then see a physio locally just to give you a more accurate diagnosis and be able to test your hand/wrist in different positions.
kind regards Matt
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I haven't injured myself yet but would like to avoid doing so if possible! Having searched through a few threads I couldn't match my symptoms exactly so thought to ask here. Thanks Matt for making this resource available!
I have noticed some moderate discomfort/pain at the very base of my ring finger when open handing sometimes. I don't seem to get the pain at all when crimped. It sort of feels like something is about to pull loose! Needless to say, whenever I feel this I stop doing it immediately and start crimping! This has occurred intermittently for perhaps a couple of months but the latest flare up came after a days crimping at Anston Stones (despite not feeling pain whilst crimping...)
Applying pressure to the base of the finger gives some small pain (we're only talking a 2 or a 3 out of 10 here) but the pain is never felt in the palm.
Any idea what this might be and what I can do to strengthen the weak link?
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What is a better way to train the antagonists to prevent/rehabilitate injury? I had a period where I was doing a lot of one armers and no antagonist training, and as a result the muscles are very imbalanced, and at the moment my forearm muscles (the ones on the inside) are very tender and hurt if pushed (don't really hurt during climbing though). I have rings, and do enjoy doing weighted dips and such on them, but am not sure if going to a conventional gym to do weights for pushing exercises would be better.
So really the question is, is going to a normal gym twice a week a good way to train my antagonist muscles?
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Hi, I don't know whether the clinic is still going, or whether this is the sort of thing you deal with but just in case...
I injured my ring finger from crimping on a small hold about a year ago. No popping noise, just symptoms of a swollen PIP joint, pain when I pressed on my A2 pulley and pain when I fully bend the finger and forcing the fingertip to touch base. I have similar injuries on different fingers that have completely recovery.
Anyway, the injury wasn't severe enough to impact my climbing too much and I have been consistently climbing "hard" and improving since. Every 4 months or so, when I think it's fully recovered, I end up pushing it too much and "re-injuring" it (making it swell again and become slightly agitated, but never nearly bad as the original incident), when this happens I just take it easy for a week or so and continue as normal.
However, two weeks ago I have noticed that my finger now makes a very faint noise whenever I close it, which sounds very similar to slowly tearing a piece of paper. I can still pull hard and there is effectively no PIP swelling and little pain when I massage the A2 pulley, but I am concerned that the long term, reoccurring, injury has evolved into a new uglier and more serious injury.
If it doesn't appear to improve in the next few weeks I may go and see someone about it, but until then if anyone could shine some light on the injury, it would be highly appreciated.
TL;DR my long term finger injury has started making noises and I'm scared.
thanks.
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Hey, wouldn't mind your opinion... After I last climbed 10 days ago my shoulder felt terrible after climbing, bit of research makes me think it's a rotator cuff injury, it's been painful ever since with rest, visited the gp and he agreed likely a rotator cuff injury/micro tear based on him getting me to do a few movements and saying my shoulder still has a lot of strength in it so can't be a big tear so should heal with rest and pain killers, does that sound accurate? Got a physio appointment through work for free but earliest I could get is in 2 weeks time...
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It's a challenge diagnosing shoulder problems with the person in front of you and practically impossible virtually. The information you give could apply to several possibilities, rotator cuff injury is a plausible one.
Try to be patient, wait to see what the physio. says, two weeks is trivial compared with the timescale of a serious shoulder problem. Relative rest for now, be gently active but any activity must be pain-free.
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Hi, I don't know whether the clinic is still going
Unfortunately Hallamshire Physiotherapy is not currently a sponsor. I have emailed them to say there are a couple of outstanding queries so they may come back with a response.
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Hi, I don't know whether the clinic is still going, or whether this is the sort of thing you deal with but just in case...
I injured my ring finger from crimping on a small hold about a year ago. No popping noise, just symptoms of a swollen PIP joint, pain when I pressed on my A2 pulley and pain when I fully bend the finger and forcing the fingertip to touch base. I have similar injuries on different fingers that have completely recovery.
Anyway, the injury wasn't severe enough to impact my climbing too much and I have been consistently climbing "hard" and improving since. Every 4 months or so, when I think it's fully recovered, I end up pushing it too much and "re-injuring" it (making it swell again and become slightly agitated, but never nearly bad as the original incident), when this happens I just take it easy for a week or so and continue as normal.
However, two weeks ago I have noticed that my finger now makes a very faint noise whenever I close it, which sounds very similar to slowly tearing a piece of paper. I can still pull hard and there is effectively no PIP swelling and little pain when I massage the A2 pulley, but I am concerned that the long term, reoccurring, injury has evolved into a new uglier and more serious injury.
If it doesn't appear to improve in the next few weeks I may go and see someone about it, but until then if anyone could shine some light on the injury, it would be highly appreciated.
TL;DR my long term finger injury has started making noises and I'm scared.
thanks.
Hi sorry about the delayed response. This unfortunately is the last response as this thread has been quite. We may start again next summer.
To begin, don't alarm yourself about your injury. It sounds like the noise could be coming from the joint rather than the tendon. If the joint is not swollen then that is a good sign. If you are having intense periods of climbing then it may be that you have just overloaded the joint and it is grumbling. Certainly back off the intensity.
I would suggest you get a physiotherapy opinion as it has been going on for a prolonged period and they may be able to give you some specific exercises and perhaps look at your technique.
Regards
Matt
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Hey, wouldn't mind your opinion... After I last climbed 10 days ago my shoulder felt terrible after climbing, bit of research makes me think it's a rotator cuff injury, it's been painful ever since with rest, visited the gp and he agreed likely a rotator cuff injury/micro tear based on him getting me to do a few movements and saying my shoulder still has a lot of strength in it so can't be a big tear so should heal with rest and pain killers, does that sound accurate? Got a physio appointment through work for free but earliest I could get is in 2 weeks time...
Hi sorry about the delayed response.
It is difficult to say what you may have injured. If it is a small tear then it will improve steadily with graded loading. If you are seeing a physio then they should look at possible reasons for this injury as well as checking for compensations that may be re- irritating the problem. If you have any queries and would like some advice then call me on 0114 267 1223.
regards
Matt
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Hi, I don't know whether the clinic is still going, or whether this is the sort of thing you deal with but just in case...
I injured my ring finger from crimping on a small hold about a year ago. No popping noise, just symptoms of a swollen PIP joint, pain when I pressed on my A2 pulley and pain when I fully bend the finger and forcing the fingertip to touch base. I have similar injuries on different fingers that have completely recovery.
Anyway, the injury wasn't severe enough to impact my climbing too much and I have been consistently climbing "hard" and improving since. Every 4 months or so, when I think it's fully recovered, I end up pushing it too much and "re-injuring" it (making it swell again and become slightly agitated, but never nearly bad as the original incident), when this happens I just take it easy for a week or so and continue as normal.
However, two weeks ago I have noticed that my finger now makes a very faint noise whenever I close it, which sounds very similar to slowly tearing a piece of paper. I can still pull hard and there is effectively no PIP swelling and little pain when I massage the A2 pulley, but I am concerned that the long term, reoccurring, injury has evolved into a new uglier and more serious injury.
If it doesn't appear to improve in the next few weeks I may go and see someone about it, but until then if anyone could shine some light on the injury, it would be highly appreciated.
TL;DR my long term finger injury has started making noises and I'm scared.
thanks.
Hi sorry about the delayed response. This unfortunately is the last response as this thread has been quite. We may start again next summer.
To begin, don't alarm yourself about your injury. It sounds like the noise could be coming from the joint rather than the tendon. If the joint is not swollen then that is a good sign. If you are having intense periods of climbing then it may be that you have just overloaded the joint and it is grumbling. Certainly back off the intensity.
I would suggest you get a physiotherapy opinion as it has been going on for a prolonged period and they may be able to give you some specific exercises and perhaps look at your technique.
Regards
Matt
Thanks for the reply Matt, much appreciated.
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Finger injury
I injured my middle finger whilst bouldering indoors just over three weeks ago. I was climbing a slab problem on small holds when I lost my feet, transferring all my weight onto my middle finger, which was on a one-finger crimp directly above my head.
I did not hear any popping or cracking, but immediately felt pain in my finger just above my palm (proximal phalanx). I tried a problem with sloper/large jugs, but this led to sharper pain. I stopped climbing immediately. I found that I could could not bend my finger past 90 degrees without sharper pain. The injury didn't seem that serious, just painful and I assumed that a week or so of rest would let me start climbing again.
That evening my finger swelled at the proximal phalanx, although I had no discolouration or bruising. I iced, elevated and put on some tape for compression. Over the past three weeks I have continued to treat in the same way, taping my finger and using topical ibuprofen gel.
Although the swelling has gone down, my finger is still somewhat swollen and my finger and palm (at the top of the metacarpal bone) are still tender to the touch and painful when used. I can now bend my finger without sharp pain until the fingertip is ~1cm away from my palm. If I extend my fingers and slightly hyperextend my finger the pain is much sharper. When applying pressure or massaging the finger the worst pain is at the base of the finger on the side and front next to my ring finger and the top of the metacarpal bone.
I would like to start building my finger up, but am really struggling to get the swelling to go down. I haven't been to see my GP but am wondering if I should, or if there is anything else I should be doing to deal with the swelling and pain.
I would love to get your thoughts on what the injury might be and on how to treat my injury.
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And a photo of the injured finger: https://goo.gl/photos/PCR2XPvAM3QgqzxS8
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New thread started for the Hallamshire Physio online clinic here (http://ukbouldering.com/board/index.php/topic,27513.msg535220.html#msg535220)