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the shizzle => diet, training and injuries => Topic started by: shark on October 23, 2016, 11:56:51 pm

Title: Online Hallamshire Physio Clinic
Post by: shark on October 23, 2016, 11:56:51 pm
Thought I would start a new thread for this.

Our Sponsors Hallamshire Physiotherapy (http://www.hallamshirephysiotherapy.com) based in Sheffield who have a wealth of knowledge of climbing injuries will answer any questions that you may have.

If you post questions during the week a member of the HP team will log in on friday lunchtime to answer.

For reference the old thread is here (http://ukbouldering.com/board/index.php/topic,22460.msg409986.html#msg409986)
Title: Re: Online Hallamshire Physio Clinic
Post by: nai on October 24, 2016, 11:07:43 am
Excellent, glad this thread is back.

I currently have a niggle which manifests mostly in my neck which feels tight and stiff, get a bit of discomfort in the back left when turning my head, can't turn it as far to the left as I can the right. Feel the discomfort turning it either way.
The discomfort manifests in trapezius, deltoid and inside of the elbow on the left too.
Symptoms feel better once warmed up and engaged in activity than when cold or inactive.
Feel a bit weaker than normal on my left-hand side, not just in climbing related activities, e.g. struggled to lift my bike over a stile with my left arm whereas it's straightforward with my right.
Title: Re: Online Hallamshire Physio Clinic
Post by: Schnell on October 24, 2016, 11:42:59 am
Thanks for reopening this.

I've picked up an odd finger tweak on my left hand middle finger. The background is that I have felt very slight discomfort in the PIP joint on that finger and on my ring finger of my right hand for a few weeks, which only appears in some circumstances mainly when pulling on slopers and (though I'm not totally certain about this) when there is some sideways torque on the joint. For that reason I had more or less dismissed it as a twinge from old collateral ligament injuries, which I had suffered on the affected fingers.

The current flare up just affects the left hand middle finger as I said. I was doing easy bouldering four days ago and towards the end of the session I noticed that there was some discomfort straightening the finger. I don't have a recollection of a particular 'pop' moment. The discomfort got worse later in the evening and the next day the PIP joint was quite swollen and tender on the palm side, right at the joint rather than near or towards the A2 and not around the sides of the joint. Also the main discomfort was if the joint gets flexed sideways at all, ie if I knocked it off something and also trying to straighten the finger, the last few mm of going from slight bend to fully extended are what seems to cause the problem. I've been keeping it more or less immobilised since and a few days later the swelling is mostly gone though it's still fairly tender.

Based on Dave McL's injury book I suspected 'tenosynovitis', mostly because I've had a few pulley injuries in the past and it doesn't feel like that at all (more a diffuse tenderness rather than a particular sore spot and not in the right place) and it's not around the side of the joint like a collateral ligament injury.

It'd be great if you had any suggestions about diagnosis and treatment, one thing is whether I should keep it immobilised til it feels normal, there seems to be conflicting advise on this.
Title: Re: Online Hallamshire Physio Clinic
Post by: mrjonathanr on October 24, 2016, 09:15:48 pm
Hi,

I would appreciate any thoughts about my left shoulder if you have a minute. It has suffered a bit over the years with supraspinatus strains and an AC separation (over 7 years ago) but is generally strong. I do a few TRX/theraband exercises to maintain it.

Several weeks ago I felt a strain across the front of the shoulder warming up on a coldish day, but afterwards fine. Two weeks ago it felt fine out bouldering but then felt very sore afterwards, a generalised ache within the joint, not specific to any point/muscle/tendon.

A week off exercise, a week of yoga to mobilise the joint (impingement?) and then some light bouldering and it's sore again... I have taken 50mg diclofenac every other day to reduce inflammation.

Daily activity -it is not acutely painful. Arm raised straight up and back (palm either prone/supinated) slightly stiff, not too bad. Reaching behind back, extending fingers up back- stiff, some reduced ROM, aches in front of shoulder afterwards. No pain when touched manually, just ache in the joint.

I have been climbing >30 years, bit baffled.

A really big thank you for any reply.

Jonathan

Title: Re: Online Hallamshire Physio Clinic
Post by: ashtond6 on October 25, 2016, 08:49:27 pm
Any help would be greatly appreciated :)

Finger (just above knuckle, maybe A4)
Injured in may, back up to speed by August.
Did 5 days on, re-injured!
Took two weeks off, yet still hurts when I climb again, seems to get better then still as bad when I try to climb again? Are there cases where the recommended 1-3 weeks initial rest isn't enough? Why after lots of rest can I not climb on even jugs??

Also, any pull ups or steep climbing leaves up shoulder super 'crunchy'. Can't get rid of it! In 2012 I had a disc rupture in my neck, since then I've had constant right hand side injuries (neck, shoulder, palm, fingers)

Any help would be appreciated - would also pay for an appointment reference the finger as I have a big trip come March

Seems stupidly susceptible to injury - now ongoing for 5 months!
Title: Re: Online Hallamshire Physio Clinic
Post by: mctrials23 on October 25, 2016, 11:51:50 pm
Thanks for opening this up again  :)

I have had a reasonably long term niggle in my left arm that was at one point super painful but over time has just become an occasional background niggle/pain. If I pull hard on wide moves with my arms just above shoulder height it is a sharp pain sometimes and if I do pullups and don't pay a lot of attention to being really controlled it hurts at about 2/3rds of the way down (of the pullup negative phase)

The pain is in the outer arm roughly half way along the humerus. Its at the very tip of the deltoid as far as I can tell. Most of the time when I am climbing it doesn't even register but when I put my arm in just the right place its quite a sharp pain. It doesn't hurt for long and doesn't seem to persist after I stop climbing.

As this was at one point a more serious injury I assume that it just hasn't properly/fully healed but any advice or information that might help me finally put it to bed would be really appreciated.
Title: Re: Online Hallamshire Physio Clinic
Post by: Coops_13 on October 26, 2016, 08:53:48 am
Hi,

I have two niggles, one with the right elbow, one with the left.

Right - The muscle at the top of my forearm (by the elbow) when my palm is flat on the table (brachioradialis muscle?) as been aching for a few weeks. It started after a an old uni climbing trip where I did a fair amount of sock wrestling (try to get opponents sock off their foot) after a big day climbing. The next day I tried climbing but after 2 climbs, both elbows (the muscle mentioned) were hurting too much I couldn't do anything. The left has settled down but the right still occasionally aches, especially if my elbow is bent under pressure (carrying shopping etc.). Once I'm warm, it doesn't hurt at all while climbing. What would you recommend in terms of icing/stretching?

Left - I fell off at Curbar on Sunday from about half a metre up and missed the pad, landing on a rock on my back. I got a graze to my back and smacked my elbow hard. Didn't climb for rest of day (was at the end anyway). The elbow bursa seems to have swollen up (only a little bit) and there is pain if I knock it or apply pressure. I went climbing indoors yesterday (Tuesday) and the whole left arm seemed really weak with the elbow hurting slightly. Is the climbing aggravating the injury? I left after only an hour and went home. Plan is to rest until the weekend. What would you recommend I do to aid recovery, also any idea how long I can expect to be better/climbing without this weird pain/weakness?

Thanks  :)
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on October 29, 2016, 07:57:26 am
Excellent, glad this thread is back.

I currently have a niggle which manifests mostly in my neck which feels tight and stiff, get a bit of discomfort in the back left when turning my head, can't turn it as far to the left as I can the right. Feel the discomfort turning it either way.
The discomfort manifests in trapezius, deltoid and inside of the elbow on the left too.
Symptoms feel better once warmed up and engaged in activity than when cold or inactive.
Feel a bit weaker than normal on my left-hand side, not just in climbing related activities, e.g. struggled to lift my bike over a stile with my left arm whereas it's straightforward with my right.
Hi Nai
This sounds like you are irritating a nerve on the left hand side of your neck.  The pain into your deltoid, traps etc are probably referred pain as is the problem with your elbow.  I assume you sit at work so correct your sitting position and stretch your thoracic spine (lost of upper back rotation). Stand regularly and reach up to the ceiling.  If this does not improve over the next few weeks you might need to see a physio.  If the weakness in your left arm deteriorated see your GP.
Steve 
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on October 29, 2016, 08:18:00 am
Hi,

I would appreciate any thoughts about my left shoulder if you have a minute. It has suffered a bit over the years with supraspinatus strains and an AC separation (over 7 years ago) but is generally strong. I do a few TRX/theraband exercises to maintain it.

Several weeks ago I felt a strain across the front of the shoulder warming up on a coldish day, but afterwards fine. Two weeks ago it felt fine out bouldering but then felt very sore afterwards, a generalised ache within the joint, not specific to any point/muscle/tendon.

A week off exercise, a week of yoga to mobilise the joint (impingement?) and then some light bouldering and it's sore again... I have taken 50mg diclofenac every other day to reduce inflammation.

Daily activity -it is not acutely painful. Arm raised straight up and back (palm either prone/supinated) slightly stiff, not too bad. Reaching behind back, extending fingers up back- stiff, some reduced ROM, aches in front of shoulder afterwards. No pain when touched manually, just ache in the joint.

I have been climbing >30 years, bit baffled.

A really big thank you for any reply.

Jonathan

Jonathan.
Thanks for your question.  It sounds like you are losing some control around the shoulder joint and the previous trauma is exacerbating the situation.  A few thoughts:  Stop stretching the joint and start strengthening with something stronger than theraband (ok for some people but the strength needed for the average climber I would use higher weight/resistance).  Careful with yoga and don't overstretch the shoulder and I agree you could be getting a degree of 'impingement' or loss of control.  As you are finding, the shoulder gets easier with climbing so it doesn't appear to be a serious pathology.  The problem occurs after load as the tissue is being over stressed.  I would reduce your climbing few a couple of week but concentrate on strengthening the shoulder and not stretching.  I see more climbers with hypermobile shoulders but tight lats and thorax, usually as a result of sitting at a computer or the nature of pulling all the time (or both).  If you have climbed for 30 years the shoulder joint will be work hardened and just need to change your loading pattern. I would think this problem will respond to conservative management. 
Thanks
Steve H 
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on October 29, 2016, 08:26:37 am
Any help would be greatly appreciated :)

Finger (just above knuckle, maybe A4)
Injured in may, back up to speed by August.
Did 5 days on, re-injured!
Took two weeks off, yet still hurts when I climb again, seems to get better then still as bad when I try to climb again? Are there cases where the recommended 1-3 weeks initial rest isn't enough? Why after lots of rest can I not climb on even jugs??

Also, any pull ups or steep climbing leaves up shoulder super 'crunchy'. Can't get rid of it! In 2012 I had a disc rupture in my neck, since then I've had constant right hand side injuries (neck, shoulder, palm, fingers)

Any help would be appreciated - would also pay for an appointment reference the finger as I have a big trip come March

Seems stupidly susceptible to injury - now ongoing for 5 months!

Hi

Thanks for the question. This sounds complicated!  I suspect the previous neck injury is causing some of your ongoing problems.  Its not uncommon for previous injuries to continue being a problem as you compensate by changing muscle recruitment in the upper limb.  You might be overusing your hand/forearm as a result of the neck injury.  The 'crunchy' shoulder is not helping but once again this is all part of the same problem.  You need to find out why you are getting these repeat injuries and see a recommended physiotherapist.  You can try stretching your neck, but be careful not to exacerbate the right arm symptoms. 

Thanks
Steve H
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on October 29, 2016, 08:34:58 am
Thanks for opening this up again  :)

I have had a reasonably long term niggle in my left arm that was at one point super painful but over time has just become an occasional background niggle/pain. If I pull hard on wide moves with my arms just above shoulder height it is a sharp pain sometimes and if I do pullups and don't pay a lot of attention to being really controlled it hurts at about 2/3rds of the way down (of the pullup negative phase)

The pain is in the outer arm roughly half way along the humerus. Its at the very tip of the deltoid as far as I can tell. Most of the time when I am climbing it doesn't even register but when I put my arm in just the right place its quite a sharp pain. It doesn't hurt for long and doesn't seem to persist after I stop climbing.

As this was at one point a more serious injury I assume that it just hasn't properly/fully healed but any advice or information that might help me finally put it to bed would be really appreciated.

Hi
This is referred from your shoulder or neck.  I assume it is a shoulder control problem that is an issue with certain wide holds as it is fine normally.  A muscle injury would be more consistent.  If its was 'super painful' you might have had a neck/nerve irritation that slowly improved but only caused problems with certain positions.  Stretch you neck and strengthen your shoulder but continue climbing.  Strengthen the shoulder in positions that reproduce your symptoms i.e. wide moves above head hight but do both pulling and pushing type exercise. 

Thanks
Steve H
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on October 29, 2016, 08:43:27 am
Hi,

I have two niggles, one with the right elbow, one with the left.

Right - The muscle at the top of my forearm (by the elbow) when my palm is flat on the table (brachioradialis muscle?) as been aching for a few weeks. It started after a an old uni climbing trip where I did a fair amount of sock wrestling (try to get opponents sock off their foot) after a big day climbing. The next day I tried climbing but after 2 climbs, both elbows (the muscle mentioned) were hurting too much I couldn't do anything. The left has settled down but the right still occasionally aches, especially if my elbow is bent under pressure (carrying shopping etc.). Once I'm warm, it doesn't hurt at all while climbing. What would you recommend in terms of icing/stretching?

Left - I fell off at Curbar on Sunday from about half a metre up and missed the pad, landing on a rock on my back. I got a graze to my back and smacked my elbow hard. Didn't climb for rest of day (was at the end anyway). The elbow bursa seems to have swollen up (only a little bit) and there is pain if I knock it or apply pressure. I went climbing indoors yesterday (Tuesday) and the whole left arm seemed really weak with the elbow hurting slightly. Is the climbing aggravating the injury? I left after only an hour and went home. Plan is to rest until the weekend. What would you recommend I do to aid recovery, also any idea how long I can expect to be better/climbing without this weird pain/weakness?

Thanks  :)

Coops
The dangers of sock wrestling!  Stick to climbing its safer.  Anyway, the forearm problem is not a local problem from what you are saying.  If you pull a muscle you would expect if to repair within a few weeks.  If both arms are a problem I would suspect this is referred from your neck.  Don't ice/stretch your forearms bit concentrate on your upper back and neck.  If you sit at a desk for long periods this might be a contributory factor.

Regarding the fall, you probably hit a nerve around the elbow and this is causing the weakness in the arm.  I would rest from climbing for a couple of weeks and then slowly load the arm.  Bursitis shouldn't cause weakness in the arm so be careful with this injury.  If it persists or you get increasing weakness see your GP. 
Thanks
Steve H
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on October 29, 2016, 01:41:20 pm
Thanks for reopening this.

I've picked up an odd finger tweak on my left hand middle finger. The background is that I have felt very slight discomfort in the PIP joint on that finger and on my ring finger of my right hand for a few weeks, which only appears in some circumstances mainly when pulling on slopers and (though I'm not totally certain about this) when there is some sideways torque on the joint. For that reason I had more or less dismissed it as a twinge from old collateral ligament injuries, which I had suffered on the affected fingers.

The current flare up just affects the left hand middle finger as I said. I was doing easy bouldering four days ago and towards the end of the session I noticed that there was some discomfort straightening the finger. I don't have a recollection of a particular 'pop' moment. The discomfort got worse later in the evening and the next day the PIP joint was quite swollen and tender on the palm side, right at the joint rather than near or towards the A2 and not around the sides of the joint. Also the main discomfort was if the joint gets flexed sideways at all, ie if I knocked it off something and also trying to straighten the finger, the last few mm of going from slight bend to fully extended are what seems to cause the problem. I've been keeping it more or less immobilised since and a few days later the swelling is mostly gone though it's still fairly tender.

Based on Dave McL's injury book I suspected 'tenosynovitis', mostly because I've had a few pulley injuries in the past and it doesn't feel like that at all (more a diffuse tenderness rather than a particular sore spot and not in the right place) and it's not around the side of the joint like a collateral ligament injury.

It'd be great if you had any suggestions about diagnosis and treatment, one thing is whether I should keep it immobilised til it feels normal, there seems to be conflicting advise on this.
Thanks for the question. Your problem certainly sounds like a local finger injury given the mechanical nature of the issue i.e difficulty straightening the finger in the end stages of extension as well as the swelling issues.  That said there is usually a reason for these issues and it would be worth getting the problem looked at as the mechanics/movement of the shoulder/trunk could be a contributory factor. Local tenderness could indeed indicate a tenosynovitis type problem, especially as you experience the pain whilst on slopers. The foream flexor muscles/tendons are mainly loaded++ in such a way to utilise both main finger tendons when using slopers whereas when crimping a hold, the fingers rely on tendon and ligament tension. The best advice is relative rest i.e low loading/easy climbing for a short period and avoid slopers for a while as they are often a culprit developin finger/tendon problems. The usual cold therapy applies locally and gentle forearm stretching. Obviously with not being able to see/assess the problem these are only suggestions, nothing can substitute a physical assessment of the problem to establish a more clear diagnosis and also a cause for the problem i.e possible shoulder or trunk asymmetry/weakness/stiffness which may contribute as you compensate during climbing.

Title: Re: Online Hallamshire Physio Clinic
Post by: shark on October 29, 2016, 02:59:50 pm
Thanks for all the replies Steve  :2thumbsup:
Title: Re: Online Hallamshire Physio Clinic
Post by: mrjonathanr on October 29, 2016, 10:53:07 pm

Jonathan.
Thanks for your question.  It sounds like you are losing some control around the shoulder joint and the previous trauma is exacerbating the situation.  A few thoughts:  Stop stretching the joint and start strengthening with something stronger than theraband (ok for some people but the strength needed for the average climber I would use higher weight/resistance).  Careful with yoga and don't overstretch the shoulder and I agree you could be getting a degree of 'impingement' or loss of control.  As you are finding, the shoulder gets easier with climbing so it doesn't appear to be a serious pathology.  The problem occurs after load as the tissue is being over stressed.  I would reduce your climbing few a couple of week but concentrate on strengthening the shoulder and not stretching.  I see more climbers with hypermobile shoulders but tight lats and thorax, usually as a result of sitting at a computer or the nature of pulling all the time (or both).  If you have climbed for 30 years the shoulder joint will be work hardened and just need to change your loading pattern. I would think this problem will respond to conservative management. 
Thanks
Steve H

Hi Steve,
Thank you for giving your time to share that answer, I am sure you have plenty of other demands on your time too. That seems really astute, thanks.
Best wishes
Jonathan
Title: Re: Online Hallamshire Physio Clinic
Post by: Ken_Kaniff on October 30, 2016, 12:11:48 pm
Hi, Steve. I'm not sure I can still post in this thread. I'd appreciate your comment on my niggle. I didn't pick it up climbing but it prevents me from doing it.

Last week I woke up with a shooting pain in the area of my shoulder blade. The pain went down my arm and resulted in the hand numbness. In the past 3-4 days, after I started exercising my upper body with theraband, the pain in the back and arm has decreased substantially. As for the numbness, it has passed but I still have problems clenching my fist as hard as I used to.

I saw my GP about the pain and he believed it was a pinched nerve in my neck, possibly resulting from terrible posture, a desk job, and a two-week cold I'd had prior to the incident.

It'd be fantastic if you had any suggestions about the issues my GP couldn't help me with:

a) whether I should do any other exercises aside from my theraband routine?
b) how long should I expect for the numbness (inability to grip on holds) to last?
c) when will it be safe to return to training and bouldering and what what type of exercises to avoid in the initial stage?

I look forward to your comments,
Ken
Title: Re: Online Hallamshire Physio Clinic
Post by: shark on October 30, 2016, 02:09:57 pm
Hi, Steve. I'm not sure I can still post in this thread. I'd appreciate your comment on my niggle.

Yes you can - but it most likely won.t be until next friday that he replies
Title: Re: Online Hallamshire Physio Clinic
Post by: cheque on October 30, 2016, 07:07:29 pm
Hi Steve,

after a summer filmmaking rather than climbing (so lots of carrying heavy loads and juggling) I seem to have developed very tight and stiff shoulders in what Google tells me is the deltoid region.

I don't have an injury per se, but I've lot a surprising amount of movement (if hold my arms out in a crucifix position I can barely raise them at all) and when
I climb or train now the first couple of times I pull on anything above me it will hurt a bit, with the pain (but not the stiffness) subsiding as I warm up.

How do I fix this? Is it just a matter of stretching my deltoids?

Cheers, Mike.
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on October 30, 2016, 09:17:57 pm
Hi, Steve. I'm not sure I can still post in this thread. I'd appreciate your comment on my niggle. I didn't pick it up climbing but it prevents me from doing it.

Last week I woke up with a shooting pain in the area of my shoulder blade. The pain went down my arm and resulted in the hand numbness. In the past 3-4 days, after I started exercising my upper body with theraband, the pain in the back and arm has decreased substantially. As for the numbness, it has passed but I still have problems clenching my fist as hard as I used to.

I saw my GP about the pain and he believed it was a pinched nerve in my neck, possibly resulting from terrible posture, a desk job, and a two-week cold I'd had prior to the incident.


It'd be fantastic if you had any suggestions about the issues my GP couldn't help me with:

a) whether I should do any other exercises aside from my theraband routine?
b) how long should I expect for the numbness (inability to grip on holds) to last?
c) when will it be safe to return to training and bouldering and what what type of exercises to avoid in the initial stage?

I look forward to your comments,
Ken

Hi Ken
I agree with your GP and  you probably have a nerve injury.  This should resolve with time and the pressure might have come off your neck but you need time for the nerve to repair.  Any nerve injury is generally slower than muscles, tendons etc. so I would stop the theraband exercises and climbing for 3-4 weeks.  During this time the numbness should resolve but it depends on how much pressure there was on the nerve.  If you woke with the medial (inside shoulder on back) shoulder pain consider your work position and change regularly if you sit all day.  Many climbers tend to get low shoulders caused by over active lats which can cause pressure on there nerve roots in the neck.So you might not have injured it during climbing but it might contribute to its onset.  Its complicated!
Cheers

Steve H 
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on October 30, 2016, 09:28:00 pm
Hi Steve,

after a summer filmmaking rather than climbing (so lots of carrying heavy loads and juggling) I seem to have developed very tight and stiff shoulders in what Google tells me is the deltoid region.

I don't have an injury per se, but I've lot a surprising amount of movement (if hold my arms out in a crucifix position I can barely raise them at all) and when
I climb or train now the first couple of times I pull on anything above me it will hurt a bit, with the pain (but not the stiffness) subsiding as I warm up.

How do I fix this? Is it just a matter of stretching my deltoids?

Cheers, Mike.

Mike

Muscles are very robust and no more so than in climbers.  If both deltoid muscles are damaged you are very unlucky to hurt 2 at same time (highly unlikely) or you have a referred pain from another structure (more likely in my experience from the history).  Don't stretch the deltoid and consider if either your neck or thorax are tight and/or painful.  Try stretching your lats (side lying with arm reaching above head) and see how your pain in the shoulder goes. 
Thanks

Steve H
Title: Re: Online Hallamshire Physio Clinic
Post by: Ken_Kaniff on October 31, 2016, 07:44:49 am
Hi, Steve. I'm not sure I can still post in this thread. I'd appreciate your comment on my niggle. I didn't pick it up climbing but it prevents me from doing it.

Last week I woke up with a shooting pain in the area of my shoulder blade. The pain went down my arm and resulted in the hand numbness. In the past 3-4 days, after I started exercising my upper body with theraband, the pain in the back and arm has decreased substantially. As for the numbness, it has passed but I still have problems clenching my fist as hard as I used to.

I saw my GP about the pain and he believed it was a pinched nerve in my neck, possibly resulting from terrible posture, a desk job, and a two-week cold I'd had prior to the incident.


It'd be fantastic if you had any suggestions about the issues my GP couldn't help me with:

a) whether I should do any other exercises aside from my theraband routine?
b) how long should I expect for the numbness (inability to grip on holds) to last?
c) when will it be safe to return to training and bouldering and what what type of exercises to avoid in the initial stage?

I look forward to your comments,
Ken

Hi Ken
I agree with your GP and  you probably have a nerve injury.  This should resolve with time and the pressure might have come off your neck but you need time for the nerve to repair.  Any nerve injury is generally slower than muscles, tendons etc. so I would stop the theraband exercises and climbing for 3-4 weeks.  During this time the numbness should resolve but it depends on how much pressure there was on the nerve.  If you woke with the medial (inside shoulder on back) shoulder pain consider your work position and change regularly if you sit all day.  Many climbers tend to get low shoulders caused by over active lats which can cause pressure on there nerve roots in the neck.So you might not have injured it during climbing but it might contribute to its onset.  Its complicated!
Cheers

Steve H

Steve, thank you for taking the time to answer so quickly. I was hoping against hope that it wouldn't be so long to get back in shape. Anyway, I'm glad these issues do pass with time.

Once again, I really appreciate your help.
Ken
Title: Re: Online Hallamshire Physio Clinic
Post by: cheque on October 31, 2016, 03:11:05 pm


Mike

Muscles are very robust and no more so than in climbers.  If both deltoid muscles are damaged you are very unlucky to hurt 2 at same time (highly unlikely) or you have a referred pain from another structure (more likely in my experience from the history).  Don't stretch the deltoid and consider if either your neck or thorax are tight and/or painful.  Try stretching your lats (side lying with arm reaching above head) and see how your pain in the shoulder goes. 
Thanks

Steve H

Nice one Steve. Above and beyond the call of duty answering on a Sunday night! (http://www.mcbroom.biz/forum/mods/smileys/images/salute.gif)
Title: Re: Online Hallamshire Physio Clinic
Post by: Evil on November 02, 2016, 01:29:51 pm
I dislocated my elbow maybe 3 years ago, and at the time, I got a nerve impingement test (electrical current thing), which found some nerve impingement, but not enough to recommend any treatment. Recently, the outside of my hand on that side has become kind of numb all the time, sometimes painful, and also the skin on the little finger has gone really dry and sore, and I am unable to fully straighten it some of the time. I'm wondering whether this could be related to the elbow injury. It is kind of sore on the back on my elbow (I can't rest it on a desk etc) though the joint itself is fine for climbing etc. That elbow does look larger than the other one, suggesting to me that there has been some bone growth after the injury which could be meaning there is less space for the nerves to travel through the joint? I don't really know how to go about getting it checked out though. I have a GP, but they're not really any use for things that aren't really really simple or really really serious as they are massively oversubscribed. I can't imagine they could do anything about that either. Who would you approach for this kind of thing? Do you think that the problem is likely damage from the dislocation, and what (if anything) could be done about it? Thanks very much.
Title: Re: Online Hallamshire Physio Clinic
Post by: Coops_13 on November 02, 2016, 04:29:56 pm
Regarding the fall, you probably hit a nerve around the elbow and this is causing the weakness in the arm.  I would rest from climbing for a couple of weeks and then slowly load the arm.  Bursitis shouldn't cause weakness in the arm so be careful with this injury.  If it persists or you get increasing weakness see your GP. 
Thanks
Steve H
Thank Steve, am having some scans (hopefully soon) at advice of doc to rule out any bone impingement of cubital tunnel/nerve damage
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on November 02, 2016, 07:00:42 pm
Regarding the fall, you probably hit a nerve around the elbow and this is causing the weakness in the arm.  I would rest from climbing for a couple of weeks and then slowly load the arm.  Bursitis shouldn't cause weakness in the arm so be careful with this injury.  If it persists or you get increasing weakness see your GP. 
Thanks
Steve H
Thank Steve, am having some scans (hopefully soon) at advice of doc to rule out any bone impingement of cubital tunnel/nerve damage
Hi Coops 13
That sounds like a sensible option.  I would also suspect you have a neck problem given the bilateral nature of your problem and the whole arm weakness. Please tell us how you get on.
Thanks Steve
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on November 02, 2016, 07:24:21 pm
I dislocated my elbow maybe 3 years ago, and at the time, I got a nerve impingement test (electrical current thing), which found some nerve impingement, but not enough to recommend any treatment. Recently, the outside of my hand on that side has become kind of numb all the time, sometimes painful, and also the skin on the little finger has gone really dry and sore, and I am unable to fully straighten it some of the time. I'm wondering whether this could be related to the elbow injury. It is kind of sore on the back on my elbow (I can't rest it on a desk etc) though the joint itself is fine for climbing etc. That elbow does look larger than the other one, suggesting to me that there has been some bone growth after the injury which could be meaning there is less space for the nerves to travel through the joint? I don't really know how to go about getting it checked out though. I have a GP, but they're not really any use for things that aren't really really simple or really really serious as they are massively oversubscribed. I can't imagine they could do anything about that either. Who would you approach for this kind of thing? Do you think that the problem is likely damage from the dislocation, and what (if anything) could be done about it? Thanks very much.

Thanks Evil  Interesting problem.  Yes, I would agree that the previous dislocation is probably contributing to your symptoms.  Trauma to the nerves around the elbow in not uncommon following a dislocation.  This could give you the pain and numbness.  You also get neurotrophic changes to the skin as as a result of nerve damage as regulation of tissue is via the nerve and this could account for the dry skin (and even nail bed changes).  Even if the original nerve conduction studies were fine, there must have been some level of damage and this is now symptomatic. The elbow might be producing additional bone around the various tunnels (osteophytes) and these could be encroaching on the nerve. Additionally if your neck is tight from sitting (or throwing yourself of boulders!) the combined neck and elbow trauma can cause something called a 'double crush phenomena'  i.e. the nerve that is damaged at more than one point along its course is more likely to be symptomatic. 

What to do?  I suspect you need to get the problem assessed by someone.  The first port of call is your GP but if that is not helping ask them to refer you to a physiotherapist or even Neurologist if the numbness is persistent. 
Thanks
Steve

Title: Re: Online Hallamshire Physio Clinic
Post by: mctrials23 on November 02, 2016, 09:17:24 pm
Hi
This is referred from your shoulder or neck.  I assume it is a shoulder control problem that is an issue with certain wide holds as it is fine normally.  A muscle injury would be more consistent.  If its was 'super painful' you might have had a neck/nerve irritation that slowly improved but only caused problems with certain positions.  Stretch you neck and strengthen your shoulder but continue climbing.  Strengthen the shoulder in positions that reproduce your symptoms i.e. wide moves above head hight but do both pulling and pushing type exercise. 

Thanks
Steve H

Thanks for this Steve. I've been stretching my neck quite a lot over the past few days and it's made a massive difference. It's not 100% sorted but it's a hell of a lot better.

There was one more thing I was wondering about injury wise. I had an a2 that hung around for a long time but it finally healed from what I can tell. A month or more later I injured something in my palm. It's not very painful but it gets worse when I climb on it.

It's either side of the a1 and causes swelling when I stress my hands through climbing.

Below is a picture of the areas that are swollen.

(http://i.imgur.com/f6ZVYFUm.jpg)
Title: Re: Online Hallamshire Physio Clinic
Post by: Evil on November 03, 2016, 03:00:54 pm
What to do?  I suspect you need to get the problem assessed by someone.  The first port of call is your GP but if that is not helping ask them to refer you to a physiotherapist or even Neurologist if the numbness is persistent. 
Thanks for the response. I just need to force myself towards the GP now...
Title: Re: Online Hallamshire Physio Clinic
Post by: battery on November 04, 2016, 10:41:05 am
OK, feeling a bit like I'm falling apart, lots of issues on my left arm and hand which I think may be related!

Both my shoulders are stiff and sore (have been for years!) but in my left arm I get a dull pain on the inside where the bicep joins the elbow. My left wrist has been sore for about a year and a half which at first I had put down to having a baby, saw a physio and had an ultrasound which showed nothing and the physio suggested I quit climbing, what did I expect at my age and didn't I have my hands full enough with a small child, I'd also talked to them about pain in my ring and middle finger but they totally ignored that. Taping when climbing helps, if I try to pull with just those two fingers it aggravates my wrist and hurts the fingers a bit but the wrist also hurts when I flex it back and it makes a lot of grinding noises.

Now I also seem to have buggered the index finger on the same hand and it's stopping me climbing. The middle joint is swollen, looks a bit bruised and very painful when fully stretched or clenched. It has improved with a week of rest (I couldn't switch a light on without yelping last week!) but I'm concerned about it stiffening or becoming a long term niggle if it's not sorted properly now. I did it on a side pull finger pocket moving up and around it, I did it probably 8 times and started to feel something a bit off so stopped that but carried on climbing with no worries, an hour after I finished climbing it was agony.

Sorry that there's lots there, I feel like I probably need to go and see someone but I'm not sure if it should be a physio (who has a bit more of an open mind!) my GP, minor injuries or a sports massage therapist! Any help you can provide would be appreciated.

Title: Re: Online Hallamshire Physio Clinic
Post by: nai on November 04, 2016, 11:14:00 am
Excellent, glad this thread is back.

I currently have a niggle which manifests mostly in my neck which feels tight and stiff, get a bit of discomfort in the back left when turning my head, can't turn it as far to the left as I can the right. Feel the discomfort turning it either way.
The discomfort manifests in trapezius, deltoid and inside of the elbow on the left too.
Symptoms feel better once warmed up and engaged in activity than when cold or inactive.
Feel a bit weaker than normal on my left-hand side, not just in climbing related activities, e.g. struggled to lift my bike over a stile with my left arm whereas it's straightforward with my right.
Hi Nai
This sounds like you are irritating a nerve on the left hand side of your neck.  The pain into your deltoid, traps etc are probably referred pain as is the problem with your elbow.  I assume you sit at work so correct your sitting position and stretch your thoracic spine (lost of upper back rotation). Stand regularly and reach up to the ceiling.  If this does not improve over the next few weeks you might need to see a physio.  If the weakness in your left arm deteriorated see your GP.
Steve

Thanks for the reply Steve. If anything things have been getting worse this week with other symptoms too, I've made an appointment for next week.
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on November 08, 2016, 11:25:51 am
Hi,
You do sound like you have a lot going on!
I would tend to be focusing on the more proximal issues initially i.e. your shoulders. This could be the cause of all your secondary issues. Basically if you are not moving through the trunk and shoulders well along with possible muscular issues and control then you will be putting increased stresses and load at the elbow, wrist and fingers. Often with bilateral (both) shoulder stiffness and soreness I would be thinking that it is more related to your thoracic spine. If you are stiff in this area or lack sufficient rotation then your shoulder movement will be compromised. Can you lift your arms fully above your head lifting your chest and ribs and can you rotate left and right being able to look behind? If you have a sedentary job I.e. Computer/ desk based then every hour lift your arms above your head 5 times. Most people hardly ever get there arms above their heads during the day. You may be going from one extreme to the other?
Your finger problems sound like they could be related to a pulley strain, possibly A3 on your index finger. Start trying to stretch it into your palm and make sure it fully straightens.
Back off crimping and slowly start to climb easier grades and add in crimps as symptoms allow. Basically don't overload the tendons too soon, allow the tissues to adapt and strengthen again.
The first thing I would suggest is to research some local Physio practices and see or ask if any of them have experience with climbing injuries although the shoulder problem ( or thoracic spine!) should be easily sorted and addressed first. You do need to be seen in person as you have many issues that are probably all related and too many to discuss in detail.
Let me know how you get on and if you have any other details you've forgot to mention such as mechanisms of injury or aggravating factors then send them on.
Regards Matt
OK, feeling a bit like I'm falling apart, lots of issues on my left arm and hand which I think may be related!

Both my shoulders are stiff and sore (have been for years!) but in my left arm I get a dull pain on the inside where the bicep joins the elbow. My left wrist has been sore for about a year and a half which at first I had put down to having a baby, saw a physio and had an ultrasound which showed nothing and the physio suggested I quit climbing, what did I expect at my age and didn't I have my hands full enough with a small child, I'd also talked to them about pain in my ring and middle finger but they totally ignored that. Taping when climbing helps, if I try to pull with just those two fingers it aggravates my wrist and hurts the fingers a bit but the wrist also hurts when I flex it back and it makes a lot of grinding noises.

Now I also seem to have buggered the index finger on the same hand and it's stopping me climbing. The middle joint is swollen, looks a bit bruised and very painful when fully stretched or clenched. It has improved with a week of rest (I couldn't switch a light on without yelping last week!) but I'm concerned about it stiffening or becoming a long term niggle if it's not sorted properly now. I did it on a side pull finger pocket moving up and around it, I did it probably 8 times and started to feel something a bit off so stopped that but carried on climbing with no worries, an hour after I finished climbing it was agony.

Sorry that there's lots there, I feel like I probably need to go and see someone but I'm not sure if it should be a physio (who has a bit more of an open mind!) my GP, minor injuries or a sports massage therapist! Any help you can provide would be appreciated.
Title: Re: Online Hallamshire Physio Clinic
Post by: Coops_13 on November 08, 2016, 12:07:36 pm
If both arms are a problem I would suspect this is referred from your neck.  Don't ice/stretch your forearms bit concentrate on your upper back and neck.  If you sit at a desk for long periods this might be a contributory factor.
The nerve issue has been advised it will recover with rest. However the forearm ache is still present. You mentioned concentrating on upper back/neck. What exercises/stretches would you recommend doing for this?
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on November 10, 2016, 02:31:40 pm
Hi Coops,
The nerve will recover and on restarting climbing remember to slowly load the arm again on easier grades and increase this as symptoms allow.
Regarding neck and upper back exercises; I would regularly reach your arms above your head making sure you lift your chest and upper back then lower and let upper back relax. In sitting you could cross your arms and rotate your trunk left and right. I would also rotate your neck to the opposite direction at the same time. Basically move and watch prolonged periods sitting in front of a computer. If this doesn't help it is probably worth visiting a local physio.
Regards Matt
If both arms are a problem I would suspect this is referred from your neck.  Don't ice/stretch your forearms bit concentrate on your upper back and neck.  If you sit at a desk for long periods this might be a contributory factor.
The nerve issue has been advised it will recover with rest. However the forearm ache is still present. You mentioned concentrating on upper back/neck. What exercises/stretches would you recommend doing for this?
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on November 10, 2016, 02:41:58 pm
Hi,
It's an unusual place to get swelling as it is either side of your joints and tendons. I can only think that maybe your pulley injury has meant that you have or are putting extra loads and stress through the palm. Also with pulley type injuries although you have strained the ligaments at the finger you can still have issues further up the tendon and even into the muscle belly.Try comparing some finger and grip exercises to your other hand and see if it feels the same. It could be weaker or fatigues quicker. Also back off the grades for a few weeks and decrease the amount of crimping and see what happens.
Regards Matt
Hi
This is referred from your shoulder or neck.  I assume it is a shoulder control problem that is an issue with certain wide holds as it is fine normally.  A muscle injury would be more consistent.  If its was 'super painful' you might have had a neck/nerve irritation that slowly improved but only caused problems with certain positions.  Stretch you neck and strengthen your shoulder but continue climbing.  Strengthen the shoulder in positions that reproduce your symptoms i.e. wide moves above head hight but do both pulling and pushing type exercise. 

Thanks
Steve H

Thanks for this Steve. I've been stretching my neck quite a lot over the past few days and it's made a massive difference. It's not 100% sorted but it's a hell of a lot better.

There was one more thing I was wondering about injury wise. I had an a2 that hung around for a long time but it finally healed from what I can tell. A month or more later I injured something in my palm. It's not very painful but it gets worse when I climb on it.

It's either side of the a1 and causes swelling when I stress my hands through climbing.

Below is a picture of the areas that are swollen.

(http://i.imgur.com/f6ZVYFUm.jpg)
Title: Re: Online Hallamshire Physio Clinic
Post by: Coops_13 on November 10, 2016, 03:10:53 pm
Hi Coops,
The nerve will recover and on restarting climbing remember to slowly load the arm again on easier grades and increase this as symptoms allow.
Regarding neck and upper back exercises; I would regularly reach your arms above your head making sure you lift your chest and upper back then lower and let upper back relax. In sitting you could cross your arms and rotate your trunk left and right. I would also rotate your neck to the opposite direction at the same time. Basically move and watch prolonged periods sitting in front of a computer. If this doesn't help it is probably worth visiting a local physio.
Regards Matt
Hi Matt, thanks again for yours and your colleagues' help. I am off to Font next weekend and my GP said I should be ok for it but take it easy, which I'm not very good at doing...  ::) Nerve is beginning to feel better, will try and get down the wall next week to test it lightly though I think I have a busy week ahead. I'll try the neck and upper back exercises. Thanks!
Title: Re: Online Hallamshire Physio Clinic
Post by: Mike Tyson on November 19, 2016, 11:55:07 pm
Hello HP chaps.

I have shoulder and elbow problems. First sign ofproblem was on a weeks holiday in Fontainebleau back in April this year. Three days on, with no real warning signs I got acute pain in my left elbow. It hurt like hell, I'm not one to complain usually but it was extremely uncomfortable. That was the last time I climbed this year.

Over the course of the year, things have worsened overall. Elbow pain had improved, but is still there. My shoulder has become very painful however. I do a manual job, very physical, as a tree surgeon. The pain is when my arm is extended out, usually above my head or with arm outstretched. Example being putting fresh bed sheets on, I reached out to tuck one corner in and lost my footing slightly and put weight down through my arms whilst they were both outstretched. The pain was intense!

I did have a session with an NHS physio who thought I had a shoulder impingement. I ended up going to see a private physio as the pain was unbearable and the waiting time was lengthy on NHS. I have been to the private physio a few times, by don't feel like I'm getting far in all honesty.

I miss climbing, and I worry I'm not going to be able to do it ever again! I'm stuck in a rut really, as I can't recover properly because of my job, but have to work as I'm self employed.

Any thoughts?


Sent from my iPad using Tapatalk
Title: Re: Online Hallamshire Physio Clinic
Post by: Mike Tyson on November 20, 2016, 12:12:36 am
Oh yes, additional info I forgot.

Private physio man says I have extremely tight tendons (?) in dodgy left arm. He speculated I might had a small stress fracture whilst in Font, but as no X-ray was taken we'll never know. He has been using ultrasound and massage on elbow and shoulder.


Sent from my iPad using Tapatalk
Title: Re: Online Hallamshire Physio Clinic
Post by: mctrials23 on November 20, 2016, 08:31:34 pm
Thanks for the advice Steve, as always very appreciated.
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on November 24, 2016, 09:03:21 pm
Hello HP chaps.

I have shoulder and elbow problems. First sign ofproblem was on a weeks holiday in Fontainebleau back in April this year. Three days on, with no real warning signs I got acute pain in my left elbow. It hurt like hell, I'm not one to complain usually but it was extremely uncomfortable. That was the last time I climbed this year.

Over the course of the year, things have worsened overall. Elbow pain had improved, but is still there. My shoulder has become very painful however. I do a manual job, very physical, as a tree surgeon. The pain is when my arm is extended out, usually above my head or with arm outstretched. Example being putting fresh bed sheets on, I reached out to tuck one corner in and lost my footing slightly and put weight down through my arms whilst they were both outstretched. The pain was intense!

I did have a session with an NHS physio who thought I had a shoulder impingement. I ended up going to see a private physio as the pain was unbearable and the waiting time was lengthy on NHS. I have been to the private physio a few times, by don't feel like I'm getting far in all honesty.

I miss climbing, and I worry I'm not going to be able to do it ever again! I'm stuck in a rut really, as I can't recover properly because of my job, but have to work as I'm self employed.

Any thoughts?


Sent from my iPad using Tapatalk
Hi,it sounds like you have had a difficult year!
The onset of your problem is interesting in that you had sudden pain without any specific mechanism of injury. It doesn't sound like a tendonopathy such as tennis elbow. The fact that the elbow has now settled but the shoulder has become problematic with intense pain makes me think that the symptoms could be coming from the cervical (neck)or upper thoracic spine (upper back). Shoulder impingements should improve if managed well but can take at least three months to settle with progressive and specific exercises. Massage and ultrasound are not enough and I would ask if the symptoms are coming from a more central origin. If it is truely a shoulder problem then it should respond to exercises but they need to be progressed. More exercise less ultrasound. You will climb again but it sounds like you need a second opinion.
Let me know how you get on and if you have any other info please post it on.
Kind regards
Matt
Title: Re: Online Hallamshire Physio Clinic
Post by: Mike Tyson on November 25, 2016, 08:50:21 am
Thanks for taking the time to reply Matt, most appreciated. I am going to seek out a referral to a specialist in Harrogate. A good friend of mine endured injured shoulder for ages, and got it sorted out by a man from the Wrightington. Bit far for me to travel, but a colleague of his now works at Harrogate, which is much more manageable. I'll keep updating my situation, but it's good to know you can see my getting fixed eventually!
Title: Re: Online Hallamshire Physio Clinic
Post by: Ali on December 02, 2016, 12:06:18 pm
Hi, I pulled a hamstring about a week ago and would appreciate any advice for getting it back to full climbing use. It's not really noticeable in day to day activity and I can walk / run ok so I'm guessing it's a fairly minor injury.
When climbing I get pain when the leg is either out to the side or when toe-ing in on any steep moves, basically any time I'm pulling with the foot rather than just standing up on it. The painful area is a few inches above the knee on the inner side of the back of the leg. (it's on the bit of muscle / tendon that stands out very prominently when the leg is tensed).
Any suggestions for stretching / re-strengthening would be great, Thanks.
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on December 06, 2016, 05:29:00 pm
[Hi Ali, if it is a mild hamstring strain then it should resolve over 2-3 week period. It makes sense that you feel discomfort with the manoeuvres you describe as you will be using your hamstrings to fix or bend your knee when pulling with your foot.
Progress the amount of load on the hamstring over the next 4 weeks as symptoms allow i.e. Back off the amount of heel use and grades and Increase as able. Mild discomfort is acceptable. If symptoms persist let me know.
Regards matt

quote author=Ali link=topic=27513.msg538627#msg538627 date=1480680378]
Hi, I pulled a hamstring about a week ago and would appreciate any advice for getting it back to full climbing use. It's not really noticeable in day to day activity and I can walk / run ok so I'm guessing it's a fairly minor injury.
When climbing I get pain when the leg is either out to the side or when toe-ing in on any steep moves, basically any time I'm pulling with the foot rather than just standing up on it. The painful area is a few inches above the knee on the inner side of the back of the leg. (it's on the bit of muscle / tendon that stands out very prominently when the leg is tensed).
Any suggestions for stretching / re-strengthening would be great, Thanks.
[]
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on December 06, 2016, 05:32:41 pm
Hi, I pulled a hamstring about a week ago and would appreciate any advice for getting it back to full climbing use. It's not really noticeable in day to day activity and I can walk / run ok so I'm guessing it's a fairly minor injury.
When climbing I get pain when the leg is either out to the side or when toe-ing in on any steep moves, basically any time I'm pulling with the foot rather than just standing up on it. The painful area is a few inches above the knee on the inner side of the back of the leg. (it's on the bit of muscle / tendon that stands out very prominently when the leg is tensed).
Any suggestions for stretching / re-strengthening would be great, Thanks.

[Hi Ali, if it is a mild hamstring strain then it should resolve over 2-3 week period. It makes sense that you feel discomfort with the manoeuvres you describe as you will be using your hamstrings to fix or bend your knee when pulling with your foot.
Progress the amount of load on the hamstring over the next 4 weeks as symptoms allow i.e. Back off the amount of heel use and grades and Increase as able. Mild discomfort is acceptable. If symptoms persist let me know.
Regards matt ]
Title: Re: Online Hallamshire Physio Clinic
Post by: Ali on December 07, 2016, 04:53:22 pm
Thanks for the reply, good to know I'm doing the right things.  Also useful to hear likely timescale for improvement as it hadn't seemed to get any better in the first week and I was starting to be worried about a possible trip at New Year. Climbed last night and was able to do a bit more with it than last session so on the mend now.
Thanks again, much appreciated.
Title: Re: Online Hallamshire Physio Clinic
Post by: Ti_pin_man on December 08, 2016, 01:25:08 pm
Hi, I recently popped my left wrist, first time I've had a joint pop, very strange.  No pain afterwards, no bruising, did it with an odd back hand move.  Did it about 4 weeks ago and have climbed on it since without really much problem.  I rested it a couple of days after it happened and then went to Font.  Anyways... today doing some strength rack pulls -max weight/low reps- it popped again.  I stopped. 

As there's really no pain and I still have full mobility without pain, should I rest it, be careful but carry on, see a physio, or?  If I have to rest it, roughly how long for do you think?  without any pain or discomfort its hard to know if it is better or not. 
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on December 09, 2016, 03:21:55 pm
Hi, I recently popped my left wrist, first time I've had a joint pop, very strange.  No pain afterwards, no bruising, did it with an odd back hand move.  Did it about 4 weeks ago and have climbed on it since without really much problem.  I rested it a couple of days after it happened and then went to Font.  Anyways... today doing some strength rack pulls -max weight/low reps- it popped again.  I stopped. 

As there's really no pain and I still have full mobility without pain, should I rest it, be careful but carry on, see a physio, or?  If I have to rest it, roughly how long for do you think?  without any pain or discomfort its hard to know if it is better or not.
[Hi,
joints can sometimes make noise when a small gas bubble is released within it. It seems like the wrist is making the noise when you are at the extremes of load or when you are performing an awkward manoeuvre. This would make sense in that you are putting it at it's end of range and it is a release of pressure. The fact you have no pain or swelling is good. If you are generally have mobile joints then they may be moving excessively with large loads. Try a strapping the wrist to give it a little more support. Don't stop the climbing but perhaps avoid odd manoeuvres if possible over the next 2 weeks. If it persists or becomes more regular then go and see a physio.
regards Matt  ]
Title: Re: Online Hallamshire Physio Clinic
Post by: Ti_pin_man on December 10, 2016, 10:39:15 pm
Thanks Matt.  Climbed indoors today and didn't try anything where I thought it would be an odd position or strain and was fine.  Will keep climbing and cruise for the next week and look at strapping/ tapes.  Thanks for your work here!
Title: Re: Online Hallamshire Physio Clinic
Post by: Charlton Chestwig on December 16, 2016, 03:34:31 pm
Perhaps a bit late to catch you guys today, but hoping to get some advice re my elbow.
It's very hard to describe and might not be something that it is useful to discuss this way but...
I basically get this feeling of tension in my elbow and wrist with tightness in the forearm (inside) also if I apply pressure there can also be slight soreness in the wrist and inside of elbow right on the joint. this is just on my right arm (I'm right handed).
The symptoms don't seem to change with respect to exercise (i.e they aren't worse during or after) but I think I can be more aware of the issue during exercise.
Occasionally I will have days where I don't notice it.
Let me know if you have any thoughts/suggestions, but I appreciate it if there is not enough here to go off!
Richard
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on December 16, 2016, 04:29:20 pm
Perhaps a bit late to catch you guys today, but hoping to get some advice re my elbow.
It's very hard to describe and might not be something that it is useful to discuss this way but...
I basically get this feeling of tension in my elbow and wrist with tightness in the forearm (inside) also if I apply pressure there can also be slight soreness in the wrist and inside of elbow right on the joint. this is just on my right arm (I'm right handed).
The symptoms don't seem to change with respect to exercise (i.e they aren't worse during or after) but I think I can be more aware of the issue during exercise.
Occasionally I will have days where I don't notice it.
Let me know if you have any thoughts/suggestions, but I appreciate it if there is not enough here to go off!
Richard
[Hi Richard,
I suppose it is a good thing you aren't getting any pain and it isn't generally sore with exercise. The Ulnar nerve runs from the inside of your elbow into your lower arm and the inside of your wrist going on into the palm and fingers. Sometimes this can be irritated locally at the elbow and wrist through overstretching and direct pressure or at its origin in the neck. You don't always have symptoms in the neck. If it is just mild tension then it may be that you have overloaded the forearm if doing a lot of intense training. Recovery between intense sessions is important for progression.
Perhaps look at your previous few weeks or month and see if you have changed anything.
We would normally assess for patterns and reasons for this problem so maybe if it doesn't settle with reducing the grades over the/next two weeks then go and see a physio.
regards Matt]
Title: Re: Online Hallamshire Physio Clinic
Post by: Charlton Chestwig on December 16, 2016, 04:35:08 pm
cheers for that I will have a think about my next few weeks of training
Title: Re: Online Hallamshire Physio Clinic
Post by: adrienbaudouin on December 27, 2016, 05:20:51 pm
Hi
I have pain on the upper left side of  PIP joint on my left middle finger for a few years now. I found that taping the whole finger from the base to the base of the DIP joint allowed me to keep climbing with only very mild pain and without worsening the injury until now. now the pain is there even with tape and the finger is too  painful to continue with the climbing level I want.
 
the pain is mainly localized on the upper left side of the left PIP joint on the left hand. I experience the pain when releasing from a crimp grip position not so much during the crimping itself. open hand grip doesn't seem to cause pain. the joint has never been swollen or painful to touch. when extending the finger , i sometimes feel some sort of click or rubbing on the upper left side of the left PIP joint toward full extension and sometimes it is painfull to fully extent the joint.  I have full range of motion in the PIP joint
 
I have tried various hand strengthening exercises ( finger extension with elastic band, spreading and closing finger in rice bucket), self myofascial release of the forearm, massage of the joint with a spiky ring but the injury didn't get better. I saw a physiotherapist who thought that I had tight muscle in my hand and that massage and stretching would solve the problem but the stretching only made it worse. I saw an ostheopath who told me that I had a slight tear of the collateral ligament and so wear in the joint and that there was nothing to be done. I saw a hand therapist, she said that my ligament were all good but couldn't really tell me what was wrong with my finger, she thought that I had a mild hyperextension in my fingers so she gave me splint to wear for a month and told me to come back if it didn't get better. and finally i went to the doctor who told me that the splint was not going to do anything, that I didn't have hyperextension in the joint, and that I was going to have to learn to live with the injury. the doctor even told me to look on climbing forum to try to find a solution because traditional medecine was not going to help.
so I decided to reach out to Dr Volker Schöffl and he said without seeing the injury that I likely have an inflammation of the joint synovial membrane, capsulitis. I am reaching out to you guys to find out which diagnosis would confirm that and what kind of treatment option are available?




Title: Re: Online Hallamshire Physio Clinic
Post by: sidewinder on December 30, 2016, 01:18:24 pm
Guessing this thread is on a winter break, but if not/anyone else has had similar.

End joint of my RH ring finger has been 'clicking' for about 6 weeks, no discomfort/pain, but the distinct feeling of something not running correctly (a tendon/similar flicking over something?). It seems worse if I move the ring finger in isolation, a little better if I move the middle finger at the same time.  I can sometimes wiggle and crack the joint and it then seems to run smoothly for a little while.

Any idea what this could be/how to resolve it? Again it doesn't hurt at all even when climbing/crimping as hard as I can, it also doesn't feel tender to the touch, hence I haven't yet tried a sustained rest period. It is possibly a little worse in the mornings, and possibly also if I have been climbing, but equally I have also had it feel worse after a rest day and a couple of days ago it seemed fine almost all day, even though I am currently in the middle of a climbing holiday.

Any help/speculation welcomed.
Title: Re: Online Hallamshire Physio Clinic
Post by: sidewinder on January 10, 2017, 02:21:38 pm
My own speculation is that this is possibly trigger finger.
Title: Re: Online Hallamshire Physio Clinic
Post by: twoshoes on January 17, 2017, 07:09:44 am
Hi guys,

I've got golfers elbow, or something very similar. It's at the point where it hurts to wash my hands or face. I've seen a physio who showed me a way to tape it and gave me the usual eccentric exercises but I've got a manual job which which not only caused the problem but makes it flare up every day. I can't get the taping to work, so I've stopped that and the exercises almost seem to make it worse. Should I be doing them on the same days I work? Or is that over doing it? (if I don't do them then I'm essentially doing nothing about it!)  I'm guessing I need to take a few weeks off work but that's not really an option...

Thanks for any advice.
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on January 19, 2017, 11:23:17 am
Hi
I have pain on the upper left side of  PIP joint on my left middle finger for a few years now. I found that taping the whole finger from the base to the base of the DIP joint allowed me to keep climbing with only very mild pain and without worsening the injury until now. now the pain is there even with tape and the finger is too  painful to continue with the climbing level I want.
 
the pain is mainly localized on the upper left side of the left PIP joint on the left hand. I experience the pain when releasing from a crimp grip position not so much during the crimping itself. open hand grip doesn't seem to cause pain. the joint has never been swollen or painful to touch. when extending the finger , i sometimes feel some sort of click or rubbing on the upper left side of the left PIP joint toward full extension and sometimes it is painfull to fully extent the joint.  I have full range of motion in the PIP joint
 
I have tried various hand strengthening exercises ( finger extension with elastic band, spreading and closing finger in rice bucket), self myofascial release of the forearm, massage of the joint with a spiky ring but the injury didn't get better. I saw a physiotherapist who thought that I had tight muscle in my hand and that massage and stretching would solve the problem but the stretching only made it worse. I saw an ostheopath who told me that I had a slight tear of the collateral ligament and so wear in the joint and that there was nothing to be done. I saw a hand therapist, she said that my ligament were all good but couldn't really tell me what was wrong with my finger, she thought that I had a mild hyperextension in my fingers so she gave me splint to wear for a month and told me to come back if it didn't get better. and finally i went to the doctor who told me that the splint was not going to do anything, that I didn't have hyperextension in the joint, and that I was going to have to learn to live with the injury. the doctor even told me to look on climbing forum to try to find a solution because traditional medecine was not going to help.
so I decided to reach out to Dr Volker Schöffl and he said without seeing the injury that I likely have an inflammation of the joint synovial membrane, capsulitis. I am reaching out to you guys to find out which diagnosis would confirm that and what kind of treatment option are available?


[Hi sorry about the holiday break. Wow, you have seen a lot of people and have had varied diagnoses. Unfortunately the more medical people you see this is often the case. It is always difficult to comment precisely without looking at you but it seems very linked to specific holds i.e. Crimping.
As you know a crimping hold puts more of a load through your finger joints, ligaments (pulleys) and tendons than any other manoeuvre. In my opinion don't chase a diagnosis as I would be more interested in why you have this and how you need to go about changing it. It could be related solely to the load you are putting through this area and although it may or may not be a capsular irritation or a ligamentous injury this should settle. Often when a joint and soft tissues are loaded it is painful on the release. The fact that taping did help makes me think you were taking the load off the area slightly and helping support the joint/ tendons.
I would suggest that you back off any crimping for at least 2 weeks and stick to the holds that are pain free. Then start to add crimps that you can control i.e. Lesser grades that you can vary the load. The idea would be that you slowly add the number of crimps over  a 2 to 8 week period and start to creep back up the grades. You need to load the area in a controlled way to enable the tissues to adapt otherwise you will overload that area again. Be patient and if it becomes sore back off to the previous level. Basically control your training intensity and have easy recovery days. Let me know how you get on.
Kind regards Matt]
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on January 19, 2017, 11:27:05 am
[q
Hi
I have pain on the upper left side of  PIP joint on my left middle finger for a few years now. I found that taping the whole finger from the base to the base of the DIP joint allowed me to keep climbing with only very mild pain and without worsening the injury until now. now the pain is there even with tape and the finger is too  painful to continue with the climbing level I want.
 
the pain is mainly localized on the upper left side of the left PIP joint on the left hand. I experience the pain when releasing from a crimp grip position not so much during the crimping itself. open hand grip doesn't seem to cause pain. the joint has never been swollen or painful to touch. when extending the finger , i sometimes feel some sort of click or rubbing on the upper left side of the left PIP joint toward full extension and sometimes it is painfull to fully extent the joint.  I have full range of motion in the PIP joint
 
I have tried various hand strengthening exercises ( finger extension with elastic band, spreading and closing finger in rice bucket), self myofascial release of the forearm, massage of the joint with a spiky ring but the injury didn't get better. I saw a physiotherapist who thought that I had tight muscle in my hand and that massage and stretching would solve the problem but the stretching only made it worse. I saw an ostheopath who told me that I had a slight tear of the collateral ligament and so wear in the joint and that there was nothing to be done. I saw a hand therapist, she said that my ligament were all good but couldn't really tell me what was wrong with my finger, she thought that I had a mild hyperextension in my fingers so she gave me splint to wear for a month and told me to come back if it didn't get better. and finally i went to the doctor who told me that the splint was not going to do anything, that I didn't have hyperextension in the joint, and that I was going to have to learn to live with the injury. the doctor even told me to look on climbing forum to try to find a solution because traditional medecine was not going to help.
so I decided to reach out to Dr Volker Schöffl and he said without seeing the injury that I likely have an inflammation of the joint synovial membrane, capsulitis. I am reaching out to you guys to find out which diagnosis would confirm that and what kind of treatment option are available?


[Hi sorry about the holiday break. Wow, you have seen a lot of people and have had varied diagnoses. Unfortunately the more medical people you see this is often the case. It is always difficult to comment precisely without looking at you but it seems very linked to specific holds i.e. Crimping.
As you know a crimping hold puts more of a load through your finger joints, ligaments (pulleys) and tendons than any other manoeuvre. In my opinion don't chase a diagnosis as I would be more interested in why you have this and how you need to go about changing it. It could be related solely to the load you are putting through this area and although it may or may not be a capsular irritation or a ligamentous injury this should settle. Often when a joint and soft tissues are loaded it is painful on the release. The fact that taping did help makes me think you were taking the load off the area slightly and helping support the joint/ tendons.
I would suggest that you back off any crimping for at least 2 weeks and stick to the holds that are pain free. Then start to add crimps that you can control i.e. Lesser grades that you can vary the load. The idea would be that you slowly add the number of crimps over  a 2 to 8 week period and start to creep back up the grades. You need to load the area in a controlled way to enable the tissues to adapt otherwise you will overload that area again. Be patient and if it becomes sore back off to the previous level. Basically control your training intensity and have easy recovery days. Let me know how you get on.
Kind regards Matt]uote author=adrienbaudouin link=topic=27513.msg540717#msg540717 date=1482859251]

Title: Re: Online Hallamshire Physio Clinic
Post by: Steve R on January 19, 2017, 11:28:59 am
Sorry quick copy and paste - just started a new topic and then saw this one too....
'Find my left arm gets noticeably more pumped than my right on endurance routes and also (I think!) takes longer to recover from a similar level of pump than my right would.  No significant differences or noticeable imbalances in strength (max hangs/bouldering) or PE stuff between my arms, just longer endurance stuff.  I guess there are a lot of potential causes for it...
Intuitively, I suspect the problem might be referred from an old shoulder injury/weakness - worse posture or shoulder position on left side reducing blood flow somehow?  Can dodgy shoulders cause you to get more pumped?'
Cheers 
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on January 19, 2017, 11:41:04 am
Guessing this thread is on a winter break, but if not/anyone else has had similar.

End joint of my RH ring finger has been 'clicking' for about 6 weeks, no discomfort/pain, but the distinct feeling of something not running correctly (a tendon/similar flicking over something?). It seems worse if I move the ring finger in isolation, a little better if I move the middle finger at the same time.  I can sometimes wiggle and crack the joint and it then seems to run smoothly for a little while.

Any idea what this could be/how to resolve it? Again it doesn't hurt at all even when climbing/crimping as hard as I can, it also doesn't feel tender to the touch, hence I haven't yet tried a sustained rest period. It is possibly a little worse in the mornings, and possibly also if I have been climbing, but equally I have also had it feel worse after a rest day and a couple of days ago it seemed fine almost all day, even though I am currently in the middle of a climbing holiday.

Any help/speculation welcomed.
Hi sorry about the holiday break. It could be a trigger finger although the finger tends to get stuck into a bit of flexion and then releases. The fact that you can still climb is good. May be try a 2 week period of lesser grades and see if this helps. If you have had an intense period of climbing or too many intense sessions in a week then you may have slightly overloaded the joint/ tendons. If it persists book in to see a Physiotherapist. Regards Matt
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on January 19, 2017, 11:47:18 am
Hi guys,

I've got golfers elbow, or something very similar. It's at the point where it hurts to wash my hands or face. I've seen a physio who showed me a way to tape it and gave me the usual eccentric exercises but I've got a manual job which which not only caused the problem but makes it flare up every day. I can't get the taping to work, so I've stopped that and the exercises almost seem to make it worse. Should I be doing them on the same days I work? Or is that over doing it? (if I don't do them then I'm essentially doing nothing about it!)  I'm guessing I need to take a few weeks off work but that's not really an option...

Thanks for any advice.
Hi, if you have a particularly busy day then don't do the exercises. Avoid wide gripping and maybe try a tennis elbow support (I know yours is on the other side of your elbow) that you can buy from a chemist.
Sometimes the neck needs to be checked and it isn't always an easy diagnosis i.e. the pain can come from a variety of sources (neck, shoulder, nerve, elbow). May be revisit the physio or get a second opinion. What is it like when you climb?
Regards Matt
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on January 19, 2017, 11:52:14 am
Sorry quick copy and paste - just started a new topic and then saw this one too....
'Find my left arm gets noticeably more pumped than my right on endurance routes and also (I think!) takes longer to recover from a similar level of pump than my right would.  No significant differences or noticeable imbalances in strength (max hangs/bouldering) or PE stuff between my arms, just longer endurance stuff.  I guess there are a lot of potential causes for it...
Intuitively, I suspect the problem might be referred from an old shoulder injury/weakness - worse posture or shoulder position on left side reducing blood flow somehow?  Can dodgy shoulders cause you to get more pumped?'
Cheers
Hi, if you have a 'dodgy' shoulder then most definitely this can cause you to use your lower arm more ( and get more 'pumped') or in some way you are compensating. You need a strong shoulder girdle that is stable when you are manoeuvring through a move. Basically I would suggest you book in to see a physiotherapist and they should identify any compensations.
Regards Matt
Title: Re: Online Hallamshire Physio Clinic
Post by: Charlton Chestwig on January 27, 2017, 12:06:08 pm
Hi Guys,
Thanks again for your continued help.

Had a finger boo boo last night and whilst I think I might be jumping the gun seeking advice within 18 hours of this happening (as perhaps I should be following the usual protocol of PRICE with move unloaded movement for a few days?) I can't help myself...

Firstly I have noticed in the past that my left pinkie seams significantly weaker than my right and is unable to hold a crimp position (it collapses into an open position). Experimenting on the fingerboard last night it felt reasonable to hang with my left hand on a good hold and my right on just my pinkie but when I tried this the opposite way my left pinkie gave way with a shooting pain. The pain went away instantly and I could climb a bit on big holds but decided to end the session.

I am hesitant to test load and see what hurts and what doesn’t at this stage, but the little bit I have done causes pain which seems to be in the ring finger rather than the pinkie! The pain seems similar to previous mild pulley damage or ligament damage but this is not severe, my range of movement is good and I have no pain in normal movement. Also no swelling.

Perhaps in the next few days I will have more info to give you, but if there is any advice you can give based on this info I’d be keen to be doing productive recovery type stuff as soon as possible!

Many thanks,
Richard
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on January 27, 2017, 03:27:52 pm
Hi Guys,
Thanks again for your continued help.

Had a finger boo boo last night and whilst I think I might be jumping the gun seeking advice within 18 hours of this happening (as perhaps I should be following the usual protocol of PRICE with move unloaded movement for a few days?) I can't help myself...

Firstly I have noticed in the past that my left pinkie seams significantly weaker than my right and is unable to hold a crimp position (it collapses into an open position). Experimenting on the fingerboard last night it felt reasonable to hang with my left hand on a good hold and my right on just my pinkie but when I tried this the opposite way my left pinkie gave way with a shooting pain. The pain went away instantly and I could climb a bit on big holds but decided to end the session.

I am hesitant to test load and see what hurts and what doesn’t at this stage, but the little bit I have done causes pain which seems to be in the ring finger rather than the pinkie! The pain seems similar to previous mild pulley damage or ligament damage but this is not severe, my range of movement is good and I have no pain in normal movement. Also no swelling.

Perhaps in the next few days I will have more info to give you, but if there is any advice you can give based on this info I’d be keen to be doing productive recovery type stuff as soon as possible!

Many thanks,
Richard


Hi, just do gentle range of movement exercises as pain allows, trying to get full range and don't stretch until 5 days. Certainly don't load it yet and again leave it 5 days and then do some gentle resistance exercises ie fingers to palm and back again against a resistance that allows your fingers to curl in and out equally at each joint. Let me know how it goes through the week.
reagrds Matt
Title: Re: Online Hallamshire Physio Clinic
Post by: Charlton Chestwig on January 27, 2017, 04:23:47 pm
OK, thanks again, will let you know how I get on...
Title: Re: Online Hallamshire Physio Clinic
Post by: Andy W on January 27, 2017, 05:03:01 pm
hello, I've posted in this topic a few times now ;)

mainly old injuries are getting better...now I have another one, several months of pain and tightness in forearm, feels a right pain in the moerning reaching for coffee, scratching my chin, drinking a beer! For a while I thought it might be tennis elbow, but I've had doses of golfers before and it doesn't feel the same, not as tender, more sharp. Straightening the arm brings on the pain. I've been doing a lot of manual work and it is the right arm. Any thoughts greatly appreciated.
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on February 02, 2017, 11:57:32 am
hello, I've posted in this topic a few times now ;)

mainly old injuries are getting better...now I have another one, several months of pain and tightness in forearm, feels a right pain in the moerning reaching for coffee, scratching my chin, drinking a beer! For a while I thought it might be tennis elbow, but I've had doses of golfers before and it doesn't feel the same, not as tender, more sharp. Straightening the arm brings on the pain. I've been doing a lot of manual work and it is the right arm. Any thoughts greatly appreciated.
Hi Andy, might need a few more details. Does it hurt when you climb, do you have any numbness or strange sensations in your hand/ fingers, what makes it feel easier, can you grip? Tightness in the forearm could be overuse in the muscles due to the recent excessive manual work, sometimes the neck or upper thoracic can refer into the forearm.
I would say still use your arm and hands but back off the grades and crimping if this increases the pain. Also it's probably worth seeing a physio locally to get a more accurate diagnosis and more importantly why you have it and how you can recover.
Regards
Matt
Title: Re: Online Hallamshire Physio Clinic
Post by: Andy W on February 02, 2017, 12:51:12 pm
hello, I've posted in this topic a few times now ;)

mainly old injuries are getting better...now I have another one, several months of pain and tightness in forearm, feels a right pain in the moerning reaching for coffee, scratching my chin, drinking a beer! For a while I thought it might be tennis elbow, but I've had doses of golfers before and it doesn't feel the same, not as tender, more sharp. Straightening the arm brings on the pain. I've been doing a lot of manual work and it is the right arm. Any thoughts greatly appreciated.
Hi Andy, might need a few more details. Does it hurt when you climb, do you have any numbness or strange sensations in your hand/ fingers, what makes it feel easier, can you grip? Tightness in the forearm could be overuse in the muscles due to the recent excessive manual work, sometimes the neck or upper thoracic can refer into the forearm.
I would say still use your arm and hands but back off the grades and crimping if this increases the pain. Also it's probably worth seeing a physio locally to get a more accurate diagnosis and more importantly why you have it and how you can recover.
Regards
Matt

Hi Matt thanks for your reply. It doesn't hurt when I climb, or at least not after I've stretched it out a bit on some large holds, no numbness, tingling either. Making a fist and turning it from palm down to palm up makes it hurt, not so bad gripping though.
Title: Re: Online Hallamshire Physio Clinic
Post by: WillRobertson on February 02, 2017, 01:37:52 pm
Hello, any help would be appreciated...

I have seen doctors/physios about this but nothing is helping so far so thought I'd see what other advice I could get!

I've been having pain in my wrists (yes, both) for about a year now - I had about 5 weeks off over summer but this didn't seem to help much, I've also restricted my climbing to one or two sessions a week for most of this time. The pain is mainly concentrated on the outside (pinky side) but it also comes over the top and on the other side fairly often. I can't do push ups due to the pain or any other motion where I am pushing with the palm of my hand with much force. Also any climbing moves that involve twisting the wrist at all tend to hurt (and I avoid) as does pulling on slopers. Advice so far has been a variety of stretches, icing, rest, taping all whilst avoiding particular climbing moves/styles that worsen the pain. I also spent a while doing lots of antagonist training on the forearm but this didn't really help and if anything made it worst. I've also had two separate weeks where I took ibuprofen which seemed to help and now use ibuprofen gel on a daily basis - this helps, but doesn't take away all the pain. Probably worth mentioning I spend most of my working day at a desk using a laptop (with a mouse though) which unsurprisingly doesn't help the issue.

One of the physios I saw referred me to someone to get steroid injections, but that person decided they weren't right for me. I'm currently trying to get referred to a orthopedic hand specialist - but unsurprisingly the NHS aren't making this easy...

Not really sure what I'm asking here, but any tips/suggestions different to what I've tried before would be great  :)


Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on February 02, 2017, 09:26:53 pm
Hello, any help would be appreciated...

I have seen doctors/physios about this but nothing is helping so far so thought I'd see what other advice I could get!

I've been having pain in my wrists (yes, both) for about a year now - I had about 5 weeks off over summer but this didn't seem to help much, I've also restricted my climbing to one or two sessions a week for most of this time. The pain is mainly concentrated on the outside (pinky side) but it also comes over the top and on the other side fairly often. I can't do push ups due to the pain or any other motion where I am pushing with the palm of my hand with much force. Also any climbing moves that involve twisting the wrist at all tend to hurt (and I avoid) as does pulling on slopers. Advice so far has been a variety of stretches, icing, rest, taping all whilst avoiding particular climbing moves/styles that worsen the pain. I also spent a while doing lots of antagonist training on the forearm but this didn't really help and if anything made it worst. I've also had two separate weeks where I took ibuprofen which seemed to help and now use ibuprofen gel on a daily basis - this helps, but doesn't take away all the pain. Probably worth mentioning I spend most of my working day at a desk using a laptop (with a mouse though) which unsurprisingly doesn't help the issue.

One of the physios I saw referred me to someone to get steroid injections, but that person decided they weren't right for me. I'm currently trying to get referred to a orthopedic hand specialist - but unsurprisingly the NHS aren't making this easy...

Not really sure what I'm asking here, but any tips/suggestions different to what I've tried before would be great  :)
Hi Will,
Are your wrists very mobile? If so I am wondering whether you may be going onto excessive extension when you are loading them and possibly disrupting the triangular fibrocartilage disc and complex. It is difficult without looking at your wrists. Have you tried putting a wide piece of tape around your wrist at the joint to block excessive extension. Have a look at TFCC injuries and see if this sounds like your wrists. The fact it is both wrists might more towards just excessive movement and joint impingement. Let me know your thoughts.
Regards
Matt
Title: Re: Online Hallamshire Physio Clinic
Post by: sidewinder on February 03, 2017, 09:26:34 am
If it persists book in to see a Physiotherapist. Regards Matt
For interest.

Saw a specific hand therapist who called in a consultant from his lunch break. Suggested diagnosis is likely some form of damage/change to the A2 ring pulley (linked to injury/scarring/early stage dupuytrens) causing catching in DIP joint (not trigger finger).

Advised to stop climbing, tape and see a consultant (likely the same one who gave me 5 mins of his lunch break) to likely get referred for an ultrasound to see the mechanism, so am now in the process of waiting for NHS appointments.

The two people I saw (though in a private setting) are both related to the nhs Pulvertaft Hand Centre in Derby, where I am now looking to go to on the nhs. For anyone who needs hand/wrist stuff it seems like a good place to consider, both for example used the word crimping, without me having said it, in the correct context.
Title: Re: Online Hallamshire Physio Clinic
Post by: WillRobertson on February 03, 2017, 09:33:07 am
Hello, any help would be appreciated...

I have seen doctors/physios about this but nothing is helping so far so thought I'd see what other advice I could get!

I've been having pain in my wrists (yes, both) for about a year now - I had about 5 weeks off over summer but this didn't seem to help much, I've also restricted my climbing to one or two sessions a week for most of this time. The pain is mainly concentrated on the outside (pinky side) but it also comes over the top and on the other side fairly often. I can't do push ups due to the pain or any other motion where I am pushing with the palm of my hand with much force. Also any climbing moves that involve twisting the wrist at all tend to hurt (and I avoid) as does pulling on slopers. Advice so far has been a variety of stretches, icing, rest, taping all whilst avoiding particular climbing moves/styles that worsen the pain. I also spent a while doing lots of antagonist training on the forearm but this didn't really help and if anything made it worst. I've also had two separate weeks where I took ibuprofen which seemed to help and now use ibuprofen gel on a daily basis - this helps, but doesn't take away all the pain. Probably worth mentioning I spend most of my working day at a desk using a laptop (with a mouse though) which unsurprisingly doesn't help the issue.

One of the physios I saw referred me to someone to get steroid injections, but that person decided they weren't right for me. I'm currently trying to get referred to a orthopedic hand specialist - but unsurprisingly the NHS aren't making this easy...

Not really sure what I'm asking here, but any tips/suggestions different to what I've tried before would be great  :)
Hi Will,
Are your wrists very mobile? If so I am wondering whether you may be going onto excessive extension when you are loading them and possibly disrupting the triangular fibrocartilage disc and complex. It is difficult without looking at your wrists. Have you tried putting a wide piece of tape around your wrist at the joint to block excessive extension. Have a look at TFCC injuries and see if this sounds like your wrists. The fact it is both wrists might more towards just excessive movement and joint impingement. Let me know your thoughts.
Regards
Matt

Thanks for getting back to me. I wouldn't say they're that mobile. I have tried taping them and do now tape them most of the time when climbing. I had come across TFCC injuries before and thought they fitted my symptoms, but the physios I've seen have suggested they don't think that's the problem. I'm trying to push to get a scan of some kind so that I'm not just getting differing opinions but some kind of objective test, would you advise this?

Thanks.
Title: Re: Online Hallamshire Physio Clinic
Post by: cheque on February 03, 2017, 09:37:00 am
If it persists book in to see a Physiotherapist. Regards Matt
For interest.

Saw a specific hand therapist who called in a consultant from his lunch break...

Glad to hear you've got a diagnosis Joe.
Title: Re: Online Hallamshire Physio Clinic
Post by: Charlton Chestwig on February 03, 2017, 11:39:00 am
Hi Guys,
Thanks again for your continued help.

Had a finger boo boo last night and whilst I think I might be jumping the gun seeking advice within 18 hours of this happening (as perhaps I should be following the usual protocol of PRICE with move unloaded movement for a few days?) I can't help myself...

Firstly I have noticed in the past that my left pinkie seams significantly weaker than my right and is unable to hold a crimp position (it collapses into an open position). Experimenting on the fingerboard last night it felt reasonable to hang with my left hand on a good hold and my right on just my pinkie but when I tried this the opposite way my left pinkie gave way with a shooting pain. The pain went away instantly and I could climb a bit on big holds but decided to end the session.

I am hesitant to test load and see what hurts and what doesn’t at this stage, but the little bit I have done causes pain which seems to be in the ring finger rather than the pinkie! The pain seems similar to previous mild pulley damage or ligament damage but this is not severe, my range of movement is good and I have no pain in normal movement. Also no swelling.

Perhaps in the next few days I will have more info to give you, but if there is any advice you can give based on this info I’d be keen to be doing productive recovery type stuff as soon as possible!

Many thanks,
Richard


Hi, just do gentle range of movement exercises as pain allows, trying to get full range and don't stretch until 5 days. Certainly don't load it yet and again leave it 5 days and then do some gentle resistance exercises ie fingers to palm and back again against a resistance that allows your fingers to curl in and out equally at each joint. Let me know how it goes through the week.
reagrds Matt

Hi again,
Following up on this one as I have plucked up the courage to do some loading now.
First thoughts are that it does not seem to be a bad case of something, that said symptoms are as follows...
Loading little finger, open hand position, on a "single pad depth hold" (distal phalanx only!) causes some pain in the finger; this is how the injury happened. Its hard to pinpoint a location of the pain exactly; it just feels palm side, somewhere between that distal joint and part way into my palm. Sorry I cant be more specific. (pain is relative to how much load I put on / and I cant fully load the finger as per other side)
If I use a bigger hold, 2 joints deep, the pain is less (in the same place).
If I go back to a single joint depth but put the finger in a crimp position the pain seems to go.
Finally, the prodding test! Applying pressure on the proximal phalanx / A2 pulley area causes some discomfort but not much (2-3/10)
Hope this helps for you to perhaps offer some suggestions?
Many thanks in advance!
Richard
Title: Re: Online Hallamshire Physio Clinic
Post by: Sasquatch on February 08, 2017, 02:07:05 am
Hey Guys -

Another shoulder question.  My left shoulder/upper arm has been having recurring discomfort.  I wouldn't call it pain, and I can't think of anything acute.  It's been something off and on for the last 6-8 months, progressing from irritating to concerning, then to nothing, and back again.  I have no pain from raising my arms overhead, no pain or discomfort while doing any rotator cuff or I, Y, T's.  If I raise my arm fully, I feel a "stretching" sensation in my lat? near the tricep.  If I hang from a bar, I feel discomfort in my upper bicep/deltoid area while warming up. Once warmed up fully, I don't notice anything really until the end of a very long session.  My gut says I may have some tendonopathy in the long head biceps tendon, but I'm not sure.  Any other thoughts? 

If it is a biceps tendonitis/osis issues, any ideas on therapy?
Cheers,
Squatch
Title: Re: Online Hallamshire Physio Clinic
Post by: Catcheemonkey on February 21, 2017, 05:51:40 pm
Hi - I'm not sure if you guys are still offering advice, but thought I'd give you a try.

About 3 weeks ago I banged my hand badly while dynoing, smacking the tip of my unbent pinkie causing immediate pain and swelling around my PIP joint. Being smarter than I look, I stopped climbing straight away and iced my hand.

3 weeks on, the swelling has substantially gone. I now have full mobility back for 'daily life' tasks - however the joint doesn't like being involved in climbing; giving me pain both underneath the PIP joint and ontop of the knuckle when I engage the pinkie in any way.

I've asked Doctor Google and am fairly sure I have acquired a Volar Plate injury from hyperextending the finger. I have a hard mass on the underside of my finger, between PIP joint and palm, which I assume is scar tissue. This is tender when pressed.

Assuming my diagnosis is right, I have two questions:
i) Should I be massaging the 'hard mass' to break down scar tissue, or am I likely to be aggravating my injury?
ii) Can you advise any exercises / stretches that will aid recovery? Google doesn't turn much up on this front. So far I've been using rubber bands / squishy balls to provide as much resistance as possible until I feel pain.

Your advice would be much appreciated!
Title: Re: Online Hallamshire Physio Clinic
Post by: Ally Smith on February 22, 2017, 02:53:30 pm
Jumping on the band-wagon too:

I've recurring problems with my elbows, but the pain is not isolated to the classic medial/lateral epicondylitis (golfers/tennis elbow) trigger points.

The pain I experience can be quite crippling at times (nauseating at worst) and radiates down the outside of the humerus, but when palpated is not specific to the brachialis origin.

Could the source of pain be nervous in origin? The symptoms are generally short lived (<2hrs) if i stop climbing when they start, and hence very difficult to present to a physio - what would your suggested course of action be?
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on March 15, 2017, 09:11:17 am
Hey Guys -

Another shoulder question.  My left shoulder/upper arm has been having recurring discomfort.  I wouldn't call it pain, and I can't think of anything acute.  It's been something off and on for the last 6-8 months, progressing from irritating to concerning, then to nothing, and back again.  I have no pain from raising my arms overhead, no pain or discomfort while doing any rotator cuff or I, Y, T's.  If I raise my arm fully, I feel a "stretching" sensation in my lat? near the tricep.  If I hang from a bar, I feel discomfort in my upper bicep/deltoid area while warming up. Once warmed up fully, I don't notice anything really until the end of a very long session.  My gut says I may have some tendonopathy in the long head biceps tendon, but I'm not sure.  Any other thoughts? 

If it is a biceps tendonitis/osis issues, any ideas on therapy?
Cheers,
Squatch
Hi apologies about the delay in response, have been away.
You could be right regarding the long head of biceps. The other area I would be interested in looking at is your neck and upper back/ ribs. The best advice is to go and get a physio assessment and they can determine the prime cause of the pain and symptoms. The problem with it now being chronic ( more than 6 weeks) is that you may be compensating.
Often these problems slowly occur over time and can be related to work and life postures and not always directly related to climbing.
Regards matt
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on March 15, 2017, 11:21:07 am
Hi - I'm not sure if you guys are still offering advice, but thought I'd give you a try.

About 3 weeks ago I banged my hand badly while dynoing, smacking the tip of my unbent pinkie causing immediate pain and swelling around my PIP joint. Being smarter than I look, I stopped climbing straight away and iced my hand.

3 weeks on, the swelling has substantially gone. I now have full mobility back for 'daily life' tasks - however the joint doesn't like being involved in climbing; giving me pain both underneath the PIP joint and ontop of the knuckle when I engage the pinkie in any way.

I've asked Doctor Google and am fairly sure I have acquired a Volar Plate injury from hyperextending the finger. I have a hard mass on the underside of my finger, between PIP joint and palm, which I assume is scar tissue. This is tender when pressed.

Assuming my diagnosis is right, I have two questions:
i) Should I be massaging the 'hard mass' to break down scar tissue, or am I likely to be aggravating my injury?
ii) Can you advise any exercises / stretches that will aid recovery? Google doesn't turn much up on this front. So far I've been using rubber bands / squishy balls to provide as much resistance as possible until I feel pain.

Your advice would be much appreciated!
Hi, my apologies about the delay in responding I have been on hols.
Massaging the mass might help and you may find through everyday movements it slowly disappears. Ultimately you want a joint moving freely without any restrictions. You can stretch it both into flexion and extension but sometimes there will be a restriction to what we call accessory movements. These are movements that you cannot actively do but they are essential for normal movement e.g. Slight traction or gapping of the joint as well as forward/ backward and sideway glide. It may be worth a once of physio assessment if there is still a restriction or pain.
You may have started back climbing but if not then try some lower grades and bigger hols and start increasing the load over a 4-6 week period bringing in crimping after 4 weeks. Expect some discomfort but this shouldn't get worse.
Let me know how you are going.
Regards Matt
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on March 15, 2017, 11:30:05 am
Hello, any help would be appreciated...

I have seen doctors/physios about this but nothing is helping so far so thought I'd see what other advice I could get!

I've been having pain in my wrists (yes, both) for about a year now - I had about 5 weeks off over summer but this didn't seem to help much, I've also restricted my climbing to one or two sessions a week for most of this time. The pain is mainly concentrated on the outside (pinky side) but it also comes over the top and on the other side fairly often. I can't do push ups due to the pain or any other motion where I am pushing with the palm of my hand with much force. Also any climbing moves that involve twisting the wrist at all tend to hurt (and I avoid) as does pulling on slopers. Advice so far has been a variety of stretches, icing, rest, taping all whilst avoiding particular climbing moves/styles that worsen the pain. I also spent a while doing lots of antagonist training on the forearm but this didn't really help and if anything made it worst. I've also had two separate weeks where I took ibuprofen which seemed to help and now use ibuprofen gel on a daily basis - this helps, but doesn't take away all the pain. Probably worth mentioning I spend most of my working day at a desk using a laptop (with a mouse though) which unsurprisingly doesn't help the issue.

One of the physios I saw referred me to someone to get steroid injections, but that person decided they weren't right for me. I'm currently trying to get referred to a orthopedic hand specialist - but unsurprisingly the NHS aren't making this easy...

Not really sure what I'm asking here, but any tips/suggestions different to what I've tried before would be great  :)
Hi Will,
Are your wrists very mobile? If so I am wondering whether you may be going onto excessive extension when you are loading them and possibly disrupting the triangular fibrocartilage disc and complex. It is difficult without looking at your wrists. Have you tried putting a wide piece of tape around your wrist at the joint to block excessive extension. Have a look at TFCC injuries and see if this sounds like your wrists. The fact it is both wrists might more towards just excessive movement and joint impingement. Let me know your thoughts.
Regards
Matt

Thanks for getting back to me. I wouldn't say they're that mobile. I have tried taping them and do now tape them most of the time when climbing. I had come across TFCC injuries before and thought they fitted my symptoms, but the physios I've seen have suggested they don't think that's the problem. I'm trying to push to get a scan of some kind so that I'm not just getting differing opinions but some kind of objective test, would you advise this?

Thanks.
Hi Will, my apologies about the delayed response. I am not sure you will necessarily find anything on a scan but sometimes it is a process of elimination.
Another thought would be that if you are sitting at a desk then try regular movements above your head i.e. Alternate arm reaches every hour. Combine this with neck rotations to the right and left as well as trunk rotations. The fact you have bilateral symptoms could be coming from a cervical and upper back origin so move it more in the day and avoid poor sustain postures. Might be worth suggesting this to a local physio and get some treatment.
Regards Matt
Title: Re: Online Hallamshire Physio Clinic
Post by: HPclinic on March 15, 2017, 11:36:27 am
Jumping on the band-wagon too:

I've recurring problems with my elbows, but the pain is not isolated to the classic medial/lateral epicondylitis (golfers/tennis elbow) trigger points.

The pain I experience can be quite crippling at times (nauseating at worst) and radiates down the outside of the humerus, but when palpated is not specific to the brachialis origin.

Could the source of pain be nervous in origin? The symptoms are generally short lived (<2hrs) if i stop climbing when they start, and hence very difficult to present to a physio - what would your suggested course of action be?
Hi apologies about the delayed response, I have been away.
The fact you are getting bilateral symptoms down your arms could indicate a central problem, i.e. Neck or upper back with possible nerve involvement. A physio will get a detailed history and should get a good idea where it is coming from. Where you are getting your pain may not be where the origin is, hence symptoms may be reproduced when palpating the neck. Work and lifestyle postures and positions may also be relevant. Book yourself in to see a physio.
Regards Matt