[tomtom]

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

Don't become a "chair shaped climber" !

I'm interested - how does swimming work as an exercise on this front - I've always thought that all that waving arms about in the water must be good for general shoulder stuff,,,?

[HPclinic]

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

Either you have a bit of bone floating in the joint surface or your ankle has reduced weight bearing dorsiflexion which needs to be regained ie foot fixed with knee moving forward. If the latter doesnt work best see your GP and you may need to be referred to an orthopaedic surgeon. This is highly treatable.

[HPclinic]

Dear Aunt Agony,

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

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

Sounds like you might have a small hernia which needs checking with your GP in the first instance. Assuming not then your sitting position needs to be looked at to reduce tightness in your groin region. Back stretches and practice lunges prior to exercise on a daily basis are worth experimenting with.

[HPclinic]

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

This has caused some debate between us. Try calf stretches 2 or 3 times a day and some local massage before climbing and report back. You are right to relieve the pressure on it as it maybe compression of a small nerve on the outside of the ankle.

[webbo]

I like it "Some debate" This sort describes my sporting injury history. I forgot to mention I am a bit on the mature side 58

[HPclinic]

Hi guys.

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

many thanks

Sounds like you have a joint reaction (mild arthritis) and stiffness is the response due to the way it is being used/overloaded. Stretch individual joints daily and introduce more variation ie open handing holds instead of crimping. Drop the grade to let it settle and improve. Sorry!.

[HPclinic]

Chaps

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

Many thanks guys

We will be producing a video that may help but it in the meantime it sounds like you need to address your training by introducing more variety perhaps ie pushing weights if you arent doing this already.

[HPclinic]

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

Don't become a "chair shaped climber" !

I'm interested - how does swimming work as an exercise on this front - I've always thought that all that waving arms about in the water must be good for general shoulder stuff,,,?

Doing crawl is good but requires good technique with plenty of rotation - something often missing with climbers!

[i.munro]

Round about this time last year I injured my wrist. This was diagnosed as a torn TFCC and treated by arthroscopic debridement. Cue long layoff from climbing.

I had the surgery towards the end of last year.

 At some point during this layoff I started having achilles tendon problems for which the physio recommended eccentric calf raises. This seemed to work & in April this year I booked a trip to Bleau to test the recovering wrist ( having completely forgotten the achilles problems)
2 consecutive days of gentle climbing in my baggy warm-up shoes produced very high levels of pain in the heel & eventually I just couldn't bear to put my left shoe on.

2 months of icing & stretching & eccentric calf raises later & i have some slight residual discomfort when walking but any pressure on the heel is  still very painful preventing me from wearing climbing shoes.
The pain seems to be in the bone where the achilles attaches rather than in the tendon itself.

I have tried custom orthotics & the physio is now suggesting a cortisone injection.

Any thoughts suggestions welcome


Thanks

[shark]

Thanks to Steve, Matt and Ian for their time this afternoon.

Unfortunately we have run out of time but hopefully they will revisit during the week to answer the outstanding questions (or you can see them in person!).

Please bear in mind that they are responding to a snapshot of your predicament as you perceive it and are responding accordingly and giving the best advice that they can in the circumstances.

[sidewinder]

http://en.wikipedia.org/wiki/Haglund's_deformity
Any chance you could have this (I do) mine is normally fine but if I wear shoes that rub on the area (guide tennies particularly bad), it causes a flare up of tendonitus(sp?) like symyptoms.  Wearing soft/no backed shoes (Sanuks/crocs), padding the backs of shoes with shiny (reduces friction) insole foam, moisturising skin around the area (reduces friction) and finding climbing shoes that fit my feet well, so they tightly fit without moving/rubbing are my injury management strategies.

I like it "Some debate" This sort describes my sporting injury history. I forgot to mention I am a bit on the mature side 58

[webbo]

It sounds possible but what puzzles me is that it only started this year and I have been ramming my feet in to misshapen shoes on and off for 40 years and it came on after a period when I'd not been wearing climbing shoes due to having a finger injury. Also I'm not sure my shoes move/rub as they are usually to tight to do this.

[sidewinder]

For me, I only started having problems after wearing an ill fitting pair of hired ice skating boots.  So if it is what I have, possibly it could even be that your feet changed a bit during a period of not wearing the climbing shoes and that they now irritate them?  Once inflamed I find that any pressure, regardless of 'rubbing' makes it worse, hence I try to make sure it is not getting irritated as much as possible (typed while sitting in my office in fake crocs, with smart shoes tucked under the desk in case of visitors).

[webbo]

Its worth bearing in mind although I have been avoiding wearing shoes that rub and customised my climbing shoes. I will try whats recommended and report back, although I'm not sure I could cope with the ridicule of wearing crocs.

[i.munro]

Sounds like this would fit my problem as well. How did you customise your shoes I can't see any way to do it?

[webbo]

I cut the rand on either side of the left pull tag. This is on a pair of sportiva kantanas, they are fine to climb in on my home board but on not so steep stuff my heel can lift out.

[Rocksteady]

Hi guys.

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

many thanks

Sounds like you have a joint reaction (mild arthritis) and stiffness is the response due to the way it is being used/overloaded. Stretch individual joints daily and introduce more variation ie open handing holds instead of crimping. Drop the grade to let it settle and improve. Sorry!.

This sounds like a mirror of three joint pains I am suffering in my fingers and corresponds with the diagnosis I've just had from a hand therapist.

She also recommended warming the hands before climbing, and cooling them after, and recommended pain killers for pain management   
She also suggested looking into whether I had an intolerance to the tomato / nightshade family of fruits/veg, which include tomatoes, peppers, aubergines. I eat loads of these so I am going to try it out. Info on joint pain and tomato allergy http://www.livestrong.com/article/496041-tomatoes-peppers-for-joint-pain/

[i.munro]

I cut the rand on either side of the left pull tag. This is on a pair of sportiva kantanas, they are fine to climb in on my home board but on not so steep stuff my heel can lift out.

Thanks. I think I'd have to cut the heel away completely :-((

[chris05]

Hi

I have had long-standing (8+ years) problems with my ‘elbows’ both when I climb and surf, especially if I try to do a number of days-on. There is no particular point of pain, it can be diffuse throughout the bicep, tricep, elbow joint and top of the forearm. I'm fairly sure it isn’t golfers or tennis elbow (although I have tried the exercises for these for fairly long periods just in case).

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

I also get a lot of stiffness/soreness in my shoulders (I believe in the rotator cuff area) when sitting at a desk and whilst running. I guess this may be the root of the problem. I have followed a few theraband routines for a reasonable length of time but although these seem to help a little, they don’t seem to help long-term.

It doesn’t seem to matter if I take time out from these activities or if I slowly build up. I am 30 years old and it would be nice to be able to climb or surf for more than a day without pain! I have resorted to popping ibuprofen on surf trips which seems to help up to a point but obviously isn’t a good long-term solution.

Many thanks for any help in advance.

Chris

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

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

Best wishes, Deidre

Many thanks for this. I will give it a try.

[Doylo]

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

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

Thanks a lot. Thinking about it the problem started straight after the hammering so I think it's a pinched nerve. Taking ibuprofen and hoping it'll clear up soon with rest 

[rich d]

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

Either you have a bit of bone floating in the joint surface or your ankle has reduced weight bearing dorsiflexion which needs to be regained ie foot fixed with knee moving forward. If the latter doesnt work best see your GP and you may need to be referred to an orthopaedic surgeon. This is highly treatable.

cheers, much more useful than A and E

[HPclinic]

Round about this time last year I injured my wrist. This was diagnosed as a torn TFCC and treated by arthroscopic debridement. Cue long layoff from climbing.

I had the surgery towards the end of last year.

 At some point during this layoff I started having achilles tendon problems for which the physio recommended eccentric calf raises. This seemed to work & in April this year I booked a trip to Bleau to test the recovering wrist ( having completely forgotten the achilles problems)
2 consecutive days of gentle climbing in my baggy warm-up shoes produced very high levels of pain in the heel & eventually I just couldn't bear to put my left shoe on.

2 months of icing & stretching & eccentric calf raises later & i have some slight residual discomfort when walking but any pressure on the heel is  still very painful preventing me from wearing climbing shoes.
The pain seems to be in the bone where the achilles attaches rather than in the tendon itself.

I have tried custom orthotics & the physio is now suggesting a cortisone injection.

Any thoughts suggestions welcome


Thanks

Thanks for the question.  Eccentric loading of the Achilles tendon has some research to suggest it works but from my clinical practice it makes more sense to remove stress on the overloaded tendon (I rarely prescribe eccentric loading exercises and see many people achilles problems who have not responded to this approach). 

Usually climbing in not a major problem with achilles tendonitis as the runners are usually harder to settle (I assume you are not running?).  I would try to see how you are using the calf and achilles.  For example, do you walk by 'bouncing' and are your calves overdeveloped as a result.  Try walking by keeping the foot flat  and lean forward slightly (as we walk many people with achilles tendon problems 'push' with the calf and this causes repeated overloading of the tendon that manifests itself as pain when walking.  Try to change your climbing style so as not push repeatedly through the ankle. Your Physio should watch you walk and even climb and suggest changes to your movement to help remove stress on the achilles.
PS
Regarding injections I am not a major fan and I would not have an injection before removing the stress on the tendon as outlined above.  If you do go down the injection route be careful not to have more than three as steroids can weaken the tendon and possibly increase the risk of rupture.  I would stop stretching as there is no evidence it works and it might be traumatising the tendon with repeat loading.  Tell me how you get on.
Steve

[HPclinic]

It sounds possible but what puzzles me is that it only started this year and I have been ramming my feet in to misshapen shoes on and off for 40 years and it came on after a period when I'd not been wearing climbing shoes due to having a finger injury. Also I'm not sure my shoes move/rub as they are usually to tight to do this.

I agree, if you have worn climbing shoes for 40 years your feet will have adapted to the compression that they produce.  The problem can be if your foot has not been on the position for while (due to finger injury).  Rate of change on tissues is a common problem so wear the shoes daily around the house and try gradually increase the time until you can climb pain free.  I like the idea of having a range of shoes as this can change stress points on the foot. Your feet wont like the compression and then loading with climbing after time off.  This is not age related in my opinion so some good news!. Steve

[HPclinic]

Hi guys.

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

many thanks

Sounds like you have a joint reaction (mild arthritis) and stiffness is the response due to the way it is being used/overloaded. Stretch individual joints daily and introduce more variation ie open handing holds instead of crimping. Drop the grade to let it settle and improve. Sorry!.

This sounds like a mirror of three joint pains I am suffering in my fingers and corresponds with the diagnosis I've just had from a hand therapist.

She also recommended warming the hands before climbing, and cooling them after, and recommended pain killers for pain management   
She also suggested looking into whether I had an intolerance to the tomato / nightshade family of fruits/veg, which include tomatoes, peppers, aubergines. I eat loads of these so I am going to try it out. Info on joint pain and tomato allergy http://www.livestrong.com/article/496041-tomatoes-peppers-for-joint-pain/

Most climbers get changes on the finger joints as a result of loading fingers in their sport.  The x-ray will show changes on joint surfaces but not necessarily be painful.  These joint changes are morphological changes in response to load on the joints and as long as the rate of loads on the joints doesn't change too rapidly, there is no problem in my experience.   The good news joint love been loaded and they will respond to movement.  That is probably why climbers hands ache after a break from climbing as the normal stresses are removed.  'Use it or lose it'. 

[HPclinic]

Chaps

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

Many thanks guys

From the description it sounds like 'Tennis elbow' (not really a diagnosis but means you have pain over the outside of the elbow).  The good news is climbing at 50 is not, from my experience of treating climbers aged 50 plus, going to stop you improving.  If you can climb pain free it does make me wonder what sort of training you do. With your training consider doing weights that make you push for example shoulder and chest presses.  Include more rotation exercises and I think kettle bells are a useful exercise and even boxing.  Don't overload the lateral elbow with dead hangs and finger pulls until the pain settles.  Matt is making a video on elbow rehab and exercises and that should be on the site soon. 
Tell me how you get on.  Steve