Wednesday, November 10, 2010

Some Thoughts on Injuries

As promised, some draft material on the subject of injuries:

How injuries happen

Injuries happen when you have done something wrong. This is obvious enough. The question is what exactly? To begin thinking about this constructively, remember that climbing is about moving a large physical mass, i.e. your body, using relatively small and potentially vulnerable body parts. When climbing is done correctly, you don’t notice this basic truth as it can be masked by strength, good technique, balance, and sometimes plain luck. When the weight of your body is loaded poorly onto vulnerable joints and muscles and tendons, trouble starts.

The causes of this are basically two-fold; bad technique going into the move caused by inadequate training or planning and trying moves that are dangerous regardless of technique.

An example of the former would be attempting to lock off a small crimp at the end of a long day of bouldering. You are tired, under-hydrated, and not moving as cleanly as you could. As you try the move, a poorly-placed foot pops off a small edge, causing you suddenly to load the crimp very hard in an eccentric fashion. At worst, you may actually hear a tendon pulley snap, other times you may feel a slight strain that allows you to continue climbing and unknown to you, actually make a bad situation much worse. If you had backed off and come back when fresher, the move would have been trivial. If the pulley hadn’t snapped but you felt something wrong, had stopped climbing and iced the affected region immediately, you might be up to speed in a week or two. Instead you might have a nagging injury lasting months, even years.

An example of the latter situation is trying a move that isolates a body part in a way that forces a load onto that part that it is not designed to handle. The classic example is a one finger pocket. No matter how strong or careful you may try to be, there is no way to guarantee you will not hurt yourself on that kind of hold. Another is doing a move that involves using a gaston high overhead or making a very long reach sideways. Both these positions involve a considerable risk to your shoulder joint, especially the rotator cuff assembly. Another is latching a hold after a huge feet-cutting dyno. The impact and subsequent swing are potentially very hazardous to shoulders, regardless of strength or technique. These kinds of moves can be anticipated and avoided but occasionally you will want to do a problem that requires their use. Just as in the first case, planning and preparation are vital.

To avoid climbing injuries, the first rule is always warm up well on a sufficient amount of easy to moderate climbing or, if that isn’t accessible, an adequate amount of exercise to get your heart and respiration rate up and your body temperature elevated a bit. The second rule is never try individually hard moves when tired. This applies to training as well as in the field. For safe healthy bouldering you want to operate at your peak in the window between warm-up and fatigue, recognizing when you have peaked and adjusting your activity accordingly. During this window, you want to stay hydrated and fueled as this allows both better performance at the peak period and quicker recovery once you have quit for the day. My advice, despite the stories of heroic sends, 5th day on and on the 20th try, is never climb to exhaustion. You are only teaching yourself to climb poorly when tired, a habit that is not easy to break. It also opens the window to injury on otherwise easy problems and moves, the type of climbing which is in no way worth the sacrifice of a climbing season to achieve.

5 comments:

  1. This is really good stuff, thanks for sharing!

    Was wondering a couple things. To what extent do you think what you wrote applies to overuse injuries in addition to acute ones? In a similar vein, any thoughts about when and how long to rest to prevent injuries in general, and also if you suspect overuse symptoms coming on?

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  2. I am writing on overuse now so a good question to ask. To me overuse begins when the microtrauma that is a normal part of training (and heals itself) shifts into significant inflammation that can't heal. The question here is why won't it heal? The answers are varied. Partly it is rest. Bodies need time to heal themselves. It is also about sleep and nutrition. Antagonistic muscle balance plays a role as well as maintaining variety of activity. More on this in a few days.

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  3. Unfortunately injuries (overuse more often) are a required necessity for some people trying to improve in climbing.

    Sometimes they just don't get the subtle signs that injury is impending and it is time to do something different.

    A layoff will have them thinking about what went wrong and hopefully they will not repeat the process. Maybe two or three months of slab climbing will be sufficient for the most critically injured.

    I myself have lingered from injury to injury always learning important lessons I probably wouldn't have gotten otherwise.

    I am always curious how the elite manage overuse injuries because we rarely here about them.

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  4. Anon,
    I would agree with the first point totally. For those people who won't listen to their bodies as you so well describe, injuries are the only thing that breaks bad habits. I would count myself in that camp, for sure. It takes a lot of time to really internalize that message

    We don't hear about overuse injuries in large part because we don't want to. Occasionally a story will show up but by and large, I think they are seen as a downer in a climate that tends to seek optimism and motivation. Personally I would like to know how people cope with them especially with age.

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