Wednesday, July 22, 2009

Elbow Pain Rehab

This gentle exercise video is great. It has all the elements of good information and appropriate exercises. You need to pin point where you have pain since there are a lot of tendons and ligaments around your elbow. Here is elbow anatomy lesson.

It sounds like you can ask her questions and she will make rehab video for you. How cool is that?

Toe or Foot Pain

Deciphering foot pain has more to do with your mind set. You are told to buy tightest fitting shoes. Often that means tight you buy them. One thing climbing shoe makers do is to make sure shoes don't stretch. So, sell them or give them away. You need tightest fitting shoes you are comfortable climbing. Make all the moves; instep, outside, on point, heel, dime size, micro dot, quarter size. Put 1/2 weight, all your weight repeatedly. Pre-hooked shoes has a tendency to channel your toes into a pocket and eventually your toes will look a lot like sardines out of tin. Spend your 1/2 hour with your shoes.

If you have right shoes and still have pain, that probably tells you are not taking care of your feet. Massaging feet is easy to do and learn them. You want to have range of motion and work those sore points out.

I thought tight shoes help me climb better. Nop. Put those shoes aside. In fact, if you are wearing old shoes with hardened rubber, you might be causing foot or toe pain. There are more bones in your foot than anywhere. Listen to this podcast from NY Times.

Longer you climb, more likely you will develop arthritic conditions of toe joints. I had to rehabilitate my toes and massage them to be flexible. It took ongoing routines and I stop using my favorite but old shoes.

The problem with climbing is that we tend to think pain is part of the game. Nop. Warm up properly especially when you are getting older. Keep joints and muscles warmed up.

Nursing shoulder injury

You can have shoulder dislocation or shoulder separation. They are two different things. You overuse your shoulder and put weight over time. You will tear soft tissues; tendon and ligament and this is called shoulder dislocation.

In my case, I had a bad ski fall and took a severe impact on the left shoulder. I use a shoulder brace and slept on the good side. I made sure I had full range of motion. Later you start getting back full motions, the more difficult it gets.

After this injury, whenever I load my shoulder or overuse, it tends to hurt. So, I do these exercises to keep pain away.

Modern medicine changes its procedure and have a patient sit up within 24 hours of an open heart surgery.

However, I learned hard way that your shoulder is complicated and requires active rehabilitation to recover. You need a rehab to stabilize.

See this simple video just using nothing but a rubber band. Here is another video with good explanation by Expert Village. Here is another video. The gentlest one is this video.

You should do these exercises to both sides.

Ankle Sprain - Fast Recovery

Lots of people sprain their ankles every year. I was walking from the car to the camp and stepped over sloped rock and twisted.

In keeping with techniques I learned, I sought to heal myself. It turns out it is easier. First off, it does not take 4 weeks. If you follow this process, it will take a week and half.

My method is as follows but I am following Robert Kennedy's method which is close enough but better with Hot-Cold therapy. First, Ice 10 minutes. Use plastic cup to make ice. RICE method means Rest Ice Compression and Elevation, [1][2]. First 24 hours is crucial. Keep applying ice with a rest of an hour minimum. As long as you keep your swelling down, you are doing good. If you are using an ice bucket, ice 5-10 minutes and no more. Rest and elevate. Watch taping method in this video. I used a ready made one. I now believe taping is better.

In most cases, you can have swelling down soon. The key is not to re-injure your ankle. As soon as you can, walk. Walk and move and rehabilitate as soon as and as long as you don't have pain.

Stop when you have pain. You get full range of motions. Use your hands to stretch and find where and when it hurts.

See these exercises. Note you need to do them on both feet. This is important.

I am able to move without pain and have full range of movement after a bad sprain. But I learn how difficult it is to have a sprain ankle. There is a minimal exercise you can do to avoid sprain ankle for the rest of your life. Here it is; stand one foot at a time for a minute. Switch. Do it once or twice a day. Here is the NYTimes article.

Here is another interesting article from NY Times. Another article by John Kennedy MD.

"Phase 1: Immediate early treatment goals are minimizing soft tissue swelling and regaining range of motion. This is done by applying a compression bandage around the ankle and foot. Elevate the ankle higher than the heart. Apply an ice pack for 20 minutes to control internal bleeding and fluid accumulation. Apply ice every two hours while awake for the next 48 hours. When the foot is elevated, perform range-of-motion exercises by keeping your heel still and tracing the alphabet in capital letters with your big toe.

Phase 2: After 48 hours, the goals are to eliminate all swelling and pain, regain full range of motion and restrengthen the muscles that stabilize the ankle. Remove the compression wrap and immerse your ankle comfortably in a container of hot water (104 degrees Fahrenheit). Perform the air alphabet. Next, place your foot into a container filled with crushed ice and cold water. While keeping the heel of the injured foot on the bottom of the container, lift and rotate the foot up and out until it makes contact with the side of the container. Hold that position for eight seconds, relax for two seconds, and repeat.

Start the hot-water exercises and perform them in descending periods of five, four, three, two and one minute. Alternate each of them with one-minute intervals of cold bath exercises. Continue using the compression wrap until the ankle has no swelling and is pain free.

Phase 3: The goal is to restore range of motion and regain strength to the muscles stabilizing the ankle. You want to be able to stand and balance on the injured foot for 20 seconds without wobbling. Heel raises are excellent. Stand on the injured foot and slowly raise your heel off the ground, then slowly lower it. Repeat 10 times for three sets. Once you can stand and balance on the ball of the injured foot for 20 seconds and have regained full range of motion, begin a jogging program on a flat, smooth surface for up to 20 minutes. When finished, ice the ankle for 20 minutes. When you are able to run on a field or court in a large figure eight pattern at quarter speed, advance to half speed and then full speed. At that point, you can return to full activities."

Wednesday, July 15, 2009

Over gripping and hand injuries

Most people over grip and end with finger injuries. I do and had to unlearn it. Always take a second to find better position to place a protection. The key is how to distribute forces. You don't need to pull hard. You need to use legs more and use as little force on your fingers. Don't hang with all your energy. Relax and breathe.

Always warm up forearms and stretch your fingers before.

Crimps exert far more force on your fingers especially on pulleys and you can cause severe damage. Use open hand grips. You can climb with injured fingers as long as you use open hand grips. Use your thumb whenever you can and wrap it to support your index finger. You can tape or buddy tape your fingers. Buddy taping is to tape two or three fingers at once.

The key improvement into higher grades is how to use your legs more and develop different techniques with your feet. Quiet feet placements can help you focus. Slower foot placement will also give precise and better position.

From the point of hand injuries, it is important to use as little force on your fingers. It also makes you a better climber.

Eric Horst tips

"If you climb long or hard enough, chances are you will experience one or more of the "big three" climbing injuries: a finger tendon pulley tear or rupture, elbow tendonitis, or shoulder subluxation (instability or dislocation). In fact, a British study has shown that nearly 88 percent of 5.12 climbers surveyed had experienced an overuse injury (not to be confused with a "fall injury") in the prior two years."

Great hand injury video - Re-edited


"How long to ice the shoulder? 10 minutes of ice is good, so 20 minutes is better right? NO! More than 10 minutes of icing may promote more inflammation and harm the skin."

"You can use an ice cube, but it's easier to use an "ice cup" for ice massage."

Special Note to young and growing climbers

Those young climbers under 16

Any injury while you are actively growing, needs to be checked by a physician as it can become lifelong problems. Especially, the consensus is that it can become arthritis. I am not a doctor and you need to confer with one.

Shoulder Injuries and Prevention

"The secret is preventative exercise. You may have honed the prime movers of the shoulder – your lats, deltoids, traps, triceps, biceps and pects in prime time at the wall. But you likely ignored strengthening a group of four muscles called the rotator cuff. The rotator cuff muscles are the core stabilizers of the shoulder. "

Hand Injury primer

There is a lot of information out there. It is hard to get good information. Here is a survey of techniques.

When you experience pain in fingers, it is bit too late. So you need to stop climbing or anything to aggravate.

First off, rest is the key to prevent hand injuries. Adequate rest is the key to climbing improvements as your body repairs and gets stronger.

It seems first 48 hours is the key to a fast recovery. Ice for 20 minutes several times. Pain results from inflamation. There are lots of little parts to your hands; pulley, tendon, bone, ligament. To get specific information, it is best to see a doctor. You need to take Iboprofen (anti-inflamatory) during this time. Also, use elastic wrap around your fingers to keep swelling down. It seems there are three categories of severity; type 1, 2 and 3. Not withstanding the most severe type, it would take a week or two.

The consensus is that you want to stretch as soon as pain is not there. This is to get the full range of motion back. This is the second key thing. Stretch each finger and each joint. Massage each part. It is a lot like kneading bread. Go through each part and check for anything like bump.

Once they are injured, soft tissues will take much longer to repair as blood supply to them is limited. Here are two methods; freeze and hot-and-cold.

Freeze method is to keep your hand (or fingers) in a bucket of ice and water. It needs to be freezing point. Your hand will cool off to severe pain and it will warm up. Keep hot tea and wear warm clothing. What happens next is magic. Your body kicks in a flood of blood to your finger tips. You need to keep your hand in for 30 minutes. No, your hand will not freeze or get damaged. It is pretty amazing. In my case, I go through excruciating pain. You do this twice a day. It will help you a great deal.

Hot-and-cold is to keep a bowl of hot water and a bowl of cold water. Always finish with cold. But keep your fingers in each for 20 seconds and alternate. This does the same thing but to lesser degree than the freeze method.

Once you feel strong and free of pain and with full range of motion, it is time to strengthen them. You can knead putty and use it as a band to flex fingers.

Working with Chinese medicine balls seems to help some climbers. freeze method

climbing injuries site

"Aimee Roseborrough - Doctor of Physical Therapy, obsessed climber, mother

Kyle Roseborrough - Researcher of climbing injuries, obsessed climber, starting to get old, father, developer of this site, survived many injuries and still climbing fairly well."


hand and acupuncture part 2

"In traditional Chinese medicine, factors that contribute to sprains include qi and blood stagnation (eventually leading to liver/kidney yin deficiency), spleen qi deficiency (creating accumulation of dampness), and invasion of external pathogens (wind, cold and damp) into the channels/meridian/vessels."


hands and acupuncture part 1

"Understanding the different types of grip techniques is essential for preventing and/or treating acute and chronic injuries associated with this sport. Typical injuries include soft-tissue damage, metacarpophalangeal-proximal interphalangeal-distal interphalangeal (MCP-PIP-DIP) sprains, flexor-tendon strains and pulley strains, joint contractures, tendonitis (and possible tenosynovitis), and carpal tunnel syndrome. More serious injuries include ruptures, severe joint contractures, and avulsions related to the fingers."