Deciphering Climbing Injuries

I have no injury but fell and broke my leg.

2010-11-06T07:51:00.000-07:00

All the injuries I worked, shoulders, fingers and son on. I have no pain and climbing was coming along nicely until.

Yes, I took a practice fall and the gear popped and I hit a ledge. I broke right fibula. A clean break and it was high enough. I did not need a caste. I physiotherapied right away and became ambulatory. What took longest are internal injuries; hematoma and stiff back and range of motion.

I ended up with sizable balls of hematoma in my right button and shin. Ligament injury in my shin and swelling prevented good blood circulation. Long story short, I was climbing in 3 weeks with broken leg. What I found with broken fibula was that it got stronger and bonded soon enough. It was not strong enough to absorb shocks. Jumps from top of bouldering did not sit well.

I became ambulatory in days but whole recovery took ten weeks. I am still working on range of motion. Good news is that I become more conservative and safe. I am working on balance more as result.

For a change, I will be working with other climbers injuries. Yay

New Chapter

2010-06-14T09:30:00.000-07:00

Having experimented and gone wrong ways many times, I feel I have a clue. I will write about various typical injuries and what I had to do to remedy....

Wow

2010-06-14T08:15:00.000-07:00

First off, I am free of injuries first time in a long while. I have many happy news to share..

Improvements in techniques and better foot work and whole a lot of fixing bad habits... They resulted in pain free climbing plus I feel I will be breaking into next grade. I am going to Yosemite with friends after a long while because I could not think of facing these injuries.

My left side came back. Knees are doing really well. Fingers are free of pain or swelling. Toes are doing great. And the left shoulder is happy.

Again, a lot of my injuries are from bad habits and it is hard to kick them off.

Whenever I had time, I am always standing on one foot and doing balance acts writing alphabets or whatever is fun. I try not to sit too long and try to move about. It helps me recycle lower back, pelvis and knee.

Always find neutral lower back using muscles. Much of my issues are from sitting around too long.

Recycling toes and using smaller toes in climbing with proper shoe fit did wonders. Also doing opposition toe exercises keeps them pain free.

Regarding fingers, also recycle them. Use smaller fingers and use thumbs every chance you get. Using your thumb separates you from 90% of climbers..

My shoulder, yes, I had two orthopedists go head to head and see who comes on top. One, they are not perfect and one especially was sloppy. Good education. I thought of going under knife to remedy the shoulder dislocation. It turns out it is not the cause of the impingement. I need to exercise and improve my shoulder curvature and lots of opposition muscle training to compensate climbing.

So, I decided to live with a small tear in anterior labrum of the left shoulder and start building back muscles gradually with good balance. So far, touch wood but it has been great.

So psyched.

Shoulder update

2010-05-06T10:17:00.000-07:00

My shoulder is doing better. I am still seeking medical help. No surgery yet. I learned much about how doctors are and my condition. American doctors do not have time for patients. Well, given that is the fact, I am studying as much and using them to get educated. Here is how it goes. I go and see 4 doctors and that would be equal to 4 times 15 minutes. It is equal to 60 minutes of consulting and education time. Perhaps that is little over the top. I am definitely seeing 2nd doctor. First one was holier than thou. He was well balanced and experienced except he decided to give me cortisone shot. I don't know if it did much good.

The diagnosis is anterior labrum tear, possible SLAP. MRI normal does not give much. Even MRI with contrast does not give. Only sure is to cut and insert a camera. It is normal and typical to make the repair; shaving loose pieces and sewing torn pieces possibly with anchors. However, during the recovery, you can't move bicep as it will re-tear sewn labrum. That could last 3 to 4 weeks. Then 3 months to recovery. So it boils down to doctors with good sewing skill and good full recovery records.

My left shoulder is getting better just by strength training with small muscles around shoulders. I wear 2 pound weight belts around wrists. That did it. It needs to be small weight as anything heavier will engage larger muscles like bicept or tricept. It took me awhile to figure this out. I figured if muscles hold things better instead having the arm hang by ligaments. Shoulder instability is not physical condition per say but sort of quasi pain awareness. Only problem is that it brings atrophy as you don't want to use that shoulder.

Shoulder Impingement - Part 1

2010-02-15T23:02:00.000-08:00

Going back to Evan deSzoeke article, it is well said.

A more experienced climber will have a better understanding of ways to position their body and feet to minimize the use of their arms. This will improve endurance due to the arms's natural tendency to fatigue faster than the trunk and legs. The primary upper extremity muscles used for more technical climbing include wrist extensors and flexors, elbow flexors (including brachioradialis, biceps brachii, and brachialis), posterior deltoid, latissimus dorsi, and scapular stabilizers.

I may be looking at either subacromial impingement or labral tears or both. Check out shoulder injuries of his article. Argh, figure 1 look just like the move I made.

Shoulder Impingement

2010-02-15T21:43:00.000-08:00

Yes, it happened. It is different from what I thought. I had a bad ski accident a few years ago and dislocated my left shoulder. This impingement happened as a result of instable/unstable shoulder. Shoulder is the most wonderous joint of your body. It is held in space perfectly balanced to provide amazing degree of freedom.

I thought it is like normal shoulder pain I know. Now I know shoulder impingement is result of over-use and inflamed tendons and such. It is more like random pain here and there as the nerve gets pinched. It feels like burning, hot, upper arm, in the elbow, in the fingers. It is strange kind of pain where you can't pin point.

I did V5 and dyno on left hand reaching overhead. I put my weight on that shoulder after wide gaston. Well, it felt weird and I sat nursing it.

That night, I have this pain in the socket and elbow. I had shoulder pain before but this is different. It is like hot wire running through my arm. Shortening this story, after a visit to an orthopedic doctor and two shots of cortisone on my left shoulder. They give these shots as a way to prevent further nerve damage. There are two basic problems. One, those shots hurt for two days, just mild pain but present. Two, the shoulder is doing its own thing to settle back. On the third day, it feels good. I am doing rehab exercises.

Climbing wise, I know is that I am doing something wrong. I put too much stresses on same joints in same fashion repeatedly. The big question is how to recycle things; hands, feet, arms and shoulders. My trouble is I keep the same grips instead of switching and using different positions including getting used to utilize as little force as possible.

Spread tension; body tension but it means positioning one's body to reduce stress on feet and hands same way over and over again.

Rehabilitation! I am doing scapular stabilization first and doing no weight ROM exercises. ROM stands for Range Of Movement. Without using weight, one needs to stretch these tiny muscles and maintain or increase ROM. Once, I am warmed up and I am exercising general opposing muscles.

One thing one needs to be careful with is to exercise these shoulder muscles, one needs not to exceed 2 or 3 pounds weight. It is better to do free weight than elastic.

Despite of opposing muscle training, I neglected pectoral muscles and MD Peter Re of the Sports Medicine, the good doctor mentioned about my shoulder curvature. I suppose it tightens and makes you prone to shoulder problems. I remember pain around scapula, aka shoulder blade a few weeks ago. Listening to one's pain is an art.

Check this gem of Climbing.com article by Griffith.

Be well.

Line and Flag Exercises from Self Coach Climber

2010-01-29T06:43:00.000-08:00

I have a small number of friends getting into exercises and training from the book; Self Coach Climber, aka SCC. I have been doing the same side traverse and it helped me break into consistent onsights of V3+. I am working to perfect the line and flag exercises. Here is my response to a friend.

So, I did 6 of line and 6 of flag exercises. It felt awkward. I had to backstep more aggressively and different muscles are sore; deltoid, lat and scapula; mostly upper shoulder. This explains why I could not do them before because I started doing shoulder recovery exercises only about a month ago and my shoulder muscles are getting stronger. I just could not rely on my unstable left shoulder.

It means there are different muscle groups I need to develop. We are supposed to pivot but with these small footholds, we can't. I had to do many more foot adjustments to make it happen.

Like my success with the same side traverse exercise, I was forcing my pivoting without good awareness of where my COG is and I had my hand not adjusting to pivoting. This caused two problems; back ache and hand pain. You need to grab holds differently from normal climbing routine. Like Gaston or layback, or just don't wrap your fingers.

What is important is if you can produce high quality moves. Quantity does not matter so much at the beginning. Don't think it is a failure if you could not finish the whole wall. Just do what you can do with sections of the wall.

Massage - Accelerated Rest

2010-01-04T07:51:00.000-08:00

I freeze my hands from time to time when I have injured fingers. Dave McCleod calls it freeze therapy. It works marvelously except 30 minutes of finger in ice bucket is a kind of hard. See his video

I have been massaging my hands, forearms and feet. The result is amazing. It takes stiffness out and increases range of motion. It feels amazing especially after a good night sleep.

You need to use oil. Nothing special just vegetable oil. Dry massage does not work.

I like to have a towel and a pail of warm water. Search self massage in YouTube. Basically you warm the part by rubbing, working it with a combination of thumb, side of your hand or a stick. You work any soreness out. The session should last good amount of time. Wash yourself and wipe off excessive oil. Having oil on you is not all that bad as your skin seems to absorb it.

Toe pain and prevention

2010-01-02T21:45:00.000-08:00

Revisited: Be gentle with your toes and massage and stretch your toes especially big one every day.

I was having toe problems until I saw Adam Ondra's climbing video. I realized how I was killing my big toe. Everybody climbs with their favorite digit; big toe. I don't know how long but using big toe is drilled into me. After climbing sessions, my big toes are hurting. So much so I would have hot flash in my feet when nerves get blocked. So I must be doing something wrong. I was looking for a solution because my foot techniques wont' improve with pain.

So back to what Adam does, he looks sloppy. He does not use big toe unless he has to. In fact, he frictions where I would use my bt, big toe. It is interesting to watch his videos just his feet. Fascinating.

So, I did what he does. Use metatasal, that is, use parts of your foot not the first two digits of your toes. How do you do this? With care! Use rest of your foot instead of just the same big toe.

Cool sites; rehab and injury

2009-12-31T06:06:00.000-08:00

I have no upper body problems at the moment but I am beginning to have lower body problems; hip, knee and foot. I am using lower body to initiate moves and am straining them without proper stretches or techinques.

I have tender spots around the hip.

Tensor fasciae latae or IT band related issues by sportsinjuryclinic

Exercise 1

Exercise 2

IT BAND

http://www.sportsinjuryclinic.net/cybertherapist/front/knee/irunnersknee.html

stretching/standing_outer_hip_stretch.php

stretching/outer_hip_stretch.php

Lower back pain

2009-12-11T07:29:00.000-08:00

Revisited: This turned out to be a muscle inbalance. Iliopoas are tight. I started doing squats and lunges to strengthen glutes. Iliopoas are muscles in your front pelvis. They get tight from lifting legs and twisting. That solves my problem and I don't have back ache any longer.

I won't say it is a pain. It is rather dull pressure in the back. As you climb overhang, your hyper extension of the back causes. I found a French site with great stretches I was describing in the previous article.

http://www.kinescalade.com/patho/lombalgie.php

Translated from definition section

The word simply defined back pain pain in the lumbar region. That is to say, the bottom of the spine. Localization of the lumbar region of low back pain are many climbers, both in the type of pain in their causes. From the surface to depth, the different structures that can generate back pain are: • the muscles of the lumbar region, which may spasm, or because of the effort, either to protect the underlying structures, · intervertebral ligaments, which may suffer a prolonged stretch, · joints which can be worn when one speaks of osteoarthritis, · intervertebral discs, which can also be worn, crushed, or submit an overhang or a hernia, · meninges, envelopes the spinal cord, which may undergo various stresses (tensions , pressures).

You can use Google translate and it does adequate job. There are videos of stretches. It is great.

Grab holds gently and softly. Don't pull it down like an idiot.

2009-12-11T07:11:00.000-08:00

The increased rest is working. I have less problems with fingers and I am fully rested. I am eager to climb.

I realize I need to go back to the basics every so often to test habits and assumptions.

For example, silent feet does not mean I place them silently and stare at it like an idiot. It means I place weight and feel and move off. Glue hand does not mean I grab a hold and think it is done. It means I place my hand the way I imagined and holding it the same way instead of shifting it after placing weight. Yesterday I realized when pieces of skin under my fingers shift under pressure. I was shifting my hand holds and stressing my skin to a breaking point. Subtle difference is how it plays out. First off, I am busy powering through without body awareness otherwise. Second, I am stressing my body through unnecessary peak stresses with poor hold contacts.

Back to the basics, I don't know how many times I am making these round-trips but the rock can wait.

I am doing some supplemental exercises; recruitment and strengthening of forearm, shoulder muscles and stretches of deeper core muscles. I complement them with opposing muscles training. This is to have muscle balance with stability.

Rest is training!

2009-11-25T21:04:00.000-08:00

Revisited: In French, there is a lot more instructions about these types of information as it turns out. I was speaking with a good French climber. He climbs 8b and V10 and trad hard climb in his town of Serre Chavalier. He said it takes 3 years for tendon and ligament be stronger enough to get beyond V6 or 7. My answer to that is freeze theraphy every rest day and it is working out nicely. My fingers feel wholesome and not run out.

I increased the rest to two days that I am climbing more intensely. I don't have real expectations where I will go with this as long as I don't have chronic injuries.

I do this routines according to SCC, aka Self Coached Climber.

Fingers are doing good. I load them carefully and generally don't load statically and excessively. Every time I load my hand, I flick my wrist and stretch hand to flush. I give Adam Ondra the credit for this little amazing trick. Left shoulder and elbow are doing better with stabilization exercises. I should do little flush trick on them as well.

I am afraid to push my fingers too much. But instead of exclusively pulling on fingers, I engage forearm and upper arm into the hand hold. It could mean I don't keep my arm dead straight but at an angle.

But most of improvements and injury preventions come from foot work. I have enormous trouble where I need lots of shoulder stability and strength. With stronger core, it is surprising that I can make moves I was not able to make in the past.

I feel I need to be patient at the moment. I need to wait for the rest of deeper muscles to develop with techniques. I need good positive motivation like "with good approach and training, I made some hard moves and sustained climbing and it felt good instead of obsessing and getting discouraged."

The Self Coached Climber - The Bible for climbing so far. I hope someone betters it.

2009-11-25T20:56:00.000-08:00

I ordered it and finally received it. Starting reading it, most of time, climbing is something I do not read about. I hate reading books on how to in sports.

In the past, I bought sports get-stronger recipe books and pick them up and down. This one is pretty readable as Dave Mcleod said. I have books I would give away because they just don't do it for me; giving me incremental approach.

It is almost like learning alphabets, learning how things fit and giving me understanding of directions and approaches I need to take.

Great climbing injury web site

2009-11-17T10:35:00.000-08:00

I stumbled onto it.

Upper Extremity Injuries in Rock Climbers

Why do my articles repeat themselves?

2009-11-16T13:06:00.000-08:00

Why do I revisit same injuries as they are new? Well, they are new.

You change one thing. It is different. Change amount of climbing from weekend to a few days at a time. Change to higher grade. Change your habits and try new techniques that you have not mastered.

Two things affect injuries drastically; angle and amount of climbing. Injuries are reactions. They flare up again and again. I call them weakest links. Elbow problem now is not exactly the same as elbow problem of the past. In the past, wear and tear of multiple days of climbing lower grade, weakest link fails first. My current elbow problem is muscle inbalance resulting in excessive stress on the weakest link.

This is the reason Dave Mcleod promotes deep learning instead of taking quick recipes. There are few reasons why this approach causes injuries.

Elbow and Shoulder

2009-11-15T18:32:00.000-08:00

Injuries tell you about what you are doing wrong. Like most people, I rely on pull strength. My elbow and shoulder injuries are from muscle inbalance and past injuries.

I over train pull muscles with poor techniques; foot works and hand use.

Answers are training of opposing muscles. Check out the article by Ali Rainey. Ali has a bunch more articles in the web site. She really has a system worked out. Basically in climbing, one tends to over train pull muscles and you injure yourself. In order to avoid, one needs to train opposing muscles. For every action, there is reaction. Injury is a reaction. More comprehensive exercises are found in this article.

Have you seen climbers whose shoulders are warped forward? It is because muscles are tightening and pulling them forward. The answer is simple push-ups or press-ups in England.

Second answer is massages. There are several massages of various affected places. I found out these massages; self massages. It loosens and warms and breaks down and promotes circulation. End result is just as good as Dave's freeze therapy. But little I did is already helping me.

I have a tender shoulder. Techically, it is an unstable shoulder. I have injured and dislocated in ski accident and since then, my shoulder joint is loose; stretched tendons. You need to do certain exercises to stabilize. Lie on your side and keep your elbow on your waist. You can keep a towel under it. Use 2-3 pounds weight. Lift it without lifting elbow; basic rotation. Do 10+. It is like fanning movement. Rotate your wrist and do some more. Then rotate wrist once again in different orientation and do some more. Just keep doing these light movements. This warms up and makes all your shoulder muscles work together. If you use heavier weight, your muscle inbalance will continue and your shoulder will be unstable.

Lazy Method Revisited

2009-11-07T11:04:00.000-08:00

Are you making progress?

If there is one hard lesson I learned, don't rush into hard training. You get beaten and the body blues sets in.

Be gentle and nourishing. Take it slow and enjoy more with less. Not enjoy less with more. I see beginners headlong into V1 and V2 and getting discouraged. I see climbers making same mistakes and powering through eventually hurting themselves. You need to learn to crawl before running. As far as vertical world is concerned, you can't even make a few steps.

Keeping yourself motivated no matter what level you climb is the name of the game and FUN.

Proper rests are golden. It is easy to train without a break, a proper break.

Putting them together, warm up properly, train gradually, be gentle. Enjoy yourself. Motivate yourself. Cool off properly. Eat well. Rest well. Don't go back without proper rest.

That keeps you injury free and stronger and happier.

Ben Moon sayz; A little and often. Be patient and let it happen. It is no good if you are not happy.Just climb, climb and climb

Francoise Legrand sayz; Not too fast, not too slow. Sometimes fast sometimes slow. I will do mental tatoos of these words...

Elbow and Shoulder

2009-11-07T08:46:00.000-08:00

It started suddenly; tiny and bothersome dull soreness in my elbow and shoulder. I was expecting them. Result of overtraining? Not. Read on.

I read one article by Nicos and then a few more by Dave Mcleod. More I read, there were many things I am doing wrong; my techineques rotten techniques. I did not know how stretch to the elbow! There are two different ligament tears; Golfer's elbow and Tennis elbow. Or they are called tendinosis and tendinitis better known as golfer's elbow and tennis elbow; dull persisting pain or sharp temporary pain. Stretching your elbow is actually stretching your pronator part of your forearm; twist your arm so your thumb points downward, keep twisting, grab it your hand with your other hand, and gently twist more with your other hand. Pronator is top portion of your forearm. Stretching it will stretch elements of your elbow.

How do you prevent? It is said climbing statically generates higher peak stress than dynamic climbing. Dynamic climbing is not the same as dynamos. Dynamic climbing can be described as dead pointing. You have a path and you make moves and letting go at the same time. Here are what pros have to say. Lynn Hill mentions dynamic release or simultaneous releases. She makes a move through releases not catches. Others elaborated in making a habit of stretching your hand after each move and shaking tension out. Some mention letting go high stress point; hand or foot holds to lower stress situation. Keep your hand hold with least amount of force. Instead of crimping, use friction. Instead of using hands at all, let forearm do the work. Bigger, the better.

Let's decipher this hand hold least force business. If you look at your forearm, bottom part is bigger and meatier than top part. If you cock your wrist, you engage the top part and it does not last long. If you relax your wrist, you engage bottom part and it lasts longer. If you don't engage wrist, there is no tension in either parts of your forearm. If you don't engage forearm or wrist, you engage your skeletal structure and shoulder muscle. You can rest and linger. But you can't swing on your shoulder as your shoulder will become unstable. Your next bet is to engage without cocking your wrist. Best yet, you should build "micro shakes" between each move to shake tension and stress out.

One needs to exercise pronator muscles and strengthen forearm. The forearm is just as complicated. Pronator is a set of muscles enabling you to rotate your arm as you have it extended in front and twist your hand. One exercise is to grab a stick and rotate it slowly from side to vertical. Then resist its falling back to side.

Rest Oriented Training

2009-11-02T21:35:00.000-08:00

So, for the time, my mantra is to have fun and get stronger and improve endurance. It has been super fun with good warm-up, stretches and cool off. I think I am building a routine course that keeps me injury free and flexible with good amount of power. My training is to see how far I can go from "rest oriented training with intensity exercises."

I did develop some sore or pain spots; deep back muscle rushing into exercise without deep stretch, tenderness of big toe from improper foot work. I am learning new stretches. I treat my toes and feet just like hands; stretching each digit and ankle stretch.

My training at the moment consists of; learning new techniques, body tension exercises and bouldering.

The same technique is not same given angle of the rock. I am working on techniques; center of gravity awareness, instinctive climbing style, and precise foot works. Learning new tricks is not easy as I have bad habits. Bad habits are; sagging, hanging on arms without proper feet, over grip, pulling instead of pushing, and bent arms.

I am doing various exercises; limited iron cross, calisthenics and v-up.

But actual climbing is the best exercises. I like to use slopers and big holds to toughen soft tissues and to increase power and to bring techniques.

I think I need to do ; touching every holds with feet and climbing without pulling. I have been sharing some of these with other climbers.

Black Toe

2009-09-16T23:21:00.000-07:00

I bought a "pre-curved' asymetric climbing shoes. When I fell off a giant roof, I came flying into a face and scraped it with my foot. It pinched and I felt a sharp pain.

I thought I broke something in this small fall. I expected the worst and it is just a case of a tight shoe and a black toe.

Last time I drilled a hole through it. Choose a small and sharp drill bit, gently press the bit in the slowest speed. It chews through the nail and you stop when it just breaks through. I was not in pain but my wife was aghast in pain looking at this antic. But it feels great after since it releases pressure. A genuine relief moment.

This time, I just used something like thumb tack. I used bit of sanitizer. Instant happy moment. I am going climbing after 4 days since poking it.

By the way, the nail is soft and lacks usual firmness when it is black. So it is a lot easier than you think.

Elbow Pain Rehab

2009-07-22T23:20:00.000-07:00

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

2009-07-22T22:53:00.000-07:00

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

2009-07-22T22:19:00.000-07:00

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

2009-07-22T21:58:00.000-07:00

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."

Over gripping and hand injuries

2009-07-15T10:14:00.001-07:00

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

2009-07-15T10:11:00.000-07:00

"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."

http://www.nicros.com/archive/lower_injury_risk.cfm

http://www.nicros.com/archive/climbers_elbow.cfm

http://www.nicros.com/archive/lateral_elbow.cfm

Great hand injury video - Re-edited

2009-07-15T10:06:00.000-07:00

Icing

2009-07-15T08:37:00.000-07:00

"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."

http://www.climbinginjuries.com/page/shoulders

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

http://health.yahoo.com/arthritis-resources/ice-massage/healthwise--zt1141.html

Special Note to young and growing climbers

2009-07-15T08:31:00.000-07:00

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

2009-07-15T08:28:00.000-07:00

"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. "

http://www.ukclimbing.com/articles/page.php?id=119

Hand Injury primer

2009-07-15T08:01:00.001-07:00

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.

http://www.allclimbing.com/archive/2005/01/hand-injuries-in-rock-climbing/

http://www.allclimbing.com/archive/2005/02/more-climbing-finger-injury-information/

http://www.allclimbing.com/archive/2005/01/more-on-finger-injuries-in-climbing/

http://www.physsportsmed.com/

http://www.davemacleod.com/articles/climbinginjuries.html freeze method

climbing injuries site

2009-07-15T07:58:00.000-07:00

"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."

link

hand and acupuncture part 2

2009-07-15T07:55:00.001-07:00

"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."

link

hands and acupuncture part 1

2009-07-15T07:54:00.000-07:00

"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."

link