12 minute read
TOP 10 INJURY PREVENTION TIPS FOR CLIMBERS
by April Henderson, Physical Therapist/Strength Coach
For many individuals, myself included, climbing serves as many things. It is our stress release from our job, the destination for our vacations, or a source of socialization with friends. For some, it means even more. Climbing is their source of identity, the thing that makes them who they are.
Injuries can serve as a devastating blow to all of these aspects, and I totally get it, having been injured a time or two myself. Some injuries are unavoidable; your foot slips on a hold and only two fingers are left on the tiny crimp, leaving you with a pulley or tendon strain. Or you’re on the way back from an awesome alpine adventure, slipping on a rock and spraining your ankle. These injuries only compose about 20 percent of total recorded climbing injuries. The vast majority (80 percent) are chronic in nature and are completely avoidable. According to data collected around the world, chronic climbing injuries most often occur in the shoulder, elbow, wrist, and fingers. Research has shown that most climbers return to climbing before the injury is completely healed, or have longer lasting pain associated with the injury. I see these often in the physical therapy (PT) clinic, and from my experience as a strength and conditioning coach turned physical therapist, here are the top 10 most common tips I give to patients. I mean this in the best of ways, but I really do not want to see any of you climbers there, so make sure you warm up, get your sleep and protein, lift weights, and take your rest week. Happy sending!
1 Lift Weights
Notice the all caps on this. You NEED lifting. It’s like brushing teeth, your muscle tissue absolutely needs weight training for the rest of your life to keep it healthy and functioning. Performing the same activity will lead to overuse injury, and I see this in every sport. For runners, I see this commonly in hips, knees, and ankles. For bikers, I see overuse patterns in backs, hips, and necks. For climbers, as mentioned previously, overuse patterns are mostly in shoulders, elbows, wrists, and fingers. Lifting increases musculoskeletal recruitment and prevents overuse burnout in muscle tissue. It also prevents the normal aging processes of sarcopenia (muscle tissue loss), and osteopenia (bone density loss) that start to increase after the age of 27. Activity will certainly help to prevent some of this, however not as effectively as weight training.
2 Change Intensity
This next tip goes to those who already lift weights, but lift at the same intensity or same rep range in their lifting. Everyone needs a combination of light lifting (less than 60 percent of perceived max effort) to serve as rehab/prehab, moderate intensity (60–75 percent of perceived max effort) to build a base, and heavy (85-plus percent perceived max effort) to push strength. As a strength and conditioning coach, we would manipulate the percentages depending on whether a team or athlete was in-season or off-season. For climbers during the inseason or when climbing outdoors more, the recommendation would be to lift at least two times per week with light prehab intensity (less than 60 percent of max) for any injury you may have, and moderate-intensity lifts to maintain a base (approximately 60–75 percent of max). For off-season, lifting sessions can increase to three to four times per week, and incorporate more moderate and max-level intensity to increase your strength and sending potential.
3 Take A Rest
This is a concept that is starting to become more mainstream, and I’m really glad it is coming around. For athletes, we would introduce a taper week every four to six weeks. Strength coaches during the taper would cut percentages to below 50 percent for weights, or change the activity completely. For climbers, it is good to reduce your climbing for a week and cross-train with swimming or biking at low intensity. This is great for nervous system activity and the regeneration of overused muscles.
4 EAT PROTEIN!
A recent article by some researchers associated with Lattice found that, on average, climbers (both men and women) need to be eating 1.2–1.8 grams of protein per kilogram of bodyweight per day for optimal recovery and strength gains. For example, a 150-pound person (68 kilograms) needs to be eating 82 grams of protein per day at minimum. That’s at least 25 grams of protein per meal, and much more than the average climber was eating in the study. Your muscle tissue requires amino acids for rebuilding after activity, and if you do not have enough amino acids regularly in your system, your body will cannibalize its gains, making recovery and strength building much, much more difficult. Individuals who were eating the recommended amount had more lean body mass, lower injury rates, and were posting consistently higher strength benchmarks in pull-ups and finger strength than their counterparts who were not meeting the recommended protein amount.
5 Change It Up
All too often I will see a patient who went to PT, was provided a rehab exercise list, and then performed the same list for a year before the problem area started hurting again. Or the common active adult who does the same routine, three to five days per week, and has been for years. Your body needs change. Changing up your exercise selection is also essential to prevent overuse injury. For example, instead of doing dumbbell rows, try doing cable rows for a day. Instead of doing push-ups, try bench presses with a bar or dumbbells. Instead of biking or running as your only means of cardio, try swimming or stair climbing. Your body needs the change for increased muscle tissue recruitment and to prevent additional overuse-type injuries.
6 Sleep
At least six to seven hours at minimum. A retrospective study was conducted that looked at the incidence of injury following different sleep levels, and those who had five hours of sleep or less were at least twice as likely to have an injury. From my time as a strength and conditioning coach, this was one of the first questions we would ask athletes if they started posting lower strength numbers. We would check in on nutrition, protein, and sleep. If they had been lacking in any of these categories, we would start a nutrition and sleep log for three days and implement a taper week if numbers were dropping a significant amount. If you start to have small injuries, aches, pains, appetite changes, or mood changes, it might be a good idea to start a threeday nutrition and sleep log to make sure you are getting a good amount of produce, protein, and sleep. Make the needed changes before small nagging injuries start growing into bigger ones.
7 Workout Time
More often than not, I see injuries occur at the end of a long day or long week, doing a menial task or exercise, but the body was too fatigued to handle it well. This concept was mostly studied in men, where higher strength performances were found in the morning vs. evening. Studies in women are increasing, but still lacking in overall data. My overall experience in the clinic has seen most injuries occur at the end of a long day or week. If you are feeling tired, maybe go lighter in your evening bouldering session.
8 Warm Up
I hate to break it to you all, but climbing a lowergrade climb or boulder is not what I recommend for warm-up. ESPECIALLY if you have a previous injury. Your joint, muscle tissue, and bone all have receptors that provide feedback to the brain on how much incoming force that tissue can handle, its position in space, and tension. An injury reduces the feedback provided to the brain from the injured tissue, causes the mechanoreceptors themselves to be more sluggish to respond to stimuli, and reduces the accuracy of the feedback itself. A low-grade warm-up involving lighter exercise to the injured joint or muscle enhances the feedback loop between brain and muscle tissue, and allows more accurate information to be relayed from these receptors. This, in turn, increases musculoskeletal recruitment and greatly reduces the risk of re-injury. Studies in recent years have shown light lifting or rehab-level weight to be much more effective at preventing injury and increasing range of motion than passive stretching. Think also of your job—what type of exercise is your upper body performing all day? For most occupations, arms are at rest or pretty stationary. The jump in force applied to your shoulders, elbows, and hands with climbing is a significant increase and needs to be met with force that is not full bodyweight hanging from a jug on the warm-up 5.7 or 5.9 for a climbing night. This concept applies to all regions of your body. If you have a previous hip injury, a warm-up should focus on light hip exercise prior to climbing. If you have a previous back injury that’s still nagging a little, you should absolutely warm up your back before activity. A little warm-up goes a long way and is drilled into all my patients (sorry y’all).
9 DON’T COMPARE TO OTHERS
It’s very easy to lose the joy of climbing a bit when you feel everyone around you is sending or crushing hard climbs, and you are still struggling with A, B, or C. This is another reason why I love the training aspect of climbing. It’s your numbers against your own, your strength and endurance against no one but yours. There are physical benchmarks for climbing that involve finger strength, forearm endurance, number of pull-ups, and core strength. I suggest to those wanting to start training for injury prevention and performance to download the free Crimpd app and take a climbing test or two. There are many, many out there, some of the more popular are the Lattice free “my fingers” test and the 9c test. There are also a few assessments on Lattice that can compare your strength to average norms required to send a certain grade (I believe the tests are $35 these days). See what is a weak point and start training. There are programs available on the Crimpd app that can guide you in this. I was fortunate enough to have five Mazama members volunteer to try some of these programs, combined with some training research I was exploring (Angie Brown, Derek Jahelka, Brendan and Alyssa Scanlan, Greg Luckeroth). All members saw great results, and some provided feedback that climbing was more enjoyable, as it has added another dimension to providing physical goals to push their climbing performance.
10 Mind Your Injuries
Climbing involves many parts, all of which contribute to your climbing performance. There may come a time when you are sidelined for a bit due to an injury. My advice is to take the time to focus on your next weakest link, and train the heck out of it. I’ll use myself as an example for this one. Back in March, I was doing a tough move on a small crimp over and over again on a problem, and ended up breaking my left index finger. Climbing with three fingers on my left hand wasn’t impossible, but wasn’t necessarily great either. Finger strength and forearm endurance were always my weakest links, so during my time off the wall I worked on my finger strength with fingerboard pulls from the floor, working at about 80 percent of my tested max on my right hand, and scaled way back to work on my three-finger strength on my left hand. It was pretty telling how much I relied on my index finger for overall crimping, and at the end of my four-month-or-so wait, my three-finger strength was at an all-time high. After a few weeks of hand PT for my broken finger, I could hit the ground running again with some new confidence in my finger and forearm strength. This concept applies to all body parts. If you hurt your ankle or knee, take the time to work on your core strength, or finger strength with hangboarding. If you hurt your back, work on forearm strength and endurance with the forearm roller and add weight (these can be found at Movement and the Beaverton Portland Rock Gym). There is always another body part that can use some extra training and focus during a time of injury. If you need help with this, you can reach out to a physical therapist with a knowledge of climbing.
April Henderson is an outpatient orthopedic physical therapist who works at OHSU and Laika Animation studio. She was born and raised in Kentucky, where her love for climbing started in the Red River Gorge 11 years ago. Prior to her physical therapy career, April was a Strength and Conditioning Coach working with college and pro basketball, tennis, and football athletes.
April has given the Advanced Rock Injury Prevention Lecture the last three years and has two good dogs named Albus Dumbledog and Finn. She loves her husband Johan, gardening, playing with her dogs, and HATES goat cheese.
Photos top to bottom: Angie Brown training at home gym; Derek Jahleka training at Movement; Brendan Scanlan training at home gym. Photos: April Henderson.
Photos top to bottom: Angie Brown training at home gym; Derek Jahleka training at Movement; Brendan Scanlan training at home gym. Photos: April Henderson.
Photos top to bottom: Angie Brown training at home gym; Derek Jahleka training at Movement; Brendan Scanlan training at home gym. Photos: April Henderson.
