The Climbing Bible: Managing Injuries (eBook)

Injury prevention and rehabilitation for climbing and bouldering

Stian Christophersen (Autor)

eBook Download: EPUB

2024 | 1. Auflage
176 Seiten
Vertebrate Digital (Verlag)
978-1-83981-201-9 (ISBN)

Infos

The Climbing Bible: Climb Injury Free is the indispensable guide to injury prevention and rehabilitation for climbers. The author, Stian Christophersen, is an internationally renowned climber who has competed and coached at international level; he is also a practising physiotherapist with over 15 years' experience, specialising in the treatment of climbing injuries. The third book in the bestselling Climbing Bible series, it describes the most common climbing injuries that the author frequently encounters in his clinical practice, and examines how they can be diagnosed and treated - and even prevented from occurring in the first place. It is designed to be scientifically strong, yet presented simply, so that it can make an important contribution to the knowledge base that healthcare professionals refer to when treating climbers, yet also be easily accessible to climbers who do not have a healthcare background. The book is split into three parts and features anatomical illustrations along with exercise and action photos. The first part gives an essential overview of factors which can influence injuries and rehab, such as sleep, training load, warming up, differences related to age and gender, and strength training. Part two focuses on the common injuries experienced by climbers - including pulley injuries, elbow tendinopathies and hamstring ruptures, as well as growth plate injuries in young climbers - and advice about how to rehab or prevent these common injuries. And the third part explores the fascinating subject of pain science - what the sensation of pain really means, and how we interpret and can influence our experience of pain.

Stian Christophersen is a physiotherapist, climbing coach and best-selling author. He has climbed for over 25 years, has been an athlete on the Norwegian national team and was the 2009 Norwegian bouldering champion. He has worked as a physiotherapist for over 15 years and runs his own practice in Oslo where he specialises in the treatment of upper limb injuries in general and climbing injuries in particular. He has worked specifically with ultrasound diagnostics since 2014. He is a sought-after speaker and lecturer and gives courses to medical professionals on how to diagnose and treat shoulder pain and shoulder injuries. He runs Norway's biggest podcast in the field of musculoskeletal pain together with his colleague Jørgen Jevne, and he also co-hosts The Climbing Injury Podcast together with physiotherapist James Walker. Stian has climbed extensively outdoors and has first ascents of routes up to F9a and boulder problems up to Font 8b+. He is a former national climbing team coach and has worked with several of Norway's best climbers over the past 15 years, including Tina Johnsen Hafsaas and Magnus Midtbø. He has also been responsible for the Norwegian Climbing Federation's education of coaches, and has educated the next generation of coaches at both a national and international level. Alongside Martin Mobråten, he is the co-author of the best-selling training books The Climbing Bible and The Climbing Bible: Practical Exercises. He lives in Oslo with his family.

Textauszug

HANDLING OF ACUTE SOFT TISSUE INJURIES AND OVERUSE INJURIES

We differentiate between acute injuries and overuse injuries because these different types of injuries require different approaches to treatment. However, there are some common factors for treatment and prevention, and in this chapter we will look at the management of acute injuries and overuse injuries from various perspectives.

 

We will examine the principles for managing acute injuries, and look at how physiological, psychological and social factors affect injuries; factors such as load management, strength training, recovery, sleep and nutrition. This chapter lays the foundation for chapter 2 which looks at specific climbing-related injuries (page 38).

ACUTE SOFT TISSUE INJURIES

FEBRUARY 2019. It is my last day in Hueco Tanks. I have never been to a better bouldering area. We have climbed a lot, and my body has taken a beating over the last ten days. Nevertheless, I feel good and ready to crush today’s wishlist on East Mountain. After a quick – too quick – warm-up I go for a flash attempt on Mo Mojo (V11/8a), but fail miserably. I work through the sequence; the crux is pinching hard with my right hand while placing a high left heel hook by my left hand before deadpointing up to a left hand sidepull. The heel hook is high and close to my body, and I can feel that I really need to pull on it to get my body around the roof that the problem climbs along. However, it feels like something I’ve done hundreds of times before, so my surprise is great when on my next attempt I hear three distinct pops from my left hip and find myself sitting on the pad below.

‘What happened?’ my friends ask.

I don’t have an answer at the moment because, honestly, I don’t feel much pain. Endorphins have that effect on us.

‘Did you hear that?’ I reply, as I check if my left hip is still where it should be.

It’s the start of the last day, so it would take a lot for me to stop climbing today. And there isn’t really any pain. I ignore the sneaking suspicion of a hamstring injury and move on to the next boulder. After a long day of climbing, a sandstorm forces us back to the car, and only then do I notice that I am limping. The next day, my left thigh is stiff all the way up to my buttock. The flight home from El Paso to Oslo is truly one for the books. Back home, what I initially suspected is confirmed. An injury in the hamstring muscles and tendon attachment at the sitting bone.

 

When tissues in our bodies are suddenly exposed to forces they cannot withstand, they become damaged to varying degrees. This tissue damage undergoes a healing process through three phases – inflammation phase, repair phase and remodelling phase – where the outcome of each phase affects both the next phase and the final outcome. This means that we actually want inflammation – an inflammatory response – even though, over the years, many hypotheses and models have been proposed which support the suppression of this response.

In this book we will focus on soft tissue injuries – injuries related to muscles, tendons and ligaments. Bone tissue injuries, such as acute fractures or stress fractures, are approached differently, primarily through stabilisation and immobilisation to ensure proper healing and stability.

In 1978, Dr Gabe Mirkin introduced RICE – Rest Ice Compression Elevation – as an acronym for managing acute injuries, with its goal being to reduce swelling while dampening inflammation, thereby accelerating the healing process. RICE quickly became indoctrinated in healthcare settings and society at large; it is still common practice for ice packs or compression bandages to be used immediately after someone sprains an ankle.

Like many theories, however, RICE has not stood up to scientific scrutiny over time. Indeed, rest along with cooling has been specifically shown to have negative consequences for the outcome of the inflammation phase. As W.B. Leadbetter put it: ‘Inflammation can occur without healing, but healing cannot occur without inflammation.’

WHAT DOES ‘INFLAMMATION’ MEAN?

The Latin origin of the word ‘inflammation’ is inflammare, which means ‘set on fire’. It describes the symptoms of the inflammatory process: redness and swelling with heat and pain – rubor et tumor cum calore et dolore.

A common misconception is that the swelling following an acute soft tissue injury is synonymous with inflammation. However, the swelling represents the accumulation of waste products produced during the inflammatory process which have not yet been transported away from the site of the injury. This transportation is carried out by the lymphatic system, which is a one-way system where fluid is pumped through lymph vessels back to the heart. This pumping function relies on muscle activity, so actively using muscles is the best way to reduce swelling. Immobilising an injured body part therefore does not contribute to reducing swelling; this inactivity also leads to muscle deconditioning, resulting in a poorer final outcome. And it is not only muscles that suffer due to inactivity. Tendons, ligaments and bones also weaken if they are not regularly stressed, so being completely immobile after an acute soft tissue injury is not something we should do.

Nowadays, we understand that we actually want and need an inflammatory process following an acute soft issue injury, yet at the same time we want to reduce swelling and maintain muscle activity and load. We want to avoid situations that can worsen the injury and we want to avoid the use of anti-inflammatory medications, aka NSAIDs (non-steroidal anti-inflammatory drugs). This development of our understanding over time has led to an evolution from RICE to PRICE to POLICE to MEAT to MOVE*, finally resulting in the latest acronym, PEACE & LOVE.

The first part, PEACE, applies during the acute phase in the first few days following an injury.

 

PROTECT
This involves avoiding worsening the injury. If we injure a finger while bouldering, twist an ankle or experience a sudden jerk in a shoulder, it makes sense to end the session early. Although we don’t want complete rest for the injured body part, we can limit its use, the load it is under and its range of motion to reduce the risk of worsening the injury. I see that I failed miserably at this first step when I injured my leg in Hueco, although I did switch boulders after the injury.

 

ELEVATE
Keeping the injured body part above heart level means that fluid accumulated during the inflammation phase can more easily flow back towards the heart via lymphatic system drainage, thus reducing swelling.

 

AVOID ANTI-INFLAMMATORY MODALITIES
As described on the previous page, we are aiming for a successful inflammatory phase, rather than trying to suppress it. Therefore, we should avoid NSAIDs and cooling measures. Such interventions may reduce pain, which can certainly be desirable in some cases, but they will have no positive effect on the inflammation phase or the final outcome.

 

COMPRESS
Despite a lack of documentation on the effectiveness of compression bandages, they may help to reduce swelling by providing support around an injured body part. They also appear to be beneficial for quality of life during the period following, for example, an ankle sprain.

 

EDUCATE
In a world full of internet and YouTube gurus, infinite Google search results, quick fixes and high-tech solutions, it can be difficult to know who to listen to and what information to rely on. Providing good answers related to the type of injury, timescales, prognosis and what a patient can do during the healing process is an important part of a healthcare professional’s job, and this is the information we should expect when seeking professional help. The late English physiotherapist Louis Gifford suggested that there are four questions all patients want answered when seeking help:

1. What is wrong with me?
2. How long will it take to get better?
3. What can I (the patient) do?
4. What can you (the healthcare professional) do?

Good answers to these questions, based on the best available knowledge, will give us a quicker start to an active approach to healing and increase our confidence in the process. It will also reduce the need for treatment modalities and medication, while allowing the rehabilitation to progress naturally in the best possible way. Being able to answer all...

Produkt-Details

• Erscheint lt. Verlag: 3.10.2024
• Reihe/Serie: The Climbing Bible
• Verlagsort: London
• Sprache: englisch
• Themenwelt: Sachbuch/Ratgeber ► Sport
• Schlagworte: Adam Ondra • climbers elbow • climbing bible • climbing injuries • climbing physio • climbing rehab • climbing training • Epicondylitis • font elbow • golfers elbow • hamstring strain • magnus midtbo • pulley injuries • Rotator Cuff • Shoulder pain • Tendinopathy • Tendonitis • Tennis elbow • Tenosynovitis
• ISBN-10: 1-83981-201-X / 183981201X
• ISBN-13: 978-1-83981-201-9 / 9781839812019