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Alli Rainey: Improve Your Climbing – Injuries continued (Part 17)

Wednesday, December 17th, 2014

Part 1:

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Impact & Other Sudden Injuries

I personally believe that entirely unpredictable and unpreventable impact/acute injuries are relatively rare in sport climbers and boulderers, too. I do believe boulderers tend to be more susceptible to impact injuries on the whole, due to the unroped nature of the activity; every time a boulderer steps off the ground, the risk of landing strangely and torqueing or busting an ankle or wrist exists, no matter how great the spotting might be – and this is a personal choice, to place oneself at risk. Sport climbers, too, can slam body parts into the wall, particularly if the belayer isn’t savvy about giving a soft catch and the climber is on fairly vertical terrain. Holds can break and rock can fall and gear can fail, all leading to potential injuries.

Other acute/sudden impact injuries include the dreaded finger popping as well as ligament/tendon/muscle strains and tears borne from within (rather than external impact); these types of acute injuries are often actually preventable and easily traced back to chronic and cumulative overuse/abuse/overtraining, or alternately, to placing stressors on the body that it is incapable of handling at the present time (i.e. undertrained for the movement in question). Not to blame the victim at all here, but it’s really important to own your part in every injury you incur in order to try to proactively avoid inviting recurrence in the future. In other words, taking as much responsibility for injuries as you can should be an empowering part of the healing process.

Prevention of Acute Injuries

Paying attention to subtle bodily cues can play a huge role in preventing acute injuries that happen from within, injuries like finger pops and muscle strains and the likes. It’s very easy to get caught up in the moment while you’re climbing and try to insist or force an issue, or even to take a conscious risk on a move or hold that you know could incur injury. If you have a split second, try to ask yourself before you commit to a hold or move that you know might be injury-provoking whether or not it’s worth risking injury on for you. Maybe it is, maybe the route or move means that much to you, but I know for me that more often than not, I’ll pass if I think the risk of injury is great – if I feel the slightest hint of a “bad tweak” when I put a finger on the hold or put my body in what I think is the correct position to do the move. It’s not worth it.

It’s true that sometimes you don’t even have the time for conscious assessment and the injury happens before you know it, seeming unpreventable and inevitable. This has definitely happened to me numerous times, and it can lead to real feelings of helplessness and a loss of faith in one’s body. However, it’s also often true that you can trace back through your actions leading up to that moment of injury and recognize certain choices that you made along the way that were likely contributors to the resulting injury.

Taking a proactive approach like this can enable you to feel like you have more agency and are less helpless in the face of the injury, as you can try to put measures in place to help avoid reinjuy or similar injuries in the future. These measures might include examining and correcting overusing and abusive training and climbing patterns, identifying and smoothing out technical flaws or choices that put undue strain on body parts, and addressing strength or muscle imbalance or flexibility issues. Complementary issues like sleeping, nutrition, attitude, stress levels and resting/pacing might also be worth examining.

Unintentional Attentional Mistakes and Accidents

Accidents do happen in sport climbing, both preventable and virtually unpreventable, of course. Attentional accidents on both the climber’s and belayer’s part can have serious consequences, just like inattention while driving a car or not wearing a seatbelt can. The injuries resulting from such accidents can serve as a harsh or even tragic learning experience for those involved. Check your safety system. Check you knot. Check your belay. Check your equipment. Check fixed equipment. Be aware of loose rock. Pay attention. Mind your children and dogs so they don’t distract climbers/belayers or walk under climbers, potentially becoming the unintentional targets for loose rock or dropped gear.

As a general rule, even in the face of the most seemingly unpredictable of acute injuries, it’s worth going back over the scenario and look for ways to try to limit the potential of such an accident occurring in the future – to regain a sense of agency and control over your climbing and the choices you or your partners made and will attempt to make differently in the future. Without this trust and faith in your own ability to moderate and diminish your injury/accident potential, it can be hard to regain climbing confidence and enjoyment after an injury like this occurs.

In the Moment: CPR/First Aid Training

To be blunt: It’s worth getting. The American Red Cross and theAmerican Heart Association offer classes around the country, including blended learning classes in which you do much of the coursework yourself via the internet, and then attend a short in-person session to learn hands-on skills. Knowing the basics about how to handle emergencies at the crags is just a good idea. It’s also a good idea to have the American Red Cross First Aid app on your phone; it provides step-by-step instructions in the event of an emergency.

Part 2:

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So I’m Injured, Now What? (I) – First Steps

Forgive me if I state the obvious here, but if you incur a climbing injury and you have any doubt or question about what you’ve injured, the severity of the injury and/or how to best treat and recover from the injury, seek advice from an appropriate healthcare professional (i.e. not your climbing buddy or even your climbing trainer; though these people might have personal, anecdotal and potentially helpful advice about how to handle an injury, they’re not the people to turn to for primary advice or guidance) and preferably one who is familiar with diagnosing and treating climbing injuries. This should be the primary step in every climber’s (and every athlete’s) recovery plan.

I say “should be,” though, knowing full well that certain circumstances may make for a reluctance to pursue this option. First and foremost is the preventative cost of healthcare diagnostics, particularly for people who are uninsured or underinsured; it can be daunting to face an array of suggested medical procedures that are far beyond your ability to pay for – though hopefully most climbers have adequate healthcare, thus removing this barrier to appropriate diagnosis and treatment.

Cost aside, I think another barrier to seeking appropriate treatment is fear of outcomes – in other words, fear that the healthcare professional will pass judgment on your injury that you simply don’t want to hear, like mandating a certain amount of time off from climbing or a surgical procedure you’re not interested in pursuing immediately. Healthcare professionals can at times also (without necessarily meaning to) plant real seeds of doubt in a person’s mind about potential for full or quick recovery (e.g. “I’ve never seen anyone have a normal “x” or recover fully after such an injury”). Even other climbers can do this; the first time I injured a finger I was told that it would “never be the same” by another climber; of course, I have no idea which finger that was at this point!

However, a fear of hearing what you don’t want to hear from a qualified healthcare professional shouldn’t prevent you from seeking their advice. If you don’t like what you hear or what’s suggested for treatment/time-off/rehab, seek a second or third or even fourth opinion. Physicians’ and physical therapists’ words and treatment plans aren’t set in stone; it’s your body and your choice, ultimately, what you do to handle the injury. Generally speaking, though, the more you get the same advice/opinion from different reputable sources, the more assured you can be that you’re choosing the smartest course toward healing your injury in the quickest and most thorough fashion available.

Please do not simply tape up the injury, downplay it or pretend that it doesn’t exist. This also may seem like stating the obvious, but it happens. People tape mildly injured fingers and climb on them until they’re severely injured, boulder with somewhat busted ankles and then land on them and wind up with severely busted ankles, and climb (hard) on strained muscles, tendons and ligaments that would benefit from more rest and recovery. Remember that you’ll regret it in the future if you don’t give it a chance to heal when it’s not as big a deal; it’s better to give up three weeks now than to give up three months three weeks from now after three more weeks of abusing an already-injured body part.

Part 3:

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So I’m Injured, Now What? (II) – Physical Training

Assuming your injury is serious enough to warrant a diagnosis and treatment plan from a healthcare professional, get a timeline from this trusted source to help you plan your recovery period and to take the fullest advantage of your time off from climbing as you can in terms of physical fitness maintenance or even potential gains. Ask for an assessment what you can do, given the parameters of your injury. If you don’t like the answer, consult with several more specialists. Ask for healing markers that will indicate if/when you should be doing certain activities, as well as what you should not be doing. Follow the guidelines but don’t be afraid to ask questions.

Above all, do not do anything to make your injury worse. This becomes your No. 1 training/climbing performance goal once an injury has occurred: to heal the injury and get back to 100 percent as quickly as possible. This means not making ill-advised in-the-moment decisions that will impact you negatively for months or even years into the future.

Informed by your healthcare professional’s advice and treatment plan, create a physical training/rehab plan that respects your body’s need to heal. Use the time as efficiently and effectively as possible, understanding that sitting around feeling bad about not being able to climb and concurrently severely decreasing the amount of physical activity you’re doing can contribute to injury-related mental-emotional health issues (topic of next entry), as well as making your comeback harder. Bodies that are used to a high level of physical activity can undergo severe withdrawal on many levels if the customary activity level suddenly declines significantly or stops entirely.

If you can’t do anything at all related to climbing, then work to figure out what works best for keeping yourself fit, maybe another activity entirely. You may also have some mandated physical therapy/rehab exercises; these take top priority in any smart injury-recovery training plan. However, if you can and have the desire to, times of injury can actually provide a much-needed impetus to train specific areas that could use more attention but that fall by the wayside when you’re healthy. A few examples: an injured ankle can often allow for upper-body training, while an injured finger can often allow for core/flexibility training. Instead of fretting about and ruminating on what you can’t do, look at what you can do and do that, knowing that you will be grateful not only now to have something to do physically but also, as you come back to an uninjured state to have kept your physical activity level as high as you could without sabotaging your body’s healing process.

Part 4:

So I’m Injured, Now What? (III) – Mental and Emotional Challenges

In addition to physical pain, the mental and emotional aspect of climbing injuries should not be downplayed or underestimated, especially severe injuries that put you squarely on the sidelines for a lengthy period of time and/or call into question your body’s ability to handle what you want it to be able to do (climb!). It’s common to feel depressed, irritable and unmotivated when injured, and it’s also common to feel guilty about having such feelings, e.g. “I don’t have a right to feel depressed; I still have all the normal luxuries of my Western life so I’m just being selfish by having these types of feelings at all.”

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While we undoubtedly enjoy an incredible quality of life compared to many other places in the world, one that allows us the indulgence of filling our free time with things like rock climbing, this doesn’t take away from the fact that a sudden decrease in physical activity – and especially one that’s so engaging and consuming as rock climbing (or any similarly pursued athletic endeavor) – can lead to a cascade of mental-emotional impacts, suffered as a result from the abrupt removal of the regular activity level and the consequent mental-physical-emotional disruption. In other words, it’s not just you being a selfish person for feeling badly that you can’t climb; it’s your whole being reacting to the situation – and you feel it in your mind as well as your body. And if you’re going to feel guilty that not climbing is making you feel depressed or down or grumpy, you might as well just feel guilty all the time about climbing even while you can climb, too – the same rules apply; it’s a privilege to have the freedom to climb at all.

So don’t feel badly that you feel badly; this is unproductive and will only make the feeling bad even worse. Instead, try to acknowledge your feelings and accept them as valid, and do what you can to mitigate symptoms and find joy in the process of injury recovery. How to do this will vary for each individual. For some injured folks, being around other climbers or hearing about rock climbing only compounds the sense of depression at not being able to participate (sort of like hanging out and drinking water while all your friends are getting hammered to hilarity on the hard stuff); for others, being around climbing and climbing conversion gets them outside of themselves and helps remind them of what they’re working back toward being able to do.

Another great perspective to keep is to remember that all is not lost – that you will not “lose everything,” which is a common fear for injured climbers/athletes. Depending on how long you’re out, you will lose some fitness, sure, and if you’re out for a substantial time with no climbing-relevant physical activity (a month or longer), you may experience some strength loss, too. But, it takes the body much longer to lose strength gains than it does to make them; the body is reluctant to let go of such hard-fought gains (strength gains take a long time to manifest when compared to endurance gains). Also, once you’ve worn a path into your body once, it’s way easier to get back to that level again than it was to get there in the first place; the body “remembers” where you were (not exactly correct, but a good image/way to think about it). And your brain does remember how to climb, though it may feel rusty at first when you get back. You will not be starting at square one, and you’re likely to get back to where you were before the injury much faster than you might expect.

Staying physically active, as mentioned in the previous entry, is a great way to help decrease withdrawal-from-climbing and concern-about-future-climbing symptoms, as is a proactive rehabilitation/climbing-training plan that is workable without causing further harm while you’re injured. Another coping mechanism is to delve into an entirely different activity (physical or not) that you normally don’t have time to do while you’re climbing but that you’re interested in, like taking an online or community course on a topic of interest, volunteering for a worthy cause, and so forth. Keeping yourself occupied instead of spending your normal climbing/training time perseverating on what you can’t do and feeling sorry for yourself can go a long way to keeping your spirits relatively high, which in turn can actually influence the pace/outcome of your injury in terms of healing time.

“Emerging and converging evidence support the perspective that the mind and body are inextricably linked and function in an integrative manner to mediate the manifestation of maladaptive autonomic nervous system responses (ANS) that can result in symptoms and eventual illness, and in the realm of sports, drive competitive anxiety, reduced attention, diminished motor control and consequent poor performance. … Identifiable mind-body processes and interactions that have been harnessed therapeutically to ameliorate symptoms and promote well-being have also been shown to enhance self-regulation and improve performance.” (from Evidence-Based Applied Sport Psychology: A Practitioner’s Manual, by Roland A. Carlstedt, Ph.D.)

Part 5:

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Starting Back After an Injury (or Any Break)

Have you ever come back from an injury only to virtually immediately reinjure that place or injure another body part – or do you know/have you heard of someone who has? It seems so unfair, to put all that time into rehabilitation and recovery, only to be sidelined again right away. Causes for this are usually pretty obvious. Either a) the injured area wasn’t fully recovered and ready to be climbed on again and/or b) the climber in question came back into climbing by doing too much, too soon, and the body wasn’t in shape or ready to climb at the same level as before the injury-mandated hiatus from climbing.

After an injury or any break from climbing, come back slowly and give it time, just like you would ideally with any new training program. Do less than you think you can, and stop way before you think you’re done. This is a smart approach when you’re adding anything new to your climbing/training; you don’t go for broke or to total exhaustion, diving in the deep end and hoping you can swim right away. Instead, you lightly dip your toes in the water and check the temperature, and then you wait for a day or two to see how your toes feel before you put your whole lower leg in the water. And then you wait again, and eventually, as you build up/rebuild your strength and fitness and technical skills and so forth, you will be swimming in the deep end, free from injury, and ready to head out into the open ocean and explore the world.

This can be very difficult, of course, because as soon as you have the go-ahead and you’re feeling better, it can be hard to put the stops on yourself to prevent reinjury or new injury. Give yourself a time/difficulty limit for each session, and stick to it, knowing that in time, you won’t need to be quite so regimented, but that it’s very important now. Don’t get pressured by the fun factor or friends into doing more than you planned – while this can be okay when you’re at peak fitness levels now and again, coming back from injury isn’t the time to push your luck. Remind yourself that you don’t want to get benched again and that a little bit of climbing every other day is way better right now than a glut of climbing followed by two months on the bench (or longer).

And, as mentioned before, keep all of what you’ve learned from your injury in your mind and your planning for future climbing and training efforts once you’re back to full capability. Draw on the experience and lessons of the injury so that you don’t get involved in a hateful cycle of regular reinjury or new injuries. Make sure you know what caused the injury as much as you possibly can and that you also have measures in place that will help you and your partners prevent such injuries in the future. In this way, you make the most of your injury and can actually make it into an overall positive experience rather than an entirely negative one – a process that I’ll delve into in greater detail in the following five entries, which will consist of personal case studies of injuries I’ve incurred as a climber.

~ Alli Rainey, prAna Ambassador

Learn more about Alli

Alli Rainey (allirainey.com) discovered rock climbing more than 20 years ago, and it has been a driving passion in her life ever since. After incurring an injury that prompted her to explore training for climbing beyond just climbing itself, the results amazed her so much that she started studying the science of athletic training in earnest. This led her to become an ACTION Certified Personal Trainer (CPT) and a climbing coach. Rainey is also a Yoga Alliance certified yoga instructor (RYT-200) and a magna cum laude graduate of Harvard University. Facebook: /alliraineyclimbing; Twitter/Instagram/LinkedIn: allirainey