May 8, 2018

Climbing Injuries

I am not talking here about injuries from falls, frostbite, falling rock, at least not at this time. I am collecting some notes on what would probably be called "repetitive use injuries" that arise from overly enthusiastic training or gym climbing.

Gym climbing is a lot different from outdoor climbing. I climbed outdoors for years without the least hint of these kinds of injuries. But a few months in the gym and I have pains arising in my fingers and now my elbows. Gym climbing involves steep and sustained routes that make serious demands on a persons hands and arms. Finger boards take this to the next level and without diligent restraint are an almost guaranteed pathway to injury.

Elbow Pain

As you may know, the fingers themselves have almost no muscle. They are actuated by muscles in the forearm which attach via tendond to the fingers at one end and the elbow at the other. The fact of the matter is that muscle strength is gained much more rapidly than tendon strength. This leads to the situation where the muscles can deliver more force than the tendons (and their attachments) can bear. And this leads to injury.

There are two sorts of elbow pain. Stand with your palms facing forward, arms at your side. If the outside part of the elbow hurts, you have what is known as Tennis Elbow, or lateral epicondylitis. If the inside part of the elbow hurts, you have what is known as Golf Elbow, or medial epicondylitis. The epicondyle by the way is the site at the elbow where the tendons attach.

In the above video, the fellow uses a Thera-band flexbar. The red is the number 2 (there are 4 grades) and is what I have. He says to do this exercise as 3 sets of 15 per day for 6 weeks.

My issue is lateral epicondylitis. This seems odd given the following description and my expectation that this is related to gripping holds, but the following seems to be accurate.

Lateral epicondylitis affects the tendons attached to the outer (lateral) side of your elbow, which are connected in turn to the muscles that extend your wrist backward and straighten your fingers. Medial epicondylitis affects tendons connected to the inner (medial) side of your elbow, which are attached to the muscles that flex your wrist and contract your fingers when you grip something.

The treatment is rest, in general for several weeks, but in any case until pain goes away, then a few weeks longer. Then carefully ease back into climbing. Nobody wants to hear this, and almost nobody listens to this. So the person climbs on and on until things get so bad that there is nothing to do but stop climbing. Then it takes a lot longer to heal, or serious damage is done.

Feedback? Questions? Drop me a line!

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