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Woman Climber

Improve Climbing & Bouldering Performance with Chiropractic 

What you need to know

Climbing Wall

The three disciplines of climbing and the effect on your body 

Climbing is divided in three disciplines: route climbing, speed climbing and bouldering. Concerning chronic injuries, an important discriminating feature between lead/speed climbing and bouldering is the relative intensity of movement. Bouldering consists of shorter climbs (termed problems); this type of climbing tends to concentrate all the difficulty of the effort in few moves of the body. For elite climbers, it is common to prepractice climbs for a longer period of time. An important similarity between sport climbing and bouldering is therefore the repetitive movements in training. The tendency to spend longer time ‘planning’ a route or boulder might possibly be a leading factor for chronic injury. The stress on elbows and shoulders is similar or higher than gymnastics in rings, while the stress on fingers in climbing is way higher than in any other activity

Ulnar Collateral Ligament Problems in climbers 

Ulnar Collateral Ligament Problems in climbers Tears to the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal (MCP) joint are commonly sustained sports injuries, with an incidence of approximately 50 per 100,000 emergency room visits per year occasionally be complicated by avulsion fractures of the base of the proximal phalanx of the thumb and are sometimes associated with Stener lesions, in which the aponeurosis of the adductor pollicis becomes interposed between the UCL and its attachment site on the proximal phalanx The period of immobilisation before initiating motion exercises varies but is typically approximately 4 weeks, and the goal is to protect the MCP joint and reduce pain and inflammation.

Climbing Rope
Physical Therapy Session
Physical Therapy Session

Finger Flexor tendon Injury 

Finger flexor tendon pulley injuries were the most commonly diagnosed neuromusculoskeletal injury. Injury to the fingers, hand and elbow regions were the most common self-reported injury by area. The risk of suffering climbing-related injuries was significantly correlated to gender, setting, grade and type of climbing, but not to frequency of climbing The diagnosis of a pulley disruption is based on the history (pop or snapping sound) and on clinical examination, where a painful flexor tendon bowstringing can be palpated during resisted finger-flexion. The lift-off or bowstringing of the tendon visualised by ultrasound or a magnetic resonance imaging (less accurate) confirms the diagnosis. The healing-time is between 2 to 3 months and full load-bearing can be expected after 4–6 month The finger flexor pulleys act like a fibrous envelop preventing flexor tendons divergence from their anatomic location. They allow the conversion of pulling action into an angular motion that causes the finger joints to bend. Pulley system injuries are overall rare; however, these lesions can be often observed in rock climbers. The reason for such peculiar finding is due to the position of the hand during the activity, called “crimp grip” with proximal interphalangeal joint (PIPJ) flexed to 90 to 100 degrees and distal interphalangeal joint (DIPJ) hyper-extended. In this condition, flexor tendons apply very intense bowstringing forces on the pulleys. The repetitive loading on pulleys during rock climbing activity may lead to acute damages or to overuse syndrome What treatment is for a pulley tendon injury ? Research has recommend the use of a special pulley protection ring designed to protect the neuro-vascular bundles while allowing an adequate reposition of the tendon without compromising circulation within the finger. After two months, the ring is replaced by a pulley protection tape To take strain off the healing pulley it is applied around the PIP-joint and inhibits flexion of that joint to more than 80° above which pulley load becomes particularly high Many climbers try to protect their flexor tendon pulleys by applying a circular tape around the proximal phalanx. Their intention is to prevent an injury of an otherwise healthy flexor tendon sheath (pulley system). Whereas in the situation of a disrupted pulley a certain amount of bowstringing can be relieved by a tape, any effect of a protective pulley-tape around an intact pulley is very unlikely Overall, surgical treatment was never indicated in grade 1 (pulley strain), rarely indicated in grade 2 (partial pulley rupture of A2 or A3, complete rupture of A4), and almost always performed in grade 3 (complete rupture of A2 or A3), and grade 4 (combined ruptures

The Shoulder In Climbers 

The shoulder The extraordinarily high mobility and range of motion of the shoulder is possible only due to its very small joint surface of the glenoid on the one side and only a minimal bony contact (clavicle) to the axial skeleton on the other side. Stability is provided therefore mostly by active muscular control and a very lax joint capsule. The requirement of a shoulder joint during rock climbing is a large range of motion to reach holds positioned at some distance on the one side, and high force transmission often supporting the whole body weight in overhanging passages on the other. If this system gets out of balance with pain and limited range of motion or force transmission rock climbing becomes impossible. The majority of shoulder pathologies are due to repetitive overload injuries and micro-traumas and are probably the most common reason for a surgical intervention in climbers. Middle-aged climbers suffer in addition from outlet impingement with rotator cuff tears, acromio-clavicular and less frequently from glenohumeral degenerative changes. The pain appears also frequently at rest and during the night finally requiring surgery Health Wise Chiropractic can help by regular checking your muscle and spinal hygiene, making sure your joints are in proper position to allow optimal function whilst climbing.

Woman Wall Climbing
Rock Climbing
Rock Climbing

The Lower Extremities role in climbing 

Besides strength and mobility of the upper extremity sport climbing requires also a good mobility of the hip and knee joints with associated problems like antero-superior labral impingement with pre-arthrosis of the hip joint. Particularly in overhanging areas dedicated techniques like the “egyptian / drop knee (maximally internal rotated hip joint), foot hooks, heel hooks and toe hooks assume that strength and mobility of the lower extremity has to be optimal. These techniques stress particularly the hamstrings where often painful and protracted muscle strains are observed. The knee joint common problems are degenerative or traumatic lesions of menisci or ligament lesion (ACL or MCL) for example caused by sudden falls from the egyptian position. Health Wise Chiropractic is ready to help you with your low back pain , hip dysfunction and meniscal problems , using our expect analysis of the spinal and muscle hygiene , we are confident our treatment options will help you get back to climbing.

Upper Body Injury in Climbers and how Chiropractors can help 

Upper Body Injuries in Climbers and How Chiropractors can help Elbow, forearm and wrist injuries are more common, These injuries included medial epicondylitis, brachialis tendonitis, biceps brachii tendonitis, ulnar collateral ligament sprain of the elbow, carpal tunnel syndrome, digital flexor tendon pulley sheath tears, interphalangeal joint effusions, fixed flexion deformities of the interphalangeal joints, and collateral ligament tears of the interphalangeal joints. Most frequent overuse syndromes identified in the literature amongst rock climbers were inflammation of the tendon sheaths and swelling of finger joints Health Wise Chiropractic Helps climbers with their muscle hygiene by adjusting the joints , shockwave therapy for ligament tears and strains as well as other treatment options

Man Climbing Wall
Physical Therapy Session
Boy Climbing a Wall

Indoor rock climbing: who gets injured?

Overuse syndromes account for over 80% of injuries at indoor climbing facilities The predominant areas of injury are the elbow, wrist, forearm, and hand.Research has suggested that 75–90% of rock climbers can be expected to develop an upper limb overuse syndrome or injury. Many of the upper limb injuries (for example carpal tunnel syndrome, lateral epicondylitis, and interphalangeal joint eVusion) sustained by rock climbers are also seen in other groups of sportsmen and women. The most common of these is “climber’s finger”, which is damage to the digital flexor tendon pulley systems, most commonly the A2 pulley tendon.This tendon is located on the volar aspect of the proximal phalanx and ensures that the flexor tendons do not bowstring when load is applied Lesser experienced climbers are experiencing more chronic injuries than elite climbers. Female climbers’ injuries differ from the injuries of male climbers. The most striking difference in prevalence of injury is found in injuries to the foot/ankle and the wrist. Male outdoor climbers are most prone to chronic injury. Fingers, elbows and shoulders represent about 80% of all chronic injuries in climbing These techniques stress particularly the hamstrings where often painful and protracted muscle strains are observed. The knee joint common problems are degenerative or traumatic lesions of menisci or ligament lesion (ACL or MCL) for example caused by sudden falls from the egyptian position. Health Wise Chiropractic is ready to help you with your low back pain , hip dysfunction and meniscal problems , using our expect analysis of the spinal and muscle hygiene , we are confident our treatment options will help you get back to climbing.

Risk factors for climbers 

Higher climbing intensity, bouldering, reduced grip/finger strength, use of a “crimp” grip, and previous injury were associated with an increased risk of overuse injury. The majority of overuse injuries seem to occur in the upper extremities, whereas lower-extremity injuries are more commonly associated with falls . Acute lower-extremity injury seems to be particularly prevalent in bouldering, whereby nearly two-thirds of injuries treated in an emergency department and obtained whilst bouldering were located in the lower extremities

Carbine and Rope
Physical Therapy Session
Rock Climber Powdering Hands

Injury Prevention ideas for Climbers

A strength training intervention prevented shoulder and elbow injuries BMI/body weight, warm up/cool downs, stretching, taping and hydration were not associated with risk of overuse injury Structured low-volume high-resistance training, twice per week hanging from small ledges or a fingerboard, is a feasible approach for climbers The following classifications are proposed in climbing: > 15 reps (or hang time > 30 s) strength endurance bias; 8–15 RM (or 3–30 s hang time) hypertrophic bias; 1- 5 RM (or 1–5 s hang time) maximal strength bias. Improving maximal finger and shoulder girdle strength may decrease injury risk; as a result of reducing percentage of maximum strength generated in each move, the overall loading stress in a session is also diminished. Recent research found that number of consecutive pull-ups and bent-arm hang duration were the strongest predictors of climbing performance In addition, recent studies showed that maintaining maximal finger flexor force during 30 s all-out test or intermediate contraction to fatigue using a climbing specific hold are more important than muscle aerobic capacity in higher elite climbers

Resistance Training in climbers 

Resistance training is the most efficient approach to increase skeletal muscle mass, strength, and power. It may also increase muscle mitochondrial content as well as cardiorespiratory fitness A general belief is that Resistance Training results in muscle hypertrophy and thereby increased muscle mass and body weight. Unfortunately, this seem to have been interpreted by the climbing community as an argument for not implementing Resistance Training in their training protocols. Studies have found that high performing climbers are leaner than age matched controlsOf note, lower percent of body fat has been reported among high-level climbers (both men (9.8%) and women (12.2%)) . However, comparing body fat between climbing performance level (e.g., elite to lower-grade), no significant differences were reported Furthermore, in a recent study it was found that those with either an eating disorder or disordered eating pattern are twice as likely to sustain an injury However, to improve climbing performance, climbers emphasise maximal relative strength and power in the shoulder girdle and back muscles In support of this approach, a recent review of climbing classified > 15 repetitions (or hang time > 30 s) as strength endurance, 8–15 RM (or 3–30 s hang time) as hypertrophy training, and 1–5 RM (or 1–5 s hang time) as maximal strength training Brief, structured, and low-volume (e.g., one- to two sets) of twice weekly, high-intensity RT may be a feasible approach for climbers Resistance training with lighter loads may be recommended in lead climbing, whereas heavy loads may be a more ecologically relevant stimulus in bouldering. Lead climbing is performed on walls higher than 10 m and comprises multiple climbing moves, whereas bouldering consists of eight-to ten moves on a shorter wall (

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Tying Shoe Lace
Tying Shoe Lace

Feet injuries in rock Climbers 

Attributes like downturn, the concave shape that places pressure on the toes, and asymmetry, concentrating the pressure on the big toe, are basic elements of modern climbing shoes The majority of climbing foot injuries result from wearing climbing shoes unnaturally shaped or too small in size The shoe seize reduction forces the foot to conform the shoe and changes the biomechanical position of the foot within the shoe. The foot shortens through supination and contraction of the digits. In front pointing the proximal and mostly also the distal interphalangeal joints are flexed and the metatarsophalangeal joints are over extended (crimping toes). Lateral X rays within the climbing shoe show that the normal foot weight distribution onto the first and fifths metatarsal head and the heal is not given any more. The foot is front pointing onto the distal toe phalanges. The plantar flexion of the metatarsal heads results in a tightening of the plantar fascia. High ability climbers experience more foot deformities and injuries compared to climbers of lower ability due to the common practice of wearing climbing shoes sized smaller than normal street wear shoes Climbers Foot The mechanism of foot injury depends on the technique used; in heeling, the heel is positioned on the support and force is exerted on it to rise above it by flexing the hamstrings. It is during this gesture that an external rotation of the knee is exerted, exerting great tension on its posterior and lateral structures. It could be said that the force exerted on the aforementioned structures, added to the angulation to which the knee is subjected, is what causes this type of injury during the heeling gesture While in the frog position, the knees will be fully flexed and with a lateral orientation. The most common injuries in this type of position are meniscus tears, on the other hand, falls can be related to both upper and lower body joint injuries

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