Rehab and extended rest

[HenryAB]

I have a question that I don't think has been specifically addressed in the book or on these forums.  I have been recovering from a wrist tendon injury (FCU) over the past three months.  My main question is when, if ever, it makes sense to include periods of extended rest in a rehab program.

There is a passage in the book where Mark talks about recovering from a severe A2 pulley strain.  He recovered with two weeks of "complete rest," four weeks of progressive hangboarding, three more weeks of rest, another four weeks of hangboarding, and then a month of climbing moderates.

What made you decide to take three weeks of rest after the first round of hangboarding (instead of just continuing the hangboarding progression)?  I am about three months out from being injured, and I am wondering if I should take a few weeks of total rest.  During extended rests like that, does it make sense to keep stretching or performing range of motion exercises?

I injured my FCU tendon mostly from too many gym boulder problems that featured dynos to poor slopers.  I took about 2 weeks of complete wrist and then performed non-climbing rehab exercises for 2-3 weeks. Then I climbed around Moab for 2 weeks.  I pretty much stuck to hand cracks and moderate desert towers, and that seemed to go pretty well.  Since then I have mostly stuck to trad climbing.  For some reason a recent 2-day trip to the New River Gorge caused this injury to flare up again.  It doesn't really hurt to climb, but my wrist just feels sore and tender the day afterwards.

My wrist seems to feel healthier after a few days of rest, and I wondering if I should just give it a few weeks of complete rest.

[jessebruni]

Man, I'm interested in this response as well. I strained my wrist about 2 weeks ago but I don't think it's the FCU, possibly the flexor tendon for the middle finger. I have climbed on it 3 times since then (light climbing one day, followed by light climbing and 2 hard routes the second day, then a week of rest followed by a climbing day where I was purposely climbing around the injury) and I just did some weight lifting yesterday. My wrist doesn't seem to be very effected except in that I can't dynamically load the wrist, reverse wrist curl ability has gone down from 25 lbs to 5 lbs, and underclings above my head in a cave or at a steep angle are impossible. I think my injury is only a strain but oddly enough it's felt better over the last 2 days (climbed the day before yesterday, lifted weights yesterday) than it did the entire week I took off.

Rest for tendon injuries are a confusing thing.

[MarkAnderson]

There are a few reasons I like to take rest periods between rehab stints.

One, there's this theory about "micro-trauma" that suggests we accumulate a bunch of imperceptible injuries throughout the course of training, and you need to takes some time off for these to heal periodically in order to avoid full-blown injuries. If this is true, than I think it especially applies during rehab when you KNOW you're causing trauma.

Two, (this is the primary reason) after several weeks of hangboarding I find myself red-lining, which is generally not a good idea when rehabbing an injury, so I make a point to back-off the resistance and re-set the intensity. Sometimes this is just backing off 10-20 pounds (and perhaps limited to certain grips), some times its starting from scratch. Especially in the latter case, I find it's hard to go back to something really easy when you know you're strong enough to handle much higher loads, so it helps me to de-train a bit before resuming (it keeps me from going over-bard and getting right back to the red line in a few workouts).

Third, if you know the entire process is going to take months, its nice to have some breaks. Hangboarding is pretty monotonous.

I definitely see no harm in this approach. The worst that could come from it is that your rehab takes a little longer, but that is nothing in the grand scheme of things.