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Post by rctmdotcom on Apr 22, 2014 12:23:24 GMT -7
"L" asked:
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Post by MarkAnderson on Apr 22, 2014 12:38:08 GMT -7
L,
I gather you have a pulley injury? If so, bummer!
We had a Physical Therapist review the chapter, and she suggested doing more reps (with correspondingly less weight). I think this is wise, but I haven't been injured since then (knock on wood) so I've never actually tried doing more reps, so I can't say with certainty what the proper number of reps would be. I would suggest adding 2 reps per set at first, see how it goes, and asjut accordingly. Note that adding reps only helps if you reduce the resistance a correspinding amount (I think 20 lb per set would be about the right amount of reduction).
When re-hapbbing I've always done essentially the same workout (same number of reps and sets, adding weight for each progressive set within a grip), but with a lot less resistance and an extra rest day here and there, as I feel I need it. I would start out taking 3 full rest days and see how it goes. I found that eventually I could handle two rest days, but I took one extra rest day each week for good measure. The grip selection depends on the injury, but in the case of a severe A2 pully strain in my ring finger, I skipped the closed crimp grip for the first 6 sessions (or so), and then gradually added it back in (one set the first workout, then two sets, and so on) with VERY LOW resistance.
For me, with a ring A2 injury, I found any type of crimp to be the most threatening, so I took huge amounts of weight off (like 50-60 lb off to start). I also found pinch grips to be quite tweaky. It depends a lot on how severe the injury is. Some of the other grips were essentially full strength, but I would restrain yourself from going all out on such grips initially. Take it really easy at first and see how it goes.
Probably the most dangerous period is near the end, when you're close to completely recovered. Be very careful at that point, it becomes tempting to push harder and harder and its very easy to re-injure yourself. The consequences of over-doing it are magnitudes greater than the consequences of under-doing it. I would avoid pain, and I would skip closed crimps for a while. FWIW, I was already climbing 14a before I ever used a closed crimp grip during a hangboard session, so its not an essential grip for most climbers.
Hope this helps, let me know how it goes.
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Post by Chris W on May 11, 2014 10:09:06 GMT -7
In the book you (Mark) mentioned that you spent some time climbing "moderates" while rehabbing your injured A2. What kinds of holds did these "moderates" have on them? Did you avoid thin crimpy routes in favor of larger holds? You also mentioned that your injury was "a long time coming - the culmination of several years of intermittent tendonitis." Do you think you could have done anything to prevent this? I have a nagging A2 strain in my right middle finger (one of many suffered using HIT strips, which in February I decided to stop using because they kept hurting me) and am trying to prevent it from getting worse (and to get it to heal well). I'm taping it before climbing/training. Some of the current medical literature states that taping does nothing to help with finger pulleys, but anecdotally it sure feels much better when I do.
I'm trying to avoid suffering a similar fate (though maybe if it goes, I'll be able to climb Flight of the Phoenix too).
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Post by MarkAnderson on May 12, 2014 14:58:05 GMT -7
Chris, The moderates in question were generally slab climbs like Topographic Oceans (below) that kept most of my weight on my feet. I tried to avoid crimpy routes when climbing outside during rehab, because its really tough to control the resistance outside. To your second question, taht's hard to say. I think I was kinda asking for it. I first noticed the tendonitis in the Spring of 2011. I strongly believe that taking lots of time off is not the answer, so I just went about my usually business of training and climbing periodically. Training seemed to help it, but then if I went overboard with outdoor climbing it might flare up a bit. Overall though I think it was improving. My mistake was I "forgot" I had a trouble spot and needed to be cautious. One day at the crag I selected a too-hard warmup, and then instead of saying "take" when things got too hard, I decided to bear down, in this case with a 2-finger crimp grip in a small pocket. Julian Saunders suggests taping pulleys for no other reason that to remind you that you're hurt. I think this can be helpful*. Warming up more gradually would have been even more helpful *I've noticed taping my pulleys can do more harm than good. Tight tape seems to irritate the tissue which can lead to inflammation. YMMV!
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Post by Chris W on May 12, 2014 20:35:47 GMT -7
Thanks for the info. We'll see how it goes. The mechanism of my injury is a bit odd (felt a pull in my middle finger A2 area using the HIT strip ring and pinkie fingers) and has me questioning my [self]diagnosis. There isn't much else in the area (anatomically) that it could be, besides the A2. I may have to armchair one of my Ortho colleagues and discuss using high powered magnets to help figure it out.
I would agree with your belief, by the way, that taking lots of time off isn't generally helpful. It's hard not to be proactive anyway.
I'm assuming the name of the route [Flight of the Phoenix] has to do with sending after the injury. Thanks for your help
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Post by MarkAnderson on May 14, 2014 11:46:33 GMT -7
There is 'fascia' connecting the phalanxes within the palm. Based on what you describe, you may have stretched or otherwise irritated that fascia. I do that pretty regularly but its never been a problem, it just hurts slightly in the moment.
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Post by Chris W on May 14, 2014 17:43:22 GMT -7
I was wondering if that is what I could have done, and it's nice to hear you've had similar issues. I've spent some time off an on going through some of my old anatomy atlases (Netter is my favorite) and figured that would make sense, considering how I hurt it. The location (and fear of injury) has made me think A2. It doesn't hurt when pulling down (less likely A2), only when pressure is directly applied.
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