|
Post by majorsick on May 1, 2015 7:22:24 GMT -7
I have had a nagging (what I believe to be) pulley strain on my ring finger. I've taken about 1 week off and would like to get to some active recovery as you guys suggest in the book. My question is on frequency and duration of workouts. I have a hangboard and pulley system set up, so I'll plan to remove lots of weight to get started but here's a few questions:
1. How frequently should I be "working out"? 2. What grips should I be using and how many sets/reps should I target? 3. How quickly should I be reducing the amount of weight I'm taking off? 4. How do you suggest warming up prior to these rehab workouts? (I usually do some easy climbing on my garage wall, but that doesn't seem like a good idea at this point...)
Thanks guys!
|
|
|
Post by MarkAnderson on May 1, 2015 14:03:12 GMT -7
1. How frequently should I be "working out"?
I recommend every 3rd day for normal/healthy hangboarding. When you're injured, all bets are off. There will probably be some swelling and extra tenderness after rehab, so space the sessions such that there is enough time for those symptoms to subside between sessions. Practically, I recommend you start by rehab-ing every 4th day and see how that goes. If it goes well, you can drop back to every 3rd day, but I would still suggest throwing in an extra rest day every two or three sessions.
2. What grips should I be using and how many sets/reps should I target?
Train as you would for your Strength Phase, except consider skipping grips that are particularly aggravating to the injury. For example, if you have an A2 pulley strain, it might be wise to skip closed crimping initially. Eventually you may want to work that back in (if it's a grip you normally train) as the injury heals.
3. How quickly should I be reducing the amount of weight I'm taking off? Not very quickly. The easiest way to screw up rehab is to be too aggressive with the resistance. Start with resistance that feels stupidly easy, and then go up no more than 5# per session. Eventually it will start to feel hard. At that point if the grip isn't risky, you can push like you would while training. If it is risky, I recommend you take premeditated steps back every so often to avoid getting too close to your limit. You have to judge that for yourself based on how the injury feels and how much risk you want to accept. 4. How do you suggest warming up prior to these rehab workouts? (I usually do some easy climbing on my garage wall, but that doesn't seem like a good idea at this point...) I warmup with ~20 minutes of easy ARCing. Avoid holds that are problematic (crimping in the case of an A2 injury, and perhaps 2-finger pockets). If you don't have suitable ARC terrain, you can warm up on your hangboard by removing tons of weight (or using a kick plate) and cycling your hands through various grips for 20 minutes.
|
|
|
Post by majorsick on May 11, 2015 8:52:29 GMT -7
Thanks so much for the quick reply Mark! I'll plan every 4th day to get started and I'll check back in here periodically with results/thoughts/progress. If only adding 5# each session (let's assume I average an increase every 1.5 sessions and start with -50# resistance) It'll take roughly 1.5 months to get back to body weight - seems reasonable.
A few more questions:
1. Do you recommend taping the weak finger for hangboarding? 2. At what point do you suggest integrating very easy climbing into the rehab routine?
Thanks again!
|
|
|
Post by latestart on May 11, 2015 9:42:50 GMT -7
My experience (which may not align with what Mark will say) is that if it doesn't hurt, you can keep doing it. I'm a recent convert to the world of training, and have been largely injury free so far. However, before I heard of the recommendation to rehab injuries on the hangboard, I rehabbed by climbing and massage. Although I kept the climbing at a lower level than I normally would have, and I avoided holds and positions that would irritate the injury.
It would seem like ARCing would be a good way for you to continue climbing, and I could see it helping with the rehab as well. From what I've read, the reason finger injuries take so long to heal is because the fingers receive fairly poor bloodflow (and because we start thinking the injury has recovered 100% before it really has). ARCing aims at increasing blood flow to the forearms and hands. In your case I'd just avoid any sort of grip that aggravates the injury (crimp grips, and potentially pinches as well).
|
|
|
Post by majorsick on May 11, 2015 10:12:28 GMT -7
Thanks for your thoughts latestart! What you're saying certainly makes sense. I'll definitely be waiting to hear what Mark has to say as well, but your suggestion that a nice long ARC phase might a good option seems like a sound one. =)
|
|
|
Post by latestart on May 11, 2015 10:27:11 GMT -7
I think ideally the two concepts would be combined - progressive hangboarding to increase the load that your injured finger can endure and light ARCing to encourage blood flow and healing. I think ultimately it comes down to how well you're recovering between sessions and whether the extra investment of ARCing significantly increases recovery time or elicits a painful response.
|
|
|
Post by MarkAnderson on May 11, 2015 11:05:53 GMT -7
1. Do you recommend taping the weak finger for hangboarding? It's a personal choice. There is some limited research that supports H-taping. In my most recent experience, taping seemed to irritate the injury, so currently I do not tape. However, many years ago I've used tape...it didn't seem to do any major harm, and it was re-assuring to have it at the time. I suggest you try it both ways and see what feels better. 2. At what point do you suggest integrating very easy climbing into the rehab routine? What would be the purpose of this climbing? Is it for fun, or does it support some more specific goal? Relative to hangboard rehab, easy climbing has essentially no rehab value, so you won't get anything out of it. On the flipside, it ALWAYS carries the risk that you will easily climb yourself into a non-easy situation that forces you to pull too hard on your injured finger. I would hold off on any "easy" climbing until you feel like you're ~90+% healed, and even then realize that it has no practical value to your rehab (ie, there is no upside as far as your finger is concerned).
|
|
|
Post by MarkAnderson on May 11, 2015 11:20:43 GMT -7
From what I've read, the reason finger injuries take so long to heal is because the fingers receive fairly poor bloodflow (and because we start thinking the injury has recovered 100% before it really has). ARCing aims at increasing blood flow to the forearms and hands. I've read this too. I've surely written it a few times, but I now think its probably hogwash. Finger injuries take so long to heal because nobody bothers to do any freakin rehab! We just sit around waiting for our body to magically heal themselves, and then periodically reef on some random holds to test our "progress".
Serious athletes in other sports don't do this. They do daily active rehab as soon as the swelling is gone, even if it is extremely painful. Even then, they sit out many weeks/months for rehab, followed by another several weeks, sometimes on the field at a diminished capacity, to get back in "game shape", and these guys are getting topflight care for injuries that are well studied. If climbers took their injuries seriously, I think we could approach similar recovery timelines. IMO the right rehab will stimulate plenty of blood flow, even in the fingers, to facilitate recovery at whatever rate collagen heals.
|
|
|
Post by latestart on May 11, 2015 11:55:53 GMT -7
Serious athletes in other sports don't do this. They do daily active rehab as soon as the swelling is gone, even if it is extremely painful. Even then, they sit out many weeks/months for rehab, followed by another several weeks, sometimes on the field at a diminished capacity, to get back in "game shape", and these guys are getting topflight care for injuries that are well studied. I agree that there is definitely a difference in the way we do things as climbers as opposed to what other, better studied sports do. It looks like more climbing specific literature is starting to make it's way out to the market though!
In the quote above, it seems like the real issue for climbers is being able to identify "good pain" from "bad pain". Because this is hard to do, seems like a great way to worsen the injury, and I'm not a medical expert, I've always erred on the side of caution and pursued rehab activities that were not painful while being performed. Some lasting soreness doesn't seem to be a bad thing, as long as it clears up within 12-24 hours.
For me, rehab has always been a progression:
1. Deal with immediate pain and swelling 2. Once initial swelling has gone down, work to establish full ROM 3. Begin rehab exercises (In my experience, this was climbing at a lower level while avoiding painful grips and holds, and some massage to try and help bloodflow. But could also be hangboarding, ARCing, etc.) 4. Continue to do rehab for 1-2 weeks AFTER you feel 100% 5. Return to normal routine
Steps 2 and 3 can usually be done concurrently. It depends on how bad you're hurt.
|
|
|
Post by majorsick on May 11, 2015 11:58:35 GMT -7
You had suggested doing some ARC climbing as a warmup for rehab on the hangboard! My intuition says climbing in any capacity at this point is too random and makes it difficult to regulate loads on fingers. Obviously since I'm asking your advice, I'm not trusting my intuition much. Perhaps I misinterpreted your advice on the warmup?
PS. I think it's just fantastic that you are so active on this forum. =)
|
|
|
Post by MarkAnderson on May 11, 2015 13:53:21 GMT -7
Yes you should warmup before hangboarding, especially when you're injured. If you meant to ask "at what point do you suggest integrating a warm up in the rehab routine?", then my answer is: "immediately prior to the first hangboard rehab session".
|
|
|
Post by majorsick on May 12, 2015 7:25:24 GMT -7
Sorry for the confusion. My question was intended to be based around the idea of warming up by doing easy climbing before the finger is ready for the relatively random loads associated with that climbing. To rephrase my intended question - have you had any experience using different warmups for rehab hangboarding very early in the process before you feel ready to do an actual climbing warmup?
I warmed up last night prior to my first session by taking LOTS of weight off and doing timed hangs on larger holds. It took me about 45 minutes to feel as warm as I wanted to be.
The session was very successful though! Took off anywhere from 50-75# and cycled through about 75% of the grips I typically used during an "uninjured" session (foregoing finger teams and semi closed crimps). Very little pain/discomfort during the workout, and some mild pain this morning but nothing acute! It's gonna be tough to be patient...
Thanks again Mark!
|
|
|
Post by MarkAnderson on May 12, 2015 8:21:20 GMT -7
Ok I see. Not really. If I'm injured, before my normall ARC warmup I will do some range of motion exercises to get my fingers loose (like making a fist and then spreading my fingers and repeating for 5 minutes). I have a warmup ARC circuit that I actually "built" when I was injured. It's about 60 moves with NO crimps. It starts out really easy and gets progressively harder towards the end. Now I use it as my first warmup every training day, injured or not.
|
|
|
Post by majorsick on May 14, 2015 6:51:52 GMT -7
A subtopic which could potentially warrant it's own thread (I'll let you decide on that Mark).
While I've been taking time off prior to beginning the rehab we are talking about above, I've been using the opportunity to drop some excess weight; I think said weight is one of the main factors in becoming injured in the first place. So I've been successful so far, dropping 10# of body fat since early April. Since I plan to continue my weight loss efforts in the coming months, should I be accounting for the associated reduction in resistance as I progress through my rehab?
|
|
|
Post by latestart on May 14, 2015 7:49:46 GMT -7
I expect it shouldn't make much difference whether you account for the weight loss or not. You're losing weight at roughly 1.5 - 2 pounds per week, but you will potentially be increasing the weight on your fingers by up to 10 pounds per week (based on 2 workouts per week, increasing by 5 pounds each workout).
If anything, I'd think not accounting for the weight loss will make your progression a bit more conservative. The only time I could see it being useful is when you get back to near your previous best effort, and then only as a reminder to pay more attention to your body and slow down if things feel tweaky.
|
|