Coming Back From Injury

Ping! You tried that problem 12 times; tweaked your finger, pulled a pulley. You rest for a month and it’s starting to feel better, but now what?

By Neil Gresham | July 21st, 2017

The author climbed one of his hardest trad routes, End of the Affair (E8 6c/5.12b X) in Curbar, the U.K., in 1996, shortly after recovering from a broken wrist. He was so glad to be climbing again he had more mental energy and strength than ever. Photo: Ray Wood.


Ping! You tried that problem 12 times; tweaked your finger, pulled a pulley. You rest for a month, Google it, ice it and stretch it, put in the occasional very light climbing session.

The critical stage comes when most of the pain hasgone but the injury still feels weak and vulnerable. You’re desperate to step things up but nervous about re-injuring. The standard advice is simply to use pain levels as a guide, yet this way always feels subjective and open to misinterpretation and hazard. For those such as myself with a malfunctioning stop button, the only way to know when to back off is when you’ve gone too far. A good physiotherapist will put you on the road to recovery, but even the best ones are often reluctant to give precise answers to your burning questions, namely: how long, how hard and how frequently can I climb, and what type of climbing can I do?

 

COMEBACK PLANNING

The answer to that last question is to set up your own comeback timeline and stick to it.

Start this plan at the end-point of the initial rest period, not from the point of injury. Injuries must be treated case-by-case, and the length of the rest depends on the severity of the injury. Use intensity and volume as sliders. The rule is that when you increase one, you decrease the other.

Start with both volume and intensity set very low by doing, say, four or five routes or up to 10 boulder problems that would normally be warm-ups for you, or equivalent stints of easy, random movement on a juggy vertical bouldering wall.

Week two you turn up the volume, but keep the intensity down. For example, do six to eight very easy routes or up to 18 easy boulder problems. In terms of the number of sessions per week, start with two in the first week or two, and then increase to three by the third or fourth week. If you’re not experiencing undue pain during and/or post training, the third week you can turn up the intensity a fraction, but you’ll need to cut the volume back to the low level of the first week. Increase the grade slightly to mid level—for example, 50 percent of your perceived current maximum—and you can also start venturing onto gently overhanging terrain.

The fourth week the volume can go up again, and week five intensity goes up to 75 to 80 percent level, i.e., to routes or boulder problems that you can do mostly comfortably and in control.

MAINTAIN CONTROL. Climb in control and with immaculate footwork. Not only will this minimize the strain on your injury, it will make you a better climber in the long run.

MIX-INS. By about week six you can work in a few hangboard exercises such as hangs and pull-ups. Contrary to popular misconception, hangboards can be really good for the final stages of rehab to assist with initial strengthening, as the movements involved are more uniform and controlled than those of bouldering. Focus on six to 10 reps, stopping just before failure (as opposed to low-rep maximums). Clearly the chosen exercises must not aggravate your injury, but by this point you should feel ready.

<em>Click to enlarge</em>.Between six and 10 weeks, the process can go through one final round where you are able to climb close to your limit, subject to the severity of your injury. It will be tempting to abandon your rehab strengthening exercises once you are climbing more, but it’s vital to keep them up during the entire comeback period.

INDOORS OR OUT? We gravitate toward the controlled environment of the gym; however, rock has a seemingly magic rehabilitating effect on injuries, possibly because there are more intermediate holds, and the movement style is less about pulling from point to point than in a gym.

CROSS-TRAIN! If you’ve lost general fitness, then give cross- training center stage during the first two or three weeks of your comeback campaign. You can push pretty hard from the onset, presuming it doesn’t aggravate your injury. Running is always a go-to, preferably with intense interval bursts to promote anaerobic fitness, combined with circuits and general strengthening sessions in the multi-gym, ideally using suspension straps (take care with elbow and shoulder injuries, and only select exercises that don’t aggravate). If you’re pushing hard in these sessions, then it will help you to maintain the discipline to keep the climbing fairly light, as you’ll feel like you are still doing something worthwhile. As the climbing sessions start to get tougher, you can ease off with the cross-training.

DEALING WITH SETBACKS. Differentiating between healthy, desirable “rehab pain” and unwanted “setback” pain is the crux of any rehab campaign. If you overdo it, rewind and place yourself a few weeks back on your timeline. For a minor tweak, rewind two weeks; for a major one, go back to the start.

REHAB TRICKS. There are many tricks to help you climb through a minor injury or ease back into climbing after a major one. Highlights include climbing open-handed after a finger-pulley injury, avoiding deep lock-offs after an elbow injury, or avoiding “gaston” sidepulls and moves at full stretch after a shoulder injury. Toward the end of the comeback plan you can start to do the high-risk moves on easy warm-ups and then build up from there, gradually testing them on progressively harder terrain.

REFLECTION. The comeback program provides a good time to reflect on how you got injured in the first place. Maybe you weren’t allowing sufficient recovery between sessions, your warm-ups were poor, or you didn’t do enough antagonist training or supportive conditioning. Repeating the same mistakes defines insanity.

GOAL SETTING. Adapt your goals to the nuances of your injury; for example, if you hurt a pulley and are still worried about crimping, then set a goal to do a hard route or boulder problem on slopers or pockets. If it’s an elbow or shoulder, perhaps focus on vertical climbing as a tough short-term goal, and then set a goal for steeper climbing later down the line.

Last, never underestimate the power of motivation. I climbed my hardest two trad routes after long injury layoffs. Physically I was well below par but it just felt so good to be back in the saddle that mentally I was stronger than ever.

 

Neil Gresham, an all-arounder, has coached climbing for over 20 years.

This article appeared in Rock and Ice issue 244 (August 2017).

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