Many of the comments from other climbers related to their injury, how they’ve been treating it, and where to go for additional advice.

Since these posts live forever via search engines, I thought it may be useful to simply have a post where anyone can comment on what doctors or other medical professionals they’ve found to be helpful in dealing with climbing related injuries.

I’ll start things off by listing some I recommend:

Kim Raupp, certified hand therapist, Lafayette, CO – She worked on my partially torn A2, helped me with an excellent rehab path, and I’m getting close to being fully healed.

Dr. Jeremy Rodgers, sports medicine/chiropractic care, Boulder, CO – He helped me with my elbow tendinitis.

Dr. Stephen Gunther, orthopedic surgeon, Washington, DC, – Diagnosed recurring shoulder issue (“loose” shoulder) and provided resources for rehabbing a separated shoulder.

Please add yours in the comments and hopefully we can compile a nice resource for all our fellow injured climbers.

As climbers, we suffer from numerous injuries. One of the more common climber injuries is medial epicondylitis or golfers elbow. Essentially this is pain on the inside of your elbow and it originates from overuse of the flexor muscles. All our gripping without exercising the opposing muscle groups is usually the culprit for climbers.

As I mentioned in a previous post, I’ve been suffering from this condition for months now. I’ve been seeing a sports medicine doctor and slowly my severe pain has reduced. When I started rehab, my pain was about an 8 on a scale of 1 to 10. After about three months of daily ice baths and exercises to strengthening opposing muscle groups (including a couple initial weeks of ultrasound), I was finally down in the 4 out 10 pain range.

So when I was contacted by the inventor of a device called Armaid, I was initially quite skeptical. First, if there was some device that would help, why didn’t my doctor or any literature mention it? Is this really going to help me and how long will it take? But since I really had nothing to lose at this point, I decided to try it out. The company saw a few of its customers were climbers and was interested to see what the reaction from the climbing community would be for this device. My goal was to test it out using my own pain and injuries as a guinea pig and provide some critical feedback to Armaid.

Amazingly, I felt pain relief from the Armaid device immediately. And before getting into details about Armaid, let me give you a quick summary. I’ve been using the device daily for about 2 – 3 minutes each on each forearm and my pain level has dropped at least another full notch on my pain scale after only a couple weeks.

Details of the Armaid Device

Armaid costs $99.95 and comes with a 30 day money back guarantee. Initially I thought was that this was a high price for an unproven device for notoriously cheap climbers. But after using Armaid and finding it actually works, I changed my mind about the pricing. Let’s assume you have medical insurance. For the price of about two co-pay sessions with a doctor or massage therapist, you’ve paid for Armaid. Comparing the cost of Armaid to all the other medical treatment I have received in the past for climbing related injuries, a hundred dollars is a steal.

The Armaid device works by relaxing and releasing tight muscle tissue by massaging and stretching muscles in the arm. It comes with a detailed DVD with instructional videos as you must use the device in a specific manner to achieve results.

The Armaid appears to be constructed well. The apparatus is made of a sturdy plastic mounted on a swivel that allows for moving to a variety of angles. There are different stiffnesses of the therapy balls that actually run over your forearms to adjust the level of pressure.

Another small climber-related complaint I had was the size of the device. Armaid is rather large (about 16″ long), but to mechanically achieve its mission I realize it pretty much has to be that way. My initial opinion (before testing it) was that climbers may not want to take it on our frequent road trips. After using it, I realize that if you have chronic pain like I do, you’re not going to care about the size and you’ll throw it in the car. It’s really not that big, but you can see for yourself in one of Armaid’s demo videos. It also weighs just over a pound so it’s not too heavy.

I haven’t seen much discussion of this device elsewhere, despite it usefulness. I did see a brief recommendation in Clyde Soles’ training book, but other than that the Armaid appears to be quite unknown to climbers.

My next obvious question was what is this company all about? Who are they and why should I trust them with my health?

Armaid’s Founder

I had several conversations with the founder of Armaid, Terry Cross, and asked him some very pointed questions that I knew climbers would be interested in learning before committing to this product.

Terry is a former sports injury and occupational injury therapist and I asked him how he came up with the idea for Armaid:

“I would see sometimes as many as ten clients a day and over time I began to develop repetitive strain (tendinitis) in my arms and hands. I began to do more self massage to maintain my own level of strength and fitness. This worked for a while by using my free hand to massage the other arm but this method often aggravated my problems and after trying several different products I felt there was not a good massage tool available for specifically helping the hand, wrist, forearm and elbow. I tried many different prototypes and designs until I came up with the idea of using a lever (as in the mechanical advantage of a nutcracker) to easily amplify the pressure on the trigger points (sore areas) without using a lot of strength necessary from the free hand.

There is a particular type of therapy that I used as a hands-on therapist that I use constantly and it is the most efficient method I have ever found to work to relieve tight muscles. I built Armaid to specifically incorporate this therapy technique. To keep it simple, I call it “trigger point therapy” on our website. It is called different names depending if you are talking to an Occupational or Physical Therapist, Rolfing Therapist, Chiropractor, etc. I’ve heard it called Myofacial Release, Client Assisted Release, Active Release etc., but it is always the same technique of maintaining static pressure on a sore spot and then stretching the muscle under that pressure (see the “two therapies” video on our website). This releases the muscle fiber much more quickly and efficiently than cross-fiber technique or mere stroking (effluerage). It also has the added benefit of letting the sufferer discover which muscles and which range of motion is the culprit in their problem.”

And on who is using Armaid and why climbers should think about using it:

“Disgruntled sufferers that have had the surgeries, taken the drugs, been upset with unending appointments with expensive therapy sessions and still not happy and are looking for something that they can do for themselves. They hear about Armaid mostly through word of mouth or a search online. For the cost of one or two medical or massage sessions they can buy an Armaid and be in charge of their own arm, elbow and hand health.

It must be made clear that Armaid is only useful if the problem is based in the forearm muscles that can create painful problems in the elbow, wrist and hand. The question that I always ask someone who is considering using Armaid is “Do you have sore forearm muscles?” if they say “yes” then I know that Armaid is perfect for them and will deliver relief when used as shown on the videos. Armaid will not be of use if the problem originates solely in the neck or shoulder region with a pinched nerve or injury “upstream” of the arm.

Armaid is not a cure all or a one-time magic bullet. It does give the sufferer a way to relieve their symptoms and to maintain their own hand, arm, elbow health. Armaid use is like brushing your teeth, regular maintenance is best for health because as an athlete you are constantly using your body and muscles and creating tension and metabolic waste products. That is why professional athletes have massages constantly before and after every work out and performance.

Summary

The Armaid is a useful product that can be used to supplement other healthy physical therapy for rehabilitating several conditions climbers experience. If you have chronic pain, the Armaid by itself will not cure you. But an overall change in habits along with this device can be an effective solution to getting back to lower pain levels.

* Special Discount *

Terry also gave me a special discount only for readers of All Climbing. If you mention you saw Armaid on All Climbing, you will receive 15% off your order of the device. Just mention it when ordering online or when calling them.

Disclaimer: It pains me to even write this, but let me reiterate – I am not a doctor. This is not medical advice. If you have medical problems, please consult a doctor or other medical professional.

I’m always going through a lot of tape for my fingers, but buying it at REI or other retail stores is getting ridiculously expensive. I did manage to find a great deal on Amazon a few days ago, but I was almost skeptical at the low price per roll. My order just showed up and this is definitely a great deal:

8 10 yard rolls of 1.5 inch Johnson & Johnson Coach Sports Tape for $20.78

For those of you mathematically challenged this afternoon, that’s $2.60 per roll. As a comparison, REI charges $4 for the same length of 1″ tape and $7.50 for a 2″ wide roll.

There may be cheaper tape out there, but not for the Johnson & Johnson brand which in my opinion is the best as it tears much easier and stays in place well.

ClimbingNarc has an injury and recently asked on Twitter for some suggestions on non-climbing activities for climbers. I then re-tweeted this and collected the following interesting responses (after removing the jokes!):

Jefner try #kayaking, it’s great crack.

EDWARDSCHMIDT Fly fishing > equally as compelling once you figure it out

boulderdiaries Snowboarding and that’s about it for me

bdestrempes Lots of biking, swimming and tennis for me

SectioDivina Kayaking, crossfit, breaking, jiu-jitsu.

sudarkoff I am doing yoga (Ashtanga) regardless of whether I can or cannot #climb. And it keeps me healthy and being able to climb!

mmoris when unable to #climb we need to go to work otherwise, snowboarding, hiking, photography, etc.

thepurpleflower yoga, indoor or outdoor cycling

Andif I like to use my mountain bike, I notice the difference on rock overs, I certainly notice if I don’t

trailsdotcom when our fingers are too torn up to climb, we love slacklining and disc golf. Wait, is drinking a physical activity?

lavala No running? I guess yoga, but I prefer running in the off season.

stepan interestingly enough skiing helps me climb

alliebrock mountain biking, power kiting. That’s mine #climb

climbingsponge Go on an off-trail hike that involves scrambling.

sugardayfox I’d vote for swimming (especially free style) as it is a great way to train/flex your antagonists for your back

tcabeen pull-ups, push-ups, core work. That’s all I got.

DivaMissT yoga!

Edmundhilarious Slacklining.

I’d like to add that due to my recent injuries, I’ve found that snowboarding does the trick for me. As a long time skier, I started learning to board this year and the steep learning curve is just what I needed to keep my mind off climbing.

After looking at all these suggestions, what makes a good on-climbing activity for a climber? I think the following sum up the criteria:

• Challenging – combines some of the same mental plus physical challenges as climbing
• Does not use oft-injured body parts from climbing (hands, upper-body)
• Not seasonal (we get injured year round right?)

What do you like to do on rest days or when you’re unable to climb due to an injury?

The finger issue was going to be more tricky as he wanted to focus on treating one thing at a time, so since I was going to be off climbing for 3-4 weeks anyway while treating the tendinitis this seemed a reasonable thing to do. Surely this much time off would heal things right?

Well, as soon as I had the green light to (lightly) climb again about two weeks ago, my second day out I started to feel that same pain and tenderness after about 30 minutes of light climbing. After calling the doctor, he referred me to a hand orthopedist.

I had my appointment with him yesterday and was given the sobering, though not surprising, diagnosis of a partially ruptured A2 pulley on my right ring finger.

This is probably the most common finger injury among climbers and now that I’ve had it officially diagnosed, I’ve likely had this injury about a dozen times over the last 18 years of climbing.

Ironically, there’s some good news in here. The bad news is that the pulley has a partial tear and hurts whenever it gets re-aggravated or re-torn.

The good news is that the doctor says there’s nothing that can be done surgically (that would actually benefit my condition) and the only real way to fix this is to not use it at all (i.e. stop climbing for an extended period of time).

Unfortunately, I don’t feel any pain after about 48 hours so it’s tough to know how long to rest. The doctor’s recommended treatment is to slowly start climbing again while doing two things.

First, tape the pulley strongly to give it support and keep it attached to my tendon. This is the second doctor I spoken to who specializes in treating athletes (including numerous climbers) that has strongly recommended taping fingers for pulley injuries. In addition, I’ve injured every single finger on both my hands (yes, including pinkies) and taping has always helped me in the recovery process. Yet, I still meet climbers who tell me taping doesn’t work or even makes the problem worse.

I’m officially going to say it right now – if you read or hear the contrary, that taping for pulley injuries is bad or does not help, it’s probably bullshit and I’d be highly skeptical of anyone stating this as fact. Forget for a moment what any climber or doctor has to say about this. Simply think of the biomechanics involved here. What do the pulleys do? They keep the tendon attached. So using tape for a short period of time while actually climbing is simply going to assist these damaged pulleys do their job. I have a hard time fathoming why climbers resist this idea.

If you’re looking for more information on this from a climbing perspective, I also recommend reading Training for Climbing by Eric Horst. He’s done a ton of research on this over the past thirty years and comes to similar conclusions.

The second recommendation from the doctor was to avoid using the finger as much as possible while getting back to climbing and training. Easier said than done, but he has a good point. Part of the process will be training myself to avoid grabbing holds that will strain that particular finger. As climbers we rely on it quite a bit, but this doctor stated that the ring finger has 15% smaller bones and about the same amount less overall strength compared to the middle and index fingers. Unfortunately, he also said that climbers have a tendency to use the ring finger in ways that bear too much stress that could probably be avoided in many cases.

Over time this injury will heal as long as it doesn’t tear again. But every time it starts to hurt (due to tearing), the clock starts again on the healing process.

So now I’m at that delicate decision point of when and how to start back climbing. My tentative plan is to securely tape the injured area and start climbing again slowly on very easy climbs. I’ll likely stop every session short just to make sure I’m not pushing into that danger zone of re-injury and just see how things go. I’m also experimenting with cold water treatment to see if that helps.

I’d love to hear what everyone else has done with these kinds of injuries? Are there any treatments I’m not aware of? How long should one rest after getting a partial rupture of the A2 pulley?

Obviously, there never has been a magic bullet, though many books would have you believe so (although I do recommend Training for Climbing). As a result, I began to re-evaluate my own goals and training plans and came to a few conclusions based on what I’ve read, discussed with various doctors and physical trainers, and my own background.

The short answer is there are no shortcuts. There is no magical plan that will make you climb 5.12 after reading a book.

And even worse, every climber’s body is different, thus making a single plan or set of techniques vary greatly in their effectiveness.

The good news is that I strongly believe there are a few simple steps climbers can take in order to make some rapid improvements in their climbing.

Many of these you may already be doing, but I know I have room to improve on each of these areas.

My overall plan is to simplify first with general goals and then built up to more specific ones as I make progress.

There’s no point in my having a goal of “do 3 10 second dead hangs on the micro-edge” when I don’t even use my hangboard on a regular basis. Instead, I’m going to start with “use my hangboard to supplement my gym climbing training X times per week”. Then once it becomes a habit, I can start to add more specificity.

So, without further ado, here is my personal training plan for the upcoming year in lieu of any New Year’s Resolutions I’d likely break or rationalize away anyway.

Food / Nutrition

• Eat some green vegetables at least once per day. This is because I tend to avoid vegetables and load up on carbs. I eat bagels like normal people eat chocolate. Most studies show green vegetables have the most antioxidants and nutrition pound-for-pound.
• Watch my carb intake. See above.
• Eat natural and organic foods as often as possible. While my wife has been pregnant we’ve been watching this one closely for the little one’s benefit. The side effect is that I have been eating mostly organic and natural foods for the past few months and have never felt better. That’s enough evidence for me.
• Decrease (or at least maintain) caffeine and alcohol consumption. I love coffee and beer. Neither one in large quantities are necessarily good for you. I’m aiming to slightly decrease coffee and maintain the level of beer consumption. Hey, I’m in Boulder now and there’s coffee shops and micro-breweries everywhere. I mean this literally – Time magazine called Colorado’s Front Range the Napa Valley of beer.
• Drink more water daily. I’m shooting for two liters per day. Fill up a Nalgene and place it on your desk. My bottle taunts me all day until I drink it.

Cross-training / Exercise / Weights

• Do more body weight training exercises several times per week (pushups, pull-ups, dips, etc.) to work antagonist muscle groups to prevent injuries (for me, it’s my loose shoulder).
• Do crunches regularly to increase my core strength.
• Use my hangboard regularly. I have a Metolius Slim Gym. Not the most variety in the holds, but it fits almost anywhere you want to mount it. Once I set a pattern of using it regularly, I’ll splurge on a better one.

Climbing

• Fully warm up before climbing. I’ve read and heard many strategies, but I think the book One Move Too Many recommended doing about 100 climbing moves to be warmed up. My personal strategy, that has been working well, is to climb about 8-10 easier boulder problems with good holds (i.e. no crimps). I’ve found that this amount gets the blood flowing for me and I’m usually good to go at this point. I honestly keep a running count in my head until I reach 8. Going back to my keep it simple theme, this little trick forces me to warm up. I don’t allow myself to work on anything hard until I get my 8-10 warmup problems in.
• Don’t always climb to failure when training in the gym. This is good for muscles, but it does not work same way for tendons. I won’t go into detail here, but take a look at any of these for more info: ClimbingInjuries.com, Training for Climbing, and Marvin Climbing.
• Ice after each climbing session. I found my fingers recover from minor tweakage much quicker when I ice them. I’ve now had this habit for a while of icing my fingers after climbing. Simple, yet once again very effective.
• Rest when needed. This sounds like the most obvious of them all, but as climbers we usually abhor resting unless we’re physically forced to. It’s probably a good thing to actively plan resting.

Your mileage may vary on all of these. None of this may work for you or maybe all of it will. Some of you may find all of the above simplistic, but for me that was the entire point. The key is that each of these components has shown some promise for me at different times of my climbing life.

My goal is to now put them all together and be consistent. Luckily, none of the above is radical, untested, or will kill you. Just a simple, common-sense way of getting fit for climbing.

I welcome all your suggestions in the comments. Are you using any common sense training concepts in your personal climbing fitness plan?

Treating Common Wrist and Finger Injuries and Integrating Medical Philosophies, Part One

Treating Common Wrist and Finger Injuries and Integrating Medical Philosophies, Part Two

I’m interested in hearing if anyone has tried using acupuncture to treat a climbing injury. Several years ago I tried acupuncture for a lingering finger injury and I did not have much success. I’ve been told, though, that acupuncture is highly dependent on the skills of the practitioner.

From my own personal, non-scientific studies over the past six months or so, I’ve found that stretching each finger individually has demonstrated noticeable gains. By gains I’m referring to faster recovery from aches and pains and lack of new injuries.

My actual routine (in addition to all other warm-up and training for climbing) involves stretching each individual finger on both hands three times a day. Every day. I take each finger, pull it back, and hold for approximately ten seconds. I then do three sets of these three times a day. Most climbers will probably not have to go to this much effort. But for those of us who have been hampered by finger injuries, this type of prevention may just be the ticket.

I’d be interested in hearing about anyone else’s struggles with finger injuries and its prevention. Please send me an email or preferably, comment below.