So, You Think You Injured a Tendon: Tendon Rehab for Climbers
by Christopher Schafenacker
Climbing is often viewed by non-climbers as an extreme, even dangerous sport and yet unless you’re climbing high in the alpine or without ropes, the risks of the sport are less of extreme danger than of debilitating minor injuries. Experiencing a catastrophic fall is far less common than rupturing a pulley, which is why climbers need to know as much about addressing that dreaded pop! as they do about safe clipping and avoiding rockfall.
At some point in their career, most climbers face the frustration of needing to hang up their climbing shoes because one pesky finger won’t pull its weight (or has pulled too much). Tendon injuries are among climbing’s most common injuries. Often, they arrive with a pop! and rapid swelling, but their onset can also be gradual and signaled by other symptoms. Sharp pain in response to certain grip types or persistent pain that does not subside when at rest are also signs of a potential tendon injury, as is localized swelling in any part of the finger. Left unaddressed, a tendon injury can end your climbing career just as effectively as a bad outdoor accident, and so it is crucial you know what to do as soon as any one of these symptoms presents.
Four Steps to Tendon Rehab
1. Get A Diagnosis
The first step to treating a suspected tendon injury is getting a diagnosis. This doesn’t mean Googling your symptoms or asking the opinion of friends, but visiting a physician or physical therapist who can tell you exactly what’s wrong.
Tendon injuries can range from a scary-sounding but relatively benign case of synovitis (tendon-sheath swelling) to a more serious pulley strain or even worst-case-scenario complete pulley rupture. Knowing the nature of your injury will determine how best to recover, and so a proper assessment is crucial. At a minimum, this involves gathering such information as the mechanism of injury, past medical history, and future climbing goals. It also means measuring strength in a range of grip positions to pinpoint the pain and assessing overall bodily condition to identify potential contributing factors.
Once you know what is going on, you can figure out how to best respond.
2. Rest Up
Climbing-specific surgeons like Dr. Volver Schöffl only recommend surgery in the case of grade IV multiple pulley ruptures or single ruptures with trauma to the lumbrical muscles or other ligaments. If you are in this unenviable position, the first step to recovery will be a visit to the OR. In all other cases, getting back on the sharp end starts with rest.
While the specific period you will be stuck on the sidelines depends on the nature of your injury, it is safe to say that you’ll likely need more time off than you think. Mild synovitis will require a week of rest, while a grade IV rupture likely means months without climbing. However great the temptation, it is fundamental that you respect the prescribed amount of rest in order to keep recovery time to a minimum.
3. Return Gradually
Once properly rested, gradual active recovery is a crucial part of tendon rehabilitation. This can mean different things depending on the nature of your injury and climbing background, but one thing it certainly does not mean is trying too hard, too soon. As tempting as it may be to hop back on your proj as soon as you’re pain-free, doing so is about as smart as blow-drying your hair in the shower.
Only a physician or physical therapist familiar with your injury can tell you how to safely work active recovery into your rehabilitation plan. This said some general principles apply:
a. Static movements are safer than dynamic movements.
b. Gripping with an open instead of a closed hand is best practice.
c. It is safer to train endurance than it is power.
d. At the first sign of pain, you need to stop.
4. Avoid Re-Injury
Finally, the best way to finish rehabilitating an injured digit is to not get injured again. Thus, prehab and injury prevention need to become a key part of your training—a topic addressed in a previous blog. While there’s more to say here than space permits, it bears underscoring that a (preferably wooden) hangboard is a crucial tool for maintaining finger health. Not only are you able to train strength in a controlled and measurable fashion with a hangboard, but you’re also able to warm up gradually without the risk of a foot-slip or tweaky move catching you off guard.
To learn more about the benefits of a wooden hangboard or about any other of our climbing products, do not hesitate to reach out via our website or give us a call at 781-739-2060.
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The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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