The path to recovery is long, slow, and winding.
And not always as neatly paved as this one.
A month and a half ago I sprained my LCL (lateral cruciate ligament) in my left knee at the wall. I was near the end of a session and was trying a leg-intensive problem to avoid over-using my injured golfer's elbow. I was in a deep squat on my left leg on a hold, right leg and hands on pretty much nothing - this is usually a strong position for me, but this time I heard a crunch in my knee and fell off. I could walk / squat immediately after and had little pain. However seeing a physio the next day showed that I definitely had an LCL sprain and would need to go through the usual slow healing / care / rehab process, which I am doing.
Having just about managed to get my head above water coping with the golfer's elbow injury and partly-associated depression, mostly by relying on slabs and leg-focused stuff, this has been very hard to cope with and has lead to some pretty bleak moments. I've managed to get a bit more stable just recently, and regardless have been sticking to rehab and aggravation-avoidance diligently.
This is the latest in a series of injuries that has either wiped out training time, climbing time, or both, and has got me speculating if there's anything obvious I'm doing wrong. So I've done a retrospective of the last few years (lower down page) to see if there are any common threads (just below).
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Common issues and prevention ideas:
Always pushing to my limit:
Something which I think people often don't believe, because by the standards of many of my peers the end results are entirely unspectacular, and because I've heard that it doesn't look like I'm trying hard - when in fact I'm battling for dear life. The reality is that in any physically focused climbing genre (sport, bouldering, indoors, even gym), I'm always pushing really really fucking hard because that's why I enjoy. This isn't a problem in itself, BUT becomes a problem when that desire / habit overrides common sense in terms of (deep breath) recruitment, preparation, warm-ups, conditions, rest days, physiological imbalances etc etc.
Prevention:
WARNING FLAGS checklist (below) - go through this before any challenging climbing session and check that the risk of injury is acceptable / manageable.
IF there's any uncertainty about any of the factors on the checklist, TEST them if possible - probably as part of the warm-up - with something that mimics the risk factors.
Have a Plan B in terms of climbs or venues.
Be wary of the risks involved in a sudden change of situation or focus (climbing to training, outdoors to indoors, wall to gym, etc). A change of focus could be equivalent to restarting an activity after a lot of time off - warm into it as appropriate.
Not warming up enough:
Related to above, I know that sometimes I don't need to warm-up much at all (good weather, well-recruited from previous climbing / training days), and sometimes I know I need to warm up well (low energy, low mood, too much time off, inactivity etc). But occasionally my judgement and self-discipline is very flawed and I'm too lazy / distracted to warm-up methodically, and definitely risk injury.
Prevention:
Have a warming up checklist: Temperature & blood flow > conditioning & stabilising > recruitment > injury & sensitivity specific > climb specific.
Refine my warming up to include recruitment.
Work on habitualising a good warm-up routine.
Ask my friends and partners to remind me to warm-up properly.
Think outside the box when it comes to warming up in situations without easy / obvious warm-ups. Play around on rock / wall for movement at least.
Remember that warming up applies after a long period of cooling down, as well as first starting.
Not adapting to weather conditions.
In the UK it weathers a lot. I've been out on a spring weekend when it's been too hot for lime one day and too cold for grit the next. And the calling of the lime is a good chance of blizzards and when I moved to Manc it was 20+ degrees at the end of February. Anyway I'm mostly good at picking a sensible crag for whatever ridiculous conditions have sprung out of nowhere, but not always, and sometimes I definitely have stuck to a plan or desire in adverse conditions that have caused a higher risk of injury for my intended climbing.
Prevention:
Now part of the WARNING FLAGS checklist (below).
Have a Plan B in terms of climbs or venues.
Not heeding niggles in the earlier or manageable stages.
I often get minor, manageable niggles - from pushing hard, irrespective of whether I should be - which isn't a big problem in itself, BUT becomes a problem when I don't manage those. I'm okay with partly managing them with rehab exercises and some balancing out work, but much worse with using sensible judgement to avoid pushing too hard in extreme situations that are high risk to those niggles.
Prevention:
Now part of the WARNING FLAGS checklist (below).
Remember that stepping back and taking it easy for a week or two will impact on training and progression much less than having to take it easy for a few months due to full injury.
Rest from the niggle-stressing activity is crucial, not resting from other activity (but heed change of focus risks).
Impacting with the ground / rock (not pads).
I've always landed like an 80kg sack of spuds, and tend very readily to break rather than bounce, whether it's hitting the rock or more likely the ground. That's how I am physiologically, and recovering from an LCL is maybe not a time when I'm thinking about a "learning to land" course, yet. Incidentally so far I've never had an impact injury from falling on pads nor falling indoors, including some semi-highball stuff outdoors and bouncing off pads etc.
Prevention:
Do more varied falling practise indoors and outdoors to learn fall more safely in awkward situations.
Seriously consider giving up the idea of never using pads before leading / soloing trad routes.
Take the lower parts of routes seriously rather than casually, and plan for falling risks
Pushing knees to extremes in unusual movements.
It's only happened a couple of times, but with frustrating consequences. I'm not really sure why as I have reasonably strong legs from gym work, and no persistent niggles from running etc. Perhaps just bad luck??
Prevention:
Warm-up legs better before leg-intensive climbs / problems.
Have additional WARNING FLAGS for a set of leg movements / positions that might be risky and need extra care, e.g.: Deep squats / heel hooks / heel-toes / drop-knees.
Being heavy.
No shit. An extra 10% weight is an extra 10% stress through all the joints / tissues in question.
Prevention: Get a magic fairy to remove my DVTs and repair my digestion so I can do more CV exercise, get more energy from food, and manage my weight better.
WARNING FLAGS
These are checklists for me to print out (in a better format), stick in my rucksac, stick in my guidebooks, tattoo on my knob (might need a smaller font...), and check off before any challenging climbing sessions.
General risk checklist:
Niggles and injuries / Other physical issues (inc fatigue) / Weather and conditions / Type of climb / Risky holds / Risky moves or positions (including unfamiliar ones).
Previous injury and weakness risk checklist:
Golfer's elbow (both) / Tennis elbow (both) / Shoulder impingements (both, especially right) / Left hand main finger A2 / Left hand ring finger PIP / Left knee in general.
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4 year timeline of injuries:
2017:
November - January 2018: Widespread impact / muscle damage in right leg.
Cause: Falling off the "easy" bit of a challenging route and slamming into an overlap.
Effects: 2-3 months recovering to full fitness / leg use. Kept up with upper body training so no extra muscular detriments (but contracted norovirus in hospital with long term digestive / mood / energy level detriments).
2018:
[July onwards - maximum fitness due to mostly redpointing during summer]
December onwards: Tennis elbow in both elbows
Cause: 4 days bouldering / training, then niggles, then more cold bouldering instead of resting.
Effects: Restricted any harder climbing and any training for several months.
2019:
January to May: Tennis elbow in both elbows.
Cause: 4 days bouldering / training, then niggles, then more cold bouldering instead of resting.
Effects: Prevented any harder climbing nor any training for several months, still weak in April.
October to November: Injured / strained lower back.
Cause: Running 0.7 miles to local gym and deadlifting on exhausted / de-oxygenated legs.
Effects: A week off climbing / training and a couple of weeks gently getting back into it.
December to Feb 2020: Tendon sheath injury (?) in left forearm.
Cause: Unknown!
Effects: Some small restrictions on hold usage especially crimps and mixed/split grips.
2020:
[Early August - maximum fitness due to mostly redpointing during summer]
Mid-August to mid-November: MCL sprain in left knee.
Cause: Pushing far too deep in a maximum effort drop knee in poor conditions.
Effects: Prevented any harder climbing nor any leg-intensive training for 3 months.
Mid-August to mid-December: Full golfer's elbow in right elbow.
Cause: Deadhanging / pull-ups with little warming up, then steep traversing instead of resting.
Effects: Prevented any harder climbing nor any arm-intensive training for 3+ months.
2021:
May onwards: Bicep tendon insertion slight impingement in right shoulder.
Cause: Attempting to climb strenuous sport after freezing on a cold and prolonged redpoint belay.
Effects: Some small restrictions on strenuous climbing, especially pulling into sidepulls / underclings from below.
May: Bruised left heel.
Cause: Dropping a couple of metres off the start of a route.
Effects: Curtailed indoor/outdoor bouldering, heel-hooks, and running for a few weeks.
July to September: Golfer's elbow slight niggle in left elbow.
Cause: Deadhanging / pull-ups with little warming up.
Effects: Little effect at time, manageable with care.
August: Bruised right heel.
Cause: Falling a couple of metres off the start of a route.
Effects: Would have curtailed bouldering as before except it was too warm anyway.
October onwards: Full golfer's elbow in left elbow.
Cause: Attempting to boulder beyond my limit, in the freezing cold, without warming up and without taping up.
Effects: Prevented any harder climbing nor any arm-intensive training 4+ months.
November onwards: Sciatica / sore piriformis.
Cause: Unknown but likely change in routine from lots of climbing to more gym / stretching.
Effects: Mostly just annoyance but some confusion when assessing LCL pain.
December onwards: LCL sprain in left knee.
Cause: Single leg deep squat position on indoor problem whilst avoiding elbow-stressing problems.
Effects: Prevented any harder climbing nor any leg-intensive training for 3 months.
Mid-December onwards: Tennis elbow slight niggle in left elbow.
Cause: Weighted deadhanging (okay for golfer's) off the couch, to max limit.
Effects: Curtailed further "training" and some gym work and rehab for golfer's elbow.
P.S. For a blog post that is just about recording events and analysing them (which should be fairly simple!!), it's taken a long time for me to write it and try to get it right. Sorry for the length / dryness / anything that doesn't make sense / etc.
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