Climbing has often been deemed a difficult sport to endure with regards to joint and tendon health. You've just taken a ton of time off to help you to heal and now you are wondering how to add back in the climbing without getting injured. This is where good old fashioned coaching comes in.
First, we begin with a gentle base.
Focus on testing out your newly healed injury on a stable safe terrain in which you have high confidence that it will NOT talk to you. A little caution is ok, but if you are about to gently pull on some jugs and you don't feel your injury during the day, it is safe to say it is worth testing out.
Begin on slab.
If you are not healing up an achilles/calf/foot injury, slab is perfect for returning to climbing. It's easier for you to stay on the wall, you have less muscle tone and less need to use those fingers or to hold as tightly as you would on overhanging routes. Slab might not be a great idea for recovering achilles or calf issues as it places great stress on these structures. Instead, choose vertical and with every foot placement, ensure you are carefully placing your feet and using positioning that you deem safe. Next week is a new week, but first, we need to see what we can do at our base and make sure it doesn't irritate our injury. If gentle climbing provokes your injury (as in makes it swell, ache, or you feel sharp or stabbing pains), you aren't yet healed. Choose to return to phase 1 of inflammation control and mobility training and instead choose to go to the weight room or to work on other climbing related weaknesses while this heals. Doing nothing is often not doing enough and some may not heal with time off, this is where the doctor or therapist comes in.
Pick large feet or handholds.
Depending on which area has just been newly recovered, you want to give it the best opportunity to return to the movement of climbing without all the demands. In regards to retuning the full body to climbing, it is ok to begin each region on a different level... For example, if your ankle is recovering from a sprain, you are fine and dandy to pick more intermediate hand placements while we wait for the foot to recover. Just because you sprained your right ankle doesn't mean that the left one can't do what it's good at, get it?
Choose low level endurance over intensity.
As for entering into climbing, we want to go for the initial goal of not irritating or injuring our previous injury. This means climb on it carefully, don't do too much, and then wait to see how the body responds to it.Your first climb is a tester to see how your body responds to using that injured part again. It's merely a test, and your answer dictates how we progress with climbing or rehabilitation tomorrow. It might be that your finger doesn't hurt at all climbing on 5.9 but then it aches tonight or is stiff when you wake up tomorrow. This might mean we missed some self-care at home, our forearm mobility needs work, or we are missing a key piece of information about what is truly going on in our "healed" injury. Some truly injured joints will ache with use. I have a busted up ankle that I broke to bits and recovery on it was hard. There was pain and swelling as I took an area that was rigid with time off and began moving and using it again. I started slow, in the pool, and then hiking on the trails, and finally, I was able to get on the rock. Amazingly, crack climbing on that ankle is great, it's overly flexible. It's the uninjured side that needs mobility work.
Prepare for inflammation and tightness of protecting regions.
Just incase, I want you to ice and compress after you climb. This is going to help us to mitigate your bodies response to climbing and to help us to see if we can return you to climbing with minimal impact. Use some compression tape on your injury and wear it all day afterwards. This ensures that the muscles around the previously injured site are less likely to be in protection mode. They have the old memory of your past accident/injury. That is not easily forgotten, especially by little muscles that have been guarding the region ever since. Be kind and possibly get in there to massage the region to loosen up these protectors. They will love you for it.
That soft stretchy tape you find at your sports/athletic shop, actually does have some benefits. Not only does it decompress the structures below, acting like an extra stabilizing muscle, but it also has been shown to create less spasm by decreasing the reflexes evoked by the brain to protect your injury. Pretty cool. Compress the area into stability (meaning we compress the joint circularly if it is a finger, or if you rolled your ankle outwardly, we tape to hold the ankle from attaining that position. Kinesiotape is just a stretchy "feedback" tape, meaning it won't do any real structural support but instead compresses and helps the body to learn to hold itself in the correct orientation.
Use this kinesiotape after you are done climbing if you worry about the area swelling or becoming inflamed. A rule of thumb is that if the area is tender to the touch or feels like it bends less when you try to move it, it is probably full of additional fluid AKA swelling. This doesn't have to be at the macroscopic level, swelling is not always easily seen by the naked eye.
If you have climbed today without pain or tightness, congrats, you are prepared to climb another day. Now remember, we are still in the testing phase. This doesn't mean to go blow it out of the water by trying that crux you hurt it on. It also doesn't mean that you can keep pushing it until you find something it cannot do, let's save this for later so we don't set ourselves back. ;-)
I give my patients this list and then depending on their feedback and response, we set up a goal week with a few bits of homework and self-care. Testing different variables in a controlled setting, we can see where your weaknesses arise and where you are solid to climb daily. This might mean staying off the bouldering scene for a few weeks and climbing ropes for a bit while we can be sure we can reintroduce you to inclines without reinjury.
Each body is different and each athlete comes from a different background of training. The rule is 15% of volume, intensity, or duration per week. Picking one and not all, we slowly (using a logbook) get you back to where you should be without injuring another site or provoking the past. Rock ninjas we will be, but first, an impeccable amount of training and goal setting must be in place to protect us from ourselves.
- See more at: http://www.climbinginjuriessolved.com/blog/returning-climbing-101/#sthash.oLut1sac.dpuf