Torn muscle? What to do about it, and how to do it.

It’s not every day that you pull a muscle, but when you do, WHAT should you do about it? My friend, if your answer is STRETCHING, you are way behind on the self-care scene.

I am here to help with what research and modern PT has changed.

Pssst. This article pairs nicely with my Un-Sprained Podcast, Episode 26, Forearm Sprains. I hope you take a listen if you prefer to learn in an auditory format ;-)

As climbers, we are a injury prone community. We hurt our fingers, our elbows and our forearms most often. Statistics on our favorite sport show that the average climber not only has more than one injury, but has also had it for more than one year.

This is pretty scary, in regards to ensuring you can climb for the long run, with as few injuries as possible side-lining you. We should be able to play hard AND recover right?!

If you feel like any of these scenarios are you (you either have an injury, or aren't healed even if a year has passed) , welcome to my site and yes, you are invited to join right in to begin working on perfecting your self-care journey, wherever it might find you.

Today we discuss forearm tears, or strains (the what, how and why) and what you need to know about healing from them.

I’ll give you step by step tricks of what NOT to do, and a few examples of why we recommend specific new techniques for rehab based on new research. My friends, if you are needing help on this topic, your world is about to change.

But first...

The ClimbingDoc's

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Let's first visit the causes and the symptoms of a muscle strain, we'll hit 3 examples I see commonly with climbers who tear a muscle. Then finally, we’ll get down to the details of what your recovery should look like, at least in the beginning.

Today's article would benefit the following injuries involving muscle belly tears:

- Pulled forearms

- Sprained forearms

- Torn forearms or elbows

- Heel-Hook Hamstring tears

- Rotator cuff muscular tears

- Calf tears

If your tear is muscle (not tendon or ligament), keep right on reading for a tutorial on how it happens, what it involves, and what to do about it. First, let’s cover the basics.

A strain or a pulled muscle (AKA a tear) can happen in many ways.

What is the most common cause of a muscle strain?

Remembering that a strain is a tear, the most common strain is caused by

elongating the muscle and also asking it (at the same time) to have a large or near maximal contraction.

Looking at different regions, we can see what this looks like with our example climbers. For me examples help me to learn so please give me feedback of if this is helpful to you!

Client Example #1.

So the first example is a gal named Erica who pulled her back climbing at the Pukes (outside of Glenwood Springs, CO). Sport climbing, the move that caused injury was a two footed slippery smear up into an under-cling. Her feet were stepped up nice and high, and the low back was flexed (into almost a sitting position) as she pushed into her calves to create and hold the feet. She held this before standing up into the next move, up and over the crux. This was it. The beginning of her tear. And she tore the muscles in her low back. A tiny slight tear, but as it puffed and swelled with the heat she became more aware of it. During the "onset" of the injury, or the move that created it,she had no idea that she had done something wrong. She felt fine finishing the climb, but then, hours later after driving back to the Front Range she couldn’t get out of the car. Her low back felt locked, hot and puffy, and she was unable to stand up straight. She had "pulled" or sprained her lumbar extensors.

So what happened?

In this case, she pulled her low back, loading the muscles into extension as far as they would go. (Though her torso flexed forward, it stretched the muscles on the back that supported her in extension). Looking at this example, the region’s fibers were stretched as far as they could go, and she was asking them to also hold tight and be strong in this position while at the same time loading other muscles that attach in the same area (hip flexors).

This is a common scenario for an injury.

Why?

For starters, this is a position that Alexis rarely ever found herself in before becoming injured. This is a major risk factor. Not only was she new to it, but she felt scared and was bracing and stiffening with her legs, asking the lumbar spine to hold stable in a position she didn't often use.

She was likely easily injured because she was doing a new move while stiffening her whole body trying while make the move happen. Doing a climbing move, with as much might as you can, can be the event that puts a tiny tear or micro-tear like this into a previously happy muscle. In her case, she was able to climb in a few days, and healed up within two weeks and ready to go again, and never injured her back again. It was a one-time deal.

Client Example #2 :

The forearm strain. Another example of an easy to earn tear is climbing at the end of the night on problems, or projects, that are successively harder and harder so as your body fatigues, you are still asking more and more of it. This is my most common injury I see in the forearm, or the back of the forearm (top of the forearm). As climbers fatigue, they tend to do more wrist flexion, cheating on big round volumes with wrist flexion, and using these poor muscles in an elongation pattern that isn’t their norm. More stress, worse position, this is a recipe for injury.

Client Example #3.

For this climber, Joel injured the underside of his wrist in a roof type setting. He was reaching and again like the first climber, stepping his feet up to make a dynamic move to the next hold, up over the roof. In doing so, he sprained the underside (palm side, or "volar" ) part of his wrist.

For this one, I commonly see a similar injury pattern. This move often entails making an under-cling, or positioning the wrist into end range extension while at the same time pulling hard up into the hold.

There is a common injury pattern that I see over and over. It rears its ugly head seemingly when you bump up weight, volume or grade. In true Murphy's law fashion, it often occurs at the end of the night or if you are on a trip to the crag, that last climbing day trying to send your project.

Take Aways:

Here are a few tips for you to try to avoid that injury experience.

Tip#1: Take it easy the first few times doing a new move, or a harder move.

Why? IF you are not trained for a particular move you are about to make, or if the muscle in question is not prepared for A. this new position and B. a heavier load or C. a quicker snappier motion (like a quick contraction request), an injury could result. So take it easy your first few times doing a new move, or one harder than you have done in the past.

Tip 2: It’s the new climbers at risk. Or those NEW to the moves.

Why? Newbies, and those moving up through the grades rapidly get injured more often.

If you are a seasoned climber, and your body is used to you throwing all kinds of things at it, you are WAY less likely to get hurt.Why? For one, you don’t over-grip and secondarily, you have great body positioning. You also are better at evaluating on the fly how much tension adn what angle to put into each hold. Again, age and how long you have been climbing only lower these risks.

Tip #3: Tightness means risk.

Why? Those of us who come to the crag with a body tight from the desk or from work and decide to ask our body to do new things it hasn’t before (or perhaps we decide we are the next grade up of climber). Totally a scenario that most of us will find ourselves in one day or another right?

TAKEAWAY:

Remember, this is a simple calculation often for WHERE the risk comes from. The most common causes I see in my clinic are when you ask a muscle to contract too fast, too hard, or in too extended of a position (elongated towards maximum) puts you into a risk situation.

Question: So what do you notice if you did cause a muscle strain or tear?

You will notice tenderness, heat or discoloration (there is a whole grading scale for tears, and if you see bruising, chances are you have a tear that will take some time to heal and or need to be evaluated).

Question: So besides bruising, spasming, pain after climbing, aching with sleep or when not in use are common symptoms of a tear.

Depending on the level of the tear, or how bad you injured yourself, you start at a different phase of homecare and rehab. Here are a few tips for those of you who are injured and trying to not lose a climbing season over it.

DON’T stretch a tear.

Most injured humans feel the need to try to stretch away the pain or the tightness in an area around a tear. This is the WORST thing you can do, and the number one cause why a tear doesn’t heal, heals improperly, or continues to bother you for years to come. A general rule of thumb is that for the first 10-14 days, stretching this area is a REALLY bad idea. Now we’ll get into the nitty gritty of this in just a bit.

To help your understanding of WHY we don’t’ stretch a tear, we begin with what is happening below the surface, the healing process, and what you are doing to it when you stretch the region.

First, in the long line of healing, at the very beginning of the process, A new tear causes a bleeding event, below the skin, to create a scab like tissue. Binding together the torn ends of the muscle fibers to unite them into one tissue again, this scab like tissue forms into a strong scar tissue, that is stronger than the muscle fibers themselves.

When you pull a muscle, stretching is the last thing you want to do, and here’s why.

Stretching breaks apart the healing tissues that you are trying to form, if we don’t give them time to form, well, you see the problem.

Ok, so we know that we shouldn’t stretch it, what else!? While we wait, we need to keep the area doing what it can, pain free, to keep it mobile and allow it to heal. So this is where buddy taping, and wrist bracing can be way overkill. And today we aren’t talking about finger injuries, just muscle tears (and as a tip, there are no muscles living ON the underside of your fingers, it is all tendon). I’ll let that sink in for those of you who are new to sports medicine, if you are thinking of applying this info to fingers, don’t this is an entirely different topic. For fingers, you can listen to episode 22, 5 ways to tell if your finger is injured, episode 14, what to do for stiff and painful pips and dips, and episode 12 pulley injury research and risks to get you started.

While we wait for the tissue to heal, we aren’t stretching the tissue, but the next important take home message for you DIY’ers is that we DO need to keep the tissue moving. And what I mean by this is that if you sit at home waiting for your low back to heal after pulling it, not only does it heal with more scar tissue, but the body has learned that any motion to the area could be a risk factor. Sitting around waiting for it to heal will often just train the body to be more cautious and touchy with the injured area. More careful about use. Inactive rest doesn’t help us to heal on many fronts. Instead, move it, keep it flexible, and let the body find a pain free way to use the region (if you can, if not, we need to see the proper PT or therapist for the correct rehab plan)

If you are healthy enough to be able to move the area (pain free) without assistance from another (or with help from your healthy hand and arm) then do it. If you cannot move the injury without help, then we need to assist it through full ranges of motion.

Timeline for our forearm injury:

Tak 10 days off from climbing, letting the area heal. Do any normal daily tasks that don’t bother it. We avoid what does bother it, regardless of how easy it is, and if it is SO injured that we cannot use it, then we don’t. This is a hard learning point for many.

For 10 days, If it hurts, don't use it.

The beauty is that IF you do the right rehab on this, it should recover and NOT become injured again. Most athletes who do NOT follow the proper rehab plan become immediately injured again within the next two months. Those that DO follow a rehab plan do NOT become injured and can quickly and efficiently progress back to climbing at a high level as if the injury never happened again. So this is why following a correct rehab plan is so important.

If we were to focus on the forearm (for a forearm strain) From here once pain free with active range of motion (with wrist flexion, extention, and side bending) without ANY load. If we apply load before it is ready, this is where the tear reappears, so we have to be careful here. For those who are still following me, her is the important part. Most tears occur in extension. So for your homecare and prevention for another injury, we work slowly from a safe flexion position, so the wrist at 45 degrees, but we slowly extend the wrist INTO an angle that elongates the injured muscle. If this is a hamstring or a back or whatever you have injured, I want you to take this takeaway because it is important.

Most injuries are rehabbed improperly, focusing on that last 45 degrees of end range into muscle contraction of the injury.

Research is pointing, with a big flashing sign, that if you don’t work the opposing direction, into extension with load, then you are missing the big picture for prevention. What this would look like is if you are standing with your hand out in front of you, and you are raising and lowering a weight, we get the MOST gain with our wrist into extension, with the weight down near the floor, than we do with the muscle contracted as short as it goes, with the weight high in the air (in this example of wrist extension).

Supportive Introspection Challenge:

Ready to begin ensuring that that injury stays healed? Or preventing? Let's jump

INTROSPECTIVE STEP #1:

1. What muscles have you torn in the past?

2. What you are recuperating from now? (if anything)

INTROSPECTIVE TEST #2: Finding the sweet spot for preventative rehab.

Have a past injury you'd rather NOT see injured again? Let's jump in, one at a time and unload that with a targeted strength program JUST for you. (assuming its healed up,

if it isn't, DON'T DO THIS!!)

First, lets think big picture, imagine your body as an image. ZOOM OUT to show each region (if many) one at a time.

Thinking (one at a time) of each muscle group that you have injured, or are currently healing, WHAT position does your body go into with this muscle elongated? If you can figure THIS out, you can begin your preventative rehab to keep this injury from recurring in this area.

ANSWER: FROM HERE, we work slowly towards strengthening that position.

Research shows us that THIS is the best scenario not only for healing this injury, but to keep that injury from happening again. This is the big take away from this podcast episode, one, don’t stretch it too soon, and two, if you want it to heal, and stay gone, work the area long after it is healed to keep elongation strong under load, because chances are for most of you that DO get injured (I should say US, because injuries happen and its no shocker that I myself am injury prone too, but that’s another subject for another episode) it would behoove us to work into the scary regions first with gentle range of motion, then with light resistance, and then once it is used to this type of load, with strength training. And the goal is that the muscle should have the same strength in elongation as it does in contraction. And often we need it stronger in elongation, not just contraction, so it makes sense why we are all getting injured here. A bit of time spent thinking about your injuries, your PT and prevention programs is well worth it if you find that you can fill in holes with this hidden gem.

Please don’t work into extension while this is healing, because there are a bunch of phases to work on (beginning with a small angle and then slowly elongating out to extension) but I wanted to make this point that once healed, and if you are wanting to get back to climbing, this is where you need to be focusing before you are ok to get back to projecting.

Especially if you are one who is looking to not only climb at your previous level, but beyond. We find these weaknesses and make them strong, before we get injured. And if we have been injured, we beef them up to ensure we don’t get injured again. I hope that helps!

Thanks for reading my article today. I hope it helped you. Consider listening tho the matching podcast to further help your understanding of this topic, as it is those who repeat and re-read that learn the most.

If this article/podcast combo resonated with you, I hope you share it!

Good things are in the pipeline for upcoming episodes, including my discussion with the author Nutrition for Climbers. Hopefully I’ll have that podcast up for you next so make sure to send in your questions for her related to heat, diet, nutrition for prevention or even nutrition for long covid and climbing. Send them to drlisabrindc@gmail.com and I’ll make sure to hit her with these before I let her end for the day.

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