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apictureofnectar
Mar 18, 2008, 4:23 PM
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I have extensor tendonitis in both wrists, worse in my right. I've stopped climbing, have been icing my wrists and wearing a brace/wrap to keep them stable. The pain has subsided and I am hoping to be able to start climbing again soon. I am just wondering if anyone has any tips on training and preventative measures to take as I begin climbing again. I just want to figure out how to let me tendons heal and keep them from flaring up when I start again. Any advice would be greatly appreciated!
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charlet_poser
Mar 18, 2008, 4:36 PM
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patience, patience, patience.
my only good advice.
make sure you are doing appropriate exercises (PTs can help you know what to do and how to do it correctly) and keep the climbing easy for a while. It is better to take care of this injury now or it could haunt you for a much longer time.
I am comming off of tendonitis in both shoulders (bicep tendon in my left; all 3 main tendons in my right) and am almost 100% after diligently doing exercises, changing my arm position while climbing and taking time off, then slab climbing for a while to keep myself entertained while regaining shoulder strength.
good luck!
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michal104
Mar 19, 2008, 1:05 AM
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The main thing you want to do is really ease back into climbing. The forces climbing puts on your wrists are likely going to be much larger than those your physical therapy exercises put on them. Take at least a month to return to your previous climbing level, and more than that to return to normal volume. The first few weeks, the best thing to do is to boulder around on vertical jugs....you want to make sure that you don't force yourself into a move that will tweak an injury. Just gradually increase the volume and intensity of your climbing and take more rest days than usual. I typically climb 3 times per week, but only climbed twice per week when returning from an elbow injury.
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overlord
Mar 19, 2008, 9:04 AM
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icing is only good for the injury just after you have injured yourself (to keep down the sweeling, reduce internal bleeding etc). afterwards its actually detrimental as it restricts the blood flow to the injured part of the body.
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reno
Mar 20, 2008, 6:17 PM
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overlord wrote: icing is only good for the injury just after you have injured yourself (to keep down the sweeling, reduce internal bleeding etc). afterwards its actually detrimental as it restricts the blood flow to the injured part of the body.
Not exactly. Ice also reduces inflammation (which, in the case of tendinitis, is a long term problem) and reduces pain; both of which will impede healing.
For the first 72 hours or so, the best thing for tendinitis pain is ice, eliminate the activity that aggravates it, pop a few NSAIDS (ibuprofen is ideal, as it is generally safe for everyone, cheap, and readily available,) and just wait it out.
After that, some mild stretching and strengthening exercises, with moist heat before and ice after, will give great benefit. Couple weeks in this phase. You should be weaning off the ibuprofen, too.
Slowly return to the exercise that caused this (in our case, generally climbing) with a gradual buildup of intensity, all while paying close attention to technique and body mechanics. Again, heat before and ice after.
Rarely, a steroid injection (cortisone, etc.) may be needed. Let your doctor determine this if you haven't gotten better in, oh, a month or two following the above.
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roy_hinkley_jr
Mar 20, 2008, 6:59 PM
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reno wrote: in the case of tendinitis, is a long term problem
FYI, tendinitis is a short term inflammation that is easily treated. What you are talking about is tendinosis, which is chronic and a bitch to heal.
http://www.physsportsmed.com/issues/2000/05_00/khan.htm
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reno
Mar 20, 2008, 8:08 PM
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roy_hinkley_jr wrote: reno wrote: in the case of tendinitis, is a long term problem FYI, tendinitis is a short term inflammation that is easily treated. What you are talking about is tendinosis, which is chronic and a bitch to heal.
OK, technically I suppose that's a valid point. The subtle difference is lost on most folks without medical knowledge, so I simplified for simplicity's sake.
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berniejv
Mar 31, 2009, 6:25 PM
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Extensor tendinitis seems to be an odd injury from climbing -- you sure you don't mean flexor tendinitis? Also, do you work at a computer terminal all day? Anyhow, here is some info that me be of general use...
I am struggling with medial epicondylitis (the dreaded "golfer's elbow") and have had success with eccentric strengthening exercises (i.e. negatives -- resistance while lengthening the target muscles). Rock & Ice's Dr. J recommended these exercises for epicondylitis in an article you can find here. This seems to be one of the best courses of therapy. Total rest does nothing; by the time you have that chronic pain, the damage is done and the recovery must be active via stimulating hypertrophy in the tendons. Massage can also help, as long as it is not done to the point of causing inflammation.
I found some really great resources here and here that seem to suggest similar courses of action. The latter has a lot of general material that could be of use to you. They also debunk the use of NSAIDS and cortisone (!) injections as effective treatments for tendinosis (see this for a description of the difference between the -osis and -itis).
Anyway, I hope this gives you something to chew on. I know how utterly annoying these injuries are! Good luck!
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Myxomatosis
Apr 2, 2009, 3:57 AM
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berniejv wrote: Rock & Ice's Dr. J recommended these exercises for epicondylitis in an article you can find here. This seems to be one of the best courses of therapy. Total rest does nothing; by the time you have that chronic pain, the damage is done and the recovery must be active via stimulating hypertrophy in the tendons. Massage can also help, as long as it is not done to the point of causing inflammation.
Ive had the same for the last five months and I have pretty much followed that website and it has cured me (nearly)
The only things that I have found to work are (also in the article)
Resting... thats a biggie, make sure you don't climb if you are feeling any pain or your elbow feels 'rusty' when stretching.. pretty much means you aren't ready to climb yet and will only do more damage. It usually feels great when your climbing as the blood is flowing but afterwards it will be worse than before. Its a real headache but you have to treat it as a balancing act and know your elbow and what pain means what. Its hard to learn and acknowledge but just take it easy.
Weights.. I started doing those wrist rolls with a 1kg for four weeks then started on 2kg for a week
Acupunture... mine was quite bad but this was the fastest way that I went from really really bad to just bad, then followed that with my weights and pretty much cured.
I would expect to take at least a month off doing the weights OR climb easy stuff once a week (but whats the point in that?).
Try avoid leading (lock off's did alot of damage and the main cause for me). Keep your movements dynamic but controlled.. that is the key.
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