/ NEW ARTICLE: Injury Management and Prevention Part 1: Shoulders

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UKC Articles - on 12 Feb 2014
Stretching the lats, 3 kbMost climbers are blissfully unaware of the more common injuries, we - as climbers, suffer from. In this article, climbing coach Robin O'Leary and physiotherapist Nina Leonfellner get to the bottom of shoulder impingements. What they are, how they happen and how to rehabilitate them.

Read more at http://www.ukclimbing.com/articles/page.php?id=6022
johncoxmysteriously - on 12 Feb 2014
In reply to UKC Articles:

God, I hate these articles. My shoulders hurt just reading them. Still; I'm sure they're useful. Carry on.

jcm
RockSteady on 12 Feb 2014
In reply to UKC Articles:

This is brilliant. I've had ongoing shoulder impingement and this both confirms the advice given by my physios and also gives additional exercise ideas. Really useful article, thanks.
funsized on 12 Feb 2014
In reply to UKC Articles:

Awesome article, more of the same genre please.
biped - on 12 Feb 2014
In reply to UKC Articles:

Great article. I've got an ongoing frozen shoulder and am looking forward to a distension arthrogram in a couple of weeks.
Jon Stewart - on 12 Feb 2014
In reply to UKC Articles:

When are you doing IIFIs (Irksome Indoor Finger Injuries)? Surely equal top priority with miscellaneous elbow ache?
Michael Gordon - on 12 Feb 2014
In reply to UKC Articles:

Can I ask, does lifting heavy objects work the antagonistic muscles or the same ones used in climbing?
Trouble - on 12 Feb 2014
In reply to UKC Articles:

Great article, the shoulders are the Achilles heal of the upper body and they need to be looked after.

Photo credit needs correcting though, the one of Robin at Cheddar was taken on 10/07/2011 and was taken by Jen Wilby.
John Kettle - on 12 Feb 2014
In reply to UKC Articles:

Great article thank you Robin and Nina.
Out of curiosity is there any research evidence to support antagonist training in climbing or similar sports? I can see how working on joint/muscle stability, muscle tightness/length and posture will improve function and reduce injury risk, but not so clear on the benefit of atagonist movements, unless they're done in a volume close to that of the climbing movements (hundreds).
Looking forward to the other aticles!
In reply to Trouble:

Sorted.
hamsforlegs - on 13 Feb 2014
In reply to UKC Articles:

Great article. I've been gradually improving and strengthening my weak, niggly shoulders with similar exercises, and it has made a big difference.

There are some great new ideas here, and the stretches are excellent.

Thank you!
hamsforlegs - on 13 Feb 2014
In reply to John Kettle:

I've often wondered this. Good question.
Ben Sharp - on 13 Feb 2014
In reply to UKC Articles:

This is perfect, the injury prevention articles on the link to the blog are fantastic as well. Thankyou
rubben - on 13 Feb 2014
In reply to Trouble:

Hi Jen,

Sorry for incorrect credit - it has been changed now - great photo!
Robin
rubben - on 13 Feb 2014
In reply to John Kettle:

Hi John,

Many thanks for the kind words. I have emailed Nina to check on this and she will make a response over the next couple of days.
As far as I am aware, no sport specific research has been completed (for climbing). I believe in weight training a journal was produced looking into this matter. If you google "Journal of Strength and Conditioning Research, 2005, 19(1), 202–205 q 2005 National Strength & Conditioning Association" you should be able to read the findings.

Would be a good research module for any PhD students out there though.

Cheers,

Robin
rubben - on 13 Feb 2014
In reply to Jon Stewart:

Hi Jon,

We will be releasing articles on these subjects over the next few weeks, so if you've got those niggles, you will be able to have your answers soon. If you need help before then, contact Nina.

Thanks,

Robin
ninaleonfellner - on 15 Feb 2014
In reply to John Kettle:

Hi John

Thanks for bringing this up. I use the term “antagonist training” broadly to describe pressing and lifting. However, we press and occasionally lift when we climb, so technically pressing and lifting exercises are also climbing, body weight exercises. It is just that we pull more, especially if we boulder and sport climb indoors. It is important that I make that clear.

I did a quick search and found an article in JOSPT that tested the strength of extensors (pulling muscles) and flexors (pressing/lifting muscles) in sport climbers vs non climbers. The article states the obvious that the climbers were stronger than non climbers, however, they did mention that the extensors were significantly stronger than the flexor groups amongst the climbers, which would be expected from climbing as it is extensor (pulling) dominant sport. They do not correlate this with injury or injury prevention. I could not find research that supports doing antagonist training to prevent injury. I will keep looking however, and I will look amongst the gymnastic population, as rock climbing is quite similar and many regards to this form of sport. Perhaps I need to research this myself...!

It is reasonable, however, to hypothesize that working the climbing “antagonists” (pressing and lifting muscles) can help prevent some repetitive strain climbing injuries by working shoulder stability, avoiding the “Quasimodo like” climbing posture you occasionally see (hollow chested, rounded upper back and internally rotated shoulders), as well as, help lengthen wrist and finger flexors after a climbing session.

Pressing exercises preformed in a closed kinetic way (hand/hands fixed to the floor or piece of equipment with the body moving around the fixed hand and wrist) is an excellent way to train shoulder strength and stability (the ability of the shoulder and elbow joint muscles to compress and hold from all directions their associated joints, and keeps them centered, or well aligned). This is obviously a good strength to have to ensure the joint and tendons are robust.

The “Quasimodo” as I call it, climbing posture, is not due to tight pecs, as some may think. This is due to underdeveloped pecs and front shoulder muscles. Climbers often have over developed, muscly lats and back muscles. This posture is apparent when the front muscles are undertrained.

A lot of pressing/lifting exercises like press ups and hand stands involve a flat hand on the floor, which places the much used climbing flexors on stretch. Kill two birds with one stone..... Sometimes people who don’t start pressing early enough in their climbing career will be too tight to do this....

To oppose all the pulling you do in a session is not necessary, as long as you do something. Some pressing and lifting will be better then none, and going until you are tired, or can’t do anymore can be even better. Hopefully this will also make the keen climber exhausted and more sore the next day, so it convinces them to rest a bit more!! I feel juniors these days, as well as the climbing wall climbers, climb too much! And as I said before, you actually press and lift a little bit when you climb anyway, just not as much as the pulling. So, you don’t actually have to do the same volume of pressing and lifting as pulling after every session. My point is to do some sort of opposition exercises to equalize forces applied to your soft tissues.
John Kettle - on 15 Feb 2014
In reply to ninaphysiotherapist:

Cool. Thanks for the replies Nina and Robin, comprehensive answers that definitely helps clarify things for me.
John
Elefan - on 16 Feb 2014
In reply to ninaphysiotherapist:

I wish there was a way to 'favourite' your reply, Nina!

Couldn't agree more about the juniors climbing too much,..and sometimes being pushed too much by people who should know better!

Nice work Robin and Nina!
Burnsie - on 16 Feb 2014
In reply to ninaphysiotherapist:

Great article. Your article hints at one thing I've been pondering over abit recently.

Is it better to finish endurance based training (roped laps, 4x4 etc) with good form or push on till failure ? The reason I ask is that if you push on till failure then it's most likely to be "elbows out" aka chicken wings.

Most other rep type exercises outside of climbing promote form over reps, with injury prevention in mind. Do you think high volumes of endurance training contribute to shoulder / elbow problems or is this only likely to cause an issue in those with poor posture /imbalances ?

ads.ukclimbing.com
hamsforlegs - on 17 Feb 2014
In reply to ninaphysiotherapist:

Wow. That's a proper reply!

Great stuff...
nick bamber - on 17 Feb 2014
In reply to UKC Articles:

A little bit of anecdotal advice, I recently stopped training my antagonists about 4 weeks ago due to the time commitment involved, yet still trained 4-5 days a week mostly on a steep board. Needless to say I blew my shoulder 1 week ago today, unable to sleep and in the worst pain I've experienced in my life, I deposited myself in the urgent care center in Blackburn. Not sleeping for 3 nights, 2 days unpaid off work and in agony for several days is not fun. Train antags, even if it feels like it does nothing because it is. Lesson learned, I was lucky, I suspect it was a sprain after emailing Nina and I can only praise the advice she gave as the suspected diagnosis was the most accurate given the information.
Note to self-Train antagonists!
LukaszWarzecha - on 24 Feb 2014
In reply to UKC Articles:

I've got to admit, I haven't read the article... Everyone seems to be so positive about it in the comments... Great!
I had a good look through the pictures and I thought I could offer an alternative view...
On a visual level this is probably the most dreadful and uninviting piece I have seen on the internet and by a country mile!
It can't be that hard...
rubben - on 24 Feb 2014
In reply to LukaszWarzecha:

Duly noted Lucasz. In the future perhaps we will approach a professional photographer. In this case, the emphasis is obviously on the information and text, but enhancing the visuals would only benefit it.
Thanks for your feedback.
NottsRich on 24 Feb 2014
In reply to nick bamber:

What sort of antagonistic exercises would you recommend?
NottsRich on 24 Feb 2014
In reply to ninaphysiotherapist:

Informative article, thanks. Is it worth doing the exercises in the article as a preventative measure, or are they only recommended if you have a shoulder impingement?
rubben - on 26 Feb 2014
In reply to NottsRich:

Hi Rich,
For me, I add them to my strength and conditioning sessions (3 times per week).
The above are good to continuously do throughout the year, even if you are not injured.
Flat, incline and decline press-ups; shoulder presses (with weight if you are happy with this), straight arm lifts, side arm lifts (again with weights or Thera-bands), bent over rows, one arm rows, bicep and tricep curls/extensions...

I also add work on legs as they are often over-looked. Squats, lunges, calf-raises.
My focus for much of this is 12-20 reps (endurance and conditioning), but often look at increasing intensity before strength and power phases - hypertrophy stuff.

If you want more information on this, ping me an email: coaching@robinolearycoaching.com

Mitch UPT - on 02 Mar 2014
In reply to UKC Articles:

Hello,
I'm a Physical Therapist in Seattle Washington in the US. I just did an independent study
on shoulder injury in rock climbers. I applied a movement screen to 10 climbers with and without shoulder pain and used the data to create an exercise program to prevent and manage shoulder pain in climbers. It's all on my website. If you liked
this article you will like what I have to say on this page:
http://www.unionpt.com/community/theclimbersproject
Best,
Mitch

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