/ Using a coach to help a shoulder injury

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SuperstarDJ - on 27 Jul 2014
Hi,

I've recently started suffering from an 'impinged shoulder'. I'm seeing a physio and he's working on it but he's also making noises about cortisone injections, shoulder surgery and 'lifestyle changes' which is a little worrying.

Has anyone used a climbing coach to change the way they climb in order to put less stress in the body? My thinking is that by using less power and by doing moves in a less dynamic and more controlled way, I can reduce the impact on my shoulder. Do you have any recommendations of coaches?

Any general injury advice also welcome. I climb mostly indoors 2-3 times a week.

Thanks,

David
Ally Smith on 27 Jul 2014
In reply to SuperstarDJ:

Find a physio who climbs and get them to point out technique issues?

Generally though, use of more body tension to keep your feet on and weighted will decrease load on fingers and shoulders and hence is the way forward for good sustainable technique.

Being less dynamic could be counter productive and you'll quote likely put more load, for longer through the shoulder. Fluid climbing using just ye right amount of momentum will be much better for your joints.

Dave Macleod wrote something along similar lines a few years back. Have a search of his blogs
John Kettle - on 27 Jul 2014
In reply to SuperstarDJ:

While changes to your technique may well reduce the strain on your shoulder, it's likely that fundamental changes to your posture and an increase in shoulder stability will make a greater difference, on and off the wall.
I'm saying this as a climber who's poor posture once lead to impingements, physio, cortisone injections and surgery to both shoulders. Now I climb harder than before, with no shoulder issues, largely due to postural changes made after surgery had repaired the existing damage.
As Ally says, climbing more statically will actually increase the load. Ask a recommended physio to make a biomechanical assessment of you, to find any postural/stability issues that may be the root cause of your problems.
In reply to SuperstarDJ:

> Hi,

> My thinking is that by using less power and by doing moves in a less dynamic and more controlled way, I can reduce the impact on my shoulder.

Whilst that is probably true, that will limit further damage to your shoulder, without particularly helping you overcome the original injury. To get over the injury, you need specific focussed work that you will get from physio but not from exercising/climbing. It is worth paying for a good physio in my book to get over injuries.
SuperstarDJ - on 27 Jul 2014
In reply to SuperstarDJ:

Thanks everyone.
chrisbaggy - on 27 Jul 2014
In reply to SuperstarDJ:

The most useful thing would be to find what movement in climbing is causing the impingement and causing the irritation I would guess internal rotation and pressing down assuming it is climbing that is causing the impingement and not other causes.

Avoiding the aggravating movement if possible would be the best, as well as ensuring that the surrounding muscles are functioning correctly especially the other rotator cuff muscles and ensuring that they are balanced.

Depending on how long you've had the impingement and symptoms for will have an effect on how long it takes to heal.

Chris

Morgan Woods - on 27 Jul 2014
In reply to SuperstarDJ:

I've had mine flare up twice in the last year. Both times my osteo has manipulated it and it's gone away. He basically said he a) didn't want me to stop climbing b) gave me a few simple exercises and c) didn't want to see me again. Two visits in a year is quite manageable and is probably mainly because I slacked off on the exercises. He can be skyped if you like:

http://www.drjuliansaunders.com/

and the site also has some good resources on shoulders:

http://www.drjuliansaunders.com/resources/feature_articles/shoulder_impingement/
Siderunner - on 30 Jul 2014
For me the long-term answer has been regular antagonist exercises and a slightly increased focus on regular stretching. I think it's kind of 3 stages of recovery to be honest:

1. Get to a point of pain free existence through no climbing and regular physio (ultrasound, massage, boring small exercises done 2-3x a day).

2. Physio specific exercises at greater loads. I do ones from the 3 physios I've seen over the last 10 or so years. There's a nice little article on UKC that includes several of them. Honestly I think you need a physio to show you as some of these are quite subtle. Start light climbing at low grades in parallel staying pain-free.

3. Changing the training regime to include a more balanced programme than simply climbing 3-5x a week. In particular I added regular antagonist strengthening, takes about 15-30mins:
- shoulder press (sitting down, dumbbell in each hand, press them out from shoulder level to overhead)
- press ups OR dumbbell bench press (improves stability more using free weight in each hand, can do one armed)
- front raises (standing up, light dumbbell in each hand hanging by your groin, raise arms straight in front of you with backs of hands to ceiling)
- side raises (as above but starting with weights by your side and raising straight arms until horizontal out to side)
- reverse wrist curls with very light weight (to reduce elbow issues)

If you're stuck at (1) I'm really not sure a coach is the answer. Perhaps an alternative physio? I could have sworn I would need surgery; but the phyio has always sorted me out in the end.

A coach makes a lot of sense at stage (3), especially if you are not doing regular antagonist training. Good article with exercises here: http://www.dpmclimbing.com/articles/view/one-workout-every-climber-should-do



Firestarter on 30 Jul 2014
In reply to Siderunner:

I've got the same problem (seeing a physio for first time tomorrow). How long did you not climb for in step 1? Had to happen over the summer!

Thanks!
Siderunner - on 04 Aug 2014
In reply to Firestarter:

About 6 months the first time, when I thought surgery was going to be the only option; but i didn't see a physio until about 4 months into that (I was too cheap & skeptical).

About 4 weeks the second and time round, when I caught it a lot earlier and saw a physio straight away (and didn't simply keep climbing through the mild niggles and post-climbing pain until the nasty pop on the crux of Peapod ...).

You're doing the right thing seeing a physio. Take the long view, do what they tell you, don't go back too soon, and you'll be a stronger and less injury-prone climber in the long run!
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Firestarter on 04 Aug 2014
In reply to Siderunner:

Had my first appointment 3 days ago (just stopped calling him a b*****d). More movement/freedom already. Thanks for your advice - I guess the days of taking a sip of man-up and cracking on are over (for me at least anyway).

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