2 September 2016
I don’t get much time to run climbing coaching sessions these days but I have just put up details of sessions I am running at my own wall in early December and over the Fort William Mountain Festival in February. These always sell out so if you are keen, do ring and book your place.
In the past I’ve tended to run either full day coaching sessions for one individual or shorter group sessions. This time I’ve decided to try out a new format of full day group sessions/seminars. This way, there will be time for two climbing sessions in the day focused on particular elements of technique, training practice and additional exercises, as well as informal lecture/discussions over lunch and after the second climbing session to cover principles and practicalities of planning and customising your training as well as preventing and managing injuries.
I’ll be running two separate one-day sessions on the weekend of December 3rd and 4th. 10am-5pm at my wall in Roy Bridge. Spaces will be limited to 6 climbers per day, £120 per person and climbers of all abilities are welcome. My wall is well suited to running sessions of this type folk operating at recreational grades right through to as strong as you like beasts!
I’ll also be running another one day seminar on Feb 19th 2017, over the Fort William Mountain Festival, as well as more traditional three-hour technique masterclasses on Feb 18th (£60 per person for these).
Full details and contacts to book a place are up on my events page here. See you there!
10 March 2016
A few shots of my own training over the past few days
I built a large climbing wall at my house a year and a half ago, not just for myself, but with the intention of running climbing coaching sessions there. I knew it would be great to have a dedicated climbing facility that I’d set up myself, without some of the limitations of big climbing centres. Last week, as part of the Fort William Mountain Festival, I ran my first few classes - three hour masterclass sessions with groups of climbers travelling from as far as Belgium to join us.
I hadn't run clinics earlier as I spent some of last year recovering from surgery and then just wanted to go climbing! So it was really interesting to be assessing and observing climbers again after a break for a while and gave me a chance to reflect on what patterns these sessions reveal about climbers and what holds them back or propels them into improvement. Here are three themes that filled my mind after the sessions.
1. The ability to try hard still trumps everything
As usual I met some climbers with good technique, some with strong fingers and some with good tactical awareness. But out of all the climbers on my sessions, I met very few who had trained themselves in how to try hard. And so they were not improving nearly as fast as they could be, even when they had already made other good training decisions. You can design a great training programme, show up and complete every session and immerse yourself in climbing tactics, but if you don’t know how to really try, where is the stimulus to yield improvements from that training?
I think I was especially aware of this because we were in my own wall, where I normally train, uninhibited by anything. Some of the climbers I coached clearly had significantly stronger fingers than me, but I sensed that they did not habitually fight to the death on a routine basis.
To gain strength, the body really needs to be pushed into it, especially if you are not that young any more. In my mind, a big overarching weakness of many, if not most climbers is simply the ability to get really determined to get to that next hold and hold onto it. Often when you put this point to climbers, they are confused, even a little unhappy about the suggestion they could be trying harder. But think of this applied to other core skills of climbing - Of course it ‘feels’ like you are trying as hard as you can, just as easy routes feel at your limit when you are unfit or sequences are at the technical limit of climbers who are not immersed in climbing day in day out. This does not mean this limit is fixed. The ability to focus physical and mental energy is trainable just as other skills are. The limit is not fixed.
It is not just about delivering physical effort either. It is also the ability to make every single climbing session an immersion in deep concentration anticipating and then analysing each effort on each route, and comparing technical strategies for the moves with that of your climbing partners. Way too many climbers are resting their minds as well as their muscles in between efforts.
If you start off by training your ability to focus and deliver a huge mental and physical effort during your climbing/training time, the rate of improvement rises. This helps to explain why two climbers who both climb the same number of routes per week at the same climbing wall improve at very different rates.
A final point on this - often I find that it doesn’t always work for me to make this point about trying harder. Climbers sometimes consider me, as a professional climber and coach, to be somehow ‘a different animal’ and not subject to quite the same constraints. However, the great thing about group coaching sessions on a bouldering wall is that over the course of the session, as we work on problems, me offering technical pointers of the fine details of the movement that get you closer to succeeding on each move, climbers in the group start to rub off on each other and lose their inhibitions to try harder than they otherwise would. They see the others doing so as desire to solve the boulder problem overtakes physical and mental inhibitions. They concentrate deeper and pull harder and often pull off some moves that seemed far off, an hour previously. Even if they don’t, I always hope that climbers can see this happening among the group and understand that real concentration and real grit is the basis for training that works.
Lesson? Boulder more, do it in groups of the keenest people you can find, and get into the habit of systematically offering each other feedback on moves and encouragement at every turn. Training is only training if you are really trying both physically and mentally.
2. Time remains a key currency of improvement
A big proportion of climbers are still seriously constrained by time to climb and train, and just as important, constrained time to rest and recover properly from the training they do get. Some only have time for one or two sessions per week. Others have time for four or five, but only get the results of two sessions, simply because they don’t have time to sleep, eat and rest well enough to get good results from their training.
I hope that running coaching sessions at my own wall would spark people’s imaginations about what fantastic training facilities you can make in a small space. My wall is about as badass as they come for home walls and it took a fair few years of prudent financial decisions to get there. But I remind folk that my last wall was in a small room and was still amazing, and the one before that was a single campus rung. The single campus rung got me up the world’s first E11 and from 8b to 9a in 18 months.
When time is constrained, convenience is the king of training variables. Many of the climbers told me familiar stories of living just minutes from a big climbing centre, but how it was difficult to get themselves to it in the 90 minutes or so they had to spare after a tiring days work that hits you after you put the kids to bed. I have two responses to this problem. First, a home facility, no matter how small, removes the ‘getting myself out of the door’ barrier to completing the training. Second, remember that when you feel tired later in the evening, it’s because your body’s metabolism is slowing down. You can usually reverse this feeling after a ten minute warm-up and feel just fine again. Moreover, creating a late evening ‘second wind’ like this doesn’t necessarily interfere with your sleep. In fact, the physical activity and mental wellbeing that goes along with it can often improve it.
I noticed that the proportion of fingerboard-owing climbers seems to have risen since I started coaching ten years ago. However, the proportion of those actually using them has not risen nearly as much. This is a rather basic problem for which I offer some solutions in my book 9 out of 10 climbers. Underlying these is a principle that relying on using willpower to make yourself train if you don’t enjoy it tends to be unsuccessful for most. Instead, you change the environment or routine, to make it take willpower NOT to train instead.
Putting your fingerboard in the highest use area of your house, so it’s where you always are, and highly visible is one way. Another is to use social pressure to your advantage. Ever noticed that your house is at it’s cleanest and tidiest when you have friends, or the landlord coming round to visit? You can capitalise on this social pressure in your training too. Invite your training partner round to share a fingerboard session two or three nights every week. You are less likely to skip it when you know they are coming. Got a TV programme or radio programme you never miss? Combine them with the fingerboard routine. It removes the boredom and makes it part of your week’s enjoyment. Digital tech these days makes this easier than ever.
There are countless other ways to tilt the behavioural environment to make it easier to complete your training, and harder to miss it. Use your imagination for your own routine, or get a coach to tell you straight.
3. Protect your hard earned gains better
It seems to me that the improvements in climbing walls could be widening the gap between the extremes of the bell curve of ability across climbers. Some of the climbers on my classes were in pretty poor physical shape, despite having a lot going for them in other aspects of the whole performance picture. Again, busy schedules are often the underlying theme responsible for this. But simply being aware of it can help you to mitigate it. A basic principle of training is reversibility. I discuss its implications in 9 out of 10 but I think it bears reinforcing as I still think climbers undervalue its effects.
Many climbers have lost periods of weeks or months of little or no training for a few common reasons - work/accommodation/family transitions, injury or simply focusing on something that makes you weak such as trad or alpine climbing. Now, some loss of base level strength and fitness may be unavoidable due to these things. But that doesn’t mean you should completely abandon any attempt to mitigate them. Yet that is exactly what many, if not most climbers do.
The result is that so much form is lost and it takes months to return to where you left off, if indeed you ever can. I have made this mistake myself several times. With hindsight I can see that 1 year without a board while I moved house and saved to construct my new board caused my level to drop to 8c. I was still out climbing just as much, but I just didn’t train. And so I lost strength, capacity to handle training and agility. Only now do I feel like I’m getting it back, 18 months later. Similarly, while recovering from surgery last year, although I trained harder than ever and emerged with stronger fingers after three months off my feet, I still lost some agility and base level of fitness. I could have mitigated much of this by incorporating more basic body strength and fitness exercises into my routine. You don’t need to make the same mistakes as me.
Of course, this problem doesn’t always apply - keep in mind your individual weaknesses. Wall rats who can be found in the climbing wall training hard 5 nights a week are often pretty strong and fit, but their climbing ability on rock will never match this because they lack the hard-to-measure tactical skills of being a rock climber. So far weaker souls who get to the crag more often will still out climb them.
Lesson? Life throws up things that interrupt your training. If you don’t plan for this, you’ll lose out. The time to really organise your training is not so much when you have lots of time, but when you have less. Don’t make the mistake of doing nothing, when you can only do a little. If you do, you’ll spend all the ‘good times’ just catching up to where you were, rather than breaking new ground.
So there are some highlights of themes I noticed that applied to a good swathe of the climbers who visited my wall for coaching. Of course there were many more - frighteningly common footwork errors, training errors, poor diet choices, psychological approaches and many more. If you are reading this thinking you’d like to get some coaching yourself, stay tuned to this blog as I’ll post up some dates I’ll be running more classes during the year shortly.
2 March 2016
Some new shapes ready to go on my wall ahead of my first masterclasses at my place last week!
I am seriously obsessive about holds, as any route-setter should be. Although you end up setting with a lot of holds you either don’t like that much or equivocal about, it’s always a pleasure both to set and to climb on holds you do. As I gradually gather holds for my own wall, it is slowly becoming a collection of rather fine holds I’ve seen in other walls or tried out.
On the whole, climbing holds have improved massively and the industry is full of innovation. Despite this, I’m often still a fan of some old hold designs, especially when training for real rock - where an old school approach of fingery moves yields good results from training, at least for weaklings like myself.
Which brings me to Stonesmith holds. I already have many of their holds on my wall at home and are some of my favourite shapes. As well as the nu-school innovative shapes, their training range also includes some very carefully designed shapes more designed for training which I love. It’s really an ideal mix - nice texture, a careful design that is nice to train on for long hours, but also nice and fingery.
The differences between different manufacturers holds are obviously tricky to describe in words - they sit on a continuum of niceness to climb and set with and ideal texture. Stonesmith holds sit as far at one end (the good end!) as any I’ve tried. I’m glad to hear I’ll have the chance to set with more of them in the new Three Wise Monkeys climbing centre in Fort William next month.
If you’ve got a wall, get some. I'm actually just off to order a set of their suspension training balls from their site just now. I've been meaning to get these for my poor weak thumbs for ages and wring this has galvanised me!
Posted by Dave MacLeod
5 January 2016
Basic Ice Climbing Technique from Ellis Brigham on Vimeo.
Here is a short video I made for Ellis Brigham and my sponsors Gore-Tex and Mountain Equipment with my thoughts on basic movement technique for ice climbing and also using an indoor ice wall for training for ice climbing.
If you are like me, waiting for winter conditions to start shaping up in Scotland, you’ll no doubt be training like a demon and feeling fit. You need to be a little inventive to get the most out of indoor walls for training for ice and mixed. But it you go beyond just doing a few short top ropes and get a bit more systematic about using your time on the wall, you can do a lot to prepare yourself for the hard leads ahead when the forecast turns cold.
If you’ve not been training - it’s never too late to start!
Thanks to the staff at Ellis Brigham in Manchester for helping us have a good time shooting this video.
26 November 2015
Since publishing my climbing injuries book Make or Break earlier this year, this is the first important paper released into the scientific field during the year which has really caught my attention. Co-authored by professor Jill Cook (one of the tendon pain research big guns worldwide), it reinforces the idea I put across in Make or Break that looking at tendon injuries simply as ‘overuse’ injuries may at best blinker us to other important causes, and at worse be plain wrong.
In this review, Cook explores the possibility that your cholesterol profile could possibly cause tendon pain. The evidence available shows association, not causation. Nevertheless, we shouldn’t ignore the data. Not only is it known that cholesterol accumulates in tendons, that people with the disease ‘familial hypercholesterolemia’ have much more tendon pain, but several studies show that various cholesterol parameters are associated with tendon pain.
Influences such as this, if causation could be ultimately demonstrated, help to explain the apparently unpredictable individual variability in tendon injury, if you are looking at the problem solely as a result of training errors.
So if we can’t ignore the data, we get to what we should do to improve our cholesterol profile. The paper points out that increased tendon pain is associated with the same cholesterol profile as cardiovascular disease, namely a lack of HDL cholesterol and an excess of LDL and blood triglycerides. Unfortunately, the world of medicine and public health is in a big fat mess when in comes to providing evidence based recommendations for how to improve our cholesterol profile.
If you want to learn just how messed up the situation is, read Nina’s book. Apart from teaching you a few seriously important lessons about trusting both science and government, it might even save your life if it turns out to be right. No joke.
Unfortunately the low fat, high carbohydrate diet (as well as the problem of the oils used in processed foods) that sportspeople are still widely recommended to eat may well cause just the bad cholesterol profile we are talking about (low HDL, high LDL, high triglycerides). Diet is not the only input of course.
My personal hunch is that this line of enquiry will continue to yield evidence we should listen to. At a basic level, the idea that human tissue is unbelievably plastic, responding to training with precisely regulated growth and maintenance responses could go so frequently awry simply by doing some training does not add up. It seems likely to me that there are some things missing from the picture. This could be one of those things.
I would urge anyone serious about their tendon health, their sport performance and their long term health to go right back to basics when it comes to diet and nutrition. It’s fair to say that the whole world of nutrition and health has been blown to bits in the past five years, and pieces are still falling back to earth. Meanwhile, some of the medical world and much of the public have yet to notice. And many vested interests are desperately trying to keep it that way. Personally, I have finally wriggled free from the paradigms I learned in University about sports nutrition and stand in a confused state of optimism mixed with distrust and scepticism. The problem is, we can't wait for better evidence - I have to eat something, in two hours time! So what to eat? I’m cautious about publishing my observations on my own diet and performance just yet. I will do when I feel a bit more comfortable and educated about what the hell is going on. But, I will tell you that I feel like I’m on an exciting journey!
2 June 2015
On the crux of Fight the Feeling 9a in Glen Nevis. For a long time I thought I was just not good enough to do this route. In the end, that thought didn’t matter. Photo: Lukasz Warzecha
A lot of folk ask me at my climbing talks about my mental tactics for climbing. They ask both about how I have been able to be confident, composed and tenacious on hard routes especially when they are badly protected. And they also ask about how I have been able to stay committed to progressing my climbing through setbacks of the hard routes I have attempted, or through injuries I’ve had in training or from accidents.
In the past I have struggled to give a good succinct answer, because it’s not something I find I have to give much conscious effort. It feels like it comes naturally. However, I have come to the conclusion that this does not mean that this ability is something inherent to me. I now think that I have, by accident, adopted an effective approach. It is not a positive thinking approach.
It’s a big subject and one I will explore in more detail on this blog in future. But for now I will try and summarise it.
The cult of positive thinking, both in society and in sports psychology, is looking increasingly like it may be among several major diversions from the path of progress of sport and health in recent decades. As a short term strategy, it can have some transient worthwhile effects. Unfortunately, the longer term effects of relying on positive thinking as a mental strategy seem to go the opposite way.
In my own climbing, I have often heard climbing partners, friends or even folk interviewing me express surprise at how ‘negative’ I sound about my chances of success on a project, or how my preparation is going. They worry that I am talking myself into failure by not thinking positively. I even attended a course (not by choice!) where the tutor taught us to rigorously identify and eliminate any negatives from our discourse about our activities. He wanted me to eliminate even the mention of falling. This struck me as ridiculous!
I do think it is possible to talk yourself into failure and have seen it done many times by climbers capable of the climbs they feel have beaten them. However, it does not follow that positive thinking is the solution!
The positive thinking paradigm, in summary, suggests that by using positive visualisation, we create an image that we are more likely to live up to in the real event. Unfortunately the research shows this approach is ineffective. Positive thinking appears to reduce motivation and self discipline. Moreover, it tends to kill the critical thinking that underpins learning of complex skills. A practical example of this is when coaching climbers to overcome fear of the most basic form of climbing fall - falling onto mats at an indoor bouldering wall. Unless you also consider what a badly executed fall looks like, how can you even visualise ‘good’ falling and landing technique. If positive thinking allows you to believe the fall will be fine when you jump for the last hold, the fall, should you miss, is that much more undermining for the confidence since you did not expect it.
In my own preparation for climbing situations of all types, I have found that I take care to examine the negative outcomes as well as the positive. I look for the problems and the weaknesses. But all this focus on the negative does not mean that I think or talk myself into failure. Quite the opposite. I deal with the problems at the time when they should be dealt with - in the preparation stage.
In this way, when I tie in at the foot of the climb, I know there will be no surprises, no confronting fears or unexpected doubts once I start climbing. All that is left is the effort. I find that the moment I step off the ground, I feel completely free to give my best effort without distraction or hesitation and in full acceptance of both good and bad scenarios should I succeed or fail on my effort. Not all performances are so cut and dry and ideal like this. I’ve succeeded on plenty of hard routes where I felt unfit, unprepared and totally gripped. I climbed them fully aware of the low probability of success and felt very pessimistic throughout. It made no difference. I had decided to try just as hard regardless of how I felt about my situation.
It is odd that the notion of focusing on your weaknesses is uncontroversial for physical training, and yet avoided in mental training in favour of positive thinking.
The funny thing is, I find that this ‘negative’ thinking is in fact the default approach for lots of people. Moreover, people often find that when they consciously try to think positively, it feels hollow. Try standing in front of the mirror and saying “I can climb 9a” out loud. Feel any closer to that goal? So if people naturally default to the right path of looking at the problems, why isn’t it working and why have people been searching for a different solution?
I find that many climbers I’ve coached go wrong at the stage right after thinking about the problems. They visualise the negative scenarios, the weaknesses they have, or their fears. But at this point they fail to move on to the next stage: taking action to eliminate/mitigate them. They keep their focus on the constraints pushing on them, rather than what they can do to alter those constraints. In the midst of this mental cul de sac, positive thinking becomes attractive as it allows you to bypass the hard bit of training - behavioural change and effort to address, rather than block out problems or weaknesses.
Another way to look at my point in this post is not that positive thinking is right or wrong, just that it is not really necessary, not that important. Any successes you have on the cliff are a direct product of your motivation for the climb and preparation put in. The perfect preparation would be to focus on all the potential causes of failure right up to the moment the success comes.
To me, this is why you see climbers explode in a whoop of delight when they grab the finishing jug. Until this moment, there are still mistakes to be corrected, weaknesses to be eliminated, self-discipline to be executed. Forced reminders to believe you can do it are just a distraction. Of course you can do it, if you meet the demands of the task. But surely you are going to need all of your focus on meeting those tasks to make sure you maximise the probability.
Sure, a determined mindset can make a huge difference in the moment of a crux move, or last move of a hard climb. But whether that mindset is positive or negative may not be the important thing. I find they are often just two sides of the same coin; “I want to get to the top on this attempt/I’m scared I’m going to fail on this attempt”. Both are really a distraction from the one thing that will actually make a difference: Focusing on what you can do right now and executing it.
In summary, If you have focused on the problems, and then moved on to addressing them with rigour, positive thinking is not necessary. A determined performance with 100% effort can exist just as easily in any state of mind, positive or otherwise. The key point is to give that effort regardless of your state of mind.
As an epilogue, here is a basic example of this thinking in action.
Thought example 1. (in training): “I’m not good enough, I’m going to fail.”
Positive thinking action: “You will succeed, you are strong and tough and you can do this.”
Critique: Note that if you really are good enough, strong, bold, tough etc then you are perfectly entitled to think that way. But the paradox is that you will have no need to, since you will not feel like you are going to fail in the first place. And if you discover that have unrealistic expectations of failure, then addressing whatever underlying problem you have, such as fear of success, is the way forward, rather than a forcing a few positive thoughts that don’t feel right. If the positive statement doesn’t match the reality, it only distracts you from the task in hand.
Realistic thinking action: “Do something about it before it’s too late - Get that climbing coaching, build that climbing board, get on that fingerboard every day, lose that stone of fat, practice and perfect that falling technique.”
Thought example 2. (at the last move of the redpoint): “I’m not good enough, I’m going to fail”
Positive thinking action: “You can do it, get the jug”
Critique: The thought offers no practical help. It merely starts an argument in your head at exactly the wrong moment!
Negative thinking action: “Be decisive, full commitment, pull down like hell on that crimp”
Posted by Dave MacLeod
Categories: mental training
26 May 2015
Many of you have emailed to let me know that you found Make or Break to be very useful for dealing with your climbing injuries. Thanks for sending those, it’s good to know the effort of writing it was worth it.
There are now a couple of reviews of the book around and below are a few comments from those and links to the full reviews. As ever, you can get the book in our shop here.
Neil Gresham, writing in Climb Magazine:
“...a modern bible for avoiding injuries...anyone who owns a pair of rock shoes owes it to themselves to get a copy...at last,there’s no longer an excuse for doing climbing and training wrong and getting hurt, now that this fantastic book exists.”
“No stone has been left unturned and advice is given on everything from supportive nutritional strategies to sleep positions, non-sporting injury contributors and so on. I particularly like the chapter on managing injuries from a psychological perspective. Again, this is delivered with empathy from someone who clearly understands how demoralising it can be to have your climbing goals dashed on the rocks. But the most revealing section is surely the one on proprioception and correction of technique. I can’t think of many climbers who won’t need to take a rain check after reading this.”
The full review was in Climb Magazine issue 122 (May 2015)
Duncan Critchley, Physiotherapist, lecturer and pain researcher, Kings College London, writing for UKbouldering.com
“This is the best book on climbing injuries by a large margin. The section on tendon injuries is one of the best I've read anywhere, clearly presenting what we know and don't know. It suggests specific treatment ideas but is happy to acknowledge when we don't know the best treatments or why treatments work. Many medical practitioners would benefit from adopting this humility. Make or Break is well designed and attractively produced. It even has an index. At £30 it is exceptionally good value for a medical text-book.”
“Pain specialists know tissue damage is one factor of many contributing to pain and how we deal with pain. Mood, beliefs about pain and injury, health behaviours and social circumstances are important in determining who gets injured, which bit hurts and how much, and speed and extent of recovery. It is great to see the 'Know Pain' chapter start to acknowledge this, explaining how to interpret pain, and why pain is rarely an honest witness of damage. This is common knowledge in pain management but unusual to see it recognised so clearly in the world of sports and sports injuries.”
The full review is on UKB here.
There is also a review by Steve Crowe on Climbonline.co.uk here.
6 February 2015
For the past 4 years or so, I have been working on a book about climbing injuries. It spells out in detail how to treat them once you have them, based on the evidence from high quality scientific research and practice. More importantly, it discusses all the things we do in our climbing routine that cause our future injuries and prolong those we have already caused.
I have titled the book ‘Make or Break’. This is because becoming an expert in understanding the causes and treatments of climbing injuries will be make or break for your climbing career. As Wolfgang Gullich said, “getting strong is easy, getting strong without getting injured is hard”. In my first book, 9 out of 10 climbers make the same mistakes, I suggested that many aspects of training for climbing are not rocket science. Keep showing up, pulling on small holds, pushing the limits of your motivation and learning from others and you will get stronger fingers and get better at climbing.
It will be injuries that will get in the way of your progress, and if you let them, they will dictate how far you get in climbing. The research suggests that nearly all climbers get injured at some point. Finger injuries are most likely, followed by elbows and shoulders. Of course there are countless bits of our anatomy that can break if suitably mistreated. When you get one of these injuries, you need to be the expert, because unfortunately you cannot rely on anyone else to make sure you recover. This is not because doctors and therapists fail to do a good job (although they sometimes do). It is because there is no single source of advice on the vast array of things you must do to make sure you recover well and prevent future injuries. The climbing coaches, physiotherapists, otrhopaedic surgeons etc. that you will see will all give you pieces of the jigsaw puzzle, but it is you who must put them together.
Claire MacLeod dispatching our pre-orders the other night.
During the process of writing the book, I have discovered many pieces of hard scientific information and subtle concepts I wish I’d known when I was 16. They would have saved me so much of the pain and psychological torment of injuries that climbers everywhere share at some point in their career. There are many strands of information in the book. It is a handbook on how to take care of yourself as a lifelong climbing athlete. In this blog post, I will briefly outline three messages that will give you a flavour of what you will find in the book:
1. Tendons don’t like rest, or change.
1. Tendons don’t like rest, or change.
Surprisingly, sports medicine research still has a lot to learn about tendons and how they heal and respond to training. However, there have been several big steps forward in the research over the past decade or two. The only problem is, new knowledge in sports medicine takes years or even decades to filter through to the advice you receive. Consider the following quote:
“In general, it takes approximately 17 years to get 14% of research findings adopted into practice. Moreover, only 30–50% of patients receive recommended care, 20–30% receive care that is not needed or that is potentially harmful and 96% may receive care with the absence of evidence of effectiveness.”
I was shocked too when I read that. I was aware through my own experience that the advice I’d been given to recover from my own climbing injuries was often at odds with research I’d read. But to discover the extent of the lag between research findings and advice given to sportspeople is depressing. We only have one life and we cannot afford to receive outdated advice. Unfortunately, the internet hasn’t made the task of unearthing reliable advice any easier. Scientific journals remain hidden to most behind a paywall, while the same poor quality, outdated and non-specific advice drowns out the few reliable sources.
One of the shifts in understanding from the past decade is that slow-onset tendon injuries such as golfer’s elbow do not respond well to complete rest. In fact, it often makes the condition worse. Moreover, many of the adjunct treatments often offered - stretching, massage, ibuprofen may do little to contribute to healing, and only affect pain. Instead, the most promising treatment has been large volumes of exercise of a specific mode (eccentric) and at a level which causes some pain. Much of this seems counterintuitive at first sight, which is why a detailed understanding of what happens in injured tendons is so important.
Some practitioners in sports medicine are still working to a pre-1990s concept of tendon healing and will advise you to heal your injured tendons by resting them completely. In contrast, modern research has found that the best way to heal injured tendons is to use them, but only in a way that is specific to the nature of the injury. Tendons do not like rest or change. The successful formula is to provide constant stimulus to tendons to maintain their health. But if you want to change that stimulus, such as by training harder, you must do so very carefully, using all the cues from the body that you can listen to.
Section 1 of the book discusses in detail the limitations of the sports medicine industry and how to get the most out of it, and section 4 details the modern understanding of tendon injuries and how to successfully treat them.
2. Know pain, or no gain
Above I hinted at the difference between the pain level and the healing status of an injury - a crucial concept for any sportsperson to understand. Understanding of the nature of pain has been another area of science that has advanced hugely in sports medicine. It is not enough to be able to listen to your body. You need to be able to decode the messages and see the patterns in them. This is both a science and an art.
Climbers need to be able to differentiate between healthy soreness from training and activity, and damage that demands action. They need to be able to take understand how various treatments affect pain from their injuries and what this means for their daily decisions on how much activity to expose them to. They need to understand how many aspects of their environment and psychological state amplify or suppress pain sensations from their daily activities. Pain sensations are an essential measure for climbers to monitor, but without detailed knowledge of how it works, it is very easy to interpret those messages from pain wrongly.
Section 2 of the book is entirely devoted to understanding pain.
3. The luxury of doing sport badly will not last
A young body can withstand a surprising amount of abuse. But the relentlessness of sport and training amplifies the effect of small imbalances or errors, and it doesn’t take long before these accumulate to the point of injury. Balance is the key word here. One area of sports medicine that has come on a fair bit in recent years has been the recognition that athletes need to develop strength in a balanced way, taking care to strengthen muscles on both sides of joints. That is a good development, but it is not enough.
Balancing of the stress imposed by training for climbing needs to come in several other ways too. Matching increases in training intensity with improvements in the quality of rest is one way. Improving technique and the design of the training progression to spread that stress is another.
Sections 1, 3 and 4 deal with these concepts and the specific details that climbers should be aware of which commonly result in climbing injuries.
Repeated forceful internal rotation of the arm (the right arm on this move) is a big part of climbing. So it is no surprise that the internal rotators of the arm at the shoulder become dominant. You may well get years out of a healthy young shoulder without feeling a thing. But the resulting impingement syndrome affects so many climbers. If you'd rather prevent it, it's not hard to do a little work to keep the shoulder joint working well. And if you are already suffering, you may be able to reverse it quite quickly, unless you've really tried to ignore it for too long!
Maintaining awareness of the foot during hand movements is a core skill in climbing injury awareness. Slipping feet are a important cause of many finger and shoulder injuries. Do your feet slip too often? Do you know what to do when they do slip? Correct your climbing technique and you can push your body a lot harder before it starts to complain.
Finally, there is the psychological challenge of injuries which is hugely underestimated by both climbers and their friends and families. In sections 1 and 5 of the book, I present the idea that we should see the injuries we suffer as a crucial message that something must change in our way of approaching climbing. By seeing the injury as an opportunity to go back to basics, to understand what must change and make that change, we can not only improve our climbing, but enjoy the process rather than endure it.
I hope the book will help many climbers prevent their future injuries or overcome existing ones. You'll find the book in our shop here, dispatching worldwide.
19 January 2015
Readers of this blog will of course know that I have been working on a book on climbing injuries for some years. It has turned out to be a much bigger book than I originally envisaged. It has been a huge project, but in a few weeks I will reach the finish line. The book is currently with the printers and some time in the next few weeks, many boxes of copies will arrive at my house. The final stages were a rather exhausting process, but I’m excited to release it and potentially help healthy climbers stay healthy and injured climbers to get back to the fray.
I’ll write a more detailed post about the content of the book when the stock arrives in early February. If you want to make sure you get a copy as soon as you can, we’ve put it up for pre-order in the shop here, and it’ll be in the post to you as soon as it arrives. I’ve also added the table of contents below so you have an idea of the breadth of the areas covered.
My aim was to write the manual on how to stay healthy as a climbing athlete that I wished I’d had when I was 16. The first priority was to base my writing on the cutting edge of sports medicine research, wherever it was available. The second was to include all the diverse aspects of injury prevention and recovery, and then present them in a way that allows you to see them in the whole context of your efforts to stay injury free. As with the world of training, too many injury texts focus on or overplay the importance of just one aspect of sports medicine.
Having spent around 4 years researching, thinking and writing the book, I do feel that if I’d had access to the information contained in it when I was a teenager, my health and climbing achievements over the past 20 years would have been significantly better. I hope the book can make this difference both for both youngsters who have yet to experience injury, and battle scarred climbers like myself.
Below is the table of contents, so you can get idea of the scope of the book. You’ll find the book in the shop here.
Section 1: Make or break
Why the treatments you have tried aren’t working, and what to do about it.
How to use this book
The real reasons you are injured
Stress and injury
The reason you are still injured
The language problem
The practitioner problem
The sports medicine problem
The missing link
Exceptional use: the luxury of doing your sport badly
Your visit to the doctor’s
Section 2: Know pain, or no gain
Pain and how to read it
Seeing the patterns in your pain
What is healthy soreness?
Understanding your pain
Going beyond reading only pain
Section 3: Removing the causes of injury for prevention and treatment
Are you only treating symptoms?
What was the real cause?
The big four: technique, posture, activity, rest
How to rest
Warm-up and injury
Section 4: Rehabilitation of climbing injuries - treating both causes and symptoms
When to move beyond acute care
Goals of mid-late rehabilitation
Modern understanding of tendon injuries and recovery
Therapeutic activity - basic exercises
Therapeutic activity - climbing
Walking the line of rehab ups and downs
Drug and other emerging treatments
When to stop rehab?
Section 5: Psychology of injuries: dealing with the anguish of injury
Face it: it really is that bad!
Section 6: Young climbers
What young climbers should know
Too much, too young: a warning
What parents and coaches should do
Section 7: The elbow
Golfer’s and tennis elbow
Other elbow injuries
Section 8: The fingers
Different grips in climbing and consequences for injury
When and how to tape the fingers
Painful finger joints
Flexor unit strains
Other finger injuries
Section 9: The wrist
Triangular fibrocartilage injury
Carpal tunnel syndrome
De Quervain’s tenosynovitis
Other wrist injuries
Section 10: The shoulder
Shoulder impingement/rotator cuff tears
Biceps tendon insertion tears
Thoracic outlet syndrome
Shoulder and neck trigger points
Section 11: Lower body injuries
Foot pain in climbers
Heel pad bruising
Ankle injuries in climbers
Ankle impingement syndrome
Achilles tendon pain
Knee injuries in climbers
Anterior cruciate ligament tears
Medial collateral ligament tears
Section 12: Further reading
Further reading and references
Getting access to good care
The author’s tale of woe and hope
Glossary of key terms
15 January 2015
Over the years I’ve heard from a few climbers who suffer from hyperhidrosis (excessive sweating) of the hands. For obvious reasons, the condition is a major hindrance for rock climbing and causes much torment for sufferers who love the activity but are constantly hampered by severely sweaty hands.
I do not have the condition myself, but I definitely have more sweaty hands than average and I find that my indoor climbing performance has always lagged as much as a number grade behind my outdoor climbing grade. I cannot imagine how difficult it would be to deal with the condition as a climber, having dripping hands with the slightest exertion.
Hopefully, most sufferers will already know about iontophoresis, but in case not, I thought I should write this post.
I am grateful to Bob Farrell who got in touch last year to let me know that discovering the treatment had completely transformed his climbing. He went from a state of despair about how to enjoy rock climbing to being able to enjoy good friction and dry hands on small holds, both indoor and outside in warm weather.
The treatment involves passing a small electrical current, supplied by an iontophoresis machine through the hands, for 15-30 minutes or so. The hands (or feet) have to be placed in a water bath to apply the current. Despite its remarkable effectiveness, its mechanism of action is still unknown. But it blocks the sweat glands in some way, temporarily. Several treatments are required to see the benefits, and top-up treatments are needed every few days or weeks (with individual variability) to maintain the effects.
But those effects appear to essentially solve the problem for a great majority of sufferers. Although I have not tried the treatment myself, it sounds from Bob’s experience and the evidence from other non-climbing sufferers, that all affected climbers should definitely try it.
It is available, at least in some places on the NHS. But most sufferers who try the treatment and have good results seem to just purchase their own iontophoresis machine and do their top-up treatments at home. Machines cost £3-400 for a standard model.
There seem to be few side effects, although if you have cuts in your fingers from climbing, these will burn during the treatment, with the workaround of just excluding the cut finger from the iontophoresis bath during treatment
I hope this post provides some help to sufferers who have yet to hear of the treatment.
Posted by Dave MacLeod