19 April 2009

Hand manual by Dr 8a

Björn Alber, Md sports medicine MSc sports physiology, has answered injury questions in the forum for more than a year under the alias - Dr 8a. Björn has been climbing since 1981 after successful career in canoeing (Olympics 1980) sailing and triatlon.

Hand manual-Taking care of your hands    

Part I- getting strong

Foot placement, balance, mental strength and much more is required to rock climb well but without good hand function you will not climb at all. So it makes sense to take good care of your hands. This manual has been compiled using  established medical and physiological principles and applying them to the most common types of problems and injuries that has been discussed on the Dr8a forum

Most of the gripping power comes from the muscles originating on the inside of the elbow (flexors) however the grip would not be effective if the counterbalancing muscles on the outside of the elbow ( extensors) were weak. The thumbs special flexibility demands that in addition to flexor and extensor muscles there are some abductor and abductor muscles (lateral movement of the thumb.

All these muscles need to be strong in several ways

  1. maximal static gripping power – statically hold a grip under high load
  2. maximal dynamic gripping power– catch and hold a grip under high load
  3. endurance gripping power – working high load grip for extended periods of time
  4. Lactic acid tolerance-ability to dispose of  performance deteriorating waste products that form when the muscle is working close to maximal power in order to keep the gripping  power high

All these demands have to be met in your training regiment but even more important your hands/fingers have to be injury free.- no matter how strong you are, with injured fingers you will not be climbing well or in the worst case scenario not at all.

Finding training tips for hand fingers climbing strength is not hard but to find reliable and effective information is harder . As in all sports the utilized muscles has to be maximally stimulated then feed and rested properly. In scientific strength training theory all agree that you can not maximally stimulate a muscle more than one intensive bout every 48-90 hours! If you do not feed the muscle properly within 20 minutes after the bout the adaptive (training) effect will be less than maximal

The exercise has to be as specific (climb simulating) as possible. The HIT-strip training method developed by Eric Hoerst certainly comes close. Here you repeat exactly the same grip formation 6-12  times on an 45 degrees overhanging wall. The publications by Erc.J.Hoerst; Training for climbing & Climbing 5:12 are highly recommended.

Take care to strengthen your extensor specifically – one method is to roll a rope with a weight suspended from it up a piece of broomstick. Don't forget to hit your pronation and supination muscles to (under resistance turns the palm down and up respectively

Use negative (breaking force  = ex-centric force) when training to overcompensate (increase strength and structural stability) This means that you should put extra emphasis on slowing down the lowering of the weight. This is easily applied when weight training But applying it to grip training is harder. One way when campusing or using HIT strips is to slowly open the grip under pressure before taking the load on the other hand. For the hand flexors you can supplement climbing with standing barbell rolls (See pict 3) and be extra slow when extending the fingers. The excentric training is not only efficient for increasing strength it also the most effective way to reduce injury and to rehabilitate an already injured structure

Hand manual-Taking care of your hands 

 

Part II – avoiding, and recuperating from,  injury

When it comes to keeping yourself from injury or recuperating from an injury your strategy will be very different from when training to increase power and capacity.

Hand/finger injury will come from

1, high demands on unstretched and inadequately warmed up tissues

2. Inadequate rest

3. Inadequate food

4. Increasing workload/demands to rapidly

5. Slipping/falling out of a high power grip

The structures that can be hurt are

Muscles (strains – tears – ruptures in increasing level of severity) – they hurt like hell becoming more inflamed and thus hurting more after hours to days and will take anything from 4-5 week to years to fully heal

In the acute phase - ice the injury down to prevent selling/bleeding and reducing pain.

Already the second day switch to warming and carefully stretching the structure involved- when healing is  obvious start to slowly increase the loading of the structure.. The muscles are well circulated with blood so healing is efficient. An anti inflammatory drug will help the healing and keep down the pain level.

Tendons ,tendon sheaths and ligaments (strains – tears – ruptures in increasing level of severity) Characteristically the pain and loss of function is immediate

Pulling a tendon is not that common considering the amount of strain climbers put on their hands. Most commonly the tendons will breaks free of their insertion on the bone (avulsion).. Far more common is to break the  ligaments. Hurting the cruciate ligaments that is holding the flexor tendons close to the bones of the fingers (bowstring injury)  is something most elite climbers will suffer sometime.

In the acute phase ice the injury down to prevent selling/bleeding and reducing pain.

Already the second day switch to warming , after at least a week begin to  carefully stretch the structure involved. Get circulation working by squeezing a foam ball – a couple of minutes a time at least 5-6 times per day  Try to use a ball that is supplied with rubber bands to resist when extending the fingers – this will increase the efficiency of the healing process You can also try increasing circulation by cooling the hand/forearm in 10-15 minute session – this will  force the compensating circulation to increase thus speeding up healing..When healing is  obvious start to slowly increase the loading of the structure.

 An anti inflammatory drug will help the healing and keep down the pain level.

Bones and cartilage (dents-sprains-fractures) Unless subjected to a fall and getting the fingers(hand caught in a hold or likewise these injuries are uncommon but especially dents in cartilage can be achieved by repeatedly subjecting the joint to the same stress (eg a hard and awkward mantling move). Bones will heal in time but for 6-12 weeks the must not be subjected to higher loads. Cartilage will recover if not torn/trashed by excessive force. The principles of healing outlined above applies here as well

In principle to heal well and fast you will be using lower load, higher repetition and concentrate on the excentric phase.

So

Strength train all your gripping muscles in all conceive able ways but do it progressively

Periodize your training and include excentric components in your training

Rest and eat sufficiently

Warm up and stretch your hands /fingers carefully before each training/climbing session – the foam ball is my favorite warm up tool prior to getting on the wall

Back down immediately when you have signs of injury- feeling better- switch to vertical wall technique training on large handholds.

Have patience in recovery and your complete healing will be faster and more secure

If injured – take a look at the Dr8a forum to give you some clue as to what is going on in your body but then -take the time, effort and money to let a medical professional diagnose and give you advise - this will get you back on the rock quicker

Good climbing

Björn Alber

Md sports medicine MSc sports physiology

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