EP 8: Discussing Elbows with Dr Tyler Nelson

As clinician we see a lot of climbers with shoulder complaints, both on the recreational and elite level. Together with renowned physiotherapist Paul Houghoghi - aka The Climbing Physio - we explore the rise of shoulder complaints and injuries in climbing and how we go about trying to both prevent and rehabilitate them. It was a very interesting discussion, where we all could get our geeks on as we talked about different types of shoulder injuries, sport specific rehab and the different factors affecting Return To Sport.  For more information about us, you can find us on Instagram and our websites:James: @sheffieldclimbingclinic / www.sheffieldclimbingclinic.comStian: @stianchristophersen / https://www.klatrebibelen.com/stian-christophersenFeel free to drop us a message with questions or subjects you would like us to address, and if you like what we’re doing, please support us at patreon.com/ClimbingInjuryPodcast

In episode 4 of The Climbing Injury Podcast we discussed different conditions concerning the elbow which you might encounter as a climber. In this episode we brought on board Dr Tyler Nelson, a climber, chiropractor and S&C coach from USA, to dive even deeper into elbow issues and climbing. Tyler is a well known figure from social media, where he runs the platform C4HP. His instagram and YouTube channel are great resources for both climbers and health care professionals working with climbers, and it was an absolute pleasure having him in the show. You can hear more from Tyler here:Instagram: @c4hpYouTube: https://www.youtube.com/@c4hp.You can pre-order Stian's new book on climbing injuries here: https://www.adventurebooks.com/products/the-climbing-bible-managing-injuries?variant=47753220489421 For more information about us, you can find us on Instagram and our websites:James: @sheffieldclimbingclinic / www.sheffieldclimbingclinic.comStian: @stianchristophersen / https://www.klatrebibelen.com/stian-christophersenFeel free to drop us a message with questions or subjects you would like us to address, and if you like what we’re doing, please support us at patreon.com/ClimbingInjuryPodcast

In today's episode, we're discussing wrist injuries and wrist related pain due to climbing. We often meet patients worried that they've injured their TFCC (more on this in the episode), which can be a serious injury. But this is quite rare, and there are other more common causes and sources to a climber's wrist pain than just the TFCC. This is also highlighted in a recent paper by Schöffl and colleagues (article here: https://pubmed.ncbi.nlm.nih.gov/37800447/). We discuss different injury mechanisms, such as slopers and underclings, and how to both manage and hopefully prevent wrist pain and wrist injuries.   For more information about us, you can find us on Instagram and our websites:James: @sheffieldclimbingclinic / www.sheffieldclimbingclinic.comStian: @stianchristophersen / https://www.klatrebibelen.com/stian-christophersenFeel free to drop us a message with questions or subjects you would like us to address, and if you like what we’re doing, please support us at patreon.com/ClimbingInjuryPodcast

Today we’re discussing hamstring injuries. We frequently see injuries to the hamstring muscles and tendons due to heel hooks and splits, and whilst hamstring injuries have gotten a lot of attention in other sports, like soccer, sprint and dancing, there’s a paucity of literature covering this injury in climbers. Since climbing differs from these sports, the injury mechanisms, rehabilitation and exercise selection also differs. Today’s talk will cover these subjects, as well as we’ve interviewed top level climber Tina Johnsen Hafsaas about her own hamstring injury which occurred during the World Championship in Moscow in 2021. ReferencesEhiogu, U. D. et al. (2020) ‘Acute Hamstring Muscle Tears in Climbers—Current Rehabilitation Concepts’, Wilderness and Environmental Medicine. doi: 10.1016/j.wem.2020.07.002.Vantorre, A., and F. Schellhammer. “Severe Injuries of Proximal Hamstrings in High-Performance Sport Climbers.” Deutsche Zeitschrift Fur Sportmedizin, 2022, doi:10.5960/dzsm.2021.521.Schöffl, Volker, et al. “The ‘Heel Hook’ - A Climbing-Specific Technique to Injure the Leg.” Wilderness and Environmental Medicine, 2016, doi:10.1016/j.wem.2015.12.007.1:03:00: Interview with Tina Johnsen HafsaasMusic: Lofi Summer Background - Vladislav Kurnikov For more information about us, you can find us on Instagram and our websites:James: @sheffieldclimbingclinic / www.sheffieldclimbingclinic.comStian: @stianchristophersen / https://www.klatrebibelen.com/stian-christophersenFeel free to drop us a message with questions or subjects you would like us to address, and if you like what we’re doing, please support us at patreon.com/ClimbingInjuryPodcast

As climbing's increasing popularity attracts more and more people to the sport, it also attracts more and more young climbers. This is of course positive, but also makes for an understanding of the more specific injuries that youth climbers are exposed to. In this episode we'll discuss how and when the growing skeleton matures, and why this is important knowledge for everyone involved in youth climbing. We'll discuss growth plates and injuries to these - called epiphyseal stress fractures. Since these carry with them a potential risk for long term consequences we need to identify and deal with them early. We'll explain how to diagnose them, how to manage them and also discuss what can be done to reduce the risk of them occurring in the first place. References:-       https://pubmed.ncbi.nlm.nih.gov/29218364/-       https://bjsm.bmj.com/content/bjsports/early/2020/10/09/bjsports-2020-102035.full.pdf -       https://journals.sagepub.com/doi/10.1177/03635465211056956 -       https://www.sciencedirect.com/science/article/abs/pii/S2468122919300726?via%3Dihub -       https://eujsm.eu/index.php/EUJSM/article/view/95/49 -       https://pubmed.ncbi.nlm.nih.gov/31696262/ Music: Lofi Summer Background - Vladislav Kurnikov For more information about us, you can find us on Instagram and our websites:James: @sheffieldclimbingclinic / www.sheffieldclimbingclinic.comStian: @stianchristophersen / https://www.klatrebibelen.com/stian-christophersenFeel free to drop us a message with questions or subjects you would like us to address, and if you like what we’re doing, please support us at patreon.com/ClimbingInjuryPodcast

Although less common than finger and shoulder injuries, we see a fair bit of painful elbows in climbers. Today, we discuss elbow pain on the inside (medial), outside (lateral) and front (anterior) of the elbow. What's actually going on here? How do these develop into painful conditions? And, of course, how can we manage them?References:-       van Middelkoop M, Bruens ML, Coert JH, Selles RW, Verhagen E, Bierma-Zeinstra SM, Koes BW. Incidence and Risk Factors for Upper Extremity Climbing Injuries in Indoor Climbers. Int J Sports Med. 2015 Oct;36(10):837-42. doi: 10.1055/s-0035-1547224. Epub 2015 May 6. PMID: 25958937.https://pubmed.ncbi.nlm.nih.gov/25958937/-       Laura A. Sims. Upper Extremity Injuries in Rock Climbers: Diagnosis and Management. The Journal of Hand Surgery. Volume 47, Issue 7. 2022.-       Cardoso TB et al., Current trends in tendinopathy management, Best Practice & Research Clinical Rheumatology, https://doi.org/10.1016/j.berh.2019.02.001 -       Paul W. Ackermann  EMAIL logo  , Md Abdul Alim , Gunnar Pejler and Magnus Peterson. Tendon pain – what are the mechanisms behind it? Scandinavian Journal of Pain. 2022. https://www.degruyter.com/document/doi/10.1515/sjpain-2022-0018/html- Keith Baar: Google ScholarMusic: Lofi Summer Background - Vladislav Kurnikov For more information about us, you can find us on Instagram and our websites:James: @sheffieldclimbingclinic / www.sheffieldclimbingclinic.comStian: @stianchristophersen / https://www.klatrebibelen.com/stian-christophersenFeel free to drop us a message with questions or subjects you would like us to address, and if you like what we’re doing, please support us at patreon.com/ClimbingInjuryPodcast

After two long episodes on pulley injuries, we wanted to discuss the somewhat lesser known finger injuries. These include flexor tendon tenosynovitis, finger joint pain/synovitis, flexor tendon strains and lumbrical shift syndrome. We discuss how to diagnose and manage these conditions both as health care professionals and as climbers. We also follow up on Stian's A4-rupture and how he has progressed the past month. References: A Life Dedicated to Climbing and Its Sequelae in the Fingers—A Review of the LiteratureCartilage abnormalities and osteophytes in the fingers of elite sport climbers: An ultrasonography-based cross-sectional studyClimbing MedicineTendon Injuries of the HandMusic: Lofi Summer Background - Vladislav Kurnikov For more information about us, you can find us on Instagram and our websites:James: @sheffieldclimbingclinic / www.sheffieldclimbingclinic.comStian: @stianchristophersen / https://www.klatrebibelen.com/stian-christophersenFeel free to drop us a message with questions or subjects you would like us to address, and if you like what we’re doing, please support us at patreon.com/ClimbingInjuryPodcast

In this episode we deep dive into how to rehabilitate pulley injuries. Since Stian managed to rupture his A4 pulley whilst bouldering in Fontainebleau, you'll get a real time insight into his rehabilitation process while we discuss the different approaches and concepts to best handle these injuries. Should we immobilize or load early? Should we climb or not? Which are the different ways of loading in a controlled way? We're also joined by pro climbers Tom Randall and Molly Thompson-Smith, and we discuss their unique experiences dealing with pulley injuries. 0:00: Pulley rehab with Stian and James 1:33:55: Interview with Tom Randall2:14:45: Interview with Molly Thompson-SmithSources:Bosco et al (2022): Closed flexor pulley injuries: A literature review and current practiceDubois et al (2020): soft-tissue injuries simply need peaCe and loveMiro et al (2021): Finger Flexor Pulley Injuries in Rock ClimbersMusic: Lofi Summer Background - Vladislav Kurnikov For more information about us, you can find us on Instagram and our websites:James: @sheffieldclimbingclinic / www.sheffieldclimbingclinic.comStian: @stianchristophersen / https://www.klatrebibelen.com/stian-christophersenFeel free to drop us a message with questions or subjects you would like us to address, and if you like what we’re doing, please support us at patreon.com/ClimbingInjuryPodcast

Welcome to the world premiere of the Climbing Injury Podcast. In this episode we want to present ourselves and what this podcast is all about. We chat about how and why we started talking to begin with, Stian’s recent trip to Sheffield with Magnus Midtbø and Adam Ondra before we get our geek on and discuss pulley injuries. This episode is dedicated to what pulleys are, injury classification and diagnosing pulley injuries. The follow-up will then obviously be about rehabilitation. Feel free to drop us a message with questions or subjects you would like us to address, and if you like what we’re doing, please support us at patreon.com/ClimbingInjuryPodcastReferences: -       Schneeberger M, Schweizer A. Pulley Ruptures in Rock Climbers: Outcome of Conservative Treatment With the Pulley-Protection Splint-A Series of 47 Cases. Wilderness Environ Med. 2016 Jun;27(2):211-8. doi: 10.1016/j.wem.2015.12.017. Epub 2016 Apr 6. PMID: 27067301-       Schöffl, Volker, et al. "Tendon Injuries in the Hands in Rock Climbers: Epidemiology, Anatomy, Biomechanics and Treatment-An Update." Muscles, Ligaments & Tendons Journal (MLTJ) 10.2 (2020).-       Berrigan W, White W, Cipriano K, Wickstrom J, Smith J, Hager N. Diagnostic Imaging of A2 Pulley Injuries: A Review of the Literature. J Ultrasound Med. 2022 May;41(5):1047-1059. doi: 10.1002/jum.15796. Epub 2021 Aug 2. PMID: 34342037; PMCID: PMC9292555.-       Larsson R, Nordeman L, Blomdahl C. To tape or not to tape: annular ligament (pulley) injuries in rock climbers-a systematic review. BMC Sports Sci Med Rehabil. 2022 Aug 1;14(1):148. doi: 10.1186/s13102-022-00539-6. PMID: 35915476; PMCID: PMC9344739.-       Schöffl et al: Climbing Medicine: https://link.springer.com/book/10.1007/978-3-030-72184-8 2022Music: Lofi Summer Background - Vladislav Kurnikov For more information about us, you can find us on Instagram and our websites:James: @sheffieldclimbingclinic / www.sheffieldclimbingclinic.comStian: @stianchristophersen / https://www.klatrebibelen.com/stian-christophersenFeel free to drop us a message with questions or subjects you would like us to address, and if you like what we’re doing, please support us at patreon.com/ClimbingInjuryPodcast