Rehab, or “Go See A Doctor”5 min read

Hi, I’m John.  You may remember me from such medical mishaps as “Dude, my balls hurt!” and “Does your finger have this lump?”  I’m here to talk to you about climbing injuries.  But before I can get to that, I need to remind you all of a piece of advice I keep forgetting:

 

Go See a Doctor

 

Fine, Brooks, you win.  I’m a convert.  If you experience some dramatic change from “this feels okay” to “this definitely does not feel okay” that is not explained by muscle soreness or a hefty bruise, go see a medical professional!  There are a bunch of reasons why this is a good idea:

  • Seeing a medical professional is the quickest way to get to see a Physical Therapist.  More on that in a bit, but your goal should always be to see a PT as quickly as possible.
  • They can rule out things like torn ligaments, dislocated shoulders, bone chips, and ball cancer much more reliably than WebMD.  In other words, you should see a doctor to reassure yourself there isn’t something seriously wrong that could lay you up for six months
  • If you have insurance, a visit to the doctor will run you $50.  To put that in perspective, that’s the cost of the two gym sessions you’d miss out on because you’re “resting” that injury which may be a sprain, or bruised cartilage, or a torn ligament.
  • Going to see a doctor the week of an injury is a much, much better idea than seeing a doctor a month later.  Save yourself weeks of uncertainty and feeling like a foolish gumby, and just see a doctor.

Right, so you’ve seen Mr. M.D. and they’ve told you there’s nothing seriously wrong with you, natch.  You knew that going in, of course, but now you really know it.  Next up, feeling better.  This will most likely involve rehab.  Which brings us to our story…

On Friday, October 6, my roommate and I got up at 3:40 to drive to the valley and begin a 3-day climbing extravaganza.  Our first objective was Royal Arches, a route most commonly done as a 16-pitch 5.7 A0.  We got to the climb, got lost on the miniscule 15-minute approach, and I got to thrash up (then downclimb) a 5.8ish offwidth off-route on the “alternate start”.  An hour later, we rejoined the route midway through pitch two:

I’m including the topo here for a sense of scale, because after the “pick your rope up and walk” traverse on pitch four, I found myself facing up the first 5.7 climbing of the day.

The pitch starts off a ledge with about 15 feet of flaring finger crack, andmarginal feet to the sides.  I got up about three feet, and slotted in a .3 X4 about 7 feet off the ground.  Moving further up, I made an unstable move with my left foot just below the X4 (my only piece).  Serves me right for not respecting the grade, but I peeled off and slid down the crack.  Achievement unlocked: first fall on gear.  My roommate was giving an all-star belay, and had mostly arrested my fall by the time I touched down on the ledge.  The only problem was that my left foot had been sliding down the crack that whole time, and was brought up short by a small rock chip about a foot off the deck.  Not.  Fun.

The pain was pretty bad, but not close to the baseline for breaking a bone (cracked fibula, rugby, 2012), so I was thinking “sprain” from the very beginning.  Problem was, I couldn’t put any weight on it.  We waited for about 15 minutes on the ledge, to see if there was any improvement, but no dice.  Time to unlock another achievement and begin my first multipitch bail.  3 painfully slow raps and 1 super-slow lower later, and we made it back to horizontal ground.  So much for our three-day weekend in paradise.

So, here’s the quick sparknotes for the recovery timeline:

  • First two days, I couldn’t walk on the foot.  I followed RICE protocol, and kept an icepack on the ankle (10min on, 20 min off), took Ibuprofen, kept it elevated, and didn’t leave the house.  So if you ever need to catch up on back seasons of Gossip Girl or want to log some time playing Shadow of Mordor, a sprained ankle isn’t the worst thing in the world.
  • Next week, I got to work on my zombie limp.  It improved to “Gary Oldman playing a guy with a cane” by week two.
  • At this point, progress plateaued, and I saw slow (but steady) improvement

Two days ago I finally got in to see the PT guy.  Folks, if you have a physical injury, your priority should be seeing a PT specialist as soon as possible.  They will know much, much more about your injury than your doc, and be able to get you on your feet in minimal time.

Fortunately, I got all good news: there didn’t seem to be any structural damage, and most of the lingering pain I was feeling was a result of swelling.  Time…for rehab!  It’s been a while since I’ve really had to do any serious rehab (pulled shoulder, also rugby, winter 2011), but it’s remarkably calming.

Andrew (Mr. PT) explained it this way: pain is your brain’s way of saying “hey, I have it on good authority this is going to cause physical damage to my body”.  Think about putting your hand over a candle: it hurts before you actually get burned.  When you get injured, like a sprain, your brain gets “flinchy” and flags movements as dangerous when they aren’t.  The goal of rehab is twofold:

  1. Break up residual swelling through activity, motion, and increased bloodflow
  2. Get your brain to re-acclimate to the proper pain thresholds by doing activity which is just at the “this hurts” point.

The exercises themselves are pretty standard, but which ones you do depends pretty specifically on your injury, progress, and fitness, so I’d highly recommend seeing your PT guy over whatever you find on WebMD.

Anyway, I’m optimistic.  I climbed for the first time in a month yesterday, and am looking forward to a full recovery in time for ski season.  Until next time

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