Last Thursday I went to the Spot to meet with Brent Apgar, an old friend of mine who is now a chiropractor. Brent read of my recent issues with my elbow and offered to help. I accepted and volunteered to share my experiences with readers who may be interested in finding solutions to similar problems. Brent began by asking about the nature of the injury and its likely origins and explained his views on how tendinitis starts, views which made sense to me. Essentially the issue is almost always the disparity between muscle growth and tendon adaptation, a disparity which can result in a separation and irritation where the tendon inserts in to the bone. This will eventually heal but usually in an unproductive and weakened fashion resulting in more pain and problems down the road. Brent proposed a few sessions using the Graston technique which is a massage technique using specially designed stainless steel instruments to break down and realign muscle and tendon fiber and promote circulation of blood. In practice this means a few minutes of fairly painful work on a specific area, just painful enough to make you want to kick something but not enough actually to do it.
After this was over, we talked a bit about how to proceed with regard to climbing. Having taken two weeks off, I was definitely hoping to find some way of resuming climbing that would not re-injure me and hopefully promote healing. Brent suggested that at this point it would be more productive to resume climbing at a pain-free level, i.e. whatever grade or type of move allows unimpeded movement. The theory behind this is that movement is always better than rest in regard to recovery and strength-building only happens in response to manageable stress. This creates an interesting problem for the climber of course in that the challenge is to find but not get to where you are making things worse. It is a game of self-control which I believe many climbers have had difficulty with, myself included.
So this morning I did about 15 very easy problems at Flagstaff up to roughly V2 but mostly much easier and for the most part had no issues. The biggest problem is crimping on a steep wall. I don't think I have ever had my elbows hurt from crimping before but such is the nature of lateral epicondylitis. It was surprisingly busy up there, not least because of two teams from Rocky Mountain Rescue doing drills in the ravine west of the Monkey Traverse.
Finally, I want to recommend a novel by Italo Calvino, The Baron in the Trees. It is a fantastic little novel about an Italian nobleman who abandons his family and station in life to live in the trees of the valley he grew up in. Any serious climber will recognize something of him or herself in the attitude of Cosimo the main character and his determination to leave the mundane terrain of the world behind. I first read it about 10 years ago on a road trip when I was working on the Present at the Gorilla Cliffs near Saint George, UT. Everything I have read by Calvino is beautifully written and thought-provoking and if you like this book, I would add Invisible Cities and If on a Winter's Night a Traveler to your list.
Brent is a good friend of mine from Portland, and he helped me out tremendously when I had some shoulder issues a while back. I kept up with the exercises he suggested and was back to normal with 2 months.
ReplyDeleteGood luck with your recovery.