Abdominal Injuries Rock Climbing with Wil Seto

Mark: Hi, it's Mark Bossert. I'm here with Wil Seto of Insync Physio in Vancouver, Vancouver's favourite physiotherapist office, and we're talking bodies. How you doing Wil? 

Wil: I'm doing good. Thanks. 

Mark: So today we're talking about abdominal injuries from rock climbing. Is there something different about hurting yourself in your guts when you're rock climbing?

Wil: Yeah, so, you know, in rock climbing especially, you know, you get into like these more athletic type of climbs these days and then with the advent of indoor climbing with the bouldering and the type of routes that they're setting these days. You know, you're using a lot of your core strength now.

And then you add these movements where you're really twisting your body, and maneuvering your body in a way where you're trying to now like, get up the climb or finish the climb and it can really lead to more potential injury in the abdominal muscles, especially if you don't take care of them.

Mark: I'm gonna assume that the main symptom is it hurts, but is there something more that you look for or that people come in and tell you about? 

Wil: Yeah, so depending on how bad it is you know, you usually like, feel and hear like a popping sensation into your abdominal area. And if it's really bad, then you get this intense pain. And you know, you end up like letting go of your hold that you're climbing and you like fall to the mats. But it can range from like that kind of intense to like say you finished the climbing session and you kind of like pulled really hard and you're doing a lot of twisting motions and bending and extending or whatnot, like the motions that put you more vulnerable to that.

And then you kind of feel more sore down in your abdominal area after and it sort of persists. And you might have a little bit more of a minor strain, which is actually something that you also wanna be a little more cognizant of post climb. So sort of different degrees of it and that's what I look for.

In terms of more specific things that contribute to these strains, it's things that are involving like rotation, especially extreme rotation of trying to reach, side bending motions and then really extending in the spine. Those are the main ones. 

But then like I said, with the more dynamic nature of climbing where you're doing what's called a dynamic movement or a dino, you know, those sort of powerful moves combined now with like the twisting and bending and extending, are the main things that can lead to a strain in your abdominal area.

And most climbers that we treat, we treat quite a lot of climbers in the clinic, they are not so great at recovery and stretching and making sure that the mobility is restored. Especially in 10 sessions. That's something that we're finding a lot of.

Mark: Is there, if I'm feeling this, is there an appreciable difference between like, just, you know, I've done too many stomach exercises compared to I've actually hurt myself. Is there some kind of gauge I could say, oh, I've hurt myself. 

Wil: Yes. That's a really good question Mark. So what you're speaking of, like if you're doing a lot of sit ups and you feel that pain, like the next day is what you're alluding to, I think. Yeah.

That's a condition called delayed onset muscle soreness and so DOMS is the abbreviation or the acronym. And that's very normal. Like if you're doing a lot more than normal sit ups or if you haven't done it in a while, then DOMS is actually very prevalent. And so you'll feel sore and that soreness will last for, you know, up to 48, 72 hours and then it goes away.

And you don't feel anything happen, like when you're doing your sit ups or when you're doing your, like, you know, oblique workout or whatever you did in your workout. And you don't feel anything until the next day, to get outta bed and you're like, oh, I feel a little sore. So that's definitely some muscle damage going on through there, but it's like it's definitely excessive muscle damage. Whereas when you tear the abdominal muscle, you end up actually damaging it acutely. And you usually feel something like more immediate. So I think, point that you're trying to get at to is like how you determine the difference between that maybe versus like the more mild versions of it.

Where you don't feel it until after because obviously with the more acute strains you feel it and you feel popping and it's like a sudden pain. Right. So that's more obvious. Where it's the more mild ones, you might have felt something go, you know, like how you sometimes feel the muscle tension abnormally, so you feel something and then you're sore after.

And that's when you know you've strained something and it's more mild. Or like you have a workout, like you're climbing whatever, and you're doing all those things and you have a really hard one and you do feel sore, but then you're like, two hours later, the same day, you feel abnormally more sore.

So you shouldn't feel abnormally more sore like that, you know, like one or two hours right after. And then the key thing actually is you're looking at that timeframe of like post 48 to 72 hours. So if it's still sore after 72 hours, like where it's not going away or getting any better, that's where you know you strained something. Where it's more of a tearing of the muscle as opposed to this other micro damage that's more related to the delayed onset muscles soreness. 

Mark: So how do you diagnose this? 

Wil: Yeah, so that's a good question too. So, first of all there's different grades to the extent of injuring your abdominals. There are three different grades. Grade one being like the micro tearing and stretching of muscle fibres. And you could say that the delayed onset muscle soreness is sort of in that category, or it's a grade one. And grade two is now you actually have partial tearing of the muscle fibres. And then grade three is now like complete tearing or rupture of muscle fibres. 

And so there's different things that we test for in the clinic when we look at, you know, what you're able to do and not do, and really rule out whether or not it's something else. Is it a hernia? You know, so that's another common thing too that we gotta rule out. Because if you have like lower abdominal area, then you know, you're always suspecting hospital inguinal hernia. And some of the things can be very similar, like, you know, if you're like, oh, coughing, you know, that can hurt the abdominals, but also it could be a hernia. I won't get into that too much, but those are things that we kinda look for. We wanna rule out that it's not other things as well. 

Mark: Sure. So what's the typical course of treatment?

Wil: Well, the biggest thing we gotta unload. So we gotta basically don't do things to put force or tension into abdominals. Like even, I mean, it's it sounds kind of funny, but not. We had an individual that had a tear in their abdominal. And even laughing really hurt. So I was like, if you wanna watch movies this weekend, don't watch anything too funny. Because you just gotta rest, right? It's gotta rest. And especially from the acute injury, you gotta give it that, you know, real good time period, 72 hours to let that acute phase kinda really settle down. 

And then once we can start to like move through now. Okay. The acute phase is over. Gently start to move through mobility phase or getting more range of motion through the torso. So obviously the range of the motion that you were working through that maybe that caused an injury, if it was an overstretch, then we wanna work those last, but we wanna start getting mobility. Because it can actually then cause other issues happening where you're compensating. And then working through strength. So the strengthening of not just where you've injured, but then now the core, the inner core. 

Quite often a lot of people like mistaken your abdominal muscles for your core muscles. Well, in sense it's true, but it's your outer core. It's not your inner core. It's not your stability core. Because your abdominals actually attach onto your pubis in your pelvis, all the way up into like your chest bone, like on the tip here.

And they don't actually have any attachments on your back. So the more inner core stabilizing muscle, they actually what you wanna work on. And there's like you know, specific regimen that we can prescribe to see where you're not activating, to really say, yeah, this is what you need to work on.

And that's key because when you have an abdominal injury, then you can be prone to having a back strain after, if you don't rehab them. Because then you're not activating your core properly. Then you're gonna start doing all the outer core muscles instead of the inner core that actually attach on your spine.

So then once you get the strength going a little bit more in this coordinated fashion, then now it's looking at, well, what we call functional strength and really getting you to build final stages of movement, like the end ranges of where you really need to to get them feeling like you're back to your full mobility strength.

Mark: If you had some kind of abdominal pain, that's not going away. You can't just rest and hope it's gonna get better. Get in to see the folks at Insync Physio. You can book online at insyncphysio.com, or you can book by calling them (604) 566-9716 for the Vancouver office. Or they also have a North Burnaby office, (604) 298-4878.

Both places book online. Very easy to do, but you have to book ahead. They're always busy. Thanks so much for watching and listening. We appreciate it. Thanks, Wil. 

Wil: You bet.