Rock Climbing Knee Pain with Wil Seto

Mark: Hi, it's Mark from Remarkable Speaking. I'm here with Wil Seto of Insync Physio in Vancouver, one of the best physiotherapist office in the Lower Mainland. And we're gonna talk today about rock climbing knee pain. Now, this isn't something I would normally think happens, Wil, what's going on here? 

Wil: Yeah, Mark being a rock climber myself, there's, well, first of all, I think to understand rock climbing and knee pain, you have to understand like sort of the way the knee is involved when you're climbing. And so essentially there's a lot of factors to consider. So normally you think of like trauma or you think of some kind of like acute incident. And that's reasonable to think that. 

And I think where it becomes a little bit harder to imagine rock climbing where there isn't trauma and then you just kind of start to develop sort of gradual knee pain. So in more of the traumatic sense, like, you know, let's say you have a fall or you twist your knee or you land on it kind of funny, and that's very reasonable to think that you've injured a ligament or the shock absorber in there called your meniscus. Or maybe you strain tendon or something like that. But typically even that in itself is rare. And so specifically speaking, when you look at the knee injuries that actually happen in rock climbing, a lot of it's more the gradual stuff. And when you look at sort of the bigger picture of like the person that comes in. 

So I'll give you an example of a client that come in to our clinic who's the rock climber. He is pretty avid rock climber and also relatively strong for a non-competitive climber. And so this person started developing knee pain gradually. And it had been going on for like months. So, you know, it's one of those things where you start to get pain and then you don't think it's that bad. You try and do stuff on your own and then kind of stays and then certain other events happen where it makes it worse.

So this person also sits a lot for work, on the computer. And then it happened to be that they went on a trip, they were sitting on a plane and they came back and he was just like trying to get outta bed and then all of a sudden he felt more pain in the knee. 

So the kind of climbing that this person has been doing was also more of like just basically route climbing, basically on ropes and leading in rock climbing where you're taking the rope and putting in the clips. And another type of climbing called bouldering. So the route climbing of the routes and ropes is basically, you're going up in the gym up to like 15 metres or 20 metres or whatever. And outside, up to 20, 25 metres. And then bouldering is just more shorter distances of where you can jump off indoors on a rock or outside, where you're up on a big boulder and you jump off on a landing crash pad.

So one of the biggest things that can happen and the gradual injuries, is that the mechanical aspect of mini is that you do this thing called a drop knee. So the drop knee is like the technique that's involved in rock climbing and you're turning in your hip and you're using all those muscles in the hip and you can injure things in the knee, yes. 

But the interesting thing is that there's also a lot of things happening with the muscles. You're always using those muscles. Now you take that in consideration with what the person does for work and what they're always doing on everyday basis. So they're sitting a lot when they're not climbing. And you know, this person also traveled a lot for work. Sitting on plane again, a lot of sitting. 

So we assessed the knee and so the physio that actually looked at him, was like, yeah, everything's okay with the knee. Nothing is screaming here. Like all the tests for the ligament stability, for the shock absorber, the meniscus seemed normal. Doesn't seem like theres any muscle strain. However, one test came up positive as we kind of scanned up a little bit higher and then the hip and then the SI joint. It was interesting cause when we looked at it, things were, imbalanced. 

This person was also an avid skier in the winter. Avid snowboarder, more of a snowboarder and skier had taken some falls in the past, landed on his butt on that side where he is getting pain with the knee.

And so as a result, you know, when we looked at his alignment, taking his history into consideration, we're like, Oh, that whole SI joint or the sacred iliac joint, that part of that hip or pelvis wasn't moving, was totally stuck. And the other thing we're also looking at is the muscles all along that hip were so tight.

So there's three muscles that make up your hip flexors, but this one in particular called the tensor fasciae latae, which is the hip flexor that attaches directly to this band that that goes all the way down to outside of the side of the knee called the IT band.

So that IT band was pulling onto his knee, giving him the knee pain. And he was pointing directly at where he was getting a lot of friction on the kneecap in his leg or in his knee, and his pelvis was rotated. So when the physio adjusted him and released the things in his hip, he was able to actually do a full squat without any pain.

And he was like, Wow, this is crazy. And his strength before that was like 50%. He could barely hold his knee up and his mobility was like horrible, 50%. Just realigning things and releasing some stuff, he was up to 75, 80% and his strength was also 75, 80%. So then the next step was looking at, okay, what do we need to do to keep it this way? 

So one of the biggest things addressing his sitting because that shortens that hip flexor and his SI joint probably from all the impact that he had falling when he was snowboarding in previous years, probably had stretched out some ligaments, which felt looser after the adjustment than the other side that was non effected. So in essence, addressing the alignment from previous trauma and rebalancing a lot of the stuff that's just imbalanced.

So taking things that were just like really super tight and releasing it and then starting to get the right muscle activation pattern. So in the end gave him some exercises after working on doing things that needed releasing and to be realigned, he didn't have any knee pain. He came back to see that physio two weeks later, for another problem, for some wrist pain. And it was funny because I remember the physio telling me this and he said, Yeah, he came in and so how's your knee, man? And it was like his second visit, and he goes Oh, oh, oh, actually it's fine. I'm actually here from my wrist.

Mark: If you're having some knee pain from your climbing and you're not sure what the heck's going on. You might have knee pain from other things too, from other sports. The guys to see are Insync Physio. Get experts working on diagnosing exactly what's going on because they can fix it fairly quickly sometimes, sometimes it takes a little longer. Depends on your body, how long you've been toughing it out for. You can reach them at insyncphysio.com to book an appointment. The Vancouver office, call them (604) 566-9716 to book. You can also go to the North Burnaby office and you can book online for them as well. Thanks Will. 

Wil: Thanks Mark.