Training for Climbing, 2nd: The Definitive Guide to Improving Your Performance (How To Climb Series)

SYNDROME
     
    Carpal tunnel syndrome (CTS) is a condition in which a nerve passing through the wrist, with the flexor tendons, is exposed chronically to too much pressure. This syndrome affects a small number of climbers, but its occurrence does not appear to be disproportionately common in climbers (Robinson 1993). Therefore, it’s difficult to conclude whether a climber with this syndrome incurred it from the repetitive gripping of rock holds or from some other source. Regardless, the symptoms include numbness, burning, and tingling of the fingers; these symptoms may become worse at night or during activity or elevation (Lewis 1993). Treatment involves cessation or lowering intensity of climbing, anti-inflammatory medicines, and splinting of the wrist in a neutral position at night for three to six weeks. Surgical decompression of the carpal tunnel may be required if this conservative treatment fails and symptoms are severe enough to be disabling.
ARTHRITIS
     
    For years I have heard speculation that active “rock climbers will someday become severe arthritis sufferers.” Fortunately, anecdotal evidence of many twenty- and thirty-year veterans, as well as recent studies of longtime climbers, indicates that these predictions are not quite panning out. In this study, radiographs of the hands of veteran elite climbers were compared with an age-matched control group. An increased rate of osteoarthritis for several joints was found in the climber group, though no significant difference in the overall prevalence of osteoarthritis was found between the two groups (Rohrbough 1998). A more recent study compared recreational climbers to nonclimbers by measuring bone strength and dimensions and occurrence of osteoarthritis. The study concluded that climbers are not at an increased risk for developing osteoarthritis; it also discovered that climbers’ finger and hand bones are wider (indicating that additional bone is deposited subperiosteally) and stronger (Sylvester 2006). These studies are really good news for those of us entering middle age with many years of climbing under our belts!
    Still, it’s possible that individuals who predominantly use the crimp grip may experience some mild swelling and arthritis in the PIP and DIP joints. As shown in figure 11.4, use of the crimp grip produces hyperextension of the DIP joint under large passive force, while the PIP joint is sharply flexed under great force. Therefore, both the DIP and PIP joints are possible sites of mild swelling and arthritis (Robinson 1993).
    If you are an aging climber who experiences some swelling, pain, or stiffness of the DIP and PIP joints, you will find some relief through use of non-steroidal anti-inflammatory medications. A growing body of research also points to a supplement called glucosamine sulfate as an effective treatment for mild osteoarthritis. Daily supplementation of 1,500 milligrams of glucosamine sulfate has been shown to reduce pain and stiffness, and—more important—to slow the degradation of affected joints (Reginster 2001). Acquiring these benefits requires a long-term commitment to taking glucosamine sulfate, because the effects are cumulative, not immediate as in taking anti-inflammatory medicines. But the promise of slowing or halting joint degradation is a huge benefit for individuals—climbers and nonclimbers—over forty years of age who take glucosamine sulfate daily.
    Many supplement manufacturers are now adding two other compounds, chondroitin and MSM, to their glucosamine sulfate supplements. Chondroitin is believed to produce benefits similar to glucosamine sulfate, and one study showed positive results in patients with joint problems from four to eight weeks of taking both supplements together (McAlindon 2000). However, a more recent meta-analysis of the best-designed studies showed no positive effects in taking chondroitin alone (Juni 2007). MSM shows more promise based on a recent pilot study. Participants who received 3 grams of MSM, twice per day, for twelve weeks experienced a significant reduction in pain and improved physical function compared with a placebo group (Kim 2006). In summary, all relevant studies showed these compounds to be safe, and with almost no side effects; however, only glucosamine sulfate and MSM, taken in long-term daily doses of 1.5 to 3.0 grams each, produced statistically significant beneficial results.
GROWTH PLATE INJURY IN JUNIOR CLIMBERS
     
    Junior climbers make up one of the