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

making a long reach on overhanging rock.
    Fresh shoulder injuries should be treated with the two-phase process of resting until pain diminishes and then use of rehabilitative exercises to strengthen the rotator cuff muscle group. Climbing activity must be markedly reduced or eliminated while you engage in the rehabilitative process, and you should also avoid any overhead motion or other activity that causes pain in the shoulder. Anti-inflammatory medicine and ice applied twice daily are useful in reducing initial pain and swelling.
    The common course of therapy begins with gentle stretching and strengthening of the shoulder, but with no exercises above the level of the shoulder. Perform the four exercises from the “Shoulder Rehab Exercises” box every other day, and gradually increase the weight from one pound to five pounds over about a five-week period. Gradually, you can introduce some basic push-muscle exercises (see chapter 6) that strengthen the antagonist muscles. Decrease resistance on or eliminate completely any exercise that is too painful. Of course, rehabilitation is best guided by a professional physical therapist, and you may need anywhere from two to six months before you can reintroduce climbing activities.
    Unfortunately, a significant number of people with shoulder injuries ultimately require a surgical solution. The procedure may include removal of damaged tissue, repair of minor rotator cuff tears, or surgical tightening of affected ligaments and tendons. Surgery will be followed with long-term physical therapy; given a successful outcome, climbing activity may resume in six to twelve months.
    Shoulder Rehab Exercises
     
    Reduce or cease climbing upon onset of shoulder pain. Apply ice (several times a day) and take NSAID medications to reduce pain and swelling for up to one week. See a doctor if you experience severe pain or if your condition does not improve with rest.
    As pain declines, begin using the following rehabilitation exercises three or four days per week. Be sure to perform each exercise on both sides of the body (with both arms). The weight used should be light: Begin with a dumbbell that seems too light, and gradually increase in one-pound increments over the course of a few weeks. There is no need to use heavy weights; in fact, performing these exercises with more than five to fifteen pounds will unfavorably stress the smaller muscles of the rotator cuff. Supplement your rehab with the antagonist push-muscle exercises detailed in chapter 6 when you become pain-free.
     
     
    Dumbbell Internal Rotation

     
    1. Dumbbell Internal Rotation
    Lie on your side with your bottom arm in front of your waist; place a rolled-up towel under your head to support your neck. Rest your other arm along your hip and upper thigh. Hold a two- to five-pound dumbbell in the hand of your bottom arm, positioning this forearm perpendicular to your body. Lift the weight up to your body and hold for a moment before lowering it back to the floor. The upper portion of your arm should remain in contact with the floor throughout the range of motion—think of your upper arm and shoulder as a door hinge that allows your forearm to swing “open and closed.” Continue in a slow but steady motion for a total of fifteen repetitions. Do two sets on each side, with a three-minute rest between sets. Increase weight in one- or two-pound increments, but do not exceed ten pounds. Using heavy weight is not necessary and may even result in injury.
     
    2. Dumbbell External Rotation
    Lie on your side with your bottom arm in front of your waist and a rolled-up towel under your head to support your neck. Alternatively, you can bend your bottom arm and use it as a headrest. Hold a two- to five-pound dumbbell in the hand of your top arm. Rest the upper arm and elbow on the top side of your body, and then bend at the elbow so that the forearm hangs down over your belly and the weight rests on the floor. Now raise the weight upward toward the ceiling until your forearm passes a parallel position with the floor. Pause at this top position for a moment, and then lower the weight to the floor. Your upper arm should remain in contact with the side of your torso and act only as a hinge that allows your forearm to swing up and down. Continue in a slow but steady motion for a total of fifteen repetitions. Do two sets on each side, with a three-minute rest between each set. Increase weight in one or two-pound increments, but do not