Ask Dr J – Issue 190 – Getting It Back

Getting it Back

Two months ago I was upgrading hardware in Rifle Mountain Park and fell from 20 feet straight onto my ass. I broke my right arm (out of the cast now, and fine), and my L1 and L2 vertebrae. The L2 break was not serious, but the L1 was a burst fracture and pushed out into the spinal column. Fortunately it did not cause any neurological damage, but it did compromise about 25 percent of the spinal canal. I did not get surgery, and was put into a torso (TLSO) brace for 12 weeks.

Two days ago I got an MRI and saw a specialist. He’s confident that I will recover fully and the bone will slowly dissolve out of the spinal canal. However, he wants me to hold off on toproping until month four, and says I shouldn’t lead for up to a year.

At first I took his opinion at face value, but in talking with him a bit more I realized he didn’t really understand climbing and the forces involved. For instance, I’ve been going for two-hour hikes on his advice, and this seems much more likely to put forces on my back than top-roping. He’s also against finger boarding, even in the brace. Why? Is this doc being overly conservative?

Josh Wharton | Estes Park, Colorado

 

Sounds like you visited a gun shop, and in the process of upgrading your hardware, shot yourself in the foot!

I am at pains not to tread on the toes of your treating physicians. They alone know the extent of your injuries. I do not. That your physician does not understand the biomechanics of climbing and has hence taken a conservative line is not a medical crime—it’s actually the responsible approach, and although I would disagree on aspects of the advice, I come from a very different knowledge base.

I would say finger boarding at this point in the healing process is probably fine, particularly given that activities like off-trail walking are deemed OK. I doubt your specialist would be concerned about muscle loading and can only guess he thinks you might slip off and land badly. But we know that you are more likely to pull a groin in your water-aerobics class.

I would question the point of it, though. What are you going to achieve in half a dozen finger sessions? Fuck all! Why bother? No good reason other than coping with your climbing obsession. There are some great studies demonstrating that a happier athlete is a stronger athlete.

Top-roping. Again, I think you probably could. But festooned in that brace! Doing nothing would be considerably better. You’d be in for awkward, tedious, discordant, spastic movements—the polar opposite of what you, I guess, really enjoy about climbing. The fact that you are even trying to climb while wearing the armory of a cockroach might actually cause you an injury.

I doubt either finger boarding or toproping would harm you, or at least the risk is no more than some activities you are already doing. But, again, you have to ask yourself about their value in the overall scheme of things.

Your spinal fractures will not be particularly susceptible to re-injury when you start training again. Rather, your feckless body will exhibit less coordination than it did upon its amniotic arrival. Your tummy will wobble like a bowl of Jell-O and your ass will feel like a custard tart. Translation: You are more likely to tear something because custard tarts are not very strong. Remember that the devil actually does not wear Prada. She is swaddled with a brace just like yours. Though it is a necessary evil in your case, when it comes off the odorous residues of the devil will remain. Yes, it will be smelly in there, but that is not what I mean. Your physical mettle will have been drained like a schooner of pale ale at a teenage party.

While we’re at it, let’s have a wee chat about life with compressed vertebrae and therefore a slightly shorter stature. Watch for signs of Short Stature Syndrome (SSS). Combined with the fact you can obviously make some serious judgment errors (a la Napoleon Bonaparte), it might make finding a partner more difficult. Luckily you are married, so you can always fall back on, “Honey, you said you would love and support me.” As far as climbing is concerned, being 5′ 2″ hasn’t affected Ramonet. Your climbing might even improve!

Mileage. That’s what you need. Pick an easy grade and then deduct another two since all climbers bite off more than they can chew, and you can’t afford that. Be gentle. Pretend you are a ballerina rather than an ape. I am sure you have had to regain climbing fitness after your popsicle missions. This time you’ll need to go a little slower due to having worn the brace and all the weakness that follows immobilization. But it’s not rocket surgery. There is no accepted sequence of rehab events from which deviation will cause you to melt into a puddle of flesh and bone. Just get out there and exercise with a bit more caution than you normally would for a few months.

There is leading … and there is leading! Sixty feet above an ice screw is out. In fact, six feet above an ice screw is still dubious. Avoid hitting things at speed, including the end of your rope.

I would certainly toprope for a month or two, as tedious as that may be. And then start doing easy sport that is gently overhanging. In 12 months you could be world champion. Personally, I made my peace last week. I said, “Julian, you’ll never be world champion.” I cried for a while. Looked at my bald spot. And cried some more.

You might also want to do some core exercises on a ball. There are heaps of good books available or check in with someone who can instruct you in the ways of the rubbery sphere. Don’t look on the internet; it’s full of misleading information for the sole reason that
it is easier to spin an ace of truth into an edifice of cards if you don’t have an editor.

 

 

Back Health

Practice the yoga posture Paripurna Navasana to strengthen the core and protect the lower back.

  • Sit on the floor with your legs benta and your feet hip-width apart.
  • Wrap your arms around your knees and lightly hold the right wrist with the left hand.
  • Use the leverage provided by the arms around the legs to help you bring length to the spine. Drop the shoulder blades down the spine. Let the shoulders fall, but at the same time lift the chest.
  • Exhale and straighten the arms. If the back rounds, then hold the legs and practice keeping the spine long, chest lifted.
  • If you can keep the spine long after releasing the arms, then lift the feet on an inhalation, keeping the knees bent, and the lower legs in line with the extended arms. Again, if the back rounds, return the feet to the floor.
  • If you can keep the spine long with the feet lifted, then extend the legs on an inhalation. The outstretched hands should be in line with your knees. The heels should be lifted to eye level. Come down when you can no longer maintain the extension in the spine, the lift of the chest, or after ten breaths (roughly one minute).
  • To come out of Paripurna Navasana: Exhale and bring the feet back to the floor. Wrap the arms around the knees and lightly hold the left wrist with the right hand. Use the leverage of the arms to help you lengthen the spine, move the shoulder blades down and lift the chest.
  • Do at least two rounds.