I got a heel hook, rocked up and tucked my foot under my pelvis, even camming my toe against the wall a little, when I felt something pop in my knee. Pain ran down the right side of my right knee into my calf and I jumped off. It was uncomfortable that evening. In the morning the knee greeted me with greater pain. I was able to walk all over the city the next day, but with some stiffness, and occasional acute pain related to lateral or twisting motions. Help! I have a Yosemite trip in two months and am in the middle of training.

MtnZealot / rockandice.com Forum

I’ll try and be positive here by saying that you can go to Yosemite as long as you stick to slabs. Cracks, however, will aggravate your knee. I can’t say for sure because I refuse to climb things that hurt, namely cracks, and granite in general since climbing granite is akin to crawling across a parking lot strewn with broken glass.

Sounds like you snapped a small ligament that restrains the top of the fibular against the side of the tibia at your knee. As you rock over your heel, with your knee angled out, the top of the fibular wants to bust outward like a booby trap, the trigger being your ligament snapping. Twaaaang!

As you report, there is a little pain at first, but the next day your knee has a class-A hangover. Twisting motions, and in particular heel-toe maneuvers, will feel like the knuckle on the outside of your knee has instantly transformed itself, terminatorstyle, into hot liquid metal. This sensation will ease over the coming months, but don’t expect pain-free use this side of six months.

As a differential diagnosis, your lateral collateral ligament is also in the general area, positioned about an inch higher than the fibula head. A moderate injury to this ligament should repair in a month or so. In terms of rehab, there is very little outside of complete rest or, for the more motivated, injury management. Translation: Avoid heel hooks and anything that fully flexes the knee. Sub-translation: Avoid pain.

 

I’ve been climbing for three years and have been suffering from a shoulder issue for the last year. Till then my day to day involved climbing, jiu-jitsu and lifting, with little rest. I woke up one morning to have my shoulder pop numerous times when I rotated it. A few months later an MRI showed no tears, but revealed a Type II acromion process and bursitis. I started PT and kept climbing, usually staying away from burly overhangs. I got stronger and stopped doing PT, but kept up with the exercises.

The whole time my shoulder felt weak. Everything was going OK until three months ago during a competition, after which I experienced inflammation in the front of my shoulder. I took a solid three months off. I just moved to Fort Collins, and my new PT noticed that I exhibit severe scapula winging. Our rehab focus for now is currently on retraining my scapula to move properly. I do think that this is helping. And I have begun climbing again. But I am wondering what your opinion is on scapula winging and how that affects proper shoulder function?

Andy / rockandice.com Forum

You have Long Thoracic Nerve (LTN) palsy. I could be wrong. It is a quantum leap in the world of speculative diagnosis, but I am a risk taker just like the rest of you. The second chapter of this story is the bursitis and biceps tendonitis that results from the shoulder demonstrating less coordination than me trying rhythmic gymnastics. The muscle that fundamentally anchors the shoulder blade against your rib cage is serratus anterior.

Originating on the inside margin of the shoulder blade, it passes under the bone like a wide belt and inserts into the low side of the rib cage under your arm—it’s the muscle that looks like the fingers over your ribs, though it’s only really visible on the overly ripped types. Needless to say, the nerve supply to this muscle is the LTN. If you compromise the nerve’s patency from, say, a fire hose to that of a straw by way of impingement or demylination (physiological breakdown due to disease processes like viral attack), the muscle doesn’t receive sufficient stimulus to function properly. Rehab is your only real tool, and if it is working, I would just stick with it and see how it goes. If not, a shoulder MRI, and possibly another on your long thoracic nerve, is a good idea. Finding a radiologist who can assess the LTN will take some research on your part since it is a very peculiar request.

 

My story begins on a day far too beautiful to normally fall on a weekend, with me standing underneath the classic climb Psychopath at Mount Piddington. Simply prepping to belay a warm-up climb, I somehow tripped and fell, resulting in a spectacular distal radius fracture below my right wrist, which explains why I couldn’t seem to grasp the tree that separated me from a further 20 feet of free fall. Anyway, while quite distressing, the situation did result in a chance meeting with a strikingly gorgeous lady rescuer, notable for the fact that I’m not really a lesbian. Although the smashed wrist took all the glory, when the dust settled I realized that I had also dislocated my collarbone at the sternum. After suffering three months of consistent irritation, I wonder what I can do? Doctors, physios and radiologists seem to pay it no attention.

Nicole / Sydney, Australia

You’re baiting me! That “strikingly gorgeous lady rescuer” remark is a dead giveaway. Your collarbone has dislocated at the breast bone. That sux. Not because it will be a great detriment to your climbing; more of a great annoyance. Once injured, that joint is prone to ongoing testiness because any motion of your upper limb will cause duress, since it is the only joint that connects your arm to your torso. Although you might consider remote Reiki from a master practitioner in a neighboring solar system, I tend to think surgery is a better option if it doesn’t settle down. And I am not going to ask you about how it all ended up with the “strikingly gorgeous lady rescuer.” No. I won’t. So there, I win.