Skip to content
214 breaking bad

ASK DR J – ISSUE 214 – BREAKING BAD – TURNING A TALUS INTO TALUS

So after nearly three decades of ice climbing, I finally got a little careless, screwed up and took a short groundfall catching one of my front points in the process and busting the neck of the talus bone in my right ankle, which is now held together with two screws. What can I expect in my first couple of months back on the rock? Do you have any recovery tips or cautions? In particular, any suggestions for minimizing risk of post-traumatic avascular necrosis?

TLBZLAND/Rock and Ice Forum

I would say something derogatory about ice climbing but I will confine myself to: “Don’t play with knives,” and “It’ll end in tears.”

Avascular necrosis (AVN) occurs when a fracture compromises blood supply to one part of the bone, and the bone laments its rotten luck at not having a more comprehensive circulation, and then dies, causing much pain and possibly a market collapse.

You can avoid AVN of the talus by … not breaking your talus. Hang up your crampons since I am sure talus fractures are over represented in this cohort. No fractured talus, no chance of post-traumatic AVN. Simples! Otherwise options are limited. Talk to God, who may have some ideas, though as a purist she’s probably a boulderer.

The biggest factor influencing AVN is the severity of the fracture(s). More damage translates to a worse prognosis. You may be able to negotiate to have the cast off a little early. Do it, even if it means signing your mother up for unnecessary hip replacements. Getting the cast off will reduce the amount of joint stiffness that is related to immobilization and causes rehab times to blow out. Get yourself a good PT who will pass you tissues instead of going easy.

What can you expect? A sore ankle and a foot that won’t conduct itself with such bravery anymore.

 

Can you please advise me on how long it is safe to climb during pregnancy? I am currently about six months pregnant with my first child. Climbing has consistently been an important part of my life with my husband from our first date at the local climbing gym to climbing up Half Dome during our wedding week. After learning that I was pregnant, I stopped lead climbing, lead belaying and outdoor climbing. My doctor is not happy with my current choice to continue indoor toproping, but I’m not sure how well she understands the mechanics.

VForest/Rock and Ice Forum

Waiver: First, I have a willy, not a gynie, and have never been pregnant, let alone given birth. However, I do have two kids, three degrees and more estrogen than all my mates put together. Second, I am assuming you have neither complications nor the potential for them. There is an obvious assumption of risk when you undertake any physical activity, infinitely more so if you are pregnant. Third, I am giving you my personal opinion based on anecdotal evidence.

I realize you are already pregnant, but here’s some basic advice for readers considering or just starting the journey. Steer clear of bouldering as soon as you and your partner start playing with live rounds. An abrupt stop in any direction is beyond bad. Shit happens and outcomes don’t always correspond to plans—spotters get distracted or they may be from New Zealand, pads aren’t moved fast enough, holds break. The chance of a hard or awkward landing is inordinately high in bouldering to the point of being outright dangerous to your bub.

Once you are up the duff, fatigue and nausea are the prevailing currents of the first trimester. We were bouldering in Font and Hottie, who had definitely found her rails again after our first child (who was then nine months old), seemed to be getting weaker by the day. In fact on the last day she was pathetic, unable even to roll off the pad so someone else could use it. I suggested she was pregnant and got a resounding “I’m not pregnant!”—you get the idea. But I knew it to be true even before the test. She smelled funny.

During the second trimester, a.k.a. the easy phase, most women find that they have a bit more energy and can climb pretty well. I have seen no anecdotal evidence to suggest that climbing on a toprope during a healthy pregnancy is dangerous to your baby.

Choose your climb carefully. The biggest danger in toproping is usually groundfalls resulting from rope stretch. Climb well within your limit on routes free of objective dangers such as a traverse where you could swing and hit something. You are not trying to be world champion here, just to have some fun, stay vaguely fit and strong, and get some head space. Usually at around seven months “structural issues” become prohibitive. Not to mention that if you do fall the harness is going to dig in no matter how adjustable and padded it is.

Prop your feet up and enjoy the remainder of the journey. Rest assured you will get back to it if you want to. When our second daughter was three years old, I bounced a coin off Hottie’s bum and it dented the ceiling! I’m with her.

Back to the top of the screen