Tissue Healing Basics for Climbers – by Katie Rendall, Physiotherapist
The following information does not replace any medical advice that you may have been given. It is always advisable to get an injury checked out by a health professional or Physiotherapist to ensure appropriate treatment and rehab can be given. A physical assessment should always be carried out and full medical history explored. The timescales outlined below are guidelines for healing times only and should not be solely relied upon.
ARE YOU AN IMPATIENT PATIENT?
Climbers are often getting injured. Finger pulley injuries, sprained ankles and shoulder impingement are a few common complaints that most climbers will have encountered at least once in their climbing life. As climbers, we are a breed who are impatient when we pick up an injury, especially when it stops us climbing. We are our own worst enemies a lot of the time; overtraining, not wanting to rest when injured, pushing through pain and generally trying to ignore what our bodies are telling us. Be honest, how many times have you grimaced your way through a climbing session immediately following an injury when really you should have stopped? How many times have you ‘rested’ for a day or two when really you should be looking at a week or more for proper healing? And how many times have you consulted a physio looking for that magic wand to heal you immediately and ignored all their advice because you wanted a quick fix and not an exercise programme? Alternatively, you may be someone who is the opposite and religiously ices an injury, rests up for the appropriate timescale and safely rehabs yourself back to climbing. Either way, having a basic understanding of tissue healing physiology and timescales can be a good way to stop yourself being an ‘impatient patient’ if you get a climbing injury.
THE STAGES OF HEALING
Inflammation: 1 – 7 days depending on injury and severity
When you injure any part of your body, the first stage of healing is inflammation where your body releases inflammatory chemicals to open up the capillaries in the area. This allows antibodies and white blood cells to seep into the area to begin the healing process. If you’ve been injured before, you’ll probably have noticed swelling in the area of varying degrees, particularly with a sprained ankle or knee, which is completely normal. This is fluid and debris caused by the inflammatory process and eventually gets reabsorbed by the body. Rest and ice therapy are your friend in this early stage to reduce pain and aid the healing process.
Proliferation/Repair: starts around day 4, lasting up to 6 weeks depending on injury and severity
This is where inflammation starts to settle and the tissues start to reorganize and restore the blood supply to the injured area. Granulation tissue is laid down and the vascular supply is repaired, forming a matrix throughout the healing area. Rehab can start here to maintain range of movement and scar tissue alignment but it is extremely important to note that the tissues are not fully healed and re-injury can occur – you should always take advice from a health professional or Physiotherapist before commencing rehab in this stage.
Remodelling: As early as 2 weeks, but can be months or years depending on injury and severity
This is the final stage of healing where the granulation tissue is replaced by scar tissue and strength starts to return to the injured tissues. Rehab is particularly important in this phase to realign the scar tissue fibres along their original lines of stress so they can cope with increasing loads and to maintain muscle strength. Again, it is important to consult your Physiotherapist before and during rehab to ensure you are doing the appropriate exercises at the right time for your particular injury.
WHY DO THE STAGES OF HEALING VARY SO MUCH?
Different tissues take different times to heal. This is because they differ in composition and blood supply. As you can probably work out, if a soft tissue is well vascularised it will heal faster than tissue that is poorly vascularised. For example, muscle belly is better vascularised than muscle tendons, ligaments or cartilage, thus heals quicker. Remember the first stages of healing and repair of the blood vessels? It all makes sense doesn’t it. Applying this in climbing terms, a finger tendon injury will take much longer to heal than a forearm muscle belly strain.
The severity of an injury also has a huge impact on the timescales involved with the stages of healing. Again, as you would expect, a minor injury will heal much faster that a more extensive injury. The level of pain you experience at the time of an injury, and after, along with swelling and loss of movement/function, can indicate the severity of an injury and most of you will be able to gauge when you need to get checked out at the GP or health centre and when you can just rest up with an icepack and some pain killers. If in doubt though, get checked out. Either way, if you experience a sprain or strain, expecting it to get better overnight is highly unlikely unless it is really very minor. Bear in mind the shortest healing time for each stage above and you’ll have some idea of how long it might take for your injury to get better.
Other health conditions and lifestyle factors can have an impact on the speed of healing too. Diabetes, alcohol, smoking and poor nutrition can slow healing and prolong each of these stages. Whether we like it or not, we are all getting older and ageing also has a slowing effect on healing tissues. The latter is something we can’t change, but we can always make tweaks to our lifestyles to help an injury get better.
TAKE HOME MESSAGE
Although climbers often feel invincible on the rock or at the climbing wall, and maybe even think our injuries should heal overnight, unfortunately this is not the case. It can take a minimum of 1-2 weeks for minor injuries, and for more severe, up to months, and even years. Consider the healing stages and the time it takes for the injury site to rebuild strength the next time you decide not to rest up, you may re-injure yourself or prolong the healing process. Not a good plan if you want to get back to climbing asap. If you really can’t sit still and rest, think about alternative exercise you can do that doesn’t involve the injured body part and focus on that until you’ve been cleared to return to climbing. Better still, are you due a holiday or complete break from exercise for a while? Even the pro-climbers do this to allow their bodies to heal and regenerate. Overall, be patient. Allow your body the healing time it needs and you’ll be a better, happier climber in return.
Photo credit: Brian Watson
N. Marieb & K. Hoehn (2010). ‘Human Anatomy and Physiology’ (8th Ed.), Pearson Benjamin Cummings.
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