Hypermobility & Injury

Throwing this out there to see if other climbers with hypermobile joints have experienced increased frequency of ligament and/or tendon injury. If so, have you found any strategies for healing injuries more quickly and thoroughly(?) and/or for preventing recurrence?

I remember being told at 12 years old that my hypermobility would cause problems when I got older, but I didn't take that seriously until 4 injuries in the last 18 months. At first I thought I was just slacking on my counter-muscle training (I was). But the most recent injury—arguably the most severe—has got me thinking that I need to reevaluate my approach.

I started dealing with some medial epicondylosis around this time last year. Through weekly acupuncture, Graston, and PT (mostly counter-muscle training), I was able to beat it into submission. Of course I started slacking off on my PT when the pain went away, and the pain came back. And then about 2 months ago I sprained my UCL, which I'm still recovering from. My doctor says this is really common for people with hypermobility, but what he hasn't told me is how to hurry up and heal it (seriously, how many months does it take to heal a sprain??) or how to prevent it from happening again.

At this point I haven't climbed in 2 months. I can't ride a motorcycle or a bicycle, or even stuff a sleeping bag into a stuff sack without pain. I'm basically stuck in NYC—and going absolutely crazy. If I could do it all again smarter, I totally would. But... what is smarter?? Have you been here? Do you have lessons learned that you want to share? Training or PT exercises or other compensatory strategies you can recommend?

I have hypermobility in my joints too, been dealing with tendonitis in my shoulder for two years, got some issue with a tendon behind my knee right now...sucks. Done some PT for my shoulder, but keep tweaking it...just gotta stay on top of it I guess. 

I’m very hyper mobile and have a slap lesion in 1 shoulder that is relatively stable due to lots of scapular stabilizing and regular exercise.  Tore the labrum in my hip about a year ago and had surgery to repair it... lots of less severe sprains and injuries... basically i strength train a lot and warm up before EVERYTHING .. and don’t boulder too much

Luna Luna wrote: ...relatively stable due to lots of scapular stabilizing and regular exercise. ... basically i strength train a lot and warm up before EVERYTHING...

Exactly, build strength to add support and keep those joints protected by your new muscles.

Do you folks basically just do PT-like exercises all the time? Like, every time before training in the gym? What about on days when you're climbing outside, or on rest days?

At this point I'm doing 20-30 minutes of PT a day (individually isolating the flexors, the extensors, and the ulnar nerve, and then doing exercises that also target the shoulder and scapular muscles). I'm very disciplined now because I know this is what's going to get me back on the wall. But I imagine my motivation is going to wane once the ROI goes down. Do you guys change up the support exercises, or just commit to the routine?

make sure you are being conscientious about your PT and training, poor form could be making your injury worse!  but yes. PT before every indoor session and a few key exercises before outdoor days, and absolutely doing a warmup route on outdoor days.  rest days are rest days, even rest days from PT... its possible to over-do rehab just like its possible to over-do training 

Throwing this out there to see if other climbers with hypermobile joints have experienced increased frequency of ligament and/or tendon injury. 

Yes. If I could magnify that word by 10, then that would be my answer.

If so, have you found any strategies for healing injuries more quickly and thoroughly(?)and/or for preventing recurrence? 

Not really. My particular condition is due to a defect in the actual collagen. I feel this is likely a hindrance to accelerated healing.
Preventing recurrence is, in a nutshell, based on learning from your injuries, keeping your joints strong and functional, and toning down the intensity of activities which might hurt you.

but what he hasn't told me is how to hurry up and heal it (seriously, how many months does it take to heal a sprain??) or how to prevent it from happening again. 

It takes sprains pretty much forever to heal. It's difficult to say how to prevent something like a collateral ligament injury besides avoid bending/stressing a joint in the direction the ligament stabilizes it. You can't strengthen ligaments directly, so there's no prevention that is quick and easy in that sense.

Do you folks basically just do PT-like exercises all the time? Like, every time before training in the gym? What about on days when you're climbing outside, or on rest days?  

Yes, sort of.
No (I don't recommend doing rehab exercises prior to training/fitness - better to do after).
No.

My strategies include: 

• I have found I have to spend more time on comprehensive non-climbing fitness stuff than other climbers in order to stave off injury (particularly acute injury). Example: I have to strength train things like my rotator cuffs, knees, back, abs, etc. more than others. 
• I have to rest my hands, wrists, elbows, fingers, and feet more than others to avoid overuse injury. In fact, I probably have to rest everything more than most.
• I have to avoid certain climbing techniques - hard gastons can cause my shoulders to sublux. I will not use hard slopers either - high risk for my wrists. I almost never use mono holds. Etc.
• I don't engage in certain climbing disciplines - I don't boulder at all anymore. I am super careful when climbing anything really thuggy and dynamic or really crimpy.
• Any route is that above 5.11, I first evaluate the climbing style and determine if it's low risk for causing injury to me. I've kinda just learned over many years how to do this. Depending on the route style or depending on how I feel that day, I avoid a lot of "harder/ish" routes entirely to avoid an injury I can see potentially occurring.
• I always warm up extensively whenever possible. 

I still get hurt frequently despite all the above. I've had an injury in my toe/foot for 16 months now. It's almost actually finally truly healed completely, but I can tell it's still not completely good for any/all activities. I've seen two docs, a podiatrist and an orthopedist, many months apart with mostly recommendations to continue neverending conservative treatment. It took 12 months before I could actually try real outdoor climbing again on the foot (before it was just gym). Now, after perhaps 3 months of happy climbing, my one "good" wrist has suffered a mild injury after a single moderate 6 pitch route recently (plus gym climbing a few days later). You can't ever really win; you can only ride the line between doing as much as you can and being injured.

it's just going to happen... you have to roll with the punches.

the hardest part is trying to realize that it's probably not going to get better.

but it's kind of freeing to be in a permanent state of recovery.