What's the shortest route back to the rock? (Climbing injury inside)
August 31, 2016 8:38 PM   Subscribe

My friend fell about 15 feet while we were bouldering and severely dislocated his elbow. Tendons were, to the surprise of the doctor, not torn; ligaments were pretty bad, broken. They said he had a "terrible trifecta". He currently has his arm in a cast and they're monitoring progress to determine surgery or not. We're likely looking at some 15 weeks he's in some state of immobility for his arm. He is supposed to rotate his shoulder as much as possible and clench his hand. He's an incredibly active and dynamic person and very much wants to recover fully and get back to activity. It's pretty difficult to watch him in the current state , despite the fact that we're so glad that he only injured his elbow. How do we help him have the best recovery possible? 1) Tips for supporting the physical recovery of a dislocated appendage and 2) Does anyone have any tips on how to stay sane during his time out? Everything appreciated. Thanks!
posted by sb3 to Health & Fitness (11 answers total) 2 users marked this as a favorite
Start helping him research physical and occupational therapists who specialize in sports injuries and athletes. You can probably start by asking at your local climbing gym(s) and listservs. They can also help him build exercise routines (and recommend trainers) that will help keep him in shape (and sane) without exacerbating his injury.
posted by rtha at 8:57 PM on August 31, 2016 [1 favorite]

I had an elbow injury probably somewhat worse than this (broken bone, immediate surgery.) You can read my AskMe history for more. The #1 piece of advice I have is get the best physical therapist you can, ideally a hand / arm specialist, and do everything they say like they were your cult leader. PTs are magical and helped me get my elbow back to almost full range of motion after a long period of immobilization. Someone specializing in athletes is probably a great idea if you can swing it.
posted by escabeche at 9:05 PM on August 31, 2016 [6 favorites]

Can I make practical suggestions? I have joint problems, which are not really in line with a scary fall like that, but I just went through a thing where an elbow flared up and I was in a sling for a while. Have you and other friends got his back on junk like raking leaves? Mundane tasks like that become overwhelming. A gift card for the sort of supermarket that sells a lot of good take-away and pre-cut veg etc would be a kind gesture -- I got my SO to slice tomatoes and cheese and so on so I could have sandwiches without swearing or cutting myself...

I had to get somebody else to drive me to and from the hospital because I was (1) pretty painkillered (2) not up to trying to drive with one working arm -- can you get a rota going for drives if he ends up with loads of appointments that are not a quick bus or Uber away; hospital parking can get expensive, and lots of doctor visits are boring and it's nice to chat with somebody?

Try to tell flakes to piss off so he doesn't have to. He posts a FB update about his elbow, somebody will ask him if he has considered going off gluten/"paleo"/"keto" or whatever (or worse, tried some stupid MLM supplement, if his FB friends are sufficiently horrid). Quickly butt in there and enthuse about the doctors/physio/etc he is choosing for himself. Injuries involve an amazing amount of terrible quack advice, often from otherwise intelligent people. "When my aunt fell off a bridge she stopped eating lettuce and only had same-sex sex, and she was perfectly fine a week later..." Everybody has a story. They are not ill-intentioned (save for the MLMers), but they are very tedious to deal with for the injured party.

Some sports medicine specialists will enthuse about certain types of very expensive injections; if your friend is not wealthy but is enthusiastic about reputable but pricy treatments, consider offering to run a GoFundMe so he doesn't have to ask somebody to/write off the treatment.
posted by kmennie at 9:13 PM on August 31, 2016 [2 favorites]

I had a similar injury from a bouldering fall.

Everything people say above, especially about getting a good physio!

Do everything the physio says, and make sure they know your friend wants to get back to climbing as soon as they can.

Make sure the physio is really clear about what kind of pain is OK to push through and what kind isn't.

In a few weeks, ask the physio what other lower body exercise is ok to do (stationary bike riding? Swimming with a pull buoy?) so your friend doesn't go stir crazy.

When recovered, consider learning how to fall 'better' - I put my arm out when I fell, causing the injury.

I have my full range of motion back (minus maybe one or two degrees - but I'm hyper mobile so that's still a larger-than-normal range of motion). For some reason falling while bouldering made me like rope climbing less than I did before, and now I just boulder, not sure why!
posted by mgrrl at 12:07 AM on September 1, 2016

The classic climbing-specific advice for arm injuries is: go deep on footwork. There's a lot of lower-body technique and balance stuff that active, dynamic people don't get around to learning when they have powerful upper bodies. Obviously listen to the physio and allow generous time to heal and all that, but drills like no-hands climbing (on slabs, presumably) are a good idea for anybody, and an arm injury is a great forcing function for them.
posted by xueexueg at 5:23 AM on September 1, 2016

Whenever I injure myself in one area, I focus on another. If I strain my hip so that I can't run, I find out I can still bike and make a go of doing more of that. If I hurt my shoulder I spend my exercise time doing leg work and focusing on my core. You are not totally out of the game and there are plenty of other muscles that you can still train without risking injury to the healing area. Combine that with complete commitment to physical therapy and the wait for healing will be over in no time. When you get back to your activity the cross training may even contribute to a better activity post-injury.
posted by cristinacristinacristina at 5:38 AM on September 1, 2016

I dislocated my shoulder while top rope climbing! Doesn't sound as extreme as this by any means and I didn't fall and it was indoors, but it was a bitch.

My full recovery was 6 months. I didn't need surgery, but I did need a hell of a lot of physical therapy. The thing with dislocated joints is that even after everything is put in place, the weakness persists for a good while. I wasn't cleared to climb again for three months and at that my PT told me if anything hurt or was strained to stop immediately and take a break. My first day back I did only two climbs and only ones where I didn't have to extend my arm fully.

Absolutely 100% he should fully listen to his physical therapist when he reaches the point of having one. He should 100% do all his exercises at home as instructed. It does make recovery easier, and he absolutely should expect some set backs. I plateaued about two months into recovery and really couldn't see I was improving at all. Then a month later I improved much faster than in the previous three months combined.

As for things you can do: all the household tasks that involve lifting or lots of arm motions. Give him gift certificates for food places so he can order food and not have to worry about making it. Have patience with him and for him if his recovery stalls. What other things has he been wanting to do that he could do now since he can't climb? Any new restaurants? Simple walking trails? Books he's been meaning to read? Plays, movies, etc?

I did a lot of Netflix binging and reading for awhile.
posted by zizzle at 7:10 AM on September 1, 2016 [1 favorite]

Help him keep off it and from getting back into serious activity too soon, repeat injuries can be worse.
posted by sammyo at 7:18 AM on September 1, 2016 [1 favorite]

Good chance to work on cardio! Slow medium exercise on a recumbent bike while listening to audio books or finally catching up on show X.
posted by gregglind at 8:02 AM on September 1, 2016

It sounds like your friend likes to climb outdoors - if being outdoors is important to him, get him out hiking (or whatever other activities he can handle). If he cycles, look into borrowing / renting a recumbent cycle for a while so he can burn off some energy that way.
posted by momus_window at 8:29 AM on September 1, 2016

Yeah, I was gonna say he should get into hiking and backpacking while his elbow is recovering, to help with his sanity. You can totally do that stuff with a bad elbow, and it'll get him out into the scenery again.
posted by Anticipation Of A New Lover's Arrival, The at 9:07 AM on September 1, 2016 [1 favorite]

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