Looking to improve outcomes related to training? Participate in a discussion with Dr. Natasha Barnes as she explores and clarifies some of the myths around injury prevention related to strength training. Learn how athletes can use autoregulation to improve training outcomes and reduce injury risk. This clinic is for all athletes currently using or interested in using strength training related to their sport with specific examples for the climbing athlete.
In This Clinic
- Myths About Injury Prevention
- What Things Actually Reduce Your Risk of Injury
- Load Management Autoregulation
Myths about injury prevention
Myth #1 Stretching prevents injury and aids recovery
Stretching does NOT prevent injury (Lauerson et. al 2013).
5 trials, including 26,610 participants with 3464 injuries.
Proprioceptive training, strength training, and stretching
“Stretching did not show any protective effect… while strength training proved highly significant…”
Strength training reduced sports injuries to less than a third (66%) and overuse injuries could be almost halved.
Myth #2 Lifting or climbing with “bad form” causes injury
“Bad form” is a myth and does not cause injury.
What is “good” and “bad” form?
We do not have evidence to determine what “injurious” and “non-injurious” form is.
There is a lot of variability in movement in the human population.
Injury has more to do with whether or not you are adapted to a certain load or position.
“Perfect form” is also an ableist concept and doesn’t take into account the ability for the body to adapt to stress.
Being hyper vigilant about perfect form can be harmful - perfectionism can increase risk of injury.
Your body is not a machine that wears out or breaks down.
You are a living organism that can adapt to the stresses imposed on you.
Myth #3 Climbers need to do opposition/antagonist training to prevent injury.
- “Opposition/Antagonist Training” = fixing muscular “imbalances” or working to strengthen stabilizers
- The problem: Manual muscle testing lacks precision and sensitivity
- Asymmetry is normal and can be an adaption to sport!
- Things like Hamstring to Quad ratio (H:Q ratio) are antiquated and unsubstantiated metrics.
- Most opposition/antagonist training is substantially underdosed; it is just not hard enough.
Preventing Injuries is Impossible.
Preventing pain is unrealistic and impossible.
Setbacks are an inevitable part of training as an athlete. Understanding injuries in general and how to come back from one are more important than thinking you can prevent them.
Improving in sports requires more training stimulus over time to induce adaptation - with this comes the inherent risk of injury.
Why do Injuries Happen?
- Overtraining/dosage issues - if you’re doing more than your body can handle.
- Lack of sleep
- Undereating - you need to make sure you're consuming enough nutritious calories.
- Previous injury - can increase your risk of getting an injury in the future.
- Sh*t just happens- we can’t always predict everything. Humans are like the weather; we’re dynamical systems and there’s many things that contribute to why certain things happen to us.
What Things Actually Reduce Your Risk of Injury
Making sure you are doing the proper weight and reps.
Smart programming, making sure you get enough sleep and enough proper nutrition.
Psychosocial Coping Skills
Not panicking or getting overwhelmed when you get an injury
Proven to help reduce your risk of injury
Load Management Autoregulation
- Most non-contact injuries are related to poor management of training load.
- Training Load = the cumulative amount of stress (physiological, psychological, or mechanical) placed on an individual from a single training session, or from multiple training sessions over a period of time.
Absolute weight on the barbell, sets, and reps
Ex: lifting 200 lbs for 8 repetitions or running 3 miles at a specific pace
The athlete’s perceptual and physiological response to an external load.
Ex: “How difficult was that set/rep?” HR (heart rate), RPE (rate of perceived exertion)
What is Autoregulation?
- A tool to select and adjust training intensity based on your performance during a given training session.
- Allows for flexibility
- Good day or bad day, you can still have a training session that is appropriate for you.
- Can reduce risk of injury
- By managing load and fatigue appropriately
- Makes training sustainable
- Ensures that you don’t accumulate excessive fatigue so that you can keep training and progressing for a long time.
These things can vary session to session:
Methods to regulate intensity:
- Rate of perceived exertion/session rate of perceived exertion
- Looking at a specific exercise or a whole session and how hard you felt you tried during it
- Reps in reverse
- How many reps you feel like you have left in the tank after an exercise
- Velocity based training
- Check out an RPE chart
- Eva Lopez has some of the only research on finger strength training for climbing
Pros and Cons of Using RPE
Accounts for variability in performance
No extra equipment
Not testing every session or every week
Perfect accuracy not needed
Autonomy & self-efficacy
Takes some time to calibrate
Can’t really be used for power training
Does antagonist training always mean trying to perfectly even out muscle imbalances or just using the opposite muscles?
It’s not necessarily working push muscles to supplement all the pulling from climbing, like fixing push versus pull muscles. It’s more about just becoming a well-rounded athlete, and doing supplemental training at an intensity that’s going to support the sport that you’re doing.
Climbing is a really specialized sport and we really only train our bodies in a very specific way. That’s why strength training is helpful because it’s a really potent, time-saving way to get stronger and build resiliency, build capacity, and build tissue tolerance for some of these structures that we stress a lot in climbing.
Don’t think of it as much as trying to fix an imbalance or make a certain push-pull ratio (we don’t actually have research for push-pull ratios). Think of it more in a way like what can I do to support my climbing that’s at the right intensity and will help prepare my body for climbing.
With auto regulating if we are leaving room in the tank, how do we know when it's appropriate to increase the load? Is it when the reserve time goes from three seconds to four or when we feel we have three more reps reserved versus two?
So for example, if you do a set of eight at RPE eight, you have two more reps left in the tank. You can do that for any rep range.
So if you're warming up and you hit the same weight you hit last week and you're like oh that actually feels easier and you have more in the tank then yeah you can go up. If the training is being dosed appropriately then you should be able to make some kind of increase week to week and go up a little bit.
Most people can go up five or ten percent weekly if they're adapting well to the training program. It depends on your fatigue, your sleep, your nutrition, and all of these other things. In general, you’ll be able to tell if you can hit that weight and it feels easier and you feel that you have more reps in the tank.
What is long-term progression for you?
I look for signs and symptoms for deload. Like numbers are going down, or you know you’re feeling extra tired, or you’re stalling for example, we probably need to change the training program and switch to a different block and switch up the variations or rep ranges to keep it fresh.
I don’t generally bring down the intensity, I would typically just lower the volume and switch the program.
I’m a climber with a history of minor shoulder rotator cuff injuries and I want to build more explosive pull arm power for bouldering. What tips do you have for keeping shoulders healthy while improving explosive pull power?
Strength is going to be your foundation - the stronger you are, the better you’re going to be set up.
So number one I would say would be to increase your shoulder strength in general, so picking exercises that are going to help you do that: bench press, overhead press, pull-ups, weighted pull-ups, etc. These things are really going to help build your base, and then you’ll have to get more specific for power for your upper body, like canvasing, certain climbing drills for explosive power in the shoulders.
Do you recommend separate days for climbing and strength?
I don’t think it’s totally necessary to do them on separate days especially if you’re autoregulating it. Even if you are a little fatigued from let’s say your climbing session, you can still make the strength training feel appropriate for you.
I like to do it on different days personally because it breaks up the sessions. To keep the numbers stable and tell if you’re actually making progress, it’s better to have at least some hours separating the sessions, but you can also do it in the same day if you want to or don’t have the time to dedicate to two separate sessions.
What are your thoughts on warm-ups for bouldering versus sport climbing knowing that they require different energy systems?
Warming up is always going to be specific to the task, so you’re going to want to consider the activity you’re going to be doing when warming up.
I would do whatever thing you’re going to be doing in that session. I don’t generally recommend a long warm-up most of the time.
What's your experience with climbers who have a torn shoulder labrum and repeated dislocations any resources for getting strong enough to minimize dislocating?
It depends on how many times you’ve dislocated it, if you have chronic dislocations and it’s happening all the time and it’s severe, sometimes that is a case for a surgical consultation.
But also labral tears are really common in overhead athletes, and shoulder pain isn’t always coming from that necessarily.
A lot of climbers I’ve worked with are fairly hyper mobile too, and strength training has really helped just make those shoulders more stable. I would just spend like a good 8 to 12 weeks just really getting stronger honestly.
I usually have tendonitis issues on my arms in competition season. Is taking a couple months off from training and working out in the cold months a good idea or should I keep strengthening year round?
I think strengthening year round is definitely what I have people do and what I would recommend. It does take a long time to build a good strength foundation so doing it year round is ideal.
How frequently you do it and how much you do is going to depend on your climbing season and I highly recommend that everybody have an off season if possible, where you're spending more time getting stronger and doing supportive training for your climbing.
Incorporating strength training regularly for any any kind of climber is going to be good, and having an off season where you’re decreasing your intensity of how much you're climbing your intensity and how much you're climbing can be good too, but if you're dealing with a tendinopathy issue, that's a dosage problem and so you probably also just need to look at your training program and see where you may be doing too much, intensity or volume, and adjust the dosage.
What kinds of shoulder exercises would you recommend if the classic internal external rotation might not be effective?
We think of those external internal rotations as the go-to exercises for rotator cuff and shoulder but literally any shoulder exercise that you do is going to strengthen your rotator cuff.
Bench press not only trains your rotator cuff but also trains all of the muscles around your shoulder girdle. Overhead press not only trains your rotator cuff, but also trains all of the muscles around your shoulder girdle. Rows are a great exercise, lateral raises, upright rows, shrugs, front raises, all of those things are great exercises for shoulder healthy and rotator cuff exercises too.
We don’t need to isolate the rotator cuff in that way, it doesn’t even function in that way, so if there’s a specific problem like a tendon issue, then maybe I would isolate it and do some eccentrics or isometrics, but I’d also do strength training on top of that.
I understand there is little correlation between posture form and injury - is there any argument for specific form or positions of shoulders and elbows when fingerboarding?
When you're hanging I wouldn't think about doing anything really specific with your shoulders. It's not actually less stress on your elbow to bend your elbow when you're hanging; it's more stress.
You're using more muscle around your elbow joint to hold that position, so hanging straight is actually less stress on your elbow joint.
You can hang however you want. I don't think it has to be complicated, just hang on a straight arm and you’re going to conserve more energy that way anyway.
Any further reading on RPE and auto regulation you'd recommend?
Mike Tuchscherer is a power lifter and he's kind of the person who adapted RPE for strength sports. It comes from the borg scale which is actually for something else and he adapted it for strength training. He's got a lot of articles and things like that about it.
Barbell medicine has some good articles about auto regulation and training as well.