Acute Hamstring Muscle Tears in Climbers—Current Rehabilitation Concepts

Abstract

Acute hamstring injuries are often caused by the heel hook technique. This technique is unique to climbing and causes injury to muscular and inert tissues of the posterior thigh. The heel hook is used by climbers during strenuous ascent on overhanging walls and when crossing difficult terrain. The technique reduces the amount of upper body strength required during strenuous climbing because the climber's center of mass is retained within the base of support. The heel hook is stressful collectively for the hamstring muscle group and musculotendinous junction. Depending on injury severity, both conservative and surgical methods exist for the management of hamstring injuries. Contemporary approaches to rehabilitation primarily advocate the use of eccentric muscle strengthening strategies because of high rates of elongation stress associated with sprinting and team sports. However, there is reason to doubt whether this alone is sufficient to rehabilitate the climbing athlete in light of the high degree of concentric muscle strength required in the heel hook maneuver. This review examines the contemporary rehabilitation and strength and conditioning literature in relation to the management of acute hamstring musculotendinous injuries for the climbing athlete. The review provides a comprehensive approach for the rehabilitation and athletic preparation of the climbing athlete from the initial injury to full return to sports participation.

Evaluation of a four-week Adjunct Compensatory Training for the treatment of climbing-specific overstrain syndromes of the shoulder

“…Performance on all of these measures was strongly enhanced relative to the first assessment. These findings are important, particularly given the lack of climbing related rehabilitation programs 4 5 11 12 as well as the rise in incidence of shoulder injuries in climbers 10 16 20 .…”

“…As climbing becomes more popular, it is essential for medical professionals and physical therapists to better understand and treat climbing-related injuries [6]. Little work was done onto prevention and rehabilitation after overstrain injuries yet [11,12].…”

Rehabilitation of Annular Pulley Injuries of the Fingers in Climbers: A Clinical Commentary

“…Off the wall climbing specific neuromuscular performance is initiated when pain and strength loss is negligible compared with the contralateral side. It is important to continue to monitor the response to mechanical load during each progression and after training (55). Climbing specific neuromuscular performance is important to restore maximal force expression (56), rate of force development, energy storage (57), and the local muscular endurance (58) of the finger muscle, tendons, and the shoulder girdle muscles.…”