S3, E2: Ankle Sprain Rehab for Rock Climbers – Nicholas Hedges
In this conversation, Dr. Nick Hedges discusses the importance of the lower body, specifically the ankle, in climbing. He highlights the prevalence of ankle injuries in climbing and the potential consequences of ankle sprains. Dr. Hedges provides self-assessment techniques to determine ankle susceptibility and reduce the risk of injury. He also explains how to test ankle mobility and function, as well as how to tease out the different systems involved in balance. Dr. Hedges offers tips for training and improving balance and provides insights on benchmarking and comparing balance performance. The conversation concludes with a case study of sprained ankles in a climbing gym. This conversation explores the assessment, treatment, and rehabilitation of ankle sprains in rock climbers. The importance of addressing ankle stability and mobility is emphasized, along with the need to determine the severity of an ankle injury. The stages of ankle rehabilitation are discussed, including the unload stage, partial loading stage, initial loading stage, dynamic and plyometric stage, and fear avoidance. The conversation concludes with a reminder to seek professional help if needed and to prioritize ankle health to prevent chronic instability and future injuries.
Nicholas Hedge’s Bio
Nic Hedges has a Doctorate in Chiropractic as well as a Masters degree in Sport Science and Rehabilitation. Since graduating chiropractic school, Nic has taught anatomy and physiology at Colorado Mountain College. He was also a member of the climbing special interest group, which provided him the opportunity to collaborate with other professionals in a niche sport. He is now the proud owner and operator of Synergy Sports Clinic in Grand Junction, Colorado. When he’s not working in clinic, he can be found climbing in rifle or trail running.
Takeaways
- Significance of Ankle Health in Climbing: The lower body, particularly the ankle, plays a crucial role in climbing, with ankle injuries being common and often severe among climbers.
- Self-Assessment and Injury Prevention: Dr. Hedges provides techniques for climbers to self-assess their ankle susceptibility, helping them to identify risk factors and take steps to reduce the likelihood of injury.
- Ankle Mobility and Balance Testing: Practical methods are shared for testing ankle mobility and evaluating balance, with insights into how different systems contribute to maintaining stability on the wall.
- Rehabilitation Stages for Ankle Sprains: The stages of ankle rehabilitation are outlined, including unloading, partial loading, initial loading, dynamic and plyometric training, and addressing fear avoidance to support a full recovery.
Listen on Apple Podcasts, Spotify, or wherever you listen to podcasts!
Timecodes
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00:00 Introduction and Background
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01:30 The Importance of the Lower Body in Climbing
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06:19 The Consequences of Ankle Sprains
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08:02 Self-Assessment for Ankle Susceptibility and Injury Risk Reduction
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11:33 Testing Ankle Mobility and Function
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14:26 Teasing Out the Different Systems Involved in Balance
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21:09 Benchmarking and Comparing Balance Performance
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22:39 Case Study: Sprained Ankles in a Climbing Gym
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22:46 Importance of Assessing and Addressing the Ankle
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27:05 Determining the Severity of an Ankle Injury
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35:30 Stages of Ankle Rehabilitation
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44:05 Closing Thoughts on Ankle Sprains and Rock Climbing
If you would like to listen to the entire interview with Nicholas Hedges, check out the podcast. If you want to watch the interview, click the YouTube link or any of the timestamps above. If you would like to read quick sample of a concise recap of key interview topics and questions, check out the excerpt from the interview below.
Nick, could you introduce yourself for those who might not know you?
Sure! I’m Nick Hedges, a sports chiropractor specializing in rehab. My journey started as a runner, which sparked my interest in lower extremity injuries after a series of personal setbacks. During recovery, I discovered rock climbing, which I’ve since embraced both recreationally and professionally.
Climbing tends to focus on finger and upper body strength. Does the lower body matter much in climbing?
Absolutely. While upper body injuries like finger and shoulder issues are prevalent, lower body injuries can be equally limiting. Look at notable climbers like Alex Honnold or Sasha DiGiulian, whose setbacks were caused by ankle injuries. Many climbers overlook ankle stability and strength, which are vital for performance and preventing chronic injuries.
How can someone assess their ankle’s stability and injury risk?
A good starting point is the anterior reach test. Stand on one leg, squat slightly, and reach forward with the other leg, marking how far you can reach. Repeat on the other side and compare. If there’s a discrepancy, it could indicate a stability or mobility issue. Also, consider doing this test in multiple directions, like backward or diagonally, to evaluate full ankle function.
Can you give us some guidance on diagnosing an ankle injury and when to seek medical help?
The Ottawa Ankle Rules are an easy self-check tool. If you can’t walk four steps without assistance, feel pain while pressing on the prominent ankle bones, or notice tenderness on the base of the fifth metatarsal (outer foot bone) or the navicular bone (inner arch), it’s time to see a doctor.
Once an ankle injury is confirmed, what are the stages of rehab?
Here’s a quick overview:
- Unload Stage: Avoid putting too much weight on the ankle. Start with gentle ankle pumps and circles to reduce inflammation and restore range of motion.
- Partial Loading Stage: Engage intrinsic foot muscles through exercises like the Short Foot Exercise and Toe Yoga to boost blood flow and control.
- Initial Loading Stage: Progress to seated calf raises to add light resistance. Always keep pain levels in check—stop if the pain persists or intensifies.
- Balance and Proprioception Training: Practice standing on one leg, progressing to eyes closed or unstable surfaces like a foam pad. This retrains your proprioceptive system, which controls balance.
- Dynamic and Plyometric Stage: Start hopping exercises and landing drills to build tolerance. Eventually, work on controlled falls in a climbing environment to reinforce mental resilience alongside physical readiness.
Any tips for climbers to reintegrate ankle stability exercises into climbing?
Yes, applying the star drill for climbing is a good approach. This is a single-leg balancing exercise in various directions and can help rebuild proprioceptive awareness on the wall. Also, exercises for the big toe flexor can enhance foot control, which is crucial in climbing.
Do you have any final thoughts for climbers with recurring ankle injuries?
Don’t ignore recurring ankle sprains, especially if it’s a seasonal occurrence when you switch sports or increase activity. Chronic ankle instability can eventually lead to arthritis. Consistently training ankle stability, proprioception, and strength can break this cycle.
Where can listeners find more of your advice?
You can reach me at drhedges93@gmail.com and find my podcast Art of Prevention on major platforms. The podcast covers climbing injury prevention and features guests from the field, like our host here, Jared Vagy.
- Disclaimer – The content here is designed for information & education purposes only and the content is not intended for medical advice.
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