TENDINITIS & CO.: WHAT’S NEVER BEEN SAID ON OUR “FRIENDS” PAIN AND INFLAMMATION
By Doctor Kelios Bonetti
A recent statistic made among our group and on our facebook page, shows that for 29,54% of climbers it is quite normal to have pain caused by climbing.
This incredible percentage, which would be unacceptable in any other sport activity, made me think that actually among all climbers that turn to me to be treated, a similar quantity comes for chronic problems. Since chronicity (that is lasting on a long-term basis ) makes the problem definitely more difficult to heal, running the risk of becoming an even more serious one, I thought I could write an article to explain at least how a trivial inflammation, when neglected, can lead to serious consequences, like chronic pain or injuries.
To tell it in simple words, we will start by saying that inflammation is the natural response of the body tissues to a damage. In climbing pathology a blunt trauma , a tear, a rupture, or the sum of continuous overloads and overtraining (e.g. training board, campus board etc..), leads inevitably to inflammation, resulting in an increase of blood supply that causes swell and even redness. The blood supply increases locally to repair a damage. Therefore inflammation is a helpful repairing process! So, inflammation is helpful? It can’t be true …Why the pain goes away if I take anti-inflammatories? Reasonable and sensible questions indeed, however the confusion arises form the fact we mistake the inflammatory healing process for the painful symptom, which in turn is misinterpreted too. The pain itself is an alarm bell: it tells us that there is a problem and it suggests we should rest a specific anatomical part so that it can fully recover. In view of this it is clear that
taking non-steroidal anti-inflammatory drug (pain-killers) after climbing is definitely not a good idea. When blocking an acute inflammation, the damaged tissue is more difficult to repair. Besides with no pain we lose the urge to rest the injury during the healing process and if this is not completed, for the reasons mentioned above, it can lead to a chronic inflammation.
If an inflammation becomes chronic, that is an inflammation that never goes out, pain is not the only problem. The main issue is the failure to repair the injured tissues and above all a disorder of their metabolism which becomes considerably slow. In some cases of chronic inflammation the pain goes away in the end but the slowed metabolism causes a progressive weakness of the structure a tendonitis with consequent risk of rupture if overloaded.
Tendinitis, that is a tendon inflammation, like all acute inflammations is helpful because it leads to recovery, pain is also helpful because it forces us to rest the anatomical part that is being healed …. so taking non-steroidal anti-inflammatory drug (pain-killers) as soon as the pain arises is harmful. If you do not let the inflammation run its course during its acute phase it could become chronic and difficult to heal. Besides the continuous pain, the injury does not get repaired and on top of this its metabolism slows considerably causing progressive tissue weakness.
So, one day it could happen that at the local crag on a fine, sunny but cool and windy autumn day with just the perfect grip … you lunge to grab a hold and you suddenly hear a cracking sound followed by a sharp pain (and the perfect day suddenly turns into a nightmare). Due to the slowed metabolism caused by chronic tendinitis, the pulley, the myotendinous junction or the insertion have gradually weakened, meaning that an overload exceeding the tissue residual resistance, can have caused the sudden tear.
About Doctor Kelios Bonetti
Doctor Kelios Bonetti, orthopaedic surgeon, specialist in orthopaedic and traumatology, expert in climbing pathology.
He has been actively studying climbing pathology for over 10 years, mastering the biomechanics and physiopathology of climbing and its specific pathologies. Thanks to his indoor and outdoor climbing experience, in treating climbers he has developed and achieved the best pharmacological, infiltrative, intradermal, orthotic methods of treatment and correction of the athletic gesture, the most effective training and selective resting techniques for the injured anatomical structures in order to assure a rapid and definitive recovery.
He is a member of the IRCRA, carries out studies and researches on the climbing pathologies and he is an active medical consultant for several climbing sites and
magazines. He cooperates with several trainers to prevent and treat climbing pathologies of their athletes. He is also an active consultant for climbing equipment companies, using his experience to help them make more ergonomic, functional and safe climbing materials in order to prevent some typical problems related to the climbing pathology …. Despite his vast experience in the field, his climbing grade stubbornly refuses to improve!