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Bicep Tendonitis and rock climbing

Sara Lingafelter
Sara Lingafelter
4 min read

Some of you have already heard that I’ve been nursing a bit of a shoulder injury. Several months ago, I became a bit obsessive about bodyweight push-ups (as in, not “girl” or “modified” pushups) and pushed them a wee bit too far. After doing a set to failure one night, I felt a twinge in my left shoulder. Being a rock climber, upon sensing shoulder pain, I panicked. Ice, rest, Aleve and massage helped with that acute stage, but even after the pain subsided after a few days, I couldn’t return to push-ups. I tried benching, instead, to do something less than bodyweight, but the pain returned. I finally found that dips on the dip bar don’t trigger the pain, which still occasionally popped up. My dear massage therapist / climber friend identified the location of the pain as my bicep, not the dreaded rotator cuff, so for a few months I just nursed it, hoping that dips would do enough to stabilize my shoulder that I could avoid it getting worse. Luckily, climbing didn’t really aggravate it, but not being able to do bench / push-ups definitely wasn’t helping my shoulder stability any.

Then, during my last trip to Index, I had an unusually long, nearly bodyweight hang on a jam on that side while on lead. By nighttime, my shoulder was extremely painful (front, side and back), and panic once again set in. As soon as business hours arrived, I called my family physician and she referred me to a physical therapist.

A nervous work week later, the back and side of my shoulder slowly felt better with ice and rest while I waited for my appointment. The front — the bicep tendon — still hurt, though.

I very nervously met John Estes at DaVinci Physical Therapy on Bainbridge Island last Friday. His demeanor was great, and while he’s not a climber himself, he impressed me immediately with his above-average understanding of the stresses that climbing places on the body. It doesn’t seem all that complicated to me, but I’ve been to several PTs since starting to climb, and have been really surprised by their lack of awareness of climbing movement and the impact on the body. The first few visits are usually educating the PT about climbing and its physical demands. John was “with it” right out of the gate.

His exam was thorough… I started out really nervous, because I was afraid that the testing would hurt and expose some sort of horrible problem, but each test showed no serious injury, which was reassuring. The final diagnosis is bicep tendinitis, aggravated by extremely weak rotator cuffs and deltoids relative to my, um, well defined trapezius muscles and biceps. More on my traps in a second.

I’m going to count myself lucky that I developed the bicep tendinitis, so that I get this chance to learn about my shoulders and back before managing to get myself in serious shoulder trouble. Had I not experienced this little setback, I probably would have kept on training, neglecting my rotator cuffs and mid-back until I wound up with a serious shoulder injury.

John prescribed an exercise routine (that link will download the PDF), including scapular stabilization, scapular flexion, scapular retraction, resisted external rotation, resisted horizontal abduction, and some stretching exercises to increase my range of motion. The bicep tendonitis is relatively mild, so unless it doesn’t improve quickly, we’ll emphasize building stability and strength. If the tendinitis doesn’t improve, then we’ll do more “treatment” of the bicep issue. That approach works for me, since I’m on a tight budget, and I’d rather do exercises at home and go to the PT (which is an hour from home) less often, if at all possible.

I’m astonished at how weak I am at the exercises prescribed, when I look like a freaking tank. The exercises are hard for me to do, so I look forward to getting stronger.

One of the highlights of the whole thing was when John was talking through the results of his exam, and he pointed out my extremely strong Trapezius muscles relative to the rest of me. I do believe he called them “overdeveloped.” Even for a climber, my Traps are huge. My climbing partner calls my traps “Hulk Hogan muscles,” to give you some idea. John demonstrated two different climbing “postures:” one with his shoulders down and relaxed, and his Traps kicking in to lift the arms only once his elbows were past shoulder height; the second, totally tight and tense, with his shoulders darn near up around his ears, using his traps to lift his arms all the way up.

One guess what my natural / typical climbing “posture” is.

I’d say my natural climbing posture ranges from “tense” to “terrified.” John ok’d me to climb at sub-max during my rehab (good move — since climbers are notorious for NOT stopping climbing when we’re told to); but, prescribed climbing with a relaxed posture to let my back and shoulders do the work that my Traps have been doing all this time. I didn’t really get a chance to try that out bouldering last weekend, since I really mostly just kept it light since I was sore from my PT on Friday; I’m hoping to get into the gym at least once this week to do endurance work, and to give climbing with a relaxed posture a try. I was really excited about that particular insight he provided — even as a non-climber, he was able to diagnose one of my biggest climbing flaws… that I’m a totally stressed out, tense climber. I look forward to working on changing that!

I’ll post updates as I have new developments or additional insights, and please chime in with your own stories…

Sara Lingafelter

Sara (Grace) Lingafelter takes steps forward and backward toward a right-sized life on a daily basis.