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Don’t Climb to Get Fit – Get Fit to Climb

Read Dr Ajai Seth’s article from HCA Healthcare UK. Or, click here to visit the original article.


Expert advice on the indoor climbing boom

With the surge in popularity of indoor climbing walls over the past five years, more people are climbing than ever before. This endorphin-inducing, full-body exercise has scaled the charts to become one of the UK’s fastest-growing sports with more than one million participants.

During the colder, wetter months, those numbers can get even higher. But, as people of all ages climb their way to fitness, sports medicine doctors are also treating more climbing-related injuries. So says Dr Ajai Seth, Consultant in Sport, Exercise & Rehabilitation Medicine at London Bridge Hospital, and Institute of Sport, Exercise & Health, part of HCA Healthcare UK.

Climbing accidents have more than doubled in the last two years,” he says. “While it’s less common than injuries from playing football or running, I’m seeing lots of new climbers who get injured because of their level of fitness, condition, or climbing technique.

ajai Don’t Climb to Get Fit – Get Fit to Climb

Why climb?

Climbers are drawn to the social, emotional and cognitive benefits they enjoy, on top of the physical benefits. For some it’s a great way to relax with friends. For others it keeps the kids entertained on a Saturday afternoon. And many people find the focus and concentration help relieve stress and boost overall wellbeing.

According to Dr Seth however, those who are drawn to the lifestyle benefits don’t always start out with enough fitness for such a strenuous sport, and are more likely to get injured.

People think they can get fit solely from climbing,” he says, “but I would always advise adding some cardio and strength training around it. Climbing requires strength, tenacity and willpower. So you need to add some fitness training or gym-based activity to prepare, and climb safely.

indoor climbing Don’t Climb to Get Fit – Get Fit to Climb

The most common climbing injuries

  1. Ligament sprains
    At least half of the climbing injuries Dr Seth treats are from bouldering accidents. This rope-free climbing style requires less equipment and is usually on lower walls. But, says Dr Seth, the risk of injury is actually higher.

    People think the higher walls are more dangerous,” he explains, “but bouldering is probably the biggest risk on the severity scale. You can start without much training, and still get up to three metres high. When people don’t have a proper descent, they can lose their grip, fall backwards or land awkwardly on the mat, causing twists and sprains to ankles and knees.
  2. Knocks and blows
    The second injury Dr Seth sees is from top roping, the next most popular form of indoor climbing. With ropes, harnesses, and higher walls to scale, Dr Seth says people typically suffer blows to the knee and ankles from losing their grip suddenly, swinging on the rope and colliding with the wall.
  3. Painful tendons
    Tendonitis in the knee or ankle is commonly linked to holding awkward climbing positions for long periods of time. Dr Seth says, “These injuries are more from overuse, but I’ve also seen acute ankle tendon flares from just one session of bouldering. People associate an Achilles injury with running, but you can easily injure it in climbing, especially when pushing off.
  4. Injuries to feet
    Another big area of injury is related to footwear. Dr Seth says climbing shoes fit very tight to protect the foot and improve grip. But shoes that are too tight can also cause injuries.

    I’ve seen climbers with plantar fasciitis, ingrown toenails, even metatarsal breaks, just from tight shoes. Good supportive footwear is critical to protect against injury, so we work with a podiatrist to ensure the patient’s shoes are the right fit for the type of climbing they’re doing.

When to seek help after injury

While many climbers know to check out a head injury or concussion, Dr Seth says it’s equally important to seek help for joint injuries. “Any swelling in the knee or ankle, persistent pain or difficulty walking, get it checked out,” he advises. “Climbing accidents are not like tripping over a step, they involve a fall from a height, so there is nearly always some trauma involved.

Maddie Tait, a Musculoskeletal Podiatrist specialising in sports injuries to the feet at London Bridge Hospital, stresses the importance of addressing any foot pain early. Maddie warns, “with ingrown toenails from tight shoes, there is a risk of infections if they’re left untreated. Most will need simple management, but more severe cases may need minor surgery.

She also stresses the importance of prevention: “anyone doing lots of climbing should get a biomechanical podiatry assessment and gait analysis to check how the joints and tendons all move.

Treatment for injuries

As Medical Director and founder of London Bridge Sports Medicine, Dr Seth works with a multidisciplinary team to offer all the latest diagnostics, evidence-based treatments and therapies for sports injuries – all delivered in a personalised plan.

I usually do an ultrasound scan in the initial consultation to see the condition of the ligaments in the foot and ankle – followed by an MRI if needed. Most of the time, patients get a diagnosis there and then, so we can quickly start creating a rehabilitation timeline.

I then prescribe the best exercise – on the bike or in the pool – or I bring in a physiotherapist. For problematic joints and ongoing swelling, we have other procedures such as injections. For more serious injuries such as a ruptured ACL (anterior cruciate ligament) in the knee, we bring in surgeons and consultants from every clinical specialism across HCA UK’s London network.

Maddie explains how podiatry can also help: “the toes do a lot of gripping and pushing away during climbing so tension can build up, so we use silicon separators and orthotics to combat this and better support the feet during training.

Dr Seth’s holistic approach means he also works closely with his patients to make small but significant adjustments to their lifestyle that better support their sport. The list includes sleep hygiene, social and emotional wellbeing, hormonal health, endocrine function and much more.

I’ll often explore my patients’ levels of health, fitness and the type of training they do to prepare for climbing. It’s important that they know why they got injured in the first place, what they can do about it, and how to prevent further injury.

Preventing injury

So finally, what advice do Dr Seth and Maddie have for the new climbing convert?

  1. Cross train
    Dr Seth stresses that climbing works best as part of a wider fitness programme: “Climbing is a great all-round sport and social activity. But don’t forget to work on your overall fitness to climb.
  2. Build up slowly
    With all the feel-good chemicals that climbing produces, it’s important not to climb too high or for too long at the beginning. Dr Seth warns that over-exertion, especially in the first few sessions, raises the risk of injury. And Maddie adds that it’s important to warm up and stretch. “Ensuring good calf and ankle flexibility is really protective,” she says.
  3. Invest in great footwear
    The right climbing shoes will protect your joints and enhance your performance. So consult a podiatrist – and choose your shoes with care. Maddie says, “a good climbing shoe should be snug enough to hold your foot in place, but not so tight or flexed that it squeezes the toes and metatarsals and overworks the feet.
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    Orla Mulligan
    Administration and Social Media Manager
    Administration, LBSM

    Orla Mulligan is the administration and social media manager for LBSM. She has a strong background in sport having herself played netball at an elite standard for the U21s Northern Ireland team in the European Championships as well as the U21s competition for Saracen Mavericks.

    She understands youth sport pathways having herself played and training in the netball Kent regional pathway. She has a keen interest in most sports and a good understanding of how injury and illness can impact on the mind and body, as well as rehabilitation pathways.

    She looks forward to speaking and assisting LBSM patients and gives her best support to them during their treatment pathway.

    A day in the life of Orla involves communicating with patients via phone and email, managing and organising clinics, operations and media management.

    Outside of work, Orla is a gym enthusiast, enjoys tennis and still finds the time for an occasional game of netball.

    Maddie Tait
    BSc, MSc
    Associate, LBSM
    Musculoskeletal and Sports Podiatrist

    Maddie treats and manages complex foot and ankle injuries in London and Surrey.

    She is particularly interested in helping her patients improve their quality of life and achieve their personal goals, working closely with Foot and Ankle Consultants, Sports Medicine Doctors and Physiotherapists.

    Maddie has a sporting background herself having previously represented England in Hockey. She understands the demands of elite sport and the importance of physical and mental health. In her spare time, Maddie continues to enjoy an active lifestyle by running, cycling and attending a Pilates class.

    Having graduated from University of Brighton with a MSc (hons) in Podiatry, Maddie focused her career in Podiatric Sports Injuries and Biomechanics. Previously she completed a BSc (hons) in Sport Science at Loughborough University.

    A day in the life of Maddie involves consulting patients in clinic, performing gait and biomechanical assessments, measuring and fitting orthotics and braces. She also regularly teaches and presents at sports medicine and podiatry conferences.

    Outside of work, Maddie still finds time to play hockey and enjoys running and skiing.

    Mr Prakash Saha
    MBBS, PhD, FRCS
    Consultant Partner, LBSM
    Consultant in Vascular Surgery

    Mr Prakash Saha is a Consultant Vascular Surgeon at LBSM. He takes pride in providing the best possible results for his patients by using the most appropriate non-surgical and surgical methods based on clinical evidence, patient results and satisfaction.

    He treats fit and active people suffering with a range of cardiovascular issues, from painful leg swelling associated with exercise to venous insufficiency, post-thrombotic syndrome and leg ulcers. He also treats people with arterial system problems including poor circulation, compression syndromes and aneurysms. He carries out both endovascular and open aortic repair and has some of the best outcomes in the country.

    Mr Saha studied medicine at the United Medical & Dental Schools at Guy’s and St. Thomas’ Hospitals before completing his higher surgical training in London and the South East. During this time, he was awarded the prestigious NIHR Clinical Lectureship in Vascular Surgery at St. Thomas’ Hospital, giving him comprehensive training in open and endovascular techniques for treating arterial and venous disease. Prakash completed his aortic surgery training at the St. George’s Vascular Institute before carrying out a specialist fellowship at the Royal Prince Alfred Hospital, Sydney.

    Mr Saha regularly lectures and runs workshops across the globe on the latest surgical techniques to treat vascular disease. He has also been awarded a number of research grants from the Royal College of Surgeons, the Circulation Foundation, the Wellcome Trust, the Academy of Medical Sciences, and the British Heart Foundation, which has led to over 80 publications and the development of innovative technologies to help treat patients. For this work, Prakash has received a number of prizes, including the Venous Forum prize from the Vascular Society of Great Britain and Ireland, an International Young Investigator Award, and an Early Career Investigator Award from the American Heart Association.

    A day in the life of Mr Saha involves seeing patients in clinic, operating in surgical theatre or lecturing at his university. He also regularly teaches and presents at vascular and sports medicine conferences.

    Mr Saha is an avid cyclist and tennis player (although yet to get a set of Dr Seth!). Outside of work, he spends time with his family who consists of 3 children and enjoys travelling.

    Dr Gajan Rajeswaran
    MBBS, FRCR
    Consultant Partner, LBSM
    Consultant in Sports and Musculoskeletal Radiology

    Dr Gajan Rajeswaran is a Consultant Musculoskeletal Radiologist at LBSM, with an extensive background of working in elite sport. He is one of the most recognised radiologists in the sports medicine field. He provides top level imaging and medical diagnostic services for patients and athletes.

    Dr Gajan Rajeswaran completed his undergraduate medical training at Imperial College London and his radiology training at Chelsea & Westminster Hospital. He has obtained two post-CCT fellowships in musculoskeletal imaging. He was appointed as a consultant at Chelsea & Westminster Hospital in 2011.

    He has a passion for all sports having worked as a radiologist at the Glasgow Commonwealth Games and London World Athletic Championships and continues to support The Championships, Wimbledon. He also continues to work with a number of Premier League and Championship Football Clubs, Premier League Rugby Clubs, England Sevens Rugby, British Athletics and the Lawn Tennis Association.

    A day in the life of Dr Rajeswaran involves giving his expert opinion on investigations such as MRI and CT scans, x-rays and ultrasound. He also performs injection lists under ultrasound, CT and X-ray including spinal injections. He also regularly teaches and presents at sports medicine conferences.

    Dr Gajan Rajeswaran is an avid football fan and life-long fan of Tottenham Hotspur (for which he offers no apologies!). Outside of work, he spends time with his family and has a keen passion for photography.

    Dr Ajai Seth
    MBBS, BSc, MSc, MRCS, MRCGP, FFSEM
    Medical Director, LBSM
    Consultant in Sport and Exercise Medicine

    Dr Ajai Seth is a Sport and Exercise Medicine Physician. He has dedicated his career to helping people with sport and exercise related injury and illness. He consults and treats everyone from the elite athlete to the weekend warrior.

    Dr Ajai Seth is part of the British Tennis Sports Physician team at the LTA and has also provided cover to elite athletes at Wimbledon Tennis, European Tour Golf, Premier League Football, British Athletics, and the Men’s England Football academies as part of the FA.

    He also prides himself for working in disability sport and is currently the Chief Medical Officer for Team GB Wheelchair Tennis which has taken him to the Olympics and Paralympics.

    Dr Ajai Seth is dedicated to education, training and research and is a Senior Lecturer in Sports Medicine at King’s College London where he lectures in all aspects of Sports Medicine and Science.

    He also has a passion for travel and Expedition Medicine, which has seen him accompany medical, scientific and charity expeditions all around the world. He also has vast experience in treating musculoskeletal injuries from children and adolescents to veteran exercisers, both male and female.

    Dr Seth also has positions in leading Sport Medicine organisations, including the non-executive board for the UK’s largest Sports Medicine charity, BASEM and Past President for the Royal Society of Medicine. 

    A day in the working life of Dr Seth involves consulting his patients in clinic, performing diagnostics and ultrasound guided injections. He also regularly lectures and tutors students and presents at sports medicine conferences internationally. He also spends part of the working week at the National Tennis Centre, LTA, supporting British Tennis players.

    Outside of work, Dr Seth enjoys playing club tennis, triathlon, golf, running and skiing (but will give any sport a go!). He enjoys keeping fit and active and good quality family time with his wife and three children.