Episode 52: Common Climbing Injuries with Allison Stowers

In this episode, Nate and I sit down with Allison Stowers, a Chattanooga-based climber and physical therapist.  We discuss the most common climbing injuries that Allison sees in her clinic: shoulders and hip-region injuries.  We also talk about how to self-diagnose, when you should see a doctor, what to do about an injury, and most importantly, how to prevent them.  

Allison has a very human approach to physical therapy that I really value.  If you're in the Chatty area, you can see her at Peak Fitness and Physical Therapy.

During this podversation, we mention several things that Allison believes will be helpful for everyone to know.  Here are some links and videos to check out:

The Nordic Hamstring Curl (Eccentric)

Scapular Pull Up

Other PT's that Allison recommends:

Jared Vagy, The Climbing Doctor

Carrie Cooper, Rev Physical Therapy

Esther Smith, Grassroots Physical Therapy

---

Like what you hear?  Subscribe to The Power Company Podcast on ITunes, Google Play, or Stitcher Radio, and leave a rating and review!

FULL EPISODE TRANSCRIPT:

Kris Hampton  00:31

What's up everybody? I'm your host, Kris Hampton. Welcome to Episode 52 of The Power Company Podcast brought to you by powercompanyclimbing.com. I got a really exciting email this morning that The Power Company Process Journal has shipped and is on its way. So as soon as I have that thing in my grubby little hands, you guys are going to hear more about it. It's a three month mindfulness journal for your climbing sessions, both training or climbing, and just asks really focused questions before and after your session so that you're able to help out your next session and look back and realize where things are going wrong, where things are going right, and be able to either change those things or repeat those things. So we're really excited about it. You'll be hearing more soon. As I told you guys last time, the Midwest Training For Climbing Conference has been canceled. Nate and I, however, are filling those dates up in Missouri. So if you happen to be in Missouri, look for us mid to end of August. And we will be at ROKC in Kansas City on August 13, and 14th. We will be at Climb So iLL in St. Louis, August, 15, and 16th and we hope to see all of you guys at Climb So iLL that we've gotten to know so well. We'll be at Zenith Climbing Center August 18, and 19th and that's in Springfield, Missouri. We're really excited to check out that gym. Haven't met those guys yet, but really looking forward to it. And then back to ROKC Kansas City on the 20th and 21st, where we're really excited to meet their community as well. Sounds like those guys have got a really tight community over there. We're stoked for that. And we'll also be at Asana in Boise, Idaho, August 25 26th, and 27th. So we hope to see all of you out there who are in the Missouri or the Boise area. Please come out and check us out. We've got a bunch of new workshops that we're working on, including our new Body Tension Workshop, so hope to see you there. You know, since we've reached our goal on Apple podcasts of 100 reviews, I've been kind of trying to figure out what the next goal should be. And our Facebook page, The Power Company business page, I think is a good goal. We'd like to see 3000 people on there. We're at around 2700, something like that right now and we'd love to see you guys over there. Once we get to 3000, we're gonna start sort of changing up the way we run that page over there and make it something entirely different from the Instagram, and just post about the the podcast and blog posts and things like that. So we'll be giving you guys some new information over there once we reach that 3000, so please find us on Facebook at Power Company Climbing. Okay, I'm going to get on with this thing. I've got a really great conversation today with Allison Stowers. She is a PT in Chattanooga. She practices at Peak Fitness and Physical Therapy. And if you guys are in the Chatty area, you should definitely go check out Peak Fitness because they've they've put on some great free free workshops for climbers and, and are putting really great information out there and I really appreciate that about what they're doing. And part of this whole thing that I'm that I'm trying to build here is is based around building a better community and and for me, that means reaching out to you guys, getting to know you guys, but also reaching out to other professionals and other practitioners and I'm building this network and and I really appreciate that they're trying to do the same thing. And you know, Allison has been a Power Company client. Paul sends people over to Allison who need physical therapy. So I really just like having this great network and Allison and Peak Fitness and PT are definitely important parts of that network. So I'm going to let Allison take this thing away.

Allison Stowers, PT, DPT  04:49

That's really important too is empowering climbers to be able to fix themselves. What I always tell people is like, I would love to see you again but not here. I want to see you out at the crag. I want to see at the gym, you know.

Kris Hampton  05:17

Well, not many people argue that. I guess before we do anything, we should probably thank Charlie and Josh for letting us sit in their little egg and talk here. 

Allison Stowers, PT, DPT  05:26

Yes. So I think at one point, no, their old trailer was called Buelah. I'm not sure what this one's name is.

Kris Hampton  05:32

Beulah. You don't know this one's name? 

Allison Stowers, PT, DPT  05:33

Not yet.

Kris Hampton  05:34

It's awfully cute. 

Allison Stowers, PT, DPT  05:35

I think we've been calling it Fowl-kor.

Kris Hampton  05:36

Fowl-kor...Oh, I like it. 

Allison Stowers, PT, DPT  05:39

Because their name's the Fowlers.

Kris Hampton  05:40

Yeah. I like it. Okay, well, even if that's not the name, that's what they're calling from now on

Allison Stowers, PT, DPT  05:46

They're calling it from now on.

Kris Hampton  05:46

Whether they know it or not. So Allison, tell me, how did you get into PT? You mentioned today that you were living in London, doing economics, right?

Allison Stowers, PT, DPT  05:57

Well, I was in London for a summer. And that was during undergrad, and my whole plan, I was working for a while, my whole plan was to go back to school, get my PhD in Econ, and go back to London to working

Kris Hampton  06:17

As an economist?

Allison Stowers, PT, DPT  06:18

As an economist.

Kris Hampton  06:19

How did that switched over to PT?

Allison Stowers, PT, DPT  06:21

So um, while I was working, I had actually taken up running and a little bit of climbing and stuff and I was just having all these injuries and just like little things, and at one point, I had to pay almost $3,000 for an MRI 

Nate Drolet  06:40

Oh man

Allison Stowers, PT, DPT  06:40

And then I ended up getting recommended for PT. Six weeks later, I was fine and it was like,

Kris Hampton  06:47

 Right, you're like, why did I just spent $3,000. 

Allison Stowers, PT, DPT  06:48

Right, so it's kinda that whole direct access thing.

Kris Hampton  06:52

Yeah

Allison Stowers, PT, DPT  06:54

I wanted to....that was really interesting to me and I really wanted to bring that to other people

Kris Hampton  07:01

Keep people out of that same situation.

Allison Stowers, PT, DPT  07:03

Yeah, and then climbing became more and more important, so

Kris Hampton  07:06

Which seems to wreck many, many lives. 

Allison Stowers, PT, DPT  07:08

Haha yeah and save some

Kris Hampton  07:12

 Yeah, for sure. Most definitely. So you move back to the States. Did you go right to Chattanooga?

Allison Stowers, PT, DPT  07:19

No. And I was actually only in London for a short time, just that summer and then I was living in Atlanta at the time. So I grew up south of Atlanta and went to school in Atlanta, was working there and then we just moved to Chattanooga about two years ago. 

Kris Hampton  07:37

Okay.

Allison Stowers, PT, DPT  07:38

For climbing. 

Kris Hampton  07:39

For climbing.

Allison Stowers, PT, DPT  07:40

Yeah.

Kris Hampton  07:40

 It's a good place to be.

Allison Stowers, PT, DPT  07:41

Yeah. And as a PT, I always knew that I wanted to work with climbers and so if I want to work with climbers, I need to go with the climbers are. So we moved to Chattanooga so that I can do PT for climbers,

Kris Hampton  07:55

Was it, just out of curiosity, was it slow to catch on with climbers?

Allison Stowers, PT, DPT  08:00

Um, I don't think so. I think

Allison Stowers, PT, DPT  08:03

I think there's a lot of wrecked folks out there who are wanting information and wanting to get better and wanting to prevent injury. So pretty soon after I moved, I reached out to some of the local climbers. I was like, "Hey, would any of you guys be interested in workshop?" And it was like overwhelming the number of people who responded.

Kris Hampton  08:03

 Good. 

Kris Hampton  08:25

Yeah, cool. I remember when those happened. I remember seeing it on Facebook on Paul's page and Nate talked about it. When did...is that when you first met Allison?

Nate Drolet  08:35

Um...I don't know when we first met. 

Nate Drolet  08:38

It was definitely.... I feel like it was definitely before that. But yeah, they were awesome. It was really cool to see like free clinics, putting out good information like, yeah, can't really ask for much better than that. 

Allison Stowers, PT, DPT  08:38

Maybe?

Allison Stowers, PT, DPT  08:51

Yeah,

Kris Hampton  08:52

 It's cool that there was such a good response to it. I feel like a lot of climbers have this, like, "I'm just gonna fix myself" attitude. So it's cool that you got some traction there in that community.

Allison Stowers, PT, DPT  09:04

Well, and I think that's really important too, is like empowering climbers to be able to fix themselves because like, you know, what I always tell people is like, I would love to see you again, but not here. Like, I want to see you out at the crag. I want to see you at the gym. 

Kris Hampton  09:19

Cool. 

Allison Stowers, PT, DPT  09:20

You know,

Kris Hampton  09:21

I think that's a that's a good and noble way to take it. 

Allison Stowers, PT, DPT  09:24

Yeah. 

Kris Hampton  09:25

And you said today that the injuries you see most often with climbers are shoulders and hip area, right?

Allison Stowers, PT, DPT  09:34

I see shoulder and hip. The research does not like show any of that, but um...

Kris Hampton  09:39

I was thinking about that about the hip thing. And I was, you know, maybe it's a Southeastern thing because a lot of the sport climbs there are really you know, a lot of the roofy stuff with the tiered roofs and a

Nate Drolet  09:54

A lot of heel toe cams

Kris Hampton  09:56

Lotta heel toe cams

Nate Drolet  09:56

Right leg dominant. 

Allison Stowers, PT, DPT  09:58

Yeah. Well, and what's interesting is a lot of the research about heel hooking in particular has to do with it'll compare climbing with Brazilian jujitsu. 

Kris Hampton  09:58

Exactly.

Kris Hampton  10:08

Oh really? 

Allison Stowers, PT, DPT  10:08

Yeah. 

Nate Drolet  10:09

Those are heel hooks of sorts. 

Allison Stowers, PT, DPT  10:10

Yeah. So they..no they actually called the move" heel hooking", sorry to anyone who does Jiu Jitsu but like, I don't know anything about it. But apparently there is a move called a heel hook. And it's very similar to a climbing heel hook, and injuries end up being very similar. And then 

Kris Hampton  10:27

This is why Paul Corsaro is so good at compression. He heel hooks while he's doing jujitsu as well.

Allison Stowers, PT, DPT  10:32

So it tends to be in those injuries that it's, you would tear an ACL and an LCL, possibly err, sorry, MCL, ACL and medial meniscus. 

Kris Hampton  10:42

Yeah. 

Allison Stowers, PT, DPT  10:43

And while I think that happens sometimes with climbers, most of the climbers that I see who have injuries from heel hooks, it's from a high hamstring strain.

Kris Hampton  10:54

 Okay

Allison Stowers, PT, DPT  10:55

Which is much easier to fix.

Kris Hampton  10:56

Oh, well, that's, that's a good thing. Let's talk about some of that, then and then maybe we can dive into shoulders a little bit later. You mentioned something about the first off, what can what can climbers do to prevent those kind of injuries from happening? Should we be warming up better? Are there stretches? What is it we should be doing?

Allison Stowers, PT, DPT  11:18

Um, so the biggest thing is doing some sort of dynamic warmup. And when I say dynamic, I mean, basically just big move type stretches. So if you know high knees marching, I call them hip openers. So you'd be standing up and you basically bring your knee up and bent in a flexed position in front of you, and then bring it out wide.

Kris Hampton  11:45

I've been doing that for the last bunch of days because of my adductor strain. 

Allison Stowers, PT, DPT  11:50

Yes exacly.

Kris Hampton  11:50

And people look at me so strange up at the boulders when I'm walking around like that. And so yeah, I'm glad you just said that.

Allison Stowers, PT, DPT  11:56

No, and I always like, 

Kris Hampton  11:57

I don't feel so ridiculous

Allison Stowers, PT, DPT  11:58

 I tell people don't feel ridiculous, because you don't want to be in my office. 

Kris Hampton  12:04

Yeah totally.

Allison Stowers, PT, DPT  12:05

And then just like, you know, standing on one leg and swinging your opposite limb, back and forth, just to kind of warm everything up.

Kris Hampton  12:14

 Yeah. 

Allison Stowers, PT, DPT  12:16

And then, you know, you can always do air squats, or, you know, if you happen to bring a band out, which I highly recommend anyone to. It's super light, super easy. 

Kris Hampton  12:26

Yep, I've got one in my bag.

Allison Stowers, PT, DPT  12:27

Just throw a band in your bag and tie it around your knees. Do some lateral banded walks, doesn't have to be anything serious. You're not trying to build strength, you're just trying to warm up the muscles, get some blood going.

Kris Hampton  12:37

Yep. Yeah. And I see, you know, I see climbers all the time and Nate, you know, you may see this as well, but swinging their arms around a ton and doing almost nothing for their lower bodies. 

Allison Stowers, PT, DPT  12:48

Right. Yeah. And the lower body is hard, because I don't know, I feel like, I mean, as climbers, we are upper body dominant and so it's super easy to forget the lower body. So another thing that I would suggest is like getting on the wall, and just kind of mimicking those moves on... in the gym, it's super easy. You can you know, hop in there, throw your foot on a big jug and just kind of gently rock over, not do you know, a full heel hook or anything like that. Just kind of warm your body up for this specific movements. When it comes to upper body warming up, I don't suggest hopping on the wall right away. There's more more to warming up the upper body. But we can get to that.

Kris Hampton  13:34

Yeah, no, I totally agree. And Nate and I talk about, you know, sort of trying to mimic your project a little bit while you're warming up. And that doesn't mean you have to, you know, if your project is a something crimpy, it doesn't mean you only have to climb other crimper problems. You can find crimps on the juggy, the super jug warmups. You know, it's totally possible and pull on those crimps. And with heel hooks, like you're talking about, you can you can find heel hooks, you just have to look for them. It may not be the way you do the warm up problem but you can jump in there, do it regardless. 

Allison Stowers, PT, DPT  14:11

Yeah. I've actually found recently that where people tend to really mess with the hamstring a little more is when they're on a big, like heel, when there's like a big cup for them to put in their heel in, because then it's easy to get lazy. I think we were talking about this earlier. So it's easy to be lazy. Like you can just place the heel up there, not really think about that engagement of the hamstring, and then pull on whereas like if you've ever used a heel hook on a Moooarn Board, like you can't be lazy with a heel hook on a Moon Board. You have to really engage and that's that feeling of like that, like strong engagement of the hamstring, that's what it should feel like even when you're on a big jug heel hook.

Kris Hampton  14:52

Right. Yeah, and you suggested today, which I thought is was really important that when you put your heel on, before you go and pull your body over it, you should sort of pre tension it. You should, you should engage it prior to the movement similar to, you know, if any of you guys listening are familiar with deadlifting, it's really similar to when you set up for a deadlift, and you tension your core and and get your whole body tense before you make the lift. You don't wait until you start to lift to create all that tension.

Allison Stowers, PT, DPT  15:31

Exactly. And when I teach a deadlift in the clinic, like I always will have somebody pause, and then I'll say "Set", and I want to see like a physical change in their posture before they go. And that's exactly what you know, in your head if you need to just say "Set."  and there should be some sort of engagement of that hamstring before you actually pull over onto it.

Kris Hampton  15:54

Right. So heel hooks, not a passive thing. 

Allison Stowers, PT, DPT  15:56

No.

Kris Hampton  15:56

It's an active move. Your your leg should be doing something and you don't want to wait until it has to do something. You want to engage it and get it ready.

Allison Stowers, PT, DPT  16:05

And the other thing I should say is if you throw a heel hook on, and you feel like, "Huh, this is probably a bad idea".... any move whatsoever,  I can't tell you how many times the patient has come in and they've been like, you know, I was doing this move and I knew it was a bad idea and then I heard a pop and yeah, now they're here to see me.

Kris Hampton  16:24

Yeah, Nate says that all the time.

Nate Drolet  16:26

Yeah, for me. I mean, I feel like most climbing injuries I've ever had, they were never really surprises. It was always something along the lines of "Man, this hold is kind of tweaky and it feels a little weird. I guess I'll just try one more one or two more times" or something along those lines. Same thing with like, yes, a weird heel hook or an odd drop knee or something like that. I feel like it's rare that they're just completely out of the blue.

Allison Stowers, PT, DPT  16:49

Yeah. 

Kris Hampton  16:49

So be aware. I think that's the, the main goal here in preventing the injuries. 

Allison Stowers, PT, DPT  16:55

Yeah.

Kris Hampton  16:55

Make sure you're warming up those areas. 

Allison Stowers, PT, DPT  16:58

Yeah.

Kris Hampton  16:59

 If they're susceptible. 

Nate Drolet  17:00

Don't get greedy.

Kris Hampton  17:01

Yeah, don't get greedy. I mean, we're all greedy when it comes to numbers. So

Allison Stowers, PT, DPT  17:05

Yeah.

Allison Stowers, PT, DPT  17:06

We love them. And as far as like some prehab kind of things that you could be doing just, you know, in a normal workout, not necessarily as a warm up, but maybe in between climbing days or something like that, is like we were talking about bridging or hip thrusts. My favorite person in the world, Brett Contreras, has like all the videos and all the variations of hip thrusts and you can see him lifting some crazy heavy weight on his pelvis, if you look at his Instagram, but um....

Kris Hampton  17:38

And I'll link you guys to Brett Contreras in the show notes. 

Allison Stowers, PT, DPT  17:41

Yeah, the glute guy. And then deadlifting and then if you really want a burn, I think they're called Nordic curls. Is that right? Do you know?

Kris Hampton  17:53

Jefferson curls? 

Nate Drolet  17:55

No...

Kris Hampton  17:55

You're not talking about Jefferson curls?

Allison Stowers, PT, DPT  17:56

You put a.... you have somebody hold your ankles and then you lower your body.

Kris Hampton  18:01

Oh, yeah, yeah, yeah. Like you're on your knees. 

Allison Stowers, PT, DPT  18:04

Mmmmhmmm

Kris Hampton  18:04

Yeah I've seen these. 

Nate Drolet  18:05

Oh I know what you are talking about and I can't think of what they are called.

Kris Hampton  18:06

I don't know what they're called either. I've actually tried them. They are quite difficult.

Allison Stowers, PT, DPT  18:09

So let's, let's set that up, how to do that. So you're on your hands and knees essentially... or you're on your knees

Allison Stowers, PT, DPT  18:09

They're called like Nordics or Nordic hamstring...they have so many different names, but yeah, so that's

Allison Stowers, PT, DPT  18:12

 On your knees.

Kris Hampton  18:12

Straight up. You have someone hold your ankles, 

Allison Stowers, PT, DPT  18:25

Or you can strap them

Kris Hampton  18:27

Or strap them down. Yep. And you try to keep your body in a hollow position, in a straight position. Keep your back straight. You don't want to bend forward. And you try to lower yourself down.

Allison Stowers, PT, DPT  18:41

Yeah, so I have people do this in front of a wall. And like so start off just like a foot from the wall. 

Kris Hampton  18:47

Right.

Allison Stowers, PT, DPT  18:47

Hands in front. Protect your face.

Kris Hampton  18:49

Yeah. Cuz you're gonna end up face on the floor.

Allison Stowers, PT, DPT  18:51

At some point, yeah. And then as you feel comfortable and strong, then you can go ahead and lower yourself or bring yourself back. So eccentrics, especially if you've already had a hamstring injury, eccentrics are some of the best ways to rehab tendons. So that's why

Kris Hampton  19:12

Eccentric meaning doing the negative.

Allison Stowers, PT, DPT  19:13

Exactly. 

Kris Hampton  19:14

Right.

Allison Stowers, PT, DPT  19:14

 Yeah. So that's why, like, you know, deadlifts are great but these are really working that lengthening side of the movement.

Kris Hampton  19:23

 Yeah.

Nate Drolet  19:23

So since you're just working the eccentric or since eccentrics are what are beneficial, does that mean you do the eccentric and maybe you put your hands down and then like push yourself back up to the starting position?

Allison Stowers, PT, DPT  19:34

That's normally what I do. I'll have people... so we, in our clinic, is it's a Pilates like based kind of therapy. Our two other therapists, Rebecca Wykle and Marie Howell, are Pilates trained and so we have all the different equipment. So I use the Cadillac table, if anyone knows what that is, and I'll bring one of the bars up so that somebody can grab that and then push themselves off the bar.

Kris Hampton  19:59

 Gotcha gotcha. 

Allison Stowers, PT, DPT  19:59

So that they're not actually lifting themselves. 

Kris Hampton  20:02

Yeah, I'm glad you brought those up too, because I've, I've definitely struggled a little bit with finding good hamstring or glute exercises that people can do with just bodyweight. 

Allison Stowers, PT, DPT  20:14

Mm hmm.

Kris Hampton  20:15

 Other than the hip bridge. 

Allison Stowers, PT, DPT  20:16

Right. 

Kris Hampton  20:17

And, and that's a really great one I had completely spaced on.

Allison Stowers, PT, DPT  20:21

Yeah. And I even think like, like the hip thrust, doing those, like with feet elevated and I mean, on the road, you can even you can find things that add weight to your pelvis.

Kris Hampton  20:36

Totally.

Allison Stowers, PT, DPT  20:36

Just tossing weight on your pelvis, and

Kris Hampton  20:38

A gallon of water weighs eight pounds, so.

Allison Stowers, PT, DPT  20:40

Doing holds in that position. I know that I'll have patients hold for like 10 seconds and we'll do like eight reps of that and it's like, sweating at the end, like puddles, so.

Kris Hampton  20:53

Yeah. Oh, good. I think that's I think that's good advice. I completely forgotten about those and, and it's just a muscle we tend to neglect. 

Allison Stowers, PT, DPT  21:02

Yeah. 

Kris Hampton  21:02

You know, unless you're a lifter.

Allison Stowers, PT, DPT  21:04

Right. I was at a conference last weekend, it was actually really interesting. I went to a hamstring, like, high hamstring strain course and it was all for NFL football players and sprinters and soccer players, and it was interesting, because every, like, mechanism of injury that they were discussing was like a lengthening injury, so like going to kick a ball, or like running and then slipping with the foot outstretched. And so it's like a lengthening

Kris Hampton  21:41

But none was a shortening?

Allison Stowers, PT, DPT  21:42

None of it, of like any sort of concentric contractions. I actually stood up and asked like, Hey, you know, this is my type of client. Does any of this change? Would any of this rehab change if you knew the mechanism of injury was on the concentric phase? And they're like, well, that injury doesn't happen.

Kris Hampton  22:03

 Oh, really?

Allison Stowers, PT, DPT  22:04

Um I does but it's with rock climbers. And they're like, "Oh". Like they and so I actually like, um, you know, in a full piece or full suit, you know, trying to explain like, how a climber heel hooks and everything. And they're like, "Huh, I think it could be the same." So I was like, okay, well, I think I'm on the right track because all their rehab was basically Nordic curls, and yeah, hip thrusts all that good stuff.

Kris Hampton  22:31

Okay. Cool. As far as what we've talked about strengthening it, and when they, when they get that injury, how can they, how can our listeners know if it's a severe injury? Should they go and see a doctor first? Or should they try and self diagnose and work on it themselves? What's your advice there?

Allison Stowers, PT, DPT  22:55

Um, so of the ones that I've seen, there is an audible pop and usually, you can walk but it doesn't feel great to walk and prolonged sitting is going to aggravate it. Any sort of like, probably your gait, so the way you walk, is going to be a little different, just because you're not going to be able to, like, put your foot, the affected foot, as far out in front of you because it's, it hurts to do that lengthening. And so as long as you're able to walk okay, 

Kris Hampton  23:39

Without pain?

Allison Stowers, PT, DPT  23:40

Yeah, without pain and like, if like the next day, you're fine, then I would say, you know, go see a PT, because then they can they can really tell you like okay, have you torn it completely or have you avulsed? So that's, that's kind of the big thing is if you've actually torn the tendon with a little bit of bone, so the tendon attaches on.

Kris Hampton  24:06

 Right. Pulled a little bit of bone off it.

Allison Stowers, PT, DPT  24:06

Yeah, so it attaches onto the ischial tuberosity, so that's your sit bone. And if you've torn it enough to actually pull some of that bone off, that is like a non weight bearing, you'd want to definitely see doctor for that.

Kris Hampton  24:20

Right. Definitely see a doctor.

Allison Stowers, PT, DPT  24:24

 But a PT should be able to diagnose you. 

Kris Hampton  24:27

Okay.

Allison Stowers, PT, DPT  24:28

You know, through special tests and different you know, modalities and stuff like that they'll be able to kind of figure out like, what's going on. But the unfortunate thing about it is once that injury does happen, and it takes a while for it to feel good, like for you to feel confident in heel hooking. 

Kris Hampton  24:49

Right.

Allison Stowers, PT, DPT  24:49

 Um, and so for a lot of my climbers, what I'll have them doing is a lot of just like toeing or like, you know, Nate at one point had me doing a lot of one legged climbing and hey, if I can't get you to like quit climbing, let's do some one legged climbing.

Kris Hampton  25:07

Yeah, yeah, it's a good drill anyways.

Allison Stowers, PT, DPT  25:09

 Or, you know, traversing, just trying to like, I'm never 

Kris Hampton  25:14

Keep off the heel hooks for a while.

Allison Stowers, PT, DPT  25:16

Yeah. And I'm not like, I'm not gonna say never, but I went to a couple PTs before I came into the field myself and you know, I'd be like, "Hey, you know, this hurts." and they'd be like, "Oh, well, you should probably quit climbing." and like, that's like, a big thing that I, I'm not gonna tell somebody who's addicted to climbing to quit climbing because that's their vice and unless it's like, going to be a danger to them.

Kris Hampton  25:46

Yep. Yeah. And I think, you know, correct me if I'm wrong, I may totally be off here, but I think what I tell my clients generally is, if it's a minor connective tissue injury, it's probably going to heal faster if you're using it a little bit to get blood flow to the area. Whereas if you just completely rest it and don't do anything, you're going to come back and it's just gonna get injured almost immediately again.

Allison Stowers, PT, DPT  26:15

Exactly. Exercise is the one thing that's never been proven to be bad for pain or injury or anything. The only thing about that is, you know, I won't tell you not to climb, but I will tell you, like, let's figure out a way to modify it. 

Kris Hampton  26:31

Yeah, totally.

Allison Stowers, PT, DPT  26:33

 And like Nate's told me before, you know, hey, that's the time to look at technique. Like, you know, were you throwing a lazy heel hook, because you aren't great at like, using toes? So let's figure out how to get some fancy footwork in there.

Kris Hampton  26:47

Yeah, for sure. And I have, I have a couple of clients right now that came to me with, with hamstring issues. And both of them, in their plans right now, have during their warm ups, they do some hamstring testing, just lightly pulling on it, you know, trying to pull over with toes, trying to pull over with heels just to see where it's at, see how it feels for the day, and then gauge where they're going from there. 

Allison Stowers, PT, DPT  27:14

Yeah.

Kris Hampton  27:15

You know, I don't think you should take every day the same as the last. Some days it's gonna hurt a little more. Some days, it's gonna feel a little better and you should just ease into it each time you are back into the gym.

Allison Stowers, PT, DPT  27:25

And if it's bad enough that I'm telling you that you should probably shouldn't be climbing on it, then hey, that's the time to get started some fingerboard training, you know.

Kris Hampton  27:34

Yeah, yeah, there's lots of options.

Allison Stowers, PT, DPT  27:35

Yeah, that's like I had a client...or not a client, a patient, who had a pretty significant shoulder surgery. And I...we did weeks of lower body stuff, in addition to shoulder rehab, you know. I was like, hey, there's no reason that you can't get your legs stronger right now.

Kris Hampton  27:53

Yeah, totally. When I had my shoulder surgery, I can't tell you how many pistol squats I did.

Allison Stowers, PT, DPT  27:58

 Exactly. 

Kris Hampton  27:59

1000s and 1000s. 

Allison Stowers, PT, DPT  28:00

Yeah. So it was like, hey, let's make that core solid.

Kris Hampton  28:04

Totally. So if they, you know, we are already, we know how to strengthen it a little bit and doing doing eccentrics if you've had an injury, and you're trying to strengthen is important, especially using the exercises we talked about. Are there myofascial things that you recommend? Are you a fan of that kind of thing?

Allison Stowers, PT, DPT  28:27

Um, so depending on how long somebody has had an injury, if it's been like a chronic thing, where they're like, you know, I did this a year ago, and it's still just kind of tweaky and not feeling great, then I'll really like dig into it using tools. That way we can kind of, it's almost like I want to, I want to recreate an inflammatory process, in that case, to kind of bring blood flow back to the area and see if we can clean some of that stuff out. 

Kris Hampton  28:53

Get the healing process going again.

Allison Stowers, PT, DPT  28:53

 Yeah. For somebody who's super acute, it kind of depends. At that point, it's more about like pain relief. And, you know, you might ultrasound it. Ultrasound is not my favorite thing. There's not a lot of evidence...um...

Allison Stowers, PT, DPT  28:56

But see a PT, that's what you would recommend.

Allison Stowers, PT, DPT  29:19

Yeah, yeah. Usually the modality kind of stuff is more for like that chronic injury.

Kris Hampton  29:26

Gotcha. 

Allison Stowers, PT, DPT  29:27

Yeah. 

Kris Hampton  29:28

Okay. Any thoughts you have, Nate, on hip region?

Nate Drolet  29:35

Um, actually, I guess just one thing I'd add. One, it'd be cool to have your opinion on this. One thing that I've seen that's worked fairly well with people whenever their like hamstrings are bothering them or something like that is having them switch over to trying to climb on really small footholds. And it seems a little counterintuitive because you think, you know, if it's something a lot smaller, you're going to pull harder with your legs. But what winds up happening, I feel a lot of times is, you know, if you put your foot on a jug, you can put so much weight on that large of a foothold, where with small footholds, you know, no matter how hard you may be trying, you can only put so much weight into it. But what are your thoughts on that?

Allison Stowers, PT, DPT  30:13

Um, that's funny. So there's a study I think was, not too long ago, like in 2014, they actually...so my research in grad school was about foot pressure. It was actually looking at diabetic feet. And so we would put these insoles and like measure foot pressures over different like, types of inserts. But there was a study using this same system, it's called the Novel pedar system, and using the same system, they actually studied climbers. And like novice climbers, people who've never climbed, which is, you know, this is going to be like a "well duh" kind of moment for most of us. But like, they aren't putting a ton of pressure in their feet at all.

Kris Hampton  30:58

Right. 

Allison Stowers, PT, DPT  30:58

And it was statistically significant that the expert climbers are putting so much more pressure through their feet. And so it just goes to show that the better you are, the more you are using your feet and so it's something to definitely focus on.

Kris Hampton  31:13

Yeah. And I think I think that transfers over to small feet. And I think, I think when you're using tiny little feet, and you don't get as much as much purchase out of it as you would on a jug, then you're, you know, you're more likely to use more of your core to pull you into position as opposed to just hamstring before it's ready. You know, that's, that's my thought and my totally unprofessional opinion here, but, but that's my thought on tiny feet. And for me, I know I've had a couple of heel hook issues, one on River Dance down in Chattanooga. And now that I'm having this adductor pain that's sprung up....sprung is totally the wrong word...it's crept up since since like December, and just started getting bad. I've definitely noticed that on big feet I can, I can hurt it much faster. You know, if I stay on little feet, then I don't tend to hurt it very often. So yeah.

Allison Stowers, PT, DPT  32:15

It's funny that you mention River Dance. I hurt my hamstring on the roof up the hill. 

Kris Hampton  32:22

Oh, yeah yeah yeah. For sure.

Allison Stowers, PT, DPT  32:23

 Lazy heel hook.

Kris Hampton  32:24

I can see that. Yeah. Yeah, no doubt. And it's hard to warm up there.

Allison Stowers, PT, DPT  32:28

Mmmhmm

Kris Hampton  32:28

 So and yeah definitely when I did that I wasn't doing any sort of movement prep prior to climbing. All my warm up was hiking in and climbing.

Allison Stowers, PT, DPT  32:37

Exactly. Yeah. Yeah. And the hike in, it's yeah, it's good for blood flow. But it's not, that's not enough. 

Kris Hampton  32:44

Right. 

Allison Stowers, PT, DPT  32:45

A lot of people will say like, "Oh, well I hiked in. I'm good. I'm warm" and its like...umm no.

Kris Hampton  32:50

It seemed to work for me when I was 20 and I was elastic, but it doesn't work for me now. 

Allison Stowers, PT, DPT  32:55

Now that you are 23.

Kris Hampton  32:56

 Yeah. Now that I'm 23. Exactly. 23 plus 20, or something like that. But I'll tell you what, let's take a quick break. And then we'll come back and talk about shoulders.

Kris Hampton  33:10

 Hey, everybody, Kris here. I'll try to keep this short and sweet. Since this thing became officially official, have basically been obsessed. I've got dozens of episodes waiting to go out and I'm constantly recording new conversations. I want to continue putting this level of energy into it. And you all can help. We've created a page at patreon.com/powercompanypodcast where you can help support what we're building. In return, even for as little as $1 per month, you'll get access to the brand new We Scream Like Eagles Podcast, which includes tips from our guests, extra conversations about hot topics and q&a with your questions posed to our guests. If you think it's worth more than $1 a month, we've got other rewards available on top of bonus episodes, like stickers, ebooks, t shirts and training plans. So if you've been considering pitching in, now's the time. That's patreon.com/powercompanypodcast. Thanks a ton. And back to the show. Okay, we are back with Allison Stowers. 

Allison Stowers, PT, DPT  34:14

You said it right. 

Kris Hampton  34:15

I know. You corrected me today, that's why I said it right. And we never talked about where you work. So let's let's talk about that really quick.

Allison Stowers, PT, DPT  34:24

So I work at Peak Fitness and Physical Therapy in Chattanooga, Tennessee. If you're familiar with Chattanooga at all, it's across from Cox Bakery, which has the best apple fritters in town.

Kris Hampton  34:35

Oh man, I didn't get any while we were in town.

Allison Stowers, PT, DPT  34:37

 It's on Broad Street on the south side. We just moved to a bigger space, because we're just continuing to grow after five years of being open.

Kris Hampton  34:46

Oh, great. Congrats. That's really cool.

Allison Stowers, PT, DPT  34:48

Thank you.

Kris Hampton  34:48

 Yeah, yeah. And your clientele base, you have some climbers in there.

Allison Stowers, PT, DPT  34:53

Yes, for sure. Yeah. Actually, when I came to Chattanooga, I knew like what I wanted to do, like I knew how I wanted my practice to be set up. And it was kind of like, well, if I don't find it, then I'm gonna have to build it myself. But as luck would have it, Rebecca Wykle owns Peak. She started it five years ago and they... a friend of mine, actually Charlie, whose trailer we are in, was like, "Oh, you should talk to Rebecca. They sponsored Triple Crown" and I was like, "Wait, what?". And I, like, turn around one of my Triple Crown t shirts and see this like physical therapy logo, like on the back of my shirt and was like, there, that's where I want to work. I bugged her enough and here I am.

Kris Hampton  35:35

 Oh, that's awesome. You went out there and got it.

Allison Stowers, PT, DPT  35:37

 Yeah.

Kris Hampton  35:37

 And you know, through your practice, you see shoulder issues. So we're gonna, we talked about hips and let's talk about shoulders. Shoulders are near and dear to my heart because I went through a pretty major shoulder surgery about two years ago. It'll be two years ago in April. 

Allison Stowers, PT, DPT  35:54

What kind of surgery did you have? 

Kris Hampton  35:55

I had a fully torn labrum, fully torn supraspinatus and my bicep tendon was shredded. So they ended up cutting the shredded section out and doing a bicep tenodesis. 

Allison Stowers, PT, DPT  36:09

Okay. So attached down below?

Kris Hampton  36:11

Attached to the humerus instead. And here's something I just I want to get your opinion on this really quick. There's a totally selfish moment here. But you guys will appreciate this. One of the scariest moments in my recovery for my shoulder was, I was in Lander and I had been working on raising my arm up to the level where I could reach a doorframe, the top of the doorframe. I wasn't planning on hanging on it or anything. I just wanted to be able to raise my arm that high. Well, the first time I got to it was in the kitchen of my fiancee's parents' house and when I grabbed the doorframe, I let go of the engagement. Like I was, I didn't keep my shoulder engaged. I just hung my arm there. And I realized I couldn't let go. If I if I let go of the doorframe, my arm was gonna drop. I couldn't reengage it. And my my theory was that it was because it was reconnected in a different place, that bicep tendon that raises my arm. So my brain hadn't created that connection yet. And it took me weeks of really focused effort to be able to re engage my arm if I disengaged it while it was up high. Have you ever heard of anything like that?

Allison Stowers, PT, DPT  37:27

Actually, no, I haven't. That's interesting. But it makes complete sense.

Kris Hampton  37:32

It was terrrifying.

Allison Stowers, PT, DPT  37:32

 Either that or you had like the concentric strength, but not the eccentric strength at that point, to be able to do that.

Kris Hampton  37:40

Yeah, it was absolutely terrifying. Okay, I was just curious if you'd ever heard that before. I was like how the hell am I going to climb if I can't ever let go of anything? 

Kris Hampton  37:49

I can do one move haha. Alright, so I'm done derailing.

Allison Stowers, PT, DPT  37:49

Haha I can't let go of anything. My arm's just going to flop down all the time.

Allison Stowers, PT, DPT  37:56

No, that's fine. That's actually a really common surgery for climbers. I've seen a lot of those at Peak. And it's, it's a long recovery, I would say, depending on skill level...I don't know what.... I'm usually seeing somebody for about four or five months, maybe even six and it's usually, you know, more frequent in the beginning. And then obviously, like,

Kris Hampton  38:28

When they've had a big surgery

Allison Stowers, PT, DPT  38:30

When they've had a big surgery like that. And so, actually, like the patient that I mentioned earlier, we were doing our normal, you start passive range of motion, and then you do active assist range of motion, where you're using your other arm to help the surgical arm up and then moving on, but like, at home, there's no reason that that person couldn't have been doing lower body or core anything like that.

Kris Hampton  38:55

Yeah, I worked constantly while I was laid up back then. 

Allison Stowers, PT, DPT  38:58

Yeah, exactly. 

Kris Hampton  39:00

Well, let's let's back up and go back to like prehab because I think a lot of I think climbers put themselves in bad positions. I think that's just what we do. 

Allison Stowers, PT, DPT  39:09

Yeah.

Kris Hampton  39:10

 So let's talk a little bit about that. How can we keep our shoulders safer?

Allison Stowers, PT, DPT  39:14

So a lot of times, most of the time when somebody has shoulder pain or some nagging thing and they come to see me, one of the first things I want to see is them just raise their arms out to the side and in front of them with their shirt off and from behind because scapular movement, it's a mess with climbers. They're never symmetrical, which I don't expect anybody to be perfectly symmetrical, but I see some crazy winging and I call it scapular dyskinesis. It's basically when when scapulas just kind of....

Nate Drolet  39:55

 Goes rogue?

Allison Stowers, PT, DPT  39:56

Yes, exactly. It goes rogue. And so that is a huge thing that I work on with climbers is trying to get middle lower traps a lot stronger and then translating that to the wall. So middle lower traps is what keeps your shoulder blades down and back on your...um...like over your rib cage.

Kris Hampton  40:20

On your rib cage.

Allison Stowers, PT, DPT  40:21

 Yeah, exactly. And so, you know, we'll do prone Ys and Ts. And so that's laying over a plinth or laying over a bench or something like that, and then lifting your arm out straight out to the side. Most people do these wrong, because they just throw their arm up and they're like, Oh, I can lift my arm all day.

Allison Stowers, PT, DPT  40:31

Like palm down lifting up?

Allison Stowers, PT, DPT  40:45

Well I usually have people 

Kris Hampton  40:46

I'm just saying when they do it wrong.

Allison Stowers, PT, DPT  40:47

 Yeah exactly, yeah. So palm down, thumb down. Or they're just using their glenohumeral joint. So where the ball and socket of your shoulder are, that's where they're driving the movement off of. 

Kris Hampton  40:59

That's where they are lifting from, yeah. 

Allison Stowers, PT, DPT  41:02

And what I always tell people is, first off, thumb up. That gets you out of an impingement position. And then think about bringing the shoulder blade across the back, and then the arms just going along for the ride. If the arm lifts, great. If it doesn't, that's fine, too. I want the

Kris Hampton  41:22

So it's the shoulder blade you're moving.

Allison Stowers, PT, DPT  41:23

 Exactly. 

Kris Hampton  41:24

And that's what moves the arm.

Allison Stowers, PT, DPT  41:25

Exactly. And if you're doing it right, the arm shouldn't raise up a ton. So,

Kris Hampton  41:33

Gotcha. So it's not a flexibility thing. You're not trying to raise your arms as high as possible.

Allison Stowers, PT, DPT  41:36

Exactly. Yep. And usually, when I have somebody do it right for the first time, I will do like, you know, eight to twelve reps. And by that 12th rep, they're like, shaking uncontrollably.

Kris Hampton  41:48

Totally, yeah, it's tiring. It's unbelievable how we think we have really strong backs as climbers, and, you know, parts of our back is really strong, but parts of it is really weak. And the first time that I was doing those after surgery, I got really tired, really fast and was blown away.

Allison Stowers, PT, DPT  42:05

Yeah. So that and then doing wall angels. So essentially, it's the same exact muscle that we're working on, really, you feet about six inches out from the wall, and then arms and a W position against the wall, trying to get the back flat. So you're gonna roll your pelvis, tuck your tail under, and then raise the arms up along the wall, and then back down. And on that down, I really have people bring their elbows as close into their body as they can so they really feel that engagement low on their back.

Kris Hampton  42:40

Okay. And a lot of us don't have the mobility to raise your arms very high. What what happens then?

Allison Stowers, PT, DPT  42:46

And that's, that's fine. Usually with, I mean, you can work into it. Um, so if... I don't know... the goal of the exercise is really like working on, for me, a lot of times, it's just getting that lower trap, middle trap engagement on the pull down. If somebody is having a really hard time keeping their wrist on the wall, so like as they go up, then they go into like this internal rotation moment. 

Kris Hampton  43:17

Right.

Allison Stowers, PT, DPT  43:18

 Which I do see a lot of, then we will kind of work more on flexibility of like, this external rotation, 

Kris Hampton  43:28

Getting the external rotation.

Allison Stowers, PT, DPT  43:29

Mmmhmm. So laying over a foam roller in that W position.

Kris Hampton  43:32

Right.

Allison Stowers, PT, DPT  43:33

 And then, so like, if they can't do it on the wall, let's do it on a mat over a foam roller and like work there first.

Kris Hampton  43:41

Okay, cool. Yeah, that's good to know. I'm glad you said that it's more about pulling down and keeping those muscles engaged, rather than just lifting your arms as high as you can.

Allison Stowers, PT, DPT  43:51

Right. 

Kris Hampton  43:54

 Okay. I think a lot of people misunderstand those exercises quite a bit.

Kris Hampton  43:59

You know, they just, they watch a video and see the motion and they're like, oh,  I'll just do that. You know, they don't understand the point of it. So

Allison Stowers, PT, DPT  43:59

 Yeah. 

Allison Stowers, PT, DPT  44:06

Yeah, and for climbers it tends, like you were talking about being strong and like, we think our backs are strong. And it's, it tends to be upper traps, you know. We're so like, upper trap dominant, and like then we are rounded in the shoulders. And if you think about that, if you're going to round in your shoulders, your pecs are going to be tight. So pecs are the muscles on the front of your arms. And then that means that the muscles that are in between your shoulder blades, they're going to have to lengthen to compensate for the shortness on the front. So what I need, you know, people to do in order to, you know, make up for that and is to get into this, you know, upright kind of posture and that's really hard for climbers to like, yeah, be reminded to stay in this all day.

Kris Hampton  44:51

Totally. Should we be stretching our pecs at all or?

Allison Stowers, PT, DPT  44:57

Yes, and no. I, you know, I don't say.... don't dig in there, because you know, we're shortened for a reason. You know, this is where part of our strength comes in. But there needs to be some sort of balance. So I get on a foam roller after your workout and just kind of lay, you can do some of the arm movements and stuff but just trying to like work on opening up. 

Kris Hampton  45:18

Yep. And when we say "Lay on a foam roller", you mean

Kris Hampton  45:23

 Lay your spine down the length of a foam roller so it opens your chest.

Allison Stowers, PT, DPT  45:23

Longways

Allison Stowers, PT, DPT  45:27

Exactly. If you need more thoracic mobility, you can always go longways and then kind of stretch back over. But specifically for what I'm talking about is longways along your spine and then open the arms up. And then you can actually take that into a scapular exercise. So arm straight up in front of you, you are laying longways on a foam roller, and just bringing one arm out by your side. So like, horizontal abduction

Kris Hampton  45:32

Like a T

Allison Stowers, PT, DPT  45:36

Yes, like a T. Bring your arm out to the side, and just do one arm at a time. And think about as you go down, squeezing the foam roller with your shoulder blade and then try it with the other side and see if there feels like, see if you can feel any sort of difference. And a lot of times people are like, Oh, well, I'm not feeling like, I don't feel like I'm able to squeeze as hard. And I I feel like the having the foam roller underneath sometimes gives people that tactile input like, "Oh, that's what you're wanting me to engage." 

Kris Hampton  46:27

Right, right. Good idea. And I like doing it one arm at a time. I had never thought about that. And I was wondering why when you were saying it, but it totally makes sense to be able to compare the two in isolation.

Allison Stowers, PT, DPT  46:37

Yeah. So and back to the Ys and the Ts. I only have people do one arm at a time there because it's really easy to just go to town and like, think that you're doing both sides the same whe you are actually not.

Kris Hampton  46:50

Yep. Yeah, totally. I've definitely found that in these guys, I was doing some shoulder dislocate type stuff the other night and these guys were pointing out that my right shoulder was shrugging up and that's the shoulder I had surgery on, it was shrugging up more than the other. 

Allison Stowers, PT, DPT  47:08

Yeah. 

Kris Hampton  47:08

And I hadn't paid much attention to that in a while. That was something I really worked on hard, shortly after surgery, but I hadn't thought much about it since then.

Allison Stowers, PT, DPT  47:16

Yeah, that's huge for climbers with every exercise that I give them is that they'll they'll come up into this, you know, shrug, upper traps dominant kind of thing.

Kris Hampton  47:28

Shoulders to their ears.

Allison Stowers, PT, DPT  47:28

 Yeah, exactly. That if you end up in my clinic, you will hear me say at some point, "Don't let your shoulder talk to your ear." If that's happening, you're doing it wrong.

Kris Hampton  47:37

Cool. And, Nate, your thoughts on any of this so far?

Kris Hampton  47:42

Ah, good question.

Nate Drolet  47:42

Oh, yeah, a couple different things. One, so with exercises like this, and just exercise like shoulder exercises, in general, you'll see people you know, walk into the gym or out at the crag, and they just do 1000 band exercises of all different... they all look about the same but you know, with different types of form. Is there any...are there any good sources that you like, for maybe videos or descriptions on good form?

Nate Drolet  47:46

So you're gonna have to help me with the last name...Ann 

Nate Drolet  48:16

Raber?

Allison Stowers, PT, DPT  48:17

 Raber, yes, has a great video if you just Google her name, Ann Raber warm up video

Nate Drolet  48:24

"The Rest Day  Shoulder Solution" or something like that

Kris Hampton  48:26

Oh yeah that's right.

Allison Stowers, PT, DPT  48:26

Yes

Nate Drolet  48:26

I know, I was just talking with her the other day with her about that.

Allison Stowers, PT, DPT  48:28

Oh my gosh, she's got like, you know, I haven't created a video for warming up or any... I had like a little one and then I ended up finding her video and was like well, I'm never gonna do another one. I'm just gonna send people here because it's so good. But yeah, I do probably about half of what she has posted on that video before I work or before I climb.

Nate Drolet  48:51

Nice.

Kris Hampton  48:51

 Okay, cool. We'll post that video on the site too. I'll check with Ann and make sure that's okay, but we'll post that video up on this podcast page.

Allison Stowers, PT, DPT  48:58

Yeah, it's super good. But one thing I was gonna say, you were asking, you know, you're kind of making a motion of internal and external rotation. So that is another exercise that for climbers, a lot of you know, if you want to warm up and do internal external rotation, great. If you have shoulder pain, and you're trying to work on things, just do external rotation. Don't do internal rotation, because we're all strong here. We're all strong on this internal rotation part. I don't, I don't need you to get any stronger at pulling in. I need you to get stronger pulling out. So what I'm basically doing is my arm, my arm is lifted up to 90 degrees and then I'm pulling a band or a weight or something up

Kris Hampton  49:47

And up and towards your back.

Nate Drolet  49:49

Like the opposite of pitching

Allison Stowers, PT, DPT  49:50

Exactly the opposite of pitching, the wind up. And I always have climbers do it at 90 degrees if they're able, because that's where we work. We don't, you know, a lot of times if you if you've had PT before, and you gotta kind of, you know, a mill kind of place, you know, you'll, you'll just get the towel under the arm and you'll do it at your side, but that's not where climbers are. We're up, you know, shoulder height or above. 

Kris Hampton  50:16

Specificity.

Allison Stowers, PT, DPT  50:17

 Yeah.

Nate Drolet  50:17

So your upper arm would be parallel to the ground. 

Allison Stowers, PT, DPT  50:19

Exactly. 

Nate Drolet  50:20

And out to your side.

Allison Stowers, PT, DPT  50:21

Mmmhmmm. Yeah,

Kris Hampton  50:24

 That's a that's a good question. I like that. You know the bands are so ubiquitous. I see everyone with them doing all sorts of crazy things. So

Allison Stowers, PT, DPT  50:32

Hey, and I'm okay with people doing all sorts of crazy things as long as they're out there doing something.

Kris Hampton  50:36

Yeah. But if we you know, we have a smarter solution that you can do, why not do it? 

Allison Stowers, PT, DPT  50:40

For sure.

Kris Hampton  50:42

 Okay, cool. And what's, what shoulder injuries do you see most often?

Allison Stowers, PT, DPT  50:47

Most often, I see like, rotator cuff tendinopathies 

Allison Stowers, PT, DPT  50:53

Rotor cups 

Allison Stowers, PT, DPT  50:54

"Rotor cups"  if you are from my part of town haha, which I was saying that most of my climbers know what their rotator cuff is and they actually say it correctly. But my grandma will still call hers...she's, she called me the other day, "My rotors are all broken". 

Kris Hampton  51:14

Hahahaha

Allison Stowers, PT, DPT  51:14

All right, Grandma. At 86, I'm glad you still got some. But um...so I see a lot of rotator cuff tendinopathies and there's a difference in tendonitis and tendonosis and then I say tendinopathy, because it's basically just a catch all injury.

Kris Hampton  51:17

Just a tendon injury right?

Allison Stowers, PT, DPT  51:33

 Yeah. So tendonitis is basically like, you felt something happen and it happened yesterday, or it happened in the last week. Tendinosis is, you know, you've been dealing with this for the past 10 years, and you still haven't addressed it.

Kris Hampton  51:48

Gradual, chronic

Nate Drolet  51:49

My elbows

Allison Stowers, PT, DPT  51:49

 Yes exactly haha. 

Kris Hampton  51:50

Nate's elbows yeah.

Allison Stowers, PT, DPT  51:51

Yeah. And so most of the time, rotator cuff stuff is happening because of overuse, or, you know, not warming up properly. Or, you know, I'm grabbing this gaston, it doesn't feel great and I'm gonna keep pulling really hard on it and one go is one too many. 

Kris Hampton  52:12

Yeah. 

Allison Stowers, PT, DPT  52:14

So I think I had mentioned at one of the workshops, it may have been the one that you were at, I'm not sure. But like, if you look at climbers, and it's like, you know, what can I do to prevent getting injured? The number one thing you can do to prevent getting injured is to actually quit climbing, because it's kind of a, it's a, it's an exposure thing.

Kris Hampton  52:37

Yeah, yeah.

Allison Stowers, PT, DPT  52:38

 It's just like, you know, teenage girls playing soccer, you know, what's the number one predictor of tearing your ACL as a young girl playing soccer? Playing soccer. 

Kris Hampton  52:47

Totally.

Allison Stowers, PT, DPT  52:48

And the more exposure you have, the more times you're out on the field and that's why I love Eric Horst and how he is like, you know, he's got his boys in football part of the year, he's got his boys climbing the other part of the year, you know,

Kris Hampton  53:01

And they're a little badasses.

Allison Stowers, PT, DPT  53:03

It's okay to take time off and you know, do other things.

Kris Hampton  53:06

Yep. Yeah, that's, they could totally be, they could probably be better climbers, or more well known climbers, if they did it all the time. But they're going to be better athletes in the long run. 

Allison Stowers, PT, DPT  53:18

Right.

Kris Hampton  53:18

By, you know, taking the the approach that Eric is, and they're gonna be healthier.

Allison Stowers, PT, DPT  53:22

Yeah. So most of the time with shoulder injuries, what I see is, it's just like, you know, going too hard, going eight days on....Nate. 

Kris Hampton  53:30

I wouldn't know what you're talking about. 

Allison Stowers, PT, DPT  53:36

But every now and again, you know, and I, without MR vision, which I still have yet to invent, I can't really like 

Kris Hampton  53:46

It's a good idea though.

Allison Stowers, PT, DPT  53:46

I know, right? If somebody comes in and has some shoulder injury, or like some kind of tendon, knee type stuff, I can't really say like, specifically, or how bad the tear is, or anything like that. But what we can do is go through some rehab stuff and if you respond, great, and if it's getting worse than that's when it's a referral. And that's the great thing about I mentioned earlier, direct access, we have it in Tennessee. We have it in most states. So you can go directly to a physical therapist without having to have a referral from an MD. 

Kris Hampton  54:01

Oh good. Yeah. 

Allison Stowers, PT, DPT  54:24

And at this point, most PTs are educated at the doctoral level, so we do know those things. Like okay, is this does this need to go for an MRI? Does this need to go for further screening? I mean, it's one of the... you never want to have that patient that you're like, oh, man, I'm sorry, but you're going to need to go get an MRI. But yeah, in the end, it usually is, is not that serious, and ends up being cheaper, coming to us.

Kris Hampton  54:58

Yeah, yeah, and here's a question for you. I, this might just the answer to this might just be trust your instincts, but not everyone has good instincts so I thought I'd ask the question. I, when when the event happened that the my shoulder got injured, I knew something was wrong, you know. I'd had trouble with it because of working overhead for years. But on certain jobs that would get worse and worse, and then other times it would be totally fine. And when this event happened, I went to a doctor, just a normal general practitioner. She told me, it's probably just tendinitis. I said, No way, I need to go see a specialist. Went to the specialist. He ran me through all their little strength tests, resistance tests, and and because I had learned to compensate so well for it over time, all the resistance tests showed that I just had tendinitis. And he told me that and I said, No way, you know,that there's something majorly wrong. You know, I need an MRI. And after I got the MRI, he said, well, your shoulder is totally fucked up. You need to come in and get surgery. So you know, what do we do in that case, that, that we know something is wrong, or we believe something is wrong, but the doctor tells us otherwise?

Allison Stowers, PT, DPT  56:20

I think at that point, you really have to be an advocate for yourself. I always tell patients, they know their body better than I do. And if you feel like something is seriously wrong, like find an outpatient center where you can just say, hey, I, I want an MRI. 

Kris Hampton  56:36

Yeah.

Allison Stowers, PT, DPT  56:38

 Use it judiciously, though, because MRIs are expensive, and a lot of times, not in your case, necessarily, but a lot of times these shoulder injuries can be rehabbed. So like you you could have a SLAP tear and and if even if it hurts, you could do PT, and still climb.

Kris Hampton  57:01

Right.

Allison Stowers, PT, DPT  57:02

And not need surgery.

Kris Hampton  57:03

 Yeah. Lots of people have them without even knowing. 

Allison Stowers, PT, DPT  57:05

Exactly.Yeah. And that's, that's what is kind of the issue with, you know, getting a little, you know, diagnostic happy is that, you know, with, if somebody gets an MRI of their back and they find that they have a bulging disc, then all of a sudden, it's like, oh, my gosh, I have a bulging disc. And it's like that pain can almost seem so much worse, than if they had never gotten the MRI in the first place.

Kris Hampton  57:34

So if you have a history of being a hypochondriac, maybe don't go to the doctor to get an MRI, hahah.

Allison Stowers, PT, DPT  57:39

Hahah, no, no, no. 

Kris Hampton  57:43

And you know who you are out there. 

Allison Stowers, PT, DPT  57:44

Yeah, exactly haha.

Kris Hampton  57:49

 So as far as you know, once you you feel like you've injured your shoulder, and it's so it's so funny, I meet more and more and more climbers who tell me they have a shoulder issue. I never heard anyone say that five years ago. 

Allison Stowers, PT, DPT  58:07

Yeah. 

Kris Hampton  58:08

But now that like there's this all this vocabulary about it, that there's all this discussion about shoulder injuries, all of a sudden, everyone has a shoulder injury.

Allison Stowers, PT, DPT  58:18

Yeah. 

Kris Hampton  58:19

You know, what do we... what do we do from there? Do we... is it the same similar stuff we do as far as warming up and pre rehabbing? Should we be strengthening in some other way? What's the what's the thought if we think we have a minor injury?

Allison Stowers, PT, DPT  58:40

Yeah, so minor injury, definitely, like listening to your body as you're climbing. So I, like tons of people tell me like, Oh, yeah, like, I've got this, like right here on the front of my arm. And they'll, they'll like point right to their biceps tendon, like, yeah, it's a little tweaky and then they climb and they're like, oh, man, like now it's really screaming at me. Um, so, you know, if you've got something little, like, take some, you know, if you need to take a day off, you know, it's not gonna kill you to take a day off.

Kris Hampton  59:15

Rest is pretty important.

Allison Stowers, PT, DPT  59:16

Right. Hydration, like we talked about earlier, and then, you know, making sure that you are doing your warm ups. And, you know, any sort of it's hard to say like specific exercises without knowing like, what somebody's specific weaknesses are, but anything that you can do to bring your shoulder blades down to back at all. I bring everything back to the scapula. So even like climbing, like I'll have people, once I know that they're engaging middle and lower traps, I'll have them get on the wall and actually climb with their shoulder blades pulled down and back, so they're climbing more with their back and their core, and less like pulling on their shoulders. So

Kris Hampton  1:00:11

And you are not advocating that they perform that way, that they're just training themselves to learn to pull that way.

Allison Stowers, PT, DPT  1:00:16

No, that they are kinda of...yeah, it'd be like a training. It's it's like, you know, Nate has me doing rooting and while I probably should be doing it more on the wall, I'm not necessarily thinking about rooting all the time. But same with

Kris Hampton  1:00:29

Some times, if you practice enough, it'll click

Allison Stowers, PT, DPT  1:00:31

 Exactly it kind of translates

Kris Hampton  1:00:33

And then you are like "Oh, look at that. I just did that".

Allison Stowers, PT, DPT  1:00:34

Yeah, exactly. And so like, the other thing is, like, I see a ton of injuries come in, because of like, deadpointing, and then sagging into their shoulders.

Kris Hampton  1:00:49

Right. Not staying engaged.

Allison Stowers, PT, DPT  1:00:50

Exactly and so it's just like the hamstring thing, you know. You've got to stay like, keep your shoulder blades, keep your delts, keep everything like, you know, bam, like, as engaged as you can. It's the second that you kind of you get lazy and sag, that's when things start to tear.

Kris Hampton  1:01:08

Yep. And I was never very aware of that until after my surgery. Because coming back from it, I was really hesitant to do any sort of dynamic move to my right side. But, you know, I apply the same principles we do in training generally, to that. And I practiced it, you know, in small amounts, and, you know, little little dynamic moves and built up and built up and the first time I did one and got a little lazy, it hurt like hell.

Allison Stowers, PT, DPT  1:01:39

Yeah. 

Kris Hampton  1:01:39

So now I've gotten much better through practice at measuring whether I'm going to be able to stay in control or not and then I can make the decision. Am I willing to risk what you know what the consequences might be by going out of control?

Allison Stowers, PT, DPT  1:01:56

Yeah, it all goes back to that is your shoulder talking to your ear? 

Kris Hampton  1:02:00

Right.

Allison Stowers, PT, DPT  1:02:00

 You know, if you're, I see it a lot of times on the campus board 

Kris Hampton  1:02:03

I was just about to say the campus board.

Allison Stowers, PT, DPT  1:02:05

 Yeah, I see I see so many shoulders talking to ears on the campus board. And that's, you know, one place that people injure themselves. Early on, very quickly, new climber, "Wow, this looks really cool. Like, let's let's do this." Like, I mean, I know that I've like tweaked fingers on the campus board, but

Kris Hampton  1:02:25

I see it in the Instagram videos of people campusing and their, their shoulders, you know, they just sag down onto their tendons

Allison Stowers, PT, DPT  1:02:34

Yeah,

Kris Hampton  1:02:34

 I'm like 

Allison Stowers, PT, DPT  1:02:35

Hangboarding too like, like hangboarding is, is about finger strength. So but but it's still like, I still need your elbows a little bit, not bent-bent, but like, at least engaged. And I need your shoulder blades pulled down and back. And that actually, there's one other exercise that once you're kind of climbing engaged, there's an exercise you can actually do on a hangboard. So you pull or you're on a hangboard and you kind of pull yourself up into a diagonal, almost like you're about to go into a .....

Nate Drolet  1:03:14

Front lever 

Allison Stowers, PT, DPT  1:03:15

Yes. Into a front lever.

Kris Hampton  1:03:16

But just your upper body, your torso goes into that position?

Allison Stowers, PT, DPT  1:03:19

Almost like, yeah, it's almost like your torso goes into that position and you're kind of it's like you're pushing your body away from the board. And if you think about what your back is doing, it's like your shoulder blades are pulling down against your rib cage. 

Kris Hampton  1:03:36

Yep. 

Allison Stowers, PT, DPT  1:03:37

Does that make sense? 

Kris Hampton  1:03:38

Yep, totally. 

Allison Stowers, PT, DPT  1:03:39

So, um, and there's a link I can send you for that.

Kris Hampton  1:03:42

 So is it similar to like a scapular pull up? Is that?

Allison Stowers, PT, DPT  1:03:45

Yeah, yes. Yes. It is. Except with most of the time with scapular pull ups, you are like, straight. You know, you're pulling straight down. And this you're almost like, you're like you're pulling down and like, it's like you're pushing the board away from you.

Kris Hampton  1:04:01

Okay. Yeah. Yeah. Shoot me that link and I'll put it in there, too.

Allison Stowers, PT, DPT  1:04:05

Yeah. So that is one that like, once I see somebody do it in the clinic, and I'm like, yeah, okay, that looks good, that is something I want you doing before you even touch the wall. You know, you've you've done your arm circles, you've done your wacky throwing your arms around and everything else and then I want you to do that on the hangboard. 

Kris Hampton  1:04:29

Okay. Just to do you have them do that, just so that they get, you know, get it in their brains to engage that position? Is that what we're looking for?

Allison Stowers, PT, DPT  1:04:40

Exactly, it's it's strengthening, but it's also like, a little muscle memory like, Okay, this is how we're going to climb.

Nate Drolet  1:04:47

Kind of building that awareness of what things should feel like?

Allison Stowers, PT, DPT  1:04:50

 Exactly.

Kris Hampton  1:04:51

 Yeah, yeah. I go through that with a lot of movements, if I'm warming up right.

Allison Stowers, PT, DPT  1:04:57

Yeah.

Kris Hampton  1:04:59

 And even out here, you know out in Hueco, that's what I've been doing. I find holds that I can do some scapular pull ups on and I do scap push ups just to just to so I can feel my scaps moving and being engaged and and then I do the same thing with my legs. 

Allison Stowers, PT, DPT  1:05:16

Yeah.

Kris Hampton  1:05:16

More so now than I was a month ago, but, you know,

Allison Stowers, PT, DPT  1:05:20

Yeah, and then a lot of times I'll tell climbers, you know, for the first 10 minutes of your climbing, climb slow and think of it almost is like yoga on the wall. Like you're gonna climb slow and really pay attention to what your body is feeling like and paying attention to what muscles are engaging. And a lot of times, I'll watch people, you know that, I have patients that then I see, you know, at TBA and I'm like, that's not slow. So if you're from Chattanooga, and you've ever seen Andy Cutler climb, I call it Cutler climbing. I want you to spend 10 minutes doing Cutler climbing. 

Kris Hampton  1:05:58

Haha okay,

Allison Stowers, PT, DPT  1:05:59

So climbing as slow as possible

Kris Hampton  1:06:01

 I spend 100% of my climbing, climbing that way. 

Allison Stowers, PT, DPT  1:06:04

Haha do you?

Kris Hampton  1:06:04

Yeah. Yeah. No, actually, I've been I've been sort of practicing the other way, you know, learning to stay engaged while moving dynamically and getting more comfortable with it. 

Allison Stowers, PT, DPT  1:06:14

Yeah

Kris Hampton  1:06:14

. But because I'm a slow climber. That's how I always start out. Thoughts, Nate?

Nate Drolet  1:06:21

Yeah, so one thing, as someone who's had to kind of retrain how I climb

Kris Hampton  1:06:27

Yeah, you know, let me let me go ahead and say that, and I'm gonna totally cut you off after I just brought you in. But I think that's something you're really good at is you've you've regressed a lot of your movements and retrained them. So 

Nate Drolet  1:06:41

That's a good way of saying I've gotten worse.

Kris Hampton  1:06:44

 Well, not exactly. But you said it, I didn't.

Nate Drolet  1:06:51

So I hit a point where I was just always injured. I had a ton of problems, shoulders especially. And for me, I had to, you know, it's like two steps back once or one step back two steps forward but this is more like 50 steps back before I could even start moving forward. Because yeah, I mean, I was really strong climbing with my elbows chickenwinged and like, shoulders talking to my ears, like, because I just did that forever and I was really good at compensating that way. And so for me, it was really hard to kind of bite the bullet and say, Okay, I need to, like, completely stripped down the way I climb and rebuild it. Is that a conversation you ever have to have with people?

Allison Stowers, PT, DPT  1:07:35

Um, yeah, yes. So much. I have a patient right now that I did my whole, you know, take off your shirt, let's see how the scapulars are moving. And it's like, oh, man, like we...you can't... we....no you can't climb like this,

Nate Drolet  1:07:55

Haha can you have someone drive you home?

Allison Stowers, PT, DPT  1:07:59

Haha not that bad, although that's happened.

Kris Hampton  1:08:02

Oh no.

Allison Stowers, PT, DPT  1:08:05

 But no, it's yeah, so okay, let's, we have to figure this out. Like we need to get this moving before you're going to get on the wall, like and, and that's really hard to tell a climber. But it's also once I like, work with a climber for long enough doing the right exercises, getting the right muscles engaged, and then all of a sudden, it's like they're climbing, you know, they're back to climbing and they're climbing stronger than they were before. Then that's usually pretty telling 

Nate Drolet  1:08:47

And while healthy now.

Allison Stowers, PT, DPT  1:08:48

 And while healthy now. Yeah. Yeah. And I mean, the climbers that that's happened to are my biggest advocates. Those are the people that are out there, like shouting from the rooftops and coming out here and climbing and crushing. So

Nate Drolet  1:09:03

Yeah, that's awesome.

Kris Hampton  1:09:04

That's cool. And it's cool to cool to be building that.

Allison Stowers, PT, DPT  1:09:08

 Yeah. 

Kris Hampton  1:09:08

So I'm stoked for it. And I'm stoked for you. I've heard that, you know, Paul's told me all sorts of good things. Nate's told me all sorts of good things. And I'm psyched that the Chattanooga climbing community is, you know, welcoming it and latching on like they should.

Allison Stowers, PT, DPT  1:09:23

Nate and Paul are getting their, like talons into me. I'm training with Nate right now and Paul has this Strong First competition coming up that he wants me to do. 

Kris Hampton  1:09:34

Are you gonna do it? 

Allison Stowers, PT, DPT  1:09:36

Um, I was planning on it and then the whole kidney stone thing happened. So

Kris Hampton  1:09:44

Yeah, likely excuse.

Allison Stowers, PT, DPT  1:09:47

I don't know. We'll see. I spent a week curled in a fetal position rolling around, so.

Kris Hampton  1:09:52

That's so horrible. 

Allison Stowers, PT, DPT  1:09:53

It's the worst. I don't recommend kidney stones for anyone out there.

Kris Hampton  1:09:58

Now you're in Hueco curling up in the fetal position,

Allison Stowers, PT, DPT  1:10:01

No, I haven't. It's been great out here. 

Kris Hampton  1:10:04

Good. 

Allison Stowers, PT, DPT  1:10:05

No, it is. It's honestly like, I think that I passed the kidney stone like 24 hours before I got to El Paso because it was like I was in pain for six days like, ER visit, everything. And then

Kris Hampton  1:10:19

That was right before you came here?

Allison Stowers, PT, DPT  1:10:20

Yeah. 

Kris Hampton  1:10:21

Oh my god.

Allison Stowers, PT, DPT  1:10:21

Like I was in the ER in Chattanooga for 13 hours. Like IV, Percocet.

Nate Drolet  1:10:29

And then you were in your car for 20

Allison Stowers, PT, DPT  1:10:30

 No, because I did fly. I flew to San Antonio. I had a, I had a physical therapy conference last week.

Kris Hampton  1:10:37

Oh nice.

Allison Stowers, PT, DPT  1:10:37

 I was like rolling around. I was on like, every four hours, Percocet or hydrocodone and was still having pain. 

Kris Hampton  1:10:44

Oh man, that's the worst.

Allison Stowers, PT, DPT  1:10:49

And then I just woke up one morning and there was no more pain.

Kris Hampton  1:10:54

You were like, let's go bouldering

Allison Stowers, PT, DPT  1:10:56

Yeah, like 13 hours later, we're in Hueco and let's go climb. It worked out. 

Kris Hampton  1:11:02

Awesome. Awesome. Any any thoughts from you any anything you want to put out there to climbers?

Allison Stowers, PT, DPT  1:11:10

The only other thing I wanted to mention about upper extremity is like if you think you have a shoulder injury, and it's like a nagging thing, don't be surprised if your PT or trainer, whoever you seek out, starts looking at your elbow or your hand or your neck or something because all of that can be super, you know, intertwined. 

Kris Hampton  1:11:30

Yeah, it's all connected.

Allison Stowers, PT, DPT  1:11:31

It is all connected. And there's a lot of times that I'll have somebody you know, turn their head left turn their head, right. And it's such a difference. It's like, okay, that's where the shoulder pain actually coming from. So let's work here first.

Kris Hampton  1:11:44

Yeah. So trust your practitioner.

Allison Stowers, PT, DPT  1:11:47

 Yeah.

Kris Hampton  1:11:48

 Yeah. Yeah. Okay. Cool. Well, thanks for sitting down with us. You know, I was when I first mentioned this to Allison, she was like, "Ummm.....can I think about it?". So I was a little surprised today, when you were like, what time are we doing it? 

Allison Stowers, PT, DPT  1:12:04

Yeah, as long as I don't have to, like, hear myself. I'm not sure that I'm gonna listen to this afterwards.

Kris Hampton  1:12:14

You don't have to.

Allison Stowers, PT, DPT  1:12:14

Chipmunky.

Kris Hampton  1:12:15

 I'm glad we have it.

Allison Stowers, PT, DPT  1:12:17

 Cool. 

Kris Hampton  1:12:18

Yeah. Thanks, Allison. 

Allison Stowers, PT, DPT  1:12:19

You're welcome. Thank you. 

Kris Hampton  1:12:23

I don't know if you guys have noticed a trend here. But I really like talking to people who can take science, can understand it, and can then relate it in a really human way. Because, I mean, I think that's just more effective for the large majority of people so so I really appreciate that. That's what Allison is able to bring to the table. I mean, you know, going to a doctor or to a physical therapist can be a little intimidating because we all want to be told that we've been doing things wrong and that we've screwed ourselves up. But going to see someone like Allison is more like talking to one of your climbing partners who just happens to really understand what you're talking about. So you know, I suggest you guys reach out to physical therapists if you have any issues that you need to you need worked on. To begin with, if you happen to be in the Chattanooga area, definitely go see Allison at Peak Fitness. All those ladies over there are athletes and climbers, and I think that's a really good resource for you. And you know, speaking of resources, that's something else that I admire about Allison is when I asked her what links she wanted included on the website, she sent me a couple of other PTs. three other PTs who are doing good work and said, you know, these are these are people who are putting out great information, and she wants those included as well. So you can check out her recommendations, the people who she follows on PowerCompanyClimbing.com on the blog post for this podcast, where we'll also have links to the videos and some of the exercises that she mentions like the Nordic curl. You can also find Allison at chattclimberPT.com. You can also find her at peakfitnessandPT.com. I'll have links to those on the website as well. And one more time if you happen to be in Missouri, August 13 and 14th, we're going to be in Kansas City at ROKC climbing gym, August 15 and 16th. We'll see you at Climb So iLL St. Louis, August 18 and 19th at Zenith Climbing Center, and August 20 and 21st we are back at ROKC Kansas City and August 25 26th 27th you can find us in Boise, Idaho at Asana Xlimbing Gym. So if you're in those areas, please come out and see us. We would love to work with you guys, get to know you guys. So hope to see you there. I think you guys know where to find us. We've been doing this for a while. You've been with us for a while. 52 episodes to be exact. And you can find us elsewheres on the Instagrams @PowerCompanyClimbing. You can find us on the Pinterest @PowerCompanyClimbing. You get the gist here. This is simple. Facebook, we're looking for 3000 likes 3000 followers on our business page at Power Company Climbing and the Twitter know you can't find us on Twitter because we don't tweet. We scream like eagles.