Date: October 19th, 2017

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About Jared Vagy, Doctor of Physical Therapy

Dr. Jared Vagy is a physical therapist, but he’s also a climber who’s incredibly motivated to help other climbers heal their bodies. In my first talk with Dr. Vagy on the podcast we talked in general about how to heal injuries, but since that time he has gotten way more specific about the steps we need to take to address them.

In addition to his ebook The Ultimate Climber, he’s now written a paperback book all about healing climbing injuries called Climb Injury-Free. In it, he describes his 4-step pyramid to healing injuries:

rock rehab pyramid

We focus mostly on shoulder impingement syndrome in this interview, but Dr. Vagy has also created protocols for:

You can see a description of all of the protocols (which he’s made available for only $10 each) at www.trainingbeta.com/rock-rehab.

Jared Vagy Professional Credentials

Dr. Vagy is an authority on climbing related injuries. He has published numerous articles on injury prevention and delivers lectures and seminars on the topic. He received his Doctorate in Physical Therapy (DPT) from the University of Southern California, ranked the number one DPT Program in the nation for the last decade by US News and World Report. He is now a professor at the University in the DPT Program. As a Doctor of Physical Therapy in clinical practice, he went on to complete a one year residency program in orthopedics and a one year fellowship program in movement science. He is a Board Certified Orthopedic Clinical Specialist and a Certified Strength and Conditioning Specialist.

Dr. Jared Vagy Interview Details

  • Some of the bad advice out there about physical therapy
  • His Rock Rehab Pyramid explained
  • Shoulder Impingement Treatment
  • Unloading tissue and muscles with tape
  • How to strengthen muscles for impingement
  • How to change movement patterns for shoulder, elbow, and finger issues

Rock Rehab Links 

Get the companion book, Climb Injury Free

Training Programs for You

Do you want a well-laid-out, easy-to-follow training program that will get you stronger quickly? Here’s what we have to offer on TrainingBeta. Something for everyone…

climbing training programs

Please Review The Podcast on iTunes

Please give the podcast an honest review on iTunes here to help the show reach more curious climbers around the world.

Transcript

Neely Quinn: Welcome to the TrainingBeta Podcast, where I talk with climbers and trainers about how we can get a little better at our favorite sport. I’m your host, Neely Quinn, and today we’re on Episode 92, where I talk once again with Dr. Jared Vagy, who is a doctor of physical therapy. He is also a professor of physical therapy. He sees patients of all kinds, so all kinds of athletes including climbers. He is a climber himself, so he takes a keen interest in it. He also has a website at theclimbingdoctor.com, and he also just put out a new book called Climb Injury Free, which you can buy on Amazon at this point. What we are going to talk about today is his whole rock rehab period program, which kind of goes along with his book. He’s set up these protocols for climbers, for specific types of injuries. One is shoulder impingement, one is rotator cuff strain, and one is neck strain. He is going to explain to you how to first of all avoid injury to those areas, but also how to heal injury to this areas if you have an injury.

Since we did this interview, we actually put those protocols up on TrainingBeta for you to purchase. Jared is extremely generous and just wants to help people, so he wanted to make them super affordable. Each of the protocols for each of those body parts is only $10, and it really does help you go from step one to step ten, to get to feeling better. If you want to check those out after listening to what he has to say about them, you can go to trainingbeta.com/rock-rehab, and check those out there. I’m just going to let Jared tell you about himself, about these protocols, and what he’s been up to, so enjoy.

Neely Quinn: Welcome back to the show Jared, thanks very much for being with me again.

Jared Vagy: Yeah, absolutely.

Neely Quinn: For anybody who didn’t hear our other interview- have we done one or two interviews, actually?

Jared Vagy: I think we’ve just done one.

Neely Quinn: Oh, that’s surprising. I just imagine that we talk all the time on the show.

[laughter]

For anyone who didn’t listen to the first interview with you, I’d love to share a little bit of your background and have you tell us what you do.

Jared Vagy: Okay. So I think the best way of telling what I do is telling how I got into working with climbers, and working with injuries. I was in graduate school- this was about a decade ago- and I was getting my doctorate in physical therapy. This was at the University of Southern California. I was studying pretty hard, and at the same time I was climbing really hard for myself. I was training basically to my limit, and I started feeling some stiffness in my shoulder, and I started feeling some tension in my finger. I kept training and training- I wasn’t listening to those signs. Eventually I tore my rotator cuff and I sprained a ligament in my finger. This was while I was getting my doctorate in physical therapy, and through that process I went on and went through a residency program- I specialized in orthopedics. From there, I went and did a fellowship program, so I sub-specialize in movement science. Each of those was a year, so totaling nine years of academic study. I went on, and now I’m a professor at the University of Southern California, teaching in the doctor of physical therapy program, which is the number one program in the country. I see patients as well clinically- about thirty percent of them are rock climbers.

Through this whole process from studying in school, to kind of getting to where I’m at now, I started thinking about how can I prevent injuries in rock climbers. When I first got into this, there wasn’t very much information out there. There was a couple of articles, a column in Rock & Ice, but there wasn’t much injury prevention information. I started writing articles for different magazine, Climbing Magazine, Deadpoint Mag, Climb Magazine in the UK, and started really focusing on movement patterns, and how climbers can change the way they move to unload different areas of their body. I started giving clinics, seminars, working with a lot of climbers, and working from anywhere from novice climbers that just started to some of the top professional climbers in the world. Climbing is a passion of mine, injury prevention is a passion of mine as well. I feel very lucky to be able to combine the two of them.

Neely Quinn: So going back a little bit- did you ever figure out how to heal your own shoulder and you own finger?

Jared Vagy: Yeah, I actually did. The shoulder, that was a tricky one at first. Really what it came down to is- and you gotta remember, I was in physical therapy school, so I was learning a lot of information. I kind of tried everything, so I was doing ten different strength exercises, I was doing a few different movement pattern trainings, so different stretches, and I kind of threw what’s called the “shotgun approach” at it. I did everything for it that I could. It took a while, and I started feeling better, but then I got smarter. I just started doing the things that I felt would work, and doing more of that, and less of the extra stuff. What I want to talk today about- and we’ll get into it- is really what do I mean by the things that I felt that would work, and is there a system or a way that you can take all this information and say “I have pain in one part of my shoulder” per se- let’s say that- is there a streamlined way that you can address it without doing hundred different things? I was able to recover from it, but it did take me quite a bit of time. Now I have a better idea and system to make it go a lot quicker.

Neely Quinn: And then over time- how many years have you been seeing patients, clients?

Jared Vagy: For rock climbers, I’ve been seeng climbers probably for about the past seven years.

Neely Quinn: Yeah. So over that time you’ve probably had plenty of people to experiment on and learn what protocols work and what don’t.

Jared Vagy: Yeah, and I’ve worked with and taught over a thousand climbers. The systems that I’ve gone through have been- obviously in the earlier years they were a little bit, you know, a little bit not as streamlined, per se. But as time has gone on, I’ve really been able to dial them in. Basically they are based on these core principles, is what’s called the Rock Rehab Pyramid. That’s something I want to talk more about later on in this podcast, is how any climber can have an injury, know the location of the injury, be able to self-diagnose, and then go through a systematic process. It just took me six or seven years of doing all the hard work of how to get to that endpoint.

Neely Quinn: Yeah, we have a lot to talk about [laughs].

Jared Vagy: We do.

Neely Quinn: You do so much. It’s always really impressive to me, because you teach, then you travel to treat teams around the world, right?

Jared Vagy: Yeah, I mean, I wear a couple of different hats. Rock climbing is my passion, but I got into climbing through track and field injuries. I worked with the Chinese national track and field team, I’ve worked with some US Olympic teams. I was just with the gymnastics national team over at the Olympic Training Center. That’s a whole other topic- those are some of the most amazing athletes that I’ve seen- the men’s gymnastics team. But they’re a little bit heavier than rock climbers, and their grip is only specialized to gripping a bar and doing some very, very dynamic moves. But yeah, I wear a lot of different hats. The hat I love the most is working with rock climbers, especially because it’s been such a big part of my life.

Neely Quinn: And how much do you do that, and where do you see people? Like if somebody wanted to see you, as s climber, where would they go and how would they do that?

Jared Vagy: The tricky thing is because my time is so compressed, because I travel around going lectures, I give different clinics, seminars, I’m basically every weekend out of the area. It gets harder and harder to book slots and find times, but I make sure that I set aside certain times for remote consults, where climbers can come in for a Skype interview, and I have template that I send them and they go through several different movements. I identify movement patterns and set up a program. Or they can see my privately as well. The best times to do that are typically the summers, because during the school year my time gets more and more compressed.

Neely Quinn: Okay. Out of curiosity, what have you learned from other kinds of athletes about the body, that you can sort of link in with climbers?

Jared Vagy: Working with different sports has really changed the game. I get to see at the Olympic level what these athletes are doing, and then I get to take a snapshot of that and say “Alright, how much of this is being integrated into climbing, and how much really has to be? Do these sports overlap, do they have similar characteristics?”. One of the big concepts, or things that I noticed, that is prevalent in high level sport- and especially this is in gymnastics- is when I do these seminars and I work with a lot of coaches, climbers are starting to catch on that a dynamic warm-up is important. A dynamic warm-up is just taking your limb through a range of motion and going smoothly through it, typically lasting about three seconds. It’s even better of you do a dynamic warm-up with movements that mirror climbing positions.

I believe on our last podcast we went into depth about how to go through these different warm-ups. If anyone wants to check that out, there is a pretty cool video of Jonathan Siegrist going through a climbing specific warm-up on YouTube. I think you just type in “The Climbing Doctor Warm-up” and “Siegrist” and you’ll be able to find it. That’s becoming more and more popular in climbing, but what I’m not seeing as much is muscle activation exercises as part of a warm-up program.

Neely Quinn: Uh, what do you mean?

Jared Vagy: So if you think about it, a dynamic warm-up is going to increase blood flow, increase mobility, warm up your body. But when we climb, we use very specific muscles, and there are certain muscles in our body that we underuse. Those are typically called our antagonist muscles. If you think about it and slump down into a really bad posture, you rotate your shoulders inwards and your arms inwards, and then you come out of that position with a really good posture with your palms forward, the muscles that take you out of that bad posture are called antagonist muscles, and they antagonize the motions that we typically do when we climb.

If we want to prime the pump, per se, if you want to- I give the example if you want to cook something in the oven, what do you do before you put it in the oven? Like put a brownie in the oven, I don’t know the last time I cooked. But what do you do to the oven?

Neely Quinn: You pre-heat it.

Jared Vagy: You pre-heat the oven. So what muscle activation exercises are, are a sustained pressure under a very low, non-fatiguable load. You hold it for about thirty seconds to a minute, and this turns on your antagonist muscles. So for example a very easy thing to think about, is if you take a resistance band and tie it around each wrist, so it’s in a loop around each wrist, and then you press out on that band with your rotator cuff and sustain pressure into it, and hold that for about thirty seconds, what you should start feeling is a little bit of a burn. Almost a waking up of the muscles in your rotator cuff. This is something that people often times do as an exercise, but it’s an integral part of a warm-up. Why? Because we need to pre-activate our muscles to support our body before we get on the wall.

By simply adding some resistance band, low level isometrics to pre-heat the oven, then we can prevent more injuries when we get on the wall and start climbing. Even better, if you can do that in climbing specific positions. So instead of just having your arms down by your side with your elbows bent, you can do something such as a wall angel, where you’re spread flat against the wall, you’re pressing your arms really hard and firmly against the wall, sustaining that pressure in a position that’s similar to what you would do when you’re climbing.

Neely Quinn: Hmm. Okay. So how can people- it’s fine and well you telling us what to do here, but we’re going to talk about your program and book coming up, but is this part of that? Can people see videos of this, or?

Jared Vagy: Yeah definitely. We’ll talk about the book a little bit later, but one of my big pushes- and this new book that’s coming out is called Climb Injury Free- is to create a system, and then to have the best visual resources available for people to follow through with it. So everything we talk about, and especially this podcast, is in the book. So there’s content in the book, but there’s also videos and programs online that people can access. Going through the system of how to warm up, there’s a whole chapter on that in the book. There’s a whole chapter on every single one of the top ten climbing injuries you can have, and then how to prevent and rehabilitate them. It’s all set up in a very step-by-step system, with tons of photos that makes it easier to follow.

Neely Quinn: Okay. Why don’t we just talk about  the book a little bit more right now. I’m excited about this book, and I think any climber who wants to avoid injury, or get rid of injury should be excited about the book. So, is it available, and how can we get it, and what kinds of things will it help with?

Jared Vagy: So the book is now available, or it should be available by the time this podcast airs. You can get it at the climbingdoctor.com, D-O-C-T-O-R, spelled out. Or you can buy it on Amazon, and it’s called Climb Injury Free. It’s a step-by-step system of how to prevent and rehabilitate injury. It was a six year process to finally get the final version of the book out, and I’ve had a ton of help along the way. It’s probably my proudest achievement in climbing, I can say.

Neely Quinn: That’s awesome. Having written a book myself, I understand how laborious it is. I had a publisher helping me, and you’re self-publishing this, right?

Jared Vagy: It’s interesting. I hit a junction, and this was about two years ago. I had a few offers from the top publishers in climbing, and I was really torn. I was going back and forth on it, and in the end, I just decided that there is a very specific way I want to put out this content. I want to give a lot of it away for free to climbers to be able to access, and I wanted to do it a certain way. I went the direction, I said you know what? I’m going to go ahead and bite the bullet, and do all the leg work on this. I went forward and I self-published it.

Neely Quinn: Which means you had to find the paper that it was going to be printed on [laughs].

Jared Vagy: Well this is a funny- I can probably disclose this story, but I sent the book out. This was about- Neely, how long was this? Maybe a year and a half ago?

Neely Quinn: Yeah, uhuh.

Jared Vagy: So I sent the book out to a lot of my friends. I sent one to Neely, and I sent it out to a lot of people who are involved in climbing, and training, and professional climbers, colleagues and so forth, because I wanted this to be dialed. I got tons and tons of advice back on technical aspects, fix this, change this. It really helped shape the book. Then Neely, in conversation, she was flipping through the book and was like “Jared, the paper quality is pretty bad. This is pretty shitty”.

[laughter]

So I don’t know if you even remember that, but I put a note down, and was like “That’s not good. This is my proudest achievement in climbing, I gotta rock this”. So I got in touch, I actually reached out and I e-mailed and called all these printing presses, all over the world, in China, Hong Kong, and Europe. I had them send me copies of their books, I went through and found the best book with the best quality of print and best level of paper, and then I went through this whole process of getting it published through them. It was actually quite an ordeal, this last year of putting the book out. But I’m super psyched about it, and excited to get it out.

More importantly, I really want to talk about the content of the book in this podcast. I’m a big proponent of giving free information and just getting info out there, and so I want to take through almost a snapshot in this podcast of what to expect for a climber that has an injury in a certain area, and how to take this rock rehab system that’s identified in the book through a whole injury.

Neely Quinn: Yes, so let’s do that. What do you want to do it with?

Jared Vagy: Um, well let’s do shoulders Neely.

[laughter]

Neely Quinn: It’s my favorite topic [laughs].

Jared Vagy: It’s your favorite topic, why not. We can talk about shoulder impingement as a common shoulder diagnosis. It typically refers pain to the outside of the shoulder, and sometimes to the front. That’s a good diagnosis that we can dip into, and I can explain how any climber can start to organize their injury prevention and rehab, just as they would organize their training progressions.

Neely Quinn: Okay, and I think that’s a really important point. You want people to understand that their rehab should be just as structured as their climbing training, right?

Jared Vagy: Absolutely. You think about your climbing training, you don’t do forty-five 4x4s because you think it’s going to get you better, and you don’t do a ten different rotator cuff exercises because you think it’s going to heal your rotator cuff. You do the specific things at the specific time in a certain sequence, and that’s how you get better and see results. So many climbers- there’s so much information out there now about how to prevent and rehabilitate injuries. Some of it is amazing. Some of it is so darn good. And then some of it is terrible. I look at it, and I’m like “Really? Where did you come up with this? This goes against all concepts of mechanics, and there’s no research to support it”. Then I see some other stuff that’s awesome, and I’m like “Wow, why didn’t I think of this? This is really, really good”.

There’s so much of a difference, and all I care about for climbers is first of all, that they get better and don’t get injured. But more importantly, can you just start to apply the same structure that you do to climbing and training to rehab? And if it makes sense to you, you will. If it doesn’t, then you’re going to come and do twenty-five different exercises and take a year to get better.

Neely Quinn: Right- or never get better. I want to go back actually, because you seem adamant that there is advice out there that you look at, and you’re like “What the-?”. That’s kind of how I feel with nutrition too. I have a feeling that people’s interest was piqued there. What kind of things do you see that you’re just straight up like “That is stupid”.

Jared Vagy: Well some of the stuff that I’ve put out a couple of years ago. I look back and I’m like “Oh man, alright”. Well research has changed, and you know, I’ve seen probably seven hundred more climbers since I put that out- the game’s changing. But I’ll take credit for putting some of this content out there that was not so good previously. One thing that climbers are fixated on is keeping their shoulder blades engaged and squeezing them together. This is a very good thing in certain positions of climbing. If you think about it- Neely, what position in climbing do you think it’s good to keep your shoulder blades engaged?

Neely Quinn: When you are on an overhung route, maybe?

Jared Vagy: Yeah, perfect. When you’re on an overhung route, you squeeze your shoulder blades together, it brings your center of mass a little bit closer to the wall and to your feet, so you’re not working as hard through your fingers.

Neely Quinn: Mhmm. Maybe when you’re at a rest?

Jared Vagy: Yeah, perfect. When you’re at a rest stance and you are squeezing your shoulder blades together to keep those muscles engaged and to stabilize your position. Those are two really good uses. But think of it this way now- everyone who is listening, and even Neely, as you are listening now, put both arms in front of you. Straighten your elbows, and then squeeze your shoulder blade back as far as you can. So both arms in front of you, arms completely straight, elbows straight, squeeze both shoulder blades as far back as you can. Squeeze them together in that position, then raise your arms as high as you can, while keeping your shoulder blades fully squeezed together.

Neely Quinn: Yeah.

Jared Vagy: You should notice, and keep that, whoever is listening, keep that position. You probably can’t go that far- maybe 130 degrees, or something like that. Now release your shoulder blades, almost push them forward a little bit, and bring your arms up overhead, and you’ll notice you can get more range of motion.

Neely Quinn: Yeah.

Jared Vagy: A concept that has been popularized, that is a really good concept for stable positions, is engaging your shoulder blades- and not over engaging them- but engaging them just enough to create stability. But when you are reaching, you better unlock them and allow them to rotate up, or you will develop what’s called impingement, and that’s the topic that we are going to be talking about today.

Neely Quinn: Well but does that mean when you do your band exercises where you are doing the- I can’t remember what you’re called, I do them all the time- but you have your arm out, you have your band in your hand, and you go out to the side either way with it. Does that mean-

Jared Vagy: Like a letter T?

Neely Quinn: Uh- no- yeah sort of.

Jared Vagy: Or a rotator cuff exercises where your elbow is in an L and you’re pressing out against-

Neely Quinn: Yeah exactly.

Jared Vagy: That’s completely fine, because your humerus, or your arm bone, is facing downwards. It’s actually at 0 degrees. If you do that same thing with your arm above your head, almost above shoulder height, between all the way over your head and shoulder height, and you squeeze your shoulder blades really tight together, then you are going to be in trouble. Now you are over engaging and limiting your range of motion.

Neely Quinn: That’s interesting because I was doing this thing called “Iron Scap”- have you heard of that?

Jared Vagy: I can probably guess what it is.

Neely Quinn: One of the exercises is basically doing that, and I of course have been trained to keep my snaps, my shoulder blades back, so at the upper range I was doing that and I probably messed myself up more. I mean, how are we supposed to know what to do? It’s so confusing all this stuff.

Jared Vagy: Well the way I see it is if you have a system- training used to be confusing. Now we have a couple of different programs or systems out there, where now we are like, alright, I can write this down, I can sequence it, it makes sense, right? I think it’s the same stage with preventing injuries and rehabilitating injuries. If there is a framework that you can work under, then injuries are going to make a lot more sense. You’re not just shooting in the dark, or guessing if something is right or wrong.

Neely Quinn: Okay, let’s talk about the shoulder impingement stuff. So this program that you are about to lay out here is in your book, and in the videos that you are coming out with, right?

Jared Vagy: Yeah, correct. This is one of the ten programs that are outlined in the book. This is a component, like a taste or a snapshot of the program.

Neely Quinn: So if somebody is going to get the book, should they get the videos as well, or is it necessary? Did they go together? How does that work?

Jared Vagy: It’s really up to the climber. If you are a really visual person and you want to see the videos, and you want to be walked through step by step with the different tips that come on the screen, and the exact ways to perform it, then I’d say get the videos. If you’re on a budget and just want to heal your injury and you just want bare bones, go ahead and get the book. If you have no money and you just climb, and you want to heal yourself, then just pay careful attention to this podcast.

[laughter]

Neely Quinn: Okay, alright great. Carry on.

Jared Vagy: Alright, so impingement is what we’ll talk about. Basically what it is, is we have rotator cuff tendons that go through a small space in our shoulder. The specific tendon is called the supraspinatus tendon. When then shoulder is rounded forward, or when the arm bone is rotated inwards, it can compress this tendon and generate some pain. That is what’s called shoulder impingement- and what were you going to say Neely?

Neely Quinn: Sorry, I thought that was with the biceps tendon?

Jared Vagy: There’s actually- so there’s two tendons that go underneath. There’s supraspinatus, that’s rotator cuff. And then you are correct- the second one is the biceps tendon, that goes the long head of the biceps, that goes underneath that space as well. There’s also a fluid filled sac called a bursa, and there’s some additional tissue in that space as well. The part that we are going to talk about specifically today is the supraspinatus component. The biceps tendinopathy is actually another section that’s in the book that’s a different protocol. The difference between-

Neely Quinn: Okay, it is in there though.

Jared Vagy: Yeah, exactly. The difference between those two  is that the biceps is typically more felt in the front of the shoulder, where the supraspinatus is typically more felt a little bit more to the side, or the lateral aspect of the shoulder.

Neely Quinn: Okay, cool.

Jared Vagy: But yeah, you are entirely correct. And I know speaking from experience, you have an in-depth knowledge of your anatomy.

Neely Quinn: Oh yeah- that I’m missing two of the things you just described?

Jared Vagy: Or they’re relocated.

[laughter]

Neely Quinn: Yeah exactly. Okay so the protocol.

Jared Vagy: So for any injury, think about it in this pyramid. This is in the book, I called it the Rock Rehab Pyramid. You have a foundational level, which is typically when most people start to worry about their injury. That is pain, inflammation, and tissue overload. That’s when you first start feeling pain, discomfort, and you’re shoulder is overloaded.

Neely Quinn: Okay.

Jared Vagy: So hang with me for a moment, I’m just going to go through these four steps. The next step in the pyramid, so right above that, is mobility. This is when after an injury that things start to stiffen up, and you no longer have pain-free motion in every direction. The next level above that is strength, and that’s where the muscles stop firing, and they’re no longer working around that area. The final step is the movement. That is your movement becomes uncoordinated, because of the pain, the strength, and lack of mobility.

Changing specific movements that load those structures, specifically in climbing, can help you heal quicker. This is not a completely linear pyramid. Know that you can have components of it at every stage of the cycle, but I’ll was you through how to actually rehab in each section of the rehab with this shoulder impingement injury.

Neely Quinn: Okay, and just to be clear, what are a few of the main things that people will look for if they want to know if they have shoulder impingement? You said that it hurts on the side- are there other things?

Jared Vagy: Yeah, so specifically with shoulder impingement is a dull ache, and it’s usually on the side of the shoulder, sometimes on the front as well. It’s painful to lay on your shoulder in bed, and then lifting the arm and specially reaching across the body, and also behind the back, can lead to some discomfort.

Neely Quinn: Okay, thanks.

Jared Vagy: So the first step of this pyramid is pain/inflammation/tissue overload. I’m not going to spend that much time talking about pain science, and I’m not going to spend that much time debating on whether it’s important to allow tissues to be inflamed or to use anti-inflammatories. I want to talk about the component of tissue overload at that bottom part of the pyramid. This is when you start having your symptoms, and if you think about it, everyone listening right now, just roll you shoulders forward, bring your arm up to about 90 degrees. Your elbow its up to about 90 degrees, and bend your elbow. Bring your arm across your body, so that your elbow is lined up with your shoulder, and then press down on your hand quite firmly, so that your arm rotates inwards, and almost your fingertips are pressing towards the ground. If you feel a little pinch or discomfort in your shoulder, this is a classic test to see if there’s discomfort in that impingement position. It’s called the Hawkins-Kennedy sign.

Neely Quinn: Okay.

Jared Vagy: And so if you think about it, that component of the shoulders rounding forward is if someone has inflammation of that tendon, and the space in that shoulder- the little alcove where the tendon goes through is decreased or made smaller by the shoulders rounding forward- how over time can you help heal the tendon? What can you do with your shoulders?

Neely Quinn: I mean, change the position where it mostly stays, lives?

Jared Vagy: Yeah exactly. You can pull you shoulders back, right? You can sit in good posture, and so forth. We all know that probably none of us do that very well, or we try to but it’s hard to do throughout the day. One is you can cue someone to be in good posture, to take them out of this pain/inflammation stage. Or you can use some therapeutic taping that pulls the shoulder blade back, and allows that tendon to unload a little bit- take stress off of it- and can heal throughout the day. Applying some taping to that area in the back of the shoulder to almost pull it back when you are resting can unload that tendon. This is different than what we talked about before. Remember when we said don’t pull your shoulders back and squeeze them together when your arms are over head?

Neely Quinn: Mhmm.

Jared Vagy: Well you don’t want to do it there, but you want to do it when your arms are down by your side. This is a way where you can start to open up the chest a little bit and allow that tendon to heal. When you’re at your school, at work, sitting at the desk, you can apply some tape on the back of the shoulder- the firmest type of tape is called Leukotape. You put that on the back of the shoulder and it can cue you into that position. There’s even apps on the smartphone. You put a little clip on your shirt, and every time you slump it’ll vibrate and make you sit in good posture. All these components to keep you nice and open. There’s posture shirts that are available . But that’s a key component in getting out of that baseline level of the pyramid.

Neely Quinn: Okay a couple of questions before we go on. Leukotape- I know people are going to e-mail me. How do you spell that?

Jared Vagy: L-E-U-K-O-tape.

Neely Quinn: Is that different from KT tape? Kinesio tape?

Jared Vagy: Yes. Kinesiolgy tape is a very flexible tape that has a lot of stretch in it. You can use it when you climb, it’s very dynamic, but it definitely does not hold your shoulder in place. It may give you a kinesthetic cue- if you put it on the back of your shoulder, it may remind you to keep it pulled back. But Leukotape is a very firm tape, that you want to use with something that is called cover roll- a white strip that goes underneath it. It’s a very firm tape that will actually reposition your shoulder back.

Neely Quinn: So you would actually use it when you are climbing?

Jared Vagy: Actually this one is not used during climbing. We’re climbing two hours a day, right, or maybe sometimes up to four hours if we are training hard. Think about all the time you’re not climbing, and all the time your arm is at your side and you are sitting in bad posture. I actually recommend this more during those times, to create a healing environment to unload those tissues at the baseline of the pyramid.

Neely Quinn: Okay. Very quickly, anecdotally, when I was just in Norway with Paige Claassen- she gets tension headaches. Her physio said- I had to apply and re-apply KT tape to her back so that her shoulders would stay in place. When she didn’t have the KT tape on, she would get tension headaches and when she did, she didn’t have tension headaches. It can be pretty powerful.

Jared Vagy: Yeah, definitely there’s research on kinesiology tape that is on either end of the perspective. Some of it is quite good to show that it activates certain muscles when it’s put on a certain way, and other research shows it can inhibit muscles when put on a different way. It doesn’t necessarily structurally change the position, but it can have very good therapeutic benefits, like the one you’re speaking of.

Neely Quinn: So how do we know where to put the tape and how to put it on?

Jared Vagy: One of the big parts of the book that I put out is that I wanted to outline how to unload the tissues. There’s a very specific outline in each video for the best research-based technique. If you have shoulder pain on the outside of your shoulder, here’s the best way to put on the tape.

Neely Quinn: Oh that’s nice.

Jared Vagy: If you have pain on the inside of your shoulder, here’s the best way. If it’s on the outside of your elbow, here’s the best way. I went through all the research, I collected to best taping techniques, and ti’s completely lead out there, one by one, the best way to do it for each body region.

Neely Quinn: Yay- good job. Okay, cool. Alright, carrying on, moving on.

Moving up the pyramid- we get out of that pain/inflammation stage, our shoulders are rounded forward. What’s the next thing that we do? Mobility. If you want to make something more mobile, what’s the first thing that you do? You’re a nutritionist- think about if we want to tenderize chicken, let’s say. What would you do if you wanted to take an external tool and tenderize it?

Neely Quinn: You would beat it.

Jared Vagy: You would beat it- you’d take a meat tenderizer and beat it up, so you can get that chicken nice and pliable.

Neely Quinn: I don’t like where this is going Jared.

Jared Vagy: You what?

Neely Quinn: I don’t like where this is going [laughs].

Jared Vagy: I’m trying to make the nutrition analogies here! But if you think about it, your chest muscles, the muscles in the front of your body- if those are short, stiff, or overactive, they’re going to roll our shoulders forward. If you tenderize those muscles by taking a lacrosse ball or foam roller to that area, you can start to loosen them up before you stretch them. A lot of climbers are big on- the thing in the book is called “Dirtbag Tips”. But I was a dirtbag for six months of my life, and that was probably the best six months of my life I’ve ever had. I was at a point where I would not pay a single penny if it wasn’t a cam- I mostly trad climb. So if I wasn’t buying a cam, or a carabiner, or any piece of equipment, I wasn’t going to spend a dime. A big part of the book too is- well if you don’t want to buy a lacrosse ball or foam roller, you can take a retired carabiner and some sunscreen you can get on that area and start tenderizing it as well, by loosening up the chest muscle with a carabiner.

Neely Quinn: Sunscreen- that’s awesome.

Jared Vagy: It was pretty fun coming up with these “Dirtbag Tips”. If we have more time we’ll get into some of the classic dirtbag tips in the book.

Neely Quinn: One of the ones I’m using actually is the corner of a wall, or like a door jam. I just stick my chest or my shoulder into the corner and it’s really amazing. But anyway, keep going.

Jared Vagy: Yeah, that’s the intense version of doing that.

Neely Quinn: Yes.

Jared Vagy: The hardcore version. Okay, so we’ve got that we tenderize the tissue, and then now you want to stretch it. When you want to stretch it, most climbers that I’ve assessed are hypermobile, meaning that they have too much motion stretching their arm out to the side and stretching their chest muscles. For example, whoever is listening to this podcast, bring your arm up into the air so your hand is at the level of your shoulder, and your arm is all the way out to your side. Press it against the wall, and then rotate your chest. This motion is typically hypermobile, or too loose with climbers. If you then take your arm and then your bring it up higher, almost to 120 degrees, and you do that same rotation or same motion, it should feel a little bit stiffer. If it’s hard to do on a wall, just go into a door frame, put your arm out to the side, rotate your chest, and then bring it up higher- almost to 120 degrees, between the top of the arm all the way overhead and your hand right at your shoulder, and rotate. It should be a little bit stiffer.

What you can do is you can start to stretch those chest muscles, but I recommend less so with your arm out at the side, more so in this wide position with you arm up overhead. You can do something as simple as go in a door frame and put both arms on either side, put them in that wide position and lean your chest forward.

Neely Quinn: Yeah, I mean as a person who has done a ridiculous amount of PT for shoulder stuff, I use a band for this, or even a dog leash. I’ll just put it in my hands, stretch it all the way out, and then just move my arms, I don’t know- in ways that stretch my pecs. It can be as simple as that too.

Jared Vagy: Yeah just trying to find those different angles to get the stretch. Exactly. So you go through that process, you tenderize the meat, you go through that range of motion, and then exactly what you are talking about right now. Then you add some assistance or over pressure. What you just said, you take a band or your an even take a stick- sport climbers like to stick clip. Or you an take a trekking pole on your approach. But you can add some over pressure on different areas, just like you are talking about, to get maximum flexibility.

Neely Quinn: Okay.

Jared Vagy: So that takes us through that pain/inflammation tissue overload, it then takes use through the stage of mobility- so increasing mobility in that same chest muscle that’s rounding our shoulders forward, and then we now want to get into a strength phase. When you think about strength, you want to go into it sequentially. The first thing to think about is how can you strengthen the muscles, but without using a band, or without applying any resistance? What you can do is go into simple things such as a wall angel. That’s going to take you out of that rounded forward position, and it’s going to pin or pull your shoulder blades a little bit further back. For this one, I’ll just have people statically hold a wall angel at that 90 degree position to start with, just to start opening up that chest muscle.

Neely Quinn: Okay a couple of questions here. First of all, can you describe in detail what a wall angel is? I’ve been shown this, but sometimes I forget how to do it, so I’ll have questions after.

Jared Vagy: Yeah, so a wall angel, you basically put your back against a wall, you step your feet out about four to six inches from the wall, you engage your stomach, flatten your spine, bring both arms out so your elbow is in one with your shoulder, and your elbows are typically bent to about 90 degrees. You actually just start and hold that position.

Neely Quinn: Okay- go ahead.

Jared Vagy: So that’s the start of a wall angel.

Neely Quinn: Okay. So is your whole spine on the wall?

Jared Vagy: The goal, if you are trying to get a stretch in the chest muscles- so you are trying to get rid of some of that impingement in the shoulder- then you want to have your entire spine flat against the wall, and you want to drop your chest bone or sternum down just a little bit to flatten everything against the wall.

Neely Quinn: Should you have your, as we were talking about before- should you have your scaps engaged, should you have your shoulder blades back, or how should they be?

Jared Vagy: So right when you are at the 90 degree position, when your elbow is right out from your shoulder, engage those shoulder blade muscles- that’s fine. But as you start getting higher and higher, I actually have some of my clients press or reach their arms forward away from the wall, so they’re not restricting their motion as much.

Neely Quinn: Like if it’s too painful, they should put their arms out?

Jared Vagy: Exactly, and you let pain be your guide. If you are squeezing your shoulder blades 100% back, and you are flattening against the wall, and then you can’t even move upwards, and it’s starting to be painful, well that makes sense- you’re over-engaging. If you engage just a little bit, turn on your muscles, it’s less squeezing your shoulder blades back for this. I’m more interested in rotating the arm bone or the humerus bone backwards- pressing the hands against the wall, versus pulling your shoulder blades inwards towards your spine. If you are starting to feel that pain, ease away from the wall and go through that pain-free motion.

Neely Quinn: So you go up, where should you hands theoretically end up?

Jared Vagy: So if you want to make it functional, or mirrored towards climbing, you want to be able to get your hands all the way up overhead. But I can tell you that people that are hypermobile, they have a lot of mobility. They don’t have much of an issue being able to bring their arms straight up over their head by pressing against the wall. The majority of us that are a little bit stiffer, at about when the elbow gets- probably about 140 degrees, if you think of 90 degrees is with your elbow out at your shoulder, 180 is towards the top, around mid-way between that point is when the elbow usually starts to deviate out of that position. That’s when usually you get a little bit of pain, or you’re working really hard in that position. I usually recommend to ease out of that until you get the flexibility- which is the first stage- to get out of that position easily.

Neely Quinn: And then how long should this take, and how many sets and reps should people be doing?

Jared Vagy: So to go through for wall angels themselves?

Neely Quinn: Yeah.

Jared Vagy: So wall angels themselves, and this is an exercise just the beginning level of strength- typically three sets of repetitions should get you through that period. I look at things a little bit differently- that’s your classic recommendation or dosage. If you are a boulderer versus sport climber versus trad climber, I’m going to be dosing that differently. If you are a boulderer, you’re going to be doing that at a little bit of a quicker speed in a shorter duration, because you are thinking about bouldering as being more power based and quicker movements. If you are a sport climber, you are gig to be doing it for a little bit longer. Instead of three sets of eight, maybe three sets of ten, three sets of twelve. Then trad climbers, they have to sustain that position even longer, so endurance phases of doing it for about fifteen repetitions.

Neely Quinn: Hmm. Okay.

Jared Vagy: The style of climbing you train for can dictate your movement. Going through this baseline stage, this pan/inflammation/tissue overload, this next level of mobility, building into strength-not over-engaging, but engaging just enough to go through pain-free range, and then eventually adding some resistance bands to the mix. Then using sports specific positions with pull-up bars or rings, where you are starting to get closer and closer into positions that look, feel, and mirror climbing relating movement.

Neely Quinn: Can you just give me one or two of the band exercises that you would use for this?

Jared Vagy: The common exercises that are use to help impingement- and if you think about the shoulder blades rotating forward- is you want to be able to pull you shoulder blades back when your arms are at 90 degrees. As it gets higher and higher, you don’t want to pull back as much, as we talked about earlier on. But you’re pretty safe at that 90 degree position, so your hand at about shoulder height, engaging the shoulder blades.

An exercise called the “bent letter T” is a preferred one to strengthen that muscle. What you would do is bend your knees, hinge your hips with keeping your spine straight, almost like you are on an overhang, and lower your chest down. You would wrap the resistance band around your waist, grab and end of it in each hand, and then you would bing your arms out into a T position and slowly bring it back down, while keeping you thumbs rotated up towards the sky.

Neely Quinn: Hmm. That’s an interesting way to do it, as opposed to just weights in your hands.

Jared Vagy: Weights are fine to use. I have no issues using weights- you can do it using weights, water bottles, you can use a resistance band. I prefer to use resistance bands, just because I incorporate them in other aspects of the warm-up. In the book as well, there’s every option you can use. If you don’t want to buy weights, you don’t have a resistance band, you can even use a piece of cordage or a piece of webbing. You just hold or maintain that resistance statically, against some webbing or some cord.

Neely Quinn: Okay. Alright. So that’s strength.

Jared Vagy: Okay, so that takes you through strength. The final section is movement. That is by far, in my eyes, the most important part of this process. You can do every single rehab prevention exercise, and mobility, and strength, but if you don’t change your movement patterns on the wall, then you’re going to continue getting hurt. If you don’t choose your movement patterns through the day, you’re gong to continue to have issues.

For movement, for every specific injury that we outline in this book, we identify each movement pattern that stresses it. For example, everyone take their arm again- this is what we did at the beginning of the episode- bring it across the body, so your arm is reaching across your body. Stop when your elbow gets to your shoulder, grab your wrist, and press downwards. This is that position that’s usually a little bit uncomfortable- it rotates your shoulder inwards, and this can cause impingement. Think about the different climbing positions, where if you overdid this time and time again, it could irritate the tendons in your shoulder. Is there anything you can think of Neely?

Neely Quinn: No.

Jared Vagy: Putting you on the spot [laughs].

Neely Quinn: I’m not smart enough for that question.

Jared Vagy: Neely, think about when you are pumping out at the crux. What happens to your elbows? You’re working really, really hard. What do you elbows start to do?

Neely Quinn: They start to chicken wing?

Jared Vagy: They start to chicken wing. The chicken wing is that same test. The chicken wing start to put pressure on that tendon, and that can cause some impingement. I’m not saying don’t chicken wing at the crux, you have to pull through the crux. You have to work hard and gotta send your project. But the twenty other routes you were climbing that weren’t your project, or your warm-up climbs, you shouldn’t be having these patterns because they can become habits that overload your tissues. So a chicken wing is one of the things that can lead to impingement. Other crack climbers, what do you think crack climbers do that causes that stress?

Neely Quinn: Double gaston a crack?

[laughter]

Jared Vagy: Double gaston for sure- especially if the gaston is below chest level, or you have to move up from a gaston. Cracks, if you do a thumbs down jam, that’s doing the same thing we are talking about. That’s impinging or creating less space for that tendon to go under. There’s definitely times you have to do a thumbs down jam, there’s no doubt about that. But same thing- think about how you don’t want to be throwing those on every move. You want to be utilizing them only on the times that you need, especially if you have pain on the outside or front of the shoulder.

Neely Quinn: I feel like people don’t know a lot of the time when they’re chicken winging. I’m sure I chicken wing and don’t know that I’m doing it. How do you know that you’re doing it?

Jared Vagy: What’s the best way to see yourself climb?

Neely Quinn: Video.

Jared Vagy: Yeah, so get a buddy, get a friend, have them come to the crag or the gym. Get some video of you climbing, and you’d be surprised how we think we move, like kinesthetically how we feel, and how it visually looks. There’s often times a little bit of a difference. There’s plenty of apps on the tablets or iPhones these days, like Coach My Video, Huddle, Coach’s Eye. These are all ones where you can take a video, slow it down, freeze frame it, you can draw in angles. You can start to get a picture off exactly how you climb from a movement perspective. If you’re not sure, get a coach at a local gym, get a doctor of physical therapy that’s an expert in movement, get a medical practitioner that knows these injuries.

Or you can check out in the book and go through one by one each injury, and take a look at which ones you might be having. But definitely if you can get some eyes on your movement that’s probably one of the most important things that you can do to prevent injuries while climbing.

Neely Quinn: Yeah, and then have a side by side with something, like what exactly a chicken wing looks like, and put that next to your video or something.

Jared Vagy: Yeah, and what we did in this video series that I put out, there’s over thirty patterns that contribute to climbing injuries. We went through, and I went through with Sasha DiGiulian, Jonathan Siegrist, Sean McColl was in a couple of them. We shot them doing inefficient movement patterns, these dangerous movements that cause pain, and then we shot them doing the proper movements. We put them in a video side by side, just as you’re saying- this is good, this is bad. We have red circles with x’s over the bad ones, and then  green circle over the good ones. That’s part of the video content that’s linked with the book, so you can see every movement pattern and then correct it.

Neely Quinn: You are way ahead of me. I say something, and you’ve already done it.

[laughter]

Jared Vagy: Well that was actually a thing that was… it was one of the hardest things to do. Imagine taking five 5.14 and 5.15 climbers and be like “Climb wrong”. Like “Alright, go ahead and chicken wing right now on this v4!”. So that was actually one of the harder things to video and shoot. Then when we went through my video editor, Matt Talesfore, who is a genius by the way, shout out to him- he put together all these videos. When he went through and went through all that stuff, it was definitely the hardest part of the process- making sure that all of the movements were incorrect and correct, and dialed next to each other. We even shot stuff outdoors and indoors, which was pretty cool.

Neely Quinn: That is so valuable, all of that. Um, okay so that’s movement. So figuring out other movements- are there any other movements that we could be doing wrong to cause impingement?

Jared Vagy: Those are the main ones for impingement, but let’s go ahead and pick an area of the upper body, and I’ll give you some bonuses, some extra ones to look out for. Pick an area- maybe should we do biceps?

Neely Quinn: Yeah. That’s what I was going to ask you to do, biceps tendon.

Jared Vagy: Since that’s something that is in a different position anatomically, for people that have a surgery that you’re aware of.

Neely Quinn: This is not for them though [laughs].

Jared Vagy: Not for them- this is for you specifically. So think about if the biceps muscle- that’s the one that flexes our elbow, right? What motions while climbing are going to overflex our elbow and put more stress? Just moves in general.

Neely Quinn: Underclings.

Jared Vagy: Yeah, underclings. How do you do that? If you’re underclinging and you’re putting a lot of strain on your biceps, if you bring your hips forward, put your hips over your toes, over your center of mass, you don’t have to pull as much. So just think about that anytime you do an undercling, you want your hips forward and center of mass over your toes.

Neely Quinn: Yes.

Jared Vagy: Another thing, if you’re climbing an overhang and climbing with bent elbows, well go ahead, straighten your elbows, and that’s a time where we talked about where it’s good to engage your shoulder blades. So straighten your arms and engage your shoulder blades and take some of the load off of your biceps. It’s probably going to help you you climb a little bit more efficiently as well.

Another thing to think about is sidepulls. If you are doing a sidepull, if you use the outside edge of the opposite foot, that can displace the weight and put you in a little bit more of an optimal position, if you are doing a sidepull. So the outside edge of the opposite foot during a sidepull.

Neely Quinn: Yeah that makes sense, because otherwise you are putting your shoulder into a jacked up position if you are using the same foot.

Jared Vagy: Yup. You got it. Maybe we will do one other- shoulder we do one other body region?

Neely Quinn: Yeah, and how does this correlate with- are all of these things also in the book and videos for biceps stuff?

Jared Vagy: Yeah. Biceps has it’s own progression, so it has it’s own step-by-step, take you through pain/mobility/tissue overload- or sorry, pain/inflammation/tissue overload, take you through mobility, take you through strength and then movement. So every single injury is outlined step-by-step.

Neely Quinn: Okay, awesome.

Jared Vagy: And I’m just going to try and blast away as much free content as I can right now.

Neely Quinn: Okay so elbows. Everybody has elbow issues it seems like.

Jared Vagy: Elbows- outside or inside.

Neely Quinn:  Inside.

Jared Vagy: Okay so inside elbow. Number one reason inside elbow pain- what do you think? And it has to do with overgripping. I guess I just gave it away.

[laughter]

Neely Quinn: Overgripping!

Jared Vagy: Oh what! Neely, you just got it! So overgripping holds is going to overactive the flexor muscles. If you look down and put a hand in your other hand and grip it really hard, and trace the muscle down from your fingertips all the way down your forearm, and it inserts into the inside of your elbow. Overusing the forearm muscles to grip can increase strain there. What do you do to not overgrip? What’s your strategy Neely?

Neely Quinn: Maybe crimp with an open hand or something?

Jared Vagy: I like it, yeah. Maybe crimp with an open hand. Or what’s another time when you overgrip? Think about the scenarios.

Neely Quinn: Like when I’m pumped?

Jared Vagy: When you’re pumped, when you’re scare or run out.

Neely Quinn: Oh, yeah, that huh. I’m never run out, so…

[laughter]

Jared Vagy: Yeah. So decreasing anxiety, and being able to breathe through run out sequences, or different aspects when you are scared is also a big component to decreasing over gripping, especially when you’re on lead, when you’re on the sharp end.

Neely Quinn: Yeah. Something not physical, that you wouldn’t think of to do, really, but it’s helpful.

Jared Vagy: For sure. Another thing that overuses your wrist flexor, whoever is listening to this, if you are listening to it while you are climbing, maybe you’re traversing around the gym, I have no idea who that is. But be on the wall right now, grab two holds, and have two feet on two jibs or what not, and then sit your hips all the way back. Sit your butt out, like your hips are sagging away from the wall. What you will notice is that it actually makes you work harder. So when your center mass is away from the wall it make you grip harder. So the simple idea is don’t let your hips sag. Bring your hips in close to the wall. You can even limit the overuse of gripping.

Neely Quinn: Which is another reason to train core strength, I suppose.

Jared Vagy: For sure, core strength, but also the movement pattern. I’ve seen plenty of people who can hold a plank for four, five minutes, but they’re still saggy butts when they’re climbing.

Neely Quinn: Hmm. So it’s just a matter of remembering to engage and put your hips close into the wall.

Jared Vagy: Often times it’s a movement pattern. Now let’s say you are overhung, you’re at the end of a route, you’re completely pumped, your feet are about to pull off. Alright, well maybe now your core is important, because it’s fatigued and you need to get it close into the wall. But if you are warming up, and your hips are sagging away from the wall, it’s probably a motor pattern or technique issue, rather than just having stronger abs.

Neely Quinn: Hmm. What about fingers?

Jared Vagy: Alright, which finger? We have pulley sprain, we have collateral ligament sprain?

Neely Quinn: What’s the most common?

Jared Vagy: Pulley sprains are pretty common- flexor tendon sprains or pulley sprains. Pulley sprains, it’s a ligament that basically adheres your tendons down, so they don’t bowstring away from your body. Most climbers know what a pulley is, because it’s one of the more feared injuries. So it’s one of the more common, or even the most common- the A2 pulley is one of the most common finger injuries. Any thoughts, Neely, on how to prevent that with movement?

Neely Quinn: I mean, I guess I would say the same thing, to do an open hand crimp a lot of the time.

Jared Vagy: Yeah, so an open hand crimp, or half crimps. Half crimps are safer than what’s called a closed crimp, and a half crimp is basically if you look at your finger and you bend your final digit, and then you have your second digits- so you have your DIP and your PIP. So the fingernail the digit right by that, or the bend right by that, and then the one in the middle, if you make that into almost an “L”, and you hold that position- that’s what’s called a half crimp. Those are some of the safer crimping positions as well. Adam Ondra, actually, when I was talking with him- he’s been a part of this book too- he actually thinks that open hand grips, when you are climbing harder routes, such as 5.14 or even 5.15 that he’s doing, are some of the more dangerous grips.

Neely Quinn: Hmm.

Jared Vagy: It’s because most of the open hand grips that he’s doing are far to reach, diagonal pockets that are going to one, be sharp, and then often times load your ring finger, which is one of your weaker fingers. You have to reach really far, and then deviate your wrist to the side, because the pocket is slanted.

Neely Quinn: Interesting.

Jared Vagy: Then you use less of your active strength, and more of just hanging on by your skin to try and hang those positions in an open hand, versus what’s called a half crimp where you are a little bit more engaged.

Neely Quinn: Okay, so what do you do?

Jared Vagy: Well, in those situations you have to do an open hand, because of the position of the hold. But typically, the open hands and half crimps are the preferred methods- the combination of those two- over a closed crimp or full crimp, where you really lock down and bend your fingers to maximal angle.

Neely Quinn: Okay, alright. So another piece of advice is don’t climb at Wild Iris.

Jared Vagy: [laughs] Monos? Yeah exactly.

Neely Quinn: Or any little pockets, right?

Jared Vagy: Yeah, be aware of pocket climbing. If you are going to climb pocketed route, you better be slowly, progressively training up to it in a controlled environment, so you have the connective tissue strength, so you have the motor programs to be able to sustain those positions without blowing out your fingers.

Neely Quinn: I think that’s actually really good advice. Obviously I was kidding when I said don’t go to Wild Iris, because it’s super fun and awesome. But I think training for that, for four weeks or something before you go, is probably a really good idea.

Jared Vagy: Yeah, and maybe other than four weeks- two to four years as well, just slowly sustaining collagen and tissue.

[laughter]

But of course, just sustaining your environment, but probably earlier in a training cycle, and then maybe when you can make tissue changes, probably one to two years prior is a good amount of time to get solid on single finger monos and so forth.

Neely Quinn: No big deal, short term goals here.

Jared Vagy: Yeah, exactly. You want to be- even dynamic moves on small edges- you want to think about how you can do those more statically. If you think about it, force equals mass times acceleration. So if you are accelerating, you are imparting more force at any stage. If you go a little bit slower on small crimps, then you have less of a chance of some of those injuries.

Neely Quinn: Mhmm.

Jared Vagy: Then the obvious one is instead of pulling from move to move on small holds, you probably want to thank about pushing, and pushing with your feet rather than pulling with your arms.

Neely Quinn: Which should be common sense, but when we get up there we get a little desperate sometimes.

Jared Vagy: Yeah, definitely.

Neely Quinn: Okay, well I think we’ve gone through a good amount of things here, and movement patterns and all of this. What you’ve laid out is extremely comprehensive and easy to understand, which I know were a couple of your goals. Where can people get- I know we already said this in the beginning, but where can people get the book, and where can people get the videos?

Jared Vagy: So for the book, you can get it on the climbingdoctor.com, D-O-C-T-O-R. Or you can get it on amazon.com, and it’s called Climb Injury Free. That’s Climb Injury Free. The videos you can get- I have all the videos available on my site. It’s called the Rock Rehab Pyramid videos. You can download those, and that will be every picture that’s in the book, or most of the pictures. There’s videos that are then associated with it. It’s basically the entire archive of the book, then in a video form online.

Then up on Neely’s site, we are going to get some specialized rehab programs and protocols going. Those will be on trainingbeta.com. You’ll be able to access a step-by-step rehab program, where you can then take the videos from the book, and put them into an injury or rehab context. The first one we are going to put out is going to be for all neck and shoulder injuries. That should be up pretty soon, up on Neely’s site, so climbers can then access- almost like you access training programs, you can access and protocol or program specifically for your injuries, that mirrors a lot of this system, the rock rehab system that’s in this book.

Neely Quinn: So it’ll be categorized by place on your body- like by body part.

Jared Vagy: Yeah exactly, it’s going to be categorized by body region. Really my goal is for any climber to say “I have pain in this area”, and then to have a resource that they can then go to and say “Because I have pain in this area, this is the step-by-step program that I can do”. For each body area, the ten out common areas in climbing, we are going to have systems and protocols out. We’ll get some more going on your site as well.

Neely Quinn: And I’ll put the link to that in the show notes of this episode, and you’ll be able to find it in the training programs area of the site as well. So, what else did we need to cover? Anything?

Jared Vagy: I think that’s everything. I mean one other thing that I’ll just kind of introduce the concept, it’s perturbation training with climbers. This is an idea that climbers that have hyper mobility or too much motion in certain body regions, instead of doing a sustained resistance against the band, or instead of doing these reps and sets with weights, what you can start to do is called perturbations. Small, almost micro movements. These shakes, or these back and forth rotations. Think of almost like- I’m going to kill this if I say it’s like the Shake Weight-

[laughter]

But think about these almost- like you’re swatting a fly, but you’re swatting it with these really small, really quick micro movements. What it does is that it fires all the muscles around the area in different timing and directions, so you can stabilize your joints. I think as a bonus, if you think about it, and especially climbers who are training pretty hard but have a lot of flexibility, if you can start incorporating what’s called perturbation training, or these small micro movements that can help stabilize these loose areas.

Neely Quinn: Are those in the videos?

Jared Vagy: Those ones are not in the videos, but we are likely going to be putting out some blog series on some of those. This is free content for climbers, but a bunch of different ways that you can incorporate perturbation training into warm-ups and then into some of your injury prevention training as well. That will be some supplemental information that will eventually be out on the Climbing Doctor blog.

Neely Quinn: Okay. I mean, when I had my first shoulder surgery, one of the videos I came across was from the weightlifter, and he was doing that. I think it’s been in use for a while, right?

Jared Vagy: One of the biggest- when I went over to China and when I worked with a lot of javelin throwers over there, and they’re in these long, outstretched positions- they were doing every single weight lift on the planet, all these heavy weights, and every stretch, so on and so forth. They weren’t integrating any of these small movements. So that was one of the big pushes, one of the big changes I made over there, and we had some really good results. I then brought that to starting to utilize it when I work with a lot of my climbers that have a lot of excessive motion, as a way to fire all the muscles concurrently around the area that has too much motion, to try and stabilize.

Neely Quinn: Yeah, I mean it’s different, and it looks a little weird, and feels a little weird- I’ve done it. But if you say it works Jared, we should do it.

Jared Vagy: [laughs] Alright. Well I do it, and I’ve been good so far since that first injury I had.

Neely Quinn: That’s true, you haven’t had any relapses from it?

Jared Vagy: No, I mean knock on wood, I practice what I preach. Best if I can drink my own Kool-Aid, and do what I tell all my climbers that I see to do. I was probably my best guinea pig in the early stages- just trying all these things out, seeing what’s worked. Now I’m lucky enough to have seen enough climbers to have enough background in my education level, to know enough about the sport to really put this all together into some pretty amazing ways to rehab injuries.

Neely Quinn: Yeah, you have done a lot of work, and we really appreciate it. I can’t wait for people to get their hands on this book. I think you’re going to get some really good feedback. So thank you for your hard work! I don’t know how many hours a week you work, it must be a hundred and fifty, but great job.

Jared Vagy: Well thank you, and thank you for all the stuff you’re doing Neely. It’s pretty amazing from when I first came on the podcast and where you’re at now. I come up to all these climbers at the crag and they’re like “Did you hear the latest version of TrainingBeta, and the newest podcast? Did you hear about this this and this?”. This program is really upping the game for the climbers, so kudos to you as well.

Neely Quinn: Well thank you. Thanks for being with me, and I will talk to you soon.

Jared Vagy: Alright, take care.

Neely Quinn: Alright, well I hope you enjoyed that interview with Jared Vagy, doctor of physical therapy. He’s always super fun for me to talk to, and he’s so knowledgable. He makes it super easy to understand, I think. Hopefully you got something out of that, and if you want to check out the programs, once again they’re at trainingbeta.com/rock-rehab. Also, if you want to check out his book, it’s Climb Injury Free, and you can find that at Amazon.

Coming up on the podcast, I actually don’t have anything in the works. I’m sort of focusing a lot right now on the presentations that I’m going to be giving on nutrition at the coaching seminar that Steve Bechtel is putting on next week, which I will be teaching at. It’s in Salt Lake City, and I think it might be full. You can check out what it is at climbstrong.com, that’s Steve Bechtel’s website. We will be doing more of these thing throughout the years, so even if you can’t make it to this one and you have an interest in learning more about training- whether it’s for yourself, for the kids you coach, or the people you coach- climbstrong.com

One last thing- if you need any help with your training, remember that we have training programs over at trainingbeta.com- that’s what we do. If you want something for route climbing, or bouldering, we have two subscription programs that will help you do that continuously. It will help you go into the gym, not have to think about what you are doing. You just follow instructions three days a week, for about two hours. It’s very doable for a lot of people’s schedules, and you can find that at trainingbeta.com, go to the top and find the training programs tab.

Thanks so much for listening to the end, and I’ll talk to you soon.

One Comment

  1. Emily October 23, 2017 at 10:56 pm - Reply

    Hey great talk as usual, thanks! Just wondering if Dr Jared has a list of the injuries that he covers in the book that he can share? I am looking for the best excercises to conservatively treat a labrum (slap2) tear. Wondering if he covers this in the book. Cheers!

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