Date: April 18th, 2018
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 our second interview he talked about how to heal shoulder impingement using his new Rock Rehab Pyramid protocol.
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:
We focus on rotator cuff strain and neck strain in this interview, and here are all three of his protocols if you’re interested in learning more about them:
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
- Rock Rehab Pyramid structure
- Mobility, strength, and movement protocols for neck strain
- Pain management for rotator cuff strain
- How to strengthen your neck and rotator cuff
- How to belay properly to avoid neck strain
- How to self-diagnose for rotator cuff strain
Rock Rehab Links
Get the companion book, Climb Injury Free
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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 102 where I’m talking with Doctor Jared Vagy.
Jared Vagy is a physical therapist and a professor of physical therapy and he’s also an author. He recently wrote a book called Climb Injury Free which you can buy on Amazon if you want to learn more about injuries that are really common with rock climbers.
He also created some protocols for neck strain, rotator cuff strain, and shoulder impingement. We’ve talked about shoulder impingement on the podcast before and today we’re going to talk about rotator cuff strain and neck strain.
He created these protocols that’s called the ‘Rock Rehab Protocol Pyramid’ and in the pyramid he describes how to address pain and inflammation, how to get some mobility back to the area that’s injured, how to strengthen that area, and then how to correct movement patterns so that you don’t reinjure the area. That’s exactly what we’re going to go through today regarding rotator cuff strain and neck strain.
If you want to check out those protocols that he put together, the Rock Rehab Protocols, they’re on TrainingBeta exclusively. They’re extremely affordable and they’re online programs and you can purchase one or all three of them. They’ve been super helpful for people so far. You can find those at www.trainingbeta.com/rock-rehab. We’ll talk about those in the interview.
Here is Jared Vagy. I hope this is helpful for you and enjoy the interview. I’ll talk to you on the other side.
Neely Quinn: Welcome back to the podcast, Jared. Thanks very much for talking with me today, again.
Dr. Jared Vagy: Yeah, definitely. Good speaking with you as well, Neely.
Neely Quinn: Tell me what’s going on with you these days.
Dr. Jared Vagy: Things are going good. I put out a book, Climb Injury Free, and I got super lucky and people are psyched on it. The book actually sold out of its first print run and I got another batch of copies in just in time for a book tour, which I’m actually currently on.
Neely Quinn: That sounds very official of you. Where are you going?
Dr. Jared Vagy: Yeah, it sounds pretty fancy. Arc’teryx is – Jonathan Siegriest is, as you know because you’re good friends with him, he’s an athlete that’s tied to the book and he did a lot of the photos and video for the book. Arc’teryx was super psyched about it so they ended up sponsoring a book tour. It’s pretty rad.
I kicked it off yesterday in Portland, Oregon and we had about 100 people out at the store, which was awesome. I brought tons of Theraband giveaways and Theraguns and all this different stuff. We just had a good time doing exercises and doing a bunch of injury prevention stuff.
I’m in Seattle right now and then I head over to Vancouver, Canada, down to Sunnyvale, Palo Alto, and then eventually I’ll make my way over to Vegas and Colorado.
Neely Quinn: Oh my god. You’re doing a legit, long tour. That’s a lot of time. You’re a busy guy as it is. How are you making time for this?
Dr. Jared Vagy: Students are on spring break and USC has been very nice to me. It’s kind of cool I guess. As you know, I teach in the doctoral physical therapy program and the students go on spring break, which is one week, and then they also go on a clinical rotation. They’re gone for an additional two weeks so this semester I get a three-week break which is perfect.
Neely Quinn: Perfect, perfect. Okay, so we’re doing this interview on March 5, 2018 and when will the book tour end?
Dr. Jared Vagy: Sometime in a week and a half. I think the 20th.
Neely Quinn: Where can people get information on it if they do by chance come across this in time?
Dr. Jared Vagy: I finally got convinced to open an Instagram account so it’s @theclimbingdoctor on Instagram. I believe there’s a post up there. I’m terrible at social media but there’s a post up there that has the locations, the dates, and all that.
Neely Quinn: Okay, great. For anybody who doesn’t know who you are, briefly tell us a little about yourself and then what we’re going to be talking about today.
Dr. Jared Vagy: I’m a doctor of physical therapy, I’m a professor at USC – the University of Southern California – I’m a climber, and I love teaching people about preventing injuries. I’ve written two books on preventing climbing injuries and rehabilitating them. I’ve written a bunch of articles for Climbing Magazine, Climb Magazine, Rock&Ice online, and I’ve teamed up with Epic TV recently to do some injury prevention content. The biggest thing I’m most interested in is teaching climbers how to prevent injuries.
Climbing changed my life. It’s a big part of who I am and I just feel very fortunate to be in a position to be talking with you today and getting in touch with the climbing community.
Neely Quinn: Right. I feel the same way. You’ve also contributed to TrainingBeta in that your first book, The Ultimate Climber, is in eBook form on our site but then recently you created the Rock Rehab Pyramid Protocols. Do you want to talk a little bit about those?
Dr. Jared Vagy: Yeah, definitely. A big thing that I’m really pushing for people to understand is how to systemize injury prevention and rehabilitation, just like climbers are very systematic about their training. The Rock Rehab Pyramid is simply just a four-step pyramid that you can look at any injury and find out how to self-treat.
The bottom of that pyramid is pain, inflammation, and tissue overload, so when you first start having the signs of an injury and it’s hurting. The next stage of the pyramid is you start losing mobility or motion. The next part is you then start losing strength, and then the final part is you discoordinate your movement.
We put together for TrainingBeta – for shoulder impingement, rotator cuff strain, and neck strain – these rehab protocols or rehab pyramids that a climber can say, “Oh, I have pain in this area of my shoulder,” or “I have pain in my neck,” and they can go step-by-step through this systematic pyramid. Those are up on your site and I’m pretty psyched about them as well and we wanted to price them pretty low so anyone can get them. Also, they have these tips in them called ‘Dirtbag Tips’ where you don’t need to buy any fancy tool, device, or bands, you can use whatever is in your crag pack to rehab.
Neely Quinn: Yes, catering to everybody which I think is really important.
Dr. Jared Vagy: Yeah, the best year of my life – well, best half-year so I can only claim six months of being a dirtbag, but that was vividly – because my schedule is so packed right now, I have these perceived responsibilities. I look back to the six months when I just wanted to spend $10 to get a used cam or something or a busted cam – actually, it was probably more like $50 those days – but spending money to only buy climbing gear. Times have changed now and I kind of look back fondly on that. I want to be able to connect to those dear years of my life when you’re not even going to buy a resistance band.
Neely Quinn: Right, you’re going to go to your book tour and get one for free. [laughs]
Dr. Jared Vagy: Yeah, exactly. I brought tons. Theraband’s been amazing so I’ve been just giving out tons of bands to everybody and I’ll quiz them. I’ll do an injury warm-up and then I’ll quiz everybody and whoever raises their hand first, I’ll throw some gear out to. It’s been fun.
Neely Quinn: We had you on – I can’t remember when. It was a few months ago – and we talked about shoulder impingement. Like you said, on TrainingBeta there are three protocols: shoulder impingement, rotator cuff strain, and neck strain. Today we’re going to be talking about neck strain and rotator cuff. Correct?
Dr. Jared Vagy: Sounds good.
Neely Quinn: Cool. Why don’t you bring us through the steps and describe kind of what’s in the protocol?
Dr. Jared Vagy: Maybe I’ll start with neck. With neck, I want whoever’s listening right now to kind of imagine they’re at the climbing gym or at the crag and you just finished your climb. You just got off your climb and you’re looking around and you see a bunch of people belaying. Now, most of the time, Neely, what do you do when you see people belay?
Neely Quinn: I make sure they’re not killing their climbing or about to?
Dr. Jared Vagy: Right, so you’re probably making sure they’re utilizing proper technique or whatnot. I’m actually staring at the backs of their neck when people are belaying. What you can look at, and start thinking about this, if you look at the back of someone’s neck and you see a large crease going through the middle of their neck, what do you think is going on? And they’re looking up.
Just imagine: your friend is belaying, you’re done climbing, you’re on the ground and you look at the back of their neck and you see a crease. What do you think is going on with that crease?
Neely Quinn: I mean I know firsthand what’s going on with that crease. I have two bulging discs in my neck and it’s partly because of belaying so I can only imagine that terrible things are happening. [laughs]
Dr. Jared Vagy: So terrible things are happening, potentially. I’m going to mellow that out a little bit. If you think about it, it’s a crease. What’s actually going on at a crease, and maybe just look at your wrist. If you bring your wrist back and forth you’ll notice that there’s a bunch of creases right at your wrist joint. Creases happen where there’s excessive motion or too much motion. If you look at someone’s neck and you see a hinge right across the center of your neck, you can make the hypothesis that they’re getting too much motion at that one point.
Now, you look at another person belaying. What if they only have a crease on the top right side of their neck? What can you start to think?
Neely Quinn: That they have too much mobility happening in the top right of their neck.
Dr. Jared Vagy: Correct. You also have to take into account some people have a little bit more adipose, or fatty tissue, in their skin so maybe that can cause a little bit more of a crease, or possibly someone just has loose skin or whatever the case is.
You can make a hypothesis that based on the location or area of these creases, that can be areas of extra motion. If there’s an area of extra motion, what do you think the adjacent areas are going to be like? They’re going to be extra motion or do you think they’re going to be a little bit stiff?
Neely Quinn: I don’t really know. I mean, it seems like they might be stiff to compensate for it?
Dr. Jared Vagy: Yeah. Chicken or egg, right? Think of this: do you have an Apple or PC?
Neely Quinn: Apple.
Dr. Jared Vagy: Okay. You know the charger? You have the charger for your computer and then you have the wire that comes out of the charger. You have that firm square energy bank and then the wire comes out. Now, I’ve blown through like three of those and it always blows through the same spot, at that hinge, right where the stiffness of the wire comes out of that box.
Neely Quinn: Yeah.
Dr. Jared Vagy: Right at that area. Typically, hypomobility, or a stiffness, will then lead to hypermobility, or excessive motion, in an adjacent area. Our body then takes the path of least resistance. While someone’s belaying or looking up there can be some stiff areas of their spine that are leading to some areas right next to them to feel a little bit more mobile. You’re probably wondering, ‘Okay, why does this matter?’
Well, first of all, check it out next time you see some people belaying. Check out their creases and if someone has a crease on their right side you can maybe ask them, “Do you have right-sided neck pain?” Just to kind of try to figure that out. It also has to do with when you treat the neck. You’re probably going to need mobility for those stiff segments and then you’re going to need stability for those segments that move too much. The combination is something that you probably need both of.
Neely Quinn: Okay, so how do you – not diagnose, but try to figure out in your own self what’s going on?
Dr. Jared Vagy: In the perfect world what you would do is just say, “Okay, I probably need a little bit of mobility and I need a little bit of strength. Let me just do both of them and do them systematically.” You’re probably going to be okay. If you really want to know then you can have someone like an expert medical professional take a look at your neck and identify which joints are stiff and which ones are too loose.
Typically, most people with neck pain, if you give them mobility in the areas that are stiff and you give the stability in the areas that need it, they end up doing pretty well. What I’ll go through is a way to start to mobilize specifically certain muscles in your neck and then I’m going to get into some specific stability work. We’ll kind of think about that pyramid. We have that bottom, that pain and inflammation tissue overload. Let’s just go straight into mobility and talk about how you can bias different muscles in your neck by stretching in different positions.
Neely Quinn: Okay.
Dr. Jared Vagy: The way to think about it is the muscles in the back of your neck, you have the two workhorses. You have the trapezius, so your upper trapezius, and then you have your levator scapula. Those are both of the muscles that are – if you almost draw a line from the tip of your shoulder up into your neck, those are the muscles that make up that region. That’s often when people have a stiff neck. That’s often part of the area of stiffness.
Neely, can you take a guess on how you stretch those muscles? Just a wild guess.
Neely Quinn: Well, so if I had pain on the right side I would just move my head to the left, to the side.
Dr. Jared Vagy: Yeah, so if you wanted to stretch out one of those muscles, upper trapezius or levator, on that right side you would move your head to the left and add some over-pressure. This is pretty common. Most people just intuitively know how to do that, but the one difference between those two muscles is one rotates your neck right and one rotates it left. They both rotate your neck in different ways. In order to stretch the correct muscle you need to add a component of rotation to your stretch.
For example, let’s say the right side of your neck was stiff. You can take your neck and you can bend it to the left, and then if you look down to your left, that’s going to stretch a different muscle than if you look to your right. If you look down to your left that will stretch the levator, if you look to your right that will stretch upper trapezius. Most people listening don’t need to know about that but they just need to know that it’s probably smart to stretch your neck in a side-bend but then rotate your neck each way as you stretch.
Neely Quinn: Okay. Are you using your hand to pull down on your head as well?
Dr. Jared Vagy: Yeah, to do a gentle stretch you would just lean your head to the side and let’s say you want to stretch levator. You’d lean it to one side, let’s say your left, you’d look down to your left and then you’d just take your hand over the top of your head and add some over-pressure for about 30 seconds.
Neely Quinn: Okay.
Dr. Jared Vagy: That’s a way to stretch the general muscles in your neck, that region between your shoulder and the base of your neck. Also, if you think about it, the other set of muscles that get really tight are the ones right at the base of your skull. Those are called your suboccipitals but they’re really small muscles, almost the size of your fingernail. That’s how small those are depending on someone’s head size. There’s a series of them that are right at the base of your skull on either side. Those are the ones that nod your chin down in a very subtle motion, just a very small chin nod. That’s another set that’s important to stretch.
Neely Quinn: Yeah, those ones. I’ve talked about this in the podcast with Esther Smith when we talked about neck, too, but it was either you or her or both of you guys who told me to do a stretch of those muscles and it changed my life. It really affected my neck in a positive way.
Dr. Jared Vagy: Yeah, the stretch is so subtle. The other ones we were talking about, the stretch for the trapezius muscles and the levator, are kind of larger movements but to stretch those tiny muscles in the back of your neck, it’s really, really subtle.
Neely, describe the stretch that changed your life.
Neely Quinn: So, you sit up straight and you put your head straight and then you kind of tuck your chin in, like you’re giving yourself a really big double chin. Then, you put your whole head back. I don’t know if I’m explaining that right.
Dr. Jared Vagy: Yeah, so basically you’re making a double chin and you’re using gravity by putting your head back to start to loosen or stretch those muscles.
Neely Quinn: I used to have to crack my neck like five times a day and now I don’t, period.
Dr. Jared Vagy: That’s good. Now you took a hypermobility or something that was very loose and it seems like you added in a little bit of stiffness to the muscles in the front of your neck and little bit of stretch to those small muscles in the back of your neck.
Neely Quinn: Yeah, something like that.
Dr. Jared Vagy: It’s a good way to summarize it. If you think about this, those really small muscles in the back of your neck, there are several different ways to stretch them. A bonus is if somebody has neck pain on one side, you can actually do that double chin – so whoever’s listening right now, maybe you try this. Even if you’re driving it’s probably a good time, or sitting, to do it. You just retract your chin back slightly and then nod your head. Almost nod your nose down a very small amount of motion. You may feel a stretch at the base of your skull. If you don’t, you can add a little bit of over-pressure and almost press with two fingers, your chin downwards. If you want to isolate that to one side you can just turn your chin slightly one direction and do the same stretch and turn the other direction.
That’s a good way to counteract the stiffness and the suboccipitals at the base of the skull.
Neely Quinn: Yeah, that’s really subtle.
Dr. Jared Vagy: It’s a small – oh, you’re trying it right now?
Neely Quinn: Yeah, I’m doing it.
Dr. Jared Vagy: Those are really small muscles. If you think about it, alright – so now you have two large muscle groups that you’re stretching. Those are the first ones we talked about, the upper trapezius and the levator. You have these subtle muscles that you’re stretching as well. All those muscles are in the back of your neck. We want to think about, ‘Huh. Let’s rewind for a moment. The stiff muscles usually occur in the back of your neck. If those are tight then the weak ones are going to be in the front of the neck.’
If you only stretch the muscles in the back of your neck, if you only do the mobility aspect of the pyramid, and you don’t do strength, well you’re probably going to miss a whole piece of the puzzle.
Neely Quinn: So what do we do?
Dr. Jared Vagy: We’re moving on from mobility work and we’re moving through the pyramid and getting to strength. This will be for the muscles in the neck. Imagine or think about, and I’ll kind of preface this with: I’ll talk a lot about this with belaying, but a lot of climbers also get issues while climbing because we’re always looking up when we climb. It’s not just belaying, it’s also climbing. Then don’t forget the other time that we spend at work or at school when we’re just sitting. That probably is some of the most detrimental.
Think about all the different scenarios that you’re in, but let’s just say you’re belaying at the moment and you’re looking up. The muscles in the back of your neck are shortening. The ones in front are lengthening or elongating. How can you strengthen the elongated muscles that are in the front of your neck? What can you do, Neely? What do you know of?
Neely Quinn: Well, I think you have taught me this, too. When you lie on your back and you just raise your head up a little bit?
Dr. Jared Vagy: Yeah, correct. You lie on your back and you raise your head up a little bit. Now, I can tell you that with this exercise, some people do it great. If they’re doing it great they feel it in the front of their neck and they feel those muscles working. A lot of people that do this, they’ll over-contract their neck muscles and they’ll actually feel their pain in the back of the neck as they lift their head. What do you think is going on with that?
Neely Quinn: Well, I know that’s it’s a really subtle movement. It seems like you have to feel/ like you have to put your hand on the front of your neck to make sure that you’re actually tensing the correct muscles.
Dr. Jared Vagy: 100%. There’s two muscles, one on each side of the front of the neck. They’re called sternocleidomastoids , or SCM, and those are the giant ones that jump out of your neck. If you turn your neck to one side you’ll see the opposite side neck muscle just bulge out. Those are ball hogs or work horses.
Did you ever play basketball, Neely?
Neely Quinn: Are you kidding me? [laughs]
Dr. Jared Vagy: Were you a baller?
Neely Quinn: I’m five feet tall. No.
Dr. Jared Vagy: Not even in elementary school or middle school?
Neely Quinn: No.
Dr. Jared Vagy: Never in your life?
Neely Quinn: I mean, yeah, I’ve played basketball.
Dr. Jared Vagy: So in basketball, what do they call someone who doesn’t pass the ball?
Neely Quinn: A ball hog.
Dr. Jared Vagy: Yeah, a ball hog. I was dead set on becoming an NBA star in middle school and then I realized I can’t jump, I can’t shoot, and I should probably do something other than that. I’m in the same boat with you. I feel you.
So those muscles in the front of your neck, the SCM, or sternocleidomastoids, those are ball hoggers. They take over. If you activate too much they start to kick in and then the muscles in the back of your neck co-contract and tighten and they kick in to lift your head as well. If you have a strain in the muscle in the back of your neck the last thing that you want is that muscle to be overworking when it shouldn’t. That cue that you mentioned, just gently touching the muscles in the front of your neck, those SCM’s or those large ones on either side, and subtly nodding your chin and lifting your head off the ground, is the best way to perform the exercise rather than grunting and lifting it up and working really hard.
Now, the normal duration that someone call hold that for without losing the chin tuck is 30 seconds. If anyone here is listening on the podcast and you have a climbing partner, take a pen and ask your partner if it’s okay if you draw on their neck. Have them tuck their chin – so they’re lying on the ground and they tuck their chin – to make a double chin. You draw a pen line from their jaw down their neck so it’s along the line of their neck. Then have them lift their head up. Get a stopwatch or timer out, or your phone, and see how long they can hold that position without the lines from the pen from the pen starting to separate. Does that make sense?
Neely Quinn: Yeah.
Dr. Jared Vagy: The lines from the pen are separating meaning the chin is lifting and that line is now no longer in a chin tuck position. If you can hold that for 30 seconds and you have no pain in the back of your neck or working in the back of your neck then you’re probably okay. You could do an exercise that’s a little bit more advanced.
Neely Quinn: What would a more advanced exercise be?
Dr. Jared Vagy: Well, you can turn that exercise into something that looks a little bit more like climbing. You can take a resistance band. I have a picture of this on my webpage if someone’s having trouble visualizing it. It’s on www.theclimbingdoctor.com. You take a Theraband and you pull it behind your head and then you press it right in front of you. You retract your chin back so now you’re pressing into that Theraband. You nod your head gently and then you pretend to belay by taking the opposite end of the Theraband and bring it up and down like a brake.
It’s a little hard to visualize, I’m assuming, when I’m describing it but it’s called the Belay Brake Exercise with a resistance band. If you need a video or a picture of it maybe we can put one up on your page or they can find it on The Climbing Doctor site.
Neely Quinn: Okay. Yeah, we can put a picture up.
Dr. Jared Vagy: So here’s the thing: those are all pretty standard but there’s been some new research that’s coming out lately that talks about the angle of the rib and the association of that with neck pain.
Whoever is listening to this – I want you to try this too, Neely – you know your navel/your belly button, right? Trace that up to the level of your rib, basically right to where you feel the ribs kind of flare out in the front of your stomach. Place your thumbs underneath either rib and there should be an angle, meaning it should almost be like a tent or a teepee where you can get your thumbs underneath your ribs, so your thumb is touching, and then the outside of your thumb is pressing up against your rib.
Neely Quinn: Okay.
Dr. Jared Vagy: Does that make sense?
Neely Quinn: Yeah.
Dr. Jared Vagy: So your thumbs are touching, your outside of arm pressing against your rib, and then pull your thumbs away and take a look at that angle.
Neely Quinn: Oh, I see.
Dr. Jared Vagy: You almost imagine there’s an upside down V where your ribs are. You want to imagine and try and think about what that angle is. It’s easier if someone does this on you, but if that rib angle is greater than 90°, so if it’s an obtuse angle meaning your ribs are lifted or flared, then there’s a strong correlation between that and having decreased strength in the front of the neck muscles.
Neely Quinn: That’s crazy. I think mine are more like 45. Is that weird?
Dr. Jared Vagy: That’s a different thing. Let’s start with the example if it’s an obtuse angle, so it it’s too great, and then we can do if it’s too tight. Neely, do you get back issues at all?
Neely Quinn: Sometimes. Mostly neck.
Dr. Jared Vagy: No worries. Okay, so for that, think about this rib angle that’s too large. This will be the opposite of yours, right?
Neely Quinn: Yeah.
Dr. Jared Vagy: How do we make that rib angle smaller? Think about the muscles that attach to it. What muscles attach to the bottom of those ribs?
Neely Quinn: Your intercostals and maybe your abs? I don’t really know.
Dr. Jared Vagy: Yeah, your abs basically. Your external obliques are the set of abdominal muscles, basically, at the bottom of your ribs your abs touch. When people perform deep neck flexor exercises, or that head lift exercise, if they have a large rib angle then those are the people that need to engage their abdominals, lower their ribcage, exhale, and breathe out as they lift their neck. You can then get a stable foundation from your core to lift your neck off the ground.
Now let’s flip that. What if it’s someone like you, Neely, and you have a really small rib angle and that’s really tight and engaged. Those are usually people that do too much core work and they’ve overdeveloped the core muscles.
Neely Quinn: Not me. [laughs]
Dr. Jared Vagy: Or sometimes it can be a genetic predisposition. I have a small rib angle but if you think about that, those are the people that before you do your neck flexion exercise or before they lift their neck off of the ground to strengthen the muscles, they need to expand out their ribs. Basically what you do with that is you dig your fingers underneath your ribs and you just pull up and out. You’re almost digging your fingers underneath, you relax your stomach, and then you just lift your ribs upwards.
Neely Quinn: And then what?
Dr. Jared Vagy: You do that, you do three sets of 30 seconds, so you’re just stretching out the rib cage, and then you go through the chin lift exercises.
Neely Quinn: Huh. Okay.
Dr. Jared Vagy: If you think about it, most climbers just do the chin lift exercises or lifting your head off of the ground. You’re going to be fine. But if you want to make it really specific then you can say, “Well, take a look at your rib angle, see if it’s acute – so smaller – or obtuse – so larger – and then based on that can you change something at your base or at your core to help with that?”
Neely Quinn: Right. It’s a lot to think about.
Dr. Jared Vagy: A lot. Usually I’ll do the hard work for people and just give them a program but if you want to diagnose yourself, I find it kind of fun because then what you do also translates into climbing performance. Now think about – let’s say for you, Neely, and how tall are you Neely?
Neely Quinn: Five feet.
Dr. Jared Vagy: Alright, so you’re five feet tall. I would consider you to be a shorter climber. Is that fair to say?
Neely Quinn: Yes.
Dr. Jared Vagy: Okay, so reach is important to you. Let’s say that you have an acute rib angle, or a really small rib angle, and you’re working on a problem and you need that extra inch of lift with your arm to get overhead. You’re probably somebody that I would say, “Well, if you expand your rib cage, if you’re able to flare that out more and lift it, then you may get that extra inch through your arm, and then maybe your neck’s not going to have to work so hard. Your neck is going to be trying to pull your arm up higher.”
Neely Quinn: Right, so if I do these exercises my ribcage could literally expand and create more space.
Dr. Jared Vagy: Yeah, it’s similar to if you have a stiff muscle. If you stretch it continually it’s likely going to elongate, but if you do it just once probably not, right? These are things – and it ties into breathing exercises. Someone with that small rib angle, what I’m going to do if they’re one of my private clients I’m seeing, we’re going to be working on expanding it. They’re going to be doing deep breathing before they get on their route, and then they’re going to go and see if that can change their neck pain. Usually what it does it it makes their neck feel better and they actually can climb harder.
Neely Quinn: This is fantastic. You can become taller through physical therapy.
Dr. Jared Vagy: [laughs] Yeah, exactly. Let’s not make false claims, though, Neely. You can position yourself in a good posture.
Then think about the person that’s the opposite. They’re the person that has that flared rib cage. They may get neck pain as well from some of that overworking of the neck muscles but what if we just have them turn on their abs before they get on the rock wall? They do some exhales and they breathe out, they lower their ribs, they do a couple flutter kicks to get those muscles engaged, so then when they reach they’re not necessarily going to be overusing their arm. They can have some additional stability from their stomach. There’s different scenarios to think about.
That’s where I have the most fun. It’s a little bit like Sherlock Holmes just trying to figure out why someone has this particular type of pain. I can tell you for the majority of people, you follow a system, let’s just say the Rock Rehab Pyramid. You treat your pain/inflammation, you improve your mobility, you improve your strength, and then finally improve your movement. You’re probably going to be doing fine. This is for that maybe 20% that don’t respond to it that need this specialized help.
Neely Quinn: Okay. So we’ve done mobility and strength and the next part is movement, or do you have more for strength?
Dr. Jared Vagy: No, that’s good. Strength, once you start to build up the strength in the muscles in the front of your neck, then the muscles in the back of your neck don’t have to work so hard.
Neely Quinn: So you move up to the top tier of the pyramid.
Dr. Jared Vagy: Top tier of the pyramid. We’re making our way up.
With movement and neck pain, it’s pretty obvious. Everyone knows when you’re belaying, when you’re sitting, there’s three components: you have your neck position which you want to have your neck upright, you have your spinal position – your mid-spine – and you want to have an erect spine, and you have your shoulder position and you want to pull your shoulders back.
Those are all components that are pretty important for basic seated posture but the hips are also super important. Just being able to stabilize your foundation, rolling your hips back and forth even when you’re just sitting can play a huge role in what happens up the chain as well.
I don’t want to get into the basics as much on this podcast because it’s not as exciting for me, to be honest. I want to talk about more the nuances and some of the concepts that are quite interesting.
Neely Quinn: Okay.
Dr. Jared Vagy: When we talk about movement – let’s talk about someone that has neck pain with reaching – these are the category of climber that I have the most fun with. You have someone that has neck pain with belaying and that’s all static positioning, right? You’re not really doing much with your arms above your head, you’re just belaying with your arms at chest-height at the highest and potentially down by your side, depending on your belaying technique or style.
Think about someone that has neck pain with reaching. Why would someone have neck pain if they’re reaching their arm up in the air? Take a wild guess, Neely.
Neely Quinn: Some sort of impingement?
Dr. Jared Vagy: Impingement, but mechanically what do you think is linking the shoulder? Raising your arm in the air is shoulder movement so…
Neely Quinn: Trap?
Dr. Jared Vagy: Yeah. You have those two muscles that we talked about earlier, you have your trapezius and you have your levator scapula. Those are the two muscles that attach from your shoulder directly into the spine in the neck. Shoulder motion can then cause movement at the neck so if someone has a muscle, and this is often times the case – we’ll use the term ball hoggers because we’re both basketball players, right?
Your upper trapezius/levator scapula, those large muscles, are ball hoggers. They attach directly onto those segments in the neck. If you can imagine – let’s just use upper trapezius so the upper trap muscle. Someone lifts their arm in the air and you have this really strong, stiff muscle that’s attaching from the shoulder to the neck. What do you think it’s going to do to the neck when it engages?
Neely Quinn: Pull it out of place?
Dr. Jared Vagy: Yeah, you got it. You imagine you have this rubber band that’s attached to the seven spinal segments in your neck and that rubber band now is yanking on one of those segments every single time that you lift your arm. How do you solve that? What do you do?
Neely Quinn: I don’t know. Maybe relax the trap and the scap and strengthen what is supposed to be strengthened?
Dr. Jared Vagy: There you go. It sounds like you’ve been through some PT. Exactly.
If you think about it, you probably want to inhibit that muscle that’s working too hard and how do you do that? We can talk about that, or you may want to strengthen the muscles that aren’t working hard enough. Some of the shoulder blade muscles that are below that – so the middle part of the trapezius, the rhomboids potentially, and then the lower trapezius, and there’s another one called serratus anterior – all those muscles. If you can increase their strength, then you’re not going to be having the trapezius muscle in the neck and the shoulder pull on the neck. That kind of sounded like a mouthful.
Neely Quinn: No, no, no. It really resonates with me because during this last shoulder surgery we kept trying to loosen up my trap and everything because I was having so much pain in my shoulder and neck area. What ended up happening or what ended up working was just me strengthening all of the my shoulder muscles instead of trying to needle my way out of it.
Dr. Jared Vagy: Yeah, and if you’re just needling the upper trapezius, it’s helpful no doubt but it’s probably just going to help maybe for a few days. Then you’re going to maybe get into the same kind of pattern of: alright, what movement coordination is leading to this? That’s when it’s so much fun to watch how people move. If I have someone stand in front of me and let’s say it’s a male and their shirt’s off or a female and they’re in a tank top, and they bring their arm up over their head, I’m watching their shoulder blade and I’m comparing side-to-side and I’m comparing to the norm.
If I see that shoulder blade rise upwards or if I see it wing out to the side, then that’s starting to tell me that, well maybe one of the muscles that prevents it from winging or coming off of the spine, the serratus anterior, may be weak and maybe one of those muscles that elevates it, the upper trapezius on the top of the neck, is overworking. We’re probably going to have to set up a plan to work on both of those and improve movement.
Neely Quinn: Is that something that you talk about in the neck protocol in the Rock Rehab Pyramid?
Dr. Jared Vagy: We talk mostly about the belay position and so don’t talk as much about the movement because actually, it’s kind of complex. If you think about the shoulder itself, it’s going to move the shoulder blade and it can move in 6-8 directions. It can move up/down, it can move in/out, in can rotate in/it can rotate out, and it can tip forward and back. Now granted, two of those directions is the most common but it still is something that’s a little bit more specific.
Neely Quinn: Okay. That’s really good information for people. If they’re doing the protocol and ti’s not working, there might be something else going on there.
Dr. Jared Vagy: Yeah, definitely. The protocols are built – it’s going to probably solve about 80% of the problems. I’ve seen them work, but if it’s not working you’re going to need something more specific and quite tailored to you.
That’s the scapular position, the shoulder position, and how it relates to movement. I’ll say one other thing that’s really fun to do: remember when we talked about that hypermobile segment? Those segments that moved too much in the neck? What I do is I palpate, or I put my fingers on the back of someone’s neck. I place my fingers on the small joints in the back of their neck, just like a peace sign. I put one on each segment. I put my fingers on the area that has that crease, that hypermobility or that line, and then I have someone raise their arm up in the air.
Based on how the joints under my fingers move, I can tell exactly which muscle is affected. Remember we talked about one muscle – so the upper trapezius moves your neck one way and one muscle, the levator scapula, moves your neck the other way. That’s a way that I could say if we’re doing something in person, “You only have to do one of these stretches. You don’t have to do both of them. If you do both of them you’re probably fine but it’s a little bit more specific way that you can assess.”
Neely Quinn: Well, that you can assess. [laughs] You’re like some sort of magician.
Dr. Jared Vagy: Well, I’ll put it this way: try it. Go ahead and try that on one of your friends and see if you, Neely, can then take that skill set and pass it on.
Neely Quinn: Yeah, I mean it’d be awesome if we could all just do this do each other.
Dr. Jared Vagy: Yeah, and the big thing about this book and the Rock Rehab Pyramid – my schedule is so compressed right now I’m probably turning away about 80% of private clients but I want the ability for anybody or any type of medical professional or any climber just to say, “Hey, here’s where I have my pain. Let me know exactly what research is affording. Let me know a system and let me go through it.”
Hopefully I can, in this podcast, give everyone that information. If they’re psyched about it, go check out the videos and get more or get the book and check out more. Also, just be proactive and try this stuff on yourself. In the end, if it’s not working out, that’s probably when you need to see someone that’s specialized.
Neely Quinn: Right. Just one other thing about belaying: doesn’t it just seem obvious that we should all be wearing belay glasses?
Dr. Jared Vagy: Oh yeah. Belay Specs are amazing. Actually, I feel like such an idiot. I was at the International Climbers’ Festival and I was very fortunate to have a chance to climb with Lynn Hill and I actually did not know much about Belay Specs. This was a while back. She put them on and I was like, ‘What are those?’ I had just written an article – this must have been six years ago or something but I had just written an article – for DeadPoint Magazine on belayer’s neck and I had all these great exercises and stretches. I neglected to mention that you could probably solve a lot of these issues by putting prism glasses on your eyes and not looking up and compressing your tissues, just looking forward.
I saw her wearing them and I was like, ‘Alright, if she’s rocking these out, if she’s wearing them, then I’m going to wear these as well.’
Neely Quinn: Oh yeah. It is so worth it. I still think that even when you’re wearing them, depending on the angle of the climb, you do still have to pay attention to your positioning, too.
Dr. Jared Vagy: Yeah, and I’ll put it this way: you’re probably not going to wear those when you’re at your desk job and you’re probably sitting at that posture at your desk job but those glasses are amazing. Climbers should definitely check them out and they’re super cool to wear.
Neely Quinn: Yes. Super cool, not dorky at all. Honestly, I don’t even notice them on people anymore. It used to be like, ‘Oh, that looks kind of weird,’ and now it’s just normal. I think that’s good.
Dr. Jared Vagy: It doesn’t phase you. Now even warming up with resistance bands and Flash Boards and stuff at the crag, that used to be like, ‘Woah, you’re taking this way too seriously,’ and now that we’ve gotten a little into it now it’s the norm, which is awesome. That means that all the people in the forefront of physical therapy, chiropractic, any type of medical professional or medical doctors that are in rock climbing are pushing the right messages and images, so it’s great.
Neely Quinn: Yeah. Any last thoughts on neck? I don’t know if we’re going to be able to cover all of rotator cuff at this rate.
Dr. Jared Vagy: We could do a Cliffhanger? No, that’s everything on neck.
Neely Quinn: Cool, so should we just jump right into rotator cuff strain?
Dr. Jared Vagy: Yeah, we’re going to have two options, Neely. We can jump right into rotator cuff strain or we can talk about labral injuries, which is not part of the protocol. It’s your call.
Neely Quinn: I think that it might be helpful for the people who get the protocols to hear you talking about them so let’s do rotator cuff.
Dr. Jared Vagy: Alright, let’s go for it.
For rotator cuff we’re back to this Rock Rehab Pyramid. We have our pain/inflammation tissue overload at the bottom, we have our mobility, we have our strength, and we have our movement. There’s several different ways to unload or take strain off of the rotator cuff and kinesiology tape is one of the better methods. The research is not great but anecdotally – and I think you can probably attest to this too, Neely, from your experience or some of your friends experiences that were climbing partners – it actually does work pretty well.
Let me flip this back on you, Neely. Have you had much experience with kinesiology tape or that flexible tape that is in a bunch of different bright colors?
Neely Quinn: I have and it was before my surgeries. I think that I just had such bad bone spurs that I just needed surgery so the KT tape didn’t really do anything for me.
Dr. Jared Vagy: And have you had friends that have had experience using KT tape?
Neely Quinn: Yes. Paige Claassen will get headaches if she doesn’t wear it, so I know that it works really well for some people.
Dr. Jared Vagy: Yeah, I can say that research is not great on it. I can say that, but I can also say that it’s five bucks for a roll of tape and you’re going to know whether it feels better or not probably within the first two weeks that you put it on. Part of the Rock Rehab Pyramid is a taping technique that unloads the rotator cuff muscles and my recommendation is try that for two weeks, see if that can inhibit or take some strain away from those muscles and allow them to heal, and then you can get into the program and work your mobility and then work your strength.
Neely Quinn: Cool. Is there anything else that goes along with unloading?
Dr. Jared Vagy: A lot of times, if you strain your rotator cuff the most common muscle strain is the supraspinatus muscle, which is in the back of the shoulder, or the infraspinatus muscle, which is also in the back of your shoulder. Those are external rotators so they rotate your arm outwards, externally. If you almost imagine you’re standing, your elbows are bent to 90° and your elbows are at your sides, so your palms are facing the air like someone is going to hand you a birthday cake, and then you rotate your hands away from your body, that’s external rotation. Those are the muscles that normally get strained in the rotator cuff.
Neely, do you have any idea maybe why those would be strained instead of the internal rotators which are in the front of the body?
Neely Quinn: You mean for climbers?
Dr. Jared Vagy: For climbers or for anybody in life.
Neely Quinn: Probably we’re doing more things out, like far away from our bodies rather than close in. Does that have anything to do with it?
Dr. Jared Vagy: Yeah, if you think about it. Let’s say you’re in that ‘accepting a birthday cake’ position and you rotate your arms in versus out. Rotating your arm in is really all we do when we climb. We’re always rotating our arms in because if you rotate your arms out, you’re going to not touch the hold and you’re going to fall off the rock wall, right?
Neely Quinn: Oh, right. Okay.
Dr. Jared Vagy: If you’re pressing your arms into the rock wall you’re gripping. You’re over-developing those internal rotators in those muscles so we’ll often strain our external rotators, which are the muscles in the back of our shoulder that rotate our arms outwards.
Neely Quinn: Actually, I want to go back just a sec. I know that there’s probably confusion of, ‘Do I have shoulder impingement or do I have rotator cuff injuries?’ Do you want to explain that a little bit?
Dr. Jared Vagy: Actually, I’ve gotten that question quite a bit with people who’ve gotten the programs up on your site. They’re like, ‘Well I don’t know if I have rotator cuff impingement or if I have a rotator cuff strain.’ The difference is the rotator cuff impingement is going to typically be a little bit more in the front of your shoulder.
Neely Quinn: You mean shoulder impingement? Or rotator cuff?
Dr. Jared Vagy: Sorry about that – shoulder impingement. Sorry about that. Shoulder impingement is typically going to be more in the front of your shoulder and it can also refer to the side of your shoulder. Then a rotator cuff strain is going to be more so the side of your shoulder and it can refer to the back of your shoulder. There’s some overlap between the two.
Neely Quinn: That’s kind of tough.
Dr. Jared Vagy: Yeah, and how the programs are structured, I actually just recommend to climbers to get both of them because if you have shoulder impingement you can probably benefit as well from rotator cuff exercises. If you have rotator cuff strain then you can probably benefit as well from shoulder impingement exercises.
If you want to just test it, it’s a pretty simple test that any climber can do right now. Just sitting or standing, wherever you’re at. Please don’t be driving. Take one arm and bring it across your body so that your elbow is lined up with your shoulder and it’s raised to shoulder height. Can you visualize that? You have one arm across your body in almost an L, so your elbow is raised up to your shoulder and it’s at shoulder height.
Neely Quinn: Right, got it.
Dr. Jared Vagy: Take your opposite hand and press your arm downwards. Now your fingertips are rotating towards the ground. Now, if that causes pain or that’s uncomfortable – that’s called a Hawkins-Kennedy test. It’s an orthopedic test. You can spend your $400 going to see an orthopedic surgeon or a doctor of physical therapy or a chiropractor, whatever medical professional, and they’ll do this test on you or you can do it on yourself and be able to self-diagnose.
If this generates pain this means you have a likelihood of shoulder impingement because you’re closing down that space where the tendons run through your shoulder. That’s just one test that someone can do on themselves to say, “Oh, do I have shoulder impingement or do I have a rotator cuff strain?”
Neely Quinn: And if it hurts it’s going to hurt in the front, right?
Dr. Jared Vagy: It will likely hurt in the front or the side of your shoulder. If you’re doing this right now and you don’t have shoulder pain and then you do that technique and it causes shoulder pain, don’t worry about it. It’s an uncomfortable position for most people anyway.
Neely Quinn: Okay.
Dr. Jared Vagy: If you have shoulder pain and it reproduces your exact pain then that’s something that you want to be aware of. You may fall in that ‘shoulder impingement’ category.
Neely Quinn: Okay.
Dr. Jared Vagy: Now, a rotator cuff strain category? That one, all you have to do is stand with your elbow at your side, have your arm bent to 90°, grasp the outside of your wrist, then press your arm outwards into external rotation. If that generates pain that means that muscle is strained and that means you may have a rotator cuff strain.
Now I’m completely oversimplifying this. If you come into a medical professional’s office they’re going to be doing clusters of tests that correlate and they’ll be doing a more thorough exam, but as a simple, quick hit, if you want to know if you are in one category or the other, those are two tests that you can do.
Neely Quinn: Okay, that’s good. Easy peasy.
Dr. Jared Vagy: Easy peasy. So Neely, we’re past that pain and tissue inflammation overload. We’re now into mobility. How would you stretch the muscles in the back of your shoulder?
Neely Quinn: You would put your arm across your body and maybe grab your elbow and pull it toward you.
Dr. Jared Vagy: You’ve nailed it. That’s a perfect way to stretch the muscles in the back of your shoulder. I can tell you that probably 80% of the clients I see in the clinics do this exercise incorrectly. How to you think people can cheat doing this exercise?
Neely Quinn: I don’t know. Maybe the angle that their shoulder is at?
Dr. Jared Vagy: Part of it’s the angle. Some people reach their arm across their body and their shoulder will shrug upwards. They’ll kind of escape the stretch and their shoulder will shrug up towards their ear. When you’re doing this you want to keep the shoulder down, but the majority of time the scapula or shoulder blade peels away from the midline of the body when people do this exercise.
The true way to do it is to actually engage your shoulder blade. Everyone who is listening, straighten your arm out in front of you, stand up tall, engage your shoulder blade backwards by pulling it in to your spine, and then bring your arm across your body while keeping your shoulder blade engaged.
Neely Quinn: So you’re not letting your shoulder blade wing out.
Dr. Jared Vagy: Correct. If you don’t do that you over-stretch your trapezius muscles and your rhomboids that are the strong muscles in your back that keep your shoulder blade in place, and you can completely blow any benefit and you can probably have a detriment by doing this exercise incorrectly.
Neely Quinn: Okay.
Dr. Jared Vagy: So you want to make sure you engage your shoulder blade. You can pin it against the wall. That’s what I’ll typically have climbers do. They’ll do an arm-across-body stretch but they’ll lean against the wall so the wall is stabilizing their shoulder blade, or you can do it lying on your side on the ground.
Neely Quinn: Oh, like a sleeper stretch.
Dr. Jared Vagy: Like a sleeper stretch but instead of rotating inwards you’re just pulling across.
Neely Quinn: Okay. What is that called so that maybe people can look this up in videos or something?
Dr. Jared Vagy: It’s called a ‘rotator cuff cross-body stretch performed correctly.’ It’s in the Rock Rehab Pyramid videos, too, if they want to check those out. I may even have a free video of that on my webpage under the ‘Exercise’ page. If not, maybe remind me, Neely, and I can find a way or a listener listening right now, send me an email and I’ll find a way to post it up somewhere.
Neely Quinn: Alright, cool.
Dr. Jared Vagy: I’m going to give some quick hits since I know we’re getting near towards the end of our time. That’s going to be one mobility exercise that I’ll put out for the rotator cuff. Should we move on to strength?
Neely Quinn: Yeah, next tier.
Dr. Jared Vagy: Next tier. So, my pet peeve of strength exercises is performing them routinely with the arms below shoulder height.
Neely Quinn: Oh yeah, you’ve talked about this quite a bit. About how that’s not like climbing. It doesn’t mimic what we actually do.
Dr. Jared Vagy: Yeah, and granted, sometimes you’ve got to do it. If you’re not strong enough, if you have too much pain to raise your arms above or up to shoulder level, then absolutely. You’re going to have to do exercises at a lower range. But if your body can handle it then you want to start lifting your arms up into climbing-specific positions as you strengthen your rotator cuff.
I’m going to start with a global concept. People listening probably know there’s different ways to strengthen or turn on a muscle. There’s isometric and there’s concentric or eccentric. Those will be the three terms that I’ll throw out. Let’s group those together. Concentric and eccentric just means movement. Concentric, imagine you’re just doing a bicep curl. You’re curling that weight upwards. Eccentric is you’re slowly lowering it down. Isometric is you’re holding that position. Is that clear?
So Neely, what do you prefer? I know you’ve had this shoulder history. I know you do a lot of rehab. Do you prefer concentric, eccentric, isometric? Does it matter?
Neely Quinn: I mean, I think I prefer concentric just because I’m strongest at that.
Dr. Jared Vagy: Okay, so you like your strengths, right?
Neely Quinn: Yeah.
Dr. Jared Vagy: Okay. For climbers I recommend training a variety of concentric, eccentric, and isometric and if you think about it, a lot of times in rock climbing we’re moving isometrically. I wouldn’t say moving. Sorry – I take that back. We’re stabilizing isometrically and then moving with our other side.
Neely Quinn: Okay.
Dr. Jared Vagy: So you’re locking off on a hold and then you’re reaching with the other side. One arm is moving while the other is staying stable or stationary. I go through several different rotator cuff exercises in the program on your webpage. Know that, whoever is listening here, you can vary them. Most of them are concentric, just like you’re talking about, Neely. You’re going in and out of the position with the emphasis on concentric. Some of them are eccentric so you’re lowering down from a position but you can perform the same exercises with a static hold.
I want you to imagine you’re a climber right now. You’re in the gym or you’re at the crag, whatever, and you have a resistance band. You have that band tied to some pole or stationary object in front of you. Your elbow is lifted to your shoulder height and the band is clasped in your hand. Can you imagine that scenario?
Neely Quinn: Okay.
Dr. Jared Vagy: So your elbow is bent to 90° and it’s at the level of your shoulder. Then you externally rotate and kind of pull your arm backwards so your wrist or your knuckles are facing up and your palm is facing forward, and then you lower back down. That’s a rotator cuff exercise. Can you picture that in your head?
Neely Quinn: I think so. I have trouble imagining things like this. Is there a name for that?
Dr. Jared Vagy: Imagine you’re a scarecrow and you’re just standing there. Imagine you’re a letter T and you’re just standing with your hands all the way out in a letter T, right? Then you bend your elbows so now you have two letter L’s in your arms. You take those letter L’s and you rotate your palms down towards the ground and you take that letter L and you rotate your fingertips towards the sky.
Neely Quinn: Oh okay. Got it.
Dr. Jared Vagy: Now rotate the fingertips to the sky, grasp onto a band that’s in front of you, hold that position, and then walk back and forth.
Neely Quinn: Oh, okay yeah.
Dr. Jared Vagy: Or grasp onto a band that’s behind you, grasp it into your hand, and then walk back and forth but just stabilize that position.
Neely Quinn: Right, so it’s moving isometrics.
Dr. Jared Vagy: Exactly. Now you’re training one arm to stabilize as your body’s moving and if you want some bonuses, walk in that isometric position, start doing some flags or different drop-knees or different climbing maneuvers, and then start to move your opposite hand back and forth. Put a dumbbell in that hand, a little bit of weight, and just start to move that arm just like you were climbing. Now you can train one side of your body to stabilize while the other side moves.
Like I said, this part isn’t integrated within the program but the exercises could set you up in a way that you could then take it to the next step and then build that in.
Neely Quinn: Got it. This isn’t stuff that a typical physical therapist would tell a climber to do. This is…
Dr. Jared Vagy: What? Really?
Neely Quinn: Right?
Dr. Jared Vagy: Here’s the most important thing: I work with tons of rock climbers but I also work with all different kinds of athletes. Track and field, figure skating, gymnastics – these are all at the Olympic level – curling. I had a guy that had just got the curling gold medal for the US which is rad.
Neely Quinn: Nice!
Dr. Jared Vagy: I know not that much about those sports. I know a ton about rock climbing and rock climbing’s my life and I’m so passionate about it. I know a lot about rock climbing movement because I do it and I study it a lot but I don’t know that much about figure skating, so what do I do? I go and research what figure skaters need to do in their sport and when I see them, what we do mirrors the movement that they have to return to.
For rock climbing, think about it: you just need to stabilize one side and move on the other and you can build that into your program. I kind of want to set the bar high or keep the bar high for all medical professionals that are dealing with athletes, to just say, “What’s the role of the sport you need to return to? Let’s mirror it.”
That’s why, in my book, there’s so much on movement. That’s what climbing is. If you don’t master movement then you’re going to get hurt.
Neely Quinn: Yeah, and I wasn’t saying that in a bad way. I’m just saying that you definitely put a lot more thought into these things than I’ve ever seen a physical therapist do with myself, you know?
Dr. Jared Vagy: Got it.
Neely Quinn: I think it’s a good thing.
Dr. Jared Vagy: Well, I’ll get off my soap box. For me, in the end, if it wasn’t fun to do this I probably wouldn’t do it. If it wasn’t fun to analyze every nuance and aspect of motion, and then document it, and then create a system for it, and then share it with people, I wouldn’t be doing it.
Right now I’m on vacation. I’m on a book tour. I could be going out and having a good time right now but I’m psyched to talk to you about rock climbing so it’s a big passion of mine.
Neely Quinn: Which we really appreciate.
Last part of this is movement. Do you feel like we’ve covered some of that?
Dr. Jared Vagy: Yeah, I think we’ve covered a lot of the movement section. I think the important thing to think about if you’re straining your rotator cuff is that there’s a lot of tips you can think about with movement itself at the shoulder, but don’t forget the lower body and the hips. What happens through your footwork, what happens with your technique, even what happens with your breathing pattern, your pacing, all of that plays a huge role.
I’ve talked on previous podcasts of yours on the nuances of all the specifics of movement but to just have all the listeners know right now, also think globally, especially with shoulder injuries and finger injuries. You probably want to be having good footwork, good technique and be careful and mindful that you move to prevent some of those. That will be a general take-home for movement.
Neely Quinn: Okay, got it. We covered neck strain, rotator cuff strain, and obviously there’s a lot more that goes into this and that’s why you created the protocols which people can find at www.trainingbeta.com/rock-rehab. Any last thoughts?
Dr. Jared Vagy: No. It’s always fun being on the podcast and kind of dissecting the nuances of rock climbing. I think that anyone’s that listening right now, if you have a nagging kind of discomfort in a certain area, just spend the 5-10 minutes a day doing the things that can help it, doing the things that you know based on research that can help limit that discomfort so it doesn’t turn into something worse.
Neely Quinn: Yes, please. All of you youngsters, do the exercises. Save yourself some trouble.
Dr. Jared Vagy: All of you youngsters, definitely. Are we getting to that age now, Neely?
Neely Quinn: I am. I don’t care. Even if you’re 30 years old you can say that to young people. When you’re 15 years old you should be doing this kind of stuff.
Dr. Jared Vagy: Oh definitely. The new generation of climbers that are warming-up on my project, those are the ones that definitely should learn those patterns early on. The old crusty climbers that have been climbing for a long time, those are the ones that should have done it a long time ago but now you’ve got to do it double. If you fall right in the middle then just do enough to keep you motivated and keep you injury-free.
Neely Quinn: Cool. Have fun on the rest of your book tour. Thank you very much for giving us all this advice for free. We really appreciate it.
Dr. Jared Vagy: Awesome. Good speaking with you, Neely.
Neely Quinn: I’ll talk to you soon. Bye.
Alright, I hope you enjoyed that interview with Doctor Jared Vagy. You can find him on his website at www.theclimbingdoctor.com. He’s written a bunch of articles that are very detailed and helpful. If you want to go to www.trainingbeta.com and search ‘Jared Vagy’ you’ll find a bunch of stuff from him on there. Then he also has blog posts on his own site and again, his book is Climb Injury Free. If you just search that on Amazon it will come up.
If you want to get this rotator cuff protocol or either of the other protocols that he has you can go do www.trainingbeta.com/rock-rehab. He only sells those on TrainingBeta. They’re $10 each and he wants them to be extremely affordable, which I really appreciate. You can get all three of them for $25.
It’s the kind of thing where you buy it and then all of the protocol, the videos, the descriptions, the pictures, and everything that you need to do the protocol is on the site so you would just login and go through all those different phases of the pyramid that he goes through. It’s really well laid out. In fact, my mother-in-law has been using it because she did something to her rotator cuff and she’s been having good success with that. She wasn’t able to climb and now she can climb and she’s climbing 11’s again, which by the way, my mother-in-law climbs 5.11 and 5.12 which is pretty awesome.
But anyway, that’s that. I hope that is helpful for you and next time we’ll talk about another body part to help you with any injuries that you’ve got.
Coming up on the podcast – I’m pretty excited. Tomorrow I have an interview with Kate Bennett, who is a specialist in eating disorders and this is kind of a big topic for me right now. It’s coming up a lot with nutrition clients and among friends that I’m talking to, so hopefully she’ll be able to shed some light and maybe help people who have eating disorders or disordered eating kind of figure out what their next steps are or if they need help and things like that. It is kind of an issue with climbers, I think.
Lastly, I am taking a few more nutrition clients right now. I have been seeing clients for a couple months again and I’m really enjoying it. I’m having some good success with people getting their energy levels back up, having peoples’ performance increase and improve pretty rapidly, just because they’re fueling properly, and getting people to lean out a little bit. Those are the kinds of things I really like working on with people but I also do stuff with food sensitivities, digestive issues, and I do work with people with eating disorders or disordered eating as well.
If you want to check that out you can go to www.trainingbeta.com/nutrition-coaching. I think that’s it. Thank you very much for listening all the way to the end. I’ll talk to you next week.