Taking Care
Back in 2016, I sustained a SLAP tear, plus a rotator cuff tear (which was probably old, actually) in one of my shoulders. I spent about four to six months working with a physical therapist, allowing it to heal instead of opting for an expensive and super painful surgery. This physical therapist was great to work with. She, not the doctors who I saw, was the one who told me I could totally rehab this injury without surgery and continue to climb. I would have to give it time and serious work, but I would be strong again in the future. Her sport was volleyball, but she was happy to read or listen to anything I sent her about climbing and climbing injuries and how to treat them. I sent her articles and podcasts that I found on trainingbeta.com. Since Neely Quinn— the woman who runs this website— had this same injury a year or so before me, chronicled her surgery and rehab experience, and had conversations with other physical therapists and climbers about the injury, there was tons of relevant information in one place. Her description of her post-surgery pain as well as my physical therapist’s advice, ultimately convinced me not to go the surgery route. My physical therapist also sent articles for me. It was a cool collaboration while it lasted.
Once I finished up with physical therapy for my shoulder, I continued the habit of doing most of the exercises she gave me every day for a year or two, and I still do some as part of my pre-climbing warm up. I climbed the whole time, with her approval, as long as I was keeping it safe and easy. This injury was due to many years of climbing with bad posture and poor shoulder integrity, and so the thing that took the longest to “get better” was learning how to climb holding my body in a much different way than I ever had. I had to do this or I would just keep injuring myself. My physical therapist taught me that.
During over 30 years of climbing, other tweaks have turned chronic but weren’t true acute injuries: a wrist, a knee, the other knee, my neck, my back, both elbows. I did something to the pulley shaft in my ring finger once. And last year I broke my ankle and had surgery, so that was altogether different. Each time, I backed off of climbing but never completely quit for longer than a few weeks. Well, except for the ankle— I didn’t climb for almost six weeks post surgery. Eventually after time, and occasionally long bouts of physical therapy, these things resolved and went away.
There is a fine line between pushing your limits to get better and stronger, and getting injured. Steve Bechtel of ClimbStrong says something like this in several of his multitude of wisely written climbing articles, “We have to walk a thin line between avoiding easy-to-get injuries and pushing our less-willing bodies to once more gain fitness. We have to climb enough to get better, but not so much that we can’t recover.” Of course, here he’s talking about the aging climber, but it’s true for all of us— especially since most climbers over the age of 25 suddenly start thinking they are old.
Ideally, no matter your age or how long you have been climbing, if you tweak something, you should do something about it before it turns chronic or into an injury. You need to know when to back off. You need to know when to get an expert opinion.
It might be daunting to start down the physical therapy road, to go to all those appointments, and make all those copays— that is, if you have great health insurance that allows a certain number of physical therapy visits per year. It can be even more expensive if you don’t, and maybe then, it’s not even an option. Sure, educate yourself; there is a lot out there on the internet and social media now. Sure, talk to other climbers you know who have been injured in the same way before. You can self-diagnose and search on IG for rehab exercises. But what if you don’t know what exactly is injured or the other body systems it is affecting? What if there is something underlying going on?
What if there was someone, a physical therapist, say, an actual human being, whom you could visit at ASCEND? A person familiar with climbing and its problematic tweaks and chronic injuries? A person to talk to face to face, who could actually see what is happening with your body, specifically?
Wait! There is! ASCEND has an in-house physical therapist, Shani Rosenthal, who owns Better Build Physical Therapy. There have been flyers up at ASCEND’s Pittsburgh gyms advertising Shani’s services for about a year now when she started out on her own. Prior to owning Better Build, Shani worked at the AHN Sports Performance Clinic in Wexford for a year. While this was a great place for her to start out, she realized that if she wanted to grow and learn more, this environment was much too busy.
Last year, when I was still going to physical therapy for my ankle, I noticed one of her ads over by the restrooms, and thought, “Oh that’s cool. I should look into that.” Then I forgot about it. My spouse and climbing partner, Brian, recently had an elbow maladjustment flare up, and he didn’t want to go through the rigmarole of making an appointment and having to regularly go to an office and paying all those copays. Then I remembered Shani’s flyer. I suggested that he could talk to her. I thought, maybe she would evaluate his problem and make some exercise suggestions without having to make too big a thing about it. And, maybe she’d know something about climbing, unlike most physical therapists at your local PT office. So one day during a climbing session, we sat and watched the ads flip by on the screen for, what seemed like, a half hour, and Shani’s finally came up. Brian captured the QR code and contacted her.
Shani has had her own stint as a climber in the past, which means she has insight into treating injuries and chronic issues that come from a lot. She wants to focus on helping climbers and meeting them where they are. This is literally true— Shani works out of the ASCEND gyms and can meet with climbers at just about any time at either location. She is even willing to see clients in the early morning, late evening, or on weekends.
Since starting Better Built PT, Shani has seen a lot of upper extremity injuries: finger, shoulders, and elbows. While she can’t name a consistent imbalance or deficit in all the climbers, she notes that in general, a lot of climber’s problems could be prevented by a good warm-up routine. Don’t wait till you’re old to do this! Plus, “strength training is the key to longevity and resilience,” she wisely said to me. It’s important for climbers to supplement the work play they do on the wall with weight workouts in the gym. In her opinion, the best supplemental exercises are those that focus on scapular stabilization and calf strengthening. Most of the upper body injuries she’s seen come from a climber’s foot slipping off a hold and an upper extremity receiving a shock-load. This made me chuckle since she just named the cause of every tweak and injury I’ve ever had.
Shani is ready for more clients. You can either sit and wait for the slide with the QR code to pop up on a screen at the gym, or you can find her on Instagram, or you can go to her website. Her current rates are $175 for an initial 90 minute evaluation (to get to know the person and their goals), which includes home programming, communication, video check-ins, and full access between visits; $120 for follow up 60 minute in-person visits. She does not take insurance.
HOWEVER! While these up front-costs can seem overwhelming, Shani believes she provides exceptional physical therapy care that is just not feasible in an insurance based clinic. You will get your money’s worth!
Working with Shani turned out to be the right choice for Brian (huge pat on the back to me, here). Brian made one appointment with her, and they met at ASCEND Point Breeze at a time that worked for both of them. She did a thorough evaluation of his elbow problem and gave him a detailed schedule of exercises to do on his own. Brian really wants this pain to go away, so he’s been religious about doing the work and staying consistent. After about three weeks, he started to see improvement and could start getting bolder on the boulders. One catch about approaching physical therapy this way: Do you have the stick-to-it-iveness to do the exercises on your own? Physical therapy is all about self-motivation and perseverance to spend a lot of time doing really boring exercises. But, long term, it can only make you a better, stronger climber and healthier person.
