What happened to Adam?

What happened to Adam?

Adam Ondra had a ground fall.

In February after flashing Supercrackinette 9a+ (5.15a), a few days later, Adam fell approximately 8 meters to the ground. Adam told me that he immediately knew what was going on and prepared himself for the landing. If you know Adam, you know that he is fast. Being fast means thinking fast. He landed on both of his feet, went into a squat position, touched the ground with his butt for a millisecond before he went into a standing position – like a tensioned spring. 

Adam was not in pain. Not at that moment. Not after. Logically they went to the hospital. MRI and X-ray were fine which definitely is very unusual, but when it comes to Adam, well maybe possible…

When did I step in? 

After my holidays I flew to Spain to help Adam with another 9a+ flash attempt in Oliana. At least that was the plan, until he told me. We both were super emotional about the incident and concluded that he is a super, super lucky bastard. While checking his body I noticed that there were several massively blocked areas which obviously resulted from the impact. But still it was extraordinary that he basically had “nothing”, so maybe I thought the landing was probably very soft, that there was rope drag and who knows… when you fall 4 meters it might feel like 8 meters, right?

What was missing?

Adam complained about a slight swelling on the knee. So I tested that as well, his medial meniscus jumped back on its position, a sign that it was locked before.
After the treatment and a conscientious check of his knee there was no indication for a not fully functioning knee. The swelling did not seem to be inside the joint. Did not seem… you see that was the problem. Make a long story short: It was not 100 percent clear. Because there was no question about the knee after the impact, there was no check up in the hospital done. But now it was.

The diagnose

Adam underwent an MRI scan. As you might now, MRI scans are always a point of discussion. That is why I think it does not do only good things to an athlete – but that is another story.
Result: massive bone bruise in the medial condyle, the lateral had one as well, the ACL was overstretched and the med. meniscus had a bad compression.  
 

Rehab started

Luckily I have a team in my clinic, so I could save all available treatment appointments for Adam. After an intensive therapy time and care of some weeks packed with full commitment of both sides Adam got a control MRI. It was taken in half the standard healing time and still, the bone bruise was gone completely. 

WOW! That was pleasant news! At this point I’d like to thank my team colleagues as well as Dr. Mark Wiedemscheck and his colleagues from the Landeskrankenhaus Feldkirch. They had never seen such a with blood well supplied spine in 20 years, as well as such a fast healing process.

And now tell me, what is key to treat a top athlete? The gold standard procedure or would you better get the individual norm of every patient? 

 

Vail for the 10th time

Vail for the 10th time

It never gets boring

It was the 10th time for me in Vail and it never gets boring. The routine of the Austrian Climbing Team starts with two days in Boulder, Colorado.
In the bouldering gym we gather with many athletes from all over the world to train one or two more times before heading to the higher grounds of Vail.

The quiet before the storm
Once we are in our amazing Lodge Tower Apartment Room 199 it’s treatment time. I prepare/treat/massage the team members.

The next day usually feels like the quiet before the storm. If not necessary I don’t treat. Athletes go out and explore Vail and the Mountain Games.
I usually walk to the beautiful rivers or ponds for fly fishing which is nice and calm.

The storm after the quiet

From that moment on when the Iso for the qualification opens, time is slipping away. After this round I have to treat: Athletes who qualified for the semis always come first, except there is an injured athlete.

And that is not an exception in Vail. I don’t know why, but every year I see injured athletes:
Kilian Fischhuber, Anna Stöhr, Katharina Saurwein, Johanna Ernst – all of them got injured in Vail.

 
Climbing injuries

So far I have experienced the following injuries in Vail: broken toe, asthmatic breathing problem (due to the very dry air), broken cruciate ligament, twisted ankle (two times), various knee issues, and so on…

Johanna got injured

This time Austrian athlete Johanna Färber injured her knee. Until now it looks like a meniscus damage, an injury which seems to occur more often in our sport. The procedure with an accident like this is clearly cooling and compressing instantly.
An anti-swelling procedure including lymphatic drainage can be seen as the standard.

One day later we had to leave Vail. For the long distance flight you have to be prepared. The main goal is to reduce the risk of a thrombosis.
Therefore treatments and preparation (compression) before and during the flight are essential.

 

Header photo © Eddie Fowke

 

Silence (9c)

Silence (9c)

 

While I’m writing this I am already sitting in the plane back home to my family. Thank you Adam and the whole crew up in Flatanger for this extraordinary adventure! And big thanks to my tolerant partner Anneliese – without her this lifestyle would just not be possible! 

So he did it! How did that happen?

The first try

In the very first try from the ground up Adam was not climbing in his usual pace. To me it seemed like there was this slight search for more security in the climb, when usually he would just walk or rather run up the first 8b part. He rested two times more as I expected. Resting in this route means hanging like a bat, head facing down with your knees jammed into a crag, which if your not specifically trained for that, would be too exhausting for most climber’s legs. This time he fell in the first crux part which is an 8c boulder sequence.

The send

I treated Adam’s legs to get rid of his calf soreness. I suggested that it would be beneficial for his legs to stretch them passively and activate them afterwards, just right before he would start again in order to get the best performance out of his legs.

It is interesting that when I first treated Adam back in January this year I started with his feet and at the end of this project the last thing I worked on were his legs again.

During the whole process of working on Project Hard there were still several moves which turned out to be from close to impossible to just too hard to do. So I gave Adam some really hard exercises which should help him performing these specific moves.

Well and then when Adam went to the far end of the cave where Iva (his girlfriend) was already waiting for him, Pavel (manager, photographer) and Bernardo (filmmaker) were already hanging on their position. Everything happened very silent. Adam started climbing and like always I started filming with my phone for analytical purposes. At his first kneebar-stop he did not rest as much and he climbed faster this time! And the pace stayed the same. He continued without any hesitation and rested again with another kneebar just before crux 1. In the following sequence every move was on time and done very precisely. Also the hardest move of the route was done as solid as it can get, followed by the „pinkie move“, where Adam had to stuck his pinkie finger in a tiny little hole and as well he could do this move more precisely than ever.

Between crux 1 and crux 2 he took his longest and last kneebar rest in order to just crush crux 2. After that I started to be a bit shaky with the filming… he was obviously tired, there was something like a 6c/7a boulder left.  That was when he (I think) fought the most. After these few moves he really clipped the anchor of his Project Hard!

„Silence“

The name of the route is “Silence” – because nobody was shouting or cheering right after his send, not Adam, not Iva, Christina, the camera crew, neither was I. Everybody was just silent. Somehow we were not sure whether he really did it or not?! Somehow we could not believe it. Somehow it was just the perfect run after such a long time of intensive preparation. Maybe that’s why at first everybody stayed silent. Somehow we needed time to realize that Adam Ondra just sent SILENCE, the hardest route in the world.  

 

  Photos © Pavel Blažek    
Project Hard, the 2nd

Project Hard, the 2nd

So that was it. 20 days in Norway are over, we left Flatanger and are back home already. This time my partner Anneliese and my son Lui-Jakob accompanied me. The time we had was great! (see photos below)

Unfortunately it was not too successful for Adam and his Project Hard. In the beginning he was in an extremely good shape, together we worked precisely on certain moves, but after a view days he got sick. And being ill for some time means it takes time to gain the strength and power again.
At the same time a camera crew was around, journalists came and left again, which doesn’t lower the pressure probably.

Regarding my second passion – fishing: I love it there – despite the fact that Adam caught two salmon and I lost two! 😉
We were eating fresh fish almost every day. This was just awesome. So tasty…

Therapeutical thoughts:

What can you do when your athlete is sick? You wait and let him heal up for 100 percent, in order not to risk anything going in a wrong direction. Example: If you “only” had a flu, start with your training routine too early (when you aren’t completely cured), it can infect your heart. In the end health is always the biggest value and part of my job is maintaining that.
The other part is focusing on not to loose too much of the performance. But well, here it’s getting tricky right? Adam can not do his exercises, with the exception of his stretching (one thing he kept doing). So what can you do? Your brain is the boss. We worked on not loosing his neurological patterns, activating his movement engrams (see video). Without any weight of course. But therein lies the other possible little thing you can do, in order not to loose too much of the specific built up skills.

To get to know the person you work with is the key, especially when working together so closely. I enjoyed it a lot to spend my energy only on one athlete this time. Considering the specific exercises I think we are about to enter a certain stage, right now I am trying to figure out whether to push him a bit further or not. We’ll see and I’ll let you know.

 

 

Incredible India

Incredible India

If you have never been to Mumbai before it is probably quite a flash in the beginning. The noise, crowds, cars, TukTuks, food, the smell (which definitely takes some getting used to), the monsoon, the completely different culture – all these experiences at temperatures beyond 30 degrees. To focus on the competition is possibly nowhere harder.

Some climbing teams brought their own food and only ate in their hotel rooms in order to stay healthy. Team Austria has been in Mumbai last year already, we’ve found a very good restaurant which we attended every evening. Indian food at its finest!! So incredibly good!

Medical view

Watching the athletes during the comp I noticed that many climbers are on their range-of-motion limit: stretching out in order to barely reach that volume on the other end of their physical possible range. This complex variations of the sport and the tendency to injure big joints still seem to be a big topic.

For the competitor the main health issue here in India is nevertheless food poisoning. Most athletes were scared of getting a bad diarrhea, which some of them actually did. But it happened less than last year, when India hosted its first Worldcup ever. Team Austria was fine though – no food and injury issues.

Cultural differences

A female competitor from the Islamic Republic of Iran suffered from shoulder pain during the qualification, however she made it into semis for the first time. Treating her at the muscelus deltoideus combined with more rotator cuff muscles allowed her to move nearly pain free in the physiological range of motion. The shoulder was stable after the treatment. I told her to see an expert in Iran, after the comp.
The treatment itself was nothing new. But treating a woman from the islamic Iran in a hotel room definitely was. In order to avoid cultural differences we organized that she was accompanied by a female friend. In the hotel lobby there was one additional person, a man who was always by their side, to make sure that the women of the Iranian Climbing Team behave according to the social rules of Iran. That means they are not allowed to remove their headscarf for example. Back home in Teheran there are even certain times when only women train in the climbing gym. Of course they also wouldn’t be allowed to see a man in a hotel room. But in this case it was a medical issue, the patient was not alone and so they made an exception. The climber was really thankful that I could help her so that she could climb her fist semifinals. And I was happy because she performed well and I got the best safran from Iran. 🙂

Severe case and fun times in Vail

Severe case and fun times in Vail

It is already a pleasant routine to fly to Denver, to train one day in Boulder before heading up to the town of Vail. On this trip we missed Anna Stöhr, who decided to do the asian tour and skip the comp in Vail and the next one in Mumbai. But two others had their tenth anniversary of being here in Vail – climber Katharina Saurwein and coach Heiko Wilhelm!

With the first daylight and a jetlag we went fishing at 5am to serve the team with breakfast before 8am. No fish unfortunately but the coffee and donut afterwards were a known reward 🙂
For me it was again an inspiration to see how motivated the young crew of climbers is whom we are traveling with.

Medical view

The town of Vail is situated at around 2500m altitude, the air is very dry and with the sun out it can be very hot. All this, the jetlag and quite a high bouldering wall result in special conditions. So Vail seems to be one of the physically most challenging competitions around the season.

Severe case?

This time one of our climbers described severe stomach ache right after the qualification round. She had problems with walking, pain and described shortness of breathing at the same time. Back in the hotel I did a brief check on her. In the meantime her symptoms were:
Strong back pain and stomach ache, dry lips, she felt sick and was nearly vomiting. The stomach ache was described as “cramping”. It got worse as we did some steps together. Breathing was still a problem.
These symptoms could seldomly but possibly result from cardiovascular system problems. If this would be the case, I as an osteopath can not provide the right medical support. I have to make sure that she gets the best care, which means bring her to a hospital (know your limits!).

In her history there was a medical check up earlier due to partly similar symptoms, the result showed no limitations on her health. Nevertheless I was already asking for a transport to the local hospital in Vail to get urgent care.
At the same time I treated her in order to get the balance Sympathicus – Parasympathicus reaction.
And I made her drink a sugary soda. After that I worked slowly on both of her psoas muscles to calm them down.

The treatment worked out. We did not have to go to the hospital.

My diagnose

A cramping psoas syndrome and a strong sympathic reaction, both things could be a possible result of the competition circumstances (see above).

One other very positive thing changed in Vail. I see an increasing number of physiotherapists, kinesiologists, chiropractors traveling with climbing teams. It is about time! Maybe this is also one of the first olympic greetings!?

Flatanger: Project Hard with Adam Ondra

Flatanger: Project Hard with Adam Ondra

First I have to say that at the beginning of this year I was looking for another challenge. And I found one. I became the physiotherapist of Adam Ondra and have the honor to help this incredibly strong climber to stay injury-free and improve his climbing, especially to make progress in his 9c project in Norway – called Project Hard.

As Adam and me planned in advance, the climbing in Flatanger would involve some fishing, or was it the other way around? 🙂
Anyway when I arrived there Adam and the rest of the crew had a rest day. So we started with the fishing first. At the end of the day Zuzka and me had to catch the food, because Vojta and Adam had to recover their forearms. 😉

Project Hard

After this nice fishing start it got serious. Adam tried a 9b in the cave but it just should not be. Later on I could watch him trying his Project Hard moves! Crazy, so crazy to see him trying something so incredibly hard and weird, upside down, overhanging and climbing feet first!
Just to be here, enjoying the nature of Norway, climb a bit myself and at the same time watching somebody with endless motivation and commitment … I’m really thankful for that. And all this takes place in the pretty and silent Flatanger region with its beautiful fjords.

Every time Adam and I met before this trip we had certain goals to work on. This time was different. I came to this spot to watch Adam doing the specific moves, right there in his project which I so far only had seen and analyzed in videos. Of course the question raised whether the treatments/exercises pay off or not.
And they did! This time Adam felt much better on certain moves we were working on. I could also show him one little trick in order to save just slightly more energy in the route. We both hope that these little additional things will work and make the difference.

But keep in mind what Adams project really is about: He wants to climb an 8b route, then an 8c boulder, the rest is an 8b boulder, followed by an 8a(+) route all the way up. This is in total about 45 metres of steep climbing.

Below you can watch some videos and photos of this awesome challenge.

 




 

Big in Japan!

Big in Japan!

Japan has a very welcoming and friendly culture! I love it 🙂 The hecticness in Tokyo happens in a silent and friendly way, that’s just mindblowing. And the food, sushiiii hmmm, so good. When I’m writing this I’m already on my way home, right now in 12 000 m altitude.

Team Austria did well. After trying to climb sick in China Jakob Schubert climbed really well in finals in Japan, ending up on a good 5th place. In bouldering very little differences can decide whether you’re going to make it into finals or not. Anna Stöhr did very well and showed great effort but her ranking does not reflect her performance at all. Unfortunately Katharina Posch, Berit Schwaiger and Alfons Dornauer didn’t make it into semis. Franziska Sterrer and Georg Parma did a very good job as well and could climb in semis. It was a well organized competition with only friendly and welcoming people around us. And the lightshow before the finals was just amazing!!!

Medical Issues

During the qualification swiss climber Petra Klingler found a tricky beta for the last boulder problem. She pulled hard on a crimp with here left arm. While the forearm was rotated she heard a popping sound and felt pain as well as tingling sensation. It would not be Petra if she would let go at that moment… good or not… After a brief check I knew that the neurological status is ok. By triggering the flexor muscles the tingling sensation could be solved. Later on with more time to examine her it turned out that she had a partial rupture of a side ligament on the elbow. Petra was qualified and very psyched to start in semifinal. Taking the higher risk of damaging the ligamentous structure even more, I prepared her as good as possible. That means applying a tape to support her elbow. Well the story continues. After making it in to finals, it was quite a task for me. Because of course there was no doubt that she wants to climb in finals. It was a tough call. I would never decide in such a situation. But I have to guide in a way. That means, we had another talk, check and an even stronger tape than in the round before. And it worked! I have to say that luckily I know Petra already better than most athletes (if not from Austria) because she has seen me in the Therapierbar (my clinic) a few times already. That made our work together and the whole process much easier. When you look at the pic of her in finals, you don´t see the strong supportive part of the tape because I covered it with some kinesiological tape. This was the tape bandage which supported her joint but allowed her to almost bend and extend normal.

Climbers statements on weight and changes in competition

Climbers statements on weight and changes in competition

It’s interesting how bouldering competitions changed within the past few years. It affects the style of bouldering, injuries, nutrition and weight aspects as well as competition rules. Besides the sport gets more and more worldwide attention.

For me as physio this development is of course significant as well. I also want to know what athletes think about these changes so I interviewed some of them. And I also took the chance to ask the chief route setter in Hachioji some questions. Watch the videos below:

 

Back to China

Back to China

This year I skipped the World Cup in Chongqing for family reasons. So my asian tour started with Shanghai, a surprisingly clean and silent city. Unfortunately half of the team already was or got ill (fever, headache, flu), similar to the german team. Nevertheless we took a very comfy and fast train (320 km/h) to Nanjing where the comp took place.

Injuries are changing

After treating the athletes of team Austria I was able to help climbers from other countries, as Valeri Kremer (Israel), Sean McColl (Canada), Ievgeniia Kazbekova (Ukraine), Petra Klingler (Swiss), Alannah Yip (Canada) and Rustam Gelmanov (Russia). Seeing it from a medical point of view, Valeri and her fingerpain-problem might become a rare case. In the past two years more and more injuries on big joints occured, instead of finger problems. Finger injuries are becoming a symptom of the outdoor climber, less of a competition climber. The style of the boulders, meaning climbing on big volumes, running and jumping, less crimping etc. is changing the inury behaviour. At this comp I treated minor muscular aching, sore backs, knee problems, finger as well as shoulder problems. We’ll see what the next comp in Tokyo will bring!

Stuck at the airport in Shanghai I used the time to interview swiss climber and Boulder World Champion Petra Klingler. She’s talking about her life after the World Championships 2016. Watch the video below: