Infraspinatus Muscle

It has been just over six weeks since injuring what I thought was my Latissimus Dorsi. After four weeks of total rest from all sports I was nearly pain free except in the late evening when the wear and tear of the day would lead to some aches.  So, I took two more weeks off and decided that at six weeks I would see a PT specialist to help direct my recovery. My main concern was discerning what exercises to use and when so I could return to full sports ASAP – especially climbing.

As luck would have it one of my fellow parishioners at Holy Trinity Catholic Church, Daneen Luna, is a back specialist with many years under her belt at the Veterans Affairs facility here in Denver, CO. Daneen has a cozy PT facility setup at her house in north Denver and after catching up on life for a half hour we settled down in the examination room. After 15 minutes of background discussion she began probing, pulling and testing ruling out lat, teres major, and teres minor muscle injuries. More then likely she was sure I had an infraspinatus muscle injury that was for the most part healed. Further, she noted that my caved in chest and over development of certain muscles had left my upper back susceptible to injures. Of course her assessment was spot on as I have had many shoulder injuries the last five years: trapezius muscle both right and left, left SLAP tear +/- (i.e., barely), left rotator cuff strain three times, and some deep muscle injures between the lumbar and cervical regions affecting breathing (i.e., mostly resurfacing injuries from snow boarding/skiing accidents).

Now with the correct diagnosis in hand and a better understanding of the basis of all these recent upper back injuries Daneen laid out a game plan to re-balance my skeletal shoulder alignment. I’ll be doing a routine of six exercises three to five times per week two sets each for ten repetitions. I was cleared to start lifting weights again except for overhead movements while erect. So psyched to be back in the gym – much more non-activity sedation and I was going to go stir crazy.

Just before the move that partially tore my latissimus dorsi. Note the upper body rotation.

Monday January 18, 2010 I hiked into the remote Diamond Head crag in Eldorado Canyon State Park with a few friends to try some obscure climbs that I had long dreamed about. Just as we arrived at the base of the climb the wind picked up and a fresh bank of clouds rolled in plummeting the temperature 20 degrees. I donned my heavy winter down coat, but my under garments were all wet from the nearly two hour hike and I remained rather chilly. Due to our location at the crag and a lack of any easily accessible warm up climbs we opted to get on Cameron’s Corner . I did a set of 30 jumping jacks before my lead. This was only my second day of climbing since my wife and I took a two week vacation and my body felt great having just recovered from a minor upper back injury to the middle of my right trapezius. 40′ above the ground you climb past a large ledge into the crux corner (.11b) which consist of making a rotating reach with your left hand for a great ledge while holding a chest high right hand crimper. The foot work mostly freezes your hips and the rotation and extension come primarily from the upper back. As I pulled into the move I felt a transverse shooting pain along my right middle back which nearly caused me to fall off. However, I wanted the onsight badly and reset my foot slightly to get a bit more left hip rotation and fought my way through the back pain successfully. Some ten minutes later lounging at the belay I was uncertain of what I had injured or the extent.

My partner and I were unsure of what to do next, but long story short I ended up trying to climb a 15′ thin head wall with a crux pseudo mantle that was probably around .10+.  On the third attempt I aggravated the newly acquired back injury. After abandoning the head wall I talked my partner into leading the last pitch of Shibumi and confined myself to following the rest of the day.

Once at home the symptoms set in immediatley as follows:

• Sharp pains at two or three points horizontally across my back from near the spine to my arm pit about one to two inches below my shoulder blade. Near my arm pit was a nasty pain that felt like a small knife. The pain begins as soon as I get up from bed and only subsides when laying down. When sitting if I slouch by moving my butt forward about 6-8″ it’s almost totally relived.
• A deep dull ache in the trapezius extending from about C3 to C10.
• Later in the day I get dull throbbing sensations across the lower transverse aspect of my pectoral extending up into my arm pit.
• Dull ache in both my right tricep and lower forearm. Probably due to a pinched nerve that accompanied the injury.

The initial self diagnosis was rotater cuff strain/tear, but notably I was able to sleep comfortably and the pain was in a lower position then when I previously had posterior shoulder impingement injuries (AKA rotater cuff). After digging through a sports injury manual I temporarily settled on frozen shoulder, but given my lack of any recent long term inactivity with my left shoulder it made little sense.  It had been five days since my injury and I still had no idea what was injured mostly due to the multiple pain locations.  I had been icing it and taking NSAIDS daily, but the pain persisted which told me I had a major injury to deal with that desperately needed diagnosis.

Finally, my brain reached deep into it’s recesses and pulled a rabbit from the mental hat – latissimus dorsi. An hour of googling and I had it nailed down.  To definitively determine if I injured my latissimus doris and/or teres major would require an MRI which I will probably forgo. Sadly, middling latissimus dorsi injuries are “uncommon” which means the literature about diagnosis, treatment and prognosis is virtually non existent. I found one abstract of a study of 11 major league baseball players who had either latissimus dorsi or teres major injuries (e.g., one with both the lat and teres major).  All were treated nonoperatively and returned to full pitching form in 3 months.

My treatment plan for now is more ice (i.e., 3X daily) and ibuprofen.  Once the swelling and accompanying pain are under control I will begin heat therapy.  My guess is this will be a 2-3 month battle to regain full use with probably the first two months being non weight bearing. Queue the sad music.

Rob Woolf, a good friend from the climbing gym and sometimes outdoors climbing partner, agreed to join me October 11, 2009 to bolt the line.  Rob has bolted numerous routes most notably Rainbow Wall in Red Rocks Nevada in the early 90′s long before it become the sought after modern test piece it is today.  I had all my equipment in order and made sure both Ni-Cad batteries were fully charged the night before.  I even went so far as to buy a $10 dead blow hammer at the local hardware store reasoning that it would be better to use it to drive in the bolts and save the expensive powder coating on the bolt heads.  Early that morning we scrambled up the back side of Lower Peanuts wall and dropped a static line down the route from a solid tree.  The first order of business was to get the anchor established.  Rob went down to the base of the route and jumared back up while I feed him data on the route, proposed bolts and how the rope would move from point to point.  Based on the last clip and taking into consideration top roping and climbers coming down the ridge who might want to use the rappel we moved the anchor location about 4′ right of the originally proposed location.

Rob came up and I went down a few feet and set up to drill.  Things went smoothly with Rob as a second set of eyeballs to help align things we had a great hole.  Out came a fresh bolt and hanger combo.  The first thing I noticed was the bolt didn’t fit into the hole like I thought it would.  I had the feeling once I gave it a few good whacks with the hammer it would go in.  I asked Rob to hand me the dead blow hammer and he sort of looked at me like I was crazy.  “What do you plan to do with that Joe?”  I responded, “We’ll I am going to hit the bolt and drive it in”.  He handed me the hammer with a grin on his face.  It hit the bolt and nothing happened.  Then again and again.  Finally, I swung as hard as I could without taking a chance of missing and wrecking the hand holding the bolt.  Nothing.  Rob looked me straight in the eye and said, “That dead blow will never stack enough to get that bolt moving” and traded me the big wall hammer for the dead blow hammer.  Three or four solid blows with the 16oz. big wall hammer and the bolt was moving, but just barely.  All told I probably hit the bolt 40 times, often very hard, to get it fully driven.  It dawned on me at about 20 hammer strokes that this bolt was better then any piton I had ever placed.  Finally, I pulled out the ratchet and socket.  I spent ten years during my late teens and early twenties working at a go-kart track so “wrenching” came pretty natural.  The bolt was tight enough, but not so tight a monkey could not loosen it. I fitted the hanger with a 3/8″ quick link and attached a 1′ length of stainless steel chain to the quick link.

The second, and bottom, hole of this vertically aligned anchor was much more complicated then the first because it had to be equalized with the already placed bolt and chain.  To accurately accomplish this I carefully hand aligned the hanger placement and marked the rock with a small scratch from a drill bit tip in the center of the hanger.  After carefully re-checking the scratch mark three more times I drilled a 1/4″ pre-hole.  The 1/4″ bit is much easier to control and gives a greater probability of starting and keeping the hole on the targeted scratch mark.  Ten minutes later the 1/2″ hole was fully drilled out, the bolt was hammered in, tightened and we were ready to put on the quick links and be done.  Rob handed me a 3/8″ Rapide Million powder coated quick link and much to my dismay it did not fit onto the chain on the higher anchor bolt.  I thought I had fit all the parts together at my apartment but after some more fiddling it was clear I had bought the wrong size quick link for the chain.  Rob and I talked over our options and we decided he would take the chain with him and hike back to the vehicle pronto and go to Boulder, CO and try to buy two new matching stainless steel quick links that fit the chain. I would stay and continue bolting.

In Rob’s absence I managed to place one more bolt and then half way through drilling the fourth hole the battery died.  These holes were much harder to drill as the rock was overhanging requiring a great deal of effort to get the drill moving into the rock.  Typically, I drilled 30-60 seconds and then rested 2-3 minutes before beginning again panting hard between bursts of drilling. However, of important note, it would have been impossible to drill from above.  Very over hanging rock often necessitates drilling top down with previous bolts being the only means to drill.

After jugging to the anchor Rob and I outfitted it with the new 8mm stainless steel quick links he bought at REI.  Rob then rappelled with a new battery to finish up bolt four and jugged backed to turn things back over to me.  I rappelled and in about twenty minutes finished bolt five, but just as I finished drilling it the second battery died.  So, we managed to get 3.5 holes out of one battery and 1.5 out of the other.  Officially out of drilling juice we packed our gear and called it a day.

Two days later, on Tuesday, I returned armed with the better of the two batteries fully charged intent on finishing the bolting.  I rapped in and dispatched bolt number six which was the hardest on the route to drill due to it being in an awkward spot and very over hanging.  Only the lowest bolt on the route remained which was on a slab of lower angle rock.  This will be gravy I thought. Just after starting the hole I realized the drill bit was not getting good bite and the rock I had chosen to drill was darker then surrounding rock and bullet hard.  It took about 20 minutes to get an inch in depth and of course in the process I killed the battery. The other battery was uncharged and more importantly sitting back at my apartment in Denver.  With a slight hesitation, but total conviction once drawn up I executed the following plan: rappell, drive back to Denver, charge both batteries while eating lunch, and return to rap in again this time to finish it off for good.

I realized when starting to drill again on the last hole that the bit was getting dull and that was part of the problem of why I was not getting good results with my progress on this hole. I switched to another newer bit and sure enough it went right through that harder rock like butter.  However, this new bit was not long enough to finish the job so once I was at about 3.5″ deep I switched to the old bit for the last two inches.  Fortunately, I was now back into some softer rock and the old bit was doing an OK job.  Just as I was finishing up the hole the carbide tip on the drill broke.  Thankfully done drilling I hammered in the bolt, but realized the hanger was not totally flush with the rock because the angle of the hole was not perfect. Mentally I was stunned temporarily.  Here I was minutes away from successfully completing my first bolted route and I had botched my last hole by five degrees and was scrambling to figure a way out.  Then it dawned on me – brute force.  I would simply hammer on the bolt hard enough to bend the hanger ever so slightly.  My plan worked to perfection.  Ten or so heavy hammer blows bent the hanger sufficiently to force it flush with the rock.  To the trained eye the flaw was evident, but the uninitiated would blissfully clip for decades to come.

About a year ago I applied for a bolting permit in Eldorado Canyon State Park via ACE FHRC to put up a new sport climb on the north side of the canyon on a rock formation known as Lower Peanuts.  The bolting application process was fairly involved requiring me to top rope and clean the route, photograph with tape marking the proposed bolt and anchor locations, and submit a written proposal to FHRC.  Thankfully, two FHRC members helped me out with the write up and even came out to the crag to top rope the proposed line.  The application was approved and a permit issued to me Spring of 2009 by Park Manager Steve Muehlhauser.

Flash forward to the middle of September, about three weeks ago, I came to the stark realization one morning that as a traditional climber of 25+ years I didn’t know squat about bolting.  I had asked a handful of local bolting experts what the specifications for new bolts should be and the resounding reply was 1/2″ stainless steel camouflaged for everything.  No problem, I thought, a few phone calls and I’ll have everything by the afternoon and will bolt the route in a few days time maybe a week tops.  First, I called Neptune Mountaineering in Boulder, CO and was informed they stopped carrying bolting equipment about five years ago.  Second, I surfed to Bent Gate Mountaineering Golden, CO and realized they didn’t have bolts matching my specifications.  Feeling stumped I googled and landed on Fixe Hardware which has been dealing in stainless steel climbing hardware for at least ten years to my knowledge.  After pouring over their online catalog and a few phone calls to friends and Fixe Hardware I settled on the following hardware for the climb:

1. 7 1/2″ x 4 3/4″ SS Bolts
2. 7 13mm SS hangers
3. 1′ 3/8″ SS chain
4. 2 SS Wiregate carabiners
5. 1 1/2″ x 10″ SDS drill bit

Further I ordered three 3/8″ SS Maillon Rapide made quick links from Green Boat Stuff in Seattle, WA which cut the climbing shops price in half (i.e., $26 down to $13).  Due to the weakness of the dollar to the Euro and fact all of this stainless steel is made in Europe it was a whopping $185 total.  I was sort of stunned at the price of the hardware – no wonder nobody wants to bolt with beefy SS bolts.  The final order of business was to get the hardware camouflaged via powder coating which outlasts paint jobs by decades.  I won’t bore you with the details but suffice to say Jerry Navarez over at Complete Powder Coating & Paint did great work and introduced me to the technical rigors of the process to the tune of $100.

Finally, yesterday I stopped by Nate Adams, an indoor climbing friend from Rock’n & Jam’n North Denver, place to pick up his Bosch Annihilator SDS hammer drill and bolting kit.  Nate gave me a few lessons on how to use the drill and specifically what to do and not to do when I bolt this new climb.  I plan to head out into the foot hills around Boulder, CO tomorrow morning and find a small rock to practice drill a few holes.  With any luck the route should be bolted in two weeks or less!  Now if I could only get strong enough to climb it.

The Black Wall, Mt. Evans, CO

Arriving at the top of the wall around 7 AM we racked up and rappelled into the depths to begin our ascent back to the rim.  I combined the first two pitches as one and then Rob grappled with the .11c crux pitch.  The crux pitch was surreal – an easy looking traverse to a hand crack followed by a burly series of hand sized pulls out the lip of a 3′ roof crack.  The easy looking slab traverse turned out to be a real enigma as even following it took me about ten tries or so to decipher – and I dared to think it looked easy when I was belaying.  The last pitch was an entirely forgettable .9 romp up some semi-wide pseudo choss.

Rob Keplye after the dicey ballet traverse

After topping out around 1 PM we ate lunch and then languished soaking up the rare environment of our alpine setting while thunder storms all around us announced their coming and going.  Given the activity level in the sky and the constant build of thunderheads due West of our position we decided it best to call of our planned second climb and retreat to civilization.  As we drove out around 4P PM it started raining confirming our decision.  Can’t wait to get back to the high country again!

Rob just after the explosive all burl roof crux

Climbers on Bookend formation routes Lumpy Ridge near Estes Park, CO.

After hemming and hawing for what seemed an eternity about our next route we hiked over to the Book and tried Corner Pump Station.  I had heard much about this route lately as Rob tried to onsight it last year and it has a reputation for being a quality climb.  Well, I failed on my onsight attempt, but it was a great battle and nuggets of knowledge were obtained for a future redpoint attempt.  I’ll be back for sure as this was a quality climb.

the next .10b/c pitch clean which was far from trivial.  Right off the belay was a weird crux on some semi crumbly feet and then an upper crux in a funky stemming corner that demanded keen attention.  While following I fell off the lower crux when my left foot greased out of a small dish and I was moving my left hand up and flagging with my left foot.  Before I had time to think ‘Holy Cow’ I was 15′ lower then a split second ago and level with the belay I had just climbed up from.  Excuses aside the only thing that matters here is not the fall, but the consequences.  In this instance there were no consequences (i.e., except my ego) as I was seconding and Steve caught me on a clean fall with little slack rope in the system and no obstacles below me like trees or ledges waiting to devour my frail body.  Often, falling circumstances do not meet this ideal.  This same day Jay Perry, who I have climbed with before, took a serious ground fall in Eldo on the West Ridge.  From the Upper Ramp as we geared up for South Face of Tower One I thought I heard a noise like falling rock over near the West Ridge and then intermittent screams for the next half hour or so which we took to be an upset climber working on a hard climb (e.g., this is not uncommon in busy climbing areas).  A few days later I realized it was Jay screaming in agony.  Still not convinced that falls can have serious consequences?  Have a read of this accident or that one.

The common thread in all falls that precipitate into “accidents” is a lack of lucid assessment of the consequences of everything going plumb wrong.  In our haste abled mis-guided judgements we trick ourselves into delusional states where the fall and it’s subsequent consequences are diminished or worse not even considered.  I am guilty of this charge.  Take the case of my following fall on Evangeline Saturday.  The .10b/c grade was well within my capabilities – a grade I have not failed to lead onsight probably  in fifteen years.  This was the third time in 25 years of climbing that I fell off a .10 following.  I was cold when I left the belay and my body felt clumsy.  The crux came immediately after leaving the belay, even unclipping from they belay was a strenuous semi aid effort.  Before I knew it I was mentally in a rush wanting to get moving and warm up, but my body was not firing on all cylinders.  I noted I was above a roof with no ledges below me so I knew instinctively that falling here would be ok, but would it?  A few days after the fall I inspected the rope and noticed that the end I was tied into had some fray on the kernmantle about 20′ out from the end point.  True, it would be the rarest of cases to cut a rope in a fall (i.e., it does happen every few years), but I never thought about it.  So in my case I was just lucky or if you prefer the climbing statistics were on my side.

Most, if not all falls, in climbing are due to a lack of planning, panic and an inherited need to get it over with faster.  Read Accidents in North American Mountaineering for any give year if you not convinced.  At some point we have to teach ourselves to move slower and wiser lest we relinquish our next day at the crag permanently.

In the meantime between outdoor climbing stints weather permitting the usual winter beat downs happen two or more times weekly at the local gym.  I have been mixing in brutal Spot sessions once a week that require two to four days to recover from properly.  Hopefully, this will bring back my power.  R&J North is working it’s usual magic to get the endurance back up to par.  If I can just keep from getting injured it should  be a great Spring ’09!

To appease the nerd in me I dumped the raw available numbers (i.e., range, strength, weight) into an Excel spreadsheet and started calculating.  BD C3s are the clear winner on weight and CCH Aliens hold the upper hand for both strength and range.

This MP.com thread has strength and weight chart images.

Note:  I wasn’t able to figure out how to use Excel to come up with a nice looking cam min/max range floating bar chart so if someone could pave the way great!  Download the Excel spreadsheet if you wanna give it a go.

I couldn’t find any numbers for head width to gauge how deeply cams need to be placed for all lobes to engage.  Further, I don’t have a clue about cam physics.  How does cam lobe shape and design impact holding power in sub optimal placements (e.g., tipped out vs. over camed)?

Enlighten me.  I am more interested in hard numbers then nieve allegiance/bias towards a particular product.  Granted CCH has had QC issues, but their base numbers on paper look good from a non scientific view point.

Key assumption is you can find a modern athletic facility with a well equipped weight room.

Begin with a warm up exercise like riding a stationary bike or running on a treadmill for 10-15 minutes. All movements should be executed for three or four sets with 10-12 repetitions per set.

1. Barbell Clean and Press
2. Dumbbell Pullovers
3. Seated Bent-Over Dumbbell Laterals
4. Standing Side Dumbbell Raises
5. 45° Standing Front Dumbbell Raises
6. Standing Bent-Over Dumbbell Laterals
7. 45° Standing Bent-Over Dumbbell Laterals
8. Serratus Punch
9. One-Arm Side Internal/External Cable Pulls
10. Scapular Cable Depressions
11. Parallel Bar Dips