A Journey Through Injury - by Alexander Lemel
9 Dec 2020
Alexander Lemel is a routesetter at the UK’s oldest dedicated climbing wall in the East End of London, and is responsible for arranging holds onto the wall to create challenges for climbers.
He tests every route he creates, so spends a lot of time on the wall experiencing the physical and mental challenges those practicing the sport will face when using his routes.
In this blog, Alexander takes us through his recovery from injury which flared up earlier this year and gives an insight into how impacted his job and sport is without full mobility.
As we went into Lockdown in April I strained my right hamstring, then started to experience pain and stiffness in my left hip and lower back. It was quite insidious at first; I’d had a nasty hamstring issue a few years before so knew right away what I’d done but the pain in my left hip and lower back were hard to distinguish from each other and things started to get worse with more pain and a loss of mobility. Soon I was unable to train without it flaring badly and I was also limping. We were mid-Lockdown so I had no access to physio, sports massage or imaging.
When restrictions eased I got a scan on my back which showed an L4 disc bulge but no nerve compromise. I thought this was probably the cause and physio and regular massage would help. Unfortunately neither really resolved the pain in my hip, and as my back started to get better it was clearer to feel. I still couldn’t train and was limping about, just a few months prior I had been in great shape so it was hard to understand what was happening.
Having a strong hip and full range of movement is very important for climbing in general and routesetting. Full range is required for end range static and dynamic movements on the wall at various angles, from slabs to overhangs, and strength plays a big part to help support and stabilise in these positions and to help transfer weight through them. Strength and stability is also required working at height all day and carrying heavy loads over soft mats.
I went to a very good physio recommended by some of the guys on Team GB. After a thorough session he suspected I had a labral tear and Femoroacetabular Impingement (FAI) Syndrome, and we made a rehab plan but things didn’t improve. A scan showed a labral tear/ CAM impingement and a large hip effusion, and I soon realised surgery would probably be the only option. After some recommendations I saw a hip surgeon, after more scans and a consultation he surgery would be a good option for me and was happy to proceed.
I spent a lot of time researching FAI and labral tears to understand what was happening and found The Lewin Clinic. I had a sports massage with Emma and we discussed my concerns about surgery. She suggested I speak with Colin who popped in mid massage for a chat, and, after an assessment and sharing the whole history he recommended one of the leading hip surgeons as a second opinion.
It’s a huge step to opt for surgery, but I’d spent time trying to manage the issue through physiotherapy and that had not worked. Two experts aligned with their recommendation of surgery and a diagnostic injection also helped make the decision, for after the injection I had lower pain levels and some range of movement back indicating the problem was definitely coming from the joint. I had confidence in the surgeon and knew I had Colin to support me with all the rehab, he liaised with the surgeon too. I had the diagnostic injection one day and surgery the next.
It went well, but the surgeon told us it would be a slightly longer recovery as my hip was very inflamed and my labrum was significantly torn which was why I was in pain, limping with it flaring up.
The first few weeks on crutches weren't bad, you are forced to rest. Colin worked out a plan for me to train my upper body safely from a seated position using the cable machine, so within a few days I was in for my first physio session and lifting light weights. I used my Compex muscle-stim machine to keep my muscles active without putting any stress through the joint so, combined with cryogenic/compression treatment twice a day, I had enough to be getting on with!
I was keen to get back to work and training, so short-term goals were important. The first step was being able to use a ladder so an initial goal was multiple step-ups with a weight vest with no pain. After I had managed this for a few weeks, Colin and I knew it would be safe for me to use a ladder, which was a great goal because I could get back to work. The next target was low level traversing, which meant I could get back to moving on the wall with minimal risk of impact from falling from height. Once Colin and I worked through a safe range of movement for my hip we used video analysis to work out the positions I would be in on the wall. After we agreed this was safe, I could start traversing.
Having the gym for rehab has been great. It’s state of the art so has everything you need for any kind of rehab or pre-hab program. I was able to come in pre physio and could complete all my lower limb/hip rehab exercises and do some upper body too. Then, during my physio sessions with Colin if there was anything I needed to check, or he wanted to see how I was getting on with an exercise, or when we needed to make changes to the rehab plan by adding in new exercises, we could go straight into the gym to asses and test them out. Having everything under one roof was brilliant.
Lots of hours have been spent rehabbing and it’s been up and down, but I’m nearly four months post surgery and hope to be climbing again in the New Year.
A big thanks once again to Colin and the whole team for supporting me through the journey!