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Monday, 23 September 2013

IFSC International Paraclimbing Cup

So I've just returned from a very busy weekend, volunteering at the Westway Sports Centre as a physiotherapist for the GB Paraclimbing Team, as part of the IFSC International Paraclimbing Cup.



It was a fantastic weekend, with teams from USA, India, Italy, France and Spain, along side the GB climbers. The competition was hosted by the BMC and the IFSC. 

Over the weekend, I got to meet Mark Wilkinson, of Paragon Physiotherapy, who specializes in spinal injuries and had done some previous work with the GB Paraclimbing Team. We did some joint assessments on a couple of the Team who required some guidance on their rehab, such as an ankle, wrist, and the obvious finger injuries. This was great learning as we got to brainstorm different theories and share knowledge.

Then, the climbers got on with the two qualifying routes. It was really inspiring to see climbers who were visually impaired, had a neurological physical disability, or had an amputated limb climb hard routes with such style and finesse, you wouldn't think they had a disability once they were on that climbing wall. 

Lower limb amputees warming up

Fran Brown (GB) on the qualifiers

Sianagh Gallagher (GB) on the qualifiers

The following day, the climbers entered isolation and proceeded to exit one by one to compete in the final. The hardest of these routes, on a steep, overhanging wall, were up to F7c+ and it was impressive, and inspiring to see the climbers work the way up these. 

Ronnie (USA) on the qualifiers

Tom Perry (GB) on qualifiers

One of the French visual impaired climbers on qualifier

Over the weekend, I got to meet many people just as invested in paraclimbing as the paraclimbers themselves, such as Graeme Hill (GB Team manager), Andy Colbart (GB Team assistant manager and IFSC Paraclimbing President),  John Ellison (of Climbers Against Cancer), the family, friends, supporters, spectators, photographers, route setters....just too many to mention. 
It was fantastic to meet some of the athletes themselves, such as the USA climbers Ronnie and Jon, GB Team Fran Brown, Tom Perry, Sianagh Gallagher and Reanne Racktoo. 

One of the French climbers on the final route

Spanish finalist being lowered from his high point

I also thoroughly enjoyed watching the skill and balance that these climbers demonstrated and the mature attitude shown by all the climbers involved. It was also brilliant to see the comradeship of those competing with each other, with all athletes cheering each other on.

I came away awed, with more knowledge than I had previously, and I am very much looking forward to future work with the GB Paraclimbing Team.
Hopefully more pictures will follow as they surface!
Check out the BMC report on the competition.

Lower limb amputee podium

Friday, 20 September 2013

Children's feet and footwear

"The foot is the foundation, and if that isn't working correctly, nothing will"


We all know children grow, most of the time, too quickly. Especially their feet.
So how do we target this, and what is the impact if we don't? This blog post is to discuss the impact of rock climbing footwear on children's feet, especially due to the growing market of climbing shoes available for the younger climber.


The first thing to note is the rate of growth in children's feet.


In girls, the foot grows linearly fashion in both width and length from 3 to around 12 years old, and stop growing completely around 14 years old.
In boys, the foot grows in a linear fashion in both width and length from 3 to around 15 years old, and stop growing around 16 years old. 



A child's foot can grow 3 sizes in a year, so it is really important to monitor growth closely.
Children's feet also sweat more, so need more ventilation from their chosen footwear to prevent poor foot hygiene.


A study done into the German Junior National Team found a higher incident of hallux valgus in those members who had spent a relatively longer time active in indoor competition climbing, as well as 74% of the team having feet pressure marks compared to 28% recreational climbers, indicating tight fitting shoes (even though the importance of tight fitting shoes in indoor walls is less important due holds being relatively larger than outdoors, enabling children to wear shoes too long if required).


Another problem with the climbing shoes is the supinated foot position as mentioned in the previous foot and ankle post, which can put a child more at risk of ankle injuries. With children, this puts them more at risk of ankle growth plate, as their growth plates are not fully formed until the age of 17 years old.


Rigid shoes or too much cushioning can limit the development of the connective tissue, muscles and bones, due to these structures requiring the mechanical stimuli to aid the growth. This is especially important as the connective tissue strength and foot flexibility does not stop forming until the age of 15.


Finally, shoes that do not cut into Achilles tendon are recommended, as this can cause shortening of the tendon when the calf is flexed, causing torsion in the plantar fascia leading to a higher arch causing a change in the biomechanics of the foot.


Any children's shoes that are too tight or too small will limit the growth of a child's foot at the key stages of their development. A poorly developed foot will impact a child for the rest of their life.



In summary, a child's climbing shoe needs to be:

  • flexible
  • not cutting into the Achilles tendon
  • not too much cushioning
  • not restrictive
  • needs ventilation
  • review the sizing often

Coming next, will be the impact of climbing on children's fingers. 

References

Hochholzer T, Schöffl V. 2006. One move too many… (2nd edn). Lochner Verlag: Ebenhausen.



Morrison A 2009 Climbing shoes: is pain insane? BMC
https://www.thebmc.co.uk/climbing-shoes-is-pain-insane


Morrison AB, Schoffl VR 2007. Physiological responses to rock climbing in young climbers. Br J Sports Med 41;852-861.


Walther M, Herold D, Sinderhauf A, Morrison R 2008 Children sport shoes—A systematic review of current literature. Foot and Ankle Surgery 14(4): 180-189