Dave MacLeod new book on injuries: Make or Break

I think Dave MacLeod gives the deepest insights and most careful analysis of English-language writers about climbing performance. His new book exceeded my expectations ... because unlike "9 out of 10", he delivers a fairly complete coverage of the topic.
Make or Break

Last night I gave up more than an hour of much-needed sleep because I just couldn't resist finding out "What does the MacLeod think about X?", and Y, and Z, and A. Applied two new ideas while I was sleeping.

This morning checked some more topics, find out an exact description of an injury I've had in the last couple of weeks which I'd never heard of before -- but there it was in the book with a name, a diagnostic procedure, and a treatment recommendation.

Also found a surprising insight about taping fingers. And a valuable perspective on massage.

MacLeod has digested lots of scientific papers and books -- way more than I'll ever have the patience for. Unfortunately since this is about Climbing, definitive scientific results are hard to come by. But MacLeod carefully describes and analyses the many (ambiguous? contradictory?) findings. Then gives his best advice and action steps for how to deal with (or prevent) an injury. He says which parts are how based on peer-reviewed science, and fills in with good ideas based on his own and other climber's experience.

His ideas and advice disagree with lots of other climbing websites and books and articles. My view is that he's the one who's most likely correct and most likely helpful.

My view is that Dave MacLeod has done a real lot of very careful helpful work of analysis and writing, and he deserves to be well-compensated for that work.

If you want simple answers, well that's just not MacLeod's style (and not a fit for the reality of climbing). The book is clearly written, but not easy. Like with "9 out of 10", be prepared to read, digest, try things out, then re-read, digest more, try more, etc. And expect the result to be way worth it.

Ken

I loved his book. Think the large section he dedicates to improving movement habits / posture / injury avoidance etc to help prevent a lot of problems before they start is something that is barely mentioned in the climbing community.

I read the whole thing cover-to-cover in a day. Luckily for my elbow injuries I had been pretty much doing what he recommends.

I remember being somewhat surprised he doesn't sound super keen on the various types of massage. It was only when I started doing different techniques with an Armaid combined with other exercises I saw any improvement (tennis elbow).

By the by, '9 out of 10' is an amazing book and should be required reading for anyone wanting to get better IMHO :)

sachimcfarland wrote:I remember being somewhat surprised he doesn't sound super keen on the various types of massage.

I noticed that too. I guess it's because:
(a) It's not easy to find well-controlled studies where massage helps with recovery time or quality from specific injuries.
(b) Just because massage is successful to reduce pain does not imply that it improves recovery time or quality.
(c) The mechanisms by which massage is supposed to help recovery could be achieved by other therapeutic approaches.
(d) Massage did not seem to help him with his own most significant injuries (though he does not say this explicitly).

Interesting also that I seem to remember MacLeod once had a video recommending the ArmAid - (though perhaps more as a mid-workout refresher than for injury rehab?). My own feeling is that while the ArmAid helped me (and taught me), I've found more effective self-massage tools since (esp. the BoDo), so I don't use it any more.

Ken

P.S. The good news is that the Placebo effect works: So if you believe in a particular massage device or technique, it might really help with recovery time or quality, even if the physiological mechanisms cannot be found.

What's a Bodo? The Placebo effect is awesome. But I believe massage is beneficial to healing. To each their own I suppose.

The more I read the book, the more impressed I get.

Sharon used the detailed description of shoulder alignment to do a quick assessment of my shoulder posture -- and reported that I seemed pretty far from an impingement problem.
Her theory is that it's because I seriously do other sports than just climbing.

The shoulder stuff gets rather complicated -- not MacLeod's fault, it's reality. Using the book does sometimes require understanding some terminology and basic functions of muscles and bones. Just like if you need to closely manage fixing a problem with your car, you need to learn words and functions for "pistons" and "alternator", etc.

Also found the book offered an intriguing idea about how to handle excessive sweating of the fingers.

Ken

I'm going to get around to a re-read at some point. I've read 9 out of 10 about 5 times now and something new always jumps out. Placebo effect aside, surely there must be some science behind deep friction massage, trigger point therapy etc? Even without climbing for a week my forearms were literally knotted masses of tissue that was hard to the touch, since using an armaid with the meanest nastiest roller the tissue is noticably more pliable and hurts a hell of alot less.

As I say, suprised at DMac's indifference to the whole massage thing. If you want healthy shoulders stay away from swimming. Messed my rotator cuffs up swimming in a club (300-400 lengths per week) and they've never really been the same since, even though they don't really cause me any trouble they are definitely a little sore after a hard bouldering phase etc.

sachimcfarland wrote:indifference to the whole massage thing.

Well every modern English-language book on training for climbing is fairly indifferent to massage. I recall one book mentions like half a page about it (with no particular insight).

I'd say it's fair to conclude that top climbers have not found clever use of massage to have made much impact on their climbing success or injury-recovery.

I do lots of self-massage to deal with post-workout pain, and it definitely helps me get sleep without taking any painkillers. And I sort of think that it shortens my recovery time from hard workouts -- but I would not know how to prove that. Even for myself, I've never made a comparison of how fresh and effective I was for my next hard workout after losing sleep time to do self-massage versus just taking Extra-Strength Tylenol and getting to bed earlier.

It's harder to do well-controlled clinical studies on "soft" muscle + tendon injuries -- and on non-surgical non-chemical recovery techniques -- because it's tricky to measure the before / after, tricky to categorize degree of severity, tricky to define and consistently apply the "correct" kind and intensity of massage -- and not much monetary payback for finding which massage techniques work or don't work for which kinds of injuries.

So maybe MacLeod just decided to focus his careful analysis and writing on aspects of rehab that he thought he could offer perspective and advice more likely to have a definite benefit to more climbers. (and maybe he'll get around to giving more attention to massage in the Second Edition).

Ken

In regards to the topics covered by MacLeod, does he talk at all about shoulder surgery? I have a SLAP tear and would appreciate opinions on biceps tenodesis compared to direct repair of the tear.

R. Moran wrote:What's a Bodo?

description + photos in this MP thread

I've reviewed Make or Break here on ukbouldering

It's an impressive book, for climbers, people training climbers, or medical professionals treating injured climbers.