So here we are with another article on vertical physiotherapy. Today will we address the basic anatomy of the axial skeleton, the importance that comes from the biomechanics and thus the prevention of injuries in climbing. The spinal column consists of 7 cervical vertebrae, 12 thoracic vertebrae and 5 lumbar vertebrae. If it is observed as a whole, the axial skeleton can be noted for the characteristic curves in the arrangement of the formation of the vertebrae: the cervical lordosis, the thoracic kyphosis and the lumbar lordosis. The functional significance of this formation is that of absorbing and dissipating the forces that weigh on the column, thus allowing good mobility but, above all, protection for the spinal cord.

From a muscular point of view, the axial skeleton is kept in a neutral and stable position thanks to the synergy of the anterior and posterior muscular chain. Most of our activities are performed in flexion and therefore with an important use of the anterior chain of the torso. In particular, in climbing, the use of the flexors of the torso does nothing but increase the kyphosis, forcing climbers to end up with the classic “humpback” posture. Over time, this deviation creates a straightening of the cervical spine and decreased mobility of the shoulders, which therefore encourages overloading of the cervical spine and shoulder girdle. In particular, a postural balance of the cervical spine is essential to keep the nervous system intact that innervates, from a motor and sensory point of view, all the upper limb muscles. From this, it is clear that in sport climbing many pathologies of the upper limbs have a possible cervical origin.

In climbing, the strength and control of the torso are essential in order to enable a good coordination of the upper and lower limbs. The training and the exercises to strengthen the torso should aim to improve control of the body, but always with the balance of the two muscular chains mentioned above. Together with the strengthening exercises it is necessary to include some specific stretching exercises into the program.

Reinforcement of the torso stabilizers

Starting position: resting on the elbows and the toes. Maintain the intermediate position of the column without increasing the flexion of the thoracic and the extension of the lumbar.
Hold for 30 seconds x 4 times.
To increase the difficulty of the exercise remain resting on one hand and the opposite foot and simultaneously raise the contralateral lower limb, keeping the torso in a neutral position.
Hold for 30 seconds x 4 times.

Stretching of the latissimus dorsi and of the posterior muscular chain. Starting position: Lying on your back with the heels against the wall, with an inclination of the lower limbs so that you feel the sensation of tension in the back of the thighs. Move the upper limbs to maximum flexion without arching the lumbar spine, the eye line must be towards the knees so to not extend the upper cervical spine. While maintaining the position breath slowly with the diaphragm, promoting muscular relaxation and stretching. In this position the thoracic spine is mobilized.

Maintain the position for 50 seconds and repeat 4-5 times. Primarily the exercise should be performed at the end of a training session.

stretching

With the fact that the cervical line moves in different directions it enables you to orient the eye line and the head. When performing these movements, some segments are excessively stressed. To function, the upper cervical spine has double the amount of movement in extension compared to the flexion and it has great difficulty in maintaining the neutral position. Because of the lack of flexion of these segments, the lower cervical section that is most responsible for the flexion is overloaded.

This muscle imbalance creates a straightening of the cervical spine that predisposes the major degenerative pathologies.
Therefore, the exercise that is proposed is to train the deep flexor muscles of the head so to enable the upper cervical spine to have greater participation in the activities of flexion and to give more stability to the cervical spine in its entirety.
Maintain the position for 5 seconds x 15 times.

The possible progression of the previous exercise is to integrate the cervical control with the movement of the upper limb. In the image on the left, you can see how the flexion of the left arm tends to involve the cervical spine with a consequent structural overload. It is possible to decrease cervical stress by training the flexor muscles of the head in different functional activities.

The progression is to use an elastic band or weights, to increase the resistance in the flexion of the arm.

Many hours spent climbing and always looking up certainly does not help to maintain our spine healthy and free from pathologies. It is therefore essential to reduce as much as possible the stress on the spine in this activity. In the first image, you can see how the extension is poorly distributed and not very harmonic, which causes the functional overload of the upper cervical spine. If instead, the extension is distributed between the thoracic and the cervical spine, it improves the quantity and the quality of movement. When belaying it is good practice to use prismatic glasses in order to further lessen the strain of extension.

Even though the pathologies of the upper limbs create more alarmism among climbers because it is impossible to climb, the pathologies of the spine are undoubtedly far more dangerous and limiting. It is essential to take care of this body part and not underestimate any signs of pain.

Happy climbing! Silvio Reffo

Cover pic: Alberto Orlandi