Telehealth for Climbing Injuries: A Case Study in Triceps Tendinopathy
The global shift toward telehealth during recent years raised questions about its effectiveness for sports injuries. A detailed case study demonstrates how a rock climber successfully recovered from triceps tendinopathy through entirely remote rehabilitation.
The Case
Patient Profile
A competitive rock climber presented with persistent elbow pain, specifically in the triceps tendon area. The injury had developed gradually over several months and was limiting climbing ability.
Initial Assessment
Despite being conducted remotely, the evaluation included detailed movement assessment via video, load tolerance testing with available equipment, climbing-specific functional tests, and training history review.
Diagnosis
Triceps tendinopathy - inflammation and degenerative changes in the triceps tendon near its insertion at the elbow.
The Telehealth Approach
Video Consultation
Weekly or bi-weekly video calls allowed for observation of exercises, real-time form correction, and progression decisions based on visual assessment.
Home Exercise Program
The program was designed using only equipment the climber had at home, including common climbing training gear, basic resistance bands, and bodyweight exercises.
Progressive Loading Protocol
Following established tendinopathy rehabilitation principles, the program progressed through phases: isometric loading (static holds), isotonic loading (controlled movement), and functional and sport-specific exercises.
Treatment Protocol
Phase 1: Pain Management (Weeks 1-2)
Focus: Reduce pain, identify tolerable loads
Exercises: Isometric triceps holds at pain-free angles, load modification during climbing, basic elbow mobility work
Phase 2: Loading Introduction (Weeks 3-6)
Focus: Begin rebuilding tendon capacity
Exercises: Progressive isotonic exercises, controlled pushing movements, gradual increase in climbing volume
Phase 3: Strength Building (Weeks 7-10)
Focus: Develop strength exceeding pre-injury levels
Exercises: Weighted triceps exercises, compound pushing movements, climbing-specific pushing (mantles, press moves)
Phase 4: Return to Sport (Weeks 11-12)
Focus: Full climbing reintegration
Exercises: Full climbing volume, sport-specific demands, ongoing maintenance program
Outcome
Successful Recovery
The climber returned to pre-injury climbing level, completing their goal routes without elbow pain. Follow-up showed maintained function and no recurrence.
Timeline
Full recovery took approximately 12 weeks - consistent with typical tendinopathy rehabilitation timelines for in-person treatment.
Why Telehealth Worked
Climbing-Specific Knowledge
The treating clinician understood climbing demands, common injury patterns, and sport-specific rehabilitation needs. This expertise translated well to remote delivery.
Self-Motivated Patient
Rock climbers often have good body awareness and exercise compliance. The climber followed home programs diligently and communicated clearly about symptoms.
Visual Assessment Capability
Video quality allowed adequate observation of movement quality, pain responses, and exercise form. Most relevant assessments didn't require hands-on examination.
Accessible Equipment
The climber's home training setup (hangboard, rings, bands) provided sufficient equipment for progressive rehabilitation without clinic-based machines.
Limitations of Telehealth for Injuries
When In-Person May Be Needed
Acute injuries requiring hands-on examination, injuries needing diagnostic imaging, complex cases with multiple contributing factors, and patients who need hands-on manual therapy may require in-person care.
Telehealth Challenges
Internet connectivity and video quality issues, difficulty assessing subtle movement patterns, and inability to provide hands-on treatment can limit effectiveness.
Implications for Climbers
Access to Specialists
Climbers often live far from clinicians who understand the sport. Telehealth enables access to climbing-specific expertise regardless of location.
Travel Considerations
For injuries sustained while traveling, telehealth provides immediate access to care without disrupting trip plans.
Cost and Convenience
Remote consultations typically cost less and eliminate travel time, making consistent follow-up more practical.
Finding Telehealth Providers
What to Look For
Seek providers with experience treating climbers or understanding of climbing demands, willingness to conduct thorough video assessments, clear communication about telehealth limitations, and ability to refer for in-person care when needed.
Red Flags
Be wary of providers who diagnose without adequate assessment, don't request video of your movements, or promise quick fixes for complex injuries.
The Bigger Picture
This case study demonstrates that telehealth can be effective for certain climbing injuries when delivered by knowledgeable clinicians to motivated patients. It expands access to specialized care and provides a practical option for the climbing community.
However, it doesn't replace in-person evaluation for all conditions. Knowing when telehealth is appropriate - and when to seek hands-on care - remains important.
Based on: Vagy J (2022) Case Report: Using Telehealth to Treat Triceps Tendinopathy in a Rock Climber. Frontiers in Sports and Active Living