James Lobb on climbing, the benefits of hang-boarding, and how tree planting shaped his physiotherapy practice

It’s been a pleasure getting to know James and learning more about how he weaves his passion for climbing into his physio practice. We sat down with him recently on a hot afternoon in August to chat. If you’re a climber in Victoria you might see him at one of the many beautiful outdoor climbing spots, at the climbing gyms, or in his clinic office!

How did you get into tree planting?

A friend of mine at university who I had a good relationship with suggested we go tree planting one summer. We knew nothing about it, but we fell into it in Ontario. All told, I tree planted for eight seasons throughout Ontario and BC. I spent quite a bit of time in a tent!

While I was tree planting one season, I injured my wrist and moved into a management-level position for three seasons, before going back to tree planting. The management experience definitely taught me a lot, particularly about leadership (both the good and the bad). I definitely wish I had been a physiotherapist at that point because it would have made my recovery a lot easier!

How did you go from being a tree planter to a physiotherapist?

I went to school for physical education and then, later on, to be a teacher. I taught in South Korea for a little over a year, but it wasn’t my forté. I was always active and also always injured in some way or another and constantly looking up videos on YouTube to rehab myself! I was curious about it and whenever I would go to physio, I thought it was really interesting.

I think I always wanted to do physio in some way, but I didn’t think I had the grades for it. I decided to go back to school to see if I could do it. It was hard but I made it!

You love climbing in Penticton

Yes at Skaha bluffs, it’s really expansive and there’s a variety of climbing to do. And, you can go to the lake and then go back to climbing! Plus, it’s nice and tall – like 30+ meters. You feel like you’re getting off the ground. Climbing something shorter even if it is harder doesn’t feel as big of an accomplishment, but climbing at crags that are taller is great; even if you’re crying a little bit [laughing]. Climbing is often “type two fun.” Type one fun is when you enjoy it the whole time!

Why is Squamish your favourite climbing place?

I first heard about climbing in Squamish while I was planting in Southern California. A fellow tree planter told me about it! I started going to Squamish every summer after that.

I’ve climbed in a fair number of places, like Thailand and in the US, but there’s something about the scale of Squamish climbing that is different. BC is so big and wild, there’s so much beauty. And the variety of climbing in Squamish is amazing: crack climbing, sport, bouldering, it’s all right here in BC. I still haven’t explored all of it. It’s endless. I really wanted to climb the Chief and one day I met a 17-year-old guy from Montreal and he kindly took me up. It took us eight hours, but we did it.

Why did you decide to stay in Victoria?

I was actually born in Vancouver, but my dad was in the military so we moved around a lot and eventually moved to Ontario. My dad is originally from Victoria, so there’s a familial element to it. And, my girlfriend is going to massage therapy school so that helped our decision: it was either Vancouver, Vernon or Victoria! I’m a small-town boy, so Victoria is just big enough: it’s busy but there’s not too much hustle and bustle and you can leave it pretty quickly.

How did volunteering shape your experience of being a physiotherapist?

I was lucky to get into a rehabilitation hospital that did a little bit of everything. I’d volunteer in one wing and eventually since I was so dedicated to the hospital, the coordinator gave me more things to do.

One intense experience I had at the hospital was while talking to an 18-year-old who had just suffered a complete injury to his spinal cord when at work. I had no clue what to say. I was shadowing a physio around at the time and she had such an easy-going way of talking to him, which was really eye-opening.

There was also a group of children there with various physical and cognitive disabilities. I worked with them in a pool and there was one little boy who was non-verbal, but after a while, I was able to get him to laugh when we were playing games or tossing a ball. It was a really rewarding experience. 

Have your past experiences informed how you approach your physiotherapy practice?

Tree planting hurt me in a million different ways and I learned how to heal from those experiences. I think all my past experiences – either with injury or even as an active person – have helped me better understand why my clients would want to get back to their daily lives. It’s helped me be more empathetic to their situation.

How do you educate clients about pain?

I always err on the side of caution because I want to make sure things go smoothly and so that treatment is sustainable. There’s only so much we can control as physios since we see our patients for a short period of time. If we don’t understand how they’re living, it’s hard to improve their pain or have them understand how far they can push themselves.

People need to know what an OK level of pain is so they can understand what’s too much and how to modify their routines. If you push through too much pain, things never get better. I’ve found that if a client is in an extreme amount of pain, they’re more receptive to education and lifestyle modifications. But as the pain dwindles, they’re sometimes less likely to continue, and that’s where the pain can flare up again.

How did you find out about Arbutus?

Actually my housemate, Felix! He works at RISE Health (another physiotherapy clinic in Victoria) and we went to physio school together. 

Working with Arbutus has been great, the mentorship is amazing, and Sandy is supportive of whatever specialty you want to get into. For instance, she’s supporting me in integrating blood-flow restriction training (BFR) into my practice. And all my co-workers are amazing, too! I think it’s neat that everyone has their own special thing. It’s a great community, you never really feel like you’re treating a patient alone. If I want to research something, I can always check in with someone. And our front desk staff are brilliant and super supportive.

What is blood-flow restriction training?

Blood flow restriction training (or, BFR) is an option for early-stage rehab to keep things moving and strong. Essentially, you strategically restrict blood flow to certain areas of your body while working out. This way, you’re lifting less weight (~20% 1RM)  – but more – repetitions. The idea is that BFR tricks your body into thinking it’s working harder than it is. When you do that, growth hormone gets released so your muscles can grow and tendons can get stronger without requiring a heavy load (like traditional weight training).

Dr. Tyler Nelson is an exercise physiologist and chiropractor in Lake Placid who studies this in terms of peak pulling force: before and after BFR training. He showed that in just six weeks, his patients were significantly stronger compared to people who just did low-load or no-load type strength training.

I think this is an interesting kind of training because if, say, you injure your finger while climbing, you obviously don’t want to lose your strength while in rehab. BFR training can be a supplement to a rehab program to maintain strength and help with the healing process a bit.

Tell us more about hang-boarding. What is it?

A hang-board is a block of wood with different-sized holes you put your fingers in so you can hang on them. It’s really focused on finger training, which for climbers is essential. If you get stronger fingers, you can climb different grades. The climbing technique is also important, but if you can’t hold on to a hold, you can’t climb at higher grades. I use my hang-board about two times per week.

Hang-boarding is a really great pre-hab tool because it reduces your chance of injury. You can improve your shoulder girdle activation while also improving the strength and durability of your ligaments and tendons. It can be a slow process: six weeks to three months to really get all the benefits. It’s ideally done in a progressive manner to prevent injury.

It’s also good for rehab to gradually regain sports-specific strength before returning to the climbing wall.
We’re going to offer something called a hang-board assessment at Arbutus. There’s a pretty good climbing scene here in Victoria with tons of bouldering but also sports climbing. I’ll help assess clients for strength training or pre- or rehab situations. I’m excited about being able to offer hang-board assessments to the community.

What’s new in physio?

I try to keep up with the research: one of my strengths is that I’ll read a ton about a topic. I try to pay attention to current training programs and implement them in a systematic way like taking rest days, timing, using weights, and quantifying results. There’s a lot of research coming out for different types of rehab.

I recently took a course with The Climbing Doctor, Jared Vagy. He’s a physiotherapist and professor at the University of Southern California. He’s one person I really trust. I had the opportunity to meet him, which was incredible. 

Dr. Nina Tappin (in Squamish) helped me rehab my finger and put me on to Dr. Nelson. 

And then there’s Dr. Eva López, who focuses on hang-boarding research. She’s a boss lady! She’s full of cool information and has a number of published papers on the technique.