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Sylvan Rocks Blog

Exos Cast for boxers break review

Daryl Stisser - Friday, January 05, 2018

While out dirt biking, I broke my 4th metatarsal 7 weeks ago.  So far so good I think.   A week in a half cast…then 5 weeks in an Exos Cast.  Finally I was able to take my stinky hand outa that thing and start rehab.



 Of course, it was a Sunday when I did it so after riding 7+ miles back to the truck and loading the bike, I went home, iced things up, and waited to see what happened hoping it was just bruised or something.  When the Monday morning rush passed I went into the Custer clinic for a x-ray.  Upon seeing it, the nurse rightfully guessed something was broken.  After living with the pain for 24 hours, I’d guessed it was my 4th metatarsal and as correct.  The x-ray verified what the nurse suspected.  The doc at the clinic knew I was an active person and suggested the Exos Cast.  It’s a modern day version of the old gauze and plaster cast of my youth that I’d expected to get.  I think they use fiberglass now and I was hoping for something in neon green, but after being through it all think the Exos was OK.

It turned out that after they tried to fit me in the wrong version of the Exos they realized they did not have the right one one at the clinic for the boxers break.  As they were about to put me in a normal cast for a 4th metatarsal I inquired if they could find one of them new fangled Exos Cast in the area and I’d go get it.  After discussion and a few phone calls and a fair amount of waiting they found what I needed  at Black Hills Orthopedics.  So off I went.  

Upon arrival there, they got me in pretty quick and had a look for themselves.  The PA did a good movement check and I think they took some more X-rays.  She explained the break better…the bone was in fact in 2 pieces, but so far not displaced so that was great news…no surgery if we could keep it there.  I promised to be a good boy and not go biking, climbing or run the chainsaw.  The hand was pretty swelled so she suggested I go home with a normal half cast and wrap for a week till the swelling went down then return for the Exos.  In hind site, this was a fine suggestion.

The Exos Cast is a good piece of kit, but after living with a half cast for a week and the Exos for  the rest of the healing, I would not say that the Exos is all around better, just different.   

Pros of the Exos

It’s smaller - Its prolly 3/4 of an inch in diameter smaller them a normal cast.  Still a total pain in the butt to get shirts and jackets on, but there are lots more of them that I can wear compared to the cast.

It’s lighter - Right away I noticed that I moved around and functioned just a bit more normally.  When I hiked, my stride was more normal.  I could do more exercises more normally then I could of with a regular cast.  I really wanted to have the bones mend...so I stayed active hiking and some jump rope towards the end, but didn't really go running in the Exos.  #1 because I didn't want the jostling around to set back my healing and #2 because it was winter with ice and snow and I didn't want to fall while wearing the cast.  Yes, makes me sound like some old guy I know, but setbacks were not something I wanted to have happen.

Vents better - even with the limb sock (which is critical I believe).  There is just way less material and with the some small vent holes it just works better.  Such that you don’t seem to sweat as much in the thing when sleeping or exercising.






Some adjustment -  and ability to reform - Since there is little to no padding, fit is everything.  With the Exos instead of the thick gauze padding there is just a MM or so of dense foam between my rather tender skin and the ridged thermoplastic…so anywhere that it was incorrectly formed, I got uncomfortable rub spots on my skin.  While I’m sure this happens with a regular cast, with the Exos there is less padding, therefore less room for error by whoever is putting it on.  I’ve done a bit of reading online and understand that creating a cast for this, the Boxers Break or Brawlers Break is a bit of a difficult one.  If your doc is not a sculptor or psyched about the art of forming the Exos or a cast you will suffer no matter what they try to create for you.  My favorite Doc was actually a dentist by trade and an artist by choice.  The crowns and fillings he created were great…they fit better then average, meshed together and always worked better then most.  He was the type of person that would do great at sculpting the Exos or a traditional cast.  The Exos has a mean tendency to create uncomfortable folds where the fingers bend if the person fitting and forming aren’t careful.  After watching the company fitting and forming videos, I know my caretakers have room to improve how they are doing things.  I lasted only a day before I attacked the huge flap they left me with, and 4 days before I had to do something about the constriction of my pinky.   I carefully and patiently warmed things up again and tried to open up the fold.  It took me a few tries to keep the 70+ degree bend they seem to strive for.  Apparently I did OK without messing anything up.  When the PA saw it again she would have liked a little more bend, but didn’t really think reforming was worth it.  I’d been able to make it pretty comfortable, and my healing time for such a break seemed normal so I cannot complain.  

After the 4 week mark, my PA said I could start taking it off to bath and work to regain some finger movement.  Those little piggies were stiff and stinky.

 

 

The Half Cast seemed to smell worse after one week then the Exos did after 3 weeks.

 

The Cons

Again…Your healthcare provider needs to be psyched about it for you to get the max benefit.  If your provider is bias towards a traditional cast for whatever reason, that may be your best bet.  Most people are resistant to change and healthcare is no different.   Just like the guys who poured concrete for me when we were building....they wanted to do things the way they'd always done them rather then try something different.

The Exos advertising touts its waterproofness.  Yes, the thermoplastic is waterproof but that doesn’t seem to actually allow you to swim or shower with it as they let on.  As I understand it…you need to keep pressure from messing with the break in your bone for max healing.  IF you are taking the Exos off to let it dry after showers or swimming you are prolly increasing your healing time.  Keeping your had in a wet Exos while things dried out seems like it would have resulted in more messed up skin and pain via some sort of rotten rash.  So, not really a con, but more of false advertising and a real let down after looking at things online in the waiting room.

In Conclusion

If you hope to stay active, and don’t think you’ll mind the lack of padding…the Exos if prolly worth it.  I’d guess for overall comfort, the traditional cast might be better for some people.  I was SUPER ready to get outa the thing, but all and all happy it was suggested to me as an alternative to a normal cast.  After 6 weeks in anything…expect inflammation and to be really weak and really stiff. That is just the reality of a human body.  My grip strength after being in the cast was over 100 pounds different between my healthy hand and my recovered hand.

After being out of the Exos only 3 days, and a few PT sessions my fingers are coming around but I’m still a long ways from being able to make a fist or even think about many “normal” movements such as a push up.  REALLY REALLY happy to be out of it though, and on the way to full recovery.  Hurt bodies are to be expected if you live an active and adventurous life so I cannot complain.  Its part of the trade off if you expect to really live your life vs just exist.  And heck…I heard tail of more then one person breaking bones slipping on ice in the driveway, so at least this little mishap in my motorbike was way more exciting then that.

 

If all continues to go well, we should be back on the motorbike soon and ready to guide this season starting in mid April.  Hopefully be doing some climbing in the southwest between now and then in preparation.  For now though, I'm just hoping to be able to bend my fingers and wrist enough to make a fist and do a pushup soon.

 

Here is a link for the Exos cast for boxers fracture that I had.

 

 

 


Its a great year to be a 4th grader

Daryl Stisser - Monday, May 02, 2016

You may have heard about the National Park Service Every Kid in a Park program granting free entrance passes to all 4th graders, and now the South Dakota Game Fish and Parks is getting on board with the new news of their Go Fourth program for South Dakota 4th graders.

 Both of these programs are geared towards building appreciation of the natural world and getting kids and families outdoors.  We perhaps all spend a little to much time on the sofa enjoying a screen.  And that is awesome, but hiking, fishing, rock climbing, and even getting caught outside in a thunder shower are all things worth doing and these 2 passes are perfect venues for enjoying some amazing places in South Dakota and across the USA.

 

 

 

New World Headquarters

Daryl Stisser - Thursday, December 25, 2014

Most of you know that since 2006 Sylvan Rocks has operated out of the SR trailer at Sylvan Lake in Custer State Park.  We will still be doing that, but the home office where all the behind the scenes organizational magic happens is going to be moving to a new location this spring.  For many years Cheryl and I have rented a beautiful home just north of Custer.  It was designed and built by the late Loretta Muehl, wife of Paul Muehl, who as many of you know...authored a 'few' routes in the Needles...esp. Middle Earth.  Since Lorettas untimely death, Cheryl and I have rented the place.  Its been an awesome home.  Cheryl rides her bike to work or walks every day and I have a great office to work from.  

In true Jan form, in June of 2013, Jan Conn stopped by to ask our full names and mailing address.  She was on her way to visit her lawyer and intended to gift 10 acres of land that her and Herb had bought back in the early 1950's to Cheryl and I.  It was as close as they could get to living next to the Cathedral Spires.  Jan said something like "you shouldn't have to wait for some old lady to die to be living out there."  And as simple as that, the adventure began.  To say that Cheryl and I were thankful, excited and overwhelmed would  be an understatement.  After a bit of a gut wrenching nightmare battle with the Forest Service for access to the parcel that went on way to long, we finally started building in earnest about mid Oct.  If you have ever built a home, you understand that its been a lot to learn in a short amount of time and the amount of work is fairly overwhelming.  All good "problems" though.  Jan comes over several times a week (esp. when the weather is good) for lunch and visits to check on the progress.  We have lots of good friends who have been out to help, and excellent guidance from our friend and project captain...Shep Vail.

We have discovered a few things that we'd do differently next time, but we hope that this place will be home to Cheryl and I as well as WORLD HEADQUARTERS to Sylvan Rocks Climbing School and Guide Service for many many years to come.  The Black Hills of South Dakota have been good to us, so I guess we will be staying as we are rooted here more then ever now.

The Pine Bark Beetles had killed most of the trees in the building site over the past few years, but we still had to tip over a few.  Amazing how fast a excavator works.


Jan was pretty impressed with the big machine and how well Matt operated it.  Because we had so much rock at the building site, we decided to build our home post frame style.....

The first poles rise out of the ground.

Happy to have had a nice warm October. 

The poo pipe goes in!

Unfortunately... Snow and cold moved in...so rather then wait on concrete...we set trusses and closed the place in!  Being flexible and creative seems to be the key to progress this time of year.

FINALLY, the last truss....and a few weeks later....some concrete.




So many choices.






Feels good to have some indoor work and ready for the snow on Christmas Eve.  Happy happy Merry Merry  everyone!

Oldest rock climber to Summit Devils Tower

Daryl Stisser - Tuesday, June 03, 2014

We have had many interesting and awesome guest and I try not to spray about them, but it has been a few years now, and I've talked about it, but never blogged about it until now.  But I'm going to go out on a limb and say that Sylvan Rocks guide Tony Schwatz had the pleasure of guiding the oldest free climber ever to the top of Devils Tower.   If I'm wrong and someone older has made the trip, please let me know.

In 2010, Amanda called me up and booked a trip for Siegfried since his english was not as good as hers.  I think she may have mentioned something about him being older, but it was a non-issue.  I didn't think much about it, as I knew Matt would handle whatever came his way.  So Matt Mieczkowski heads over to the Tower, and met up with this Austrian dude.  That was the year the Durrance Route was closed so they fired up El Cracko without problem.  Come to find out, Siegfried was 81years old and not afraid to perhaps pull on a piece of gear though the crux.   I thought that that was pretty darn cool.  I've seen guys young enough to be Siegfrieds great grand children get shut down by Devils Tower.  I've said it before and I'll say it again.  Rock climbing up Devils Tower is just pure work...there is no easy way climb up that darn Tower.  I wish there was, but if you wanna get to the summit and earn that view, you gotta really want to get there.

So, 2012 rolls around, Amanda calls back and booked several days of climbing in the Needles and another trip up the Tower.  Amanda...Siegfrieds younger wife at the tender age of 67 had started going to the climbing gym with him every week and she got in on the action when she joined Tony and her hubby for the 3 days spent climbing in the Needles, but on Sept 9, 2012 Siegfried chugged his way up the Durrance route.  In Tony's words..."he was a machine."  I'd like to think Tony's great guiding had something to do with it all, but truth be told, Tony just hung the rope for a very determined bundle of energy to blast his way up the route climbing in a controlled, steady, good climbing form.   How cool is that?  All the next 40 years of medicine can bring on...if Cheryl and I can goto the climbing gym once a week when I hit 80 and summit the Tower at 83... to say the least, I will be pretty psyched.

In talking to Siegfried, he said he climbed from age 30 to 50, then quit for 20 years, but at age 70...he decided that it was time to get back into rock climbing.  So, I guess that he is set up until 90 or so.  We will hope for another visit from Amanda and Siegfried.  Two of the sweetest, most humble guest I have met.

Just let it be known that while the great Frank Sanders is getting a little long in the tooth...he has another generation of climbing the Tower before he catches up to Siegfrieds age record.  I think the gauntlet has been thrown...lets salute 2 of my favorite athletes.  Amanda and Siegfried












When I hit 83...I wanna watch this shadow and capture this photo like Siegfried did.  A guy can dream.  Right?






Have you been inspired today?

Daryl Stisser - Tuesday, May 06, 2014

Its been many years now since we have adventured in Patagonia, yet in many ways, my heart is still there.  There in a way that the Black Hills were after my first visit here.  I knew I'd be back...I knew that I'd make these granite spires part of my life.  It is amazing how a place, a landscape can capture a persons heart and inspire them to act on dreams...obsessions...goals ...desires.  I have dreamt about a little cabin for Cheryl and I at the end of the world down there.  A simple life with the gauchos on the pompas.  Not sure I'll ever have the guts to leave all this behind, but I hold it up as an ideal and a fall back when things get hectic around here.  I know that being down in Argentina would come with its own set of issues, but in the dream state...it can bring a smile on a rough day and that can be worth a lot.

I don't really know Rolando, but from the video shown here by Black Diamond, he seems like someone I'd enjoy sharing a cup of Mate with.  Sometimes you see a little glimps of something good and it makes you need to grow a little more.  Today, for me..it was talking with a good friend on the phone and watching this video.  Salute....and thanks to those who make things happen for themselves and others by living a life that inspires us all. 

Click here or on the pic to watch the video and read about Rolo.

Have you been inspired today?


New Mountain Pro Edition

Daryl Stisser - Wednesday, April 02, 2014

The UK's E-zine Mountain Pro has a new edition out.  There are a few nice articles to check out.  Snow falling here for the past 3 day.  Should have done a time laps when it was really coming down this morning....or stayed in Moab instead of coming home!!!

Click on the pic and check out the magazine...grab a cuppa good coffee and enjoy.  Climbing season will be here soon enough.


Devils Tower Climbing Video - Jenn Flemming and Guide Anthony Schwartz

Daryl Stisser - Wednesday, December 11, 2013

Many of you have climbed and been guided by Anthony Schwartz.  He loves climbing as much as anyone I know.  He lives it...breathes it...and he is mighty good at it.

This video, put together by the National Park Service about climbing at Devils Tower National Monument, does a great job of not only describing what it is like to climb on the rock at Devils Tower, but captures a little bit of why rock climbing is such a great activity.  The images feed into the feeling of empowerment / respect for what surrounds a climber up on the stone, and the sheer joy that people experience when they slide fingers and toes into perfect holds and micro ledges.  Up on the wall with just a rope, gear and a partner or guide, life is simplified.   Life is good.

Pull, push, rest.....flow....enjoy the moment, embrace the challenge.  

These are things that make climbing so worthy and life worth living.  We all have to have something to motivate us beyond the normal day to day grind.  For many people, the adventure of rock climbing is that thing that takes life to the next level.

Tony was part of the team of pro climbers and videographers that put this great piece together.  He shared his knowledge of Devils Tower, his love for climbing and rope skills to help put that crew in position to get those inspiring shots.  

I hope you enjoy the video and descriptions Jenn Flemming shares about climbing in special places like "Devils Tower National Monument in beautiful northeast Wyoming"....  Anyone take a guess who I stole that line from?

Should you choose to hire Sylvan Rocks to guide you up the top of Devils Tower...I promise we will choose routes with appropriate challenges.  While there is no super easy way to the top of the Tower, there are many ways with much larger handholds and footholds then the routes that were shown in this video.  Climb on!


Jenn Flemming in Devils Tower:  National Parks Epic Challenge video.  Thanks to Camp 4 Collective for doing such a great job putting this video together for the National Park Foundation.


AMGA Survey Results

Daryl Stisser - Friday, September 27, 2013

Whats it like to be a rock climbing guide?  Best job in the world right?  Well most guides do enjoy a sweet office space, but it does help to enjoy living out of your backpack and being extremely tolerant of less then idea weather if you choose to pursue this career path.

The AMGA collected some data about guides and this is what they to shared.  Click to read more.  


Mount Rushmore Access Fund Trail Day July 27

Daryl Stisser - Wednesday, July 03, 2013

The Access Fund Conservation Team is scheduled to arrive in the Black Hills in a few weeks to help the Black Hills Climbers Coalition with a trail project at The Mount Rushmore Climbing Area.   On Saturday July 27, plan to come and volunteer on the project.  Along with working on improving the climbers trail up towards Garfield Goes to Washington on the Emancipation Rock Formation...there will be other projects that we could use some help with.

 Be sure to keep watching the Sylvan Rocks and BHCC Facebook pages and calendars for more updated info as the event gets closer.

 Check out the video of the Access Fund Conservation Team working in Utah with the Salt Lake Climbers Alliance.  You might recognize a Black Hills local in the video moving a few stones.  

 

Happy Salathé Day. 25th anniversary of the FFA

Daryl Stisser - Sunday, June 16, 2013

I was emailing with Paul Piana yesterday, and he wished me a Happy Salathé Day!  25 years ago, he and Todd Skinner made history.  Here is how he described it in an interview with NPR  

"Mr. PIANA: Well, it made a big splash in the climbing world, actually. It was something that the climbing world hadn't considered as possible. And in some ways, parts of our minds didn't consider it possible either, but we believed it just enough to continue trying. And we tried and we tried and we tried. And most of those tries we failed. We only succeeded on one of the tries. And I can remember being a rope length from the summit with Todd, when we knew we really had it done, we'd succeeded, and how much fun that was. I can't imagine giving so much physical and mental effort to succeed on something as ridiculous as climbing a big rock wall with anybody but Todd."

Free climbing thousands of vertical feet like that.....I cannot imagine the giddy feeling these to men must have felt as they finished something so bold. 

The climbers of today continue to break records, climb new lines, and create rad new challenges for themselves, but without a doubt, Paul and Todd were an unforgeable team that opened the minds of many to what might be possible.   Thanks to both of them for dreaming big and going on to live out those dream!

If you are interested in seeing some great photos of that trip.  There is a collection of Bill Hatchers work on Todds website.  Click Here for the Link

SR Climbing School Blog

Happy Salathé Day. 25th anniversary of the FFA

Daryl Stisser - Sunday, June 16, 2013

I was emailing with Paul Piana yesterday, and he wished me a Happy Salathé Day!  25 years ago, he and Todd Skinner made history.  Here is how he described it in an interview with NPR  

"Mr. PIANA: Well, it made a big splash in the climbing world, actually. It was something that the climbing world hadn't considered as possible. And in some ways, parts of our minds didn't consider it possible either, but we believed it just enough to continue trying. And we tried and we tried and we tried. And most of those tries we failed. We only succeeded on one of the tries. And I can remember being a rope length from the summit with Todd, when we knew we really had it done, we'd succeeded, and how much fun that was. I can't imagine giving so much physical and mental effort to succeed on something as ridiculous as climbing a big rock wall with anybody but Todd."

Free climbing thousands of vertical feet like that.....I cannot imagine the giddy feeling these to men must have felt as they finished something so bold. 

The climbers of today continue to break records, climb new lines, and create rad new challenges for themselves, but without a doubt, Paul and Todd were an unforgeable team that opened the minds of many to what might be possible.   Thanks to both of them for dreaming big and going on to live out those dream!

If you are interested in seeing some great photos of that trip.  There is a collection of Bill Hatchers work on Todds website.  Click Here for the Link


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