Rock Climbing Injuries: Finger to Shoulder

Rock climbing has surged in popularity with the growth of indoor climbing gyms, making the sport accessible to people of all ages and fitness levels. While climbing builds remarkable strength and provides excellent exercise, it also creates unique injury patterns, particularly affecting the fingers, shoulders, and elbows. At M.O. Therapy in Markham, we help climbers prevent and recover from injuries to enjoy this challenging sport safely.

Understanding Climbing Injuries

Climbing injury patterns reflect the sport's unique demands:

• Finger injuries are most common, affecting 40-50% of climbers
• Overuse injuries predominate in regular climbers
• Shoulder and elbow problems are frequent
• Acute injuries increase with outdoor climbing
• Injury risk correlates with climbing frequency and difficulty level
• Many injuries result from training errors

Finger Injuries

Pulley Injuries

The finger pulleys (A2 and A4 are most commonly injured) hold tendons close to bone during gripping. These injuries are the signature climbing injury.

Grades of Pulley Injury:

Grade 1 (Strain):

• Microtearing
• Mild pain during climbing
• No bowstringing
• Recovery: 1-2 weeks

Grade 2 (Partial Tear):

• Partial tear of pulley
• Moderate pain
• May have slight bowstringing
• Recovery: 4-8 weeks

Grade 3 (Complete Rupture):

• Full pulley tear
• Significant pain
• Visible bowstringing
• Recovery: 3-6 months

Grade 4 (Multiple Pulleys):

• Multiple pulley damage
• Severe bowstringing
• May require surgery
• Recovery: 6+ months

Common Causes:

• Crimping grip position
• Dynamic moves to small holds
• Foot slipping (sudden loading)
• Insufficient warm-up
• Overtraining

Prevention:

• Thorough warm-up before hard climbing
• Progress difficulty gradually
• Use open-handed grip when possible
• Avoid campus boarding when fatigued
• Allow adequate recovery between sessions

Treatment:

• Rest from climbing (grade-dependent)
• H-taping or ring taping
• Progressive loading protocol
• Gradual return to climbing

Flexor Tendon Injuries

Tenosynovitis:

• Inflammation of tendon sheath
• Pain with finger movement
• May have swelling or crepitus
• Results from overuse

Flexor Tendon Strains:

• Pain in palm or finger
• Weakness with gripping
• Results from acute overload
• Responds to rest and rehab

Collateral Ligament Sprains

• Pain on side of finger joint
• Often from twisting on hold
• May have swelling
• Tape for support during healing

Elbow Injuries

Medial Epicondylitis (Golfer's/Climber's Elbow)

The most common elbow problem in climbers, affecting the inner elbow.

Causes:

• Repetitive gripping
• Pull-up training
• Overuse without adequate recovery
• Insufficient antagonist training

Symptoms:

• Pain on inside of elbow
• Weak grip
• Pain with wrist flexion
• Worse after climbing

Treatment:

• Rest from aggravating activities
• Progressive loading exercises
• Eccentric exercises
• Gradual return to climbing

Prevention:

• Balanced training (push as well as pull)
• Gradual progression of difficulty
• Adequate warm-up
• Wrist and forearm conditioning

Lateral Epicondylitis (Tennis Elbow)

Less common than medial epicondylitis but still occurs in climbers.

Causes:

• Excessive extension grip
• Slopers and pinches
• Imbalanced training

Treatment:

• Similar to medial epicondylitis
• Address specific causes
• Progressive rehabilitation

Triceps Tendinopathy

• Pain at back of elbow
• Often from mantling moves
• Results from repetitive pushing
• Responds to load management

Shoulder Injuries

Rotator Cuff Problems

The overhead reaching and dynamic movements of climbing stress the rotator cuff.

Rotator Cuff Tendinopathy:

• Pain with overhead movements
• Night pain in some cases
• Weakness with reaching
• Results from overuse

Impingement:

• Pain when arm elevated
• May affect sleeping position
• Often position-related
• Responds to technique modification

Prevention:

• Rotator cuff strengthening
• Scapular stability exercises
• Proper technique (especially lock-offs)
• Adequate rest between sessions

Shoulder Instability

• Common in climbers with naturally loose joints
• May result from repetitive overhead stress
• Can lead to labral damage
• Requires comprehensive strengthening

SLAP Tears

• Labral injury from repetitive stress
• Can result from dynamic moves
• May cause clicking or catching
• May require surgical repair

Wrist and Forearm

Wrist Tendinopathy

• Pain with wrist movement
• Often affects extensors
• Results from repetitive gripping
• Responds to rest and rehab

De Quervain's Tenosynovitis

• Pain on thumb side of wrist
• Common with certain grip positions
• May have swelling
• Responds to rest, splinting, therapy

Forearm Compartment Syndrome

In severe cases, climbers may experience:

• Chronic compartment syndrome
• Forearm tightness and pain
• May require surgical release

Knee and Lower Extremity

Knee Injuries

Less common but can occur from:

• High-step positions
• Heel hooks
• Drop knees
• Falls

Prevention:

• Proper technique
• Leg strengthening
• Avoiding extreme positions when fatigued

Ankle Sprains

More common in outdoor climbing or bouldering from:

• Landing from boulders
• Uneven terrain
• Falling

Prevention:

• Proper spotting
• Good landing technique
• Awareness of fall zone

Prevention Strategies

Training Principles

Progressive Overload:

• Increase difficulty gradually
• Allow adaptation time
• Don't rush progression

Adequate Recovery:

• Rest days between hard sessions
• Active recovery with easier climbing
• Sleep and nutrition for recovery

Balanced Training:

• Include antagonist exercises
• Push as well as pull
• Core stability work
• Flexibility maintenance

Warm-Up Protocol

Effective Warm-Up (15-20 minutes):

1. General cardiovascular activity (5 minutes)
2. Upper body dynamic stretches
3. Finger exercises and gentle stretching
4. Progressive climbing (start 3-4 grades below project level)
5. Gradually increase difficulty

Finger Conditioning

H-Taping for Prevention:

• Learn proper taping technique
• Use during high-stress sessions
• Don't rely on tape to climb through injury

Hangboard Training:

• Progress slowly
• Warm up thoroughly before hangboarding
• Avoid crimping when possible
• Allow adequate recovery

Antagonist Training

Essential Exercises:

Push-ups:

• Balance pulling with pushing
• Diamond, wide, and standard variations
• Progress to more challenging versions

Wrist Extensions:

• Balance forearm muscles
• Light resistance, high repetitions
• Include in regular routine

External Rotation:

• Shoulder health
• Band or dumbbell exercises
• Scapular stability work

Finger Extensions:

• Balance flexor strength
• Rubber band exercises
• Include in warm-up and cool-down

Treatment at M.O. Therapy

Physiotherapy

Our physiotherapists specialize in climbing injuries:

Services:

• Comprehensive injury assessment
• Specific rehabilitation programs
• Return-to-climbing protocols
• Prevention strategies
• Training optimization

Massage Therapy

Our RMTs help climbers:

• Recovery after hard sessions
• Address forearm and shoulder tension
• Improve flexibility
• Maintenance treatments

Chiropractic Care

Chiropractic benefits climbers through:

• Spinal and joint assessment
• Shoulder and elbow treatment
• Soft tissue therapy
• Movement optimization

Frequently Asked Questions

What is a pulley injury? A pulley injury involves damage to the annular ligaments that hold finger tendons close to the bone. These injuries range from mild strains to complete ruptures and are the most common climbing injury.

How can I prevent finger injuries? Prevention involves thorough warm-up, gradual progression of difficulty, using open-handed grip when possible, avoiding training when fatigued, and allowing adequate recovery between sessions.

Should I climb through elbow pain? Generally no. Climbing through elbow pain often worsens the problem. Rest, address the underlying causes, and gradually return when symptoms resolve.

How long does recovery from a pulley injury take? Recovery depends on severity. Mild strains may heal in 1-2 weeks, while complete ruptures can take 3-6 months. Proper rehabilitation helps ensure full recovery.

Book Your Assessment

If you're a climber dealing with an injury or wanting to optimize your training, M.O. Therapy in Markham can help. Our team understands the unique demands of climbing.

Call (905) 201-5827 or book online for your assessment. We offer direct billing and same-day appointments.