5 Most Common Climbing Injuries and How to Treat Them

In this article, climbing physical therapist Emily Horst, PT, DPT, OCS with The Jackson Clinics shares five of the most common injuries rock climbers may face, focusing on fingers, shoulders, neck, knee, and elbow injuries, along with recommendations on how to address them.

Note: If you have a persistent injury, it’s always best to see a specialist. Climbers face unique physical demands, and not all physical therapists are equipped to fully address them. That’s why we’re so grateful to be partnering with Emily and The Jackson Clinics!

If you would like to schedule time with Emily you can email her here.

Emily in action giving a sports massage to a patient at Sportrock Climbing Centers in Sterling.

1. Finger Injuries

Pulley Injuries:

What is a pulley injury? A pulley injury is characterized by pain in between the joints on the palm side of your finger. This most commonly affects the ring finger and is aggravated by crimping motions. This injury can sometimes be accompanied by a popping sensation and typically occurs at the end of a climbing session when muscles are fatigued. 

How to Address a pulley injury: To address a pulley injury, allow the tissue to heal by avoiding crimping and high intensity gripping exercises. Use this time to focus on climbing form with lower intensity climbing grades. Finger exercises such as tendon glides, massage at the tender area and wrist flexibility and strength exercises can also help speed up recovery. Depending on the severity of the pulley injury you may need to seek further medical care. 

Capsulitis:

What is Capsulitis? Capsulitis is the inflammation of the tissue around a joint. Complaints of pain, swelling and stiffness around the joints of the finger could be due to synovitis. This is typically caused by increased stress and overuse of these areas. 

How to Address Capsulitis: To decrease pain related to synovitis, consider modifying your climbing intensity and/or frequency to allow the irritated tissue to heal. Addressing wrist and finger flexibility and strength can also improve gripping ability on the wall. Also consider shoulder and scapular strength to decrease load on fingers while climbing.

2. Shoulder injuries

Shoulder Impingement:

What is a Shoulder Impingement? This is a term used to describe the pinching or painful sensation felt in the shoulder when reaching, pushing or pulling. Usually, one of the tendons of your rotator cuff is being irritated with these activities and could be due to poor mobility or strength of the shoulder. 

How to Address a Shoulder Impingement: To decrease pain in the shoulder with these activities make sure to address mobility limitations in your shoulder and upper back. Also consider incorporating banded exercises for shoulder rotation and shoulder blade strength to improve shoulder movement while climbing.

Shoulder Instability:

What is shoulder Instability? Shoulder instability is characterized by painful clicking, popping or feeling of decreased strength when using the shoulder. This can be the result of a traumatic fall or injury to the shoulder that has affected the structure that stabilizes your shoulder joint called the labrum. 

How to Address Shoulder Instability: To address shoulder instability consider strengthening the muscles around the shoulder and shoulder blade starting in positions of comfort and progressing to more challenging positions without pain. Depending on the severity of injury you may need to seek further medical care.

3. Neck pain

Muscle Strain:

What is a Neck Muscle Strain? A muscle strain of the neck usually causes pain when turning or bending the neck in one direction. This can occur secondary to overuse due to neck positions while belaying or when pulling on a hold while climbing.

How to Address a Neck Muscle Strain: To address pain with neck movements due to a muscle strain, try using gentle stretching to decrease tension in the muscles. The use of a hot pack can decrease pain following a period of sitting or sleeping. Also consider massage to the area and improving upper back mobility and strength to decrease strain on the neck while climbing and belaying. We also recommend the use of belay glasses which use a mirror so that a belayer can safely belay their climb from a neutral neck position.

Nerve Compression:

What is a Neck Nerve Compression? Neck pain that travels from the neck down into the shoulder, arm or/ hand can possibly be due to compression of a nerve. This can occur during or after prolonged or repeated extension of the neck specifically when looking up while belaying.

How to Address a Neck Nerve Compression: To decrease pain related to nerve compression try using belay glasses to minimize time spent looking up while belaying. Also consider stretches the joints of the upper back and focusing on exercises to focus on proper posture. We again, also recommend the use of belay glasses which use a mirror so that a belayer can safely belay their climb from a neutral neck position.

4. Knee Pain

Hamstring Strain:

What is a Hamstring Strain? A hamstring strain can occur after repeated or sudden bending of the knee against resistance. This can happen when performing moves like heel hooks and result in pain behind the knee or thigh.

How to Address a Hamstring Strain:Tto decrease pain related to a hamstring strain, use massage techniques such as foam rolling or massage gun to improve blood flow to the area and decrease pain. Follow this with gentle stretching of the hamstring and progressive knee bending exercises to activate and strengthen the muscles behind the knee or thigh.

5. Elbow Pain

Tennis / Golfers Elbow:

What is Tennis or Golfers Elbow? Tennis elbow is the inflammation of the tendons of the muscle on the outside of the forearm while golfers elbow is the inflammation of the tendons of inside of the elbow. This can be due to tendonitis which occurs when muscles create increased strain on the tendons attached to the elbow while gripping.

How to Address a Tennis Elbow: To decrease pain due to tendonitis of the elbow focus on stretching and massaging the muscle of the forearm to release strain on the tendons near the elbow. Follow this with gentle strength exercises, progressing to resisted eccentric flexion and extension of the wrist. Also consider strength exercises for the muscles of the shoulder and upper back to decrease pressure on the gripping muscle of the forearm.

See a Climbing Specific Physical Therapist!

Climbing can be hard on the body, and not every physical therapist may know the best ways to treat your injury as a rock climber. Emily Horst, PT, DPT, OCS is a PT who specializes in physical therapy specifically for rock climbers, she is even a climber herself!

If you are interested in scheduling time with Emily, you can email her at EHorst@thejacksonclinics.com. She practices out of Sportrock Climbing Centers in Sterling. Seeing patients at the climbing gym offers her a totally unique way to treat the patients and get climbers climbing again!