As rock climbing grows in popularity, injuries — usually from overuse — are becoming more common. Climbers can help reduce their risk of injury with warmups and conditioning.
“From a fitness perspective, rock climbing uses your entire body and every part of the musculoskeletal system,” says Dawn LaPorte, M.D., an orthopaedic surgeon who specializes in hand and wrist injuries. “It strengthens the upper extremities in a way that few other sports do, and it also strengthens focus in the mind. It’s really that combination of mind-body. ”
She has two kids who climb on their college teams, and has been treating an increasing number of patients with climbing injuries for the past 10-plus years. She sees upward of 10–20 patients with such injuries a month.
LaPorte and medical student Grace Chen recently published a survey study, “Risk Factors and Injury Prevention Among Female Rock Climbers,” in the Journal of Women’s Sports Medicine. It is one of few research papers that focuses specifically on female climbers and injury risk.
Below, LaPorte reviews climbing injuries and provides pointers for warming up and strategies to help all rock climbers avoid injuries.
What injuries result from rock climbing and bouldering?
Upper Extremity Injuries
The majority of injuries that result from climbing are in the upper extremities.
- Pulley injuries — the most common rock-climbing injury
- “Pulleys are the soft-tissue structures that hold the tendon to bone in the fingers,” LaPorte says. “Because there is so much load on the fingers, there’s a risk of partial or complete pulley rupture, in which the tendon pulls away from the bone and takes away some mechanical advantage, in addition to causing pain and swelling.”
- Tendonitis in the shoulders
- Elbow and wrist sprains
- Ligament injuries
Lower Extremity Injuries
Lower extremity injuries are less common, but occur more often in bouldering, which involves climbing without ropes. These include:
- Ankle sprains
- Ankle and foot fractures
- Knee injuries, which occur less frequently
In their study, LaPorte and Chen found that most injuries did not require surgical intervention, and most patients returned to climbing after recovering. Both findings are consistent with previous studies.
What are injury risk factors and prevention tips for female rock climbers?
In their study on women climbers, LaPorte and Chen found:
- Bouldering may have a higher risk for injury when compared with other climbing sports.
- Climbers with eating disorders may be at a particularly high risk of injury. This is because nutrition plays a major role in building and maintaining healthy bones and muscle, and eating disorders can weaken bone density.
- Cross-training and climbing-specific warmups may help protect female climbers from injury.
What are injury-prevention activities for all rock climbers?
- Cross-training (nonclimbing activities such as swimming, running or yoga)
- Graded/progressive grip training to gradually increase hand and finger strength
- Warming up before climbing
“Interestingly, warming up with climbing-related activities was more protective than warming up with a cross-training approach,” LaPorte says.
Warmup recommendations
- Start with slow, controlled climbing of routes that are well below the climber’s maximum ability, gradually increasing difficulty.
- Warm up the fingers by using a grip trainer or by performing tendon-gliding exercises (controlled hand and finger movements to increase flexibility and strength).
- Hang on a pull-up bar, climbing hold or hang board, starting with short intervals and slowly working up to longer periods of time.
- Systematically work through the various types of climbing grips.
- Do dynamic stretches — especially for wrists, shoulders and hips — such as wrist circles, leg swings, hip openers, arm circles and PVC pass-throughs (holding a lightweight pole overhead and moving it front to back).
- Use a resistance band to warm up the shoulders and wrists with shoulder external rotation and wrist flexion.
What are treatment options for climbing and bouldering injuries?
Upper extremity injuries can often be treated with rest and splinting. A device called a pulley ring, which provides additional pulley support, may also help climbers ease back into the sport.
For some nonoperative injuries, occupational or physical therapy may help recovery as well. Patients can also be referred to bone health experts and endocrinologists if there are bone density concerns.
LaPorte also recommends starting off on easier climbs when coming back from an injury, and gradually ramping back up to previous levels.
“People love climbing, and it’s an amazing exercise,” she says. “Going into it, people should be thoughtful, warm up properly and make sure they’re looking after their overall fitness.”
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