Rock Climbing – The Rise of a Sport
The sport of rock climbing has become increasingly popular over the past decade. This results in a greater number of potential climbers with injury. It is understood that the risks involved are correlated by the skill-level of the participant and the level of difficulty of routes that are attempted. In this sport, the climber’s hands are used as tools during the ascent and much of the climber’s body weight is distributed from the fingers to the wrists, elbows, and shoulders. The repetitive nature of the sport can result in overuse injury.
Overuse injuries account for 80% of injuries at indoor climbing facilities. Many of the upper extremity injuries that are sustained by rock climbers are also often seen in participants of other sports including: carpal tunnel syndrome, interphalangeal joint effusion (swelling), and lateral epicondylitis (“tennis elbow”). However, one common injury that is nearly exclusive to rock climbers includes what has been termed “climber’s finger,” which is an injury to the digital flexor tendon pulley systems. Specifically, the most commonly injured is the A2 pulley tendon which is located on the volar aspect of the proximal phalanx. Ring fingers and middle fingers have a high incidence of this injury. This injury results from excessive stress on the second annular pulley, typically during a cling/crimp grip which results in a strain. This can be an acute injury or occur with chronic use and overuse. Other serious injuries specific to climbing include tendon ruptures or collateral ligament sprains of the fingers.
In general, most climbing hand injuries are relatively minor and can be treated with rest. Resting requires stopping climbing right away. Range of motion and gentle stretching is usually okay, but sometimes may benefit from a period of immobilization or splinting/casting. After a minor injury occurs, return to activity should be gradual and as tolerated. Returning to activity too soon or too intense after injury may result in a prolonged recovery time. Anti-inflammatory medication, topical or oral, can help with pain while recovering and after return to activity. Splinting and taping may also be beneficial as taping can provide stability to the fingers after injury.
To prevent skin and superficial fingertip injuries, thin rubber pads or sleeves can be applied to the fingers, or tape can be wrapped around the fingers.
Circumferential finger taping while climbing may also reduce the risk of pulley injuries. Strengthening and conditioning parts of the body that are susceptible to injury is an important key to prevention. The hands and fingers can be strengthened through an activity called hangboarding. This consists of dead hangs from small holds. Proper form during this activity is important. Open hand gripping is recommended; avoiding crimping. The elbows should have a slight bend and shoulders and shoulder blades should be held down and back. You should be able to controllably lower your feet and touch the ground, as a rapid letting go or dropping to the ground can cause injury or strain. For hangboarding exercises, the duration and intensity of exercise should progressively increase over time. By creating an exercise program that includes strengthening, stretching, and range of motion exercises for the wrist and fingers flexor tendon, pulley injuries can be prevented.
While starting out or increasing the intensity of climbs, allowing adequate recovery time is also a key part of injury prevention. Cumulative load on unconditioned body parts can result in an overuse injury. Recovery and healing time can differ between people, so listen to your body if you are feeling fatigued or more sore than usual after activity.
Time to go to the doctor
Severe injuries or injuries that are not healing may call for a visit to a physician to investigate the injury further. Some injuries can benefit from interventions such as formal physical therapy, injections, or even a surgical procedure.
By Zuma Speakman and Jon Minor
- Indoor rock climbing: who gets injured?
D Wright – British Journal of Sports Medicine – 2001
- Rock Climbing Injuries: Acute and Chronic Repetitive Trauma
Connie Chang-Martin Torriani-Ambrose Huang – Current Problems in Diagnostic Radiology – 2016
- Hand Injuries in Rock Climbing
Peter Jebson-Curtis Steyers – The Physician and Sportsmedicine – 1997