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Reach New Heights: Understanding Rock Climbing Injuries

Climbing is an exhilarating sport that requires strength, endurance, and mental toughness. Thanks to the growing popularity of indoor climbing gyms, sport climbing has become more accessible in recent decades, with over 25 million climbers in 150 countries. Sport climbing will return to the 2024 Olympic Games in Paris after making a thrilling debut at the 2021 Games in Tokyo.

Types of Climbing

In this summer’s Olympic Games, you will see three types of sport climbing events:

  • Bouldering: Athletes climb a 4.5-meter-high wall without ropes in a limited amount of time in the fewest attempts possible. Bouldering requires a combination of balance, strength, and problem solving.
  • Lead: Climbers have six minutes to go as high as they can on a wall that is over 15 meters high. The athletes have never seen the route ahead of time, but they do have ropes and harnesses. (They will see the route ahead of time for finals).
  • Speed:Athletes climb a 15-meter-high wall in under six seconds for men and seven seconds for women. In the last year, men have broken the five-second barrier.

Acute vs. Overuse Injuries

Acute injuries happen from a single traumatic event, such as a fall or blow. Bouldering is most likely to cause an acute injury since the climbers do not have ropes and fall onto padded mats.

Overuse injuries happen when repetitive movements cause accumulated stress over time that is more than the body can handle. All three climbing events can lead to overuse injuries.

Whether or not you should seek out medical intervention depends on the severity of the injury. Call 911 for any major acute injury, like a head injury or neck injury. Some broken bones like arms and fingers do not require an ambulance ride.

“If the climber is able to walk around and pain is not too severe, an urgent care or regular doctor’s visit may be enough, but it is never wrong to be evaluated,” says Julia Rawlings, MD, the team physician for USA Climbing and sports medicine specialist at University of Utah Health.

Overuse injuries are less urgent and can be treated with the PRICE method:






“If pain continues despite home treatment, see a sports medicine specialist to help diagnose the problem,” Rawlings says. “Most of these injuries will benefit from a good physical therapy program, which will help the climber strengthen the area that is injured and weak, as well as supporting the muscles around the injured body part.”

Common Climbing Injuries and Treatment

Rawlings says overuse injuries are more common in climbing than acute injuries and tend to get worse over time if adjustments aren’t made. The following injuries are some of the most common in climbing. Understanding how they occur and how to treat them will keep you reaching for the next handhold:

  • Finger pulley injuries. This happens when the tendons in the fingers are overstretched or torn. Gripping thin holds while supporting the weight of the body can put tremendous strain on the fingers, usually resulting in pain, swelling, and difficulty making a fist. Climbers may hear a “pop” sound when the injury occurs.

    Treatment: PRICE method and gentle stretches of the fingers. Gradually return to climbing by choosing routes with easy handholds and slowly increasing stress over time.

  • Trigger Finger Syndrome. Trigger finger happens when the tendons in your fingers or thumb become inflamed or develop a cyst. You may have trouble gripping or experience pain, stiffness, or a locking sensation.

    Treatment: Wear a splint and avoid repetitive gripping in the affected hand. Severe cases may require steroid injections or surgery.

  • Tendonitis. When tendons become inflamed from overuse or repeated strain, it can cause pain and tenderness in the area, especially during activity. Tendonitis can occur in various parts of the body, but in climbing it is particularly common in the elbow, wrists, shoulders, forearms, and knees.

    Treatment: PRICE method, over-the-counter anti-inflammatory medications, and physical therapy.

  • Rotator cuff tears. The rotator cuff is a group of muscles and tendons that stabilize the shoulder. Repeatedly pulling body weight up with arms extended over the head can tear these muscles. This leads to pain, weakness, and limited range of motion. Rotator cuff injuries are uncommon in young climbers, but these muscles can be strained.

    Treatment: Complete rotator cuff tears cannot heal on their own without surgery. For partial tears or muscle strains, non-surgical treatments to manage pain and improve shoulder function are helpful. These include wearing an arm sling, steroid injections, and physical therapy.

  • Knee injuries. Knee pain, swelling, and instability can happen from landing awkwardly, dynamic movements, and high steps. Twisted knees, sprains, strains, and even torn knee ligaments can be seen in climbing.

    Treatment: Severe injuries, such as an ACL tear, will require surgery and physical therapy. More minor injuries can be treated with the PRICE method, taking over-the-counter pain medications, and a gradual return to climbing.

Know the Best Prevention Strategies

Sometimes accidents happen and an injury occurs, but you can take steps to prevent common climbing injuries.

“Proper technique is very important to safety in climbing,” Rawlings says. “In lead climbing, the athlete needs to know how to safely and properly clip the rope in as they ascend the wall, and a well-trained partner to belay the climber is essential. In bouldering, the athletes are trained to fall and land as safely as possible, but they are often not falling feet-first and instead can be jumping from one part of the wall to another or hanging sideways when they fall, so body awareness is key.”

Besides learning proper technique from a qualified coach, other ways to prevent climbing injuries include:

  • Proper warm-up and cool down
  • Grip training
  • Strength training
  • Flexibility and mobility work
  • Rest and recovery

Being armed with the knowledge of the most common climbing injuries, how to treat them, and how to prevent them from happening in the first place will help keep you reaching for new heights in your climbing journey.