Article and Photo by Ryan Ojerio

In addition to the risk of bodily harm from falls, rock climbers may suffer injuries as a result of the excessive strain placed on the body while climbing. Overuse injuries to the upper body are particularly common. Unless they are treated during the early stages, damage to the connective tissues of the hand, forearm or shoulder can plague a climber for the rest of their life.

Understanding the factors that contribute to these injuries is essential to preventing them. All climber's should be able to answer the following questions:

Q: How does your climbing style affect your risk of a chronic or acute injury?

How you climb can drastically increase or reduce your odds of suffering an injury. Do you warm up and stretch adequately before climbing? Warm muscles and tendons are more elastic and less likely to rupture. Do you repeatedly work strenuous moves while bouldering or training finger strength?

Consider spreading the stress around by putting variety into your climbing. Do you rest and recover in between climbing sessions? Giving your body time to repair micro-tears in the fibers or your muscles and tendons decreases your chances of developing tendonitis. Even the most fit climbers should not climb three intense days in a row. And lastly, do you gradually build up the intensity of your climbing or anxiously jump on hard routes at the beginning of the season?

Q: How do muscle imbalances increase the risk of injury?
Muscle imbalances develop in climbers as they work on strengthening the pulling muscles while neglecting their opposing muscle groups. Consider the muscles that flex your fingers when gripping a ledge. They may become extremely strong during the course of a climbing season, whereas their antagonists, the flexor muscles that lie on the top of your forearm, remain relatively weak. Powerful contractions of the flexor muscles can stress the tendons in the extensor muscles resulting in tendonitis in the elbow. Similarly, tendonitis in the elbow may occur with an imbalance between the triceps and biceps. Joint stability is also affected by imbalances, particularly the shoulder. Doing exercises such as push ups and dips will help even out imbalances in climbers who typically have over developed pulling muscles.

Q: What are the high risk movements or body positions?
High risk movements or body positions set the stage for injury by concentrating stress on particular part, or placing joints in unstable positions where an small error can push the joint out of its socket (dislocation). For example, one or two digit pockets put a huge amount of stress on the flexor tendons of those fingers potentially causing a ruptured tendon or leading to tendonitis. The crimp grip has a similar effect because of the hyperextension of the first knuckle and the extreme flexion of the second joint. Annular pulley rupture is often caused by the excessive force applied while crimping on small holds. (See the Anatomy diagram below).

Q: What is the most effective treatment for various soft tissue injuries associated with rock climbing?
If caught during the early phases, most overuse injuries respond well to treatment and you can return to climbing pain-free much sooner than if the injury is ignored. Severe cases of tendonitis, trigger finger, or acute injuries such as a dislocation or ruptured tendon may require steroid injection of surgery. The most important thing to do when you suspect an injury is to STOP CLIMBING! (duh!) Testing injured parts or attempting to "climb through it" will only make things worse and shorten your climbing career. Climbing coach and author Eric Horst provides the following guidelines for treating soft tissue injuries:

PHASES OF REHABILITATION

1. RICE 3 days - 2 Weeks Rest, Ice, Compression, Elevation and an anti-inflammatory medication such as ibuprofen will speed recovery by reducing swelling.

2. Range of Motion Exercises 3 days -6 Weeks Working the joint through its range of motion will keep recovering tissues limber and gradually strengthen muscles and tendons.

3. Progressive Resistance Exercises 1-6 Weeks Low intensity resistance exercises using a stretchy rubber strap will build strength progressively, preparing you for a return to normal activity.

4. Reintegrating the Injured Part 1-6 Weeks Even though the joint may not hurt anymore, you should ease into a return to climbing by working easy routes at low intensity. Don't slip into a relapse during this critical phase.

Total time from Injury = 3 Weeks - 5 Months

These are just rough guidelines, only an experienced sports therapist or orthopedic doctor can recommend the right course of treatment. If possible ask around and try to find someone experienced in treating climbers.

Q: Does finger taping help prevent injury or provide support for damaged tendons?
The jury is still out on this one. Although many climbers tape their fingers, the only proven benefit is protecting the skin from abrasion. Furthermore, relying on tape to support your pulley tendons could prevent them from growing stronger as your body relies on the tape for support rather than strengthening the tendons. From my personal experience and the advice of a sports therapist at the University of Oregon, I would suggest using tape to support recovering tendons during the 4th phase of recovery, but gradually wean the finger off of the tape.

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