March 2, 2022

8 Common Climbing Injuries: Prevention and Treatment

by Bernice

Table of Contents

As a climber, you will inevitably experience at least some of the most common climbing injuries. It’s just a part of the sport.

However, there are ways to help prevent injuries from happening in the first place, as well as ways to speed up your recovery process.

This article explores the most common climbing injuries and how to treat them effectively so you can get back on the rock as soon as possible.

1) Shoulder Injuries

Shoulder injuries in climbing are usually due to overuse of the rotator cuff. Climbers tend to use their rotator cuff muscles more because they’re trying to pull themselves up rather than pushing off the ground.

The shoulder is a ball and socket joint that connects the arm to the body, allowing for a great deal of movement in all directions.

But this flexibility comes at a cost: it comes at the expense of stability. That’s why the shoulder is more prone to injury than other joints like the knee or hip.

Rotator cuff tears

To understand rotator cuff injuries, it’s essential to know what the rotator cuff is and what it does.

A rotator cuff is a group of four muscles that originate on the scapula (shoulder blade) and insert onto the humerus (upper arm bone).

These muscles stabilize the humeral head on top of the glenoid fossa – basically holding everything in place while your arms move through space.

You use these muscles every time you climb, which is why they are among the most commonly injured structures in climbers.

A/C joint injuries (separated shoulder)

The acromioclavicular (A/C) joint is where your collarbone meets your shoulder blade, and ligaments hold it together.

An injury to this area is called a separated shoulder. This injury is common among cyclists but occurs in all sports that involve falling onto an outstretched arm – climbing included!

The separation can range from a small sprain to a complete tear of one or more ligaments and sometimes involves damage to the cartilage under the collarbone.

Rotator cuff impingement (aka “cuff tendinosis,” “shoulder impingement”)

A rotator cuff is a group of four muscles that stabilize the shoulder joint and allow you to rotate your arm.

The rotator cuff runs underneath a bony structure called the acromion (from which you get “acromioclavicular joint” or “A/C joint injuries”).

If a tendon or bursa sac gets pinched between the acromion and ball of your upper arm bone, it can become inflamed, leading to pain and a reduced range of motion.

If you have a rotator cuff injury, treatment will depend on how severe it is. If you have minor damage, your doctor may suggest RICE therapy:

  • Rest. Stop doing the activity that caused your injury.
  • Ice. Apply cold packs for 20 minutes, several times a day.
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  • Compression. Use an elastic bandage around your shoulder to keep swelling down. Don’t make it too tight because that can cause more swelling below the bandage.
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  • Elevation. Keep your shoulder above the level of your heart as much as possible to help reduce swelling. Severe injuries may need surgery or other treatments to repair damaged tendons or muscles in the rotator cuff.

2) Elbow Injuries

Elbow injuries in climbing can stem from overuse, repetitive stress, or acute injury, such as falling on the elbow and causing a fracture or sprain of one of the ligaments around the elbow. 

Tennis Elbow

Tennis elbow, also known as lateral epicondylitis, is inflammation of the tendon outside your elbow. Tennis elbow usually causes pain when gripping with a palm facing up and can cause weakness and instability in the wrist.

RICE therapy is the first recourse for tennis elbow. Many people find that using a brace for a tennis elbow can help.

The brace will compress the muscles in the arms and make sure that there is plenty of support provided so that you can keep on working without causing any further damage to your arm.

Consider surgical intervention if the injury doesn’t heal within 6-12 months.

Bursitis

Bursitis is an inflammation of the sac that surrounds your elbow joint, and it causes pain on the outside of the elbow. The two main types of bursitis are olecranon bursitis and prepatellar bursitis.

Olecranon bursitis occurs when there is too much stress on the back of your elbow while climbing overhanging routes, which can cause a fluid buildup around your elbow joint. 

Prepatellar bursitis occurs when there is too much stress on the front part of your knee while climbing boulders or sitting for long periods in a climber’s position.

It is worth taking painkillers when you have bursitis. If the pain doesn’t start to die down after a few weeks, you should consider seeing a doctor about whether there are any other steps you must take to treat the problem effectively.

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3) Wrist Injuries for Climbers

Rock climbers spend most of their time gripping holds with their fingers and supporting that weight with their wrists. So, it is no surprise that wrist injuries are common in this sport.

The most common wrist injuries are listed below.

  • Wrist sprains
  • Scaphoid Fracture
  • Colles Fracture
  • TFCC Tear

Wrist sprains

A wrist sprain can result from over-extending or over-twisting it. The symptoms include pain, swelling, stiffness, and possibly bruising. A wrist sprain will hurt more when you move your hand or twist your wrist.

Treatment for wrist pain depends on the underlying cause. Some causes of wrist pain require surgery. Some do not. Some cases can be resolved with immobilization, while others can heal with exercise.

Scaphoid Fracture

The scaphoid bone connects to the thumb and runs outside your wrist. Because a web of ligaments and tendons surrounds it, it’s fairly easy to injure when you fall on an outstretched hand during rock climbing.

Unlike other wrist bones, it also has very little blood flow, so doctors can take a long time to diagnose and treat fractures. Scaphoid injuries are often mistaken for sprains.

And if you don’t get treatment quickly enough, your injury can become more serious.

The most common treatment for a scaphoid fracture is a cast that goes from the wrist to above the elbow.

You typically wear it for about 6-8 weeks. Sometimes, your doctor may want you to wear it for as long as 12 weeks.

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Colles Fracture

A Colles fracture is a break of the distal radius or lower end of the arm bone. It’s often caused by falling on an outstretched hand.

The wrist may bend back, and the lower end of the radius may get pulled forward. The most obvious symptom is a swollen, tender wrist with a visible deformity.

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TFCC Tear

The triangular fibrocartilage complex (TFCC) is between the ulna bone at your pinky side and the lunate bone at your thumb side.

The TFCC helps stabilize your hand when you grip and twist. TFFC tears can occur during a fall where you land on an outstretched wrist or elbow.

Treatment for TFFC tears includes rest, ice, NSAIDs (non-steroidal anti-inflammatory drugs), and physical therapy. Most cases heal within a few weeks with proper treatment.

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5) Finger Injuries

There are several common injuries that climbers experience with their hands and fingers. Here are a few of them.

A pulley injury is an injury to the pulley system in your hand. The pulleys are bands of tissue that hold the tendon against the bone as it moves through your finger joints.

A climber who jams their finger into a small pocket on a climbing hold could injure their pulleys. These injuries can be severe enough to require surgery to repair.

A pulley strain can be treated with rest, proper support (such as taping), and icing the area until the swelling goes down.

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Trigger finger or stenosing tenosynovitis is an overuse injury to the tendon tissue of your finger flexor tendons. It can result from overloading these structures during climbing sessions.

It is characterized by swelling and pain at the base of your fingernails and in the palm of your hand (climber’s palm).

You can help heal the trigger finger by icing the affected area. Do this frequently – whenever the pain starts to increase or if you climb more than once a day – for at least 10 minutes.

Don’t overdo it because that can cause more harm than good. Be sure to protect the skin with a towel before applying ice.

6) Forearm Injuries

Forearm injuries in rock climbing are common. Rock climbers depend on using their forearm muscles. As these muscles fatigue, the tendons and ligaments that support the muscles become more likely to be injured.

Forearm strain is a common injury in rock climbers that occurs due to repetitive use of the forearm muscles in gripping, pulling, and hanging. It is most likely to occur in the flexor muscles and cause pain, swelling, and muscle spasms.

Forearm fracture is also common but less frequent than forearm strain. A fracture can occur due to a direct blow to the bone or impact when falling from a height. It can cause pain, swelling, bruising, numbness, tingling, or weakness in the hand.

Treatment for both conditions includes rest, ice, compression, and elevation (RICE). You can treat forearm strains with non-steroidal anti-inflammatory drugs (NSAID), such as ibuprofen, for pain relief and muscle relaxants for relieving muscle spasms.

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You might need surgery to recover from severe forearm fractures. Common procedures involve the insertion of metal plates in the wrist to stabilize the broken bones.

7. Knee Injuries

Knee injuries are fairly common for rock climbers due to the movements that involve bending at the knees. The knee is a complex joint, and many different parts can become damaged from climbing. 

Patellofemoral pain syndrome: A dull ache or pain behind the knee cap (patella) is common in climbers who have a repetitive motion injury from repeated knee bends over time.

You can prevent this knee pain by ensuring your climbing shoes are fitted correctly and by avoiding wearing them too tight. Further, read how to treat toe pain from rock climbing and tight climbing shoes.

You can treat knee pain from rock climbing with rest and physical therapy. If your knee pain doesn’t respond to conservative measures, you may need to consider surgery.

Tendonitis

Tendonitis is an inflammation of the tendons that surround our joints. Tendons connect muscles to bones, so when we climb, we use our muscles to pull on holds, which pulls on our bones. 

Tendonitis stems from the overuse or repetitive strain placed on the tendon to such an extent that the tendon becomes inflamed and swollen.

Early treatment with ice and rest will lead to a speedy recovery from the pain. If you ignore the pain, the inflammation can spread to the surrounding tissue and take longer to heal.

In most cases, tendonitis responds well to rest and rehabilitation. If you find yourself getting sore after climbing – especially with beginner climbers – take two days off from climbing (or more). During these days off, ice your arm regularly to reduce pain.

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8) Ankle Sprains

Ankle sprains and fractures are the most common injuries in rock climbing, accounting for close to half of all injuries.

They can be very painful and even debilitating since they occur in a joint that’s not only responsible for getting you up and down climbs but also the one that keeps you balanced while you’re walking on uneven terrain.

There are two major types of ankle sprains: high ankle sprains and low ankle sprains. High ankle sprains result from damage to the syndesmosis (the area between the upper ends of your tibia and fibula bones). 

These injuries can take up to 12 weeks to heal and often require surgical intervention. Low ankle sprains, by contrast, only involve damage to the ligaments that hold your lower leg bones together (called your tibiofibular ligaments). These injuries typically heal within six weeks without any surgery.

The good news is that ankle sprains can often be treated with simple self-care measures, such as resting the joint, applying ice, and using compression bandages or wraps.

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With time, these conservative treatments will usually help you return to climbing without any permanent damage.

The bad news is that severe ankle sprains may require medical treatment or even surgery, which may mean time away from your sport.

Ultimately, the information you gain from this article should help you better recognize, treat, and prevent common climbing injuries.

By following these suggestions, you will be better prepared to meet climbing challenges, whether it be a sport or a hobby. And believe it or not, staying healthy is the best way to continue progressing your climbing ability.

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About the author 

Bernice

Bernice often jokes that she is better at climbing than walking. With avid parents of climbing, her first encounter with the high vertical rock walls was at the age of one. Her favorite style of climbing is bouldering.

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