Rock climbing has many physical benefits such as increased strength, balance, and flexibility, yet can be a dangerous activity so it is important to understand the risks and how to mitigate them. When thinking about rock climbing injuries, most people immediately think of the dreaded ground fall, but most climbing injuries are not the result of a fall from great heights. Rather, most injuries occur from falls close to the ground or improper training and overstressed tissue.
During training, too much emphasis is often placed on strengthening the finger flexors. The extrinsic fingers flexors (meaning those that originate in the forearm) cross the wrist joint and exert a wrist flexion moment when attempting to flex the fingers. Therefore, sufficient strength of the antagonist muscle groups, the wrist and finger extensors, is needed to keep the wrist stable and allow for strong grip. Over-emphasis on flexor muscle groups creates an imbalance that can be detrimental to grip strength and predispose a climber to injury.
When climbing more difficult grades, the demand on finger strength is often unavoidable, but when starting out in climbing and when training, footwork and technique are much more important than finger strength. Focus on placing as much weight as possible on your feet and keeping your elbows as straight as possible to preserve energy in your elbow and finger flexors. Training should focus on slow, controlled movements with emphasis on body position and balance. Dynamic movements (“dynos”) should be performed by experienced climbers after sufficient warm-up. Failure to sufficiently warm-up and overstressing tissues through dynamic movements, such as dynos and dead-points, can result in A2 pulley injuries, flexor tendonitis, medial epicondylitis, and biceps tendonitis or tears.
Finally, whether in the local climbing gym or in the backcountry, it is critical to fully understand proper set-up, usage, and safety checks for all the gear that you will be using for your climb. Most accidents are avoidable and result from human error and not equipment failure. Furthermore, knowing how to fall can reduce serious injury when bouldering or lead climbing. Maintaining an awareness of your body position relative to the ground or rock wall during a free fall or controlled fall can significantly reduce the impact of your fall. When falling while bouldering, try to absorb the fall through your legs and avoid reaching your arms down or behind you to brace your fall. This will reduce your risk of wrist and elbow fractures. When falling while lead climbing, keep your body facing the wall, and again, absorb the impact with your legs to reduce the impact to the rest of your body.
In summary, rock climbing involves a lot of finger strength, but to avoid injury, training should be focused on body mechanics, footwork and technique, and antagonist muscle groups. A technical climber uses balance and efficiency to minimize stress on the fingers, which results in lower risk for overload injury.
Nick Maroldi is the manager at the Hand and Upper Extremity Therapy Center. He is a doctor of physical therapy, certified hand therapist, and certified orthopedic clinical specialist, as well as an avid rock climber.