With some of the world’s finest bouldering and rock climbing terrain, the Colorado’s Rocky Mountains draw a large number of the nearly 25 million rock climbers in the US. In addition, the sport of climbing will debut at the 2021 Summer Olympics in Tokyo, Japan, featuring competition in bouldering, speed climbing and lead climbing.

With the current increase in competitive and recreational rock climbing and bouldering, injuries occur. The 4 most commonly injured joints in rock climbers are:

1. Shoulder
2. Knee
3. Wrist
4. Hand

Falls, inadequate equipment, weather changes, high altitude, and lack of experience for the demands of a given climb are some of the contributing factors.

Shoulder Injuries

Shoulder injuries are commonly seen in rock climbing. This gravity defying sport puts a lot of demand on the shoulder joint increasing the risk for injury. This may include:

• Shoulder Dislocation – Our shoulders are inherently unstable joints as we are more reliant on the shoulder ligaments to stabilize the shoulder. If a climbing move results in over-extension of the shoulder joint, the ball of the joint may be forced forward and out of the socket, causing a full or partial dislocation. The climber will feel a sharp pain in the shoulder, a deformity, and experience a sudden loss of strength and range of motion. One would be unable to continue climbing with such an injury. Rotator cuff strengthening exercise to prepare for climbing, shoulder warm-up exercises on the day of your climb, graduated increase in climbing difficulty, and being careful when your shoulder is at its end range of motion can help prevent shoulder dislocations.
• Rotator Cuff Tears – Repetitive overhead sports such as climbing has wear and tear effects on the rotator cuff tendons of the shoulder. One can get inflammation of the rotator cuff tendons with prolonged climbs resulting in acute pain. To treat this, rest the shoulder and avoid overhead activities in order to let the tendon calm down. Alternatively, if someone has been climbing for years and notices gradually increasing pain in the shoulder and pain that wakes you at night, then you may have a torn rotator cuff tendon as a result of years of wear and tear to the shoulder. This may require surgical repair as rotator cuff tears do not heal and usually worsen. To prevent shoulder injuries, go into your season having done rotator cuff and scapular muscle strengthening exercises, add warm up and cool down stretches to your rock climbing routine, and maintain a shoulder conditioning regime.
• SLAP Tears – The repeated high intensity overhead motions demanded of the shoulder in rock climbing can cause a tear to the labrum, which is a gasket like structure that attaches to the edge of the shoulder socket. If someone tears the labrum from the top of the socket, this injury is known as a superior labrum anterior and posterior (SLAP) tear. This is a painful injury and is due either to repetitive stresses to the shoulder or a single acute traumatic event to the shoulder. The labrum can be simply frayed at the point of attachment to the biceps tendon, or fully torn from the bone socket. Physical therapy can be of benefit but at times surgical repair may be necessary to alleviate the pain due to a SLAP tear.

Richard Cunningham, MD is a shoulder specialist and treats rock climbing shoulder injuries with the goal of returning climbers to their sport as soon as possible.

Knee Injuries

Rock climbers often rely on highly specialized movement of the legs to make vertical gains. Heel hooks, also called leg locks, are an example, where the leg is twisted creating maximum torque, from the leading hip to the knee. Drop knee, a foot move meant to create maximum body tension also creates great torque on the knee. High steps, exactly as it sounds, also creates demand, great flexibility and maximum range of motion to the knee joint. These aggressive activities, along with repetitive motions and overuse, as well as many hard landings and accidental falls, lead to various types knee injuries.

The most common rock climbing knee injuries are tears of the medial meniscus, irritation of the IT (iliotibial) band, or tears to the anterior cruciate ligament (ACL). Dr. Cunningham has the expertise to help rock climbing enthusiasts prevent, diagnose and treat knee injuries sustained during rock climbing.

Wrist Injuries

Few athletic activities tax the wrist as much as rock climbing and bouldering. From lacerations of the wrist to fractures when attempting to break a fall, there is a wide range of possible wrist injuries in rock climbers. The intense load to the wrist and the repetitive flexing of the joint can cause carpal tunnel syndrome, tendonitis, sprains, and even ligament tears.

The most common injury to the wrist for rock climbers are tears of the triangular fibrocartilage complex (TFCC). The TFCC is a meniscus like rubbery cartilage that is located on the small finger side of the wrist between the forearm and the wrist bones. It functions as a load bearing and twisting support to the wrist. Symptoms of a TFCC tear include:

• Localized pain along the pinky side of the wrist
• Loss of strength in wrist
• Swelling
• Limitation in motion range
• “Popping” sound with wrist motion

Tendons about the wrist can also be sprained or tear as a result of climbing injuries. Wrist fractures are also common as a result of falling from a height on an outstretched hand.

Rock climbers are wise to include wrist exercises in their fitness routine. Rotating, extending and flexing the wrist with resistance will strengthen the wrist to meet the demand of the sport. Paying attention to pain that develops in the wrist is important.

Hand Injuries

Healthy hands are essential in rock climbing and bouldering. There are common hand injuries associated with this sport. Injuries to the fingers are the most common injury found in rock climbing. The two most common finger injuries are:

• Flexor tendon and pulley injuries – The tendons in our hand are held in place by small, ring like tissue structures called pulleys. One can sustain a tear of a flexor tendon in the hand or tear of one of these pulleys as a result of the extreme forces these structures encounter while crimping, or hanging onto small rock edges. When the tendons or pulleys are over-loaded, a flexor tendon or tendon pulley can tear. One often feels a pop, immediate pain, and swelling. The two center fingers are most vulnerable, but any digit can have these injuries.
• Trigger finger syndrome – This syndrome is caused by inflammation of a pulley leading to constriction of the flexor tendon and preventing smooth gliding of the tendon within the pulley. One’s finger can become stuck in a bent position. The finger can be manually straightened, but with pain. The best prevention to avoid trigger finger syndrome is to rest the finger and hand to allow the inflammation to subside.

Dr. Cunningham is your go-to orthopedic sports medicine doctor for any injury sustained in rock climbing and bouldering. If you have suffered from a rock climbing or bouldering injury, contact Dr. Cunningham and his team today.