informative, research evidence

Four ways to reduce climbing injuries to fingers, elbows and shoulders

Since arriving at Pinnacle Climbing Centre in mid-July I have been learning a lot about climbing injuries. It goes without saying that fingers, forearms and shoulders appear to represent the overwhelming majority of niggles, injuries and mobility issues among these issues. Although I can’t be too specific, I would say that around half of those who I have spoken with have told me that they are either currently injured and of these, the majority of these individuals described at least one form of upper extremity injury (fingers, forearms, shoulders, elbows) – with a few neck and upper back issues thrown in for good measure. In fact, most of the folks with lower extremity injuries and pain seem to attribute them to other activities such as running – not climbing.

Now, as science is my specialty let’s delve into the research… or at least, what there is of it to delve into! Climbing is commonly associated with a host of injuries. I now understand from speaking with the Pinnacle team members that one of the biggest badges of honour on a rock climbing trip is to be the first to draw blood! However, despite the popularity of the sport, climbing injuries have not been heavily researched. But from what I have found, it seems that for indoor climbing most of these are overuse injuries of the hand and the finger, with a few elbows, shoulders and ankle injuries here and there.

one of the biggest badges of honour on a rock climbing trip is to be the first to draw blood!

For those of you who are interested in learning how to reduce their risk of injury I am going to breakdown the findings of a Dutch prospective cohort study by Middelkoop et al. published in 2011. The study reported that 42% of their 178 recreational indoor climbers reported sustaining an upper extremity injury over the course of one year. Their study found that the majority of these were finger injuries, although the elbow and shoulder are also commonly reported. But here is the oddest part… the individual factors that were associated with a higher risk of injury identified in the ‘univariate’ analysis of data (comparing injury incidence with one risk factor at a time) included:

  • higher climbing level/ability
  • climbing for more than 40 hours over a 3 month period
  • bouldering
  • training using a campus board
  • performing a warm-up
  • performing a cool down

That’s confusing!

How can those individuals who perform warm-ups, cool-downs, and dedicate significant time to improving their performance and grip strength be at more risk of injury? Surely, these activities should be reducing their risk of injury, not increasing it. Does this mean we should avoid warm-up routines and bouldering? Should we ditch the campus board and forget about cool-down exercises? Do we need to reduce our climbing hours?

magnifying glass
Let’s take a closer look…

The meaning of these individual factors really only make sense when we look at the output from the ‘multivariate’ analysis (comparing injury incidence with multiple risk factors at once). The only significant (important) variable in the multivariate analysis turned out to be the level of ability of the climber. In other words, the higher level climbers experienced more injuries regardless of the fact that they performed these additional activities – not because of them.

So what does this mean for you?

Firstly, let’s just make a sweeping generalisation that most higher level climbers train for longer and more often, take part in bouldering and additional training activities (such as using a campus board) and invest time in performing a warm-up and/or cool down routine. However, despite the fact that they do all these things to improve their performance – perhaps even with the intention to reduce their risk of injury – they still sustain more injuries. It is quite possible (and IMO, quite likely) that their higher injury incidence is more closely linked with the increased volume of work they do in their training, as well as the greater difficulty of the courses they climb.

In all truth, the only way that we would know whether the individual activities they perform (i.e.: warm-ups, cool-downs, bouldering, campus boards and climbing hours) actually influence the risk of injury is if we directly compare the incidence of injury between climbers who perform each of these activities and climbers who don’t perform them. Sadly, there isn’t any research looking at this – at least, that I can find yet. But, I would like to note that I am only reflecting on the findings of one study here. This is not a full on literature review, and the findings of this study are by no means finite. However, it is an opportunity to consider the influence of a number of factors on risk of upper extremity injury.

Four ways to reduce climbing injuries to fingers, elbows and shoulders:

  1. DO include warm-ups and cool-downs: You are not putting yourself at any greater risk by integrating warm-up and cool-downs into your climbing routine. In fact, I would encourage this – it is more likely to help with your climbing performance and efficiency than it is to increase your risk of injury.
  2. DO undertake conditioning activities that are related to your sport: Prevent traumatic injuries by using sport-specific training activities such as canvas board work in order to improve your climbing skills and endurance, which in turn reduce your risk of ‘event-related’ injury (such as falling).
  3. DON’T forget to monitor and plan your training or climbing frequency and intensity: If you would like to prevent or address ‘repetitive-strain injuries’ relating to chronic overload (i.e.: tendinopathies), then one area that you shoulder definitely tinker with (beyond efficiency and technique) is your climbing frequency and intensity. You are more likely to experience issues if you have big climbing sessions with long gaps in between (for example: you climb only twice a month, but you spend 4 hours on the wall for each session). Even more so, if you have a fairly sedentary job, like many of us, then you are creating quite big peaks and troughs in training volume. This is most often the cause of persistent pain in recreational athletes.
  4. DON’T rely on sports massage alone for pain and injury management: Sports massage is great as a short term fix for recovery from muscle soreness. However, in order to manage pain caused by repeatedly overloading the body, this requires a more active approach. But the good news is, it can be fixed very simply – albeit, it can take some time and effort.

In fact, I am delivering a workshop on this very subject in September…

The ‘Move Well Clinic Workshop: Preventing and Managing Shoulder Injury and Pain will take place on Wed, 25 Sep 2019 at 19:00 at Pinnacle Climbing Centre (Northampton). If you have experienced issues with shoulder pain or injury and would like to learn more about how to manage or prevent a recurence then this is a great opportunity to get the wheels in motion.

The workshop will help you to:

  • assess your shoulder function
  • understand the concepts of pain science and tissue healing after injury
  • consider the influence of other joint biomechanics on shoulder function
  • select and perform appropriate strength and mobility exercises to strengthen and prevent injury and pain in the shoulder

Tickets are just £10 (10% discount for Pinnacle Members), but there will only be 12 spots available.

To book your ticket or find out more: CLICK HERE

If you have questions about anything in this article or about the clinic please email me at:



Van Middelkoop M, Rakhshandehroo S, Bruens ML, Koes BW, Bierma-Zeinstra SM. Br. J. Sports Med. 2011; 45(4): 380-381.

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