Rock climbing injuries

Helen Dean, SPT

Competitive rock climbing is a sport that is beginning to grow in popularity, especially now that it is becoming an Olympic sport in 2020. As the popularity of the sport increases, and climbers push their limits more and more, the incidence of hand injuries increases with these athletes as well. In order to properly treat these hand injuries, it is important to understand the most common hand injuries occurring among climbers and the mechanism behind these injuries.
     According to the literature, over 50% of competitive rock climbers have had a hand injury within their climbing careers, and by far the most common was an A2 pulley tear or rupture, with the second most common being tendonitis of the flexor tendons. Both of these injuries occur because of the overuse of the “crimp” grip, a grip that puts a strain on the flexor tendons due to its angles and the force of the body weight on the fingers. Injuries that do not involve a rupture of the tendon or pulley can be treated conservatively with taping, rest, gentle ROM, and easy sport specific activities once any pain and inflammation have subsided. Ruptures of the pulley or flexor tendons will require surgery and a slower return to climbing.
     Other common hand injuries include strain of the finger flexor tendons, lumbrical tear, and ganglion of the finger flexor tendons.  Strain of the finger flexor tendons occur due to use of the crimp and pocket grips in climbing, while a lumbrical tear occurs specifically due to use of the one finger pocket grip in climbing. It’s important to identify the difference between the causes of these injuries so the injured so the climber can be informed not to over train using these grips. Treatment of these injuries can be managed conservatively as well, with rest and gentle ROM. Lumbrical strains will require immediate gentle stretching to prevent formation of scar tissue, as well as avoidance of the use of the pocket grip until fully healed.
     Rock climbers in general need to be educated on proper training and use of the healthcare system for their injuries. Literature shows that on average, climbers warm up for less than 10 minutes, or do not warm up at all. Additionally, climbers often do not seek medical attention for their injuries because they either trusted their climbing peers’ advice, believed the injury would resolve on its own, or believed that the healthcare providers did not have the proper knowledge to treat climbing injuries. This is why it is important for physical therapists to be aware of all sports injuries and feel comfortable treating athletes from any sport.