Rock Climbing and Bouldering Injuries

Over the past few decades, rock climbing and bouldering has increased in popularity as both a recreational and competitive sport. It made its Olympic debut at the 2020 Summer Olympics in Tokyo, which provided viewers with an insight into the high and comprehensive physical demands required to compete in the sport. However, the increasing popularity and professionalism of climbing has been associated with a rise in climbing-related injuries.

Current research suggests that injuries of the upper extremity are more common as opposed to those of the lower extremity. This is sincevertical climbing requires the upper extremity to support the climber’s body weight, whereas a typical outdoor climb would require added support of the lower extremity. However, there is emerging evidence to suggest that climbers are also at risk of traumatic injuries involving the lower extremity.

Upper Extremity Injuries

Due to the prolonged and repetitive upper body movements required for vertical climbing and overhanding manoeuvres, climbers are often susceptible to injuries of the upper extremity.

The annular ligaments of the fingers, which are often referred to as the annular pulleys, govern the flexor mechanism of the hand and prevent ‘bowstringing’ of the fingers. This occurs when the flexor tendon becomes dislocated from the centre of its respective bone joint, resulting in a malfunction of the pulley system and making it difficult to create a fist. Other symptoms associated with this injury include pain and tenderness of the palmar side of the hand, swelling, and/or an audible popping sound at the time of injury.

Although the shoulder is likely the most mobile joint of the body with its ‘ball and socket’ mechanism, the added mobility it provides makes it more vulnerable. Unlike the hip joint, the ‘socket’ of the shoulder joint is rather shallow, and the ‘ball’ is almost four times the size of this socket! As climbers are constantly reaching overhead to pursue that next hold, this makes them prime candidates for shoulder impingement syndrome (SIS). This occurs when tendons of the rotator cuff group of muscles which provide stability at the shoulder joint, become inflamed. This can result in a nagging pain and ‘pinching’ with movement of the shoulder.

Lower Extremity Injuries

The most frequent factors for injuries to the lower extremity in rock climbing and bouldering are a wall-collision fall or a ground fall. Typical injuries sustained from such fall include contusions or compound fractures. Wall-collision falls occur when a climber falls and the tension of the rope pulls him to the rock face, placing stress on the distal extremities, in particular the feet. Ground falls can often result in more serious injuries such as a fracture of the ankle joint, which can occur from as little as 8 feet above the ground.

Although acute injuries cannot always be avoided, chronic overuse injuries such as SIS can be managed and prevented from further injury with the use of a strengthening exercise programme. The shoulder joint relies on the strength of the rotator cuff muscles to provide stability, as opposed to the anatomical structure. Therefore, exercise training is recommended to reinforce the shoulder complex and reduce susceptibility to injury.

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