Rock Climbing Injuries
Rock climbing has grown in popularity over the last several decades. Many people pursue rock climbing as a serious hobby, while others climb occasionally as a weekend activity. With the right training and gear, rock climbing is generally a safe activity. However, specific injuries are common among rock climbers.
Causes
The most feared risk of trauma while climbing is a single fall event. Repeatedly scaling a wall can also result in overuse injuries. Overuse injuries can affect any joint in the body. Because the upper extremities do so much work during climbing, the shoulder, elbow, wrist, hand, and fingers can be especially prone to injury.
Shoulder Injuries
Rock climbers spend a lot of time with their arms overhead while pulling up their body weight. This places them at risk for rotator cuff injury. The rotator cuff is the group of four muscles and tendons that surround the shoulder joint and provide strength and stability. Rotator cuff injuries can include tendinitis, tendon degeneration, or a partial or complete tear.
Shoulder Injury Signs and Symptoms
- Pain
- Decreased motion
- Weakness when lifting or lowering the arm
- Clicking, popping, catching, or locking
- Feeling like the shoulder is not stable
Shoulder Injury Diagnosis
Diagnosis of a rotator cuff injury begins with a history and physical examination by a doctor. X-rays do not directly show the rotator cuff muscles, but they are often obtained to look for bone problems or other causes of pain or weakness. If your doctor is suspicious of a rotator cuff tear, an MRI may be ordered.
Shoulder Injury Treatment
Treatment depends on the type and severity of the injury. Tendinitis and small tears may be treated with rest, ice, anti-inflammatory oral medications, and physical therapy. If these measures fail, corticosteroid injections may be considered. Large tears or degeneration may require surgery to repair or reinforce the tendon. Tears that cannot be repaired may require tendon transfers or joint replacement surgery.
Elbow Injuries
Lateral epicondylitis is often called tennis elbow, but it is not limited to tennis players. This irritation of the tendons on the outside part of the elbow is caused by repetitive movements. Because climbers repeatedly grip holds to stay on the wall, these tendons can become irritated.
Elbow Injury Signs and Symptoms
Pain is the most common symptom of lateral epicondylitis. The pain is located on the outside of the elbow over the bone, is often worse when the area is touched, and may worsen with rock climbing or other activities that require gripping or lifting. Occasionally, any motion of the elbow can be painful.
Elbow Injury Diagnosis
The diagnosis is usually made by history and physical examination. X-rays may be obtained to rule out other causes of elbow pain.
Elbow Injury Treatment
Lateral epicondylitis is almost always treated without surgery. Non-surgical treatments may include activity modification, anti-inflammatory medications, a brace worn over the muscle just below the elbow, or a steroid injection. A physical therapist may also help modify grip or climbing technique to reduce pain.
Wrist Injuries
Rock climbing requires a lot of joint stability. Too much climbing can damage the structures that stabilize and support the wrist. The most common wrist injury in climbers is damage to the triangular fibrocartilage complex, also called the TFCC. The TFCC connects the two forearm bones to one another and connects the forearm to the small bones on the pinky side of the wrist. It acts as a cushion and stabilizer during gripping and rotation.
Wrist Injury Signs and Symptoms
- Pain
- Clicking or popping while turning the forearm or moving the wrist side-to-side
- Weakness
- Limited motion
- Feeling like the wrist is not stable
Wrist Injury Diagnosis
Diagnosis of a TFCC injury begins with a history and physical examination. X-rays do not show the TFCC, but they are often obtained to check for other causes of wrist pain. If your doctor is suspicious of a TFCC tear, an MRI may be ordered. Wrist arthroscopy, which uses a small camera to look inside the joint, may also be used to identify a tear.
Wrist Injury Treatment
Treatment depends on the type and severity of the injury. Many patients improve with splinting, activity changes, anti-inflammatory medications, or a steroid injection. If these treatments do not help, surgery may be required to repair the injury.
Finger Injuries
Rock climbing requires significant grip strength to hold a climber close to the wall or pull the body upward. Tendons connect muscles to bones, and a system of pulleys holds these tendons close to the finger bones. Ligaments hold the bones in alignment with one another. These structures create the balance of forces that allows a climber to fight gravity, but they can also be injured.
Flexor Tendon Tear
Each finger has two flexor tendons: the flexor digitorum superficialis, or FDS, and the flexor digitorum profundus, or FDP. These tendons are under a lot of tension during climbing and can stretch or tear.
Signs and symptoms of a flexor tendon tear may include pain in the finger, palm, or wrist; tenderness; and inability to bend one or more finger joints. Diagnosis begins with history and physical examination. X-rays may be obtained to look for fractures, and ultrasound or MRI may be ordered to confirm whether and where the tendon is torn.
If you think you may have a flexor tendon injury, see a hand surgeon right away. Partial injuries may be treated with splinting, rest, and hand therapy. Complete flexor tendon tears do not heal by themselves and require surgery to repair the tendon and restore motion. After surgery, a splint and hand therapy are required to protect the repair and aid recovery.
Trigger Finger
Trigger finger can develop in climbers when the flexor tendon becomes irritated from overuse. This can cause thickening and nodules of the tendon that prevent smooth gliding, making it difficult to bend or straighten the finger.
A2 Pulley Strain
The A2 pulley holds the flexor tendon close to the first finger segment, called the proximal phalanx. A2 pulley injury is the most common injury for climbers. It often happens when a climber slips and tightens their grip to catch themselves. The pulley may partially or completely tear, causing the tendon to pull away from the bone. Climbers may notice weak grip and finger pain.
Signs and symptoms of an A2 pulley strain may include a pop at the time of injury, pain, bruising, swelling, difficulty forming a fist, and weak grip. Diagnosis begins with history and physical examination. X-rays do not show the injured pulley, but they may be obtained to check for fractures. Ultrasound or MRI may also be ordered.
Treatment depends on severity. Strains or partial tears are usually treated with rest, ice, splinting, and physical therapy. After the pulley heals, many climbers use tape or a specialized ring to support the pulley while climbing. Complete ruptures may also improve with conservative care, but surgery may be required if symptoms do not improve.
Collateral Ligament Strain
The collateral ligaments surround each finger joint and help hold the finger bones together. These injuries can occur when a climber suddenly moves weight sideways, such as when swinging to place both hands on the same hold.
Symptoms may include pain, swelling, tenderness, and difficulty moving the joint. Diagnosis is usually made by history and physical examination. X-rays do not show the ligament, but they may be obtained to look for associated fractures. Most patients are treated with rest, ice, anti-inflammatory medications, and taping or splinting. In rare cases, acute or chronic collateral ligament strain requires surgery, especially when pinch stability of the thumb or index finger is affected.