Climbing injuries: finger pulleys, shoulders, elbows and how to prevent them

TUREFF• •0

Climbing is a safe sport in the sense that serious accidents are rare in a gym, but overuse injuries are very common. Fingers, shoulders and elbows take loads they are not used to, and connective tissue adapts much more slowly than muscle. The good news is that most of these injuries are avoidable with sensible habits. This is general information, not medical advice; if something hurts, get it looked at.

Finger pulley injuries

Your finger tendons are held close to the bones by bands called pulleys. In climbing, the one most often injured is the A2 pulley at the base of the finger, with the A4 near the middle joint next. The main cause is the crimp grip, where the fingertips are on a small edge and the middle joint is sharply bent. Crimping puts far more force through the A2 pulley than an open-hand grip. Injuries usually happen with a sudden spike of load, for example when a foot slips and the fingers suddenly take your whole weight on a small hold. Signs to take seriously:

A pop or crack felt or heard in the finger
Pain at the base of the finger or along it when gripping
Swelling, bruising or pain when you bend the finger against resistance

Damage ranges from a mild strain to a complete rupture. Stop climbing for the day if you feel a pop, and get it assessed.

Shoulders

Steep climbing, big reaches and hanging on straight arms with a passive, shrugged shoulder all load the shoulder joint. Impingement-type pain and rotator cuff irritation are common. Prevention is mostly about keeping the shoulder engaged (shoulder blades set down and back rather than hanging loose at full stretch on every move) and doing some pushing and rotator cuff exercises to balance all the pulling.

Elbows

Pain on the inner side of the elbow is often called climber's elbow or golfer's elbow; on the outer side, tennis elbow. Both are overuse problems in the tendons that attach the forearm muscles. They tend to build gradually, especially after a sudden increase in climbing volume or a lot of steep, pulling-heavy sessions.

Warming up

A proper warm-up is the single cheapest piece of prevention.

Five to ten minutes of general movement to raise your heart rate: skipping, a rowing machine, brisk walking.
Mobility for shoulders, wrists and hips: arm circles, band pull-aparts, gentle stretches.
Easy climbing on big holds, several climbs well below your limit.
Gradually harder climbs before you try anything near your maximum.

Leave crimpy and powerful problems until you are fully warm, and avoid finger-board training until you have been climbing regularly for a good while.

Rest days and load

Increase slowly. The classic beginner injury comes from going from once a week to five times a week because it is fun.
Rest between sessions. Many people climb every other day rather than consecutive days, particularly in the first year.
Vary the style. Mix steep, slab and technical climbing so the same tissues are not loaded every time.
Stop when you are tired. Injuries cluster at the end of sessions, when you are making sloppy moves and over-gripping.
Use open-hand grips where possible so you are not crimping everything.

When to see a physio

See a physiotherapist or doctor, ideally one familiar with climbers, if:

you felt a pop in a finger
pain lasts more than a week or two despite rest
pain wakes you at night or is there at rest
you have swelling, numbness, tingling or weakness
your shoulder clicks painfully or feels unstable

Early assessment usually means a shorter time off. A good physio will also give you a graded plan to return, which matters because resting alone rarely rebuilds the tissue's tolerance. Have you had a climbing injury, and what helped you come back from it? Share your experience or questions in the comments.