Skip to Content

Rock Climbing: Upper Body Injury Prevention

For many of us, our days are spent sitting in front of a computer screen. We all know that exercising is important, but many forms are repetitive and unstimulating. For these reasons and more, many people are getting into rock climbing. With its community-based environment and puzzle-like routes (called “problems”), climbing provides a workout disguised as a mentally stimulating and varying physical activity. There are many climbing gyms in Seattle offering bouldering, top rope, and lead climbing and as the climbing community continues to grow, so too does the incidence of injury.

Bouldering is the most popular form of indoor climbing as it requires no ropes and can be done without a partner. With its dynamic, gymnastic, and powerful movements, it should come as no surprise that bouldering has the highest incidence of injury of all climbing disciplines (Jones article).

Most Common Injuries

Because of the heavy demands placed on your upper body with climbing, overuse injuries occur most frequently in your upper extremities. Injuries to the hands and fingers account for more than 50% of all climbing injuries. Common finger injuries include pulley ruptures or tears, most commonly A2-A4 (see diagram below), particularly with crimps and sloper holds which can create pain, swelling, and a “bowstringing” of the flexor tendons impacting your ROM and strength with climbing (Jones article).

diagram showing pulley tear

Due to the direct forces in your fingers with a full crimp position, you can also impact ligaments and joint structures in your knuckles resulting in Swann neck and Boutonniere deformities seen below.

diagram showing swann neck and boutonniere deformities

Similarly, injuries impact the wrist (e.g. carpal tunnel syndrome or a sprain to your triangular fibrocartilage complex), elbow (flexor musculature tendinopathies), and shoulder (17% of all climbing injuries, most frequently a labral tear or subacromial impingement) (Sims article).

How Can Physical Therapy Help?

Whether you get your first climbing-related injury or are dealing with more chronic aches and pains, a physical therapist will likely be able to help you. They are experts in evaluating and treating musculoskeletal injuries and can provide invaluable insight into the underlying causes of the injury and appropriate rehabilitation strategies (including exercise, stretches, manual therapy, and a supervised progression to return to sport).

How Can I Prevent Injury?

While climbing movements and hold types vary, as the sport relies heavily on the latissimus dorsi, pectoralis major (for compression problems), and the wrist and finger flexors, this repetitive activity can create many musculoskeletal imbalances that contribute to an increased risk for overuse injury. Consequently, it is important to incorporate a comprehensive training program to rehabilitate from an injury, reduce the risk for injury or re-injury, and ultimately improve your climbing performance. A recent study of climbers found that a comprehensive training approach (involving understanding anatomy and mechanisms for tissue injury in conjunction with a training program focusing on flexibility and strengthening reduced the risk for a minor injury by 2.3x and up to 8x for a more severe injury (Kozin article).

  • Stiffness in the latissimus dorsi (lats) and pectoral muscles (pecs) can pull your shoulders forward and downward and can further flex your thoracic spine. This pattern limits your ability to reach overhead with appropriate mechanics and leads to compensations elsewhere increasing demands on your shoulder joint proximally or finger joints distally. Therefore, it is of the utmost importance to stretch your lats and pecs as well as to improve the mobility of your thoracic spine.
  • In addition to working on flexibility to allow greater ease for natural movement while climbing, strength work is equally as important. A particular focus on the scapular muscles (e.g. middle and lower trapezius, serratus anterior) will aid in the proximal stability and subsequent efficiency with reaching and pulling movements. Further strengthening should target the wrist and finger extensors as these muscles oppose the oft-overused flexor muscles and help to maintain the wrist in a neutral position while climbing (e.g. slight wrist extension). This neutral position places the flexor muscles in a more optimal position to generate force while gripping a hold.
  • Finally, focusing on your climbing technique can reduce the strain on your body and help you maximize the use of the strength and flexibility that you possess. Practice footwork drills and climb with the intention on your foot placement as it will help reduce the strain on your upper body by distributing forces throughout your body. Try to minimize a full crimp grip when possible as this places extra demands on the joints in the fingers and can place you at an increased risk for injury. An open-handed grip more evenly distributes forces between fingers and allows for a better transfer of force into your larger forearm and shoulder musculature (Fuss article). Consider varying the forces through your body by practicing on different types of problems that utilize different skill sets (e.g. overhang versus slab climbing).

If any of this sounds unfamiliar, or you are unsure where to start with a preventative program, we are here to help. Come stop by and see one of our physical therapists for advice on how to accomplish all these preventative tips. We are movement experts and injury prevention specialists after all.

Rock climbing is a challenging yet rewarding sport that is engaging physically and mentally for individuals of all ages and levels. By supplementing our typical climbing routine with the appropriate flexibility, strength training, and technical work we can spend less time recovering from an injury and more time on the wall.


  1. Fuss FK and Niegel G. Instrumented Climbing Holds and Dynamics of Sport Climbing. Engineering of Sport. 57-62.
  2. Jones G, Schöffl V, and Johnson MI. Incidence, Diagnosis, and Management of Injury in Sport Climbing and Bouldering: A Critical Review. Current Sports Medicine Reports. 2018: 17(11): 396-401.
  3. Kozin SV. Biomechanical technology of injury prevention in the training of specialists in physical education and sports. Health, Sport, Rehabilitation. 2021; 7(2): 65-76.
  4. Sims LA. Upper Extremity Injuries in Climbers: Diagnosis and Management. Journal of Hand Surgery. 2022; 47(5).

View by Month