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Rock climbing and bouldering are popular sports in Central Oregon. It’s no surprise since the birthplace of American sport climbing, Smith Rock State Park, is located just 30 miles north of Bend. In addition, there are many other outdoor and indoor options available for climbers of all abilities. While there is always a risk of falling or traumatic injury in this sport, avid climbers more frequently experience overuse injuries at some point in their climbing careers.

Shoulder Injuries 

Rotator cuff injuries are common for climbers because of the amount of time they spend with their arms overhead pulling up their body weight. The rotator cuff provides stability for the shoulder. It is comprised of tendons in the shoulder that attach to the humerus, as well as the four major muscles that surround the shoulder joint. A weak rotator cuff and/or poor biomechanics can contribute to a tear or tendonitis. Common symptoms include pain, weakness when lifting or lowering the arm, limited range of motion, and hearing clicking or popping sounds.     

Conservative treatment can be effective in treating tendonitis and small tears. This includes rest, ice, anti-inflammatory medications, corticosteroid injections, or physical therapy. If symptoms don’t go away or there is a large rotator cuff tear, surgery may be necessary to repair the tendon. 

Elbow Injuries

Tennis elbow, or lateral epicondylitis, is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. Because climbers use motions that include repetitive gripping and lifting, this is another common overuse injury. Symptoms include tenderness on the outside of the elbow, pain or weakness when using the affected elbow, and pain with resistance.

Most cases of tennis elbow can be resolved without surgery. Conservative treatment options include rest, ice, anti-inflammatory medications, bracing, or physical therapy. If symptoms do not improve over 6-12 months, your doctor may advise surgery to allow you to return to comfortable, normal activity.

Finger Injuries

Rock climbers use an excessive amount of force on their fingers, especially when a climber’s foot slips and their hand grip tightens. An A2 pulley strain is the most common finger injury for climbers and most often occurs in the ring or middle finger. Each finger has tendons and ligaments that helps the finger bend, move, and grip. This network of tendons and ligaments runs under a sheath called a pulley that helps hold them near the bones of the fingers. There are five pulleys on the palm side of every finger. The A2 pulley is located in the first finger segment (proximal phalanx) closest to the palm. The most common symptom is hearing or feeling a pop in the finger while pulling down, followed by pain, bruising, swelling, and difficulty forming a fist. Injuries can range from a mild sprain or a complete tear. Rest, ice, splinting, and physical therapy are common treatment options. After the pulley heals, most people use tape on that finger to provide additional support when climbing.

The flexor tendons that run underneath the pulleys can also tear or stretch when climbing. When a flexor tendon tear occurs, pain is felt between the palm and the wrist, as well as tenderness, numbness, and an inability to bend one or more joints in the finger. Surgery is often necessary to repair complete tendon tears.

Collateral ligament strains usually occur with sideways loading, such as when you are throwing one hand out to a hold with the other. It most commonly occurs in the middle joint of the middle finger. The collateral ligaments surround each finger joint. Symptoms include pain, swelling, and tenderness at one or both sides of the finger joint. Treatment for this type of strain is usually nonsurgical and includes rest, ice, anti-inflammatories, and taping the finger for support.

Trigger finger is a common overuse injury that occurs when the flexor tendon becomes irritated and begins to thicken, eventually creating nodules that make it difficult for the joint to bend and straighten. If symptoms are mild, your doctor may suggest resting the finger or placing it in a custom splint. If there is pain and discomfort, taking a non-steroidal anti-inflammatory medication or injecting the area with corticosteroid can be effective. If pain does not subside after conservative treatment, surgery may be recommended.

Wrist Injuries

The most common wrist injury in climbers occurs when there is damage to the triangular fibrocartilage complex (TFCC). This is a cartilage structure located on the pinky side of the wrist that sits between the end of the ulna (forearm bone) and the carpal bones of the wrist. It provides stability and support when the hand grasps or the arm rotates. When a climber feels the onset of wrist pain and continues to climb, the TFCC can degenerate and even tear. Symptoms include a dull, achy pain on the side of the wrist and sometimes a sharp pain is felt when bending the hand toward the pinky finger. When diagnosed early, rest, anti-inflammatory medication, and using a splint can typically heal the injury. After the TFCC heals, taping the wrist while climbing can help provide additional stability and support, as well as prevent re-injury. In more severe cases, surgery is necessary to remove the damaged tissue and clean off the torn edges; this is also known as debriding. Recovery from this procedure includes wearing a cast for several weeks followed by physical therapy to regain range of motion and strength.