A recent trend I have observed in my practice is that I am treating more and more rock climbers. Just in the last year, I have worked with climbers with various shoulder injuries, low back pain, and biceps/elbow strains.
As a climber myself, I am also acutely aware of the risk of repetitive strain and more traumatic injuries with such a sport. I have dealt with both biceps/brachialis strains, and low back pain due to poor core control/latissimus dorsi tension.
With the nature of climbing being so physically exhaustive, it can challenge strength, endurance, and place extreme load on less-often utilized connective tissues. Due to these factors, it has been found that most injuries are sprains and strains due to “repetitive overuse” (1). Some of the most common sprains and strains are to wrist flexor and extensor tendons (and their associated pulley-system), the biceps and other smaller muscles as they get pinched at the shoulder, the hamstrings, and various ligaments at the fingers and knees (2, 3).
The role of physiotherapy with these sorts of soft-tissue injuries is a significant and effective one (4, 5). Appropriate stretching, strengthening, manual therapy, taping and other interventions will aid in a quicker recovery and lasting injury prevention. Also, a specific stretching and strengthening program can be helpful in avoiding the above-listed injuries to begin with (2).
The following is a climbing-specific injury-prevention stretching and strengthening regimen:
Latissimus Dorsi Stretch:
On all fours, bring the buttocks onto (or as close as you can) your heels and lengthen one arm (palm up) in front and a little bit toward the inside as far as possible without moving the buttocks.
Keep the head down and aligned with the spine. Hold 1-2 minutes per side.
Sit on a firm surface, one leg extended and the other on the floor. Place a small pillow or rolled towel under your knee and while keeping your back straight, gently lean forward. Hold the position when you feel a comfortable stretch behind your thigh (ensure no pain/pull into calf muscle). Hold 1-2 minutes per side.
Lie on your back and move to the side of the bed. With your elbow straight and palm facing the floor, place your arm over the edge of the bed. Relax your arm (yet keep shoulder blade positioned against bed) and allow it to drop towards the floor until you feel a stretch across the front of your shoulder and upper arm. Hold 1 minute and do 2-3 times per side.
Stand up in front of an open doorway. Place your forearm along the wall. Lean your body forward until you feel a stretch across your chest and the front of your arm.
To emphasize the upper chest, place the arm lower than horizontal, to stretch more the middle portion, place the arm perpendicular and to stretch the lower portion, place the arm higher than parallel. Hold 1 minute and do 2-3 times per side.
Wrist Extensor Stretch:
Extend one arm out in front with the elbow straight. Use the other hand to grasp it at the side of the thumb and bend the wrist downward. Turn wrist towards the small finger to increase the stretch. Hold 1 minute and do 2-3 times per side.
Wrist Flexor Stretch:
Sit up straight and look directly ahead of you. Use one hand to spread apart and straighten the fingers of the other hand and then stretch your wrist back gently as far as you can. Relax your hands. Apply the pressure through the tips of the fingers and be sure to include the thumb. Do not apply pressure to the palm of the hand. Hold 1 minute and do 2-3 times per side.
Start in all fours, then prop yourself up on your forearms and toes, with your chin tucked in. Lift up your body, creating a straight line with your body. Maintain the position without arching the lower back. Perform 2 sets of 5 repetitions beginning at 30 second holds. Can progress sets, repetitions and holds from here.
Lie on your back with your knees bent and an elastic tied around your lower thighs. Lift your pelvis up until you reach a neutral spine position (i.e. don’t arch your back). Keep feet and knees hip width apart during exercise. Feel your bum (glute) muscles fatigue while you perform this exercise. Perform 2 sets of 10 repetitions beginning at 10 second holds. Can progress sets, repetitions and holds from here.
Stand and tie an elastic in front of you at waist level. Hold tightly both ends of the elastic in both hands. Your elbows are slightly flexed. Keeping the elbows locked, shoulders down and torso stable, pull the elastic backwards as far as possible by joining your shoulder blades together and your arms back. Slowly return to the initial position and repeat. Perform 2 sets of 10 repetitions beginning at 10 second holds. Can progress sets, repetitions and holds from here.
Resisted External Rotation:
Anchor a resistance band at elbow height at your side and place a rolled towel between your arm and body. Keeping your elbow on the towel roll, rotate your arm out against the resistance of the band. Make sure your elbow does not come away from your body. Return and repeat. Keep the elbow bent 90°. Perform 2 sets of 10 repetitions beginning at 10 second holds. Can progress sets, repetitions and holds from here.
To reiterate, these exercises form an evidence-informed program designed specifically to prevent common injuries noted in rock climbers of all demographics. If you have any actual injuries please be sure to see a physiotherapist but in the meantime this may be the key to help you keep climbing!
- Emery CA, Kang J, McKay CD, Meeuwisse WH, Woollings KY. Incidence, mechanism and risk factors for injury in youth rock climbers. British Journal of Sports Medicine. 2015; 49: 44-50.
- Jebson PJL, Steyers CM. Hand Injuries in Rock Climbing - Reaching the Right Treatment. The Physician and Sports Medicine. 1997; 25-5: 54-63.
- Corry IS, Hanratty B, Thompson RN. "Heel Hook" Rock-Climbing Maneuver: A Specific Pattern of Knee Injury. Clinical Journal of Sport Medicine. 2011; 21-4: 365-8.
- Côté P, Piper S, Shearer HM, et al. The effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities: A systematic review by the Ontario Protocol for Traffic Injury management (OPTIMa) collaboration. Manual Therapy. August 2015.
- Goad CL, Long BC, Mohr AR. Effect of Foam-Rolling and Static Stretching on Passive Hip-Flexion Range of Motion. Journal of Sport Rehabilitation. 2014: 23; 296-99.
- Pictures and exercise descriptions linked from: PhysioTec. www.physiotec.ca. Accessed Sept. 13, 2015.