How to prevent hand and wrist injuries when rock climbing

I am a chiropractor and rock climbing is something I have always wanted to try. Unfortunately, living in Florida doesn’t give me many options besides an indoor gym. So I headed to a local indoor climbing gym. As I started to put on the climbing harness, my heart started pounding and my hands started sweating. The carabiner was then attached to my harness and the rope was pulled tight. It was time to climb.

I could hear my kids below cheering me on with words of encouragement: “You’re only 25% of the way there, it’s easy, I made it up, don’t look down.” It felt like he had been climbing for several minutes, though I’m sure only a few seconds had passed. My forearms were already on fire. My fingers ached from the grip. Every muscle in my body was tense. I paused. I took a deep breath and said a few words of encouragement to myself: “Don’t stop, take your time, it will be great!” My experience soon ended when I lunged at an overhead climbing handhold that extended to the right. Instantly, the safety rope tightened, tightening my harness. I heard a voice below yell “Relax, lay back, kick the wall, I got you.” I only got halfway there, but I was excited and determined to go further next time. My son was next and he maneuvered himself to the top like a little braggart.

So what gave me the idea to climb? I am a hand and foot chiropractor and several weeks earlier began treating a patient who injured her wrist while climbing. As I mentioned, I wanted to try rock climbing, so next weekend off I gave it a try.

Rock climbing has become an increasingly popular sport with indoor climbing gyms popping up everywhere. Although a small percentage of my patient population with wrist injuries were actually injured while climbing, I have seen several patients since my first climbing experience described above, which was several years ago.

The sport is very demanding providing great strengthening and cardiovascular training. It is generally a safe sport, but injuries often occur from falls or overuse injuries. Data in the literature varied with exact percentages, although it’s safe to say that less than 20 percent were from falls and about 80 percent from overuse. The upper extremities (arms) had a much higher percentage of overuse injuries than the lower extremities (legs). Fingers make up the highest percentage of injuries at 40 percent of all injuries. The shoulder accounts for 16 percent, the elbows 12 percent, the knees 5 percent, the lower back 5 percent, and the wrists 4 percent. (1) Other data indicates that Carpal Tunnel Syndrome is very common in climbers. Up to 25 percent of climbers. (two)

These injuries typically cause damage to tendons, ligaments, joint capsules, muscles, and, rarely, bone fractures. The most common injury is climber’s finger, which is caused by damage to the flexor tendon pulley. (2) The crimp grip is the culprit. This is when the grip consists of a nearly 90-degree flexion of the middle finger, which places an enormous amount of force loading on the tendon.

So how are injuries prevented? One of the most important things to do is warm up. Not only the large muscle groups, but especially the fingers, hands and wrists. Open and close your hands for about a minute. Then open and close your fingers for about a minute. Then extend your arms in front of you shoulder-width apart with your palms facing up. Flip your hands palm down and then back palm up. Repeat for 30 seconds. This warms the elbows and shoulders as well. Next, place your palms together in a prayer position around the middle of your chest. Extended elbows by your side. Pull your hands down until your wrists are about 90 degrees relative to your forearm. Hold the position for 15 seconds and then relax, repeating about 5 times.

Also make sure you know your knots and climb with someone experienced in belaying. Include strength training to work your forearm and hand muscles. This can be done by taking a 12-inch round stick. Punch a hole in it and slip an 18-inch rope through it. Next, tie a large knot in one end of the rope so it doesn’t slip through the hole. The other end of the rope has a weight of 1 to 2 pounds. The amount of the weight will adjust as the force increases. Next, grab the ends of the stick with both hands and hold it in front of you. Start wrapping the rope around the stick by turning your wrists until the weight is completely wrapped. Then lower the weight by twisting the stick in the opposite direction. Repeat 5 times. Fingers can be strengthened with a simple gripping exercise.

Lastly, avoid overstretching, overexerting yourself, use good judgment, and most importantly, know your limitations. Climbing can be a fun and safe sport if you follow these steps. If you develop an injury to your hand, wrist, elbow, or shoulder, see a chiropractor who has specialized training in the hands and wrist. Have a great and safe time climbing.

References:

1) Doran, DA; King, M. (2000). “Injuries and associated characteristics of training and performance in recreational climbers.“. The Science of Rock Climbing and Mountaineering (A Collection of Scientific Papers). Human Kinetics Publishing.

two). Preston, Dayton. “Rock Climbing Reaching New Heights”. Hughston Health Alert. Retrieved January 11, 2011.