In recent years climbing has exploded in popularity. Even with a lack of outdoor climbing in NYC, indoor climbing gyms are popping up everywhere. With all things considered, climbing is still considered a new sport. The first indoor climbing gym in the US was opened in 1987, which consisted of rocks glued to plywood panels and cinder block walls. To think how far the indoor climbing world has come in just 38 years! Data taken in 2021 showed that there are approximately 10.3 million people who participate in climbing activities in the US. From 2021 to 2024 the number of climbing gyms in the US rose from 591 to 870. It’s very obvious that the sport is growing rapidly, in part thanks to the sport being in both the Tokyo and Paris Olympics. But why does this all matter? As a Physical Therapy clinic we know a thing or two about injuries, and climbing is a sport that is no stranger in this department. While generally speaking climbing has lower injury rates than other popular sports, there are few studies that have gathered data on climbing injury incidence. While few climbers have tales of serious injury, you will be hard pressed to find a climber who hasn’t “tweaked” a finger, or isn’t climbing through a painful wrist or elbow. With the rise of popularity, we are seeing more clients walk through our door with climbing related injuries. Our goal is to give you a guide on how to set yourself up for success and stay injury free in the climbing gym! Whether you are new to climbing or a regular crusher, we aim to provide valuable insight to help you safely climb, and stay healthy so you can climb on!

Indoor climbing typically consists of three disciplines: bouldering, top rope, and sport climbing (aka lead climbing). Bouldering gyms are the most common climbing gyms in New York City, however there are still many gyms that have rope climbing. Bouldering consists of no ropes, shorter walls, and thicker pads for falling. Top rope consists of a fixed static rope that is anchored, and requires a belayer (someone managing the rope), and a climber. Lead/sport climbing consists of a belay and climber, however the rope is not prefixed to an anchor at the top. The climber must clip the rope into fixed quick draws that are typically 3-5 feet apart until reaching the anchors. Each has a unique challenge that requires different skills. Bouldering consists of shorter routes that require more power and strength. Top rope and lead climbing are typically 30-60 feet (indoors at least), and challenge your endurance. All three styles have much overlap, and climbers must be able to do hard moves while tired. Climbing is a physically demanding full body sport with an endless amount of movement variability. This poses a challenge, as it is hard to train for all of these characteristics that will help you improve. The answer for many climbers: train more or train harder. While it may seem obvious that spending more time doing a skill will lead to improvement, this logic can easily lead to overuse or acute injuries. 

Fingers account for the most climbing related injuries and that is no secret as you are almost always using your fingers to some capacity while climbing. One of the reasons we see so many finger injuries is due to this repeated stress. Regardless of how long you have been climbing, when you increase training volume or intensity, you are more likely to overload a muscle or tendon. This goes for any sport. So why does this matter and how is this helping you if you already have a nagging finger that is only getting worse? Well, let’s talk about it. 

Warm ups: 

Let’s talk warm ups. Everyone knows you should be doing a warm up, yet there are so many climbers who just throw themselves at the wall as soon as they walk in the gym. The key principles of a warm up are universal across all sports. The RAMP protocol is an effective and efficient way to ensure you are ready to participate in most sports. The R stands for raise, which entails raising your body temperature and heart rate. This could be as simple as getting on a bike for 2-3 minutes, doing jumping jacks, jogging, etc. The A stands for activate, which entails getting the muscles that you will be using warmed up. For climbing, we recommend warming up your fingers/forearms, shoulders, core and legs. A simple way to warm up your fingers is to find a hangboard, keep both feet on the ground, and lightly pull and hold. You can progressively increase the time or intensity. Single leg bridges, plank variations, and bands or cables are great options for warming up other muscles you’re likely to use. M stands for mobilize, which consists of going through ranges that your joints are likely to experience while climbing. Here you want to focus on mobility exercises for the shoulders in overhead positions and the hips. Finally we have P, which stands for potentiate. This is where you perform drills or do movements that mimic the demands of the activity you are doing. For climbing, this will likely be doing very easy warm up climbs. Here you want to think about doing easy climbs with different holds. Each option has overlap, but once you find exercises that check these boxes, you should be getting on the wall climbing in no more than 10 minutes. 

Managing Volume/Load:

Now that we have covered some general warm up considerations, let’s talk about training and climbing volume/frequency. For beginners, you want to slowly ease into climbing. Muscles and tendons take months to adapt, and often the climber will gain skills and progress faster than your tissues can adapt. The harder the climbing, the more exposed you are to high loads on the finger tendons and ligaments. To avoid this, you want to think of climbing as something you have to build tolerance to. A great strategy is to limit the amount of sessions per week. You can also limit the amount of climbing done each session if you want to climb more often. Another great strategy is to not climb consecutive days. This gives us more time to recover and be fresh for our next session. For more advanced climbers, you can use the same principles, however experienced climbers have likely already made adaptations to allow them to climb more. For those dealing with nagging finger or hand pain, reducing sessions frequency, duration, or intensity can be helpful for managing symptoms. It should be noted that you should consult with a medical professional to find an individualized rehab plan if you are dealing with an injury. Luckily, we can help with these things by clicking here. 

In summary: managing volume and intensity, especially for beginners, is super important for staying healthy. 

Climbing Modifications: 

While our goal is to climb pain free, we understand that little injuries pop up, and it’s important to not ignore these things. In order to keep climbing while working through an injury, there are modifications you can make. As we touched on, proper warm ups and managing climbing volume and intensity are viable options. We can also consider different holds, routes, or types of climbing to keep you on the wall. There are many different types of holds including but not exclusive to pinches, crimps, jugs, pockets and slopers. If you are working through injuries, especially hand/wrist/finger, it is important to identify which holds are typically provocative. You can selectively choose routes that don’t have those holds, or try to find other ways around using those holds. Another great option for boulders is to add in some rope climbing. This is typically lower in the intensity department, which could be helpful for reducing high level stressors to your injury. Finally, think about footwork. Using your legs is a great way to reduce stress on your fingers, and can help to improve climbing efficiency. Try focusing on routes with good foot holds, or focus on finding footholds before handholds. 

Hangboards:

One of the most controversial topics in the climbing world is hangboarding. Many professional climbers use them, and yet it is common to hear that they are dangerous. The reality is hangboarding can be an absolutely great way to train finger strength or endurance, and even reduce the risk of injury. This is not always the case, as many climbers will do an intense climbing session, then finish the session with hangboarding. This would be the equivalent of trying to set a 5k run personal best immediately after running a half marathon. Hangboarding is best as a separate entity, or before a climbing session. It can be safe for new climbers, however new climbers should start with bigger edges and consider doing lower reps and sets to progressively build tolerance. 

Strength training: 

If you haven’t realized from our previous blog on strength training for runners, or our constant instagram stories, we absolutely love strength training. We can’t think of a sport that wouldn’t benefit from strength training. Set aside potential performance improvements, and you are left with the ability to create stronger, more resilient tissues. This provides us with a support system to better handle the demands of our sports and activities, whatever that might be. Rock climbing is no different, and for many, strength training can be the low hanging fruit to help keep them healthy and make improvements on the wall. We recommend picking a few big compound movements like deadlifts, landmine press, rows, squats, etc, and doing 3-5 sets of 2-5 reps 2-3x/week. Because climbing is a full body sport, training any big muscle group with these principles can be beneficial. It should also be noted that it does not (and nor should it) look like or mimic climbing to help you with climbing. Sure, weighted pull ups are a great exercise for climbers, but so are bent over rows. Think about strength training as a way to keep climbing hard, with an added bonus that you might see some carryover to climbing performance. The more injury free you can stay, the more you can progress and keep enjoying the sport of climbing. 

Other considerations: ankles and falls

While this blog is focused more on injury reduction tips for fingers and hands, there are a high amount of ankle and lower extremity injuries as well. Ankle injuries in particular, are common in bouldering as there is no rope to catch you, but can also occur with top rope/lead climbing as you can pendulum into the wall during a fall. When it comes to falling, there is only so much you can control, but having a plan and understanding what not to do is a great start. First, you should always examine the route and perform a risk assessment. Ask yourself “where am I likely to fall, what is underneath me, and what are the potential consequences”. Oftentimes the risk to reward ratio is not worth it, especially when there are hard moves at the top of a boulder. Fear can certainly hold you back, however you should still acknowledge the risk of each climb and determine if you are comfortable proceeding. Because falling is inevitable, there are a few things you can do to mitigate risk of more serious injury. The first one is never extend your leg or arm to break the fall. This is a recipe for a fracture, so please, don’t do this. The goal of falling is soft landings. If you are unsure how to properly land, please ask the staff at your local gym as their goal is to help maintain the safety of climbers. Another consideration is bailing. There are always down climb holds, which are very good holds that are sprinkled next to climbs. This allows climbers to have an easy exit strategy if they want to bail, or once they get to the top of the route. While a victory jump looks cool, the better option is to climb a bit lower (or all the way down). 

Final Thoughts:

We know that regardless of how methodical or careful you are with training, climbing, falling and all the factors that can help reduce injury, we can never definitively prevent injuries. Our goal for this blog is to educate climbers on strategies to reduce injury risk, and give some tips on how to keep climbing even with a few tweaks. Regardless of severity of injury, you should always consult with a medical provider and understand that this blog does not serve as medical advice. We are by no means recommending anyone to climb through pain, we just understand that it is common practice for climbers to do so. In summary, we want to engage in a proper warmup, properly manage climbing volume, and think about making modifications to intensity, volume, frequency or types of climbs to keep climbing. Adding in strength training is a great way to supplement climbing, and hangboard can also be a great way to build healthy strong fingers (when done correctly). From beginner climbers to experienced senders, remember that climbing is meant to be fun. Climb on!

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