Climbing is a relatively natural endeavor for human beings as our bodies evolved directly from apes, who are more than at home swinging from high branches. But perhaps we have strayed enough from that physiology and activity over time to sometimes develop problems when climbing at a high level continually. And of course, there is always the possibility of a sudden onset injury caused by slipping off a hold, bouncing off the wall or falling to the deck. I would like to briefly discuss how and why both types of injuries occur, how to prevent them and how to recover from some typical climbing injuries. I must stress that I am not a doctor, nor should this post be considered an adequate substitute for professional medical consultation.
Since we all started climbing, we have more than likely not avoided some late onset muscle pain after a workout as our muscles repair themselves or some tenderness in the joints from high tension and impact. Muscle soreness is typical after pushing physical limits and should not be ignored. If you are exceedingly sore after a workout, eat well and drink plenty of water. Rest until the soreness subsides and warm up thoroughly before your next workout. Avoid anti-inflammatory medications unless you have trouble performing your work or sleeping during your post-workout muscle recovery because these types of medications can sometimes slow or inhibit the repair of muscles and other soft tissue. Along with muscle soreness, mild to severe tendonitis is a common cause of pain among climbers, especially in the shoulders and elbows. Tendonitis is a soreness of tissues surrounding tendons and ligaments which connect muscle to bone. These structures take longer to heal than muscle and can become over-stressed very quickly, especially if you are already relatively strong in the major muscle groups. If tendonitis becomes an issue, rest at least until the pain subsides and try to eat vitamin rich foods, as well as periodically icing the affected areas. Taking anti-inflammatory medication is sometimes necessary to help muscles relax and allow tendonitis soreness to subside. Static stretching, manual massage, plyometric tension (purposeful tensing and flexing of muscles in the affected area) and opposition workouts (pushups, dips, planks, overhead press, etc.) may all be effective in treating mild to moderate tendonitis. Severe tendonitis may have other underlying causes and may require the advice of a medical professional in how to proceed with treatment.
The skin is another cause of overuse pain in climbers. This could be because it's our first gym session and the skin needs time to toughen up or maybe because we spent the last five days in a world-class destination and we climbed our little hearts out. Anyway, there are a few things climbers should do (or not do) when it comes to our skin. The first thing is to use enough chalk but not too much. Chalk protects skin from abrasion and adds friction so we slip less and give up less skin to the plastic or rock. But too much of it can over-dry our skin, leaving it cracked or even so damaged it may bleed. The best habits to get and keep good climbing skin are to avoid hot and soapy water and avoiding water based moisturizers. Both of these things will break the skin down and remove too much dead skin which toughens into callouses and allows us to grip harder on sharper holds. If you need to repair your skin when it's dry, use a beeswax based moisturizer like Burt's Bees Farmer's Friend in moderation. Always wash your hands thoroughly with cool water before climbing to remove dirt and oils and also after climbing to remove chalk. After particularly rough sessions when your hands feel hot and sore, use a small amount of beeswax moisturizer as well. Keep your fingernails trimmed and also trim or sand down callouses that become too large. Keeping good skin is important to climbing hard!
Now that we have covered some of the most common causes of long-term pain and how to treat them we can investigate how and why some acute injuries may happen in climbing. These types of injuries are often more severe and sometimes catastrophic. Preventing these kinds of injuries is the easiest way to stay climbing harder and longer.
One of the most common acute injuries in climbing is a finger pulley rupture or tear. You may have heard one climber or another talk about hearing a loud "pop" as they crimp a nasty hold or "snap" off the slippery hold at peak tension, or maybe their foot pops off and their hands bear all their weight. This kind of event is sometimes called a "blow-out"; it's basically a spontaneous fall that you didn't expect and subsequently something you were holding on with got really stressed out, like your fingers. When this happens, the damage can be virtually none at all, straight up to a full pulley rupture or muscle tear. In any case, the best way to treat this injury is to never have it! That means only grabbing crimps with an open hand and avoiding full crimping at all costs while maintaining superb form and footwork, putting as little stress on your hands as possible. Always warm up properly and recruit strength from your hands in a gradually increasing way until you are confident you can pull on that little credit card without popping off! If you do experience a pulley injury, seek professional medical treatment, as this kind of injury typically requires surgery, physical therapy, or both to properly treat.
Other catastrophic injuries mostly occur when bouldering or roping and a climber falls directly to the ground or rocks below. The best way to prevent these kinds of injuries is obviously to protect your boulder problems with multiple quality pads, have attentive spotters and only attempt movements and problems that you are confident with! This category is a no-brainer: just be safe!
But this type of injury can occur even without a fall! I know from experience that getting your back really strong without strengthening your shoulders and chest is a recipe for a dislocated shoulder. By performing movement that requires compression tension, like reaching around an arete and squeezing, the back muscles can over engage and actually push the shoulder right out of the socket, effectively dislocating your own shoulder! I did it last year and boy was it a surprise. Thankfully, not much major damage was done because it was a partial subluxation which reversed once I relaxed my muscles. Still, my shoulder is not the same and I always need to remain vigilant to strengthen the shoulder and chest structures to keep the joint stabilized. This means doing pushups, dips and other opposition exercises regularly. I also try to avoid movement that stresses my shoulder in the same way it got injured and warm up properly and fully understand the movement before I decide to try it. Recovery for that particular injury is still ongoing and will probably affect my climbing indefinitely. Avoidance of this type of situation is key!
Of course, one can be on the "sharp-end" and take a nasty whipper and come screaming back to the wall and get bruised and scraped up along the way. Slab climbing is notoriously difficult as most falls will put you right into the rock below! The best way to prevent injuries when climbing in these situations is to understand the rope dynamics and to be aware of the location and timing of a possible fall, as well as communicating with your belayer so that they may mitigate your fall in the best possible way. The worst lead climbing injuries can usually be avoided by placing gear properly and at even intervals, orienting carabiners properly, managing rope drag and direction and anticipating falls. Never run headlong into a trad or sport lead without having a good idea of what's going to happen up there; it could be your life!
Climbing can be great fun but can be risky. We all need to do our part to help reduce risk for ourselves and others when we climb. Whether it's a day out bouldering, top roping, sport leading or tradding, always let someone know where you are and when you plan to be back. Keep handy a cell phone or two way radio and a whistle to signal for help. Always understand as much as possible about your climbing trip before embarking; this is called getting the beta. Talking with friends from the gym or others you might meet at the crag will help you understand what it takes to stay safe and have fun when climbing outdoors or even pushing your level in the gym. Resting is necessary! Listen to your body and understand what is good pain and what is bad pain. As your climbing progresses, avoiding and assessing injury will become exponentially more important. Stay aware and always have fun!