What is the most common injury in rock climbing?

Rock climbing has gained significant traction as a sport that rigorously challenges both physical and mental faculties. Whether it be navigating outdoor cliff faces or engaging in team-building sessions at indoor bouldering facilities, participants must exhibit strength, agility, and concentration. However, akin to any athletic pursuit or physically demanding endeavour, rock climbing inherently carries the risk of injury.

Common climbing injuries include shoulder injuries, wrist and elbow injuries, as well as scrapes, bruises and the occasional broken bone from losing grip or position during a climb. Among the array of potential injuries climbers may encounter, there is one injury that stands out.

What is the most common injury in rock climbing?

The notorious “climber’s finger” stands out as one of the most prevalent and potentially debilitating injuries in rock climbing.


What is ‘climbers finger?’

Climber’s finger, also known as a pulley injury, refers to damage to the A2 or A4 pulley in the finger. These pulleys are crucial in maintaining tendon alignment and stability, particularly during gripping motions.

Image 1: Finger pulley anatomy – Image on the left shows a partial rupture of the A2 annular pulley. The image on the right shows a full rupture of the A2 annular pulley.

Studies show that the A2 and A4 pulleys are not as deformable and lack the elasticity that the other pulleys (A1, A3 and A5) have. The A2 and A4 pulleys are therefore more prone to getting injured.

Climbers subject these tendons to tremendous stress, especially when performing dynamic movements or holding onto small holds with a crimp grip. Vigouroux et al. (2006) compared the load of an open grip to a crimp grip and found that a closed crimp grip caused an increase of force on the A2 and A4 pulley 31.5 and 3.9 times respectively. 


How do you treat a climbers finger injury? 

If you suspect you have this injury, here’s a general range of options to answer ‘how do you treat a climbers finger injury?’ The following treatment options would be relevant at different stages during injury recovery. Seeking professional medical attention, and individual advice for your own situation is important for the best recovery.

Prompt treatment is crucial in the event of a pulley injury to facilitate healing and minimise complications. The cornerstone of conservative management for an acute pulley injury (both pre and post-surgery) lies in protecting the pulley and promoting proper healing. 

  • Rest: Avoid climbing and heavy activities.

  • Ice: Apply ice packs for 15-20 mins, several times a day.

  • Compression: Use a bandage to reduce swelling.

  • Elevation: Keep the finger elevated above heart level.

  • Pain Relief: Take over-the-counter pain relievers if required 

  • Immobilisation: Splint or buddy tape the finger.

  • Physical Therapy: Gradually introduce gentle exercises.

  • Return to Activity: Start climbing gradually.

  • Medical Attention: Seek help for severe or persistent pain.

Do I need to see a Physio for a climbers finger injury?

Depending on the severity of your injury, you may need a review by a surgeon, seek splinting from a hand-specialist Occupational Therapist, or complete rehabilitation under the guidance of a Physiotherapist, with an interest in rock-climbing.

Physiotherapy treatment for a climbers finger injury would include a range of different techniques including:

  • Taping or splinting with a pulley ring

  • Dry needling

  • Manual therapy

  • Ergonomic advice

  • Education on preventing recurrences and self management techniques

  • Rehabilitation exercises working towards optimal performance back into rock climbing 

In the instance of a more severe grade 5 strain, surgical intervention may become necessary.



 What should I do if I have a climbers finger injury?

If you’re a climber with a current injury, be sure to find a Physiotherapist who has an interest in climbing injuries, so you can have the support of someone with knowledge of your sport, to guide your recovery. Physio Micaela is an avid climber, and consults at our Glenelg clinic 5 days per week.

Book to see Micaela using the ‘Book Now’ button if you have a current climbing injury.