New in town? Injury risk reduction 101 for boulderers

I recently took a friend bouldering in Melbourne for the first time. They only had a short period of time to spend at the gym, so when they asked me what they needed to be aware of, I tried to come up with my shortlist of efficiency and injury prevention techniques. As a climbing physio, I'd happily ramble on for hours about managing load, tendon health, taking care of your skin, being aware of movement patterns and variability, shoulders, elbows, finger health and adaptation, psychology of climbing, etc etc etc... but what to cover in 30 minutes with someone who hasn't encountered rock climbing before?

Here is my prioritised list:

1.  'Straight arms' is a relative term
Yes, climbing with straight arms majority of the time is energy efficient. Give it a go if you haven't - your biceps will be thankful! Staying low over your feet also gives you more space and ability to plan your footwork and movement. However, in the clinic I see a lot of people who spend a lot of time hanging their entire body weight off their hands. While our soft tissue and bony structures adapt to climbing (particularly forearm muscles and finger flexor systems - see Schreiber, Allenspach, Seifert & Schweizer, 2015; Schoffl, Hochholzer & Imhoff, 2004), hanging like a sack of potatoes on joints at the end of their available range of movement (e.g. elbows, shoulders, wrists and hands) with little muscular support or activation is a surefire way to place extra load on passive joint structures such as ligaments. Over time, this may predispose to excessive joint movement or true joint instability, increasing demand on the neuromuscular system in these ranges. 

To avoid this, climb on relatively straight arms but think of having active shoulders or hands. This can alter your movement pattern and cause a little more muscle activity in a slightly less end-of-range joint position - win-win! Active shoulders would encompass cues such as climbing with an open chest, a long spine, and/or shoulder blades gently sliding back around your ribs towards your spine - all aiming to encourage lower trapezius and rotator cuff muscle activation. Active hands means gently curving your palm inward on itself, as if you were holding a balloon and gently tried to push your fingertips inwards without curling your fingers. Either of these two cues, or a combination of both, can promote increased neuromuscular activation of the entire arm, without wasting energy through large, fast-twitch muscle fiber recruitment.


2. Think feet
Picture someone banging and crashing their way around the wall. This can signify a lack of  sequence planning, forgetting looking at foot placements, and a general lack of consideration for what the major muscle groups of the body are doing - the legs! If we talk biomechanics for a minute (indulge me), the foot is the point of contact with the wall from which a line of force, or force vector, will be generated, causing movement of the body's center of gravity (which is about where your sacrum is) in the direction of that line of force. Therefore, footwork is critical in achieving the desired outcome of a move - reaching the next hold! Different styles of climbing call for different styles of footwork, but as a general rule, think of your foot generating that force vector, and align your foot along that vector. Often this involves learning to use the outer edges of the toe box of a climbing shoe. Other ways to optimise use of your feet might include toe and heel hooks, smearing, etc etc - all discussed beautifully here and here.

Using your feet well sets you up for success in using those legs. We get so much power, strength and endurance from them - it just makes sense to capitalise on what our legs can do in order to conserve precious upper body endurance and strength.
If you notice yourself banging your feet, try looking at each foothold before or as you place your foot. Quiet feet go hand in hand with precision feet and more considered climbing.


3. Get twisty!
Take the time to explore the effect of different body positions. Frogs don't climb vertical cliffs very well - but learn to turn your hips and shoulders in different directions and you might find a whole new universe of movement options opens up.

Having a hip close to the wall will increase your capacity to stretch up through that side of your body, maximising your reach.


Learning to control your center of gravity in a static (still) and dynamic (moving) manner will lead to better technique and ability, increased awareness of your preferred climbing styles and where you might need to brush up on skills, and reducing likelihood of injury - my favourite! Moving in a controlled manner allows you to prepare for loading a body part, i.e. placing your bodyweight on a hand or foot without sudden, unexpected movements. We know that falls are the highest cause of injury in climbing, closely followed by overuse injuries - learn how to control the movement of your center of gravity, and you can decrease the risk of both.

 

4. Take your time
Rock climbing is exciting. Really exciting. It's sometimes hard to keep the stoke/psych/excitement at a manageable and sensible level. I'm 100% guilty as charged and have been known to employ my own Stoke Police when returning to climbing after an injury. However, we know that tissue adaptation takes time. Nobody started running one day and won the Olympic marathon a week later - no difference here. It takes a minimum of around 36 hours for your tendons alone to fully recover and adapt to one session of loading or training (Magnusson, Langberg & Kjaer, 2010), so allow yourself at least one rest day between climbing sessions as you start out. Learning to listen to your body is a hard task, but being sensible and actually stopping when you feel it is probably in your best interest is really important. Better to mix up your training or speak to someone about niggles than it is to push through and end up injured and off the wall.

5. Vary your grip positions
It's really tempting when first starting out to rely on a crimp grip position. It's a position that gives us a sense of strength on a hold, but it has also been shown to stress certain finger structures more than they may be designed for. It's unwise to rely on a full crimp position, and learning other options will make you a more versatile climber. Add in variety on each climb you do - explore each hold, and work out how your hand can conform to its shape. An 'open' grip ensures happier fingers than a crimp grip, and also helps you to develop strength in muscles other than the big forearm and finger flexors.


crimppng
a) Open hand grip - get comfortable with this one! b) Half-crimp - not great for fingers c) Full crimp - use only when necessary (NB: this is less often than you think)! Source



References:

Magnusson, S.P., Langberg, H., & Kjaer, M. (2010). The pathogenesis of tendinopathy:
 balancing the response to loading. Nature Reviews. Rheumatology, 6(5), 262 - 268.
 doi: 10.1038/nrrheum.2010.43.

Schreiber, T., Allenspach, P., Seifert, B., & Schweizer, A. (2015). Connective tissue
 adaptations in the fingers of performance sport climbers. European Journal of
 Sport Science, 15
(8), 696 - 702, doi: 10.1080/17461391.2015.1048747

Schoffl, V., Hochholzer, T., & Imhoff, A. (2004). Radiographic changes in the hands  
 and fingers of young, high-level climbers. The American Journal of Sports
 Medicine, 32
(7), 1688 - 1694, doi: 10.1177/0363546503262805.