Risk Factors for Overuse Injuries in Climbers: Evidence-Based Prevention
With climbing's growing popularity, understanding what causes injuries—and how to prevent them—has never been more important. A comprehensive systematic review of 34 studies has identified the key risk factors for overuse injuries and evaluated common prevention strategies.
The Big Picture
Overuse injuries account for up to 93% of all climbing injuries. Unlike acute injuries from falls, these develop gradually from repetitive stress without adequate recovery. The good news? Many risk factors are modifiable.
Confirmed Risk Factors
1. Higher Climbing Intensity
Pushing harder grades consistently correlates with increased injury risk. The relationship is clear: more difficult climbing = greater stress on tissues.
What to do: Periodize your training with adequate recovery between high-intensity sessions.
2. Bouldering (vs. Other Disciplines)
Bouldering shows higher overuse injury rates than route climbing. This likely reflects:
- Higher intensity moves
- More attempts in shorter time
- Greater forces per individual move
What to do: Balance bouldering with route climbing for active recovery.
3. Reduced Finger Strength
Counterintuitively, weaker fingers are associated with MORE injuries, not fewer. Possible explanations:
- Compensatory movements stress other tissues
- Weaker fingers fatigue faster, leading to form breakdown
- Less margin for error on difficult moves
What to do: Build finger strength progressively with structured hangboard training.
4. Crimp Grip Usage
The crimp grip places exceptionally high forces on finger pulleys and joints. Overreliance on crimping increases injury risk.
What to do: Develop open-hand and half-crimp strength. Use full crimps sparingly.
5. Previous Injury
Prior injury is one of the strongest predictors of future injury. Scar tissue, altered movement patterns, and incomplete rehabilitation all contribute.
What to do: Complete full rehabilitation before returning to climbing. Address underlying causes, not just symptoms.
What Does NOT Seem to Matter
Surprisingly, several factors showed NO association with overuse injury risk:
Body Weight/BMI
Despite assumptions that lighter climbers have less injury risk, the evidence does not support this. Being underweight may actually increase injury risk due to reduced tissue resilience.
Stretching
Static stretching before or after climbing showed no protective effect against overuse injuries.
Warm-Up/Cool-Down Routines
While important for performance, general warm-up and cool-down protocols were not associated with reduced overuse injury rates in the studies reviewed.
What Actually Works for Prevention
Strength Training (Evidence: Strong)
One intervention study found that a strength training program prevented shoulder and elbow injuries. Building tissue capacity before loading is protective.
Load Management (Evidence: Moderate)
Gradually increasing training demands allows tissues to adapt. Sudden spikes in volume or intensity are problematic.
Practical Prevention Protocol
Based on the evidence:
-
Build finger strength progressively
- Structured hangboard training 2-3x/week
- Start conservatively, progress gradually
- Include open-hand positions, not just crimps
-
Strengthen supporting structures
- Shoulder stability exercises
- Antagonist training (extensors, external rotators)
- Core conditioning
-
Manage training load
- Track climbing volume and intensity
- Avoid sudden increases (more than 10% per week)
- Schedule recovery days
-
Vary your climbing
- Mix bouldering with route climbing
- Train different grip positions
- Include easier climbing for volume
-
Address injuries completely
- Do not return too early
- Identify and fix underlying causes
- Maintain preventive exercises long-term
The Bottom Line
Overuse injuries in climbing are largely preventable. The key factors—climbing intensity, finger strength, grip technique, and previous injury—are all modifiable. Building strength progressively, managing training load, and completing full rehabilitation are your best tools for staying healthy.
Based on: Quarmby A, Zhang M, Geisler M, Javorsky T, Mugele H, Cassel M and Lawley J (2023) Risk factors and injury prevention strategies for overuse injuries in adult climbers: a systematic review. Front. Sports Act. Living 5:1269870