Common Finger Injuries in Climbers

23 June, 2020
It's common for climbers to suffer from finger injuries. Particularly since body weight rests on the fingers during climbing activities.
 

Climbers take care of their fingers. They know that the majority of their weight rests on them. If they don’t function properly, climbers could suffer from finger injuries or even a fall.

Climbers train their fingers and protect them with specifically designed accessories. Even so, finger injuries are common. Although they’re preventable, it’s reasonable to suspect that every climber will suffer an injury of the fingers at least once.

Although, when climbing, body weight is distributed over all of the upper limbs and part of the lower ones, it doesn’t all transfer to the fingers. In fact, only part of the energy is shared with other joints, such as the shoulders.

Among injuries associated with sports climbing, 41 percent occurs in the fingers, and in second place, 13 percent of injuries happen in the elbows. This shows just how important climbers’ fingers are.

According to the way the hands are made up, the main problem is extreme tension. When climbing, the fingers are jerked from one side to the other. Sometimes they can support this, and sometimes they can’t.

Anatomy of the fingers and hand

The hand has countless components, between hard parts and soft parts. Also, it has blood vessels, lymphatic vessels, and elements of the neural system. Everything works together to move.

Focusing on climbers’ fingers, we want to highlight the tendons, ligaments, and pulleys. These elements concentrate the bulk of sports injuries in climbers.

 

Tendons connect a muscle to a bone. The ones on the top and the back of the hand are the extensor tendons. Those that circulate underneath are the flexors, and they help us to grab.

A woman climbing a cliff.

Among the ligaments, there are several, and they work in different ways. They stabilize joints by holding them in place. Ligaments are elastic, but they have a limit to how far they can stretch. If you stretch one too much, you’ll sprain it.

Finally, there are pulleys. The pulleys can be annular or cruciform, and it’s a soft tissue that covers the phalanges, which are the bones inside the fingers. Ring pulleys are ring-shaped and cruciform pulleys are cross-shaped. One of their basic functions is to keep the tendons close to the bones.

The most common finger injuries in climbers

Although they’re exposed to different hand problems, there are actually three common finger injuries among climbers:

 
  • A tear of the flexor tendon: the flexor tendons are very long and start above the hand, reaching to the fingers. Pulleys keep tendons close to phalanges. If they’re torn, the flexor tendons hurt and you can’t move them fully. In general, you can usually close your fist.
  • A2 Pulley breakage: finger pulleys are numbered in anatomy, and one of them is called A2. This point is extremely sensitive for climbing, and might even be one of the most common finger injuries for climbers. When you tear pulley A2, there’s an audible snap, followed by pain in the fingers, usually where the phalanges start. Fluid builds up and the area swells. However, you rarely need surgery; it’s usually enough to immobilize it for a little while.
  • Collateral ligament injury: all the joints in the fingers have a collateral ligament at their sides. While climbing, sometimes you make a pendulum movement with your body, swinging from one side to the other. Then, you can overstrain this ligament. It doesn’t always require surgery, but extreme cases might.

Treatments

The first step if you have a finger injury is to restYou need to stop climbing until you can fully assess what happened.

Then, apply ice to the painful area and make gentle movements. Make sure you control the movements, slowly moving your other hand.

Physical therapy to help with finger injuries.
 

When you go to the doctor, he’ll probably request tests to evaluate the case. Not all climbers always go to the doctor, but we recommend it, especially if your fingers are inflamed. Also, you should probably go if your skin changes color or if you can’t move your fingers.

X-rays and MRI’s are basic but efficient tools. In addition, the doctor might request a finger ultrasound to check how much fluid has built up.

With the results and subsequent diagnosis, the doctor will give you a treatment plan. It’s almost always rest and immobilization, plus anti-inflammatory drugs. However, a traumatologist will suggest surgery if there are complete tears, or more than a month has passed without a full recovery.

Finally, climbers should gradually start climbing again after finger injuries. You can’t return to climbing all at once, so make sure you gradually and slowly increase your training.

 
  • Backe, S., Ericson, L., Janson, S., & Timpka, T. (2009). Rock climbing injury rates and associated risk factors in a general climbing population. Scandinavian Journal of Medicine and Science of Sports, 19, 850-856.
  • Jones, G., Asghar, A., & Llewellyn, D. J. (2007). The epidemiology of rock climbing injuries. British Journal of Sports Medicine, 7, 1-16.
  • Hernández Pérez, Luken. “La escalada y lesiones: revisión.” (2017).