Climbers are particularly prone to climbing shoulder injuries because of the repetitive upper-limb movements on vertical or overhanging terrain (Journal of Shoulder and Elbow Surgery).
Studies say about 17% of injuries in climbing are shoulder-related mostly because of overuse, accidental falls, or even human biomechanics.
On my way to discovering the true meaning of well-being, I did a great job at taking my healthy body for granted. Looking back I don’t feel sorry: sometimes it’s only by rebuilding something that got broken that you learn to properly care for it – do you find that climbing injuries resonate with that idea?
Read on and learn how to avoid the most common shoulder injuries, how to safely recover if you are currently experiencing shoulder pain from climbing, and how to keep climbing with a shoulder injury!
Anatomy of the shoulder
Shoulders are without doubt one of the most flexible parts of the body because they allow one to do a wide range of movements with ease. However, for the very same reason, shoulders also lack stability.
Therefore this elaborate and complex ball-and-socket joint that is comprised of bones, joints, muscles, tendons, ligaments, and cartilage structure is very prone to injury.
Image credit: InjuryMap, CC BY-SA 4.0, via Wikimedia Commons
Rotator cuff
A broad, flat white tendon that interacts with four separate tendons attached to the muscle: the subscapularis, the supraspinatus, the infraspinatus, and the teres minor.
This structure works together to provide power and control when you move your arm part way over your head. This tendon allows a muscle to attach itself to a bone, is located deep within the shoulder, attaches to the humerus, and is discreetly associated with the deltoid muscle.
Simply put, the rotator cuff sustains a normal motion in your arm and shoulder in daily life and it’s also essential for controlling movement, especially in high-level climbing.
Labrum
A type of rubbery cartilage found in the shoulder joint, the labrum is what keeps your shoulder in place and makes it stable. This is why when it’s torn can lead to partial or complete shoulder dislocation.
To diagnose shoulder injuries you’ll first need a physical examination and muscle testing, along with imaging tests such as X-Ray or MRI. Such tests usually reveal the underlying cause of pain and injury. They are also the starting point for effective treatment and a tailored recovery plan.
It’s best to ask advice from a specialist early on in the stages of any shoulder pain or discomfort, as a correct diagnosis and treatment can help prevent further damage and promote faster healing.
What are the most common climbing shoulder injuries?
- Shoulder impingement syndrome (SIS)
- Rotator cuff muscles strain
- Tendon-related injuries (such as tendinitis or tendinopathy)
- SLAP (superior labrum anterior to posterior) tears and partial tears
What are the common causes of climbing shoulder injuries?
Even though these injuries can also happen due to accidents such as sliding on slippery surfaces, most of the time they are a result of:
- Muscle imbalance and lack of core needed to sustain full wingspan movements or dynamic loading
- Degeneration of a tendon or joint
- Repeated movements, especially shouldery and twisting ones
- Poor footwork, when we reach overhead we pull more on our arms than we raise our legs
- Skipping shoulder warmup. A warm-up before climbing will help lubricate the soft tissues such as muscles, tendons, and joints. Additionally, it increases blood circulation and stretches these areas.
- A lot of shoulder pain and injury is often caused by poor posture and strain on the spine, as well as issues climbers particularly have in the cervical and thoracic areas
What are the symptoms of climbing shoulder injuries?
- A constant and dull pain deep within the shoulder joint
- You experience difficulty sleeping due to shoulder discomfort
- You need support to lift the arm and you feel pain when doing so
- You experience pain when doing activities, loss of range of motion, and weakness in the arm
- A dull or sharp pain in the shoulder area. Sometimes it gets better with warming up and worse after cooling down (usually when it’s related to tendons).
- Intense weakness in the arm
- Sensations of discomfort characterised by audible clicking, popping, stiffness, or instances of the joint feeling locked
When should I see a doctor or a physiotherapist who understands climbing?
As soon as you feel there is something wrong! If despite your best efforts the pain still interferes with your range of movement in daily life go see a specialist, ideally, someone that specialises in climbing injuries.
Always ask for a second opinion unless you are 100% sure about the diagnosis. When addressed early on, surgery can be avoided depending on the gravity of the injury.
Often enough, the healing process includes nonsteroidal anti-inflammatory drugs, rest, physical therapy, strengthening, massage, and stretching exercises.
Want to stay strong and avoid injury?
Many climbers I know find training boring and prevention even more so.
However, I believe it’s ironic that when you get injured, you end up doing prevention exercises that are similar to the recovery ones!
Warm-up your shoulders
This will not only prepare you for climbing but will also make your shoulders more stable and strong during sketchy moves. I like this video below from Sasha Digiulian for that because it’s simple, doesn’t take long, and is effective. I’ve been using it as my pre-climbing routine ever since I got the SLAP tear.
Prevent shoulder injury
Sasha DiGiulian is famous not only for her achievements in climbing but is quite known for overcoming climbing injuries and coming back stronger. That’s why I appreciate her posting really helpful recovery videos such as this one.
Specific shoulder workout for climbers
This one I used during my rehab as well from Hoopers Beta:
Maintain your shoulder strength
Promote scapular movement by regularly doing shoulder strengthening exercises. The following video demonstrates four highly effective exercises that focus on the smaller muscles located in the posterior chain. These muscles are often neglected in climbing but are essential for maintaining a good posture.
Top 6 exercises for rotator cuffs and strong shoulders
Always start from easy, using soft bands, and progressively make it harder using stiffer elastic bands (available in our shop here).
Core exercises
A strong core allows you to engage your body as a whole in the movement and takes away pressure from your shoulders as soon as it gets slightly overhang. My core routine consists of daily Yoga (check out our guide on Yoga for climbers here) and other exercises specific to climbing such as Shauna Coxsey’s Core for Climbers below:
Self-massage
I can’t emphasise enough how important this is and how good is going to make you feel! A classic case of “hitting rock bottom to learn what is best for you”, ironically enough my SLAP test helped me to discover the benefits of massage as well as to recognise when my back muscles got incredibly sore!
You can use a tennis-sized ball or/and a trusty spikey massage ball to massage your back and arm muscles against the wall. I do this a lot after each climbing session as it helps me to relax and feel good in my body.
A climber’s advice
Avoid stressing your body by repeatedly doing big and strenuous moves. Learn to take breaks from trying the same route and alternate climbs instead. It will not only keep your psyche high but it will also give your shoulders a break and minimise the wear and tear from overuse.
Did you already get injured?
Here’s your recovery from A to Z!
Receiving the ‘best’ care
Not being a pro athlete but wishing to climb at your best can make it difficult for you to receive the best care because most doctors will first care about you being functional but not necessarily performant.
I know how you feel. It’s no secret that getting injured can be a frustrating and confusing experience. You may feel overwhelmed with questions and concerns about the best way to recover. The first step is to focus on having things clear so you’ll know you can contribute to healing faster. Taking action is often a way to empower yourself!
I remember I was often asked if I earn a living out of climbing. After saying “no” I was offered the “normal” people’s solution being told I would not even notice the difference since I am not a pro.
This is why I urge you to see more specialists and ideally stick with one who first understands what a V9 is and just because you’re not sending them for breakfast doesn’t mean you have a wish to be slightly debilitated or stop climbing for a year!
How to avoid surgery
I particularly enjoyed watching Dr. B’s approach to rotator cuff tear injuries and how to avoid surgery. Although I had a SLAP partial tear, this Precision Movement video helped me to better understand how tears progress during one active person’s lifetime:
As a bonus, you get an example of easy exercises you can do in the early stages of your shoulder recovery. I found those very effective especially since I was experiencing a lot of pain in the beginning and I wasn’t able to do many of the climbing-specific exercises as a recovery.
When I first learned that my recovery could take up to a year, I felt overwhelmed. No one had prepared me for how difficult it would be to do all of the exercises while my shoulder was still not feeling great. However, climbers who had similar experiences helped to remove some of the question marks I had regarding my injury and gave me hope that eventually the pain would subside and I would regain my strength.
Rehab exercises for climbing shoulder injuries
It is important to adapt your exercises to what you can do at that moment and change whenever you feel like you are pushing too hard. They should feel hard but not painful!
Unfortunately, very few physios can provide you with all the information you need. That’s why it is best to do your own research so you can get back to doing the things you love faster.
There are MANY good online videos but why waste time and energy searching for answers on your own when you can simply access my personal archive which will save you a whole lot of time and energy?!
Are you experiencing arm pain, tension, soreness, and even numbness or tingling in the arm and palm? Most probably! These symptoms are common because a labral injury can also cause nerve damage.
No worries! There are exercises you can do to ease your pain and make you stronger – I’ve tried some of these life-saving exercises myself and they’ve worked wonders for me!
- Numbness in the arm? Check out these median, ulnar, and radial nerve nerve floss exercises! They’re simple to do and they worked for me.
- Mobilisation technique for the median nerve
- Midback mobility stretching for neck, lower back or shoulder pain
- Simple but effective exercises on shoulder stability and stretching
- Strength and mobility exercises the can be done at home (The Williams Belle Method)
- Exercises to improve your shoulder range of motion
- Do you have pain between your shoulder blades? Focus on midback and shoulder movements
- If you’re into Yoga check out this forearm balance video for shoulder stability and mobility with Fiji McAlpine
If you’re in an “SOS, I got injured” situation you can also check out the Climb Injury Free book by Dr. Jared Vagy DPT.
What happens if you don’t treat a shoulder injury?
It’s important to treat a shoulder injury to avoid potential risks such as shoulder arthritis, damage to the cartilage or the rubbery cushions in your joints, and shoulder instability.
Basically, at some point later in your life, you may not be able to raise your arm overhead due to shoulder weakness and pain. So it’s serious!
Can I still climb when experiencing a shoulder injury?
Yes! Don’t even consider giving up. However, your climbing should be adapted according to your injury. For example, in the case of tendon-related ones healing has more to do with rest, proper warm-up, and progressive loading when training.
Injuries are not happy news. However, most of the climbers I know continued to climb during their recovery process, myself included. A shoulder injury is not as limiting as one might think – it just takes a long time to heal. Fortunately, you can adjust your climbing technique to focus on more vertical or slab routes and still climb close to your level while avoiding moves on your shoulder.
A week after my SLAP partial tear, my physio said I could start climbing again. So I did. It was scary! At first, I avoided using my left arm but then I was told I should not shy away and try to use it as normally as possible.
I did a lot of on-sighting under my usual climbing level and months later, when I wanted to climb harder I either top-roped or did lead, keeping in mind I needed to avoid shoulder moves. While bouldering I limited myself to slabs and vertical and avoided tricky falls.
These tips on climbing with a shoulder injury from Lattice Training are worth checking out:
Will I be able to climb hard again after a shoulder injury?
Yes, you will! Here are some great examples of climbers who went through a shoulder climbing injury and got back stronger.
From a chronic shoulder injury to sending 8c, Hazel Findlay shares her incredibly inspiring story on injury, surgery, recovery, and coming back stronger. Hazel also sent Esclatamasters in 2022, becoming the second British woman to climb a 9a.
Robbie Phillips not only has an outstanding climbing CV but also an outstanding list of climbing-related injuries! In this video, he briefly shares his experience with his rotator cuff tear and the rest of his climbing-related injuries as well as tips to avoid them . The bottom line – his shoulder injury did not hold him back!
I sent my hardest climbing route a bit over a year after my SLAP partial tear. Far from comparing myself with these amazing climbers, the reason I am mentioning it is for you to trust that even normal climbers like us can get better and stronger after experiencing a shoulder injury.
Inspiring and informational podcasts
- Check out the TrainingBetaPodcast on shoulders with Esther Smith where she mentions how she helped Babsi Zangerl heal a shoulder injury WHILE she was training hard
- A talk with Dr. Hackett about the most common injuries in climbers, prevention, and treatment
- A mini-episode of Ask Kris series: Avoid having shoulder issues, train your shoulder program
What to expect during your shoulder rehab process:
Unusual soreness
After climbing or engaging in recovery habits, most probably you will experience soreness and tension in your arm, shoulder, and back. This is because your muscles are trying to compensate for the other side that isn’t functioning at 100%.
Solution: Self-massage against the wall your painful points in muscles by using a tennis-sized ball. For an even more accurate massage, you can try the spiky massage ball – I promise it does wonders! And the foam roller. They’re still my best friends even more than a year after my recovery.
Hopelessness and Frustration
At times you might feel in the dark. Pain in the shoulder can come and go for unknown reasons. It’s all normal. I promise if you keep trusting you will eventually be ok.
Fear
When going back to harder climbing you will probably feel afraid to re-injure yourself so you’ll find it hard to trust the injured part again. Give it time – Rome wasn’t built in a day. You can try hard moves again gradually without forcing yourself too much.
Pay attention to what your shoulder tells you and don’t shy away from taking or simply skipping a tricky move until you feel it’s ok 100% to do it.
Power from patience and learning from our mistakes
One thing is sure: injuries are often part of the game. However, there are a few measures we can take to prevent them. As well as to heal and learn from them. And in this sense awareness is power. Bear in mind that shoulder injuries can take up to one year to fully recover.
So that being said, with a little patience and a willingness to learn from our mistakes we can make it.
We’d love to know your thoughts on this one. Drop a comment for your fellow climbers in the community!
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