Rock Climbing Injuries Part 3: The Climber’s Elbow

In this post, we will examine the anatomy of the elbow and discuss one of the most common injuries in this area that is related to climbing activity, lateral epicondylopathy of the elbow (commonly referred to as lateral epicondylitis.) Lateral epicondylopathy refers to irritation of the tendons attaching to the lateral elbow. The region highlighted in this photo is commonly referred to as the common extensor origin, because there are several muscles that are involved in extending your wrist and fingers that attach here. When a tendon is overloaded beyond its capacity, either through increased weight or repetition, it can become a nagging pain whenever that tendon is loaded or put under tension.

Climbers tend to focus on training their finger and wrist flexors, while neglecting their extensors because they are not as active in climbing.This can result in extensor tendons that are not conditioned for the repetitive loading and stretching they undergo during prolonged climbing.

Injury Prevention
Our tendons get stronger through appropriate loading. To decrease the risk of developing lateral epicondylopathy, we need to use our wrist extensors and finger extensors. In general, tendons do well with heavy, slow resistance training. Because of their poor blood supply, tendons also take longer to recover than our muscles do. When training to strengthen your tendons, you should typically follow these guidelines: aim to complete 2-3 sets of 5-8 repetitions at about 70-85% of your 1 repetition max, and allow at least 48 hours between training sessions. I recommend the following exercises to decrease your risk of developing lateral epicondylopathy:

Weighted wrist extensions:
In order to most closely replicate the position your arm will be in while climbing setup like this video with your shoulder out to the side at ~90 degrees and your forearm supported. Hold the dumbbell with your wrist just off the table and begin at full wrist flexion. Slowly extend your wrist fully over the course of 3 seconds, then lower back down over the course of 3 seconds. Here is a link to a video of this exercise: https://www.youtube.com/watch?v=tsrHum6SLAs&ab_channel=GregLouie 

Finger extensions:
For this exercise begin with your thumb and fingertips all touching with a thick rubber band around them. Slowly pull your fingers away from each other extending through each joint, then slowly return to the starting position. Here is a link to a video of this exercise: https://www.youtube.com/watch?v=MTSETVUQVFI&feature=youtu.be&ab_channel=AskDoctorJo

Injury prevention will decrease the risk of injury, but it will not eliminate the risk entirely. If you feel pain while climbing, or sustain an injury, schedule an appointment with an MTI physical therapist, who will help you through your rehab process.

In the next and final post of this 4-part series, we will discuss the climber’s shoulder.