Climbing Shoulder Injuries - Exercises and Tips


In this classic UKC training/health article, physiotherapist Gabriella Frittelli takes us through some shoulder exercises that can help prevent shoulder injuries and the well known and feared Shoulder Impingement Syndrome.

Gabriella teaches us how to strengthen our 'Rotator Cuff' muscles, with a series of exercises using a theraband.

The article was originally published back in 2005 but has been revamped and reformatted for 2011.

So you hit the climbing wall hard all winter and now you're off to tick some real rock at Portland or Stanage. Better pack one piece of personal protective equipment besides your cams or quickdraws – stable shoulders.

"What?" you say, "I'm strong – I've been cranking 6a's on the wall!"

Strong shoulders, however, are not necessarily stable shoulders and if you are pulling down often, you could be a prime candidate for Shoulder Impingement Syndrome (SIS). Climbers are particularly susceptible to SIS because they are always reaching overhead – higher, higher, higher for that next hold.

Shoulder diagram

While the shoulder is likely the most mobile joint of the body &ndash it's also one of the most vulnerable to injury, especially with over-use from hard climbing. &copy Ennemoser  © Ennemoser
While the shoulder is likely the most mobile joint of the body &ndash it's also one of the most vulnerable to injury, especially with over-use from hard climbing. © Ennemoser
If you feel a sensation of "popping" or "crackling" at your shoulder as you reach for that gaston or jug you might be experiencing the start of SIS. That nagging pain that you may experience at the shoulder is likely inflammation of tendons of the rotator cuff getting "pinched". If it continues, the only thing you may be reaching for is a bottle of pain killers. In worst case scenarios SIS can lead to surgery. Ask John Dunne or Jerry Moffat who both had complicated shoulder surgery because of severe SIS. But it's not just top climbers who are at risk, we all are.

The good news is you can avoid SIS. The secret is preventative exercise. You may have honed the prime movers of the shoulder – your lats, deltoids, traps, triceps, biceps and pects in prime time at the wall. But you likely ignored strengthening a group of four muscles called the rotator cuff. The rotator cuff muscles are the core stabilizers of the shoulder.

While the shoulder is likely the most mobile joint of the body – it's also one of the most vulnerable to injury. You can blame the architecture of the shoulder joint. The shoulder is a "ball and socket" type joint like the hip. Unlike the hip, however, the socket is not deep. In fact, the "socket" of the shoulder joint is similar in shape to a saucer. The end of the humerus (your arm bone) is shaped like a ball and sits in this saucer. The ball of the humerus, called the "humeral head", is almost four times the size of the saucer. While the structure of the joint allows considerable mobility of the shoulder, it does not offer stability. The stability of the shoulder joint relies on the strength of the rotator cuff. The job of these four tiny muscles is to "hug" the humeral head and keep it centred in the socket.

Think of the rotator cuff as the guide wires of a tent. If one is too slack or too tight, the tent won't sit erect. Each muscle of the rotator cuff works to keep the shoulder bone (the humeral head) centred in the joint socket. If your rotator cuff is weak, when you reach overhead the humeral head will ride "high' in the socket and butt up against another bone- the "ceiling" of the shoulder joint called the acromion. Repetitively reaching overhead on the rock will eventually lead to pinching, shearing of the tendons of the shoulder. Ouch! Pinching, shearing of the tendons leads to inflammation also known as tendonitis. You likely have developed "Shoulder Impingement Syndrome".

The good news is you can prevent chronic shoulder tendonitis by regularly investing a few minutes in a rotator cuff strengthening program. All you need is a towel and a length of resistive band or theraband. Below are some exercises that may prevent shoulder injuries. Lisa Rands, one of the USA's top boulderers and headpointers follows a similar set of exercises. She stresses that it is important to do these exercises right. Always maintain good posture when performing the exercises – back straight, upright shoulder girdle – no slumping!

If you can manage to these exercises three times a week you will be on your way to healthy shoulders but you will benefit even more if you do them everyday.

&copy Mick Ryan  © UKC
© Mick Ryan

I. Internal Rotation Tuck a folded bath towel under your armpit. Place the resistive band at elbow height. Keeping your elbow bent at ninety degrees pull the band toward your belly-button. Return to the starting position slowly. Do three sets of ten repetitions.

&copy Mick Ryan  © UKC
© Mick Ryan

II. External rotation Tuck your arm at the side of your body as for the internal rotation exercise. Keep your elbow at the side of your body. Pull the band outward keeping your elbow bent at ninety degrees. Squeeze your shoulder blade toward spine as you pull the band out. Return slowly. Do three sets of ten repetitions.

&copy Mick Ryan
© Mick Ryan

III. Rows Stand with good posture and grasp two strands of the band in front of you at chest height. Pull the band down to the side of your body keeping your elbows straight. Squeeze your shoulder blades together and return slowly. Do three sets of ten repetitions.

&copy Mick Ryan  © UKC
© Mick Ryan

IV. Scaption Place one foot on the band and grasp the band with your thumb face down. Lift the band upward and slightly forward of your body in a thirty-degree arc of motion. Return slowly. Do three sets of ten repetitions.

Please note: This article is not intended as a treatment guideline for shoulder injuries. The exercises illustrated may be more effective under the instruction of a physiotherapist or athletic trainer.

If you have pain in your shoulders, seek the medical advice of your doctor. Shoulder pain can have a variety of causes. Sometimes it is caused by referred pain from the neck. You may have a stiff and painful shoulder caused by osteoarthritis or an adhesive capsule. Your doctor will be able to determine the cause of your pain and will select the appropriate treatment plan. You may be referred for physiotherapy intervention. Physiotherapy treatments may include joint mobilization, posture and exercise training to ensure optimal joint mechanics, and anti-inflammatory modalities such as ultrasound, electrical stimulation and ice. Consultation with a physio and/or occupational therapist may keep you climbing high all season.

Gabriella Frittelli, BA, MSPT Gabriella Frittelli, BA, MSPT, is a graduate of Simmons Graduate School of Health Studies in Boston. She spent many weekends rock and ice climbing in New England and the Gunks of New York State. For the past ten years she lived in Bishop, California where working as a physical therapist she gained much experience treating injuries related to climbing, skiing, and other mountain sports. She presently works at Regional Therapy Center at Saratoga Springs Hospital as a Senior Physical Therapist.

23 Sep, 2011
I'd be interested to have some references to the research on the causes of SIS and in particular research showing that these exercises make a difference in prevention and rehab. I find the article plausible. I'd just like to see the research.
23 Sep, 2011
I streeeeeetched up for a grip on a bouldering wall and felt a scrunch in my shoulder. I had mild to moderate pain when raising my arm above my head for a while and saw a physio. Impingement was the diagnosis and he gave my the same exercises as in the above article. What sorted me out, and was a chance discovery shortly after the physio visit, is surfing. I can only assume it's all the paddling. So perhaps swimming crawl would have the same effect?
23 Sep, 2011
Agreed, but equally i'd be interested to hear from people who can say they've noticed definite improvement from doing these excercises (mixed with a little climbing maybe). I've been doing them as and when I can based on a physio's diagnosis of SIS. Maybe I haven't been as religious as I should be but it feels like simply climbing is making my shoulder stronger. Although the symptoms still seem to randomly crop up every now and again. Buggered knees and a buggered ankle has led me to believe no matter what I do, my shoulders are also soon to be well and truly buggered.
23 Sep, 2011
Yes, I'd be interested to hear that too and people reporting no improvement or deterioration. My wife's view (she's a physio) is that in some cases SIS has nothing to do with the muscular imbalances referred to in the article and it can be simple overuse. That appears to be the case with my occasional SIS: it is very easy to trace it to overdoing it (especially indoors bouldering, slapping for holds).
23 Sep, 2011
I’ve been suffering from shoulder problems since the end of last year. I’ve been seeing a physio that diagnosed Supraspinatus impingement. Months of shoulder stability exercise have given me an improvement to the point where I’m able to climb relatively unaffected and some days I experience no pain at all. I still get pain occasionally. Recently I saw an upper limb specialist who seemed to think it could be a Bursa problem or a tear in the bicep tendon. I have an MRI scan on Wednesday which should hopefully clear up the cause and allow them to treat it.
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