Written By: Dr. Alyssa O’Krent, PT, OCS

I was inspired to write this blog by a friend of mine who took a liking to rock climbing only to find out that his elbow pain was limiting his ability to enjoy the sport. When I mentioned that his shoulders might be worth looking at he looked at me a little sideways and told me he had dislocated his shoulder while wakeboarding and then again while snowboarding years ago and that his shoulder was (*insert expletive here) as well. 

As physical therapists, our treatments are often guided by a concept known as regional interdependence. This is a fancy term, but simply put, it means that different areas of the body are related to one another. If there is a problem in one part of the body, it can affect another area.

One common example of regional interdependence in rock climbing is the relationship between the shoulder and elbow. We know from both clinical experience and research that people who have elbow pain are more likely to have weak shoulder muscles than those without elbow pain. Why is this the case? It turns out that elbow positioning during rock climbing is largely influenced by shoulder musculature.  If your shoulders are weak, it’s difficult to control your elbow position during activity. For this reason we are going to discuss the role the shoulder plays in injury prevention during climbing.

Typically speaking, if you find yourself breaking down one body part repetitively then it’s a good idea to look directly above and below that body part to see what’s going on. In rock climbing this especially holds true since our arms, as well as our legs, are uniquely positioned in a closed kinetic chain.

Before moving forward, let’s clarify a few semantics. Closed chain: movement of one joint causes other joints to move in the chain (e.g., squat or pull up). Open chain: a joint can move independently without directly causing another joint to move (e.g., bicep curl). Most overhead athletes engage in open chain sports; think tennis, golf, swimming. Rock climbers pull and sometimes push against a wall, or maybe a tree if they’re desperate, which places them in a closed chain situation. A limitation in the range of motion or weakness of any one of the joints will affect the range of motion of the entire movement.

Now that I’ve spent half the article on a soap box about why we can rarely blame an injury on one body part alone, especially in climbing, let’s explore the shoulder, aka the Queen of the upper body castle.  

The most common advice I overhear is to “pull your shoulder blades down and back”. The intent of that advice is to engage the lower trap, a beautiful and important muscle; but pulling your shoulders down and back also recruits the rhomboids and lats (which will leave less room for the humerus- or arm itself- to reach overhead and leads to shortened rotator cuff musculature which then renders them less powerful) this is a term known as active insufficiency. *Nerd Alert*

A better, albeit more complicated cue is to “pull the bottom tip of your scapula up towards your elbow, while keeping your elbows in, in order to lift your chest up.” How can you tell if you’re doing this correctly? 

1) Raise your arm overhead like you’re asking a question in class

2) Touch the bottom angle of your shoulderblade using your opposite hand

3) Read and perform the cue above

4) If your angle stays in place or moves slightly upward while your hand moves slightly downward, YOU’VE GOT IT! 

If your angle moves toward your spine your rhomboids are trying too hard. Tell them to chill while you isolate your lat and lower trap and try for a more subtle movement. If all else fails, you can find a friendly physical therapist and ask them to nerd out with you.

I’ve also overheard advice to straighten your arms while hanging, but I’ve found that your core and rotator cuff tend to disengage when your elbows lock out. Just focusing on bending the elbows however can place too much tension on the biceps. It’s best to think about following the cue above and then do your best to keep the elbows directly under the hands’ line of pull while allowing the elbow to passively bend as the shoulder does the work to get it there. 

Does this take time? Yes. Does it take training technicality of movement? Yes. Are you trying to prevent injury while progressing at a technical sport? If you’re reading this article then the answer is likely a YES, so take a few minutes next time you’re hanging out and play around with this concept. 

For any questions feel free to reach me on Instagram: @aok_pt or through my website: aokpt.com.