Complete Guide to Preventing and Treating Bouldering Injuries

Dr. James - Orthopaedic Surgeon in Singapore

Medically reviewed by Dr. James Tan

Love bouldering but are worried about the risk? You are not alone! This dangerous but satisfying sport undoubtedly has a learning curve when it comes to health and safety. Fortunately, our experts are here to help you prevent and treat all of the top bouldering injuries and common safety concerns.

Here is your in-depth guide to bouldering safety precautions and treatment.

Understanding the Risks of Bouldering

Bouldering, like spinning, is a high-risk sport. The dangers are inherent to the sport and even the most unseasoned climbers are all too aware of the hazards. It is common for climbers to be injured while bouldering and these injuries can range from minor scrapes to serious emergencies. The tough moves required in bouldering can lead to neck and back strains, as well as shoulder injuries like rotator cuff strains, wrist injuries, contusions, and knee injuries. Bouldering injuries like ankle sprains, finger wounds, and climber’s elbow are all rather common and we see them regularly in our Singapore clinic.

Check out our rotator cuff injury treatment page for more information on causes and how to prevent them, as well as proper treatment options for them.

While bouldering can be dangerous, there is a lot that you can do to prevent bouldering injuries. Taking simple steps like properly warming up, working to master correct techniques, and climbing gradually are the foundation of staying healthy and active. Other added elements like crash pads and spotters will reduce the risk while getting adequate recovery and rest, strength training, and careful climbing techniques make all of the difference. These are just a few of the many ways to safely boulder. Keep reading here for a complete look at climbing safety.

What Are the Most Common Bouldering Injuries?

There is always some level of inherent risk to climbing, similar to HIIT workouts and F45 classes. If you are inexperienced or have become lax in following proper safety protocols, this is doubly true. While proper safety precautions make a world of difference, there is always a chance of injury.

The following are the most common injuries for boulders:

To help you understand how to prevent these injuries, let’s take a look at some of the typical causes of them.

Sprained Ankle from Bouldering

With the complicated movements involved in bouldering as well as the unpredictable landings and the potential for rolling or twisting the ankle, sprained ankles are common. This is where you might want to seek treatment for ankle injuries.

Here is a full rundown of everything that can increase your odds of spraining your ankle while bouldering:

  • Unstable footing: Bouldering often involves getting around across unstable rocks or loose gravel, which increases the odds of ankle twists or rolls.
  • Bad jumps and falls: Sudden and improper foot placement during jumps or falls can cause you to strain the ligaments of your ankle joint. Bad jumps can also cause ACL tears.
  • Lack of a warm-up: The ligaments and muscles in the ankle are more susceptible to injury when you’re not fully warmed up before climbing.
  • Fatigue: Climbing until you are exhausted or setting out without adequate sleep will affect balance and stability, which increases your odds of injury.
  • Bad footwear: Wearing shoes that don’t fit properly or provide adequate ankle support makes it more likely that you will end up with an ankle injury.
  • Lack of awareness: If you get distracted and don’t pay attention to your footwork or surroundings, you are more likely to have an accident. At every stage of the journey, it is essential to be mindful of your skill level and not push yourself too far.
  • Rest and recovery: On top of being well-rested and alert, it is critical to make sure that you give your muscles enough time to recover between climbing sessions. Preventing muscle fatigue goes a long way in preventing injury and muscle cramps, while also building muscles at the same time.

Related Read: Can ACL Tears Heal On Their Own?

Finger Injuries During Bouldering

The gripping and pulling movements of bouldering put an extreme strain on your fingers. Let’s take a look at some of the common finger injuries from bouldering and how to prevent them.

  • Finger pulley strains and tears: Too much force or sudden jerks can affect your finger pulleys (the ligaments responsible for stabilising the finger tendons).
  • Tendonitis: The excess strain on your finger tendons can cause inflammation and tendonitis. You will be able to recognise finger tendonitis by the telltale hurting, swelling, and a limited range of motion.
  • Sprained fingers: Pain, swelling, and decreased grip strength are signs of a sprained finger, which can be caused by hyperextension, hyperflexion, or sideways impacts on your fingers.
  • Flexor tendon strains: Repetitive gripping and pulling motions can cause the flexor tendons in your fingers to become strained or irritated.

Here are a few ways that you can prevent finger injuries while bouldering:

  • Don’t dive in: Start with easier climbs and gradually increase the difficulty. This will give your fingers the chance to adapt and build up strength.
  • Use proper technique: Pay attention to your hand positioning and gripping technique to reduce stress on your finger joints and tendons.
  • Finger strengthening: Do resistance training to increase your finger strength and resilience.
  • Rest and recovery: Give your fingers plenty of time to rest between climbing sessions.
  • Warm-up: Prevent strain on your finger joints by warming up before climbing, stretching afterwards, and using finger tape.
  • Listen to your body: Pay attention to any signs of discomfort or pain. Take a break from climbing and let your body heal if you experience any swelling or discomfort.

Climber’s Elbow from Bouldering

Boulderers often develop climber’s elbow (also known as medial epicondylitis or golfer’s elbow). The muscles and tendons of your forearm are pushed by repetitive stress and strain, which can cause this common condition. If the inside of the elbow is tender and your wrist and hand feel weak, you may have a climber’s elbow. Here is how to treat and prevent climber’s elbow:

  • To minimise stress on the tendons and muscles in your forearms, focus on using proper climbing techniques and positioning. If you are new to the sport, consider working with a coach to learn the correct way of doing things.
  • Slowly increase the difficulty and intensity of your climbs to give your muscles and tendons enough time to adjust and build up strength.
  • Be sure to always stretch and warm up to increase your flexibility and prevent injury.
  • Build up your strength with exercises like wrist curls, reverse wrist curls, and other focused exercises.
  • Don’t overtrain!
  • If you are hurt, look to try out ice therapy using ice packs and compression bandages. If you notice swelling and pain, use a compression wrap and apply ice packs regularly for the first 48 hours. Remember that elevation is always helpful in reducing swelling so try to keep your elbows higher than your heart as often as possible. If the pain does not go away, you might have to visit an orthopaedic doctor for PRP treatment to manage the pain.

Shoulder Injuries When Bouldering

The repetitive and physically demanding nature of climbing can cause damage to your shoulders. Here are a few of the most common issues:

  • Rotator cuff strains or tears: The stabilising muscles and tendons of your rotator cuff can become partially or completely torn with excess use or sudden stress.
  • Shoulder impingement: If the bursa or rotator cuff tendons of your shoulder become compressed between the bones of the shoulder joint, you will experience the pain and restricted range of motion that comes with shoulder impingement.
  • Shoulder dislocations or subluxations: Your shoulder joint can partially or entirely slip out of its socket during a fall or difficult movements.
  • Labrum tears: The cartilage ring around your shoulder socket, called your labrum, can tear as a result of chronic stress or unexpected trauma.

Like most sports injuries, you can prevent shoulder injuries with regular strength training and by properly warming up each session which also improves shoulder mobility, and listening to your body as you gradually increase the intensity and difficulty of your climbs.

Back and Neck Strains

Back and neck pain from bouldering is all too common. Even for those who don’t climb, back pain is, unfortunately, a normal part of life. Believe it or not, experts say that around 80% of the world’s population will experience low back pain at one point. It is the leading cause of disability amongst athletes and sedentary people alike.

When it comes to back injuries, they fall into two categories: flexion and extension. Keep on reading to understand the important difference between these two common back injuries from bouldering.

Flexion vs Extension Back Injuries

Flexion back injuries come from bending forward while extension back injuries develop from bending backward. While flexion injuries compress the disks in your back, extension injuries compress the joints.

Neck Injuries

Your neck has flexor muscles in the front and extensor muscles in the back. When you are climbing and looking up at your partner or the next move, your neck extensors are pushed to their limit. While your neck muscles will become stronger with time, the neck flexors can become weak, which creates an imbalance. This imbalance causes compression of the joints in your neck.

Related Read: How To Differentiate Between Neck And Shoulder Pain

Neck and Back Injury Prevention

To prevent neck and back injuries while bouldering, try a few tried-and-true strategies.

  • Train your core for increased stability.
  • Use crash pads and spotting to prevent injury.
  • Practise smart falling techniques.
  • Avoid overexertion.
  • Always pay attention to your posture.

Knee Injuries from Bouldering

While knee injuries are not quite as common in bouldering as they are in other types of climbing disciplines, it is essential to be aware of the possibilities. Here is a look at some of the most common knee injuries from bouldering:

  • Patellar tendonitis: This inflammation and pain in the front of your knee come from the overuse of your patellar tendon (the part that attaches the kneecap to the shin bone).
  • Meniscus tear: Sudden twists and hyperextension can cause a tear in your meniscus (the cartilage pads that cushion and stabilise your knee joint).
  • ACL and MCL Sprains: The ACL, or anterior cruciate ligament, (the part that connects your thigh bone (femur) to your shinbone (tibia) and the MCL, or medial collateral ligament (which keeps your shin bone (tibia) in place) of your knee can also be torn by sudden force and twisting.
  • Patellar dislocation: Your kneecap can slip out of place during a hard impact or an awkward landing.

Having good form when doing exercises like squats and preventing accidents is fundamental to preventing knee injuries. As always, it’s also crucial to keep a consistent strength training and pre-climb warming routine. If you suspect a knee injury, it is recommended to seek a diagnosis as soon as you can and start treatment for injuries like meniscus tears.

Wrist Injuries from Bouldering

The need to grip, bear weight, and make dynamic movements puts serious stress on your wrists and can lead to injuries when bouldering. Here is a quick look at some of the most common bouldering injuries that can affect your wrist.

  • Tendonitis: Regular gripping, intense strain and poor hand technique while climbing can cause inflammation in the tendons of your wrist. Stretching and stretching your wrists as well as paying attention to your form can prevent tendonitis.
  • Sprains: Abrupt movements, falls, and bad landings can cause tears to the tendons of your wrists, known as a sprain. Crash mats and spotters can help you prevent these painful wrist sprains.
  • TFCC Injuries: Your Triangular Fibrocartilage Complex (TFCC) works to stabilise the ligaments and cartilage of your wrist. Extreme twisting and direct impact can damage your TFCC. Strengthening exercises can help prevent these injuries along with good climbing form. 
  • Fractures: Landing with a high impact can fracture your wrist. This requires immediate care so don’t delay seeing a doctor if you think you’ve fractured your wrist. To keep yourself safe during climbing, pay attention to your technique and use crash pads. 

While progressive training and proper recovery are a part of all good climbers’ routines, it is especially important to pay attention to your hand positioning and wrist support to prevent these injuries.

Contusions and Abrasions from Bouldering

The nature of bouldering keeps you on rough surfaces with an ever-present chance for falls. This presents the risk of abrasions (scrapes) which are painful and, worst yet, can lead to an infection. Contusions (or bruises as they are more commonly called) are caused by damage to the blood vessels under the skin. While this uncomfortable swelling and tenderness can be hard to avoid in many cases, there are a few bouldering safety measures that will help.

When the skin rubs against a rough surface, the outer layer of the skin is removed, causing an abrasion. If they are not cleaned and cared for properly, they can be uncomfortable, bleed, and increase the risk of infection.

Here is how to prevent contusion and abrasions while bouldering:

  • Always be aware of your surroundings, especially during transitions and landings.
  • Wear clothing (ideally durable fabrics designed for climbers) to cover exposed skin as much as possible.
  • Use climbing tape or gloves to protect your hands. 
  • Practise controlling your movements and landing safely.
  • Always bring a first aid kit and supplies for cleansing wounds.
  • Keep your skin moisturised and your body hydrated.

Tips to Prevent Injuries During Bouldering

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  • Work on strengthening your muscles and grip to prevent overloading of tendons, ligaments and muscles.
  • Learn proper technique
  • Wear appropriate attire

Treating Bouldering Injuries in Singapore

When you hurt yourself bouldering, you want nothing more than to treat it and get straight back to climbing! We are here to help you do just that. The team of experts in our Singapore clinic will assess your conditions, create a customised treatment plan, and help you achieve your level of fitness. Here at Ray of Health, we also offer other orthopaedic treatments like knee pain treatment and treatment for shoulder pain.

Check out our other articles:

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About The Author

dr james tan

Dr James Tan Chung Hui

Dr James Tan is a skilled orthopaedic surgeon at Quantum Orthopaedics who has more than 10 years of experience in sports surgery and exercise medicine in Singapore. Apart from partnering with the industry to introduce various treatment techniques, Dr Tan has treated athletes from the Singapore National Teams and professional footballers from the Singapore Premier League and the Young Lions.

Dr Tan specialises in treating sports injuries of the knee, shoulder and elbow joints, as well as cartilage and meniscus surgery. He is a member of the elite Asian Shoulder and Elbow Group and a founding member of the Singapore Shoulder and Elbow Surgery Society.

Qualifications and Achievements
MBBS - National University of Singapore (NUS), Faculty of Medicine
Member of the Royal College of Surgeons of Edinburgh (MRCS)
MMed - Master of Medicine in Orthopaedic Surgery (NUS)
Fellow of Royal College of Surgeons (Edinburgh)
Adjunct Assistant Professor | NUS, LKC
Senior Consultant Orthopaedic Surgery, Sports and Exercise Medicine
Head of Department | Orthopaedic Surgery and Sports Medicine Centre
Principal Investigator of Tissue Engineering
National Medical Research Council grants
Collaboration with Scientists at NTU, TUM, A*Star, Osteopore & Trendlines Medical Singapore


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