Camp4 Human Performance

UPPER EXTREMITY REHAB FOR CLIMBERS
Mile End Climbing Wall

2-Day Course for Healthcare Providers

Treat climbers and want a more confident, evidence-informed approach to assessment and rehabilitation?

This course covers:

💥 Climbing-specific biomechanics and injury mechanisms

💥 Common shoulder, elbow, wrist and finger injuries

💥 Climbing-specific assessment and clinical reasoning

💥 Force, rate of force development and capacity testing

💥 Modifying climbing and training during rehabilitation

💥 When education, passive care, bracing or imaging are appropriate

💥 Practical testing, training progressions and case studies

Day 1: Shoulder & Elbow
Day 2: Wrist & Fingers

Move beyond protocols. Learn how to apply principles of load, tissue stress and progression to real climbers and real clinical situations.

If you treat climbers and want to improve your outcomes, this course is for you.

Comment REHAB for ticket information.

I remain skeptical of generic “balance” testing for climbers.

There is a small group of studies showing climbers outperform non-climbers on Y-Balance, Star Excursion, force-platform, and similar tests. That’s cool. But when researchers compare higher-grade climbers with lower-grade climbers, the relationship becomes weak.

More importantly, when balance is studied during actual climbing, better climbers don’t simply minimize movement. They intentionally move their center of mass and redistribute force between contacts. Zampagni’s study of elite climbers actually had more lateral COM (center of mass) movement than controls.

So, I’m not at all convinced that supporting the body on one leg or arm and reaching farther tells anything useful about what a climber needs to climb harder.

If the problem is balance on the wall, train it on the wall.

Upper Extremity Rehab 4 Climbers Mile End Climbing Wall

2-Day Course for Healthcare Providers

This 2-day course is built for physicians, PTs, chiropractors, and massage therapists who treat climbers and want a clearer, more defensible approach to injury assessment, diagnosis, prognosis, and rehabilitation.

We’ll cover:

-Climbing-specific biomechanics and injury mechanisms

-The most common shoulder, elbow, wrist, and finger injuries in climbers

-Client intake and clinical reasoning specific to climbing

-Functional testing: force, rate of force development, and capacity

-How to modify climbing and training

-When education, passive care, splinting/bracing, or imaging actually makes sense

Format

Day 1 AM: Shoulder & elbow injuries (didactic)
Day 1 PM: testing, training progressions and case studies

Day 2 AM: Wrist & finger injuries (didactic)
Day 2 PM: testing, training progressions and case studies

This course is not about protocols. It’s about understanding load, tissue stress, progression, and applying that understanding to real climbers with real constraints.

If you treat climbers and want better outcomes, this course is designed for you.

Comment REHAB for ticket information.

This paper has some useful prevalence data. Climbers reported a high rate of finger, elbow, and shoulder pain. No surprises there.

Where I lose interest is calling questionnaire-reported pain “functional,” then discussing nociplastic pain (chronic pain with altered perceptions) without actually examining anyone. You can’t establish that pain has no identifiable tissue cause when you never looked for one.

The useful takeaway is quite simple. Pain is common in climbing, but pain isn’t synonymous with significant tissue injury. Track how symptoms respond to load, modify what needs modifying, maintain what you can tolerate, and build capacity back over time.

Climbers love core training. Hollow holds, TRX, ab wheels, front levers, and increasingly complicated stabilization exercises.

None of these are inherently bad exercises.

But do they actually add to the training you’re already doing?

If you’re climbing and already strength training a few days per week, your trunk is already doing a lot.

Direct trunk training can still make sense. But you need to identify what you’re missing, not replicate more climbing movements.

Pick 2-3 qualities, progressively load them, and move on.

This is an interesting, but limited, paper looking at what happens to climbing movement with upper extremity fatigue.

Surprisingly, these climbers didn’t show significant changes in measures of fluidity or hand movement, but they did start falling more.

There are plenty of limitations here, so I wouldn’t interpret this as “fatigue doesn’t affect technique.” But it does make an important point.

You can maintain a reasonable movement solution and still lose the physical capacity to execute it.

Not every fall when you’re pumped is a technical problem. Sometimes you do run out of gas.

I’ve learned, and taught for years, that most complete pulley ruptures are essentially avulsion-type injuries from the bony attachment. I still think attachment failure is part of the picture, but this paper is a good reason to update that model.

In this surgical paper, the authors consistently found oblique tears through the pulley itself rather than an avulsion from the bone.

That does not prove this is the dominant tear pattern in all climbers. The sample was tiny and highly selected for surgery.

But it is a useful reminder that “pulley rupture” describes loss of the restraint, not necessarily the exact tissue failure pattern.

So I’m changing how I explain it to my clients. Avulsion is one mechanism, and mid-substance oblique tearing is also part of that model.

The useful part of this paper is simple.

Both exercise groups improved pain and joint position sense (whatever that is) over 8 weeks. Adding Mulligan mobilization (specialized manual therapy technique) did not improve the outcomes beyond exercise alone.

That supports progressive shoulder loading.

It does not prove the scapula was “corrected,” the humeral head was repositioned, or the subacromial space increased. None of that was measured.

Exercise helped. The manual therapy did not add much. That is the part worth remembering.

I like this paper because it supports making finger testing as simple as possible.

All six grip positions were associated with bouldering ability, but half crimp strength had the strongest relationship. Adding the three-finger drag improved the model further, while the other grips didn’t add additional information.

For general finger strength testing, I think there is a good argument for doing a highly standardized four-finger test and adding other positions when you actually have a reason to test them.

That does not mean everyone should just train half crimp. This wasn’t a training study. Specific grips still need specific exposure, especially when they matter for the climbing you’re actually trying to do.

Testing and training don’t have to be the same thing.

I’ve been using, programming, and teaching about BFR for over a decade, so it’s great to see decent climbing studies get published.

I think the interesting part of this study gets lost if we simply say “BFR works.”

Of course it worked. They made 40% MVC training really hard.

More importantly, the climbers improved finger strength and critical force while accumulating about 19% less force time integral than the high load group.

That does not make BFR better than heavy finger training. The high load group did great as well.

It makes BFR interesting when the goal is to create a meaningful muscular stimulus while limiting high force finger exposure.

That is a much more useful way to look at it.

B STRONG