How come so many climbers develop shoulder problems? Almost all my friends, most of whom have been climbing for years if not decades, have been sidelined by acute or chronic shoulder injuries at times. I’m no stranger to this issue myself.

Orthopedists primarily use imaging diagnostics such as x-rays and MRIs to look for structural changes like bone fractures or soft tissue tears and ruptures. They will usually attribute the pain and dysfunction we experience to what they can visualize on these tests. An attempt of surgical repair often follows. Many people, though certainly not all, find this helpful. Surgery is usually followed by lengthy physical therapy before you can go back to climbing.

A good physical therapist may be able to alert you to functional imbalances in your musculature and show you how to work on this.

A cornucopia of options

A specially trained acupuncturist, massage therapist or physiotherapist may also be able to identify trigger points in your muscles and myofascial adhesions and dysfunction that impede natural movement and can cause persistent pain. As a licensed acupuncturist trained in orthopedic and sports medicine acupuncture, I can use specialized needling techniques to release trigger points and reset the communication between muscles and their respective nerves using motor points. I use manual therapy to promote myofascial release and improve lymphatic drainage.

Electroacupuncture is another technique specifically employed to achieve pain release. It can be combined with traditional and modern acupuncture approaches. Studies have demonstrated that it can create more lasting effects than manual needle stimulation. A mild electrical current is transmitted through adjacent needles by attaching little clips from an electrical stimulation device. It should be a fairly pleasant experience.

I also find that a classical acupuncture style handed down by students of Master Tung, a famous acupuncture doctor who practiced in Taiwan, can be enormously effective in relieving shoulder pain and many other health problems. This is an approach that stays away from the injured area of the body. For example, for left shoulder pain, points on the right calf are chosen. Very appealing for people who do not want to have needles inserted in a painful area!

In addition, I use herbal ointments and liniments derived from East Asian martial arts traditions that can be applied topically to reduce inflammation and pain, and speed healing of the injured tissues.

How did we get here?

It’s good to know that there are are wide range of therapeutic options to fit your particular circumstances, but it’s also important to gain an understanding of why we develop these shoulder problems in the first place. I will take a crack at it.

First of all, it’s pretty clear that humans are not monkeys or apes, though they’re pretty close relatives to our species. These animals evolved to use their upper extremities in ways that humans gradually lost as we evolved to walk and use more sophisticated tools. As a result, the attachment of our hands and arms to the central part of our bodies, namely the torso, is now quite different and not optimally designed to hang from tiny hand holds with our body weight (and gear).

Many people who start climbing notice that they gain strength in their upper extremities within a few months. Then, the problems start. This is because tendons and ligaments take much longer to adapt to the physical stress of climbing than muscle. We’re typically talking a couple of years, not a couple of months.

In addition, hard climbing strengthens certain muscles and neglects others that can throw your agonists and antagonists out of balance and contribute to poor body alignment and posture. Just take a look around the climbing gym. What happens is that many climber lose awareness of the connection between their arms and torso provided by the shoulder-stabilizing muscles. These are of course not as visible to you as your biceps. Out of sight, out of mind. An argument could be made that the core muscles of your spine and those attaching your shoulder blades to the ribcage are more important in climbing than the muscles in your arms and forearms. Without this strong support from your back, your rotator cuff muscles and all the muscles down the line have only a weak connection to your center of gravity and will have to work much harder than they’re designed to do.

Developing awareness and a holistic training program to address these connections is fundamental to avoiding severe shoulder injuries and during recovery and rehabilitation. Unless you already have extensive experience and body awareness from yoga, pilates or physical therapy, I recommend that you seek out a therapist or trainer with solid knowledge of postural training. It can be difficult to get the hang on your own.

Lynn Hill often spoke about patience

One of the biggest challenges, though, is to have patience. Depending on your age, your nutritional status, your overall health, and the type and severity of your injury or irritation, healing can take a long time. Icing has been mostly debunked as a helpful therapy. Even complete rest will slow your healing, so very gently movement that doesn’t aggravate the injured area can promote circulation to the healing tissues, reduce adhesions, and teach the tissues what their functional range is while they lay down new fibers.

Resuming strength training and climbing hard will probably have to wait longer than you’d like. Try to keep up your fitness by engaging in other sports or exercise. Once you resume these activities, it’s important to really pace yourself, start at a level you might find embarrassing in normal times. Really emphasize rest days because this is actually when the healing and strengthening happens. The time we need to recover from a training session or climbing day lengthens as we get older, though this doesn’t mean we’ll automatically get weaker if we don’t constantly work out hard.

Next time you step up to the wall, check out how much you can do with your feet instead of your hands, à la “hike when you can, climb when you must.”

© 2021 Christiane Siebert