When it comes to common climbing injuries, climbers suffer primarily from upper extremity injuries. In a study published in the US National Library of Medicine at the NIH, 90% of the 357 participants who climbed regularly reported sustaining an upper extremity injury. Per the study:
“Fingers (41%) were the most commonly injured, followed by the shoulder/arm (20%) and the elbow/forearm (19%). The most commonly reported injuries were abrasion/bruises (66%), followed by lacerations (57%) and tendon injuries (56%). Of those reporting a tendon injury, 86% were reported as a flexor tendon or pulley injury of the hand.”
With those kinds of statistics, it’s no mystery why climbing foot injuries are often overlooked in the climbing world. There are, however, common acute and chronic foot injuries climbers encounter – many of which are not represented in the limited number of studies on lower-extremity climbing injuries.
Chronic Climbing Foot Injuries and Conditions
The use of extremely tight climbing shoes causes a whole host of conditions. The fit of climbing shoes not only changes the biomechanics of the foot, but it also increases the load and stress applied to the fore-foot. In addition to bunions, corns, calluses, toe rot, subungual hematoma and pitted keratosis, overly tight climbing shoes can cause a number of chronic toe and foot issues.
A form of osteoarthritis, hallux rigidus is a progressive condition that affects where the big toe connects to the foot. Advance stages make walking difficult and painful – and serious cases may require surgical intervention to shave the bone, fuse the joint or insert an implant for support.
Hammertoe is a foot deformity that creates an abnormal bend in the middle joint of the (typically) second, third and fourth toes. Hammertoe is caused by an imbalance in the ligaments, tendons and muscles that keep the toes straight and stabilize the foot.
While most bones in the body are connected by joints, sesamoids are attached to tendons or embedded in muscle. There are two sesamoids in the underside of the foot, near the big toe, that act like pulleys, assist in bearing weight and help elevate the bones in the big toe. A form of tendinitis, sesamoiditis is when these two tiny bones are inflamed.
While there are a number of chronic foot conditions climbers suffer from regularly, the risk of acute lower-extremity injuries is nearly as common as acute upper-extremity injuries. As noted in the NIH study above:
“While injuries of the upper extremity are widely discussed in rock climbers, reports about the lower extremity are rare. Nevertheless, almost 50 percent of acute injuries involve the leg and feet.”
The following acute injuries are typically caused by ground falls, rock hit trauma during a fall or getting zippered in while belaying.
Thankfully, foot sprains are incredibly rare for climbers (one benefit of tight climbing shoes). While they’re technically not a foot injury, ankle sprains are the most common lower extremity injury and are all too common among climbers.
Acute, painful and usually ugly, foot contusions (aka bruises) are typically caused by traumatic impact with rock during a fall. While not as serious as a fracture or even a sprain, contusions from climbing can be treated at home with RICE: rest, ice, compression and elevation.
Fractures in the foot can range in scope and severity: tiny cracks to multiple fractures to complex fractures in which the bone(s) pierce your skin and are exposed. In climbing, foot fractures result from traumatic falls and impacts and may require surgery to repair.
So, you may want to think about more than just foot holds the next time you climb. While lower-extremity climbing injuries are largely overlooked, climbing foot injuries are more common than you might think.
If you have suffered an injury while climbing and have questions about what to do, please don’t hesitate to contact us. One of our orthopedic surgeons will be happy to answer any questions you may have.