Physiotherapy in sport

Many people view physiotherapists as a glorified masseuse, ‘magic sponge’ operator or extra linesman/walkie-talkie operator. In reality a sports physiotherapist; in particular a climbing physiotherapist is a complex and ever changing role.

Ultimately their principle role is diagnosis. The physio needs to understand the symptoms the climber presents with and structure an effective treatment pathway to allow them to return to their sport. The physio must be able to tell the climber 5 key points:

  1. What the cause of the pain is
  2. What to do to get rid of the pain
  3. What they can do to rehabilitate their injury
  4. How long until they can return to climbing
  5. How best to prevent the injury from reoccurring

Ligament injuries, contusions and fractures are the most common injury types in climbing1, with sprains and strains combined accounting for 53% of these and the cause being repetitive overuse in 42% of all injuries. Interestingly hands and fingers were the most commonly injured areas at 21%2 and worryingly flexor pulley injuries in the hand occur in up to 20% of climbers3. This shows there is clear need for physiotherapy input to ensure climbers can return to their beloved sport. We will be delving in to injuries further in the blogs to come.

Research is providing scientific data on many aspects of climbing; for example the maximal voluntary contraction of crimp and open-crimp positions4, maximal muscle strength5 and rapid force capacity of finger flexors6, all allowing physiotherapists to better understand the demands of climbing, prepare you effectively and prevent injuries as best as possible.

The recent explosion of research in sport and exercise science has provided a wealth of data for climbers and physiotherapists. Although research is relatively scarce in climbing compared to most sports there is wide ranging information that can be used to understand the forces that act on the body during movements, an understanding of the key factors that allow bone, muscle or ligaments to heal, implications of movements and training methods that can both help prevent injury, improve performance and rehabilitate from injury.

We strive to keep up to date with sport physiotherapy research and aim to provide you with the most current and best evidenced practice. A well known example is the P.R.I.C.E principle (Protection, Rest, Ice, Compression and Elevation) immediately following an injury. Thanks to research, this has now progressed to P.O.L.I.C.E (Protection, Optimal loading, Ice and Elevation)7. Although an injury needs an initial period of rest (known as protection), it is now thought progressive loading of the tissues best promotes healing in the structure, whilst allowing restoration of strength and function. This loading provides stimulation of the natural healing process, preventing deconditioning of the tissues and can actually reduce swelling through the body’s natural process of venous return with muscle contractions. Of course the key is balance hence the ‘optimal’ in the P.O.L.I.C.E. acronym.

This is why physiotherapy is regarded as highly as it is. Physiotherapists in sport are in a suitable position to work with you (and your coach or personal trainer) to prevent injuries, manage symptoms when you have them and provide you with a professional, evidenced based, progressive functional rehabilitation programme. We are lucky here at Climbing Physio to be based at Highball Climbing Centre, allowing us to provide comprehensive rehabilitation both on and off the wall.

If in doubt or concerned by your injury then always see a doctor to get it properly assessed and of course come see us to allow a thorough assessment and guidance of your rehab.

  1. Neuhof, A., Hennig, F. F., Schoffl, I. & Schoffl, V. 2011. Injury risk evaluation in sport climbing. Int J Sports Med, 32, 794-800.
  2. Woollings, K. Y., Mckay, C. D., Kang, J., Meeuwisse, W. H. & Emery, C. A. 2015. Incidence, mechanism and risk factors for injury in youth rock climbers. Br J Sports Med, 49, 44-50.
  3. Kubiak, E. N., Klugman, J. A. & Bosco, J. A. 2006. Hand injuries in rock climbers. Bull NYU Hosp Jt Dis, 64, 172-7.
  4. Fanchini, M., Violette, F., Impellizzeri, F. M. & Maffiuletti, N. A. 2013. Differences in climbing-specific strength between boulder and lead rock climbers. J Strength Cond Res, 27, 310-4.
  5. Balas, J., Panackova, M., Strejcova, B., Martin, A. J., Cochrane, D. J., Kalab, M., Kodejska, J. & Draper, N. 2014. The relationship between climbing ability and physiological responses to rock climbing. ScientificWorldJournal, 2014, 678387.
  6. Vigouroux, L., Goislard De Monsabert, B. & Berton, E. 2015. Estimation of hand and wrist muscle capacities in rock climbers. Eur J Appl Physiol, 115, 947-57.
  7. Bleakley, C. M., Glasgow, P. & Macauley, D. C. 2012. PRICE needs updating, should we call the POLICE? Br J Sports Med, 46, 220-1.