Although the palm is extremely complex, with many intrinsic muscles and tendons, climbing injuries affecting this area are relatively few. This article focuses on a few common injuries and best practice for treatment.


This is an updated version of probably the most widely read article in climbing media history! Why? Because if you’re excited about climbing, chances are you will at some point try a little too hard for a little too long and your elbows wont like it one little bit.


Tennis elbow. Bugger! Read here, but for more info read Dodgie Elbows Revisited, Ask Dr J (201) and check out the Frying Pan protocol in the videos section. Golly gosh, and then there is the Voddoo floss band for elbow tendonosis, and compression garments to make the legs of an old man jealous.


Can you climb on an osteochondral fracture before the doctor says? NO! How about blunt trauma to the inside of your knee? Possibly, possibly not. Dodgie Elbow? For sure, if you’re doing the right exercises (check out Dodgy Elbows [issue 156], and the more recent update, Dodgy Elbows Revisited [issue 223]).


Is a swollen tackle box a hydrocele (swollen scrotum), varicocele (dodgy veins), spermatocele (a school of wayward swimmers) and or a tumors (badness)? Is a hose clamp better than tape for supplementing the strength of a strained pulley? How long should a wrist injury like a TFCC strain be immobilized for? Such great questions in this episode of Ask Dr J.

ASK DR J – ISSUE 199 – Arthritis, Inevitable?

Is pain in the base of your thumb arthritis? Maybe. Is bilateral shoulder pain rotator cuff tendonosis? Probably, but the ‘maybe not’ side of the argument definitely warrants further investigation. Oh, and another dude with elbow tendonosis resulting from shear exuberant enthusiasm. Also check out Dodgy Elbows [issue 156], and the more recent update, Dodgy Elbows Revisited [issue 223].

Tape and Other Catastrophies

Finger injuries are perhaps the most common amongst climbers. [Certainly upper limb injuries would constitute around 80% of all injuries]. Of these, the vast majority involve damage to what is called the pullie apparatus.

Dodgy Elbows

Dodgy Elbows Click here to download the pdf which contains the full rehab program. More recalcitrant than Castro, though less charismatic, elbow pain is the most common and debilitating of chronic climbing injuries. It might be called golfer’s or tennis elbow, but it is climbers (and professional knitters) who are most likely to suffer the […]

Ankles Away

Ankles Away Climbing Doc Julian saunders gives the lowdown on boulders’ most injured joint Click here to download the pdf Highball atmospherics are the elixir of life. Once you start doing them, nothing else will quench your thirst in the same way. Like narcotics, great sex with someone you don’t like and pre-emptive strikes, this […]

Avoiding Injuries

Avoiding Injury A complete guide to your body Click here to download the PDF Snap! Bang! Grind! Ow, FUBAR! Oh, the mellifluous sounds of injury. Their regularity forms the leitmotif of Modern Climbing: the Musical. If you get into the groove, you will end up dancing the Charlie Foxtrot. As training and preparation move into […]

Stretching The Truth

Stretching The Truth Click here to download the pdf The age-old art of bending yourself into positions never before realised sat at the citadel of conditioning theory. Now the news—apparently stretching ‘doesn’t do anything’! The citadel still stands but on shaky foundations; think the Leaning Tower of Pisa! Stretching has been studied primarily on three […]

The Injury Gospel

The Injury Gospel Injured again—bummer. Julian Saunders helps you off the injury treadmill Click here to download the pdf Thou shalt not crimp, much Two groups of people crimp: beginners (because it feels stronger), and those who never grew out of it. Two groups of people crimp significantly less: those who naturally evolved, and those […]

Wrist Injuries

The Big Squeeze NAVIGATING THE SLIPPERY SLOPE OF WRIST HEALTH Click here to download the pdf THE WRIST, INNOCUOUSLY situated between your hand and elbow, home to eight carpal bones and a web of ligaments and tendons, is a Pandora’s box of injuries: cysts, ganglions, repetitive strain injuries (of many painful flavors),fractures, arthritides, ligament and […]

Shoulder Impingement

Click here to download the pdf As any biologist will tell you, ‘the Golden Rule’ when studying an organism is that structure governs function. Our shoulders are purportedly designed for everyday dexterity and range of motion, not swinging about on vines— or for that matter, cliffs. Ask a few of your friends; chances are that […]

Stressed Out Fingers

Dr. J takes a look at climbing’s most under diagnosed injury: finger stress fractures. Click here to download the PDF You might think it would be difficult to break a finger while climbing. However, the chronic prehensile force generated by a climber is second to none. With training techniques focusing on nano-hold strength, and the […]

Ask Dr J – Issue 198 – NSAIDS: Killing you softly with their love

A hysterical aversion to even the lowest end of the pain spectrum is driving the tsunami of non-steroidal anti-inflammatory drug abuse. Is it an egg laid by the pharmaceutical giants? In other news, a climber suffers a labral tear in his shoulder, and a young lass poses the question of whether to get her ankle fused following a horrid break and eight surgeries.

Ask Dr J – Issue 197 – “I hate rock climbers”. Cripes!

The long run on wrist injuries continues in this installment of Ask Dr J – a TFCC tear, a pinch of bone necrosis and a surgeon who shall here after be referred to as Captain Tactless. Let me say this straight – injectable therapies like PRP injections for anything at all is about as therapeutically effective as Joan Rivers would be as Secretary Of State. For elbow tendonosis try an eccentric weight program (Dodgy Elbows [issue 156], and the more recent update, Dodgy Elbows Revisited [issue 223]).

Ask Dr J – Issue 196 – Out For Life?

Looking down the barrel of a third operation to repair ligament and triangular fibrocartilage complex (TFCC) damage in your wrist is a solid reason to question your choice of sports. Additionally, we take a squiz at the pitfalls of caffeine withdrawal. Here’s an idea – don’t stop!

Ask Dr J – Issue 195 – Sex and Elbows

Opioid pain medication can knock your testosterone levels to somewhere south of your ankles. So does taking testosterone supplements affect your climbing? Oh, and here’s a surprise, another elbow with medial epicondylosis. How about surgery for that? Also check out Dodgy Elbows [issue 156], and the more recent update, Dodgy Elbows Revisited [issue 223].

Ask Dr J – Issue 194 – Love The Sloper

Crimping is associated with pulley injuries. Slopers are associated with wrist injuries, namely damage to that pesky little thing called the triangular fibrocartilage complex, or TFCC for short. Our second question is from . dude who ruptured a finger tendon. Holy leaping short-arses, Batman! Yes Robin, you heard me. Ruptured. Finger. Tendon. Can’t say I have ever seen one in real life.

Ask Dr J – Issue 193 – Practitioner Love

I’m pretty sure Molly has a crush on me. This is the second time she has written in, although this time it is about a chondral fracture in her knee from a bouldering fall rather than the last time when she had to grab her bum because she tore her hamstring insertion. Palm pain from pocket pulling? It’s probably a lumbrical tear, and yet another practical use for the Dr J Test.

Ask Dr J – Issue 192 – Ankle Mayhem

Having dislocated an ankle while bouldering, Dr J can empathize. Will it ever be normal? No. Like sands through the hour glass, we discuss elbow tendonosis yet again. Also check out Dodgy Elbows [issue 156], and the more recent update, Dodgy Elbows Revisited [issue 223].

Ask Dr J – Issue 191 – Snap, Crackle, Wrist

In this issue Dr J takes a look at cartilage damage in the wrist (triangular fibrocartilage complex, or TFCC for short), the real and potential dilemmas of being struck by rock-fall, and how an enormous man called Gatito, meaning kitten, is the very definition of why a smashed ankle doesn’t necessarily need to hold you back.

Ask Dr J – Issue 189 – Ruined!

Does hypermobility lead to tendonosis? No, that’s a croc of shit. Read on. Have a look at Dodgy Elbows [issue 156], and the more recent update, Dodgy Elbows Revisited [issue 223] for an in depth look at elbow tendonosis rehab. And we look at yet another story of “ You will never climb again”. I mean, really, people climb with no legs, this guy only has a bit of his patella missing.

Ask Dr J – Issue 187 – Cracked Tip Smackdown

There are actually people who don’t use chalk. It true, no joke. And they climb HARD! So if chalk is messing with your skin, simples, don’t use it. We also take a look at what could be the cause of lumps forming on your fingers.

Ask Dr J – Issue 185 – Bouldering? In your dreams!

ACL rehab and when you can return to climbing is first cab off the rank in this Ask Dr J column. After that we head north to the shoulder and discuss how to approach a SLAP lesion (a type of cartilage tear), and what to do when your bicep tendon pulls anchor and sails down to your elbow.

Ask Dr J – Issue 184 – Chin In, Tits Out

Why do some climbers look like the Hunchback of Notre Dame? Can you climb with herniated discs in your back, and is banging your head in a car door more therapeutic than spinal surgery? What happens when an A2 pulley passes through the Land of Overtraining? This and other fantastical anecdotes in the Book Of Dr J.

Ask Dr J – Issue 182 – Strong to the Core

Does being told that you should give up climbing actually mean you should give up climbing? Of course not, you silly dill-brain. That just means you ask someone else! Dr J discusses ripped abdominals, trigger happy thumb (not so happy), and what is the Dr J Test?

Ask Dr J – Issue 181 – Big Boots and Tantric Pole Dancing

In this issue Dr J looks at the causes of Pseudogout (as opposed to Gout) and how little you can do for it, getting back into the swing of things after a full knee reconstruction, and why Levaquin, an antibiotic from the fluroquinolone family come with an FDA Black Box warning for tendon pathologies.

Ask Dr J – Issue 180 – SHOCKING!

Read all about it – Broken toes that don’t heal and why supplements probably wont help, electrical modalities that don’t work (aside from vibrators), and why cortisone is the new cocaine – get your copy right here, right now.

Ask Dr J – Issue 176 – Uncomfortably numb

Frozen shoulder (adhesive capsulitis) is like a bad relationship: painful, too long and, for the avid rockateer, soul destroying; what to do? Though not common in climbers, how does one solve the rather recalcitrant carpal tunnel syndrome? And we look at a rather tricky case of elbow tendonosis (also covered in Dodgy Elbows [issue 156], and the more recent update, Dodgy Elbows Revisited [issue 223]).

Ask Dr J – Issue 175 – Dust in your gun, and things that go POP!

Ever heard of a condition called Trigger Finger (not the George Bush variety)? It will cause your finger to lock into your palm. Dr J also looks at what to do with AC joint separation (AKA shoulder separation), climbers and pulley injuries (A2, A3 and A4), and cartilage (labrum) damage in the shoulder.

Ask Dr J – Issue 174 – Tabsco Fiasco

This column shed light on that dreaded painful elbow (medial epicondylosis), stress fractures in the ulna bone of the forearm, and what to do with a dislocated biceps tendon. For a more comprehensive look at elbow tendonosis, refer to the articles titled Dodgy Elbows (issue 156), and the more recent update, Dodgy Elbows Revisited (issue 223).

Ask Dr J – Issue 172 – A Viral Affair

This month Dr J explains how an itty bitty virus can cause debilitating shoulder pain, and how riding a bike can make your little finger go numb. As well, Dr J looks at one of the more common climbing injuries that can cause palm and/or forearm pain and puts forth the Dr J Test for diagnosing this injury.