For the past six months (give or take a week) my right index finger has been swollen around the first finger joint above the knuckle. It is, however, very swollen and the past several mornings it has been especially stiff. I am 24 and have been climbing for seven months. Climbing causes no pain, but any lateral pressure applied to the index finger (such as scooping peanut butter or using the touch pad on my laptop) can cause a minor twinge. There is a bit of stiffness and grinding, but it’s fairly minor and goes away after I warm up. If I fully extend the finger a distinct clicking noise seems to come from the lateral ligament (on the left side of the right index finger). Should I take an extended break from climbing? Avoid crimps? Switch to squeezable peanut butter?

Evan / Forum

Sounds like you are suffering in a joint that is not accustomed to what you are asking of it. This kind of issue is quite common among beginners. The synovial surface and connective tissues that give stability to the joint are simply not strong enough to cope with the load. This prevents the bone ends from operating in a nice mechanical fashion, which leads to inflammation and, usually, pain.

Slow down, cowboy. There’s still time for you to become world champion, but you are just going to have to let your bits adjust to the load. The first couple of years of climbing are where most of this “adjustment” takes place, so be careful and give your body all the rest it needs. Let pain be your guide.

Avoid crimps like they were made of asbestos and coated with arsenic. Avoid squeezable peanut butter as a general rule.


I’ve been battling posterior shoulder pain since about 2005. It’s an aching, hard-to-pinpoint pain all around the left scapula that builds gradually during a climbing session and is most noticeable during rests between climbs. The pain seems to be related to volume rather than intensity. I don’t experience pain every time I climb but it is more likely if I’m not taking two or three days off between climbing days. I’ve seen several PTs and orthopedic specialists over the years and have tried a host of shoulder- stabilizing exercises and stretches. An MRI showed an area of persistent inflammation around the supraspinatus. A steroid shot and physical therapy seemed to keep the pain at bay for several months but it has since returned. For bouldering season I was able to minimize the frequency of painful sessions by always taking two days off between sessions. Now, however, even that strategy seems to be failing despite continued attention to shoulder-stabilization exercises and stretches.

Ed mclen/ Forum

Chronic pain is like the sword of King Arthur, obstinately intractable unless you find someone with the right touch. I, of course, have that touch, and am more than willing to pull the sword of pain out of my fellow man. Unless you are wealthy, and then I ask just for a small Greek island.

Posterior shoulder pain doesn’t necessarily originate in your shoulder. That’s the most obvious answer to your conundrum, given that an MRI has shown little by way of a pain source. The area of chronic inflammation could be it, but it doesn’t sound like it can account for the volume of your pain. That said, it’s worth trying to strengthen that tendon with some eccentric supraspinatus exercises.

Have the previous physicians looked at the possibility that the pain is coming from your neck? Is the pain worse when you are climbing or bouldering? If it’s worse on routes, the continual neck extension could be aggravating a disc/nerve root.

Scapula pain, for the most part, is a product of thoracic dysfunction. Teenage boys who have a disease called Shermans, which causes early degeneration of the midthoracic spine, have a particular propensity for your presentation. But either way, I would have someone look at you and determine whether you need some thoracic mobilization and strengthening. Get a set of thoracic x-rays.

Pain and mechanical dysfunction arising from the thoracic spine can easily cascade to affect the way your scapula moves, which could cause tendon issues at the shoulder, but they would be secondary, so treating them as primary is Band-Aid therapy only.


A week ago I injured my left knee while heel hooking on a boulder problem in the gym. There was an audible pop and moderate pain/numbness immediately thereafter. Pain is now pretty localized to the outside of the knee, in the groove between what I think is the hamstring tendon and IT band, just behind the top of the fibula. If I bend my leg slightly and drag it towards me there is sharp pain in this location. 

Climbgunks/ Forum

Though I am reluct ant to say something has been missed on the MRI, your history strongly suggests as much. Or at least the MRI hasn’t been read with a particular injury, one that is uncommon in the normal population, in mind. Although this site is viewable on most knee MRIs, it is often overlooked as a source of pain.

The Tibiofibular joint at the knee has two primary ligaments, anterior and posterior. When you rock onto a heel, usually with your knee pointing more out than up, these ligaments are under enormous duress.

One of my patients snapped both of hers, and now the head of the fibula floats around like yesterday’s celebrity. Most often, only one ligament ruptures, and the joint remains quite stable.

I have only seen this injury in climbers, and usually at a rate of one every few months. The history is always the same and almost identical to yours. A heel rockover is the primary mechanism of injury; heel-toe techniques are especially aggravating post injury, and can take up to several lifetimes to settle down.

This is a complex area and other structures could be involved. I can’t rule out some damage to the popliteus and its anchors if your foot was pulling in line rather than the rock over described above. Either way, surgery is unlikely and it’s a matter of time and rehab.