Don’t climb to get fit – get fit to climb

Expert advice on the indoor climbing boom

With the surge in popularity of indoor climbing walls over the past five years, more people are climbing than ever before. This endorphin-inducing, full body exercise has scaled the charts to become one of the UK’s fastest-growing sports with more than one million participants.

"Climbing accidents have more than doubled in the last two years," he says. "While it’s less common than injuries from playing football or running, I’m seeing lots of new climbers who get injured because of their level of fitness, condition, or climbing technique."

Why climb?

Climbers are drawn to the social, emotional and cognitive benefits they enjoy, on top of the physical benefits. For some it’s a great way to relax with friends. For others it keeps the kids entertained on a Saturday afternoon. And many people find the focus and concentration help relieve stress and boost overall wellbeing.

According to Dr Seth however, those who are drawn to the lifestyle benefits don’t always start out with enough fitness for such a strenuous sport, and are more likely to get injured.

"People think they can get fit solely from climbing," he says, "but I would always advise adding some cardio and strength training around it. Climbing requires strength, tenacity and willpower. So you need to add some fitness training or gym-based activity to prepare, and climb safely."

The most common climbing injuries

1. Ligament sprains
   At least half of the climbing injuries Dr Seth treats are from bouldering accidents. This rope-free climbing style requires less equipment and is usually on lower walls. But, says Dr Seth, the risk of injury is actually higher.
   
   "People think the higher walls are more dangerous," he explains, "but bouldering is probably the biggest risk on the severity scale. You can start without much training, and still get up to three metres high. When people don’t have a proper descent, they can lose their grip, fall backwards or land awkwardly on the mat, causing twists and sprains to ankles and knees."
2. Knocks and blows
   The second injury Dr Seth sees is from top roping, the next most popular form of indoor climbing. With ropes, harnesses, and higher walls to scale, Dr Seth says people typically suffer blows to the knee and ankles from losing their grip suddenly, swinging on the rope and colliding with the wall.
3. Painful tendons
   Tendonitis in the knee or ankle is commonly linked to holding awkward climbing positions for long periods of time. Dr Seth says, "These injuries are more from overuse, but I’ve also seen acute ankle tendon flares from just one session of bouldering. People associate an Achilles injury with running, but you can easily injure it in climbing, especially when pushing off."
4. Injuries to feet
   Another big area of injury is related to footwear. Dr Seth says climbing shoes fit very tight to protect the foot and improve grip. But shoes that are too tight can also cause injuries.
   
   "I’ve seen climbers with plantar fasciitis, ingrown toenails, even metatarsal breaks, just from tight shoes. Good supportive footwear is critical to protect against injury, so we work with a podiatrist to ensure the patient’s shoes are the right fit for the type of climbing they're doing."

When to seek help after injury

While many climbers know to check out a head injury or concussion, Dr Seth says it’s equally important to seek help for joint injuries. "Any swelling in the knee or ankle, persistent pain or difficulty walking, get it checked out," he advises. "Climbing accidents are not like tripping over a step, they involve a fall from a height, so there is nearly always some trauma involved."

Maddie Tait, a Musculoskeletal Podiatrist specialising in sports injuries to the feet at London Bridge Hospital, stresses the importance of addressing any foot pain early. Maddie warns, "with ingrown toenails from tight shoes, there is a risk of infections if they’re left untreated. Most will need simple management, but more severe cases may need minor surgery."

She also stresses the importance of prevention: "anyone doing lots of climbing should get a biomechanical podiatry assessment and gait analysis to check how the joints and tendons all move."

Treatment for injuries

As Medical Director and founder of London Bridge Sports Medicine, Dr Seth works with a multidisciplinary team to offer all the latest diagnostics, evidence-based treatments and therapies for sports injuries – all delivered in a personalised plan.

"I usually do an ultrasound scan in the initial consultation to see the condition of the ligaments in the foot and ankle – followed by an MRI if needed. Most of the time, patients get a diagnosis there and then, so we can quickly start creating a rehabilitation timeline."

"I then prescribe the best exercise – on the bike or in the pool – or I bring in a physiotherapist. For problematic joints and ongoing swelling, we have other procedures such as injections. For more serious injuries such as a ruptured ACL (anterior cruciate ligament) in the knee, we bring in surgeons and consultants from every clinical specialism across HCA UK’s London network."

Maddie explains how podiatry can also help: "the toes do a lot of gripping and pushing away during climbing so tension can build up, so we use silicon separators and orthotics to combat this and better support the feet during training."

Dr Seth’s holistic approach means he also works closely with his patients to make small but significant adjustments to their lifestyle that better support their sport. The list includes sleep hygiene, social and emotional wellbeing, hormonal health, endocrine function and much more.

"I’ll often explore my patients’ levels of health, fitness and the type of training they do to prepare for climbing. It’s important that they know why they got injured in the first place, what they can do about it, and how to prevent further injury."

Preventing injury

So finally, what advice do Dr Seth and Maddie have for the new climbing convert?

• Cross train
  Dr Seth stresses that climbing works best as part of a wider fitness programme: "Climbing is a great all-round sport and social activity. But don’t forget to work on your overall fitness to climb."
• Build up slowly
  With all the feel-good chemicals that climbing produces, it’s important not to climb too high or for too long at the beginning. Dr Seth warns that over-exertion, especially in the first few sessions, raises the risk of injury. And Maddie adds that it’s important to warm up and stretch. "Ensuring good calf and ankle flexibility is really protective," she says.
• Invest in great footwear
  The right climbing shoes will protect your joints and enhance your performance. So consult a podiatrist – and choose your shoes with care. Maddie says, "a good climbing shoe should be snug enough to hold your foot in place, but not so tight or flexed that it squeezes the toes and metatarsals and overworks the feet."