Common Climbing Shoulder Injuries and How to Treat Them

4 Exercises to Get Your Shoulder Ready For Fall

Common climbing shoulder injuries

Our shoulders are a pretty amazing joint; they allow for movement in nearly any plane. Due to the nature of the joint, we trade some amount of stability in favor of maintaining a significant amount of mobility. As a result, the muscles surrounding the joint have to work hard to keep you strong through your full range of motion. 

Climbing as a sport can challenge the limits of both our shoulder’s mobility and stability and unsurprisingly shoulder injuries are a relatively common site of injury or discomfort for climbers.  A few of the most common rock climbing injuries we see in climber are: 

  • Impingement 
  • Rotator cuff muscles strain 
  • Labrum tear 
  • Tendinopathy 
  • Cervical spine referred pain
  • Rotator cuff tears

Causes of climbing shoulder injuries 

  • Repeated loaded overhead motion: We reach overhead A LOT in climbing. Not only overhead, but off to the side, behind your back… really we reach in all directions. Our shoulder joints are designed to allow for a large range of motion, but on occasion some structures can become irritated when we repeatedly utilize that range of motion. This is typically more of an “overuse” injury and develops slowly over time, rather than experiencing a specific moment of injury. 
  • Loading at end ranges: Climbing presents many opportunities to utilize our full wingspan and reach in order to get to the next hold on a route. It is more challenging to engage muscles at the extremes of our muscle length (when the muscle is maximally lengthened or shortened). In these cases, there is an opportunity to overuse or strain a muscle in an attempt to pull on a hold that is far away. 
  • Muscle imbalance:  The fun thing about climbing is that it forces you to move in many directions and solve sequences.  Although you are moving in many planes, climbing is essentially a ‘pulling down’ activity and that can cause certain muscles to become more developed than others.  
  • Dynamic loading: Certain movements in climbing require moving dynamically to a hold. Sometimes this happens during a dyno, other times it happens when your foot slips unexpectedly and you find yourself catching the next hold with some unexpected momentum. In either circumstance, this results in your shoulder absorbing a load quickly. If you are fatigued or if you have some weakness in the muscles around your shoulder this can result in an injury to either the muscles, tendons or labrum. 
  • Traumatic loading: This is a less common injury but can occur when your shoulder is unexpectedly overloaded and your muscles are unable to control the motion at your shoulder joint. This type of loading can result in a dislocation or subluxation. 
  • A dislocation occurs when the ball of the humerus (upper arm) is displaced fully out of the socket of your shoulder joint, often requiring assistance to “pop it back in place.” A subluxation occurs when the humerus is partially, but not completely, displaced out of the socket and typically does not require any assistance to return to a neutral position in the shoulder joint. 

Exercises for shoulder injuries 

Whether you are training and trying to stay on top of injury prevention or starting to notice some nagging pains in your shoulder, these exercises provide a good place to start building a strong foundation for your shoulders. If you are unsure about which exercises to try based on your shoulder pain, please schedule an appointment with one of our physical therapists to establish the best routine for you. 

We have put together this list based on the most common areas of weakness we see in clinic. We do not recommend pushing through more than a 2/10 pain with these exercises. Please note that these are not “level 1” exercises so these might be challenging if shoulder strengthening is new to you. 

Rotator cuff strengthening: these can be good if you have pain in the front of your shoulder joint or in the back and are generally good for overall stability 

  • “Rocket Ships” – This exercise is an excellent blend of rotator cuff strengthening and scapular stability (see below) making for a very climbing specific and efficient exercise
  • Set up: band anchored at shoulder height and to the opposite side of your body as the arm you intend to exercise


  • Start with your arms folded in front of you at shoulder height
  • Rotate your top arm so that your hand is now pointed towards the ceiling
  • Keeping your forearm vertical with your wrist stacked over your elbow reach towards the ceiling
  • The exercise stops when you cannot maintain this alignment while reaching up

Scapular strengthening: the muscles that attach to your shoulder blade and assist with overall shoulder stability overhead include your lower trapezius, middle trapezius and serratus. These muscles are notoriously weak for most climbers and can play a big role in overall shoulder health. 

  • “Cheerleader pom-poms”: affectionately named by a previous patient, this exercise involves pressing your arm up overhead at about a 145 degrees angle (diagonally up) and engaging your lower trapezius and middle trapezius to assist with the motion. 
  • Set up: band anchored in front of you at about waist height 


  • Relax the top of your shoulder at the base of your neck (upper trapezius) 
  • Keep your shoulder, elbow and wrist all lined up in the same plane 
  • Press your arm-up to the side at about 145 degree angle and slowly return to start position 
  • Try to stay relaxed in your neck and top of shoulder and emphasize engaging the muscles in your back 
  • Serratus Block Raise: the serratus is a muscle that attaches to your shoulder blade and helps rotate your shoulder up as you lift your arms overhead. This muscle is an important stabilizer and is often under-utilized by climbers. 
  • Set-up: yoga block between your elbow, light resistance band in your hands


  • Place the yoga block between your elbows, this helps keep your elbows in line with your wrists 
  • Hold a light resistance band between your hands with light tension, keep your wrists in line with your elbow
  • Keep 90deg. bend at elbows, shoulders relaxed and raise arms up toward the ceiling
  • Lower arms back down and repeat 

Muscle Mobility: As addressed earlier, climbing can cause some muscles to become stiff, tight, and too developed relative to others in the shoulder complex.  Very commonly this is the latissimus dorsi and may also be the pec minor and/or major.

  • Foam Roll Stretches – Set up: Start laying with your back aligned along a foam roll so you are supported from your pelvis up along your back and head


  • Start with your hands together reaching up towards ceiling
  • For a pec stretch: make a large radius allowing arms to reach to the side opening up your chest and your body makes a “T” shape.  You should feel a gentle stretch in your chest. (note: in the picture his arms are bent, you can perform this stretch with arms straight or arms bent depending on comfort)
  • For a lat stretch: keep your hands together and allow your arms to reach overhead.  Stop at the first point of muscle resistance, give a gentle reach overhead (hands will be pointing towards the wall at this point), and allow arms to be heavy and continue towards the floor
  • Important considerations: these should be stretching muscles and not nerves or joints.  If you are feeling numbness or tingling and/or a stretch/discomfort in joints back off.

When to seek physical therapy for shoulder injuries 

Not all climbing injuries are season-enders.  It can be challenging to know what is going on and if it is important to take relative rest, to strengthen and load the tissue, or to seek additional medical care. To ensure a thorough diagnosis, create a recovery plan that is right for you and get back out on the rock as soon as possible, please schedule an appointment at our Seattle-based physical therapy office, where we specialize in treating the injuries of rock climbers.  


About the authors

Jon Sparks, PT, DPT, CSCS is a physical therapist at Union PT in Seattle. He is experienced in treating acute and chronic industrial injuries, postoperative rehabilitation and orthopedic injuries. He enjoys staying up-to-date with evidence-based treatments. Outside the clinic Jon is thoroughly obsessed with rock climbing. When not climbing, he enjoys traveling, exploring new restaurants and snowboarding.

Shannon Russell, PT, DPT is a physical therapist at Union PT in Seattle. She was initially drawn to physical therapy after a series of injuries while competing both nationally and internationally in rock climbing competitions. She also has experience as a route setter in the Seattle area. She has a passion for blending her rock climbing background and love for outdoor activities into her treatment of local athletes and outdoor enthusiasts.