Do you have shoulder pain when climbing? - 4 underlying factors

Have you ever had an epic climbing session and had to stop because you were experiencing pain in the shoulder? Nothing can ruin your flow during climbing more than experiencing pain during or after a climbing or bouldering session. As a physiotherapist working in a bouldering & climbing hall, I see a lot of climbers with these pains and aches. One of the most common injuries I see is this pain on the front side of the shoulder while climbing or after a session. In this blog I want to point out a few things that I think are really important in treating and preventing these issues. If you ever had problems with your shoulder or you still have some issues, hopefully this blog can help you out!

Let’s start with describing where your pain is coming from and which symptoms I often see in our practice. The most commonly the pain is on the front side of the shoulder with symptoms varying from:

  • Pain radiating towards the chest and/or biceps, for sometimes it radiates all the way down to your elbow.

  • Mostly it’s painful with overhead and rotation movements in your shoulders.

  • Sometimes it’s can be a very specific movement you do with your shoulder that suddenly provokes pain, and other times the pain is random and non-specific while you move your arm

So what is actually causing your pain? What I see in most cases is that the muscles responsible for the pain are located on the BACK of the shoulder blade, even though you don’t specifically feel it there. Anatomically it makes sense, the muscles come from the back side of your shoulder blade and all insert the frontal side of your upper arm. These muscles are better known as your rotator cuff muscles. These muscles are small and their main goal is to locally stabilize your upper arm in your shoulder socket. Once you load them to much, let’s say by putting a lot of force on them when you are hanging on a hold, they tend to get injured and cause the pain you are feeling. Your big shoulder and back muscles such as your Lattisimus muscles are meant to take the most of the load. I’ll talk about this more in detail later on.   

Let me first point out that when you exercise there is always a chance in getting an injury. This happens to the best and you shouldn’t be worried about experiencing pain in the shoulder ones or twice. However, if it is an issue that keeps returning or doesn’t get better over time. It could be that there is an underlying cause why the injury is not healing and why you’ve got the injury in the first place. In the end there are many factors that could play a role, let me point out a few factors that I see a lot: Mobility, Strength, Stability and Climbing technique. Let’s break it down for you.


How you can help yourself with (preventing) shoulder pain:

Mobility

A big issue (not only for climbers, but with a lot of people in general) is the lack of external mobility of their shoulders. You can measure this by bending your elbows 90 degrees and putting them in your side, now rotate them outwards and you should be able to make an 90 degrees rotation. Of course everybody is anatomically a little different so it can be different between person to person. It’s not pure your shoulder that is responsible for a having a healthy external rotation. A good mobility in your neck and your upper spine are just as important for your overall shoulder health. If your mobility is not ideal, you may be putting a lot of tension and stress on your muscles, joints and ligaments in order to get to those big reaches while doing static movements. Because you could be forcing yourself in a position your joint a not able to do. 

“So I should stretch more?”. Well yes but there is more to it. Moving your joints from the beginning to the end of their range of motion is a very healthy way for maintaining a good mobility. Generally, we think mobility problems form because of a sedentary lifestyle. The lack of movement and long-term static body positions we have on a daily basis negatively affect the mobility in our joints. There are of course other reasons, such as a former injury or a dis-balance in muscle strength causing problems in our posture. 

Flexibility is however not the same as having a good mobility. Because your joints need to have a good stability in order to move correctly. This brings us to our next point, because if you want to increase your mobility on the long term, it’s important to work on your coordination and strength, especially in your mid-back section (more over this in a minute).

Stability

Stability is defined as the ability to maintain control of joint movement or position. This means that your surrounding tissues (such as muscles and ligaments) and your neurological system are fine-tuned and work properly together. Improving your coordination gives you more stability in the joints and can be trained with any kind of exercises with a little bit more focus on the aspects speed, timing, complexity and most important of all: mindfulness and concentration. To give you an example of a few drills we love to do, we can recommend doing the T4 spine mobilization and the crab reach. These are great exercises to make you actively bring your joints to the end of their range of motion, therefore improving the stability and mobility of your joints. There are great tutorials on YouTube or you can check out our blogs on our website!

We also love to look at the Joint-by-Joint approach to give you an idea that if you want a good mobility in let’s say your shoulder, you need a good stability of the surrounding joints as well.

Strength

Climbing is a great sport because it’s full body and every muscle in your body needs to work together. However, most of the time you are fighting against gravity with your front side towards the wall, this puts more load on your frontal side of your body than your back side. In other words, if you just do climbing your frontal muscles will develop stronger than the muscles that are on the back of your body. Frontal muscles tend to give load internally, the muscles on your back give load externally. To prevent a disbalance in strength between your frontal muscles and your back muscles, we would recommend you target the following muscle groups: Lattisimus muscles, lower traps and yes, for your shoulders sake, train your glute muscles. Your glute muscles are important for a healthy body posture and have an important connection with your Lattisimus muscles. The two muscle groups are strongly connected and can’t be used on their full potential without having proper strength and control in both muscle groups. On our website and YouTube channel you will find great exercises you can do to improve the strength in these muscles. Also, grip has a huge connection with your shoulder stability. Therefor improving your grip strength as a climber, can reduce stress in your shoulder muscles and make you climb stronger and longer. You can read more about the importance of your grip strength in an earlier blog we have on our website. 

Here are three exercises I love to do in order to work on these three muscle groups: 

Scapular pull-ups

  • 4-10 reps, 2-3 sets 

  • Slowly and controlled, focus on squeezing your shoulder blades together and releasing them.

TRX row with T or/and Y combinations 

  • 10-15 reps, 2-3 sets

  • Concentrating on your mid back section, keeping your shoulders depressed. 

Reversed plank combinations 

  • Hold 45-60 seconds, 2-3 sets/ OR with TRX 8-12 reps, 2-3 sets 

  • Focus on squeezing your butt in order to maintain a straight back, not a hollow back. 

Climbing technique

Your climbing technique has a huge impact on how much pressure you put on your shoulder. One of the most important issues we see with a lot of beginners is that they don’t engage their big shoulder blade muscles and therefor ‘hang’ in their arms, putting a lot of pressure on smaller muscles and tendons. But also intermediate and experienced climbers could work on small things as their footwork or the intensity they grab on the holds to reduce the pressure on the shoulder. I would recommend to attend coaching classes within your climbing community to see which technique you can work on in order to make your chances of injuries smaller.


Hopefully this blog has helped you out knowing where your shoulder pain is coming from and what you can do to heal and prevent it in the future. If your shoulder pain doesn’t get better and if you have questions whether you are doing right for your healing process, I would recommend to have a check-up with a physiotherapist or any other shoulder expert. So you can check on other things that might work for you. If you have any questions feel free to contact us and we would love to hear your feedback! Keep climbing and enjoying your time on the wall!