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Rock Climbing Rehab


By Heather Buschman, PhD   |   June 27, 2019

Roee has been a recreational rock climber for many years. He typically climbs two or three times a week, at both indoor gyms and at local climbing hot spots, such as Mission Gorge and Eagle Peak. But around two years ago, he started having pain in his right shoulder and upper arm.

“To be honest, I waited months, maybe even a year, before seeking medical help,” said Roee, who asked to be identified only by his first name.

Roee first saw his primary care physician at UC San Diego Health, who diagnosed tendinosis — inflammation of the tendons — in his rotator cuff, the group of muscles and tendons that hold the head of the upper arm bone in the shoulder socket. That physician recommended physical therapy.

“At first, I didn’t know what to expect,” Roee said. “I had never done physical therapy before, and by nature I’m skeptical. I was willing to try it, but wasn’t going to be convinced until I started seeing results.”

Roee was referred to Jason Hooper, a physical therapist in the Koman Family Outpatient Pavilion at UC San Diego Health. Hooper is himself a rock climber, something that Roee found beneficial.

“I think that often injured climbers will tell a health care provider something like ‘I have pain when I'm crimping on this problem,’ or ‘I'm stemming out my shoulder.’ And while that might not make any sense to most people, it does make sense to me,” Hooper said.


Jason Hooper, UC San Diego Health physical therapist, frequently helps rock climbers overcome hand, finger and ankle injuries, including pulley strains or ruptures, flexor tendon tears and collateral ligament strains.

Hooper helps many injured climbers get back to their sport. The most common injuries are in the hands, including finger ligament tears, known as pulley ruptures. These occur due to the stress and slippage that occurs while climbing. He also sees ankle injuries from falls. Many patients, like Roee, experience overuse injuries in their shoulders.

“We love this sport so much that we all tend to overdo it quite a bit,” Hooper said. “It's really hard to stop climbing, even when you have a little pain and know you should take a break. Climbing can be a bit like trying to solve a puzzle as you figure out the best way up, which is a blast, but also can lead to repetitive stress from repeating the same movements.”

Since rehabilitation and physical therapy services moved into a spacious new facility in Koman Family Outpatient Pavilion when it opened in 2018, Hooper has enjoyed the opportunity to use two main pieces of state-of-the-art equipment when working with rock climbers. The first is a harness with pneumatic pressure. As a patient practices climbing techniques on a hang board with finger holes that mimic a rock wall, Hooper operates the pneumatic harness to help reduce or add body weight.

“The person can hang on those surfaces and test out his or her shoulder, wrist or hand to see if their body can handle those forces again,” Hooper said. “We then gradually work up to holding their full body weight, which helps them to train safely.”

Hooper also uses a machine that can measure a person’s strength in a particular joint. That allows him to take a baseline measurement, compare the injured side to the uninjured, and track improvement over time until the patient is back at 100 percent strength.

“These two machines in particular give us valuable information that helps determine if a person is ready to go back to climbing, or needs additional training,” Hooper said.

When Hooper’s patients need more than physical therapy, they are already at UC San Diego Health, with access to world-class multidisciplinary care, including advanced sports medicine and orthopedics care, as well as emerging surgical techniques and imaging and diagnostic tools.

For Roee, Hooper developed a personalized, comprehensive shoulder program that strengthened his rotator cuff and external rotators. He had Roee perform resistance movements with elastic bands, exercises with light weights and strengthening exercises for his shoulder. They gradually increased the difficulty of these exercises as Roee began to recover. Hooper also helped him practice very specific climbing positions and maneuvers, and they worked at it until Roee was back climbing at full strength with no pain. Roee now says he has the knowledge and training to prevent further injury to his shoulder.

“I’ve learned that physical therapy can be slow — sometimes two steps forward, one step back — but if you see an overall positive trend, you just have to keep doing it,” Roee said.

Both Roee and Hooper enjoy rock climbing in part because of the supportive community.

“You may not even know the person climbing near you and all of a sudden you're up there and they're cheering for you to finish your climb,” Hooper said.

That also means that the community frequently shares training tips and tricks with each other, which, according to Hooper, can often include misinformation about what’s helpful and safe.

“There are a lot of simple, evidence-based training techniques and safety tips that I don’t think enough climbers know about,” he said. “So the big thing for me is that I want people to know that we're here, I can relate, and I'm ready to help.”

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