Rock Climbing, Fat Fingers and Arthritis

In any physical activity, there is always the risk of acute injury - cuts, scrapes, bruises, and even broken bones are often par for the course. For some extreme sports like rock climbing, where you voluntarily drag your body hundreds of feet into the air on the side of a sheer rock wall, athletes are even willing to risk death.

Me following up a 5.9 in Rumney, NH... probably not risking death.

Those acute sports injuries can sometimes grab headlines, but people are increasingly becoming aware of the long-term consequences of physical stress on the body. Football and hokey players can suffer from memory loss and depression as a result of swelling in the brain associated with repeated concussions, tennis players often get stress fractures on their spine (not to mention the aptly named tennis elbow), and many, if not all sports are thought to increase the risk of developing osteoarthritis - in which the cartilage in your joints breaks down, allowing bone to rub against bone and inducing inflammation.

This increased risk of arthritis is of particular concern for climbers - there are a lot of joints in the hands, and climbing tweaks them in all kinds of ways.

I'm not sure who this climber is, but he was competing in the Dark Horse finals in Feb 2012

It's sort of accepted wisdom in climbing circles, and I never questioned whether or not it was true until a friend of mine told me that actually, climbers have a decreased risk of arthritis. So I decided to do some digging. 

First off, let's take a look at the increased risk of osteoarthritis for sports in general - it turns out, it's not that simple:

Participation in sports that cause minimal joint impact and torsional loading by people with normal joints and neuromuscular function may cause osteophyte [bone spur -kb] formation, but it has minimal, if any, effect on the risk of osteoarthritis. In contrast, participation in sports that subject joints to high levels of impact and torsional loading increases the risk of injury-induced joint degeneration. People with abnormal joint anatomy or alignment, previous joint injury or surgery, osteoarthritis, joint instability, articular surface incongruity or dysplasia, disturbances of joint or muscle innervation, or inadequate muscle strength have increased risk of joint damage during participation in athletics.

Let me translate: if you're not putting too much strain on your joints, a bit of sport isn't going to increase your risk. But sports that "subject joints to high levels of impact and torsional loading," does increase your risk. If hanging your entire body weight from two fingers doesn't count as high torsional loading, I don't know what does.

The move after this involves doing a one-armed pull up while holding onto that two-finger pocket

So then was my friend completely full of crap? It turns out, there have been a several medical studies on this very topic, and they offer up conflicting results. One study published in 2006 examined the hands of 26 recreational rock climbers and compared them to the hands of non-climbers. As you might expect, the hands of the climbers were much stronger than the hands of the non-climbers, and the climbers even had thicker bones, which the authors suggest might indicate that the bone is actively remodeled to make it more powerful. However, these researchers found no indication that the climbers had an increased risk for osteoarthritis.

By contrast, a study published 2 years earlier examined 19 members of the German Junior National Climbing Team (professionals), 18 recreational climbers and 12 non-climbers - these researchers determined that the climbers were at increased risk, since one member of each of the climbing groups had early signs of osteoarthritis and none of the non-climbers did. Another study published in 2011 supports this conclusion, showing that adult male sport climbers regularly get bone spurs and show significantly increased signs of osteoarthritis.

Finally, the study that I think has the best methodology, followed the 10 members of the German Junior National Team, 10 recreational climbers and 12 non-climbers over the course of 5 years. Their conclusion:

Intensive training and climbing leads to adaptive reactions such as cortical hypertrophy and broadened joint bases in the fingers. Nevertheless, osteoarthrotic changes are rare in young climbers.

 Unfortunately, all of these studies suffer from the same basic flaw - small numbers of test subjects. All of the bone-thickness stuff is pretty consistant - climbers' hands are structurally different - but the signs of osteoarthritis are so rare that they could have arisen by chance. Furthermore, all of the athletes in these studies were fairly young, and age could reveal problems (or lack thereof) that might not be apparent in the younger athletes.

Based on what we know about sports-related stress and osteoarthritis, it's reasonable to assume that there would be similar effects on the hands of climbers. But seeing as how we evolved from tree-climbing ancestors, it's also reasonable to predict that our hands might be better able to adapt to these stressors better than the stressors of swinging a racket (as far as I know, there's no evolutionary precedent for tennis). In fact, I don't even think it would have been unreasonable to predict that the increased strength attained from climbing might help you ward off osteoarthritis, though none of the studies I found suggested that (if any of you know the study my friend was referring to, please let me know in the comments). This type of intese climbing really started increasing in popularity about 30 years ago, so the first crop of climbers is starting to approach retirement age. It will be interesting to see if anyone begins to study these old timers to see how their hands and other joints are keeping up. As with so many things in science, the best I can say right now is that more research is needed to draw solid conclusions.

Well, I might be able to draw one conclusion: climbing is awesome!

Daniel Woods - Dark Horse 2013 Champion, on route 3 of the Men's finals

[All photos in this post were taken by me* and are licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License]
Creative Commons License

*Obviously, the picture of me wasn't taken by me, but it's still mine!

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Thanks for a rational look at the subject. I was all prepared to point out logical fallacies and was happily surprised to find none.
I'd like to add a bit of anecdotal data. I'm 42 by last count, spent many years climbing, and still climb when I can find time and a location. I'm physically healthy (for mental state, ask my wife), and still retain much of the muscle tone from my climbing years. Granted, at least some of this is genetics since I've never had to work very hard at physique, but I also attribute a portion to climbing. Done right, it is relatively low impact and, as you mentioned, strengthening. Most importantly - done right - it doesn't result in weight lifter issues like muscles tearing away just because the wrong one(s) were strengthened too much too fast. I can put on a 75 pound pack (I weigh 150) and hike 5 miles without much trouble or scramble up a 5.11 without weeks of working out ahead of time. Not that I recommend either of those without working up to them, but I've been able to. I attribute this to having built my core muscle structure while I was climbing in my late teens to twenties.

An aside: You may be in the photo, but U.S. copyright law says the photographer still owns the rights. That said, the photographer cannot legally sell or distribute that photo without a modeling license, which is generally settled by "I get the photo rights, you (the model) get copies of the photo." So in effect, unless you came to a different agreement, you're right. Just don't try to sell that pic on Shutterstock unless the photographer was a good friend. They could sue.
Also, kudos on using Creative Commons licenses. That's always nice to see.

Thanks for the comment, Cliff (and the assurances of no logical falacies) :-)

It's true that climbing right usually doesn't result in those sorts of issues, but I know a lot of recreational climbers that have torn tendons or muscles as a result of pressing just a little too hard. Repeated injury is also something that is thought to increase risk of osteoarthritis, so that may be a factor.

Many sports, if done right, are not particularly risky, but being human, we often don't do them right.

Re: your aside - that picture of me was taken by my girlfriend on my camera... I don't think she'd ever try to assert her copyright for it, but I suppose you never know. That said, I don't try to make any money on the photos I take unless I've been specifically hired to do the job, so it usually doesn't come up.

I'm 66 and started gym climbing four years ago-some bouldering but mostly top rope and lead. Prior to taking up the sport I was beginning to feel twinges carpal-tunnel problems from work related stress, but that disappeared entirely within 6 months of climbing.

My finger joints are usually sore but rarely reach the level of painful. Also, I've been a knuckle cracker all my life.

No signs of arthritis yet! And it's definitely nice not to be bothered by the repetitive stress issues I was beginning to face.

@ RobR - That's great! Repetitive stress injury is a bit different from arthritis, and I think it makes a lot of sense that strengthening all parts of your hand would help alleviate some of the problems. I wonder if anyone's done any scientific studies on that front...

One of the things I love most about rock climbing is that there are challenges at all levels, and you can start whether you're young or old, tall or short, skinny or overweight. And since the focus is competing against yourself, there are a lot of little victories you can achieve along the way.

More anecdotal evedence. After 30 years of whitewater kayaking I got bone spurs in my elbows. Surgery helped the chronic pain but it still hurts when I paddle, so I don't do that much any more. Just paragliding.

@ Roy - That seems similar to the tennis elbow issue - paddling isn't exactly a "normal" motion from an evolutionary point of view.

One prosthetic knee, one knee with one arthroscopic surgery. 50 years old. I was a high school football, baseball player, dabbled in wrestling, lifted weights in college (including "heavy" squats and deadlifts), ran in my late 20's while in the navy(only for about a year, for about four miles a shot). Arthritis runs on my mothers side of the family.
Having said that, personally, my knee issues began in 7th grade with a hard bump to the knee that caused a very odd, localized swelling on the front of my left knee. Three years later, I fractured my tibia immediately below the left knee while in a wrestling practice. Ten years later I had my first knee surgery on my left knee. Twenty years later I had that knee replaced, after walking with a limp for four years. My right knee was injured immediately prior to the left being replaced while attempting to restrain an acting out delinquent child. That required surgery to repair.

All of that to say: my personal impression is, hard jarring motion or heavy stressful movements are injurious to joints. On the other hand, smooth continuous movement utilizing a full range of motion is beneficial.

The research I've read seems to indicate arthritis is or can be stress related, exercise offers stress relief as an additional benefit to improving endurance, flexibility and strength. I've also been lead to believe that the right form of exercise can alleviate arthritic symptoms, while a lack of exercise can worsen arthritic symptoms.

Honestly, I come from a small midwestern town. I'm not the toughest guy in the world, but a big part of me wishes I'd been a little quicker in taking an interest in biking, swimming and body weight strength training and being less interested in heavy weights, martial arts and other high risk (low social pay off activities). Meaning, being a volunteer firefighter was a good risk to take, being a navy corpsman was commendable...trying to lift as much weight as I could, questionable, being concerned with fending off comic book villians really stupid.

Today I bike, I stretch profusely, and do body weight strength movements...sit ups, pull ups, push ups. If I had access to a pool I'd swim too.

Given my own joint issues combined with my family history...I think it is for the best.

By Mike Olson (not verified) on 23 Jan 2013 #permalink

@ Mike O - Yes, repeated injury definitely increases risk of arthritis (and other complications). It would be interesting to see the difference between climbers that have never had acute injuries vs those that have - the differences would probably be telling.

Re: high risk behavior.

You must recognize you're insane, turn your life over to God. Take a moral inventory and only then will you stop engaging in the high risk behavior which can lead to disease injury and death. Failure to do so can only lead to death, prison or institutionalization.

He'p me Jesus! He'p me! He'p me! My name is Kevin and I'm a rock climber. Thanks to my lord and savior Jesus Christ and this group, I'm alive with working fingers today!

All kidding aside, one of the things I found very cool about hanging around with folks with a higher education was that they had cooler recreational activities. Rock climbing, scuba, surfing, etc....many uneducated folks seem to go from sitting in a bar to sitting in a church or recovery meeting. I know it sounds weird...but it really seems to be true, the more education, the greater the dedication to health and legitimate recreation. have a good one.

By Mike Olson (not verified) on 23 Jan 2013 #permalink

Kevin that's true that climbers do experience a lot of joint changes that is being related to Osteoarthritis also it is found that climbers do have thick fingers and often the finger joints are injured. Getting injured numerous times also increases the risk of Arthritis.

By julianswilson (not verified) on 23 Jan 2013 #permalink

Wave to RobR -- 52-year old Berkeley climber here. If you climb indoors, I've probably seen you around.

I'm sixty one now, I did climbing intensively in my early twenties. I suffered overuse injuries to the tendons in my fingers, and had to quit. Now nearly forty years later this soft tissue damage is becoming an issue. Its not just hard parts -joints, but soft tissues that can be chronically stressed.

I had also done training to be able to climb in subfreezing weather, carry snowballs in bare hands, etc. ,perhaps that was a factor.

By Omega Centauri (not verified) on 27 Jan 2013 #permalink

I'm 32, been climbing for 5 years and have started developing arthritis in my fingers. It does run in the family. So possibly just started a bit earlier due to climbing.
Stil climbing though but maybe avoiding crimpers and hanging off my fingers too much - although that is hard to do.
For me its more about being outdoors, climbing with friends and maybe pushing myself a little bit :)
But my fingers do frustrate me at times!!

I just started climbing. I know that arthritis runs in my family, and am wondering if climbing is more likely to make it less or more severe if/when it sets in.

I may be overly optimistic, but I just keep telling myself bionic joint replacement will be feasible and affordable when I'm old and gray.

Unfortunately, the science isn't particularly clear on this subject. Chances are, if you develop osteoarthritis, climbing is going to become more difficult. It's possible that the increased musculature in your hand will prevent or delay some of the symptoms, but it's also possible that you'll have a major injury that will accelerate the degeneration.

My advice, keep climbing, because climbing is awesome. Just be careful to avoid injury - work up slowly, remember that muscles get strong faster than tendons get strong, and try not to do finger-jams and other moves that put intense load on your joints. If you're not planning on becoming a professional, I wouldn't worry about it too much.

I'm 56 and have been climbing indoors for 1 1/2 years. Absolutely love it. Have noticed non painful bony "bumps" on both sides of most of my fingers at the first knuckle. No pain, no stiffness (except the usual post climb stuff). Have wondered if climbing caused this weirdness or exacerbated a problem (like R.A.) I didn't know I had. Well, I'm not going to worry about it and just chalk up my gnarly looking fingers (and a crazy titanium rod/screws in my left leg) to doing what I love-climbing!!! Well, the broken leg was due to falling but you get my point. Climb away!

I've never heard of that. If it was exacerbating an inflammatory problem like arthritis, there would definitely be pain associated with it. Have you seen a doctor about it?

I'm a 56 year old female climber and climbing has DEFINITELY exacerbated a familial tendency towards osteoarthritis in my hands. Cutting back to climbing twice a week has eliminated my joint pain though. My hands are ugly, but so what!

I have been looking on information on this subject. I'm 47 and my mom and grandmother (and a few aunts) have terribly gnarly arthritic hands. Mostly from knitting I think!
I've started climbing indoors a few months ago and the bumps on my fingers seem to be getting worse. (i used to climb a bit years ago but never consistently). They get inflammed, which doesnt go down quickly though ice is helpful. So maybe the climbing is accelerating their inevitable decline. But I feel my hands getting stronger which makes me think climbing is good in the long run. If they are going to look twisted anyway, isn't it better if they have some power in them?
My doctor is not as enthusiastic as I am saying "well just take it easy". It seems the medicals don't know a lot about this either.