How to Avoid Rock Climbing Injuries: Talking with OrthoCarolina’s Stacy Rumfelt

After a nasty hand injury, Karen Shaub is now back to climbing.
After a nasty hand injury, Karen Shaub is now back to climbing. Karen Shaub
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The middle of November can be a tricky time for spending time outdoors in central Carolina. The leaves, which just a couple weeks prior decorated tree limbs with stunning brilliance, now gather in great menacing piles on the forest floor. Recently clear trails are now covered, concealing the rock and root “trail gators,” which are easy to avoid during other times of the year.

On November 17, 2013, this was the downfall, literally, of local rock climber Karen Shaub. After a day of route bagging at Crowders Mountain State Park, a near weekly activity for Shaub, she stepped on a hidden stone, catapulting off trail. Her pack, she says, saved her from serious injury but a quick check of her extremities revealed something not right with the ring finger on her left hand.

A surgery, officially a hemi-hamate arthroplasty or reconstruction of the middle joint, was the first step in fixing the broken digit. But there was more work to do. Shaub had only 42 degrees of movement in her rebuilt finger where the normal is over 240 degrees. Therapy was needed to regain the strength and flexibility required in mountain climbing. And that’s where Shaub met OrthoCarolina’s Stacy Rumfelt. A certified hand specialist with a doctorate in occupational therapy, Rumfelt has helped children and adults come back from all manner of injuries. When all was said and done, after two surgeries and two rounds of hand therapy, Shaub regained 235 degrees of motion and 85 percent of her grip strength. She’s back to her old self, climbing routes all over the Carolinas.

We had the good fortune to speak with both Shaub and Rumfelt. They helped us understand rock climbing injuries, how to avoid them, and where they like to spend their outdoor time near Charlotte.

Stacy Rumfelt on her favorite peak at Crowders Mountain State Park
Stacy Rumfelt on her favorite peak at Crowders Mountain State Park Stacy Rumfelt

What are some of the most common injuries climbers face?

Rumfelt: A2 pulley strains or ruptures. That usually happens in the finger, between the base of the finger and the middle knuckle. That’s just from different grips, from hanging, just the pressure that’s applied on the tendons against the pulleys. Sometimes it’s too great and it ruptures. That’s a pretty common injury.

The flexors are what flex your fingers and they connect to tendons in your forearm. So whenever you flex your fingers, that’s what’s working. Sometimes they can tear or rupture, or get avulsed (when the tendon pulls a piece of the bone away). Worst-case scenario, if it ruptures or avulses, you end up needing surgery. So the tendon pulls a piece of the bone away with it.

Collateral ligaments are the ligaments around the sides of our fingers. So, those can get strained when rock climbers are swinging up to reach the next hold. Climbers can get their fingers kind of jammed up in tight places. That can put a lateral strain on that ligament and that can cause a sprain.

Bouldering at Rumbling Bald.
Bouldering at Rumbling Bald. Karen Shaub

What should you do if you are injured while climbing

Rumfelt: If you are injured, if you do feel a pop or feel pain, you need to stop climbing immediately. Then you want to incorporate the basics: rest, elevate, use compression. Seek medical attention if your pain does not stop after three to five days.

Are there any ways climbers can avoid injury?

Rumfelt: In general, for injury prevention, you need to have a strong core and strong shoulders to be able to maintain that static hold that climbers have to use. If you don’t have a strong core or strong shoulders, you’re really going to tear up your hands as you overuse those muscles. You’ll be more efficient if the rest of you is strong.

Also, for things like tendonitis and muscle strains, overuse injuries associated with climbing, those can be prevented doing specific exercises for the forearm and upper extremities.

For forearms, use flexion and extension with dumbbells. Climbers use so much of their fingers, their forearms, wrist flexors and finger flexors, it’s good to counterbalance the extensors on the other side of those forearms. If you’ve got an imbalance, if you’re stronger on one side than the other, you can end up with carpal tunnel just because climbing is such a repetitive activity with the wrist and the fingers. That can create what’s called tenosynovitis, which is just an inflammation around that tendon in the wrist and that can create carpal tunnel. So to balance it out, bend your elbow with your palms facing down. Lift your hand up towards the top part of your forearm.

A strong core will help prevent injuries while climbing.
A strong core will help prevent injuries while climbing. Karen Shaub

Forearm stretches are also important. Having your arm straight out with your elbow extended, pull back on your extended hand with the opposite one. Hold for 10 to 15 seconds, and then do the opposite so you’re stretching the forearm muscles and finger muscles. There’s also a benefit using Thera putty or stress balls to strengthen the forearm...Static hangs on a bar improve forearm endurance and finger rolls with a dumbbell are also good.

Shaub: I was wearing tennis shoes that day. Make sure you have hiking shoes. Just be extremely careful when you’re walking over leaves. Having correct shoes really makes a big difference.

What’s your favorite way to get outside around Charlotte?

Rumfelt: Typically I like to spend my time hiking at Crowders Mountain (State Park). We go out there a lot. There or the Kings Mountain Gateway trail.

The infamous stairs at Crowders Mountain.
The infamous stairs at Crowders Mountain. Rob Glover

Before or after a hike at Crowders I love going to the Shelby Café . It’s your hometown, old timey café that’s been there forever. It’s always consistent and the service is great. I recommend the Greek omelet and home fries.

Shaub: I’ve been all over North Carolina climbing. I like Shiprock and Rumbling Bald is great for bouldering. But I love Crowders Mountain. That’s totally my favorite. I go almost once a week.

My favorite at Crowders is the resurgence area at the end of the mountain. Not many make it there to climb. It’s harder to get to. It has some neat, challenging climbs. It has some easier 5.7 to 5.8 all the way up to 5.11. I’m currently working on “Dewey Used to Love It” (a 50’, single pitch climb on the Trundlasauras Wall in the Resurgence area). There’s lots of other climbs nearby.

Originally written for OrthoCarolina.

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