New research review - Audry Morrison interview

Audry Morrison and Volker Shoffl have just published a review of the available research relevant to young climbers in the British Journal of Sport Medicine As well as collating some interesting data on studies carried out within climbing, it also draws on other useful sources of information to give us a better picture of the effect of climbing and training on the young body. Not everyone has access to the scientific research press or can digest the information it offers; so I asked Audry if she would answer a couple of questions for this blog.

Young climbers are always asking (and if they don’t they should be!) “how much should I train at my age?” and “what harm can training at a young age do?” The review underlines the need for young climbers and their parents to educate themselves as to what activities and intensities are safe at given ages, and what can be done to minimise risks of permanent alteration or injury to the developing tissue.

Audry Morrison

Non-climbers are always noticing my hands and commenting that they look very different to 'normal' hands. What changes should climbers who train regularly expect in their hands and are there any negative consequences to consider?

Audry: Climbing is certainly a ‘load-bearing’ sport, with the fingers supporting a lot of this ‘load’. Those bones that are most involved with this ‘load-bearing’ or ‘resistance’ exercise are constantly remodelling themselves in response to this type of exercise. Bones are not static. So in a veteran adult climber’s fingers there is up to a 50% increase in the tendon width size (a few years to achieve), a thickening of the collateral ligaments here too, the bones in the fingers physically remodel themselves to become wider/thicker to better accommodate this loading (especially at joints, notably the middle joints), and the fingers just tend to be thicker. How much the finger bones thicken is in direct relationship to the number of years climbing, hours spent training, and climbing ability level. Repeated over training can create micro traumas that collectively can result in stress fractures, ganglions, pulley strains/rupture, tendon nodules, finger nerve irritation, arthritis, etc.


Negative consequences to consider
Good bone remodelling to create strong bones also relies on the assumption that good nutrition is also in place…. like not drinking a lot of soft drinks. An American study found females around age 20 had osteoporosis (brittle bone) similar to that of a 70-year-old because of the volume of soft drinks they drink. These drinks act to limit the amount of calcium your bones can absorb when they remodel themselves. Also, if calcium intake poor, the body will ‘steal’ calcium from other bones to use when remodelling the bones that are getting most of the resistance workout.

A lot of climbers quite rightly have concerns about their fingers and hands. We ask a lot of fingers when climbing, especially at a high ability level.

This is probably obvious, but high ability climbers generally experience more injuries, especially to the fingers, because of the greater mechanical stresses and weight-bearing loads to the fingers. ‘Crimp’ position exerts the greatest compressive force to a finger joint cartilage, compared to the ‘open hand’ position that is more protective and also allows you to climb for longer. Over gripping holds will limit climbing performance because of the direct knock on effect of increasing blood pressure and heart rate, increasing stress hormone levels etc that in turn influence and change metabolites in the forearm so you get pumped quicker.

Climbers should continually assess the full range of motion in all 3 joints of each finger. Can you place your hand palm down so that it is flat on a table surface? If any of the fingers can’t go flat, it may suggest Dupuytren’s disease. This used to be confined to those aged 40-60 who worked manually that created micro traumas to the fingers, though there is also a North European genetic predisposition to it. Unfortunately even young climbers have various stages of Dupuytren’s, that if severe, requires an operation to straighten the finger. But some NHS hospitals a while back refused to perform this surgery any more along with some others as a cost cutting exercise.

In one good study examining osteoarthritis in 65 veteran adult climbers (average age=37.5, climb experience=19.8 years, grade=5.12c) compared to non-climbing age-matched controls, there were five specific joint areas in the climber’s fingers that scored significantly higher than the controls. But having said this, the overall osteoarthritis scores between both groups were similar.

What do you think are the main things young climbers should keep in mind to progress quickly and safely to the upper levels in climbing?

Audry: Below the age of around 12 (pre-pubertal), no youngster has the ability to adapt to either aerobic or anaerobic exercise as would happen in an adult. There are many adaptations in their body that prevent this from happening. But they can learn movement well, and they most definitely should be participating in sport (all sorts). It’s not known when specialisation in climbing should take place. They must be encouraged to learn very good technique because they don’t have the strength, have immature pain barriers, etc. In younger children, actually demonstrate what they are doing wrong.

Elite young climbers will also have thickened finger bones. What’s critical for young climbers is that their finger bones grow to their full length around age 16.5, and that this is not interrupted by finger training too intensively. Damage (temporary or permanent damage) can occur when young climbers undertake extensive finger strengthening exercises. This is especially so when they try to compensate for their increased weight when they have their final growth spurt around age 14-15. Some 20% of adult height is achieved in this final growth spurt where skeletal mass increases twofold and a lot of muscle can be packed on. Ligaments and tendons have not yet adapted to these increases in bone length and load, and increasing levels of certain hormones can also weaken the joints. The training focus must be on ensuring good technique/efficiency (always!) and on volume & diversity of route, rather than doing any finger strength training those elite adults do.

Also check for any curvature of spine, tight shoulders that have a rolled hunched look. If so, much more stretching needs to be carried out, possibly physiotherapy or medical intervention if severe.

Check feet too. See if there is any pain or deformities, or loss of nerve sensation. If any of these is the case, the shoes are too restrictive. Feet grow in a linear manner length and width from ages 3-12 (in females) and to age 15 in males. Height is highly correlated to foot growth to the age of 18.

Thanks for answering those questions Audry and well done on the research. Its quite a striking figure that tendon width increases so much – when you consider the effects on the cross sectional area of a doubling of tendon width it seems even more impressive. But we ask so much of our fingers in climbing and muscles work at such a mechanical disadvantage that I suppose it’s not so much of a surprise that the adaptations are so striking. I’ve certainly noticed a marked thickening of my PIP joints over the past two years and more aches and pains in them than before.

I think the key takeaway from all this is to read and educate yourself before you launch into the training, rather than once you start having problems. At the same time, all these consequences to getting training wrong as a youngster doesn’t mean you cant push yourself until you are adult. It just means that there are trade-offs between going hard when you are still growing and accepting and managing some consequences from it. But most of the negative consequences should be avoidable with healthy respect for the body. Just look at climbers like Fred Nicole who was climbing F8b+ at 16 and has been bouldering at the cutting edge right through to his late thirties with seemingly no breaks – inspiring.

You can see the abstract for Audry’s paper here. You can view the full text if you have an ATHENS password.