Rock Climbing Shoulder Pain with Wil Seto

Mark: Hi, it's Mark from Remarkable Speaking. I'm here with Wil Seto of Insync Physio in Vancouver, one of Vancouver's best physiotherapist clinics. And we're gonna talk about rock climbing and shoulder pain. How you doing Wil? 

Wil: Yeah, I'm doing good, thanks. 

Mark: So shoulder injuries from rock climbing, I guess this is fairly common?

Wil: Yeah. So rock climbing injuries in the shoulder are quite common. I mean, they make up you know, one of the top three in terms of injuries when it comes to climbing injuries. You know, and primarily when we're looking at shoulder injuries, you can classify them as either you know, like traumatic type of injuries, acute injuries, or non-traumatic. Or I guess where you could say is chronic overuse type of injuries.

And sometimes when we get them, you know, these chronic overuse injuries, it can all of a sudden be like, Oh, that's like a sudden acute thing that never happened before. So what I'm speaking about specifically is this condition that is referred to as shoulder impingement.

So the big question is, well, what is that? It's kind of an umbrella term. Because when we think of shoulder impingement, basically the things that are kind of in the shoulders that you have, like basically certain structures like your, your tendons and, and the main structure in there, your rotator cuff tendons, that can get pinched.

And the main reasons for that is usually there's an imbalance. And with rock climbing, you tend to overemphasize a particular set of muscles. And then there's also a set of muscles that are under-emphasized. And so when you have this imbalance happening, then you can alter your mechanics in your shoulder.

And just with the nature of climbing and in terms of overhead loading repetitively. And then especially when you're looking at you know, the types of climbing, if you're doing a lot of what's called bouldering, where you're not using a rope and you're just sort of climbing up short distances. And these days when you go to the climbing gym, the bouldering gym specifically, where some of these problems that they call them root problems and bouldering problems, quite gymnastic like very parkour like and require a lot of like hanging and just with the arms. And then you do it over time and recognize like, you know, in terms of the recovery aspect of it, then you can really start to bring other problems. 

Mark: So I'm sure it's probably a painful injury. What are other symptoms that are showing up? 

Wil: Yeah, so the biggest one is that you know, it can happen during your training session or your climbing session or might not appear until the day after. And you start to get pain just with like trying to carry something, like say you go to the grocery store and you notice, Oh, I'm starting to get a little bit of a pain. And and another thing is like, you're maybe just reaching up into your cup to grab your mug for coffee or tea or your beverage for thing in the morning to even just like lowering the shoulder down without any weight.

And then you get this like sharp pinching pain. And so what ends up happening is that you have this imbalance that's already been developing there for quite some time. And so the individuals that are more prone to having this happen, you know, are usually like beginners that are just starting up climbing.

Or even more advanced climbers who have taken a bit of time off who just start back up again and now they're just like learning how to reload their body. So you have sort of this muscle memory in your head, but then your body needs to also be conditioned. Or you may be like a seasoned climber, but now you're upping your training and you're upping your game and with doing more higher intensity workouts or climbing sessions. When you're pushing the envelope a little bit more, now you really gotta look at recovery in a different way.

And part of that recovery, it isn't just about stretching, it's really looking at, well, where are you tight? Where are you imbalanced? Is the primary key to all this? Like, where are you really tight and basically always using those muscles all the time? Or weak. Where are you not like up-trained enough, where certain things can stabilize. 

So in your shoulder you have muscles that work on stabilizing the shoulder so it moves properly. So you get better movement and mechanics happening when you're doing complex movements with loading and ballistic type of movements, sometimes when you're climbing.

Mark: So how are you diagnosing this when someone comes in? 

Wil: Yeah, so obviously, after taking a history and asking questions we run them through a bunch of tests. Cause you know, the biggest concern a lot of people have is like, Oh, did I tear something? Especially if they come in and it's been like a week or two weeks because you can actually have this type of faulty mechanics and you're getting this impingement, it could be going on for like 2, 3, 4 weeks and you just haven't done anything about it because you thought that maybe you could do it on your own. It just doesn't go away. 

So yeah, we take you through a bunch of different tests and look at what's going on. Our physio team, you know we see a lot of climbers and we run you through different things to do and we look at did you tear something? Did you actually tear a ligament in there? Did you actually potentially have a tear in your rotator cuff. Which we can talk about in a different segment as well. Or is it more of a higher probability that it's just a mechanical thing going on? 

So usually if it's just a mechanical issue of what's happening under the shoulder and the rotator cuff with the impingement, then we usually get really, really excellent result in as little as like a one to two, to up to three treatment kinda thing.

Mark: And so what is the typical course of treatment for this? 

Wil: Yeah, so like I was saying, you know, this kind of stuff usually doesn't happen overnight. So we look at the impairments, like the things that are not working properly. So maybe you've developed some stiffness in your actual shoulder capsule. So then we have do some things and manually work that out. You know, maybe there's a lot of this imbalance where we gotta manually facilitate mobility to go in that area. 

So we do certain things on a manual basis after we've assessed it. And it's pretty clear, like this very clear sign if it's impingement, we do these things. It almost like instantly better. If we're talking that it's just strictly a biomechanical thing and you don't have any tearing of a rotator cuff. 

And then what's really important after you feel this instant, sort of like gains, is the reinforcement of your mobility patterns that we give to you, to mobility exercises and specific strengthening for stability and for functional strengthening. Because we wanna try and keep you climbing you know, as safely and as hard as possible.

Mark: So if you're having some shoulder pain, that suddenly come on but maybe you've up your game, rock climbing, bouldering, or you're just a beginner and suddenly you're finding, ah, it's hurting. Get in to see the folks at Insync Physio. They're experts. They're rock climbers. They're people who know what's going on. They'll be able to diagnosis and get you feeling better. You can book online at Or you can call the Vancouver office at (604) 566-9716 or in North Burnaby, have another office, (604) 298-4878. You can book either of them online. Thanks, Wil. 

Wil: You bet.