Injuries in rock climbing may occur due to falls, or due to overuse (see Sports injury.) Injuries due to falls are relatively uncommon; the vast majority of injuries result from overuse, most often occurring in the fingers, elbows, and shoulders. Such injuries are often no worse than torn calluses, cuts, burns and bruises. However, overuse symptoms, if ignored, may lead to permanent damage (esp. to tendons, tendon sheaths, ligaments, capsules).
The climbers most prone to injuries are intermediate to expert within lead climbing or bouldering.
Overuse injuries in climbing
In terms of overuse injuries a British study found that:
- 40 percent occurred in the fingers
- 16 percent in the shoulders
- 12 percent in the elbows
- 5 percent were the knees
- 5 percent back
- 4 percent wrists
604 injured rock climbers were prospectively evaluated from January 1998 to December 2001, due to the rapid growth of new complex finger trauma in the mid-1980s. Of the most frequent injuries, three out of four were related to the fingers: pulley injuries accounted for 20%, tendovaginitis for 7%, and joint capsular damage for 6.1%.
Damage to the flexor tendon pulleys that encircle and support the tendons that cross the finger joints is the most common finger injury within the sport (see climber's finger). The main culprit for pulley related injuries is the common crimp grip, especially in the closed position. The crimp grip requires a near ninety-degree flexion of the middle finger joint, which produces a tremendous force load on the A2 pulley. Injuries to the A2 pulley can range from microscopic to partial tears and, in the worst case, complete ruptures. Some climbers report hearing a pop, which might be a sign of a significant tear or complete rupture, during an extremely heavy move (e.g. tiny crimp, one- or two-finger pocket). Small partial tears, or inflammation can occur over the course of several sessions.
- Grade I - Sprain of the finger ligaments (collateral ligaments), pain locally at the pulley, pain when squeezing or climbing.
- Grade II - Partial rupture of the pulley tendon. Pain locally at the pulley, pain when squeezing or climbing, possible pain while extending your finger.
- Grade III - Complete rupture of the pulley, causing bowstringing of the tendon. Symptoms can include: Pain locally at the pulley (usually sharp), may feel/hear a 'pop' or 'crack', swelling and possible bruising, pain when squeezing or climbing, pain when extending your finger, pain with resisted flexion of the finger.
- Stress fractures
- Collateral ligament injuries
“Any finger injury that is sustained by a young adolescent (12 - 16) should be seen by a physician and have x-rays performed. These skeletally immature athletes are very susceptible to developing debilitating joint arthritis later in adulthood.” 
- Related topics
- Hörst, Erik J. (2003). Training for Climbing: The Definitive Guide to Improving Your Climbing. Guilford, Connecticut, Helena, Montana: Falcon Publishing. p. 151. ISBN 0-7627-2313-0.
- Wright, D. M.; Royle, T. J.; Marshall, T (2001). "Indoor rock climbing: who gets injured?". Br J Sports Med. Retrieved 11 January 2011.
- article by: Doran, D. A.; Reay, M. (2000). "Injuries and associated training and performance characteristics in recreational rock climbers". The Science of Rock Climbing and Mountaineering (A collection of scientific articles). Human Kinetics Publishing. ISBN 0-7360-3106-5.
- Preston, Dayton. "Rock Climbing Reaching New Heights". Hughston health alert. Retrieved 11 January 2011.
- Schöffl, V.; Hochholzer, T.; Winkelmann, H.P.; Strecker, W. (Summer 2003). "Pulley injuries in rock climbers". Wilderness Environ Med (Wilderness & environmental medicine) 14 (2): 94–100. doi:10.1580/1080-6032(2003)014[0094:piirc]2.0.co;2. PMID 12825883.
- Hörst, Eric J (2008). "Finger Tendon Pulley Injury". Nicros. Retrieved 11 January 2011.
- Roseborrough, Aimee; Roseborrough, Kyle (2009). "DIAGNOSIS: Pulleys". Retrieved 11 January 2011.
- Roseborrough, Aimee; Roseborrough, Kyle (2009). "Climbing Injuries: Shoulders". Retrieved 11 January 2011.
- Edell, David (24 October 2009). "Finger Injuries". Retrieved 11 January 2011.