The Climber’s Body: Injury Prevention With Clinical Pilates



  • Common climbing injuries
  • Injury prevention & preparation
  • Review of Clinical Pilates exercises used for treatment


Rock climbing has been building in popularity as a sport that pushes individuals to their limits in physical and mental strength, power, endurance, and flexibility. Whether your preferred method of climbing is traditional, sport, or bouldering, it’s only a matter of time before you encounter climbing problems that challenge your body. Injuries are common in climbers and doing the required rehab while healing can be neglected by impatient climbers eager for an early return to the rock. This frequently leads to re-injury of healing structures while also predisposing the body to new injuries due to compensation for the original issue.

Common Climbing Injuries

The most frequent injuries climbers experience are rotator cuff tears at the shoulder, lateral and medial epicondylalgia (commonly known as tennis elbow and golfer’s elbow respectively) and strains of the A2 pulleys in the fingers. To prevent these injuries climbers should warm up, active stretch or perform resistance band exercises before climbing.


A2 pulleys assist the function of the flexor tendon when curling the fingers around a hold.

Prehab vs. Rehab

Where rehabilitation targets repairing and strengthening after an injury, prehabilitation, or prehab, focuses on the assessment and improvement of movement patterns before commencing activity in order to improve the likelihood of safe and injury-free results. Preventing injuries before they occur is arguably a favourable strategy as it reduces pain, down time, and general body wear and tear from injuries. While the previously mentioned injuries can occur suddenly or develop slowly over extended periods of time, they all involve part of the body being unable to tolerate the load placed upon it and result in a tear, tendinopathy, or rupture. For this reason, the preferred action is a preventative one. The best form of preventative management involves progressively training the body to accept climbing-specific loads or movements such as attempting a big Dyno move* after a long day of climbing.

Climber’s Assessment 

Clinical Pilates is often used by professional athletes as part of a preventative exercise program to correct poor body biomechanics that would predispose them to injuries when performing at their limits. In a Clinical Pilates assessment, athletes (and you) undertake a comprehensive assessment looking into the following:

Muscle length

⦁ Joint mobility

⦁ Control

⦁ Endurance

⦁ Strength

⦁ Core stabilization

From this assessment, an individualized Pilates program is created to target body impairments or deficits with exercise progression tailored towards the individual’s goals and athletic requirements. While each climber may present with different body limitations that need to be factored into their program, there are specific biomechanical requirements of climbing that would need to be worked into every climber’s prehab program. These include rotator cuff strength, scapular control, wrist and forearm strengthening, core stability and mobility of the thoracic spine and hips.

Injury Prevention with Clinical Pilates

The following exercises should be performed as a part of a rock climbing injury-prevention program. If the listed injuries have already occurred the following exercises will be essential as a part of the late-stage rehabilitative program in order to prevent re-injury of damaged structures and safe return to climbing.


The Snake and Twist on Reformer

Exercise: The snake and twist on reformer

Exercise goals: Scapula and rotator cuff stability, upper limb strength, head, neck and shoulder alignment, core control and multi-segmental movement.


Kneeling Arm Series on Reformer

Exercise: Kneeling arm series on reformer

Exercise goals: Forearm strength, wrist, elbow and shoulder stability, rotator cuff strength, scapulo-thoracic control, core stability, head, neck, and shoulder alignment.


The Snake on Wunda Chair

Exercise: The snake on wunda chair 

Exercise goals: High level scapula and rotator cuff strength and stability, load acceptance through upper limbs, core control, pelvic stability and spinal alignment, head, neck, and shoulder alignment.


Inversion on Trapeze Table

Exercise: Inversion on Trapeze Table

Exercise goals: Grip strength, forearm flexor strength, late-stage tennis elbow rehab for climbing, scapula and rotator cuff control, core stability, and spinal articulation.


Standing Hip Stretch on Reformer

Mermaid on Wunda Chair

Exercises: Standing hip stretch on reformer and mermaid on wunda chair

Exercise goals: Hip and thoracic spine mobility respectively.


Always consult with a healthcare practitioner before undertaking any new exercise regimen to make sure it’s right for you.


*A move in which the climber jumps or moves dynamically from one hold to another.


Shedden, M., and Kravitz, L. (2007). Pilates: A corrective system of exercise. ACSM’s Health and Fittness Journal, 11(5):7-12.

Haas, J.C., and Meyers, M. (1995). Rock climbing injuries. Sports Medicine, 20(3)199-205.

McGill, S., (2010). Core training: Exercise translating to better performance and injury prevention. Strength and Conditioning Journal, 32(3):33-46.

Rogers, K., and Gibson, A. (2006). Effects of an 8-week mat Pilates training program on body composition, flexibility, and muscular endurance. Medicine & Science in Sports & Exercise, 38(5):279-280.

 Otto, R., Yoke, M., McLaughlin, K., et al. (2004). The effect of twelve weeks of Pilates vs resistance training on trained females. Medicine & Science in Sports & Exercise, 36(5):356-357.

Trudel, D., Duley, J., Zastrow, I., et al. (2004). Rehabilitation for patients with lateral epicondylitis: a systematic review. Journal of Hand Therapy, 17(2):243-266.
Millett, P., Wilcox R., O’Holleran, J., (2006). Rehabilitation of the rotator cuff: An evaluation-based approach. Journal of the AAOS, 14(11):599-609.

Image Credits:

  1. Woman climbing
  2. A2 pulley injury
  3. The snake and twist on reformer
  4. Kneeling arm series on reformer
  5. The snake on wunda chair
  6. Inversion on trapeze table
  7. Mermaid on wunda chair
  8. Standing hip stretch on reformer

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