What 105 Youth Climbers Told Us About Finger Injuries, Awareness, and Seeking Medical Care

You’re 13 years old and enjoy climbing. The thing you look forward to most each day at school is going rock climbing after classes end. Classes finally end, you go to your home gym for practice as a young competitor who has just reached the minimum age for the competition. After practice, you try all kinds of fun moves and climb with your best friends at your gym. One day, a finger starts to hurt. It seems normal minor because your coaches have seen many people experiencing finger pain, and your teammates ignore their finger pain and keep trying their projects. Weeks pass, the pain is neither too severe to make you stop climbing nor severe enough to convince you to go see a doctor. What do you do?

What is a Finger Epiphyseal Injury?

A finger epiphyseal injury, also known as the growth plate injury, occurs when repetitive stress is placed on the developing finger of a young climber. This injury is the most common injury in youth climbers because the growth plates are particularly vulnerable during adolescence. Unlike many sports injuries that result from a single traumatic event, finger epiphyseal injuries are often caused by repeated loading over time and may initially present as pain when pressure is applied around the finger joint Meyers et al.¹

Survey Findings from 105 Youth Climbers

To better understand youth climbers’ experiences with finger pain, knowledge of finger epiphyseal injuries, and medical-seeking behaviors, 105 climbers between the ages of 9 and 21 were surveyed. Participants were asked about their finger symptoms, actions they took after symptoms developed, the scenarios in which they got injured, and their training frequency. The findings provide insight into how young climbers recognize and respond to finger injuries in real-world settings.²

Injury Prevalence and Awareness

Prevalence

In the survey, eight participants reported a diagnosed finger epiphyseal injury, representing 7.6% of all surveyed climbers. These injuries include both epiphyseal fractures and other growth plate abnormalities, such as erosive changes. Among the eight cases, six participants specifically reported epiphyseal fractures.

Figure 1. Prevalence of diagnosed finger epiphyseal injuries.

Previous research has also documented growth plate injuries in youth climbers. Woollings et al.³ reported that 53% of the surveyed youth climbers had sustained at least one climbing-related injury, with hand and finger injuries representing the most common injury location. Among the 111 youth climbers surveyed, four reported finger epiphyseal fractures, highlighting that growth plate injuries remain a recognizable concern in adolescent climbers.

Awareness

When participants were asked about their understanding of finger epiphyseal injuries, more than half ( 50.5%) reported that they do not understand these injuries. Another 46 participants (43.8%) reported only a slight understanding, of which just 6 participants (5.7%) considered themselves very familiar with these injuries. This finding suggests that the awareness of growth plate injuries among youth climbers remains limited, with over 94% of the respondents reporting either no understanding or only a slight understanding.

Injury Scenarios and Mechanisms

Injury Scenarios

Seven out of eight participants reported their injuries occurred when bouldering; several participants identified other potential contributing factors, including competition and various forms of board training. Only one participant reported lead climbing as the primary injury scenario.

Mechanisms

Schöffl et al.⁴ identified Campus board training, including free-feet climbing and double-dynamic moves, as potential contributors to epiphyseal injuries. Also, it shows that maximum-power training on small edges using the crimping position may increase the risk of finger injuries and overuse syndromes. Because crimping is commonly used in bouldering, these findings may help explain why most diagnosed cases in our survey occurred during bouldering.

Common Symptoms and Warning Signs

Figure 2. Symptoms reported by participants with diagnosed epiphyseal injuries.

Among the eight participants who reported a diagnosed finger epiphyseal injury, pain and swelling were the most frequently reported symptoms.

Warning Signs

These findings shown in the chart are generally consistent with previous research. Schöffl et al.⁴ reported that patients with finger epiphyseal injuries commonly experienced a slow onset of pain around the finger middle joint, swelling, and reduced range of motion. Clinical examinations also frequently demonstrated swelling and limited finger mobility. This similarity between the symptoms reported in our survey and those described in the literature suggests that pain, swelling, and reduced mobility may serve as warning signs of potential growth plate injuries in youth climbers.

Medical-Seeking Behaviors

Figure 3. Medical-seeking behaviors following finger symptoms

Nearly half of the symptomatic participants did not seek medical examinations. This finding suggests that symptoms alone may not always prompt young climbers to seek professional evaluation.

When Should a Young Climber Seek Medical Care?

Pain around the finger knuckle (growth plate region) in a young climber should not be ignored, especially if it develops gradually and worsens with climbing.

Growth plate injuries typically present as:

• Pain
• Tenderness
• Swelling around the knuckle
• Stiffness or reduced range of motion.
• Decreased grip strength

Evaluation by a medical provider is recommended if symptoms persist for more than a few days, recur with climbing, or are associated with swelling or loss of motion.

Imaging and Diagnosis

Imaging

• Standard radiographs (X-rays) are commonly used to evaluate suspected epiphyseal injuries.
• Additional oblique views may be required because some fracture lines are not visible on standard AP and lateral radiographs.
• CT may be used when fracture healing cannot be clearly assessed on radiographs.

Figure 4. No fracture is visible on the lateral view (A), whereas the oblique view (B) demonstrates a fracture line. Reproduced from Bärtschi et al.⁵

Diagnosis

• Early epiphyseal stress injuries may not be visible on initial radiographs; therefore, follow-up imaging every 2–3 months is important when symptoms persist.

Figure 5. Early epiphyseal stress fractures may not be visible on initial radiographs. In this case, the fracture was only detected at the 6-month follow-up, highlighting the importance of continued monitoring when symptoms persist. Reproduced from Bärtschi et al.⁵

Recovery and Return to Climbing

Figure 6. Return-to-climbing protocol adapted from Meyers et al.

Implications for Youth Climbers, Coaches, and Parents

For Youth Climbers:

Recognize persistent finger pain early and seek medical evaluation rather than climbing through symptoms.

For Coaches:

Encourage early reporting of finger pain and support gradual, evidence-based return-to-climbing processes.

For Parents:

Take ongoing finger pain seriously and work with qualified physicians to ensure safe recovery.

Disclaimer

This blog is designed for informational and educational purposes only and the blog is not intended for medical advice.

References

1. Meyers RN, Schöffl VR, Mei-Dan O, Provance AJ. Returning to Climb after Epiphyseal Finger Stress Fracture. Curr Sports Med Rep. 2020;19(11):457–462.
2. Wu X. Survey of Finger Epiphyseal Injuries Among Youth Climbers in China. Unpublished survey. September 2025.
3. Woollings KY, McKay CD, Kang J, Meeuwisse WH, Emery CA. Incidence, Mechanisms, and Risk Factors for Injury in Youth Rock Climbers. Br J Sports Med. 2015;49(1):44–50. doi:10.1136/bjsports-2014-094067.
4. Hochholzer T, Schöffl VR. Epiphyseal Fractures of the Finger Middle Joints in Young Sport Climbers. Wilderness Environ Med. 2005;16(3):139–142.
5. Bärtschi N, Scheibler A, Schweizer A. Symptomatic Epiphyseal Sprains and Stress Fractures of the Finger Phalanges in Adolescent Sport Climbers. Hand Surg Rehabil. 2019;38(4):251–256. doi:10.1016/j.hansur.2019.05.003.

Acknowledgements

The author is incredibly grateful for the mentorship, guidance, and help from Dr. Jared Vagy throughout the process of conducting this article. His expertise and patience played a critical role in this process.

Special thanks to Alice Chen and Wesley from Sender One. Their encouragement and support for the author and their introduction to opportunities were what made this article possible.

The author sincerely thanks the 105 youth climbers who took the time to complete the survey and share their experiences. This article would not have been possible without their participation.

Lastly, the author hopes these findings help raise awareness of finger injuries and encourage young climbers to seek medical care when needed.