Finger injuries: pulleys, growth plates and which pain means stop
Adult and young climbers tend to hurt different parts of the finger. In adults it's usually a pulley. In growing climbers the usual problem is a stress fracture through the growth plate of a finger bone.
In plain words
Climbing puts big forces through small fingers. In adults the weak link is usually a pulley, one of the bands that hold the finger tendons against the bone. It can strain or tear, sometimes with a pop. In children and teenagers the bones are still growing, and the soft growth plate near the middle finger joint is weaker than the tendons and pulleys around it. Repeated hard crimping can crack it, often with little warning. This page is general information, not a diagnosis: finger pain that doesn't settle needs a medical check.
Memory hookAdults strain pulleys; growing fingers crack growth plates. Pain means stop.
Adults and young climbers: different weak points
| Adults | Growing climbers | |
|---|---|---|
| Usual weak point | Pulleys (especially A2, A3, A4) | Growth plate at the middle finger joint |
| Typical cause | Hard crimping, especially sudden loads | Repeated hard crimping; campus board work, especially double dynos; added weight |
| Typical signs | Pain on the palm side of the finger, sometimes a pop | Pain and swelling at the back of the middle finger joint, worse when crimping |
| What to do | Stop and get it checked; ultrasound is the usual first scan | Stop climbing and see a doctor; insist on an experienced review |
Which pain means stop
-
Sudden pain or a pop in a fingerStop
Stop climbing for the day and have it checked.
-
A young climber with pain at the back of the middle finger jointStop
Stop climbing and see a doctor. Don't climb through it, even if X-rays look normal.
-
Pain that lasts more than a day, or keeps coming backStop
Stop and get it assessed.
-
Swelling, stiffness, or a finger that won't straighten or bend like the othersWatch
Treat as an injury until someone qualified says otherwise.
The evidence
- Measured Pulley injuries are the most common overuse injury in rock climbers. The crimp grip is the mechanism, the A2–A4 pulleys are most at risk, and ultrasound is recommended as the first scan. Miro et al. 2021, a review of the climbing literature. Wilderness Environ Med 32(2):247–258.
- Measured Finger growth-plate stress injuries are the most frequent sport-specific injury in adolescent climbers. In one clinic series of 27 young climbers (37 injuries, mean age 14.7), 28 of the injuries were fractures running through the growth plate into the joint (Salter-Harris type III). Schöffl et al. 2022. Am J Sports Med 50(1):229–237.
- Measured Growth-plate stress fractures are the most common injury in youth climbers, and campus board training is a known risk factor. Meyers et al. 2020, a review. Curr Sports Med Rep 19(11):457–462.
- Measured The AOSSM STOP Sports Injuries climbing sheet advises no double-dyno campus board training until age 18 (or until the growth plates close), and no added weight on a campus board. It says to stop and see a professional for finger pain lasting more than 24 hours, or recurring pain for more than a week. Reviewed September 2025. sportsmed.org/rock-climbing.
- Measured The British Mountaineering Council guide describes dorsal (back of the finger) tenderness at the middle joint and says "Pain = STOP!" It notes that X-rays can look normal when an MRI shows the fracture. Typical time off is 6–8 weeks, with re-imaging to confirm healing. BMC growth plate guide, v1.0, February 2024.
- Coaching practice Never let a young climber "work through" finger pain.
Try it
Growth plates shows why the same crimp loads a growing finger differently from an adult one.
Common mistakes
in young climbers the bone, not the pulley, is often the weak point, and the warning signs are different.
growth-plate stress fractures can be missed on X-ray; an experienced clinician may need an MRI.
stop and get the finger checked.
tape doesn't treat a fracture.