Part 2 Why Climbers Get Elbow Pain: Understanding Climber’s Elbow Causes

In the last article, we broke down what’s happening inside the tendon and how to rebuild it with the right kind of loading. But there’s still a problem:

If you only treat the tendon and don’t address the cause, it will come back. Most climbers don’t develop elbow pain because the tendon is weak in isolation. It happens because:

• Load exceeds capacity

• Movement is inefficient

• Other parts of the system aren’t doing their job

  
  

So the tendon adapts… until it can’t. This is where regional interdependence matters. Your body is a system—not separate parts.

Kinetic chain of a climber

The Kinetic Chain of a Climbing Move

Every move follows a chain: Feet → Hip → Core → Shoulder → Elbow → Forearm → Fingers. When the system works:

• Force transfers efficiently

• Load is shared

• Movement feels controlled

  
  

When it doesn’t, the elbow has to compensate, and fingers grip harder.

Why Climbers Over-Grip

Over-gripping is one of the biggest drivers of elbow pain. Climbers over-grip for predictable reasons:

• Fear of falling

• Poor foot positioning

• Inefficient movement

• Weak shoulder or trunk

  
  

Over-gripping is not a hand problem—it’s a system problem. If your shoulder or core is unstable, your fingers grip harder to compensate. You’ve felt this:

• The “barn door” swing

• Drifting away from the wall

• Suddenly needing to squeeze harder when off balance

  
  

That’s a loss of control upstream.

Shoulder Weakness and Elbow Pain

Climbers commonly have:

• Lower trapezius weakness

• Serratus anterior weakness

• Poor scapular control

  
  

When the shoulder can’t stabilize, the arm position is off, control declines, and force increases. This leads to:

• Increased elbow flexor demand

• Increased forearm activation

• Higher tendon stress

  
  

Technique Errors That Stress the Elbow

Most elbow pain in climbers isn’t just about strength. It’s about how you use it on the wall.

Pulling Instead of Pushing with Your Feet

This increases arm load unnecessarily. Footwork matters. If your feet aren’t doing their job, your arms take over.

Locking Off Excessively/Not Reading the Route

Sustained tendon loading occurs with long lock-offs. Better climbers don’t just get stronger—they get more efficient. A great example is during Adam Ondra’s ascent of Silence. One of the keys to success was reducing time on holds during the crux to ~2–3 seconds per hand. He didn’t just gain strength—he reduced time under tension through precision and movement efficiency.

👉 Less time hanging = less cumulative tendon load.

Read your route before you leave the ground. Efficiency is protection. If you’re hesitating, searching, or adjusting mid-move:

• You spend more time hanging

• Your forearms fatigue faster

• Load shifts more to the tendon

  
  

Campusing/Dynos Too Early

Dynamic, powerful pulling places very high force through the elbow. If your shoulder, trunk, and tendon capacity aren’t ready, 👉 the elbow becomes the weak link. Earn the right to campus.

Not Managing Volume and Intensity

Cumulative overload is a common issue. (We’ll break this down *here

If you feel more fatigue in your forearms than your feet or core… you’re likely overloading your elbow.

Strength Imbalances That Drive Elbow Pain

Climbers are typically:

Strong:

• Finger flexors

• Forearm flexors

• Biceps

  
  

Underdeveloped:

• Shoulder external rotators

• Scapular stabilizers

  
  

This creates a system that pulls well but stabilizes poorly. Strong fingers + weak shoulders = elbow overload.

What Climbers Should Train Instead

Fixing elbow pain isn’t just about the elbow. It’s about restoring balance. Focus on:

Scapular Control

• Scapular pull-ups

• Controlled isometric hangs

  
  

Horizontal Pulling

• Ring/TRX rows

  
  

External Rotation Strength

• External rotation in neutral

• External rotation in elevation

  
  

Scapular Stability

• Y / T / I raises

• Serratus press

  
  

Pushing Movements (Often Neglected)

• Push-ups

• Ring push-ups

  
  

Think close chain exercises to train your core. Sport-specific training focuses on training your body in the way it will be used in your sport. For trunk training, you will gain more proprioception and motor control for controlling your body on the wall if you are using the long body levers during your training.

The ring rows, push-ups, and scapular hangs with a hollow body all use the trunk as the link between the feet and the arms. This is likely more effective than doing crunches, bicycles, and long hollow body holds in supine.

One last thing: Lack of Discipline (or Knowledge) Around Volume and Intensity

Most climbers don’t get elbow pain because they’re weak. They get it because they’re doing too much, too often, without realizing it. This is where things break down:

• Too many hard attempts

• Too little rest between sessions

• Stacking climbing + hangboarding + pulling workouts

• No structure to intensity across the week

  
  

The tendon doesn’t fail in a single session. It fails when load exceeds capacity repeatedly over time.

The Core Problem: Load Mismanagement

Tendons respond to magnitude + frequency + recovery. You can tolerate:

• High intensity (hard climbing)

• High volume (lots of climbing)

  
  

But not both at the same time for long. Most climbers unknowingly combine:

• Limit bouldering

• High session volume

• Frequent sessions

  
  

→ This is the exact recipe for tendon overload.

Simple, Evidence-Based Guidelines (Climber Translation)

We don’t have perfect elbow-specific dosage research, but tendon literature (Achilles, patellar, lateral elbow) gives us strong principles:

Intensity Needs Separation

High-intensity sessions (limit bouldering, max hangs):

• 2–3x per week max

• At least 48 hours between

  
  

Why? Tendon collagen synthesis peaks ~24h and normalizes ~36–72h (Magnusson et al., 2010).

Volume Is the Silent Killer

Volume accumulates faster than you think. General guardrails:

• Keep total hard attempts at a threshold per session pain-free and count attempts so you have a baseline to judge—this is what pitchers do to manage longevity in their sport.

• Stop when grip quality drops, not when you're exhausted.

• Avoid “just one more try” loops.

  
  

Weekly Structure Matters More Than One Session

A better structure:

• 2 harder climbing days

• 1–2 easier/technique days

• 2–3 rest or low-load days

  
  

Instead of:

• 4–5 medium-hard days in a row.

  
  

This may be an aggressive schedule if you are starting from a lower baseline, over 40, over 50, or recovering from an injury. Wherever your baseline is, start there and add 10%-20% a week, stopping and holding progressions if any negative symptoms or prolonged soreness occur. Adjust with greater rest and/or less intensity. There is no one size fits all. Log your training if you are serious about progressing your intensity and volume so you have the info to know when to dial back or where to rest more. This can be tricky to figure out, and I am happy to help you design a system that makes sense.

Avoid Load Stacking

This is one of the biggest mistakes climbers make:

❌ Same day:

• Climbing + hangboard

• Climbing + heavy pulling

• Climbing + campus

  
  

✔ Better:

• Separate by 24–48 hours or reduce the intensity of one.

  
  

How to Prevent Climber’s Elbow From Coming Back

The Takeaway

• Manage volume and intensity.

• Improve shoulder control.

• Reduce over-gripping.

• Train full-body movement.

  
  

Ready to Fix the Root Cause?

If your elbow pain isn’t improving, I help climbers identify the exact driver and build a plan that actually works. At Beta for Your Body, I help climbers:

• Identify the real driver.

• Rebuild capacity.

• Return stronger.

  
  

Book a consult and get a plan built for your climbing.