Tendon training for climber: how to prevent Injury

Tendon Training for climber

Tendons have a high rate of injury in climbers. I have treated my share of finger flexors, elbow tendinopathy, shoulder impingements, rotator cuff tears, biceps tendinopathy, if climbers have experienced it I have treated it. Sadly, when scouring the research, we find comments like this: "At present, no conclusions can be made regarding the effectiveness of shoulder injury prevention program in overhead athlete (Phys Ther in Sport 2021)."

On the bright side, we do not need a specific journal article to tell us how to treat collagen tissue such as tendons and ligaments. Clinical experience and extensive study into the histology and healing of collagen tissues gives us much of what we need to know. 

Follows these tip for how to train the integrity of your tendons.

Tip #1 -Tendon Stiffness is a good Thing

Stiffness is not flexibility. Stiffness is the mechanical property of tissue and indicates its ability to resist stress and strain. If the tissue has higher stiffness it will take greater stress and strain to deform the tissue. When I load my shoulder with a high force as my foot slips off a hold, yanking my arm off the wall, a tendon with high stiffness is much less likely to deform and become injured. 

Tissue repair and regeneration throughout the body is generated by a process called mechanotransduction. This means the mechanical stress will drive a response in the tissue. For for tendon and ligament the mechanical stimuls realted to strain or strech of the cells within the tissue will produce a signal that causes cells to respond and become more resilliant to stress and strain producing more collegen and changing the material properties of the tissue.

Research reports healthy collagen tissues like tendon and ligaments have a sweet spot for the stimulus needed to produce stiffness and stimulate collagen production. A strain rate of 4.5-6.5% has been shown in the literature to promote tissue response in healthy collegen tissue. We can not measure strain outside of the lab. Studies do show that this level of strain corresponds to training with loads of 70% 1RM to 90% 1 RM. This is different from muscles which will respond to very large range of load. You can build muscle mass using loads anywhere from 40% 1 RM to over >100% 1 rep max. Tendons and ligaments may only respond in a small window of high loading intensity.

However, most of the research is done on healthy young men.  The few articles on women show they need less intense loading and may respond as low as 55% 1 RM and respond less then men at 80% 1 RM suggesting a lower load may be more optimal for females. More research is needed to confirm the sweat spot for tendon trainig in female climbers.

Tip #2 - Training in Lengthened and outer range postions of the tendon are key to injury Prevention

What if you are not comfortable training with heavy loads or your fighting an injury and can not tolerate heavy loads? Not a problem.  The research also shows that when the tendon is loaded in a lengthen position, the amount of strain through the collagen is substantially increased and lighter loads will do the trick when you train with the muscle in a lengthed position rather then in just the mid range of the tendon.

One study looking at the patellar tendon mechanical properties after 8 weeks resistance training using high-load (80% 1RM) training with the muscle-tendon either in a shorted knee straight) position or lengthened position (knee bent). A third group was trained at 55% 1 RM in the lengthened position (knee bent). The actual strain through the tendon was greater in the 55% 1 RM group in the lengthend position (knee bent) compared with 80% 1RM group in the shortened position (McMahon 2013). This means if you train the tendon through the full range into the lengthed position of the tendon, you do not need as heavy of loads to hit the sweet spot for generating stiffness and collegen synthesis in the tendon. The other very beneficial aspect to training through our full range of motion is that we need to be strong in those stretched out positions we encounter when climbing. Use a light load and reach though your full range! Every muscle tendon complex has a differnt position to train to achie full length of the tendon. Check out this video: Climbers Guide to Bulletproof Your Tendons: Essential Training for Injury Prevention of the Shoulder.

Tip #3 - Lighter Load with ongoing progression primes performance

The importance of load progression should not be underestimated for any tendon.  Starting with lighter load will ensure you develop the coordination necessary to eventually lift heavy loads. It will also give you a chance to monitor any symptoms suggestive of over stressing tissue before you overshoot your limit. On the other hand, it is easy to never hit the ‘sweet spot’ for training tendons. Clinically, this results in a plateau effect of rehabilitation. The load will need to be progressively increased over time. As always, training should be done without pain or negative aftereffects. Always stop when you feel fatigued or any pain/strain. The goal for tendon training reps to a is gentle fatigue, not failure (espcially when trianing with heavy loads). Stop when you have 1-2 reps left in the tank. 3-5 different exercises for the upper body may be appropriate depending on what the individual. Include training into a larger range of motion with lighter weight. Gradually, increase the weight as tolerated. A common progression is 10% increase in load every 2 weeks. Whatever the load you choose, you should be able to do all of the repititions without a break down in form. Rather than increasing load, your progression could be to increase the range of your movement. As long as you are going into the lengthen range muscle, you will impact the stiffens of the tendon even if the load is light.

Tip#4 Tendon Training in climbers:How long to get strong?

Again, there are no human trials to illuminate the optimal duration and frequency of training to maximize tendon strength. However, lab research on engineered ligaments and tendons found that ten minutes of tension at 2.5% of resting length repeated every 6 hours was optimal to improve tissue stiffness (Paxton 2012). After about ten minutes, the molecular response peaked. If loading continued, the molecular signals began to switch off. Training past 10 minutes provided no added benefit to the ligament. All of input to signal change in the ligament had occurred by ten minutes. It takes about 6-8 hours to recover the ability to input the signal again. Thus, minimal effective dose of loading to improve ligament health is about 10 minutes of loading, repeated every 6-8 hours to improve engineered tendon and ligament physiology. Over a span of 5 days, the engineered ligaments subjected to this protocol produced higher levels of collagen compared to those that were exercised continuously (Power 2023).

Using this data, we can surmise that short sessions of loading multiple times a day will likely create greater mechanical input then one long session when promotion of collagen synthesis and improve mechanical properties of tendon is the goal. Practically, this may be one session specific to tendon loading during a work break and then climbing after work. Or climbing in the morning and then tendon specific training after dinner. If you are not climbing, perhaps three sessions a day can be tolerated. Theoretically, tendon training could be done daily, but we must consider this in the context of your other activity and strength training goals. The frequency for training in other studies on tendon mechanical properties has shown improvements when training 3-5 times a week. Your frequency will depend on all the other variables you are managing. Try this at least 2-3 times a week. Keep a dumbbell handy so its easy to run through a handful of full range training separated from your primary workout.  

Finish strong

To recap, evidence thus far suggests that tendon strain created by heavy resistance training (>70% 1 RM) seems to provide the most appropriate stimulus for improving mechanical properties of healthy tendons in humans, especially men. Females may benefit from somewhat lower loads (60% 1 RM). Targeting the specific tendon through isolated, single muscle exercises is shown to provide the greatest opportunity to induce adaptive changes to the tendon.  Type of contraction (concentric, eccentric, or isometric training) does not seem to matter as long as its done with slow repetitions. Training with lighter loads into the lengthen position of the muscle tendon complex is also effective in creating adequate strain rates to improve the quality of the tendon and as a bonus builds strength in those outer ranges. This strategy may have more impact for climbers as we need to be strong in stretched out positions.

Whether you training to prevent injury or are working through an injury, the quality of the tendons and their ability to attenuate load is a priority for the upper limbs of climbers. This protocol is ideal for healthy tendons with the goal of injury prevention. If you are contending with injury, you may need modifications and consideration. When in doubt, keep it pain free during and after training and modify the range and or load if you experience any negative effects.

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