How to Prevent and Treat the 7 Most Common Rock Climbing Foot and Ankle Injuries in Seattle

At one time rock climbing was a sport that primarily attracted young, male adrenaline junkies. But no more. With the proliferation of climbing gyms in places like Seattle and actual rock climbing so close by, people of all genders and ages are enjoying the thrill of climbing. And unfortunately, the accompanying foot injuries.

No other sport puts so much pressure on the feet as does rock climbing. Because climbers are so dependent on their hands and their feet to launch them upwards, wearing tight, tight climbing shoes to get them there comes with the territory and a price!

What’s the Problem With Really Tight Climbing Shoes?

Our feet were built to spread out, not be confined to shoes. Tight climbing shoes do the opposite. They compress your toes and put pressure on your toenails. They can also change the biomechanical position of the foot in the shoe adding stress to the ball of your foot. Finally, they cause your toes to contort and contract putting you at risk for future toe problems.

7 Most Common Rock Climbing Injuries to the Foot and Ankle

In addition to wearing tight shoes, rock climbing injuries occur through overuse and acute injuries.

Feet and ankles bear a huge burden due to the stress and pressure they go through when you climb. The load applied to very small foot holds only adds to that force. You can also injure them through ground falls and arrested falls on the rock face.

More aggressive and advanced climbers tend to have more foot and ankle problems than their more novice counterparts. That’s primarily due to the tighter shoes with higher arches they choose to wear.

The different types of foot problems climbers develop from rock climbing sounds like a litany of every possible foot problem out there. Here are the more prominent ones.

1. Toenail Injuries

When you apply a lot of pressure to your toenails, there will be problems. Toenail damage is very common among rock climbers and includes the following.

• black toenails
• toenail loss
• ingrown nails,
• dystrophic (misshapen) toenails
• fungal toenails.

The pressure can cause a subungual hematoma or bleeding under the nail (cause of black toenails) and toenail loss. It can also cause the toenail to lift slightly making your nailbed the perfect host for toenail fungus or onychomycosis. Wearing shoes made out of rubber and synthetic materials also increase the temperature and humidity around your feet, another great place for fungus to thrive.

Nails that receive constant pressure are much more likely to become misshapen or dystrophic. Once distorted nails will not return to their previous appearance. And nails often grow out in distorted ways as well, making them more difficult to care for.

Recurrence of ingrown toenails are also more common in climbers.

To help prevent damage to your toenails be sure to keep them short, but not too short. Nails should not extend beyond the toe. Always trim them straight across.

2. Back of Heel Problems

Climbing shoes can also add pressure to the back of the heel. Several foot conditions caused by this pressure can develop including:

• Haglunds deformity- also known as “Pump bump” because it’s common in people who wear pumps.
• Retrocalcaneal bursitis or Achilles tendon bursitis
• Achilles tendonitis

3. Chronic Toe Conditions: Bunions, Hammertoes, and Hallux Rigidus

Three chronic toe conditions can develop or worsen as a result of rock climbing: bunions, hammertoes, and hallux rigidus.

While rock climbing doesn’t cause bunions to develop, it can make existing bunions worse due to the pressure from tight shoes and climbing. A shocking study found that 53% people who’ve climbed for 5 years or longer, had bunions in at least one foot, while in adults 17-44 only 4.5% have them.

Hammertoe, claw toes, and hallux rigidus or “big stiff toe” can result from wearing shoes that are too tight and too short and faulty foot mechanics.

4. Metatarsalgia

Metatarsalgia or ball of foot pain was found in 12.5% of rock climbers in one study in 2013. Wearing tight shoes, and repetitive stress on this area of the foot are the primary culprits.

5. Lisfranc and Other Joint Injuries

Rock climbers are also prone to a common athletic injury, called Lisfranc. Twisting the feet during climbing is a likely culprit. The Lisfranc joint can fracture or become dislocated and the ligaments can get sprained. Other joint injuries common in rock climbing are hallux interphalangeal joint injury and first metatarsophalangeal joint injury.

6. Blisters

Anytime feet are exposed to pressure, heat, and friction a blister will form. Your rock-climbing shoes should be an exact fit. Neither too snug or too loose. Shoes that are too loose will allow for friction and blisters to form. Rock climbers tend to get blisters on the top and bottom of the feet and toes. If you develop a blister, keep the skin intact as long as possible. Don't pop your blister as infection can set in. If it does pop, keep the area clean and cover with a non-adhesive pad. You can also use a product. If you notice pus, redness, or swelling from the affected area it's very likely infected. Get this checked out by your podiatrist as soon as possible.

7. Ankle Sprains

One of the most common injuries of rock climbers is sprained ankles. Climbers often roll their ankle when coming down from a climb. While rock climbing shoes are made to allow climbers to stand on small holds, they don’t offer support for the ankle. In addition, the shoes themselves place the foot in a supinated (foot rolls out) position which is unstable and can increase the risk for recurrent lateral ankle sprains.

Immediate treatment for a sprain follows the RICE protocol which includes:

• Rest or staying off the injured ankle
• Icing the ankle for 20 minutes and then after another 40 minutes.
• Compress the area using elastic wrap to control the swelling
• Elevate the ankle above the level of the heart to reduce swelling
• Wear a brace or walking boot if recommended by a podiatrist.

Follow-up treatment may include physical therapy or cold laser therapy such as MLS laser to continue the healing process.

To prevent future sprains, consider wearing a elastic wrap to better support the ankle. Here’s a video from REI that discusses taping for an ankle sprain. You can also use this to help prevent a sprain.

How to Reduce Foot and Ankle Problems When Rock Climbing

You might wonder with all the havoc rock climbing can wreak on your feet and ankles, whether there is anything you can do to decrease the potential pain and damage. Fortunately, there is.

• Buy the right size climbing shoe – often rock climbers choose shoes that are too tight for their feet which can cause more damage. Knowing your proper shoe size and the type of rock climbing you do (more or less aggressive) will also help inform the type of shoe you should buy. Learn more about buying rock climbing shoes from the experts at REI.
• Wear your shoes only when rock climbing – it’s best to limit the amount of time you’re in your shoes. Don’t go walking around in them if you’re not actually rock climbing.
• Keep your toenails short but not too short. If your toenails push into the front of your shoe, you’re much more likely to get an ingrown toenail or other toenail infections and damage.
• Wear appropriate shoes when you’re not rock climbing – you’re spending most of your time not rock climbing, so be sure to wear shoes that provide plenty of room in the toe box and provide you with the support you need.
• Keep your feet and ankles flexible and strong – foot and ankle exercises can help prevent injuries. Check out this video on “3 Exercises to Improve Foot and Ankle Strength and Flexibility”.

Treatment for Rock Climbing Foot and Ankle Injuries in Seattle

Treatment for rock climbing foot and ankle injuries varies widely depending on the diagnosis. But here are some of the treatments your Seattle podiatrist will likely use.

Toenail Fungus and other Toenail Problems

Toenail fungus is difficult to treat. Our best advice is to find a podiatrist that uses a comprehensive treatment program which includes laser. One of the products we use in our Seattle office, Tolyclen, can also help with nail appearance even if your toenails don’t have fungus but look unsightly.

Ingrown toenails are treated through a surgical procedure done in the office, sometimes along with a round of antibiotics if the toenail is infected. Learn more about how rock climbers develop an ingrown toenail and how it's treated in the video below.

Bunions, Hammertoes, Haglund’s Deformity, Achilles Tendonitis, and Metatarsalgia

All of these conditions along with the stress from rock climbing are caused by abnormal foot biomechanics. Custom orthotics can assist in correcting faulty foot mechanics in your everyday life.

Joint and Ligament Injuries

Most joint injuries are treated by immobilizing the foot or ankle. Surgery may be required if this is insufficient. For decreasing inflammation and healing old injuries our office offers MLS laser therapy.

Need Treatment for a Rock Climbing Foot or Ankle Injury in Seattle, Washington? Request an Appointment Now

Get your rock climbing foot and ankle injuries checked out as soon as possible. Complete the contact form on this page or call our office, the Foot and Ankle Center of Lake City, at 206-368-7000 to schedule an appointment with Dr. Rion Berg.

Most new patients are seen within 1-2 week's time. During your initial visit, Dr. Berg will spend up to 30 minutes getting to know you, your podiatry complaints, and your goals so that he can recommend the treatment best meets your needs. Don’t wait—contact us today.

North Seattle Foot & Ankle Specialist Dr. Rion Berg offers compassionate podiatry care for all foot and ankle problems to those living in Seattle Washington and the surrounding areas. Call us today at 206-368-7000 for an immediate appointment or request an appointment online.