Why Climbers' Hands Look Less Symmetrical
At some point, a climber’s finger joints start looking less symmetric side-to-side.
For most athletes, if this change happens over decades, it is an adaptive response to the imposed demand.
In response to repetitive stress (essentially micro-traumas), the ligaments, joint capsule, volar plate, and pulleys will hypertrophy (increase in size) to create more stiffness across the joint. Because the ligaments aren’t attached to a muscle, they must be repetitively stressed (stretched) at a moderately high magnitude and volume to adapt in this way.
Suppose these changes happen too quickly, within the first few years of climbing, or with too high a volume for a seasoned athlete. In that case, the stress response is no longer adaptive and will create a less stable joint. This negative adaptation will drop stress tolerance and create an inflammatory response that can be hard to get rid of.
This first picture shows a well-trained (20-year-old) climber’s typical grip, with a sub-acute (month of hard in-season climbing) onset of joint pain on the thumb side of the PIP joint. If we look at the static image (next picture), we see that the ultrasound shows a collateral ligament that is 2x the thickness on that side. That’s the kind of adaptive response I’m talking about.
This image is not alarming clinically; I see it daily.
However, this athlete must make some grip position and training changes over the next month to control the pain and acute swelling. These long-term physical changes to the joint are a big part of why I’m a proponent of using more ergonomic grips for regular strength training. Flat edges with a fixed depth (10-25mm) are still asymmetric loads.