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After a year of climbing, your back and forearms have filled out and you can do a few more pull-ups. But lately, after bouldering, the front of your shoulder feels tight and the inside of your elbow aches now and then. A friend says: "You only pull, you never push. You're imbalanced."
That's half right. This post covers three things: what antagonist muscles are, how far research supports "pulling-only causes injury", and a once-a-week prevention routine you can also do at home. The previous post, Home Training, touched on press-ups and core; here they become a full session.
What to do after an injury is outside this post; see the Climbing Injuries and First Aid series.
What antagonist muscles are
Climbing mainly uses pulling muscles. A coach from the Fitness Factory gym chain, interviewed by Liberty Times Health (in Chinese), lists the biceps, wrist flexors, and the back's trapezius, rhomboids and lats.
Antagonists work in the opposite direction. For climbers there are three main groups:
- Pushing muscles: pecs and triceps. Lattice's upper-body article notes that the triceps are an important antagonist to the biceps, and that the pecs, besides pushing, internally rotate the shoulder, which you use in cross-throughs and twisting moves.
- Finger extensors: the forearm muscles that open your fingers, opposite to the flexors that grip.
- Shoulder stabilisers: the trapezius and rhomboids that position the shoulder blade, and the rotator cuff muscles that externally rotate. Lattice says these don't move through a large range, but they decide where your shoulder joint and arm sit while you climb.
Eric Hörst's free tiered programs list "stabilizer and antagonist-muscle strength" among the priorities for beginners (under a year of climbing), adding rotator cuff strength at the intermediate level.
Something you can do tonight: Do 10 press-ups. If you can't, or they're harder than your pull-ups, your pushing clearly lags your pulling.
"Pulling-only causes imbalance and injury": how far does the research go?
This is the line you hear most at the gym. Unpack it and it's really two claims.
Claim one: strength training prevents injury (supported, but narrowly)
Quarmby et al.'s 2023 systematic review pulled together 34 studies on overuse injuries in adult climbers. One conclusion: a strength training intervention prevented shoulder and elbow injuries.
The full text shows how narrow that is:
- The evidence comes from two papers on the same cohort: student climbers doing closed-chain eccentric and strength exercises 3–4 times a week for one year.
- The authors state that the result cannot be applied to finger injuries, and fingers are the most commonly injured site in climbing.
- The same review found that BMI or body weight, warm-ups and cool-downs, stretching and taping were not associated with overuse injury; for warm-ups, stretching and taping the evidence is limited.
So a more accurate statement is: one randomised controlled trial supports strength training for protecting shoulders and elbows. It's a good starting point, not a settled answer.
Claim two: flexor–extensor imbalance causes injury (currently speculative)
In experienced climbers, finger flexor strength is about six times extensor strength, according to measurements by Devise et al. 2023. The team then randomly assigned participants to four weeks of hangboard training:
- The flexor-only group got stronger flexors; the ratio didn't change.
- The extensor-only group got much stronger extensors; the ratio trended down but didn't reach statistical significance.
- The control group didn't change.
In other words, to improve extensor strength you have to train the extensors directly; more climbing or more hangboarding won't do it for you. But the authors also write that the relationship between this ratio and injury rate is, for now, only speculative.
More numbers
- Devise 2023 tested 78 climbers: mean flexion/extension ratio 6.27, with values above 8.75 defined as extreme. After four weeks, the extensor group's extension strength rose 41%, and the ratio fell about 28% (p = 0.1).
- The extensor training in the study was above 70% of maximum extension strength. The authors note that the popular rubber-band finger extension exercise is probably much lighter, and no study has reported its effects.
- Lattice's data on 6,000+ climbers: pull-ups roughly double from low to high grades; press-ups barely change.
What coaches say
Lattice's data show press-ups barely track climbing grade, yet Lattice still puts antagonist training into its plans. The reasoning: they know antagonist training benefits climbing, so there's no need to chase press-up numbers as a performance score.
Lattice's beginner guide observes that many beginners pick up elbow and shoulder pains. Modern gym setting uses a lot of macro holds that demand hard pulling and pressing, which may make this more common. It recommends starting with pull-ups and press-ups, squeezed onto the end of your climbing sessions.
Something you can do tonight: Next time someone says "you're imbalanced", you can reply: "There's one trial supporting strength training for shoulder and elbow injuries; the link between the flexor–extensor ratio and injury isn't proven yet." Then do the routine below, for the first reason, not the second.
Shoulder blades and core: why train them
Shoulder blades
On vertical walls you spend a lot of time with your hands overhead pulling down; on steep terrain your hands are in front of you, pulling toward your chest or hips. Lattice notes that as the wall angle changes, so does the balance of muscles doing the work.
In Hooper's Beta's weekly routine, physical therapist Jason Hooper uses three band exercises for external rotation and the shoulder blades:
- Bilateral external rotation with scapular retraction: holding a band in both hands, rotate the forearms outward and squeeze the shoulder blades back on every rep. Don't rotate too far; if your arms go too wide, choke up on the band.
- W's: squeeze the shoulder blades back and down first, don't shrug; arms about 45–60° out to the side, as if punching someone behind you.
- Face pulls: pull the band toward your face, shoulder blades down and back, rotating outward. Hooper's cue is to "punch the wall behind you".
Core
Lattice says core isn't just the six-pack: the transverse abdominis braces your midsection so you can hold tension between your contact points, and it controls your hips, both for holding positions and for generating momentum. It recommends varying planes, volume and intensity instead of doing the same few exercises all season.
When you do core work on a bar, Lattice warns against over-engaging the shoulders, or your shoulders will give out before your core does.
If your feet keep cutting loose on steep walls, besides core, look for causes in Footwork and Balance.
Something you can do tonight: Stand and do 10 W's, band or no band. Watch in a mirror: are your shoulders creeping up toward your ears? If so, press your shoulder blades down first, then go.
The once-a-week prevention routine
Below is Hooper's Beta's routine. Evidence level: coaching consensus. It hasn't been tested in a study, but its direction matches the Quarmby review's finding that strength training protects shoulders and elbows.
How to do it: one set of each of the four exercises in a circuit, a short rest, then go again; 2–3 rounds per circuit.
| Circuit | Shoulders | Core | Legs | Forearms |
|---|---|---|---|---|
| 1 | External rotation with scap retraction × 15 | Plank shoulder taps × 20 | Nordic hamstring curls × 10 | Eccentric finger rolls × 12 |
| 2 | W's × 12 | Side plank 30–60 s | Stiff-leg RDLs × 10 | Reverse curls × 12 |
| 3 | Face pulls × 10 | Hollow rocks × 10+ | Sumo squats × 10 | Recruitment pulls on a small edge × 5 per hand |
Key points:
- Frequency: once a week; if shoulder or elbow issues are significant for you, twice.
- Which day: a rest day, or a moderate climbing day focused on technique rather than limit attempts.
- Legs: Nordic curls and stiff-leg RDLs build heel-hooking strength and help you pull into the wall on steep terrain; for heel-hook technique, see Footwork.
- Forearms: reverse curls work the brachialis, brachioradialis, wrist extensors and finger flexors; they're the only forearm exercise in the routine that trains the extensors. The final "recruitment pulls" are done on an edge too small to hang one-handed: ramp from light to about 80% effort over five seconds.
Without a barbell or dumbbells at home, Hooper says a band can stand in for the forearm exercises, though it limits the range of motion. In circuit 3, a Romanian deadlift is actually the better choice than the sumo squat, but if you're not confident with the form, start with sumo squats.
Something you can do tonight: Do just circuit 1, one round of each exercise, and note which one was hardest. That's where your attention goes next week.
Practice: four scenarios
Answers are under each question. Think first, then check.
1. A friend says: "Research proves stretching and warming up prevent climbing injuries."
Answer
A 2023 systematic review (Quarmby) found that warm-ups, cool-downs, stretching and taping were not associated with overuse injury, although the evidence for these is limited. What was linked to preventing shoulder and elbow injuries was a strength training intervention. That doesn't make warming up useless: a clinical review of finger pulley injuries still considers warming up protective; see Hold Types and Grips.
2. You see online: "Open your fingers against a rubber band 100 times a day and you'll prevent finger injuries."
Answer
Two problems. First, the extensor training in Devise 2023 was above 70% of maximum extension strength; the authors say rubber bands are probably much lighter, and no study has looked at their effects. Second, the link between the flexor–extensor ratio and injury is itself still speculative. You can train your extensors, but don't treat it as insurance for your fingers.
3. You climb three times a week (Monday limit bouldering, Wednesday technique, Friday lead) and want to add Hooper's routine.
Answer
Put it after Wednesday's technique session, or on a rest day. Hooper recommends a moderate climbing day without limit attempts. Don't put it after Monday's limit bouldering, when your hands and shoulders are already tired.
4. You've done the routine for two months, but the inside of your elbow still aches, and more often.
Answer
The routine is prevention, not treatment. If pain persists or gets worse, see a doctor or physical therapist. Also check whether your climbing load jumped: the Quarmby review found higher climbing intensity associated with overuse injury.
Next step
However well you train, your body can't repair without enough food and sleep. The last post in the series, Nutrition, RED-S and Recovery, asks whether "lighter is stronger" holds up and how to tell when you've overdone it.
References
- Quarmby A et al. Risk factors and injury prevention strategies for overuse injuries in adult climbers: a systematic review. Front Sports Act Living 2023
- Devise M et al. Finger flexion to extension ratio in healthy climbers: a proposal for evaluation and rebalance. Front Sports Act Living 2023
- How to NOT Get Injured Climbing (No Gym) (Jason Hooper, Hooper's Beta, 2021)
- Training the Upper Body at Home (Josh Hadley, Lattice × UKClimbing, 2020)
- The Beginner Climber's Training Guide (Lattice Training, 2022)
- Finger Strength For Climbers Increases, In Relation To Grade (Ollie Torr, Lattice Training, 2026)
- Free Training Programs for Climbers (Eric Hörst)
- Coach explains which muscles climbing works (Liberty Times Health, Fitness Factory coach Kyle) (in Chinese)
Update Log
- 2026-10-18: The Climbing Injuries and First Aid series is now published; replaced "in progress" mentions with links.