Young Climbers and Finger Growth Plates: Warning Signs, Who to See, and Training Limits for Parents and Coaches

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Your child is 14, on the gym's youth team, training four times a week. Lately they've mentioned that the second joint of their right middle finger hurts a bit, is stiff to bend in the morning, but "is fine while climbing". The coach says it's probably a tweaked pulley and two days off will sort it.

This post is about why, at this age, the more likely answer isn't the pulley.

The previous post on the spine, lower back and neck covered serious acute injuries from falls. This one returns to overuse, in a body that is still growing. It's written for three readers: parents of kids who climb, youth-team coaches, and teenage climbers themselves. By the end you'll be able to name the symptoms that mean stop climbing now, and which doctor to see.

This post doesn't diagnose. If a child's finger hurts, a doctor makes the call.

What a growth plate is, and why teenage fingers are different

Bones don't grow from the middle; they grow from the growth plates near each end. The BMC's parent guide puts it plainly: bone is weakest at the growth plate, and growth plates are significantly weaker than the surrounding tendons and ligaments.

That's the key difference between teenagers and adults. Pull hard on the same small edge, and an adult might strain a pulley; in a teenager, the first thing to give is often the not-yet-finished bone underneath it.

When do fingers finish growing? The sources roughly agree:

• BMC guide: around age 17.
• UIAA Medical Commission factsheet on sport climbing: around 16 to 17.

These are biological ages. The BMC article on campus boards notes that biological age can differ from chronological age, and late maturers finish later.

The UIAA factsheet also recommends plotting a child's height and weight on growth charts regularly, for example every three months. Outgrowing clothes or shoes is a sign of a growth spurt, and training should be adjusted during that period.

Something you can do tonight: measure your child's height, note it on your phone, and measure again in three months. A fast spurt within six months marks the high-risk period this post is about; tell the coach.

The most common injury isn't the pulley

The gym wisdom is "finger pain means a pulley". For adults, pulleys are indeed the most common finger injury (see Finger Pulley Injuries). Teenagers are different.

A 2025 prospective study by Schöffl's group included every patient under 18 seen at a German climbing-medicine clinic over four consecutive years. The most common injury was a finger growth plate stress injury (PPSI), at 45.3% of all injuries. Research

Schweizer's 2019 review from the Balgrist hospital in Zurich reaches the same conclusion. The most common climbing injury in children and adolescents is a fatigue fracture of the growth plate at the base of the middle phalanx, not the pulley rupture typical of adults. It occurs almost only in climbing.

A second common belief is that "kids' bones are soft, so they don't get hurt". The UIAA factsheet says the opposite: adolescent connective tissue is two to five times weaker than an adult's, so a force that sprains an adult does more damage to a teenager. Expert opinion

Something you can do tonight: ask your child one question: "Is there a finger joint that hurts after climbing or the next morning?" Ask first; don't suggest whether it's a pulley.

What it typically looks like: which finger, which joint, when

Put the sources together and the typical case looks like this:

• Age: usually during the pubertal growth spurt. Schöffl's 2024 review collected more than 200 cases, mostly aged 13–15. The BMC guide notes that girls peak earlier than boys, and timing shifts with early or late development.
• Location: the middle or ring finger, at the middle joint (proximal interphalangeal joint, PIP). The BMC guide says these two fingers take the most strain when crimping.
• Onset: gradual pain, usually with no injury moment the child can remember. In Hochholzer and Schöffl's 2005 series of 24 cases, none had an acute injury; all were fatigue fractures from repetitive stress.
• On examination: swelling and tenderness on the back (nail side) of the joint, sometimes with reduced bending or straightening.

A normal X-ray doesn't clear it. The BMC guide includes a case where the first X-ray showed nothing and a repeat a few weeks later showed the fracture. The guide says that when X-rays show nothing, a focused MRI of the joint may confirm a stress fracture. Bayer et al. 2013 scanned a small group of adolescents with high-field MRI and found bone marrow oedema in every affected finger. Research

Why is it so often mistaken for a pulley? Both show up as finger pain after climbing. The sources describe growth plate pain at the middle joint, on the back of the finger. That's a clue, not a way to diagnose yourself; telling them apart takes a doctor's examination and imaging.

Something you can do tonight: ask your child to lay both hands flat on a table. Compare the middle joints of the middle and ring fingers: is the back of one joint more swollen than the other? Then have them make a slow fist and see whether both hands bend equally far. If there's a difference, follow the next section and see a doctor.

When to stop climbing right away, and who to see

The BMC guide has a section whose heading says it all: Pain = STOP! It says a young climber with persistent pain, or pain that affects movement, loading or performance, "should never be allowed to work through the pain" and should be assessed by a doctor.

Paediatrician Isabelle Schöffl told the BMC symposium: "Climbing with undiagnosed finger pain is not acceptable, especially if you are under 18."

If any of the following apply, stop climbing and finger training and arrange a medical visit:

• The middle joint of the middle or ring finger has become gradually painful, and training makes it worse.
• The back of that joint is swollen or tender.
• The finger won't fully bend or straighten, or it hurts too much to crimp.

Lattice physiotherapist Sam Radcliffe advises UK parents to see their GP and insist on a referral for an MRI and review by a hand specialist.

In Taiwan, you can book directly with orthopaedics (骨科) or a doctor with hand-surgery expertise. The Taiwan Society for Surgery of the Hand (in Chinese) explains that hand surgeons are orthopaedic or plastic surgeons with additional hand-surgery certification, covering everything from the shoulder to the fingertips, including non-surgical treatment. When booking, say three things: the child's age, that they train climbing intensively, and that you suspect a finger growth plate stress injury.

Watch boys especially. In the Schöffl 2025 data, boys waited on average more than twice as many days as girls between pain starting and seeing a doctor.

Something you can do tonight: save the three warning signs above in a phone note titled "Kid's finger hurts = stop". Ask the coach to save one too.

After diagnosis: treatment and time away

Treatment is the doctor's decision. This section only reports what the sources say, so you know roughly how long you may be facing.

The timelines differ a lot between sources, mainly because the endpoint differs: some measure from starting treatment to returning to climbing, others to full recovery.

The cost of a late diagnosis matters more than the timeline. The BMC guide says that continuing to train on a stress fracture can lead to rotational malalignment and partial necrosis of the growth plate; Schweizer notes that a missed diagnosis can lead to joint destruction and arthritis. Meyers et al. 2020 add that intensive finger training in adolescence can lead to early-onset hand osteoarthritis up to a decade later.

Once the doctor clears a return, how to build back gradually is covered in the next post, Returning to Climbing After Injury. Meyers 2020 also proposes a return-to-climb protocol specifically for young climbers, which a doctor or physiotherapist can refer to.

Something you can do tonight: if your child is currently off climbing, help them separate "no climbing" from "no exercise". At the next appointment, ask the doctor which activities can continue, such as running, leg or core training.

Prevention: where there's consensus, and where there isn't

Campus boards: one of the few clear consensus points

• BMC campus board guidance (approved by the UIAA Medical Commission): under-18s should not campus feet-off or dynamically. Growth plates aren't fused yet; an injury means a long time off climbing and can cause permanent damage.
• The BMC campus article (by Audry Morrison and Volker Schöffl of the UIAA Medical Commission) goes further: no campus board use at all under 18, and perhaps up to 20 for late maturers.
• UIAA factsheet: campus training only for veterans with close to ten years of climbing, and not for those up to around 16 or 17.

The BMC article relays Schöffl's clinical experience: most of young climbers' finger injuries happen while training, not climbing, and the campus board and crimping are the main culprits.

Fingerboards and added weight: same direction, different thresholds

The UIAA factsheet says not to increase finger-strengthening exercises, or train excessively on routes that strain the fingers, during the growth spurt. The BMC article adds that under-18s should not wear added weight while climbing.

Coaches set different starting ages for fingerboarding; Hangboarding collects several views. For campus boards in more detail, see Strength, Shoulders and the Campus Board.

Crimping: supported by biomechanical research

Bärtschi et al. 2023 used ultrasound on 37 adolescent climbers without symptoms. Under load in a full crimp, the middle joint shifted toward the palm far more than in open-hand or half-crimp grips, which raises the force on the back of the joint. The authors recommend avoiding the crimp grip until the growth plates fuse. Research (a biomechanical measurement, not an injury follow-up)

The Schöffl 2025 authors point prevention in the same direction: less crimping, monitored training load, adequate recovery and targeted education. For the differences between grips, see Hold Types and Grips.

Consensus isn't the same as practice

McMullen 2021 surveyed US gym coaches with youth teams: more than 60% let some of their climbers do feet-off campus training, and they cited all sorts of criteria for deciding who.

Another common belief: "if a kid climbs as hard as adults, they can train like adults". The UIAA factsheet rejects this directly: some elite youngsters climb the same grades as elite adults, but that doesn't mean they should train the same way, because they are still growing.

Something you can do tonight: ask your child's coach three questions. Does anyone on the team campus or fingerboard? How do you decide who can? What does the team do when a kid says a finger hurts?

Practice: four scenarios

Answers are under each question; think first, then look.

1. Your 13-year-old daughter says the middle joint of her right ring finger has hurt for three weeks. It doesn't hurt much while climbing, only afterwards. She wants to tape it and keep training because a competition is coming up.

2. Your 15-year-old son had an X-ray for finger pain and the doctor said nothing is broken. He asks whether he can go back to climbing.

3. The youth coach says: "He already climbs V7, harder than lots of adults, so he can start campusing." He's 16.

4. You coach a youth team. A 14-year-old boy mentioned finger pain last week and hasn't brought it up since, but he keeps switching hands on holds.

Next steps

Once the doctor says climbing can resume, how to build back from easy routes, and how much pain means stop, is in the next post, Returning to Climbing After Injury. For other adult finger problems, see Other Finger Injuries; the map of the whole series is in the Climbing Injury Overview.

References

• Growth Plate Stress Fractures in Teenage Climbers: A guide for parents, coaches, GPs and hand surgeons (Katharine Rivett, BMC) (PDF)
• Campus boards: guidance on use (BMC, approved by the UIAA Medical Commission)
• Should under 18s use campus boards? (Audry Morrison, Volker Schöffl, BMC)
• Top 5 tips from the BMC Climbing Injury Symposium (BMC, 2016)
• UIAA Medical Commission: Factsheet on Sport Climbing (PDF)
• Schöffl VR et al. Prospective analysis of injury demographics, distribution, severity and risk factors in adolescent climbers. BMJ Open Sport Exerc Med 2025
• Schöffl V et al. Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers. Am J Sports Med 2022
• Schöffl V, Moser O, Küpper T. Stress fractures of the growth plates in the fingers of adolescent rock climbers. Unfallchirurgie 2024 (in German)
• Schweizer A, Göhner Schweizer K. Sport climbing, bouldering and associated injuries in childhood and adolescence. Orthopäde 2019 (in German)
• Hochholzer T, Schöffl VR. Epiphyseal fractures of the finger middle joints in young sport climbers. Wilderness Environ Med 2005
• Bayer T et al. Epiphyseal stress fractures of finger phalanges in adolescent climbing athletes: a 3.0-Tesla MRI evaluation. Skeletal Radiol 2013
• Schöffl V et al. Injury trends in rock climbers: evaluation of a case series of 911 injuries between 2009 and 2012. Wilderness Environ Med 2015
• Jaini A et al. Finger growth plate injuries in adolescent sport climbers: A scoping review. PM R 2026
• Meyers RN et al. Returning to Climb after Epiphyseal Finger Stress Fracture. Curr Sports Med Rep 2020
• Bärtschi N, Scheibler AG, Schweizer A. Palmar Shift of the PIP Joint in Different Grip Positions as a Potential Risk Factor for Periphyseal Injuries in Adolescent Climbers. Wilderness Environ Med 2023
• McMullen CW et al. Coaches' Attitudes Toward Campus Board Training in Adolescent Climbers in the United States. Wilderness Environ Med 2021
• Part 6: Finger Injuries (Sam Radcliffe, Lattice Training × UKClimbing)
• Taiwan Society for Surgery of the Hand: About the Society (in Chinese)