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Foot Health for Climbers: A Physical Therapy Approach for Pain Prevention

Climbing shoes serve a wonderful purpose - they are designed to be able to transmit force and hold our body weight on the tiniest of foot chips. This is accomplished by a narrow and downturned toe box and an asymmetrical shape. Additionally, climbers will down-size their shoes to obtain a tight fit to ensure they can yard on a heel hook without their shoe slipping off. This evolution of climbing shoes, however, leads us to cram our otherwise wide and sprawled out toes into a very unnatural position. We all know the feeling of sliding your foot into a brand new pair of climbing shoes, or a pair of shoes that have been in your hot car all day. There can be immediate cramping in the arch of the foot, and discomfort on the skin as your foot acclimatizes to its new, small home. Due to this, climbers can be prone to developing hallux valgus (AKA bunions), hallux limitus (AKA restricted big toe mobility), as well as claw or hammer toes and general joint pain. There are also a load of skin issues that can develop due to tight and prolonged time in the climbing shoes, but I will not touch on those today.


Due to the nature of climbing and subsequent climbing shoe design, there is no way to 100% eradicate the discomfort associated with wearing a small shoe. However, I would like to offer you some suggestions and strategies to minimize the pain and potential long term damage of wearing aggressively small, downturned climbing shoes. Below are some general tips to keep your feet feeling good so that they are not the reason you have to end your climbing session.


1. The less time in climbing shoes, the better


The longer our muscles and joints are in a crammed position, the more time the muscles spend shortened, and the harder it gets to reverse and lengthen these muscles. That being said - climbing shoes should absolutely be taken off between climbs. And under no circumstances should you be belaying, lifting weights in the gym, or walking to and from the water fountain with your shoes on!


Also, consider only busting out the overly aggressive, downsized climbing shoes when you really need them. In other words - get a roomier pair to warm up in and do volume sessions in, and just use the super tight shoes when you are working on a project with small foot holds or an aggressive heel hook.


2. In between climbs, work to strengthen and lengthen the intrinsic muscles of the foot


We have 10 small muscles that start and end in the foot, AKA your intrinsic foot muscles. Each of these muscles serves a wonderful purpose to support your foot and generate strength when walking, running, and climbing. While resting between climbs, this is a perfect time to work on some intrinsic strengthening to bolster these muscles and allow them to keep the joints of your foot supported. These exercises also work to actively reverse the binding of the climbing shoes, which can help lessen your risk of developing foot injuries.


Heads up - these exercises initially may seem impossible, as these muscles may have been neglected for decades. Our brain may need some time to work on re-establishing connections with these muscles. Don't give up! Do short, frequent sessions: at home, work on these for 5-10 minutes at a time, or alternatively at the climbing gym or crag, work on one of these for 2-3 minutes at a time while resting between goes. You want to do high reps of these exercises, shooting for 15-20+ reps in a set.


Try the below exercises to build strength and control in the foot!


- Toe Splaying

Lift all of your toes off the ground while keeping the rest of your foot in contact with the floor. Try to spread your five toes out as far as you can, while actively reaching back down to the ground.

- Big Toe Abduction

Try to isolate just your big toe with this one. Bring the big toe towards midline. Initially, it may be helpful to start with first lifting the big toe off the ground, and then actively reaching towards midline while you lower back to the ground.


- Toe Yoga

The holy grail of foot exercises! Start with lifting just your big toe a few times, then lift just your outside four toes. The progression is going back and forth - big toe, outside toes, big toe, outside toes. This will work on coordination and isolation of the intrinsic muscles.



- Interlaced Toe Mobility

This one is amazing to do after a climbing session, preferably after you have washed your feet but no judgement. Slide your fingers between each toe, and perform gentle circles in each direction. Stabilize the middle of your foot to isolate this movement and to mobilize to the front of the foot. Initially it may feel very difficult and uncomfortable to get your fingers between your toes, but keep working at it!


3. Consider grabbing a pair of toe spacers to wear around the house after a climbing session

This is again a great, easy way to counteract the binding nature of climbing shoes. Wearing these helps put the foot in its natural position and allow the intrinsic muscles to more naturally do what they were designed to do. Spreading the toes can also help to enhance circulation to the toes and improve balance.


CorrectToes are a comfortable option that you can also wear in shoes with a wide toe box (such as Altra). There are also cheaper options, but they will not be quite as comfortable. You can also grab a pair of toe socks (Injinji is the most comfortable brand I have found; and they have the most fun patterns!) and wear the toe spacers on top of your socks to keep your toes toasty around the house in the winter!

Toe spacers (CorrectToes) over toe socks (injinji) to promote foot health in rock climbers
CorrectToes + Injinji Toe Socks

One final note - if you have been dealing with foot pain and find any of the above exercises to be painful, do not push through this pain. Consult with a physical therapist who has experience treating the foot/ankle, and get a personalized program tailored to your individual needs.


Click here to schedule a free 15 minute phone consultation if you have questions about working with us at The Climb Clinic or want to make sure we are a good fit for your rehab needs!


Woman rock climbing
The author putting her climbing shoes to work!

References:


  1. Cobos-Moreno P, Astasio-Picado Á, Gómez-Martín B. Epidemiological Study of Foot Injuries in the Practice of Sport Climbing. Int J Environ Res Public Health. 2022 Apr 3;19(7):4302. doi: 10.3390/ijerph19074302.

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