Knee Torque Injuries: MCL Strain, Meniscus Irritation & Rotational Mechanics

Knee Torque Injuries: MCL Strain, Meniscus Irritation & Rotational Mechanics

1. Why the Knee Fails in Climbing

The knee is a hinge joint.
It is designed for:

  • flexion/extension (bending/straightening)

It is not designed for:

  • rotation under load
  • sideways shear force
  • twisting with the foot fixed

But climbing demands exactly those forces during:

  • dropknees
  • high-steps
  • Egyptians
  • pivots on small footholds
  • twisting to generate hip tension

When the hip doesn’t rotate enough, the knee steals mobility → gets injured.

2. The Three Main Knee Structures Climbers Overload

1. MCL (Medial Collateral Ligament)

Resists inward knee collapse.
Overloaded when knee falls inward while foot is fixed.

2. Meniscus (cartilage pads)

Cushion + stabilize.
Overloaded by twisting under compression.

3. Patellofemoral joint (kneecap tracking)

Controls knee glide.
Overloaded by extreme high-steps or poor hip mobility.

Different pain patterns → different injuries (see below).

3. How Knee Injuries Happen in Climbers (Mechanics)

1. Dropknees with poor hip rotation

If hip can’t rotate externally → knee rotates instead → MCL strain.

2. Egyptian moves with foot locked

Foot fixed + torso twists → meniscus compression + shear.

3. High-steps without hip mobility

Knee collapses inward → patellar tracking issues + MCL load.

4. Twisting during weight transfer

Small footholds force rotational torque through knee.

5. Dynamic movement into twisted positions

Momentum × rotation = cartilage irritation.

6. Weak hip stabilizers (glutes, ER muscles)

If hip can’t control rotation → knee absorbs everything.

Knee injuries in climbing are hip problems in disguise.

4. Pain Pattern: What Each Injury Feels Like

MCL Strain (inside of knee)

  • pain on inner knee
  • worse when knee collapses inward
  • pain during dropknees
  • pain when pushing outward against resistance
  • tenderness along inside joint line

Meniscus Irritation

  • sharp pain during twisting
  • catching / locking sensation
  • pain when squatting or pivoting
  • tenderness deeper inside joint
  • swelling after session

Patellofemoral Irritation (kneecap)

  • pain during high-steps
  • pain when lowering from high-step
  • pain when straightening knee
  • creaking or grinding sensation

If pain comes specifically from twisted positions → it’s rotational (this guide).

5. Yellow & Red Flags

Yellow Flags (reduce load)

  • mild inner knee ache
  • discomfort only during dropknees
  • no swelling
  • pain improves during warm-up

Red Flags (stop climbing)

  • swelling
  • catching or locking
  • sharp pain in twist
  • instability (“knee gives way”)
  • pain during normal walking

Meniscus symptoms require extra caution.

6. Technique Errors That Cause Knee Injuries

1. Twisting from the knee instead of the hip

Most dangerous error.

2. Dropknees without hip rotation

Knee collapses inward → MCL overload.

3. Over-reaching high-steps

Knee twists because hip is too stiff.

4. Foot slipping while twisted

Sudden torque change → cartilage stress.

5. Dynamic moves into twisted positions

Momentum + rotation = high shear load.

6. Using the knee to generate tension

Hip should generate tension — never the knee.

7. Immediate Actions (0–7 Days)

1. Reduce climbing load

Especially dropknees, Egyptians, high-steps.

2. No twisting under load

Pivot foot first → then load.

3. Hip mobility drills

Hip does rotation → knee stays safe.

4. Light isometrics for quad + hamstring (20–40%)

Promotes joint stability.

5. Gentle cycling or walking

Keeps knee fluid moving.

If pain improves with movement → tendon/ligament safe.
If pain worsens → reduce load further.

8. Rehab Plan — The Three-Phase Model

Phase 1 — Reduce Shear & Restore Control (1–2 weeks)

Goal: unload knee + improve hip contribution.

Exercises:

  • hip external rotation mobility
  • hip internal rotation mobility
  • glute activation (clam shells, bridges)
  • quad/ham isometrics
  • straight-leg raises

Criteria to progress:
→ no sharp pain during gentle twisting

Phase 2 — Strength & Stability (3–6 weeks)

Goal: strengthen hip so knee doesn’t take rotational load.

Exercises:

  • mini band walks (glute medius)
  • controlled high-steps
  • single-leg balance
  • step-downs with knee tracking
  • split squat with hip alignment focus

Protocol:

  • 3× week
  • pain <3/10
  • tempo controlled

Criteria:
→ stable knee during high-step
→ no inward collapse on landing

Phase 3 — Climbing-Specific Reintroduction (6–12 weeks)

Goal: return to torque under safe technique.

Exercises:

  • shallow dropknees with perfect hip rotation
  • controlled Egyptians (light)
  • slow twisting foot transitions
  • lock-off + hip rotation drills

Progress 2–5% per week.

Criteria for full return:

  • no pain in twisted positions
  • no morning stiffness
  • stable knee during dynamic moves

9. Return-to-Climbing Protocol

Step 1

Vertical climbing, no twisting.

Step 2

Slow foot transitions, no dropknees.

Step 3

High-steps with perfect hip rotation.

Step 4

Shallow dropknees (controlled).

Step 5

Light Egyptians.

Step 6

Steeper terrain + moderate torque.

Step 7

Full dropknees, full twisting, dynamic moves.

If pain returns → regress 1 step.

10. Long-Term Prehab (4–6 minutes)

  • 10 hip ER mobility reps
  • 10 hip IR mobility reps
  • 10 glute medius reps (banded)
  • 5 controlled high-steps
  • 5 shallow dropknees (technique drill)

This keeps rotational load where it should be: the hips, not the knees.

11. When to Seek Professional Help

  • swelling
  • locking or catching
  • instability
  • sharp pain with rotation
  • pain worsening over time
  • visible knee misalignment

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