1. The Core Distinction: Same Cause, Different Timescale
The biological mechanism is identical:
load > capacity = tissue damage
The difference:
- Acute injury → one large overload
- Chronic injury → many small overloads
This is the reason why a climber can develop:
- chronic elbow pain after months,
or - a sudden A2 tear in one move.
The trigger is different.
The mechanism is the same.
2. Acute Injuries: Force Spikes That Exceed Tissue Capacity
Acute injuries are mechanical overload events where external force overwhelms the structure in a single moment.
Typical climbing scenarios
- catching a dynamic move with poor wrist angle
- foot cutting leading to violent shoulder torque
- sudden crimping under fatigue
- slipping mid-move while pulling hard
- swinging into a hold and “popping” something
- hard landing on a twist → ankle or knee failure
Acute injury types
- pulley rupture (A2/A3/A4)
- biceps tendon pop
- MCL sprain
- ankle inversion sprain
- acute shoulder impingement
- muscle strain
Mechanical signature
- high velocity → high force
- poor alignment → high shear
- fatigue → low stability
- high range position → weak tissue angles
Acute injury = catastrophic capacity breach.
3. Chronic Injuries: Micro-Overload Repeated Until Failure
Chronic injuries happen when tissue is:
- under-recovered
- repeatedly overloaded
- progressively disorganized
- mechanically misused
This creates micro-damage faster dan het lichaam het kan repareren.
Typical chronic patterns
- overgripping
- high training volume without deload
- poor wrist alignment on slopers
- strong pulling with weak scapula
- hip drift → elbow overload
- too many dynamic moves without recovery
Chronic injury types
- medial epicondylitis (“climber’s elbow”)
- lateral epicondylitis
- flexor tendinopathy
- shoulder impingement syndrome
- wrist tendinopathy
- chronic knee irritation
Chronic injury = long-term capacity mismatch.
4. Why Acute Injuries Happen: The Four Triggers
Trigger 1 — Fatigue
Stabilizers fail → vector breaks → force dumps into tissue.
Trigger 2 — Alignment Error
Bad joint stacking during high load = catastrophic failure.
Example:
Catching a swing with internally rotated shoulder.
Trigger 3 — Sudden Unexpected Movement
Slip, foot cut, miscatch → massive load spike.
Trigger 4 — Max Force in Cold Tissue
Cold tendons/pulleys have poor elasticity → failure threshold ↓.
Acute injuries = high load + low readiness.
5. Why Chronic Injuries Happen: The Five Drivers
Driver 1 — Slow Collagen Adaptation (capacity lags behind strength)
Muscles strengthen in days.
Tendons take months.
Driver 2 — Poor Technique
Off-axis vectors increase local tissue load 20–60%.
Driver 3 — Volume Overload
Too much frequency or density for tendon recovery cycles.
Driver 4 — Incomplete Recovery
Sleep, nutrition, hydration, high stress → capacity ↓.
Driver 5 — Weak Stabilizers
Scapula, wrist, extensor chain, hip rotators.
Chronic injuries = load slightly > capacity, repeatedly.
6. Pain Signatures: How to Tell Acute vs Chronic
Acute injury pain
- sudden
- sharp
- local
- often accompanied by “pop”
- immediate dysfunction
- swelling possible
- everything hurts, even rest
Chronic injury pain
- dull ache
- morning stiffness
- improves after warming up
- predictable movements hurt
- pain lingers post-session
- comes and goes
This distinction alone prevents 50% van misdiagnoses.
7. The Transition Zone: How Chronic Injuries Become Acute
Climbers often push through early tendinopathy.
This lowers local capacity further.
Eventually a normal movement causes a catastrophic failure.
Example:
- elbow soreness for weeks
- morning forearm stiffness
- then one big catch → sharp tearing pain
Chronic → acute = capacity collapse.
8. How to Prevent Acute Injuries
Rule 1 — Never load cold tissue heavily
5–10 min progressive warm-up = huge risk reduction.
Rule 2 — Respect technique under fatigue
Most acute injuries = when stabilizers are tired.
Rule 3 — Land safely
Ankles and knees fail from poor falling mechanics.
Rule 4 — Vector control for dynamic moves
Catching internally rotated = top risk factor for shoulders.
Rule 5 — Avoid high-intensity on back-to-back days
Capacity needs 48–72h.
9. How to Prevent Chronic Injuries
1. 2–5% progressive loading
Tendon-safe progression.
2. Load management
Alternate grip types, intensities, styles.
3. Technical efficiency
Better vectors → lower tissue load.
4. Strength-balancing
Extensor chain, scapula, hip rotators = injury prevention.
5. Early intervention at morning stiffness
Reduce load immediately.
10. Prevention Routine (short daily)
- 30–60s isometrics per involved tissue
- wrist / elbow mobility
- scapular depression + protraction
- hip IR / ER control
- controlled high steps
- 15–20 slow extensor curls
5–7 minutes.
Massive impact.
When to Seek Help
- acute swelling
- immediate loss of strength
- audible pop
- joint instability
- persistent pain beyond 7–14 days of load management