Sport climbing and bouldering has developed from a rarely performed to a very popular sport in the last 30 years. Sport physicians are increasingly faced with its specific and otherwise uncommon injury pattern. Overall, the sport is relatively safe, particularly if performed in indoor facilities.
The injuries frequently occur on the upper extremity, with the fingers being the most affected. Acute traumatic lesions such as sprains, fractures or ligament lesions are much rarer than overload and overuse caused by repetitive and highly stressing climbing movements. The most common injury is not the pulley rupture, as in adults, but the epiphyseal stress fracture of the base of the middle phalanx, which occurs practically only in climbing sport. The injury is treated conservatively, has a long recovery time of about 8 months and may lead to joint destruction and arthrosis if missed.