Although “belayer’s neck” is not an official orthopedic diagnosis, it is an official pain in the ass—er, neck—for most climbers. We focus so much on avoiding injury while climbing that we ignore the possibility of chronic injury from belaying. It’s particularly bad because the long hours spent with your head thrown back or twisted awkwardly can wreak havoc on vital body parts like your spine and neck. Everyone has been there— back of your head touching the top of your back, eyes straining to see your partner, and getting antsy, hoping he would just hurry up and finish the route so you don’t have to endure one more moment of that painful craning position. As climbers, we use the term belayer’s neck to refer to any pain in our neck or upper back, but there are many different actual diagnoses. Read on to understand the causes and find a solution.

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Muscle Strain

When your head is stacked upright and over your shoulders, gravity’s impact on your neck muscles is negligible. However, when your head moves forward, sideways or backward so that it no longer sits centered over your shoulders, gravity pulls your heavy noggin down and nearby muscles fire in high gear to support your neck. Too much of this will lead to an overused, strained muscle, which can occur on the front, side, and back of the neck.

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Facet Joint Irritation

Vertebrae stack on top of each other like blocks divided by little pillows, called discs. Vertebrae connect via the facet joints, which are located on the back side of the spine. When your head is upright, they have a nice space between them; that space increases when you look down at your belay device (known as flexion) and decreases when you look up at your climbing partner (known as extension). Looking up essentially jams the facet joints together. Over time, these joints get inflamed and report pain to your brain. This pain can remain local, or it can worsen. The condition can progress to cause neurological irritation, and the pain will start to radiate below the initial irritation area down into your upper back and shoulders.

Nerve Root Irritation

Your spine houses and protects your spinal cord. Between each vertebra block, the spinal cord shoots off a nerve that exits the spine and supplies certain tissues (muscles, skin, bones, etc.) with other nerves that allow our bodies to move and feel. When there is inflammation in any area or another obstruction that interferes with this nerve’s pathway, it gets angry and lets your brain know by way of pain. Obstructions could include anything from inflammation to arthritic or degenerative bone changes.

Thoracic Outlet Syndrome (TOS ) / Nerve Entrapment

When your muscles get too tight, they can trap nerves that run through or under them, similar to how your old or dirty rope doesn’t slide smoothly through your belay device. There is basically just less space available for the nerve to travel due to tightness or inflammation. An angry neck can trap nerves that run to your shoulder, arm, and hand.

Prevention Tips

A few problems can develop down the road due to repetitive belaying, including headaches due to muscular tension and joint irritation, and degenerative changes (arthritis). Prevention is the key. Regardless of your specific pain or diagnosis, the following steps should provide some relief.

Change your footing. Depending on the climb or pitch, this may not be possible. However, when you change the location you are standing on the ground, it can change the angle at which you look up at your partner.

Motion is lotion. The more you move your neck around, the less your neck will hate you. Be attentive when necessary for your climbing partners, but after a clip or while they are resting, mix it up. Look up, look down, tilt your right ear to your right shoulder, left ear to left shoulder, turn your head to the right and left. Changing position is likely the most significant thing you can do to avoid neck pain.

Get some balls. Two tennis balls in a sock may just become your best friend at the crag. Lie on your back and position each ball (in the sock) at the base of your skull under those meaty and often very tight neck muscles. Gently massage your neck with the balls or isolate areas and simply lay there on the balls to help those muscles relax. The sock keeps the balls from rolling away. Pay attention to the type of “pain,” you experience with this: If it’s acute and unbearable, stop—rest and consider calling it a day. If it’s general soreness and tightness, it’s working—it should feel like a good massage.

Take breaks between belays. Would you hop on your project over and over without giving your body some recovery between each go? Of course not! Belaying really isn’t that different. Small muscles are forced to do intense work over a long duration when belaying, just as your forearm flexors are on a climb. Between each belay, perform gentle stretches or use the tennis balls as described earlier. The break doesn’t have to be long—just a few minutes— but your muscles and joints need some time out of that jammed belaying position.

Strengthen your deep neck flexors. A strong neck will help support your heavy head and decrease the chances of belaying causing an injury, so practice chin tucks at home. Sit or stand upright and draw your head back over your shoulders, creating a double chin. Don’t look up or down, just draw back. Hold for about three seconds and repeat 15 to 20 times per set, three sets total. You can also do these lying on the ground, flattening the back of your neck to the floor and creating a double chin.

Professional Techniques

If you already have chronic mild or acute pain, ask your doctor about the following treatments.

Active Release Technique® (ART), also know as myofascial release, breaks down scar tissue in the myofascia (muscular tissue and fascial tissue, which sits right under your skin). It works wonders on tight muscles throughout the entire body. When tight muscles are released, it can often alleviate joint-related pain.

Graston® Technique is becoming very popular in sports therapy. Six stainless steel instruments are used with this technique to manage scar tissue in the fascia by applying a direct, scraping pressure on the affected areas.

Joint mobilizations and adjustments by a licensed manual practitioner are an extremely effective way of managing particular types of joint pain.

Needles (acupuncture, IMS, etc.) can offer a potent and positive impact on muscular tightness and joint pain.

As a chiropractor, climber, and yoga instructor in British Columbia, Canada, Cupido (drcarlacupido.com) believes patient education is the most important part of treating injuries and healing.