Youth Climbing Finger Injuries: Our New Classification Standards | Frontiers in Sports and Active Living
Big news from Camp4 Human Performance: Dr. Tyler Nelson co‑authored a new classification system for primary periphyseal stress injuries (PPSI)—the growth‑plate stress injuries most often seen in adolescent climbers’ fingers. Published August 14, 2025 in Frontiers in Sports and Active Living, this Brief Research Report proposes a shared language clinicians, coaches, and parents can use to describe what they’re seeing on imaging and in the clinic
What the Paper Propose
The problem: research and case reports on youth climbers’ finger PPSI use inconsistent terms; existing systems like Salter–Harris don’t map neatly to overuse stress injuries of the physis. That muddles diagnosis, treatment, and comparison across studies.
The solution: a five‑grade classification (with “a/b” subtypes based on whether CT shows sclerosis) that combines clinical presentation and imaging findings (X‑ray, MRI, CT). Figure 4 in the article illustrates the scheme; Tyler created the figure for the paper.
Why it matters: a common framework helps teams decide next steps more consistently (rest vs. gradual return vs. when to consider surgery in algorithms where sclerosis is a key factor). The authors plan reliability studies next.
Key Imaging Signs the Paper Highlights
Radiographic Sign 1: dorsal widening/irregularity of the middle‑phalangeal physis.
Radiographic Sign 2: non‑displaced dorsal fracture of the epiphyseal‑metaphyseal complex (EPM).
Radiographic Sign 3: displaced dorsal EPM fracture.
(These signs underpin the classification’s grades and help differentiate early stress injury from acute fracture patterns.)
Who Should Care
Parents & youth climbers: this is the most common sport‑specific injury in young climbers; clearer grading = clearer plans.
Coaches: language to use with medical providers when a youth athlete reports dorsal PIP pain or performance‑limiting finger soreness.
Clinicians: a proposed scale tying clinical presentation to X‑ray/MRI/CT—including the “a/b” sclerosis modifier that can inform decision pathways in prior algorithms.
How We’ll Use It at Camp4
At Camp4, we’ll adopt this framework in our youth screening, education, and return‑to‑climb progressions, so everyone—parents, coaches, clinicians—speaks the same language from first symptoms to full return. (Note: the authors explicitly call for future studies on inter‑rater reliability; we’ll update our guidance as that data arrives.)
Read the Paper
Frontiers in Sports and Active Living (Aug 14, 2025): “Proposal of a specific classification of primary periphyseal stress injuries in adolescent rock climbers.” Authors: V. Schöffl, X. Iruretagoiena, T. Nelson (Camp4), P. Miro. Open access.