Prevent Chronic Climber's Toe Pain

Climbers are used to having sore little piggies, whether it’s from jamming them into cracks or cramming them into tight, high-performance shoes. But toe pain is more serious when it doesn’t disappear after a few hours, and it happens to a lot of climbers because of the way we use and abuse our feet. Chronic stiffness and swelling in the big toe joint is an early sign of osteoarthritis that could permanently cramp your climbing style.


Climber's-Toe-Graphic-660Osteoarthritis occurs when the cartilage protecting bones wears away, leaving the bone ends to grind painfully against each other. In the big toe, the condition is known as hallux rigidus, or the less serious hallux limitus, and it develops at the joint where the toe connects to the foot (A). Hallux rigidus may advance to the point where it’s extremely painful to walk—let alone climb—and it can require surgery to shave the bones, install a supportive implant, or fuse the joint.

Osteoarthritis usually develops between ages 30 and 60, but it can strike even earlier. Genetics, personal anatomy, and injury history are the primary determining factors, but climbers can be especially susceptible. Dr. Yvonne Weber, a podiatrist and climber, says, “Hitting your toe against the rock [as in a lead fall] or rockfall hitting the toe can lead to osteoarthritis. Also, wearing super-tight or really flexible shoes and repeating the same move puts high torque on the joint.”

Hallux rigidus frequently leads to bone spurring, a bony growth that’s painful and may require surgical treatment. Plus, by compensating for a sore toe while climbing or walking, you may overload other parts of the foot, possibly leading to neuroma (a tumor of nerve tissue) or hammer toe (deformation where toes are permanently bent).
Pain, swelling, and decreased mobility in the joint are potential indicators of hallux rigidus. If you have a family history of osteoarthritis or have injured your big toe previously, Weber says, “Get an exam and X-ray, and you and the doctor can decide how seriously to take it.”

Hallux rigidus is a progressive condition, making early detection and preventive steps essential. If you experience pain or inflammation, Weber recommends the following:

  • Wear stiffer climbing shoes to support the joint. A snug fit is good, too, to maintain stiffness. But avoid shoes that crunch the toes.
  • While belaying or chilling between routes, put on stiff-soled shoes like your approach shoes or supportive sandals (read: not flip-flops). Don’t wear minimalist approach shoes or walk off a route in your climbing shoes.
  • Get highly supportive and well-fitted sole inserts for your everyday shoes—anything to stabilize the joint day to day.
  • Try MSM (methylsulfonylmethane) and fish oil to reduce inflammation, and glucosamine to strengthen cartilage.
  • When pain flares up, avoid slabs and consider toproping versus leading or bouldering—you’ll move quicker and put less stress on the joint.
  • Don’t mask chronic pain with anti-inflammatories—this condition won’t heal on its own. See a doctor.


Previous Comments

I had surgery on one of my bunion toes and took 2 years off climbing. I thought my climbing days were over due to the pain, but I tried climbing again on a whim and felt no pain at all. I was 25 when I returned to climbing. After 5 years of climbing fairly hard, the pain has returned. I just finished taking another long period off (8 months). Ironically, the toe that had the surgery is visibly worse off than the toe that didn't have the surgery, and it's much more painful. I've never actually felt any discomfort or pain in the bunion toe that didn't had the surgery. That foot feels and works just fine. Two podiatrists have looked at my feet and said the same thing - and that it's probably not the doctor's fault who did the surgery. Most likely it's a case of a strong genetic predisposition to bunions. Apparently 5-10% of bunion surgeries are not successful because the toe simply moves back into its old position. At this point all I want is to climb pain free without significantly aggravating the problem. The list of preventative steps in this article is really good. I'm doing most of them already, except for the the MSM and fish oil but I'll try that too now. In case anyone's interested, I've also discovered these tricks along the way to reduce my pain. Maybe they'll be useful to you: - Avoid dress shoes like the plague. I had to wear these at work and realized they may have been causing more of pain than my climbing shoes. I've cut them out of my wardrobe for about a year now and all of the pain in my bad toe is gone. I'm trying to climb again now to see how much difference it makes... - Spend $$$ a good-fitting pair of runners. This alone reduced a lot of my pain. - Running caused me significant pain, so I've stopped this completely. The repetitive motion on the big toe will definitely aggravate a bunion, my doctor tells me. By not running, I hope I'm buying my climbing career more time. - Ice climbing doesn't hurt my bunion toe so far, which was a big surprise. I thought with all that kicking into hard ice it would be worse. But in ice climbing you wear your boots a bit loose so your big doesn't hit the end of the toe box - otherwise everyone would be losing their big toe nails. If you have bunion pain when rock climbing, I suggest giving ice climbing a try. That way if you do have to step away from the rock in the future you'll have a great fallback sport that keeps you climbing. - I'm having custom orthodics made for my regular footwear as I get back into climbing. Not sure how helpful they'll be but they sure are expensive ($600). - If you have hardwood, get slippers! We moved into an apartment with hardwood everywhere and my bad bunion toe hated it. I started to really overcompensate in my step and supinate to avoid stepping directly on my right bunion. That was the most painful period with my foot. I was also wearing dress shoes at work every day. - I'm still up in the air about one of the biggest issues: what kind of climbing shoe works best with a bunion. People above have suggested a shoe with a stiff toe box keeps the bunion from getting worse because the big toes moves around less. But from what I can tell, most stiff shoe boxes are on aggressive shoes which put more pressure on the actual bunion. At least in my case, less aggressive shoes cause me less pain after I leave the gym or crag, so I plan to continue on that path. I was wearing Anaszai's, now Scarpas, and I plan to try the Mythos or something else along those lines. - I showed my podiatrist my climbing shoes and he suggested having the rubber around the big toe blown out to create more room for the bunion and less pressure on it. I'm going to try that too. One more thing. A few people above say they can't imagine taking a long time off climbing for a toe to heal. I was in exactly the same boat so maybe can offer some advice. If you love climbing, that time off will suck. Absolutely. But a couple months flies by faster than you'd think. Go catch up on some video games or something stupid and you'll be back before you know it. Also, you return much less weak than you'd imagine. After taking a year off I thought I'd be back to 5.8s. But I'm still at a 10d level and imagine I will gain the rating or two I lost in a few weeks. Sorry for the long comment. As you can tell this issue is close to home and will probably determine more about my climbing life than anything else - gear, strength, training, climate, partner etc. If you're in the same boat as me I hope you find your own strategies to reduce the pain and keep climbing for as long as it makes you happy :)

Daniel Moore - 02/16/2015 8:44:09

I'm 20 and die hard slab climber. I have extreme pain in my left big toe joint that started about 4 months ago. My mom and grandpa don't climb but the have huge bunions, I heard its genetic. i went through probably 12 pairs of anisazis before I just switched to tc pros which are stiffer. Taking a break for more than 2 weeks isn't going to happen. Tried going easy on it a bit but it doesn't seem to get any better or any worse. Has anyone had any luck with an ultimate cure? Nice article but suggesting to not climb slabs and to wear your climbing shoes less seems like a very mild solution for how serious you make it seem.

V14 in mocs - 01/12/2015 5:58:44

IMO......I've had this issue due to bouldering at my local gym and jumping from the top of the boulder problem and landing on my toes in tight shoes. It was the constant jamming of my toes that caused my issue. I now down climb or fall/jump and land on my heels.. Kids --- don't land on your toes......

coyote - 10/01/2014 11:31:49

I have the same condition in my big toe. I was able to climb pain free and even climb harder by wearing a shoe with a very thick, stiff toe and forefoot area. Here is a list of climbing shoes with VERY stiff toe areas. - Five Ten Newton (currently being discontinued, but you can find on clearance) - Five Ten Guide - Hero - Five Ten Ansari Verdi

Rusty Bridges - 07/27/2014 8:18:37

Also, you can ask a shoe re-soler to make VERY stiff mid soles. I find that using very stiff mid soles AND orthotics is a bad idea. Shoes are too stiff. One or the other.

Gail - 05/08/2014 3:54:45

will send photos of orthotics.

Gail - 05/08/2014 3:52:56

hi gail can you please send me a photo of the orthotics ? I'de like to get a couple too my mail is jorge.canelhas(at) thanks

jorge - 04/21/2014 9:11:04

Thanks, Ben, for that link. Very good article with great diagrams and xrays. I think I have pain in my big toe from shoes that are too tight - pain in the forward joint (not at the base) and it's hard to describe or elicit the pain. I think it's part bunion/part twisting of the joint as it squeezes into the toebox of my 5.10 coyotes. The pain can be blinding if i hit it just right. I think I will find some less constricting shoes and maybe look for stiffer sole as Gail (above) and the doctor in your link suggested. As popularity of this sport increases, I imagine many more will have experience foot problems T.T

allan - 03/12/2014 9:02:26

Any climbers out there who have had hammer toe surgery? My husband has very painful hammer toe, and has tried conservative treatments and is considering surgery. There are 3 types of surgery: 1 where they cut a tendon to allow the toe to flatten out, 1 where they cut off part of the enlarged joint, and 1 where they take out the joint and allow the 2 toe bones to grow into a single straight bone. All of these sound fairly scary for a guy who likes to climb hard, run, nordic and telemark ski, and bike. Can anybody say if they've had any of these surgeries and can do these types of activities aggressively with their surgically repaired toe?

Sue Schroeder - 02/24/2014 4:00:33

I suffer from osteoarthritis in both of my big toes. In fact, I had surgery to "clean up" my toes. The only way I can climb comfortably is to use carbon fiber orthotics in my climbing shoes. It makes my shoes extra stiff and takes a lot of pressure off my big toes. My (very handy) husband made plaster molds of my feet and then created the carbon fiber inserts. I highly recommend this approach if you have big toe pain due to arthritis.

Gail - 01/02/2014 7:13:32

Hey, Great article. There's a very detailed article written by a physiotherapist on the same subject here: If anyone would like some further reading

Ben - 11/26/2013 8:11:09

Boulder Valley Foot and Ankle

Craig Hoffman - 11/25/2013 4:16:50