Therapeutic potential of indoor climbing: from physical fitness to neurorehabilitation and mental health
DOI:
https://doi.org/10.12775/QS.2026.54.70371Keywords
rock climbing, bouldering, psychotherapy, neurorehabilitation, depression, pshysical fitnessAbstract
Background
Rock climbing is experiencing a global surge in popularity, integrating resistance and isometric training with high neurological stimulation. It challenges the traditional dichotomy between cardiovascular and strength sports by offering a complex, interval-based exertion where movement precision is as vital as power.
Aim
This review explores rock climbing as a health intervention, focusing on physiological adaptations, musculoskeletal health, and therapeutic efficacy in psychiatry and neurorehabilitation.
Material and Methods
This paper reviews recent literature, including meta-analyses and randomized controlled trials. The analysis covers physiological parameters (VO2 max, bone density, core strength), Bouldering Psychotherapy (BPT) for depression, neurorehabilitative protocols for Parkinson’s disease, Multiple Sclerosis, and Autism Spectrum Disorder (ASD), alongside an assessment of injury risks.
Results
Climbing significantly improves VO2 max, grip strength, and core stability, proving effective for chronic low back pain. In mental health, BPT reduces moderate depression symptoms (average 8.3-point decrease on the MADRS), achieving outcomes comparable to Cognitive Behavioral Therapy with long-term sustainability. In neurorehabilitation, climbing reduces Parkinson’s motor symptoms (tremor by 51%, rigidity by 30%), aids fatigue management in Multiple Sclerosis, and enhances selective attention in children with ASD. Overuse injuries, particularly to the finger pulley system, remain the primary risk factor (up to 68% of adult injuries).
Conclusions
Rock climbing is a safe, multi-modal intervention offering significant physiological, psychological, and neurological clinical benefits. It shifts patient identity from limitations to capabilities, warranting integration into standard healthcare. However, clinicians must remain vigilant regarding overuse injuries and skeletal maturity in adolescents.
References
Balas, J., Strejcová, B., Maly, T., Malá, L., & Martin, A. (2009). Changes in upper body strength and body composition after 8 weeks indoor climbing in youth. Isokinetics and Exercise Science, 17, 173–179. https://doi.org/10.3233/IES-2009-0350
Bertuzzi, R. C. de M., Franchini, E., Kokubun, E., & Kiss, M. A. P. D. M. (2007). Energy system contributions in indoor rock climbing. European Journal of Applied Physiology, 101(3), 293–300. https://doi.org/10.1007/s00421-007-0501-0
Broupi, A. E., Kokaridas, D., Tsimaras, V., & Goudas, M. (2025). Effect of an indoor climbing program on selective attention of children withautism spectrum disorder (ASD). Human Movement, 26(4), 120–129. https://doi.org/10.5114/hm/211148
Callender, N. A., Hart, P. W., Ramchandani, G. M., Chaggar, P. S., Porter, A. J., Billington, C. P., & Tiller, N. B. (2020). The exercise pressor response to indoor rock climbing. Journal of Applied Physiology, 129(2), 404–409. https://doi.org/10.1152/japplphysiol.00357.2020
Callender, N. A., Hayes, T. N., & Tiller, N. B. (2021). Cardiorespiratory demands of competitive rock climbing. Applied Physiology, Nutrition, and Metabolism, 46(2), 161–168. https://doi.org/10.1139/apnm-2020-0566
Engbert, K., & Weber, M. (2011). The Effects of Therapeutic Climbing in Patients with Chronic Low Back Pain: A Randomized Controlled Study. Spine, 36(11), 842. https://doi.org/10.1097/BRS.0b013e3181e23cd1
Fryer, S. M., Giles, D., Palomino, I. G., de la O Puerta, A., & España-Romero, V. (2018). Hemodynamic and Cardiorespiratory Predictors of Sport Rock Climbing Performance. The Journal of Strength & Conditioning Research, 32(12), 3534. https://doi.org/10.1519/JSC.0000000000001860
Gürer, H., Akçınar, F., Arslan, S. C., Akçınar, S., Güllü, M., Eken, Ö., Kurtoğlu, A., Ilkım, M., Alotaibi, M. H., & Elkholi, S. M. (2024). Evaluating the impact of rock climbing on mental health and emotional well-being in adolescents. Frontiers in Psychology, 15, 1426654. https://doi.org/10.3389/fpsyg.2024.1426654
Kratzer, A., Luttenberger, K., Karg-Hefner, N., Weiss, M., & Dorscht, L. (2021). Bouldering psychotherapy is effective in enhancing perceived self-efficacy in people with depression: Results from a multicenter randomized controlled trial. BMC Psychology, 9(1), 126. https://doi.org/10.1186/s40359-021-00627-1
Langer, A., Hasenauer, S., Flotz, A., Gassner, L., Pokan, R., Dabnichki, P., Wizany, L., Gruber, J., Roth, D., Zimmel, S., Treven, M., Schmoeger, M., Willinger, U., Maetzler, W., & Zach, H. (2021). A randomised controlled trial on effectiveness and feasibility of sport climbing in Parkinson’s disease. NPJ Parkinson’s Disease, 7(1), 49. https://doi.org/10.1038/s41531-021-00193-8
Langer, A., Roth, D., Santer, A., Flotz, A., Gruber, J., Wizany, L., Hasenauer, S., Pokan, R., Dabnichki, P., Treven, M., Zimmel, S., Schmoeger, M., Willinger, U., Gassner, L., Maetzler, W., & Zach, H. (2023). Climb up! Head up! Climbing improves posture in Parkinson’s disease. A secondary analysis from a randomized controlled trial. Clinical Rehabilitation, 37(11), 1492–1500. https://doi.org/10.1177/02692155231174990
Larsson, R., Larsson, A., & Nordeman, L. (2025). Effectiveness of indoor rock climbing and bouldering as treatment for depression – a systematic review. BMC Psychiatry, 25, 858. https://doi.org/10.1186/s12888-025-07292-3
LI, L., RU, A., LIAO, T., ZOU, S., NIU, X. H., & WANG, Y. T. (2018). Effects of Rock Climbing Exercise on Physical Fitness among College Students: A Review Article and Meta-analysis. Iranian Journal of Public Health, 47(10), 1440–1452.
Limonta, E., Brighenti, A., Rampichini, S., Cè, E., Schena, F., & Esposito, F. (2018). Cardiovascular and metabolic responses during indoor climbing and laboratory cycling exercise in advanced and élite climbers. European Journal of Applied Physiology, 118. https://doi.org/10.1007/s00421-017-3779-6
Luttenberger, K., Karg-Hefner, N., Berking, M., Kind, L., Weiss, M., Kornhuber, J., & Dorscht, L. (2022). Bouldering psychotherapy is not inferior to cognitive behavioural therapy in the group treatment of depression: A randomized controlled trial. The British Journal of Clinical Psychology, 61(2), 465–493. https://doi.org/10.1111/bjc.12347
Luttenberger, K., Stelzer, E.-M., Först, S., Schopper, M., Kornhuber, J., & Book, S. (2015). Indoor rock climbing (bouldering) as a new treatment for depression: Study design of a waitlist-controlled randomized group pilot study and the first results. BMC Psychiatry, 15, 201. https://doi.org/10.1186/s12888-015-0585-8
Mermier, C. M., Janot, J. M., Parker, D. L., & Swan, J. G. (2000). Physiological and anthropometric determinants of sport climbing performance. British Journal of Sports Medicine, 34(5), 359–365; discussion 366. https://doi.org/10.1136/bjsm.34.5.359
Michael, M. K., Witard, O. C., & Joubert, L. (2019). Physiological demands and nutritional considerations for Olympic-style competitive rock climbing. Cogent Medicine, 6(1), 1667199. https://doi.org/10.1080/2331205X.2019.1667199
Muehlbauer, T., Stuerchler, M., & Granacher, U. (2012). Effects of climbing on core strength and mobility in adults. International Journal of Sports Medicine, 33(6), 445–451. https://doi.org/10.1055/s-0031-1301312
Sherk, V. D., Bemben, M. G., & Bemben, D. A. (2010). Comparisons of Bone Mineral Density and Bone Quality in Adult Rock Climbers, Resistance-Trained Men, and Untrained Men. The Journal of Strength & Conditioning Research, 24(9), 2468. https://doi.org/10.1519/JSC.0b013e3181b60407
Steimer, J., & Weissert, R. (2017). Effects of Sport Climbing on Multiple Sclerosis. Frontiers in Physiology, 8, 1021. https://doi.org/10.3389/fphys.2017.01021
Stelzer, E.-M., Book, S., Graessel, E., Hofner, B., Kornhuber, J., & Luttenberger, K. (2018). Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial. Heliyon, 4(3), e00580. https://doi.org/10.1016/j.heliyon.2018.e00580
Zieliński, J., Grygorowicz, M., & Lewandowski, J. (2025). Epidemiology of Musculoskeletal Injuries Among Climbers—A Systematic Review. Journal of Functional Morphology and Kinesiology, 11(1), 19. https://doi.org/10.3390/jfmk11010019
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Copyright (c) 2026 Tomasz Pluszyński, Natalia Padula, Karol Piotrowski, Małgorzata Jerczak, Iga Piórkowska, Filip Przybył, Mikołaj Polewka, Aleksandra Polańska , Kacper Paczosa
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