Climbing hard with degenerative arthritis (fingers)

Valerie A B provided the exact opposite advice of what you should be eating to combat arthritis, which should not be whole grains, and man-made medicines. There's a reason why so many people are sensitive to grain products through either celiac's or crohn's disease, yet those diseases don't exist in anywhere near the same numbers for people who eat healthy animal-product based diets. Don't confuse what I mean by that with a typical American meat diet either, which is where most health issues originate. Degenerative arthritis(or any other sorts of degenerative conditions, like frayed labrums, inflamed and weakened or sprained tendons, or anything else) is caused by a lack of nutrition in relation to your level of training. If you have an overabundance of high-quality nutrition on a regular basis, barring rare genetic disorders and stuff, you can stave off most injury. That doesn't mean you'll be impervious to injury, it simply means you have the best building blocks available to you.

This includes eating high quality, bioavailable, complete proteins, which only come from animal products. Don't change anything about your diet, go buy yourself eight grass-fed tenderloin steaks. Eat one every other day for dinner the next 2 weeks with some steamed broccoli or something. The amount of meat you'll be eating would be about the size of your palm. It's filled with 45 grams of complete and bioavailable proteins, omega 3, healthy amounts of cholesterol and a litany of bioavailable micronutrition. Report the results back to us and then imagine eating a diet like that for years. Cut out animal products and eat steamed vegetables and rice for dinner and feel yourself continue to fall apart.

*former plant-based eater of 6 years, vegan for 1, recovered on a healthy animal-based diet for 3/4 years now and will never go back. 

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...as I said, we have a long way to go. 

:(

I spend a lot of time dispelling harmful myths about osteoarthritis but this on is completely new to me. The idea that a lack of animal protein is the cause of osteoarthritis is quite amusing to someone who has spent countless hours studying its pathophysiology. 

I once bought 6 months of supply of UC-II collagen pills for the same reason as you, and it did absolutely nothing. No effect on soreness, stiffness, recovery time or finger strength.

I think it was around 5 years ago that I noticed the same bumps on the joints as you. They are called heberden nodes and are often a sign of a advanced osteoarthritis, but in my case X-rays showed no cartilage wear. I have since then talked to many other climbers who went through the same process of an inital diagnosis of osteoarthritis and "you need to stop climbing", followed by X-rays that show no wear.

Climbing has only recently become popular, so doctors don't have much experience with its long term effects yet.

Today the joints look a bit more symmetrical and are simply thicker (look a bit more like those elite or vetaran climbers who started as children) and are no longer sore or stiff. They feel healthy.

After having gone through tons of research, my uneducated guess is - long story short - that it's a kind of supercompensation. I hope I'm right :)

Collagen has very low absorption and is generally a low quality protein. What’s more important for bone synthesis is vitamin D supplementation, which everybody should do because EVERYBODY is deficit, with office jobs and especially with diet changes to plant-based milks which either have no vitamin D, like fortified whole milks, or very little vitamin d with low bioavailability because it’s a plant-based source. And calcium obviously.

To meet your recovery needs you should be eating about as much protein as a strength athlete, .8 grams of complete, bioavailable proteins a day per pound of body weight, if you consider yourself less serious about your training .6 minimum. If you’re not at least hitting those numbers your climbing is suffering and you may not even know it.

Cocoapuffs 1000wrote:

Dragging this thread back up for an update:  I have been climbing for a few years now since my OP and haven't had much issue, except the finger joint in question does occasionally feel a little stiff.  Then I got Covid this past August.  A few days after I first got sick the same joint started aching again - and I had not been climbing or doing much besides sitting on my ass at home.  After I more or less recovered (although still feeling a little weak) I started cautiously climbing in the gym.  The joint still had some nagging pain (like 0.5 out of 10) but less than when I was sick and doing nothing.  I thought that moderate activity was helping it.  After a few weeks there was almost no pain and at this point I wasn't taking any Aleve, etc

A couple weeks later I went to the Red and tried a hard route that I have been gunning for - lots of sloping pinchy holds - and that immediately sent my finger downhill - after the second attempt pain was up and I called it quits for the weekend.   At this point Fall was getting close and I went into emergency rehab mode - very low volume of climbing, cautious hangboarding, the ice bath/heat thing... and what climbing I did was quasi-static and very controlled.  Again it seemed to slowly improve but still still a little flared up.  I did my planned week-long trip at the Red this past week, but only climbed every other day and limited hard climbing to only 1-2 burns per climbing day.  Despite this, by the end of the week it again seemed to be going downhill.  Now yesterday at the gym I tried a couple hard moves and it hurts.

I mentioned it to a (non-climber) doctor on a routine checkup and they said Covid can cause inflammatory response in seemingly random and very specific places.  But they cautioned me that there was probably an underlying issue and not to blow it off as phantom pain.

Anyway, I have one more trip coming up over Thanksgiving and at this point I am beyond frustrated.  After several years of battling other injuries that partially hosed my climbing goals, to have this happen now is super discouraging.  And while the acute inflammation will (hopefully) go away eventually, I doubt it will be in the next 2 weeks. And it's a reminder that I am likely to have more trouble in the future - on a longer term/permanent basis.  Not sure if I should just say screw it and climb my ass off of the rest of fall.

Anyway, I am more venting frustration than asking for advice.  Perhaps will see if there is a hand doctor in Lexington that knows climbing, that I could visit on a rest day (no one like that in Columbus where I reside), which would at least be a good reality check.

Hey Cocoapuffs,

I'm in a very similar boat, climbing for 12 years (mostly bouldering and sport up to 7c), and diagnosed with osteoarthritis in the PIP joints of my middle and ring fingers. X-ray shows significant joint space narrowing and osteophytes. It actually started with chronic synovitis (inflammation) in those joints, and for a long time there was no visible cartilage damage. Over the years the persistent inflammation likely led to the thinning/erosion.

Pain is still very low—maybe 1–2/10 after really hard sessions. I'm worried though about how much longer I'll be able to climb or use my hands normally, because this wear and tear doesn't lead to anything good.

Jacopo Roggi wrote "X-ray shows significant joint space narrowing and osteophytes".

I had inflammation, joint space narrowing and osteophytes in my knees about 10 years ago.

Running was painful and I started walking up and down stairs (that was more tolerable than running).

Pain gradually diminished and I was even able to restart running.

Based on my experience I believe that moderate (rather than extreme) load is essential for healthy joints. At the same time I am not sure how exactly my experience with my knees can be translated to your experience with your fingers. ;)

Yurywrote:

Jacopo Roggi wrote "X-ray shows significant joint space narrowing and osteophytes".

I had inflammation, joint space narrowing and osteophytes in my knees about 10 years ago.

Running was painful and I started walking up and down stairs (that was more tolerable than running).

Pain gradually diminished and I was even able to restart running.

Based on my experience I believe that moderate (rather than extreme) load is essential for healthy joints. At the same time I am not sure how exactly my experience with my knees can be translated to your experience with your fingers. ;)

Great to hear, and I hope you’ll be able to continue doing what you love for a long time! Do you keep track of your arthritis progression with any check-ups or imaging? And are you taking any supplements to help support your joints?

Valerie A Bwrote:

⌃ ⌃

...as I said, we have a long way to go. 

:(

I spend a lot of time dispelling harmful myths about osteoarthritis but this on is completely new to me. The idea that a lack of animal protein is the cause of osteoarthritis is quite amusing to someone who has spent countless hours studying its pathophysiology. 

Even though the typical American gets plenty of protein, the bro-science podcast world has convinced us more is necessary, often in the form of some grass-fed animal product. Meanwhile, the same food scientists who gave us ultraprocessed foods, contributing greatly to the spike in obesity and related diseases (including osteoarthritis), are now surreptitiously adding whey to nearly everything.

Sure, athletes need more protein than sedentary individuals (somewhere between 1-1.6 grams/kg body weight daily), but it isn’t a panacea. And for overall health, plant sources are demonstrably better, even though it’s easier to build muscle with animal products. 

Open Evidence is an AI tool using peer reviewed evidence to provide up to date medical advice. Here is their summary of nutrition and arthritis:

Dietary interventions show promise for osteoarthritis management in general populations, but no specific evidence exists for rock climbers with hand/finger OA. The available evidence supports anti-inflammatory dietary patterns, omega-3 fatty acids, and increased fiber intake for reducing OA symptoms, though data specific to athletes or hand OA are limited.[1][2][3][4]

General Dietary Evidence for Osteoarthritis

Recent systematic reviews and meta-analyses demonstrate that dietary interventions can significantly improve pain and physical function in OA. A 2025 meta-analysis found that dietary interventions reduced pain (SMD: -0.67) and improved physical function (SMD: -0.62), with reduced energy diets showing the most effectiveness.[2] A "prudent" dietary pattern—rich in fruits, vegetables, fish, whole grains, and legumes—was associated with decreased radiographic and symptomatic knee OA progression, while a Western dietary pattern (high in processed foods, refined grains, red meat) increased progression risk.[5]

Specific nutrients showing benefit include:

- Dietary fiber, folic acid, and niacin: Higher intake associated with 27%, 28%, and 33% lower odds of OA, respectively[1]

- Omega-3 fatty acids: Evidence is mixed. While some studies suggest omega-3s from fish oil may reduce inflammation and pain, a 2024 JAMA trial found that 2 g/day of krill oil did not significantly improve knee pain compared to placebo in patients with knee OA and effusion-synovitis. However, an earlier trial with 4 g/day krill oil showed modest improvements in knee pain and stiffness[3][4][6][7]

- Plant phenols: Diets high in plant phenols and omega-3s showed improvements in pain and physical function[3]

Hand Osteoarthritis Considerations

Research on hand OA and diet is extremely limited. One study found that moderate alcohol consumption (1-7 drinks/week) was associated with hand OA severity and erosive hand OA, while BMI showed no association with hand OA.[8] No studies specifically address dietary interventions for hand OA management.

Rock Climbers and Finger OA

Rock climbers represent a unique population with high prevalence of finger joint changes. Studies of elite climbers show:

- Progressive radiographic changes: A 10-year follow-up of elite climbers found that 74.2% had clear signs of OA in DIP joints and 64.5% in PIP joints, compared to minimal changes in controls[9]

- Osteophyte formation: 100% of elite climbers had osteophytes in DIP joints after 25+ years of climbing[9][10]

- Cartilage abnormalities: Climbers show thicker cartilage initially but progressive thinning over time, with substantial osteophyte occurrence[11][12]

- Digit III most affected: The middle finger bears the highest load and shows the most severe changes[10][13]

Importantly, despite these radiographic changes, many climbers remain asymptomatic or minimally symptomatic, suggesting that structural changes don't always correlate with pain.[11]

Practical Recommendations

While no evidence specifically addresses dietary interventions for climbers with finger OA, extrapolating from general OA literature suggests:

Anti-inflammatory dietary pattern:

- Emphasize whole plant foods, fish, nuts, seeds, legumes

- Increase dietary fiber intake

- Include omega-3 rich foods (fatty fish 2-3 times weekly)

- Minimize processed foods, refined carbohydrates, and saturated fats[3][14]

Weight management: If overweight, weight reduction through calorie restriction combined with exercise shows the strongest evidence for OA symptom improvement[2][4][15]

Specific nutrients: Ensure adequate intake of folate, niacin, and vitamin K; evidence for vitamin D supplementation is unconvincing[4]

The lack of athlete-specific or hand OA-specific dietary research represents a significant knowledge gap. Given that climbers' finger OA appears mechanically driven rather than metabolically driven, dietary interventions may have limited impact on structural progression, though they could potentially reduce systemic inflammation and associated symptoms.

References

1. Associations Between Nutrient Intake and Osteoarthritis Based on NHANES 1999 to 2018 Cross Sectional Study. Lv X, Deng X, Lai R, et al. Scientific Reports. 2025;15(1):4445. doi:10.1038/s41598-025-88847-y.

2. The Effectiveness of Dietary Intervention in Osteoarthritis Management: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Asadi S, Grafenauer S, Burley CV, et al. European Journal of Clinical Nutrition. 2025;:10.1038/s41430-025-01622-0. doi:10.1038/s41430-025-01622-0.

3. Diet Modification Reduces Pain and Improves Function in Adults With Osteoarthritis: A Systematic Review. Stanfar K, Hawes C, Ghajar M, Byham-Gray L, Radler DR. Journal of Human Nutrition and Dietetics : The Official Journal of the British Dietetic Association. 2024;37(4):847-884. doi:10.1111/jhn.13317.

4. What Is the Evidence for a Role for Diet and Nutrition in Osteoarthritis?. Thomas S, Browne H, Mobasheri A, Rayman MP. Rheumatology (Oxford, England). 2018;57(suppl_4):iv61-iv74. doi:10.1093/rheumatology/key011.

5. Dietary Patterns and Progression of Knee Osteoarthritis: Data From the Osteoarthritis Initiative. Xu C, Marchand NE, Driban JB, et al. The American Journal of Clinical Nutrition. 2020;111(3):667-676. doi:10.1093/ajcn/nqz333.

6. Krill Oil for Knee Osteoarthritis: A Randomized Clinical Trial. Laslett LL, Scheepers LEJM, Antony B, et al. JAMA. 2024;331(23):1997-2006. doi:10.1001/jama.2024.6063.

7. Krill Oil Improved Osteoarthritic Knee Pain in Adults With Mild to Moderate Knee Osteoarthritis: A 6-Month Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial. Stonehouse W, Benassi-Evans B, Bednarz J, et al. The American Journal of Clinical Nutrition. 2022;116(3):672-685. doi:10.1093/ajcn/nqac125.

8. The Prevalence, Incidence, and Progression of Hand Osteoarthritis in Relation to Body Mass Index, Smoking, and Alcohol Consumption. Haugen IK, Magnusson K, Turkiewicz A, Englund M. The Journal of Rheumatology. 2017;44(9):1402-1409. doi:10.3899/jrheum.170026.

9. Cortical Bone Thickness, Base Osteophyte Occurrence and Radiological Signs of Osteoarthritis in the Fingers of Male Elite Sport Climbers: A Cross-Sectional 10-Year Follow-Up Study. Pastor T, Fröhlich S, Pastor T, Spörri J, Schweizer A. Frontiers in Physiology. 2022;13:893369. doi:10.3389/fphys.2022.893369.

10. A Life Dedicated to Climbing and Its Sequelae in the Fingers-a Review of the Literature. Pastor T, Schweizer A, Andronic O, et al. International Journal of Environmental Research and Public Health. 2022;19(24):17050. doi:10.3390/ijerph192417050.

11. Long-Term Evolution of Cartilage Abnormalities and Osteophytes in the Fingers of Elite Sport Climbers: A Cross-Sectional 10-Year Follow-Up Study. Pastor T, Schweizer A, Reissner L, et al. European Journal of Sport Science. 2022;22(9):1452-1458. doi:10.1080/17461391.2021.1943716.

12. Cartilage Abnormalities and Osteophytes in the Fingers of Elite Sport Climbers: An Ultrasonography-Based Cross-Sectional Study. Pastor T, Fröhlich S, Spörri J, Schreiber T, Schweizer A. European Journal of Sport Science. 2020;20(2):269-276. doi:10.1080/17461391.2019.1631389.

13. Osteophyte Growth Over 10 Years in the Fingers of High-Level Climbers and Contributing Factors. Schmid P, Fröhlich S, Pastor T, Reissner L, Schweizer A. European Journal of Sport Science. 2026;26(1):e70108. doi:10.1002/ejsc.70108.

14. The Role of Nutrition in Osteoarthritis: A Literature Review. Wei N, Dai Z. Clinics in Geriatric Medicine. 2022;38(2):303-322. doi:10.1016/j.cger.2021.11.006.

15. Effect of Diet and Exercise on Knee Pain in Patients With Osteoarthritis and Overweight or Obesity: A Randomized Clinical Trial. Messier SP, Beavers DP, Queen K, et al. JAMA. 2022;328(22):2242-2251. doi:10.1001/jama.2022.21893.

I don't know if they're doing it in your part of the country but there are cancer places doing low dose radiation treatment, ldrt  for inflammation and arthritis in joints. It's a very low dose over eight sessions. If you Google it they often talk about doing it in knees. However I did a round in my thumb joints and got some relief. I'm about to do another round and I'm going to do it in the the whole hand as my fingers have been playing up climbing in the gym.

Jill Lawrencewrote:

I don't know if they're doing it in your part of the country but there are cancer places doing low dose radiation treatment, ldrt  for inflammation and arthritis in joints. It's a very low dose over eight sessions. If you Google it they often talk about doing it in knees. However I did a round in my thumb joints and got some relief. I'm about to do another round and I'm going to do it in the the whole hand as my fingers have been playing up climbing in the gym.

Did two treatments of rso (radiosynoverthesis), which is a radioactive substance injected in the joint. It did help the inflammation a bit, but isn't a game changer.

Jacopo Roggiwrote:

Do you keep track of your arthritis progression with any check-ups or imaging? And are you taking any supplements to help support your joints?

I live in Canada and do not have such luxury as imaging for the sake of keeping track of arthritis progression.
I do not take any supplements.