This project was supported financially by the University of Calgary Sport Medicine Centre Physiotherapy Research Fund. This study was undertaken to understand the clinical presentation of injured rock climbers as well as possible mechanisms of injury. A survey was conducted of rock climbers registered at the University of Calgary Outdoor Pursuits Centre climbing wall in order to document the distribution of traumatic and overuse injuries associated with climbing. One hundred forty-eight people responded; the mean age was 28 years, with a range of 15-54 years. Of those that responded, 49 stated they had sustained a total of 124 injuries in the past year as a result of their climbing activities. Traumatic injuries (eg., falls) accounted for 18% of injuries and predominantly affected the lower limbs. The majority of injuries (82%) were categorized by the respondents as overuse injuries. Upper extremity injuries were the vast majority and accounted for 63% of all injuries. Hand overuse injuries predominated (28% of all injuries), although elbow injuries were a close second (19%). Combined upper extremity overuse injuries were common. This apparent pattern of overuse injuries could be related to the architecture of climbing walls, climbing styles, training techniques, or relative weakness of specific anatomical structures. Consideration of the anatomical distribution of injuries associated with rock climbing may be useful in injury prevention and in rehabilitation of the injured climber. J Orthop Sports Phys Ther 1992;16(2):68-73.