Introduction and objective:
The transformation of sport climbing into a high-performance Olympic discipline has increased exposure to extreme finger loading and a rise in overuse and acute structural injuries. The aim of the review is to synthesize clinical and biomechanical evidence to support accurate diagnosis, evidence-based treatment, and safe return-to-sport strategies after sustaining climbing-related finger injuries.

Review methods:
A structured narrative search of PubMed/MEDLINE, Scopus, and Web of Science prioritized peer-reviewed studies from 2017–2025 with key foundational literature. Clinical and biomechanical investigations involving climbers or climbing-specific grips were analyzed thematically across epidemiology, anatomy, imaging, treatment, and rehabilitation.

Brief description of the state of knowledge:
Finger injuries are the most prevalent musculoskeletal condition in climbers, with flexor pulley lesions representing the dominant structural pathology. High-resolution ultrasonography is supported as the primary diagnostic modality. Evidence favours rigid pulley-protection splints over taping for Grade II–III injuries and progressive, load-based rehabilitation grounded in mechanotransduction. Injury patterns vary by age, discipline, and grip mechanics, requiring individualized clinical decisions.

Summary:
Management integrates precise imaging, pathology-specific protection, and criteria-driven rehabilitation aligned with sport-specific training to reduce recurrence, optimize recovery, and sustain long-term performance.